介绍一种小儿头皮静脉留置针送管方法

静脉留置针的应用减少了患儿因反复穿刺造成的痛苦与恐惧,保护了患儿血管,减轻了患儿家长因担心穿刺困难而产生的焦虑心理,且便于危重患儿的抢救与用药,所以在临床上应用越来越广泛。我们对留置针送管方法进行了改进,提高了穿刺成功率。现介绍如下。1方法1.1血管选择选择粗、直、柔软、有弹性的静脉血管,如额正中静脉、颞浅静脉、耳后静脉等。1.2材料美国BD公司生产的24G型静脉留置针、肝素帽、3M敷贴。1.3操作步骤血管周围备皮,穿刺部位常规消毒(范围8 cm×8cm),依次打开静脉留置针、肝素帽及敷贴的外包装,放在右手方便易取的地方,依使用…     

Formula choices in infants with cow’s milk allergy

QuestionI frequently encounter infants with symptoms suggestive of allergy after being introduced to standard cow’s milk formula. Parents are concerned and ask for recommendations regarding formula alternatives. Which formulas are best for children with cow’s milk allergy?AnswerCow’s milk allergy is common, and the criterion standard for diagnosis is elimination, provocation (with a double-blind, placebo-controlled food challenge protocol), and re-elimination. The allergy is treated by eliminating cow’s milk protein from the diet. Formula alternatives include hydrolyzed cow’s milk formula, rice-based formula, soy-based formula, and amino acid–based formula, which are all nutritionally adequate alternatives to cow’s milk formula. Symptom severity, patient preference, cost, and efficacy are factors to be considered when choosing an alternative.

Exclusive breastfeeding has been recommended by the World Health Organization to be the sole form of nutrition for infants in the first 6 months of life.¹ However, many women might supplement or replace breastfeeding with infant formula for reasons including difficulties with breastfeeding and concern for maternal and child health.² The most commonly used and recommended infant formula has cow’s milk as a source of protein. However, infants who are introduced to these formulas develop cow’s milk allergy (CMA) more frequently compared to exclusively breastfed infants.³     

CT定位下经颅磁刺激对卒中后运动功能障碍的治疗效果

目的:观察CT定位下经颅磁刺激对卒中后运动功能障碍患者的治疗效果。方法:150例缺血型脑卒中患者按入院时间分为观察组（n=75）和对照组（n=75）,两组患者一般资料无显著性差异。观察组患者给予CT定位下经颅磁刺激治疗,对照组患者给予常规经颅磁刺激治疗。于治疗前和治疗8周后评估患者下肢肌力、上下肢运动能力评分、平衡能力、生活能力以及治疗有效性。结果:观察组患者治疗后下肢肌力、上下肢运动能力评分、平衡能力、生活能力显著高于对照组（P<0.05）;观察组治疗有效率显著高于对照组（84.00% vs 68.00%, P<0.05）。结论:CT定位下经颅磁刺激治疗对卒中后运动功能障碍患者疗效显著,其具体机制有待于神经生物学基础研究进一步揭示。     

氟烷致肝线粒体膜内脂质成分改变的实验研究

目的探讨氟烷性肝炎的发病机理。方法将传统吸人麻醉药氟烷与新吸入麻醉药七氟醚对比，用高压液相技术分析肝线粒体膜磷脂在麻醉药作用后的脂质成分改变。结果氟烷在低浓度即可使肝线粒体主磷脂降解，溶血卵磷脂增加，在高浓度时有不可逆转的肝细胞损伤作用；而七氟醚只有主磷脂降解。溶血卵磷脂增加的倾向。结论氟烷致肝线粒体脂质改变可能为氟烷性肝炎的根本原因。     

预扩张的跨越人体中线肩胛皮瓣治疗儿童项背部巨痣(附7例报告)

采用预扩张的跨越人体中线肩胛皮瓣治疗儿童项背部巨痣7例，将儿童颈部和背部巨痣切除后，用扩张的肩胛皮瓣带蒂转移覆盖创面，供瓣区直接拉拢缝合，皮瓣均成活良好。此方法可最大程度地减少损伤和供区瘢痕，并获得良好的美容效果。     

Change of platelet activation markers using flow cytometry in patients with hematology/oncology disorders after transfusion

In spite of the frequent need of platelet transfusions, there is limited information on the association of platelet activation markers, in transfused patients with hematology/oncology disorders, with platelet function using flow cytometry. The goal of this study was to evaluate the changes of PAC-1 binding and CD62P expression, with or without agonists in patients after transfusions. Twenty-eight whole blood samples were obtained from 24 patients admitted to the department of Hematology & Oncology and transfused with platelets; these samples were compared to 30 healthy controls. Whole blood samples, either with or without agonists, such as 20 microM adenosine diphosphate (ADP) or 100 microM thrombin receptor activating peptide (TRAP), were stained with the fluorescein conjugated monoclonal antibodies PAC-1 or CD62P. Then, the percent expression for each marker was analysed using flow cytometry. ADP and TRAP induced an increased percentage of CD62P expression and PAC-1 binding after platelet transfusions compared to the samples studied before transfusion, and these findings were lower than those of the healthy controls. However, the expression of platelets without the agonists was not significantly changed, despite the transfusions. Therefore, agonist-induced platelet activation markers, studied by flow cytometry, appear to be more useful for the evaluation of platelet function after transfusions than platelet activation markers without agonists.     

Gliotoxin ameliorates development of fibrosis and cirrhosis in a thioacetamide rat model

Activation of hepatic stellate cells causes most of the pathological changes in cirrhosis. The fungal metabolite gliotoxin was shown to induce apoptosis of hepatic stellate cells in vitro. We examined whether gliotoxin may prevent or reverse liver fibrosis in a rat model of thioacetamide-inducedcirrhosis, and whether gliotoxin administration in vivo causes apoptosis of activated stellate cells. Gliotoxin treatment resulted in a significant decrease in liver fibrosis in rats, but did not improve liver functions. We observed a significant reduction in the numbers of activated hepatic stellate cells in the gliotoxin-treated rats. Gliotoxin administration also resulted in parenchymal apoptosis of hepatocytes and hepatic stellate cells. In conclusion, gliotoxin reduces hepatic fibrosis, an effect accompanied by reduction of the numbers of activated hepatic stellate cells in the liver.     

山东省原发性高血压1号染色体基因扫描

目的对原发性高血压患者及正常对照者的1号染色体进行扫描，查找与原发性高血压关联的遗传位点。方法在1号染色体上间隔10cM遗传距离选择31个微卫星遗传位点，用DNA混合池的方法对原发性高血压患者450例和正常对照者450例的DNA样本进行基因扫描。采用CLUMP软件对患者组和对照组每个位点的等位基因频率进行比较。结果在D1S196位点（1q24．2）、D1S249位点（1q32）和D1S2667位点（1p36．22）发现患者组与对照组的等位基因频率存在显著性差异（P〈0．01）。结论山东省原发性高血压患者在1号染色体的D1S196、D1S249与D1S2667位点附近可能存在原发性高血压易感基因，需要进行候选基因突变筛查。     

体外转染PTEN对胰腺癌细胞增殖能力的影响

目的选择PTEN低表达胰腺癌细胞系,探讨体外转染PTEN对该细胞系的影响。方法将PTEN转染到PTEN低表达胰腺癌细胞系,应用RTPCR、免疫组化、克隆形成率及观察裸鼠移植瘤生长等方法检测PTEN对胰腺癌细胞系的影响。结果PTEN在ASPC1细胞呈低表达,ASPC1、ApE、ApEP细胞PTENmRNA表达量和克隆形成率分别为203%、150%、568%和333%、317%、240%;ASPC1细胞转染后PTEN蛋白表达水平升高,血管内皮生长因子蛋白下降,表皮生长因子受体蛋白无明显变化;5周时转染前后荷瘤裸鼠瘤结节体积分别为2027mm3和1424mm3,差异有统计学意义(P<001)。结论PTEN低表达ASPC1细胞系经转染PTEN后细胞增殖活性及裸鼠致瘤能力明显降低。     

应用品管圈降低老年病人PICC穿刺点渗血率的实践

[目的]探讨品管圈手法在降低老年病人经外周静脉穿刺置入中心静脉导管(PICC)穿刺点渗血率中的应用。[方法]成立品管圈,通过品管圈活动步骤,运用质量管理常用工具对老年病人PICC穿刺点渗血存在问题进行改进,并将改进前后状况进行比较。[结果]品管圈活动使老年病人PICC穿刺点渗血率从89.7%降至36.8%,差异有统计学意义(P0.01)。[结论]运用品管圈的手法有效地降低了老年病人PICC穿刺点渗血率,有效提高了护理质量和团队凝聚力,而且也提高了护士主动参与质量管理的意识和能力。