Clinical features and management of intracranial subependymomas in children

Subependymoma is a rare low-grade glioma of the central nervous system that occurs most commonly in middle-aged and elderly men and rarely in children. Only a few paediatric patients with subependymomas have been reported. The authors retrospectively analysed five paediatric patients (4 males and 1 female; mean age 8.6 years; age range 5–13 years) at a single institute from July 1998 to April 2009 and summarised the clinical characteristics and management of paediatric intracranial subependymoma. The most common symptom in these five paediatric patients with subependymoma was intracranial hypertension. The tumours were located in the fourth ventricle in two patients, in the fourth ventricle with extension to the cerebellopontine angle (CPA) in one patient; in the right CPA exclusively in one patient, and intraparenchymally in the left parietal lobe in one patient, the latter two of which are rare locations for subependymoma. Surgery was performed on all five patients. The surgical approach was selected as appropriate for the tumor location. Total resection was achieved in three patients, and subtotal resection in two. All five patients had good outcomes without recurrence. We conclude that surgery is the optimal therapy for paediatric patients with intracranial subependymoma.     

1例术后心跳骤停70 min病人的康复护理

急诊医学不但在综合医院临床重要,而且在专科医院备受重视。因此,要发展急诊护理专业化的意识。即使是专科护士也要有大量的急诊临床实践水平、急诊专业水平,为病人提供全面、系统、专业、优质的护理服务[1]。2005年9月我院在手术间成功抢救1例胰十二指肠术后心跳骤停长达70min的病例,通过病房急救护理15d后康复出院。现将其康复护理的过程介绍如下。1病例介绍病人,男,58岁,术前诊断胰十二指肠占位,于1年前做过心脏瓣膜置换术。经麻醉会诊后在全身麻醉下行胰十二指肠切除术,术中生命体征平稳,关腹后病人突然面色苍白、口唇发绀、血压下降、…     

Cognitive-coping therapy for obsessive–compulsive disorder: A randomized controlled trial

Pharmacotherapy and cognitive-behavioral therapy (CBT) are widely used to treat obsessive–compulsive disorder (OCD). These treatments have helped many patients with OCD, but there still is room for improvement. Recently, a promising psychotherapy for OCD, cognitive-coping therapy (CCT), has been developed. Pharmacotherapy plus CCT (PCCT) demonstrates higher efficacy in a shorter period of time and lower relapses than pharmacotherapy or pharmacotherapy plus CBT. In this randomized controlled trial, we investigated the efficacy of CCT for OCD treatment. One hundred and forty-five OCD patients were randomly assigned into two groups: pharmacotherapy (N = 72) and PCCT (N = 73). In each group, drug-resistant (DR) and non-drug-resistant (NDR) OCD were further analyzed to examine the efficacy of CCT. Some clinical features and the Yale-Brown Obsessive Compulsive Scale (Y-BOCS) were blindly assessed pre-treatment and post-treatment at week 1, 2, 3, 4, and 12. The Y-BOCS scores were significantly lower in PCCT than in the pharmacotherapy group at any post-treatment time-point (P < 0.001). Compared with pre-treatment, the Y-BOCS scores were significantly reduced at any time-point (P < 0.001) in PCCT group, but only at week 12 (P < 0.001) in the pharmacotherapy group. In the PCCT group, there were no differences between DR and NDR groups' Y-BOCS scores at any post-treatment time-point. The response rates and remission rates were higher in PCCT than in the pharmacotherapy group. Three variables, the number of weeks of treatment, insight, and disregarding of obsessions, were significantly correlated with the Y-BOCS score. Therefore, CCT might be a potential treatment for OCD.     

酚妥拉明治疗小儿喘憋性肺炎不良反应的观察

喘憋性肺炎是儿科的常见病 ,好发于 2岁以内的小儿 ,临床表现为发热、阵发性咳嗽、喘息 ,尤其多见于呼气性呼吸困难。酚妥拉明是一种α受体阻滞剂 ,能扩张肺血管 ,改善肺循环 ,促进湿口罗音的吸收 ,并能降低肺动脉与外周血管阻力 ,减轻心脏负荷 ,预防早期心功能不全的发生 ,因而早已被广泛用于肺炎患儿的辅助治疗[1-3 ] 。但因其半衰期短 ,用微量输液泵输入既能保证血药浓度 ,又能提高疗效。合理的护理是顺利完成治疗的重要条件。现将我科 2 0 0 2年 2月— 2 0 0 4年 1月收住的 12 0例患儿使用酚妥拉明治疗中出现的不良反应及护理报告如下。…     

皮质激素辅助治疗结核性脑膜炎的研究现状

结核性脑膜炎（tuberculous meningitis，TBM）以血脑屏障紊乱、颅内压升高和脑水肿为特征，是人型结核分枝杆菌感染最严重的类型。未经治疗死亡率达100%，治疗后死亡率约为10%，生存者中约80%有严重的神经系统后遗症。随着新增病例的不断增多，世界卫生组织（World Health Organiza-tion，WHO）在2007年的结核防治报告中提出：“要让所有结核患者都有机会得到有效的治疗。”目前尚没有明确针对TBM最佳治疗方案的临床指南。临床上主要参考肺结核的治疗方案。     

乙肝病毒携带孕妇健康知识调查与分析

目的 了解乙肝病毒携带孕妇健康知识需求情况和预防母婴传播.方法 采用自行设计的问题和症状自评量表对450例孕妇进行心理健康知识和母婴传播知识调查.结果 70%的乙肝病毒携带者存在不同程度的心理障碍,只有90%的孕妇了解常见母婴传播知识,35%的乙肝病毒携带者不了解母婴传播的危害性,10%的乙肝病毒携带者不知道乙肝病毒会母婴传播,不同职业、不同文化程度的乙肝病毒携带者对母婴传播知识存在统计学差异.结论 加强乙肝病毒携带者健康知识宣教,传授预防母婴传播的正确方法,有利于阻断乙肝病毒的母婴传播.     

澳大利亚急救医疗体系的发展

澳大利亚的急救医疗体系在过去的30年经历了本质性的转变,包括院前急救的发展,院内急诊科的发展,以及急诊专科医师和急救师作为新的职业的发展.这一本质性的转变在其他很多国家也同时存在,并缘于卫生体系提供高质量的急救医疗服务的义务和不断增加的职业责任.     

Study on Coated Zr-V-Cr Getter with Pore Gradient Structure for Hydrogen Masers

As the core component of satellite navigation, the hydrogen maser needs a high vacuum environment to maintain the stability of the frequency signal. The getter pump, composed of various non-evaporable getters, plays an important role in maintaining the high vacuum. In this paper, the Zr_100-xCu_x (x = 0, 2, 4, 6)/Zr_56.97V_35.85Cr_7.18 getter was studied and the contradiction between sorption performance and mechanical properties was solved. The Zr-V-Cr getter, a better candidate for getter pump, exists for problems which will destroy the high vacuum and affect the service life of the hydrogen maser. To solve the problem of dropping powder from Zr-V-Cr getter, Zr-Cu films were coated on the surface of Zr-V-Cr matrix to obtain the pore gradient structure. After vacuum sintering, the interface showed gradient structure and network change in pore structure from Zr-Cu film to Zr-V-Cr matrix. These characteristic structures made Zr-V-Cr getter have good absorption properties, which is better than a similar product of SAES company and mechanical properties. Because the Zr-Cu film on Zr-V-Cr matrix effectively prevented dropping powders from the matrix, (Zr-Cu)/(Zr-V-Cr) getter solved the problem of dropping powder. The self-developed new getter with pore gradient structure is of great significance for maintaining the high vacuum of hydrogen maser in the future.