重症急性胰腺炎并发上下消化道出血的病因和处理

重症急性胰腺炎（SAP）是临床常见的病死率很高的急腹症。病人主要死于早期的休克、多脏器功能衰竭和全身感染，以及残余感染期的出血和感染相关的并发症。SAP并发致死出血的发生率在1．2％～14．5％，主要表现为消化道、腹腔以及腹膜后出血。SAP病人消化道出血可表现为突发腹痛、腹胀、心动过速和低血压，但有时也表现为慢性间断性出血。SAP并发消化道出血的常见病因包括：应激性溃疡出血、胰源性门静脉高压症出血、胰腺脓肿或假性囊肿穿破消化道引发的出血。     

保持下颌骨完整性改良联合根治术在中晚期舌癌治疗中的应用

目的:探讨保留下颌骨完整性的改良舌鳞癌联合根治术的操作要点、适应证及临床效果。方法:在研究舌外肌、舌下腺及下颌骨的特点,以及颌周淋巴引流特点的基础上,选择临床39例T3-T4舌鳞癌病例,行改良联合根治术,保留下颌骨及牙槽突的完整性。结果:39例均保存下颌骨及牙槽突的完整性,其中直接拉拢缝合9例,30例采用组织瓣修复舌及口底缺损,所有病例均保存良好的咬合功能;术后1年原发灶复发1例,3年原发灶复发9例,淋巴及远处转移5例;3年生存率为(61.72±5.44)%。结论:对于未侵犯下颌骨内侧黏膜的舌鳞癌病例,改良的保留下颌骨完整性的联合根治术能获得良好的生存质量,而不影响对原发灶的控制。     

卫生职业技术学校教学中存在的问题及对策

社会的飞速发展和科学技术的巨大进步,对教育界提出了更高的要求,提高全民文化素质,为社会培养更多、更好的德才兼备人才,是我们每一个教育工作者应尽的责任。然而,近几年来,由于大学扩大招生,致使高中升温,而导致中专学校生源数量和质量都大受影响,而生源结构的改变,对教学产生了很大影响,笔者就卫校教学中存在的问题及对策浅议如下。1存在的问题1.1学习目的不明确,没有就业危机感为了解学生思想动态,笔者曾以“你为什么读卫校”为题,在一个班进行了一次不记名的问卷调查,全班53人,收到答卷33分,拒交答卷原因,一部分是不愿意回答,一部分是…     

消毒剂敌菲特的研究

经全面考察研究,敌菲特缓释消毒灭菌剂具有良好的消毒灭菌效果,对细菌繁殖体、病毒和细菌芽孢均可完全灭活;即使在—20℃低温条件下,对枯黑变种芽孢仍具很好的杀灭效果。此外,该消毒剂基本克服了氯制剂对金属腐蚀性的缺陷;原药性能基本稳定。     

人巨细胞病毒感染对肾移植受者血清白细胞介素－6水平的影响

应用ＰＣＲ检测ＨＣＭＶ－ＤＮＡ，ＥＬＩＳＡ检测ＨＣＭＶ－ＩｇＭ、ＩｇＧ，诊断肾移植受者ＨＣＭＶ感染，６５例受者中ＨＣＭＶ感染者３９例，非感染者２６例。应用ＭＴＴ法检测受者血清ＩＬ－６生物活性，阐明了ＨＣＭＶ感染对肾移植受者血清ＩＬ－６水平的影响。结果表明：感染与非感染组间血清ＩＬ－６水平差异无显著性（Ｐ＞０．０５）；６例原发性感染者血清ＩＬ－６水平随感染时间延长呈增高及降低双相改变，表明慢性迁延性感染者血清ＩＬ－６水平降低。临床工作中监测ＨＣＭＶ感染的肾移植受者血清ＩＬ－６水平变化具有重要意义。     

孕酮受体拮抗剂ZK98299类似物的合成

为寻找新的、活性强且毒副作用小的孕酮受体拮抗剂，从３，３－乙撑二氧－５α、１０α－环氧－△（９（１１））－雌烯－１７－酮（１）开始经四步反应得到孕酮受体拮抗剂ＺＫ９８２９９类似物（１２）、（１３）及其Ｃ（１７）差向异构体（１０）、（１１），化合物（３～１３）均未见文献报道，目的物（１０～１３）的生物活性正在进行测试。     

The effects of hyperthyroidism on oesophageal motility.

This study, evaluating the effects of hyperthyroidism (HT) in oesophageal motility, depended on an oesophageal radionuclide transit test. A modified standard method was used to calculate: (a) total mean transit time (MTT), (b) residual fraction (RF) and (c) retrograde index (RI) in a supine position. Eighteen untreated patients with HT and 25 normal volunteers (NV) with a similar age distribution were included in this study. The results showed that oesophageal motility in patients with HT was worse than in the normal controls (P < 0.05 by Student's t-test). The correlation of MTT, RF and RI with size and function of thyroid glands in the patients with HT were calculated to explain the effects of HT in oesophageal motility. The results showed that neither the size nor the function of the thyroid glands in HT affected oesophageal motility.     

Mediating effects of social support on firefighters' sense of community and perceptions of care

This study examined the relationship between psychological sense of community, social‐support networks, and care‐giver stress and satisfaction among firefighters. No significant gender differences were obtained, but zero‐order correlates demonstrated significant relationships among all four variables. In examining the mediating effects of social‐support satisfaction, partial mediation for psychological sense of community on care‐giver satisfaction was determined, as well as full mediation for psychological sense of community on care‐giver stress. Therefore, firefighters who are satisfied with the support they receive may experience less stress with their care giving than those who experience low levels of support satisfaction. Future studies should assess these relationships more extensively in other areas of civic responsibility among public‐service employees to delineate effective support avenues. © 2004 Wiley Periodicals, Inc. J Comm Psychol 32: 121–126, 2004.