综合实践教学模式的实施与护生综合能力的培养

目的在《护理学基础》教学中，运用整体护理思维，探讨课堂综合实践教学模式的实效性，以提高护生的职业素质和能力。方法随机确定实验班和对照班，对照班采取传统的实践教学模式授课，实验班采取小群体综合实践模式教学。结果实验班护生的规范操作能力、沟通能力和知识运用能力与对照班比较有显著提高。结论小群体综合实践教学模式对护生综合能力的培养具有实际意义。     

环境线索对戒断期海洛因依赖者神经电生理的影响

Objective To explore the changes of craving and neuro-electrophysiological reactions under the exposure of heroin-related cues in abstinent heroin dependents.Methods In this self-controlled study,382 abstinent heroin dependent patients watched video of heroin smoking and injecting situations,and in the meantime were exposed to herein simulacrum and apparatus after relaxation exercises.The neuroelectrophysiological reactions were mcagured with a multi-biofeedback instrument before and after the cue exposed.Self-reported craving was also assessed before and after cue exposed.Results The craving were increased[(18±22)mm vs.(29±29)mm,P＜0.01]after cue exposures compared to pre-exposure,EMG[(12±7)μN vs.(14±10)μV,P＜0.01]and SC[(6.8±4.3)μS vs.(7.4±4.3)μS,P＜0.01]also increased.But the percentages of δ,θ,α,SMR,low β,high β decreased compared to that under the cue exposures[8:(10.8±4.7)%vs.(9.7±4.4)%,P＜0.01;0:(6.8±2.0)%vs.(6.3±2.0)%,P＜0.01;α:(4.8±1.8)%vs.(4.5±1.7)%,P＜0.01;SMR:(3.0 ±1.2)%vs.(2.8±1.2)%,P＜0.01;low β:(2.6±1.1)%vs.(2.5±1.1)%,P＜0.01 and high β:(4.6 ±1.5)%vs.(4.5±1.5)%.P＜0.05].Conclusions The results indicate that drug-related cue induce heroin craving and electrophysiological reactions.     

pH值对IFN-α2b、rIL-2、ADM合用维拉帕米对人肝癌细胞杀伤作用的影响

目的　观察培养液在 pH值为 6 .8、7.3、7.6条件下rIL - 2、IFN -α2b、ADM及合用维拉帕米对人肝癌细胞 74 0 4杀伤作用的影响。方法　MTT法于 96孔培养板上进行杀伤实验 ,测定培养液pH值分别为 6 .8、7.3、7.6状态下 ,rIL - 2、IFN -α2b、ADM、及与维拉帕米联合杀伤人肝癌细胞 70 4 0的差异。结果　pH值为 7.6状态下rIL - 2、IFN -α2b、ADM及合用维拉帕米杀伤效果最佳。pH值为 6 .8、7.3、7.6时 ,IFN -α2b都能增加ADM抗肿瘤作用 ,但pH值为 7.6时 ,IFN -α2b +ADM杀伤效果最佳。结论　在偏硷性环境下 ,rIL - 2、IFN -α2b、ADM及合用维拉帕米对肿瘤细胞杀伤效果最佳     

The Application of Topical Anesthesia Combined with Subconjunctival Anesthesia for Glaucoma Surgery

Purpose: To evaluate the feasibility, reliability and analgesia effect of topical anesthesia combined with subconjunctival anesthesia in anti-glaucomatous surgery.Methods: Two hundred and four cases (357 eyes) underwent anti-glaucomatous surgeries under topical anesthesia with 0.5％ Alcaine eye drops combined with subconjunctival anesthesia with 2％ Lidocaine. The analgesic effect was analysed with visual analogue pain scale.Results: Among all of 357 eyes, 62 eyes underwent peripheral iridectomy, 67 eyes underwent simple trabeculectomy, 167 eyes underwent compound brabeculectomy and 12 eyes nonpenetrating trabecular surgery. The effects of anesthesia were as follows: 304 eyes (85.2％) were painless (Grade Ⅰ), 50 eyes (14.0％) were slight painful (Grade Ⅱ), and 3 eyes (0.8％) were more painful (Grade Ⅲ) during surgery. And no severe complications were observed in all the cases during surgery and postoperatively. Amaurosis fugax was not observed in the glaucoma patients at the late stage with narrow vi     

白内障超声乳化术后角膜地形图和屈光状态的观察

目的　观察白内障超声乳化人工晶状体植入术后 ,患者角膜地形图和屈光状态的变化。方法　对2 0 0 0年～ 2 0 0 1年行白内障超声乳化的 136例 (15 1只眼 )患者术前、术后随访一年的资料进行回顾性分析。结果　术后 1、3、6、12月术眼的球镜、散光、角膜地形图曲率和散光 sim k值统计结果无明显差异 ;术后 1～ 12月视力和屈光状态稳定 (方差分析 P >0 .0 5 )。术后 6月平均视力为 0 .5 9± 0 .2 3,矫正视力为 0 .82± 0 .19,术后 6月 ,球镜为 (-0 .2 4± 0 .88) D,散光为 (- 0 .5 6± 1.0 1) D,在± 1.0 D之内球镜和散光眼分别为 84.0 %和 6 4.0 % ,≥ 0 .5和≥ 0 .8的视力分别为 70 .0 %和 2 8.0 % ,≥ 0 .5和≥ 0 .8的矫正视力分别为 94.0 %和 72 .0 %。≥ 0 .5和≥ 0 .8裸眼视力和矫正视力的平均百分率分别由 6 1.96 %和 2 3.49%提高到配镜矫正后的 92 .35 %和 6 3.0 9%。结论　超声乳化术后角膜形态和屈光状态保持良好的稳定性 ,患者可以达到良好的视力。由于植入的人工晶状体无调节功能和测量误差 ,目前部分患者需要配戴较低度数的眼镜矫正远或近视力 ,达到更好的视觉效果。     

Graves病介入栓塞治疗的病理研究

目的观察Graves病栓塞后的甲状腺组织动态病理变化。方法15例甲状腺动脉150 mm聚乙烯醇（PVA）微粒及平阳霉素栓塞治疗的Graves病患者,于术前、术后7天、3个月、6个月、1年、3年分别行甲状腺穿刺活检,共行44次穿刺活检,其中动脉栓塞术前15例、栓塞术后7天2例、3个月3例、6个月6例、1年5例次、3年13例次。结果栓塞后7天主要表现为凝固性坏死;栓塞后3-6个月表现为纤维组织增生变性和淋巴细胞浸润,滤泡灶性坏死为主;栓塞后1-3年主要表现为间质纤维组织增生明显和滤泡萎缩,部分散在增生滤泡被纤维间质分隔包裹,难以形成腺小叶结构,滤泡周围血管网减少。结论经甲状腺动脉栓塞治疗Graves病,甲状腺组织的病理变化是在栓塞后近期内主要表现为急性缺血坏死,然后表现为持续的慢性炎性破坏、滤泡萎缩、部分滤泡增生被明显增生的纤维组织分隔包裹的变化过程。提示微循环栓塞能肯定地破坏甲状腺组织,达到治疗Graves病较好的疗效。     

超声引导下VacoraTM旋切系统的实验研究

目的探讨VacoraTM真空辅助活检系统的准确性和安全性,为临床应用奠定基础。方法选用里脊肉和鱼丸作为实验材料,根据鱼丸大小将实验分为5组:0.5、0.8、1.0、1.5及2.0cm组,每组鱼丸3~5个。采用VacoraTM活检系统,先行灰阶超声扫查肌肉后将鱼丸置入肌肉中,超声扫查置入的鱼丸,同轴套管针在超声引导下插入鱼丸底部,在套管针引导和超声监视下行旋切真空抽吸术;旋切后取出采样腔内的组织标本,用超声检查肌肉内的残腔,确定无鱼丸残留声像图。结果每次旋切组织条比较完整,其大小为20.0mm×0.6mm,旋切次数随鱼丸大小的增加而增加;0.5、0.8、1.0、1.5及2.0cm组里脊肉内鱼丸全部切除的平均旋切次数分别为12、15、19、26和31。所用的平均时间分别为15、18、23、27和34min。结论VacoraTM真空辅助活检系统定位准确、取样完整、操作简便。可为良恶性病变的诊断提供足够量的病理检查标本,为良性病变的完全切除提供具有潜在价值的手段。     

Comparison of the effects of three different combinations of general anesthetics on the electroretinogram of dogs

The objective of this study is to compare the effects of three different anesthetic combinations on the electroretinogram in the same animals under similar laboratory conditions. Thiopental–isoflurane (TI), medetomidine–ketamine (MK), and xylazine–ketamine (XK) were used on each of 12 healthy miniature schnauzer dogs (MS) with a period of at least 3 weeks in between subsequent anesthesia protocols, using the Dog Standard Protocol. The scotopic ERGs consisted of scotopic low stimulus strength (S) responses designated S1, S2, S3, S4, and S5, at 1, 5, 10, 15, and 20 min after dark adaptation, respectively, and scotopic standard stimulus strength (S-ST) responses. The photopic ERGs consisted of a photopic single flash (P) response and 31 Hz flicker (P-FL) responses. For S-ST (2.5 cd s/m²), the amplitude of the a-wave using TI was significantly lower than that using MK (adjusted P = 0.05) and XK (adjusted P = 0.03), and the implicit time of the a-wave was significantly shorter than that using MK (adjusted P = 0.04). For P (2.5 cd s/m²), the amplitude of the b-wave using XK was significantly higher than that using MK (adjusted P = 0.01). The implicit times of the b-wave using TI was significantly longer and shorter than that of MK for S1, S2 and P-FL and for S4 and S-ST, respectively, and than that of XK for S2 and P-FL and for S5 and S-ST, respectively. The results of the present study showed that TI affected both the amplitude and the implicit time of the a-wave for S-ST and the implicit time of the b-wave relatively more so than was the case when using XK or MK. Therefore, it appears that either XK or MK could be advantageous to use rather than TI for clinical studies.     

王成荣治疗子宫内膜异位症“火热致瘀”理论探讨

王成荣研究员长于以中医药诊治子宫内膜异位症（EMT），根据其临床经验认为“火热致瘀”是EMT的基本病因、病机，且火热与瘀血互为因果、恶性循环，致使EMT病程缠绵不愈、反复复发。王老据此提出“清热解毒、化瘀散结”的治疗法则，为治疗EMT开辟了另一思路和理论。