干细胞的生物学特性：异基因骨髓细胞防治小鼠骨髓移植后移植物抗宿主病

目的:研究可溶性肿瘤坏死因子受体基因修饰的粒-巨噬细胞集落刺激因子短期培养的异基因骨髓细胞,对小鼠骨髓移植后移植物抗宿主病的防治及与移植物抗白血病的关系.方法:实验于2002-06/2003-03在第二军医大学免疫研究所完成.选择纯种近交系C57BL/6小鼠作为供,BALB/c小鼠作为受,用^60Coγ射线照射后,随机分为5组,每组10只.①未处理组:接受照射后,尾静脉注射磷酸盐缓冲液.②移植物抗宿主病组:照射后移植骨髓细胞和脾细胞.③粒-巨噬细胞集落刺激因子组:照射后移植粒-巨噬细胞集落刺激因子培养的骨髓细胞和脾细胞.④LacZ基因修饰组:照射后移植粒-巨噬细胞集落刺激因子培养后LacZ基因修饰的骨髓细胞和脾细胞.⑤可溶性肿瘤坏死因子受体基因修饰组:照射后移植粒-巨噬细胞集落刺激因子培养后可溶性肿瘤坏死因子受体基因修饰的骨髓细胞和脾细胞.经上述处理后主要观察:①各组小鼠生存期.②隔3日鼠尾静脉采血检测各组小鼠外周血白细胞的变化,以观察不同方法对造血功能恢复的影响.③各组小鼠脾脏淋巴细胞杀伤活性的改变.结果:纳入BALB/c小鼠50只,均进入结果分析.①小鼠生存期:可溶性肿瘤坏死因子受体基因修饰组平均存活期较移植物抗宿主病组明显延长(35 d,12.5 d,P＜0.05).②小鼠脾脏淋巴细胞杀伤活性的改变:可溶性肿瘤坏死因子受体基因修饰组小鼠脾脏淋巴细胞杀伤同种肿瘤细胞的活性明显高于LacZ基因修饰组和粒-巨噬细胞集落刺激因子组.③对造血功能恢复的影响:处理后各组小鼠外周血白细胞计数均明显降低.6 d白细胞开始逐渐回升,尤以移植粒-巨噬细胞集落刺激因子组、LacZ基因修饰组和可溶性肿瘤坏死因子受体基因修饰组小鼠白细胞回升明显.结论:可溶性肿瘤坏死因子受体基因修饰的骨髓细胞能有效地抑制移植物抗宿主病的产生,有利于骨髓移植小鼠恢复造血功能.骨髓细胞异基因移植是一种有效防治移植物抗宿主病的新方法.     

应用LED蓝光治疗面部痤疮的护理体会

目的:探讨LED蓝光治疗面部痤疮的方法及护理,为推广LED蓝光治疗面部痤疮提供临床依据。方法:用LED照射治疗面部痤疮,每次15—20min,2次/每周,4周为1疗程。同时口服维胺脂胶囊50mg,3次/日。奥硝唑片0.5片,2次/日。外用维A酸红霉素软膏2次/日。周为一疗程。连续治疗四周评价疗效。结果:总有效率为90%。结论:LED蓝光治疗面部痤疮疗效显著,值得临床推广。     

新疆阿克苏地区重点人群碘营养和智力水平调查

Objective To investigate the iodine nutritional status of school children, lactating women and infants in iodine deficient areas of Baicheng and Wushi Counties in Xinjiang Autonomous Region. Methods According to the geographic location of east, south, west and north of county, 10 primary schools of 8 townships were selected. In each school, 10 children among each gender and age group from 8 to 10 years old were selected. A total of 300 school children were chosen. One hundred and four infants aged 0-2 years old and their mother were selected in 8 townships. Iodine content in edible salt at household level, the urinary iodine in school children and lactating women, total goiter rate(TGR) and the status of the intelligence quotient (1Q) of school children, the status of psychological development of infants were observed. Direct titration assay for testing the salt iodine, colorimetric ceric-arsenic assay and vitriolic ammonium assimilation were used for testing urinary iodine. The size of thyroid gland was measured by palpation. The Combined Raven Test for Chinese Rural was used to test the IQ. The psychological development of infants was tested by Danver Development Screening Test (DDST). Results The coverage rate of iodized salt at household level was 73.1% (123/182), however, the proportion of households using adequately iodized salt was 64.1% (118/182). The medium of urinary iodine in school children was 103.7 μ/L, with 47.8%(75/157) less than 100 μg/L and 28.0% (44/157) less than 50 μg/L; it was 123.0 μg/L in Baieheng County, with 44.4%(28/63) less than 100 μg/L and 33.3%(21/63) less than 50 μg/L; it was 100.3 μg/L in Wushi County, 50.0%(47/94) less than 100 μg/L and 24.5%(23/94) less than 50 μg/L. The medium of urinary iodine in locating women was 143.3 μg/L, it was 119.7 μg/L and 184.6 μg/L in Baicheng and Wushi Counties, respectively. The total rate of goiter in school children was 14.3%(43/300), it was 10.8%(13/120) and 16.6%(30/180) in Baicheng and Wushi Counties, respectively. The average IQ in school children was 80.6±11.6, it was 83.0±11.6 and 79.0±11.7 in Baicheng and Wushi Counties, respectively. The proportion of mental retardation in school children (IQ≤69) was 13.0% (39/300), it was 6.7% (8/120) and 17.2%(31/180) in Baicheng and Wushi Counties, respectively. In addition, the proportion of psychological development in infants being normal, suspicious and abnormal was 78.8%(82/104), 12.5% (13/104) and 8.7%(9/104), respectively. Conclusion This study confirms the fact that there is also existence of mental retardation in children and infants, caused by iodine deficiency.     

小儿手足口病的传染 预防及治疗

手足口病是肠道病毒柯萨奇A16型、埃可病毒或肠道病毒71等感染引起的以出疹、发热为主要特征的急性传染病，往年各地均有散在发生。该病可在多年龄组人群引起感染，但常在5岁以下婴幼儿中造成暴发流行，传染源为患者和隐性感染者，传播方式主要是通过密切接触急性期患者的粪便、     

备班制在PICU护理人力资源调配中的应用

儿科重症监护室（pediatric intensive car unit,PICU）是接诊和救治危重病人的重要场所,具有病人病情危重、变化快、无规律,仪器设备复杂、急救药物种类繁多、护理工作繁重等特点.特别是夜间时间,护理人员明显不足,影响了危重病人的抢救护理工作.     

馕加碘防治碘缺乏病的初步实验研究

目的 用新疆市场上销售的碘盐和当地产的土盐烤制馕,探索馕作为补碘载体的可行性.方法 采用新疆当地馕坑和打馕的传统方法,取30 g碘盐和30 g土盐,分别加水后各与2 kg面粉混合,烤制两种馕即碘盐馕和土盐馕各10个.分别取两种馕的上皮部,炉壁部、混合部(上下及中间),采用食品中碘的碱灰化-砷铈催化分光光度测定法,测定两种馕及其不同部位的含碘量,并与成人及儿童每天摄碘推荐量进行比较.结果 碘盐馕含碘量为(0.654±0.076)mg/kg,远远高于土盐馕的含碘量[(0.075 ±0.022)mg/kg],二者比较差异有统计学意义(t=13.520,P<0.01).碘盐馕和土盐馕的上皮部、炉壁部、混合部含碘量分别为(0.700±0.100)、(0.064 ±0.029)mg/kg,(0.647 ±0.076)、(0.070 ±0.019)mg/kg,(0.659 ±0.073)、(0.073 ±0.030)mg/kg,两种馕相同部位比较,差异有统计学意义(t值分别为3.826、4.201、4.103,P均<0.01),同种馕不同部位比较,差异无统计学意义(F值分别为0.220、0.190,P均>0.05).结论 采用碘盐烤制的馕含碘量高于当地产的土盐烤制的馕,同种馕的不同部位含碘量没有明显的不同,鉴于馕作为主食,在当地具有普遍性,采用碘盐烤制的馕可作为有效补碘载体.     

产科子宫切除术38例病因分析

目的：探讨降低产科子宫切除术及并发症发生的可能性。方法：对我院近10年所进行的38例产科子宫切除术作回顾性分析。结果：产科子宫切除术发生率为0.13%,其中剖宫产子宫切除占71.1%,阴道分娩子宫切除占23.7%,引产子宫切除占5.2%。产科子宫切除术主要指征：胎盘因素、子宫收缩乏力、子宫破裂、羊水栓塞、妊娠急性脂肪肝。结论：做好孕产妇保健和计划生育,提高产科工作质量,正确掌握剖宫产手术指征,可以有效降低产科子宫切除率。     

胺碘酮治疗充血性心力衰竭并室性心律失常临床分析

目的：探讨胺碘酮治疗心力衰竭合并室性心律失常的疗效。方法：回顾分析2009年1月～2009年12月本院诊断明确的充血性心力衰竭合并室性心律失常的患者48例的临床资料。结果：48例患者经胺碘酮治疗后,显效35例（72.92%）,有效12例（25.0%）,无效1例（2.08%）,总有效率为97.92%。治疗期间无明显不良反应。结论：胺碘酮是一种广谱而安全的抗心律失常药物,对室性心律失常作用明确。     

护患纠纷的原因及预防

目的分析引起护患纠纷的原因,制订有效的预防措施。方法对临床护理工作中常见的护患纠纷原因进行观察分析。结果发现引起护患纠纷主要有三方面的原因：护理人员职业素质、护理管理、患者。结论找出引起护患纠纷的原因,针对性地采取预防措施,可减少护患纠纷的发生。