综合ICU中低年资护士培训方法探讨

目的探讨为综合ICU培养合格的护理人员的方法。方法根据ICU护士应具备的素质及低年资护士的特点,采用定期集中培训、一对一带教、参加护理查房等方法,对基础理论和基本技能进行强化,重点加强了ICU专科护理知识地训练。结果通过客观考核和主观考核,效果良好。结论经过为期12个月两个时段较规范的岗位培训,低年资护士能较好的适应ICU工作。     

The interaction between native serum albumin and hepatitis B virus

Summary Purified hepatitis B virus particles were obtained from HBeAg positive serum by sucrose gradient ultracentrifugation and sephadex G-200 gel filtration. These virions formed a precipitation line in counterimmune electrophoresis with anti-albumin antibody, but the reaction could be inhibited by anti-HBs. After two months at 4°C, another precipitating line was formed under the same condition which could not be inhibited by anti-HBs and was, thus, due to free albumin. When that sample was incubated at 37°C overnight, the line of free albumine disappeared. The virion bound albumin was monomeric in non-denaturing gel electrophoresis. These results suggest that a reversible binding between virion and albumin may occur in vivo and does not require chemical modification or cross-linking.     

甲襞、球结膜微循环的应急观测方法

甲襞、球结膜微循环的应急观测方法是在甲襞、球结膜微循环加权积分综合定量评价方法的基础上，保留权值为４、３的指标，同时观察血管清晰度和红细胞聚集二项指标而形成。同时提供其应急观测积分表、异常分度积分值、诊断标准，并与常规方法进行比较，证明其可以反映绝大部分流态类指标和大部分形态类指标及重要的袢周改变，没有丢失微循环重度异常的信息，保证了重度异常诊断的正确。但在大致正常、轻度异常和中度异常的诊断中应急方法部有判重的倾向，说明应急方法漏掉了一些信息，不能全面地了解微循环的改变，造成了判重的倾向。因此应急方法不能代替常规方法，只能在特定条件下应用。     

肢端黏液样炎性纤维母细胞肉瘤2例及文献复习

目的探讨肢端黏液样炎性纤维母细胞肉瘤的临床病理学特征及鉴别诊断。方法对2例发生在下肢末端的黏液样炎性纤维母细胞肉瘤进行光镜观察和免疫组化标记，并复习文献。结果2例发生在下肢末端的病程较长的渐进性肿块，术后局部复发。镜检：病变呈多结节状，边界不清；黏液样基质中见数量不等的各类炎细胞浸润，散在或灶性分布梭形、奇异形和多空泡状脂肪母细胞样3种形态的瘤细胞。免疫表型：肿瘤细胞Vim弥漫阳性，CD68和CD34灶性阳性，CK、SMA、HHF-35、S-100蛋白、CD45、CD45R0、CD15、CD30均阴性。结论此病病程较长，术后易局部复发，是一种低度恶性的肿瘤。鉴于病变黏液样基质及各类炎细胞浸润的背景较为突出，而特征性的瘤细胞稀疏，应注意与炎症性病变或具有相似组织形态的良性或恶性肿瘤鉴别。     

Preparation of graded porous titanium coatings on titanium implant materials by plasma spraying

Graded porous titanium coatings have been deposited on titanium substrates for dental implants by plasma spraying in an argon atmosphere. X-ray diffraction (XRD), scanning electron microscopy (SEM), surface roughness measurement, and tensile strength tests were performed on graded porous coatings. The results showed that Ti(3)O(5) was formed in the outermost surface of the porous coatings due to oxidation. The graded porous coatings consisted of three layers. The outer layer was full of macropores with a surface roughness of approximately 100 microm. The diameter of many macropores reached and even surpassed 150 microm, which could be beneficial for tissue to grow into the coating. The middle layer consisted of a mixture of micropores and macropores. The inner layer was a very dense and tight interface layer that included mechanical, physical, and metallurgical bonding. In tensile strength tests, testing bars peeled off the coatings, because the adhesive agent fractured, but the coatings remained intact.     

Stimulus-dependent activation of c-Fos in neurons and glia in the rat cerebellum

The intent of the present study was to use chemical or electrical stimulation of cerebellar afferents to determine how different stimulation paradigms affect the pattern of activation of different populations of neurons in the cerebellar cortex. Specifically, we analyzed immediate changes in neuronal activity, identified neurons affected by different stimulation paradigms, and determined the time course over which neuronal activity is altered. In the present study, we used either systemic (harmaline) or electrical stimulation of the inferior cerebellar peduncle (10 and 40 Hz) to alter the firing rate of climbing and mossy fiber afferents to the rat cerebellum and an antibody made against the proto-oncogene, c-fos, as a marker to identify activated neurons and glia. In control animals, only a few scattered granule cells express nuclear Fos-like immunoreactivity. Although no other cells show Fos-like immunoreactivity in their nuclei, Purkinje cells express Fos-like immunoreactivity within their somatic and dendritic cytoplasm in control animals. Within 15 min of chemical or electrical stimulation, numerous granule and glial cells express Fos-like immunoreactivity in their nuclei. Cells in the molecular layer express Fos-like immunoreactivity following harmaline stimulation in a time and lobule specific manner; they do not appear to be activated in the electrical stimulation paradigm. Following harmaline injections, there is an initial loss of Fos-like immunoreactivity in the cytoplasm of Purkinje cells; 90 min later, nuclear staining is observed in a few scattered Purkinje cells. Following electrical stimulation, the cytoplasmic staining in Purkinje cells is enhanced; it is never present in the nucleus. Data derived from this study reveal cell-specific temporal and spatial patterns of c-Fos activation that is unique to each paradigm. Further, it reveals the presence of an activity dependent protein in the cytoplasm of Purkinje cell somata and dendrites.     

VALUE AND LIMITATIONS OF SINUS NODE FUNCTION TE.ST BY ATRIAL PACING IN SICK SINUS SYNDROME DIAGNOSIS

In order to evaluate the significance of the sinus node function test by transvenous atrial pacing in the diagno,sis of sick sinus syndrome (SSS), sinus node recovery time (SRT), co]rrected sinus node recovery time (CSRT) and total atrio- sinus and sino-atrial conduction time (SACT) are observed in 69 patients including non-SSS group 39 cases and SSS group 30 cases. According to our data, we suggest criteria for sinus node dysfunction as follows. SRT>1,400 ms and/or A-V junctional esca.pe before sinus recovery and;or secondary pause, CSRT>560 ms. total SACT>300 ms. With l item abnormal, the false positive rat.e in the non-SSS group is 7.7c7。 and the false negative rate in the S.SS group 3.30i" with 2 items abnormal, the false positive rate in the non-SSS group Oi and the false negative rate in the SSS grOiup 6.7'70. Atropine test results are compared with that of atrial pacing, 95.8To and 84.2% are compatible with each other in these 2 groups. In order to cut the use of invasive technic to the minimum, we propose performing the atropine test first. Only in those with unexplainable test results should the trial pacing test. be resorted to..