颈椎术后病人首次下床活动的感受及需求的调查

早期下床活动的必要性已得到大家认可,但术后早期病人常常较虚弱,且下床活动时会引发一些不适,病人也会有一些担心和顾虑,这在一定程度上会影响病人下床活动的积极性。颈椎手术本身有其特殊性,术后对颈部的稳定要求较高,因此此类病人活动有其特点。本研究以颈椎术后已下床活动的病人为研究对象,通过问卷调查,了解颈椎手术后病人首次下床的感受和相关需求,为进一步提高颈椎术后护理质量提供依据。1资料和方法1.1对象采用方便取样,选取2005年4月—2005年6月在某三甲医院因颈椎病入院、术后已下床活动的病人75例。其中男54例,女21例;年龄28岁~7…     

UB-I粘结剂粘结面的微形态观察

目的：研究UB-Ⅰ粘结剂的粘结界面和粘结表面的微形态特点。方法：用扫描电子显微镜观察UB-Ⅰ和牙本质的粘结界面和粘结表面。结果：UB-Ⅰ粘结剂在牙本质小管内可聚合形成树脂突，在牙本质小管内的树脂突表面有树脂侧枝呈树枝状横行排列，并且和相邻的树脂突相连接，在牙本质和复合树脂之间有杂合层形成。结论：UB-Ⅰ粘合剂具有良好的渗透性，与牙本质之间可以形成良好的机械嵌合。     

临床输液监控系统的设计

本文针对临床输液过程中出现的漏、停、输液速度改变等各种问题，讨论了一由单台微机和多个单片机通讯实现的多床输液自动监控、自动反应、自动报答系统的可行性，并给出了主要部分的硬件、软件设计方法。     

鼻咽癌增强CT扫描的影像表现及价值(附102例报告)

目的　探讨鼻咽癌 (NPC)增强CT表现和价值。方法　对 10 2例NPC放化疗前病人行平扫加增强扫描 ,观察癌灶密度变化、鼻咽表面线样强化层和癌灶周界情况。结果　平扫癌灶密度与同层面鼻咽肌相近的有 89例 (87% ) ,其余与翼外肌相近(13 % )。平扫难以明确癌灶的大小和范围 ,所能显示的仅是有无占位。增强扫描癌灶密度差异明显的占 44% ,单靠密度差异能使其周界全部或大部清楚的仅占 40 %。根据癌灶强化和线样强化层的表现 ,综合判断癌灶周界全部或大部清楚的达到 76%。结论　增强扫描对准确判断NPC癌灶的大小、范围以及对发现小的癌灶和鉴别诊断有重要作用。在主要针对鼻咽部本身的检查 ,增强也应列为常规扫描     

移植肾破裂的处理

目的　提高移植肾破裂的防治水平。方法　 6例移植肾破裂 ,手术前 2例 ,手术后 4例。 2例术前供肾破裂 ,采用切开移植肾破裂处包膜 +裂口内明胶海绵填塞 +肠线修补 +肠线编织肾袋收缩保护移植肾。 1例术后移植肾破裂早期 ,出血少 ,针对顽固性高血压采用“硝普钠”降压 ,配合常规抗排斥药物。 3例术后移植肾破裂出血量估计超过 10 0 0ml者 ,采用手术延长移植肾破裂处包膜 +裂口内明胶海绵填塞 +肠线修补 +肠线编织肾袋收缩保护移植肾。结果　 ( 1)手术前 2例手术后 4例 ,采用切开或者延长移植肾破裂处包膜 +裂口内明胶海绵填塞 +肠线修补 +肠线编织肾袋收缩保护移植肾并配合“硝普钠”降压的方法处理 ,均未再破裂出血 ,移植肾功能恢复良好。 ( 2 ) 1例术后移植肾破裂早期的患者 ,针对顽固性高血压采用“硝普钠”降压 ,配合常规抗排斥药物 ,非手术治疗成功。结论　 ( 1)采用手术切开或延长移植肾破裂处包膜 +裂口内明胶海绵填塞 +肠线修补 +肠线编织肾袋收缩保护移植肾可以有效治疗移植肾破裂。 ( 2 )移植肾破裂出血少的情况下 ,可以在密切观察下非手术治疗     

慢性心力衰竭病人的临床分析

慢性心力衰竭（CHF）目前是老年人住院和死亡的主要原因，近几年研究结果显示CHF病人出现的肾功能障碍即心肾综合征发病率高，预后差，狭义的心肾综合征特指CHF引起的进行性肾功能损害，并导致肾功能不全，我们回顾性分析我院收治的100例CHF住院病人，着重探讨CHF程度与肾功能不全的发生率及其与住院的时间的关系。现将其临床分析介绍如下。     

668颗后牙镍铬合金PFM边缘适合性的临床观察

目的：观察采用2种边缘形式的后牙烤瓷熔附金属全冠边缘适合性和对牙龈健康的影响.方法：对668颗后牙,分别采用2种边缘形式的后牙烤瓷熔附金属全冠（单冠或桥的基牙）在修复2年后进行复查,检测其边缘适合性及牙龈指数（GI）和牙周探诊深度（PD）,用统计学方法分析修复体边缘形式与牙龈病变间的关系.结果：采用羽状边缘360°金属脚边的PFM边缘适合性明显优于凹面肩台型边缘PFM,凹面肩台型边缘的PFM的牙龈病变发生率,明显高于羽状边缘360°金属脚边的PFM,而边缘适合性差者较适合性好者牙龈病变发生率显著增高.结论：后牙PFM的边缘采用羽状边缘360°金属脚边是一种好的选择.     

Point mutation in the parkin gene on patients with Parkinson’s disease

Summary To investigate the distribution of possible novel mutations from parkin gene in variant subset of patients with Parkinson’s disease (PD) in China and explore whether parkin gene plays an important role in the pathogenesis of PD, 70 patients were divided into early-onset group and late-onset group; 70 healthy subjects were included as controls. Genomic DNA from 70 normal controls and from those of PD patients were extracted from peripheral blood leukocytes by using standard procedures. Mutations of parkin gene (exon 1–12) in all the subjects were screened by PCR-single strand conformation polymorphism (SSCP), and further sequencing was performed in the samples with abnormal SSCP results, in order to confirm the mutation and its location. A new missense mutation Gly284Arg in a patient and 3 abnormal bands in SSCP electrophoresis from samples of another 3 patients were found. All the DNA variants were sourced from the samples of the patients with early-onset PD. It was concluded that Parkin point mutation also partially contributes to the development of early-onset Parkinson’s disease in Chinese. WANG Tao, male, born in 1961, Associate Professor This work was supported by grants from the key program of the special scientific project of Scientific & Technologic Agency of Hubei Province (Serial No. 2001AA308B01) and the Hygienic Research Project of Hygienic Agency of Hubei province (Serial No. WJ 01529).     

Production and characterization of genetically engineered antibody molecules

Expression of antibody heavy- and light-chain genes by transfection permits the production of monoclonal antibodies with improved biological and antigen-binding properties. The immunoglobulin genes are placed in vectors containing a gene for encoding a protein that provides a biochemically selectable function in eukaryotic cells; these vectors are transfected into myeloma and hybridoma cells. Selection of drug-resistant cells permits the efficient isolation of the rare cells that express the transfected DNA. By placing heavy and light chains on plasmids with different selectable markers, one can deliver heavy- and light-chain genes simultaneously to the same cell. The transfected immunoglobulin genes are efficiently expressed and the proteins produced are a faithful mirror of the genes that were introduced. Using the standard techniques of genetic engineering and gene transfection, we can now produce antibodies of widely varying structures, including chimeric antibodies with segments derived from different species. These antibodies provide useful reagents to study structure-function relationships within the antibody molecule. Ultimately it will be possible to produce a new generation of antibody molecules with improved antigen-binding properties and effector functions.     

Changes in total sodium intake do not lead to proportionate changes in total sodium removal in CAPD patients.

BACKGROUND: Dietary salt and fluid restriction is important in controlling fluid balance in patients on continuous ambulatory peritoneal dialysis (CAPD). However, it is often difficult to monitor patients' dietary total sodium intake (TSI). Usually, total sodium removal (TSR), the sum of urinary sodium removal (USR) and dialysate sodium removal (DSR), is suggested to represent TSI. In the present study, we investigated the reliability of using TSR as a surrogate to TSI in CAPD patients. METHODS: 40 clinically stable CAPD patients were closely followed for 3 months. Their TSI, USR, DSR, and fluid status were measured twice: at baseline and at the end of this study respectively. Fluid status was evaluated by bioimpedance analysis. Patients with increased sodium intake (group ISI) or decreased sodium intake (group DSI) (both >0.5 g/day or >21.74 mmol/day elemental sodium) were included in this study. RESULTS: There were 15 patients in group ISI and 9 patients in group DSI. During the follow-up, although TSI increased in group ISI and decreased in group DSI (p < 0.05), there were no significant changes in USR, DSR, or TSR in either group. No relationship was found between TSI and TSR. Changes in weight, blood pressure, urine volume, ultra-filtration, and small solute removal (Kt/V and creatinine clearance) were not statistically significant between the two groups. Fluid status deteriorated in group ISI and improved in group DSI (p < 0.05). CONCLUSIONS: Our study suggests that changes in total sodium intake do not lead to proportionate changes in total sodium removal in CAPD patients. Therefore, TSR (the sum of USR and DSR) should be used cautiously to monitor TSI in this patient population.