PTCA及支架植入术治疗心肌梗死并重症泵功能衰竭近期效果观察

OBJECTIVE: To evaluate the short-term therapeutic effect of percutaneous transluminal coronary angioplasty (PTCA) with stent implantation in the treatment of myocardial infarction with severe pump failure. METHODS: The clinical data of 73 patients receiving PTCA and stent implantation for myocardial infarction with severity pump failure were analyzed and grouped according the occurrence of complications, degree of the vascular lesions and the complexity of the surgical procedures. Preoperative and postoperative ventricular ejection fractions (LVEF) were compared in each case. RESULTS: The degree of vascular lesions and surgical complexity were not shown to relate to the occurrence of the complications. Except in cases complicated by chronic renal dysfunction, significant improvement was achieved in the patients 7 d after the operation (P<0.05), regardless of different degrees of vascular lesions and surgical complexity. CONCLUSION: PTCA with stent implantation is effective to improve the short-term cardiac function of patients with myocardial infarction and severe pump failure.     

B超对急性腹腔内出血的诊断价值(附52例分析)

急性腹腔内出血常见于外伤和妇科急诊病人,是急腹症最常见的并发症.患者发病急,死亡率高,因此对急性腹腔内出血的早期诊断,尤其重要.超声与X线检查及X-CT检查相比,简便易行,对急性腹腔内出血的诊断具有重要价值.     

放疗化疗联合治疗局部晚期非小细胞肺癌43例

目的 探讨以顺铂为主的化疗方案加放疗对局部晚期非小细胞肺癌的疗效。方法 86例局部晚期非小细胞肺癌患随机分为治疗组及对照组各43例，放疗方案以CAP、EP、MVP或MOP，每人至少化疗两个周期，化疗后10～14天放射治疗，放疗采用^60Co外照射。结果 治疗组有效率83．7％，中位生存期14．5个月，对照组有效率67．4％，中位生存期10个月，两组不良反应为骨髓抑制、胃肠道反应。结论 以顺铂为主的化疗方案加放疗治疗局部晚期非小细胞肺癌的疗效较高，可提高肿瘤的局部控制率和延长生存期。     

医院档案综合管理的意义及对策

对我国医院目前档案管理的现状,档案信息资源在医院现代化建设中的作用以及实行医院档案综合管理的重要意义及对策进行了全面系统地分析,强调了实现医院档案规范化、科学化和现代化管理的重要性和紧迫性。     

小儿急性肺损伤的短期肺功能随访

Objective To study the pulmonary functions of pediatric ALI/ARDS(acute lung injury/acute respiratory distress syndrome) survivors. Method A prospective cohort study of all survivors of ALI/ARDS in the PICU of Beijing Children's Hospital was performed. Patients were divided into three groups(0-3 years of age,3 ～ 7 years of age, and over 7 years of age) and followed up three months after diagnosis. Results There were 36 survivors in total of 44 ALl patients, three patients lost follow-up, 12 died and 21 survived. Five survivors refused to participate in the study because of asymptomatic, and one was unable to participate because of lymphoma com-bined with sepsis. A total of 15 children completed the whole survey (11 patients were less than 3 years old, andfour were over 7 years of age). Twelve patients had no discomfort in their respiratory tracts. Three months after be-ing enrolled, the pulmonary functions of all children improved, especially in terms of tidal volume and respiratory compliance (P<0.05). Conclusions The abnormal respiratory symptoms and signs in most children disap-peared three months after discharge. Most survivors still have pulmonary dysfunction at 3 monthes after discharge, but better than discharge.     

关于发展中医特色的卒中单元的思考

阐述目前中风治疗的概况，介绍国外卒中单元（stroke unit,SU)在中风病人急救和康复治疗中的重要作用和SU的特色、优势及临床实践模式，分析了我国发挥中医优势、建立中西医结合SU的可能性及必要性。     

高效液相色谱法测定不同部位两面针原植物中L-芝麻脂素和L-细辛脂素的含量

目的　建立两面针原植物中L-芝麻脂素和L-细辛脂素的测定方法,并测定两面针不同部位两者的含量。方法　采用高效液相色谱法（HPLC）,色谱柱为HYPERSIL　BDS　C18,流动相为乙腈:水（50:50）,检测波长287nm。结果　L-芝麻脂素和L-细辛脂素的平均回收率和相对标准差分别为100.13％、1.61％和101.24％、1.46％。结论　此法可用于两面针的质量控制。两面针原植物根部的被测成分含量最高。     

护理程序在临床教学中的应用

把护理程序运用于临床教学中 ,提高护生的综合素质 ,培养实用型高素质护理人才。通过对护生社会心理状态及学习情况的评估 ,确定知识目标、技能目标、素质目标 ,然后分别组织实施 ,最后作出综合评价。结果显示 ,运用护理程序进行带教后 ,护生的专科知识、技能、服务意识都有了全面的提高 ,同时也培养了护理人员运用护理程序实施带教的能力。揭示 :护理程序在临床教学中的应用具有科学性和实用性 ,值得进一步推广。     

先天性心脏病动脉导管未闭介入治疗及血流动力学变化

目的观察动脉导管未闭经皮心导管封堵术前后右心血流动力学的变化,评价其临床意义。方法对50例动脉导管未闭儿童患者,在进行介入性经皮心导管封堵术治疗前应用X线降主动脉造影测量前,术后经导管检测右心血流动力学指标变化。结果未闭动脉导管最窄处直径(5．6±1．3)mm;术前肺动脉平均压(19．1±2．3)mmHg,左向右分流量平均为(0．41±0．13)l／min,血流分流量占肺循环血流量的比例平均为(0．17±0．03);术后肺动脉平均压(14．4±1．7)mmHg,左向右分流量平均为(0．03±0．01)l／min,血流分流量占肺循环血流量的比例平均为(0．02±0．01),相应数据比较,差异有统计学意义(P＜0．05)。结论动脉导管未闭经皮心导管封堵术前后血流动力学会发生改变,肺动脉平均压,左向右分流量以及分流量占肺循环血流量的比例均会不同程度下降,这种改变可以作为评价介入治疗效果的重要指标。     

关于癌症患者"坚强"的概念分析

全文以Walker和Avant概念分析格式介绍坚强（hardiness）的定义和特征,说明案例,分析前置因子和后果,列举坚强的评估方法和在不同人群中的运用.希望通过对坚强的全面分析加深医务人员对此概念的理解,从而有助于激发患者的坚强特质.