丁螺环酮和阿普唑仑治疗广泛性焦虑研究

目的：比较国产丁螺环酮和阿普唑仑治疗广泛性焦虑的疗效和不良反应。方法：对78例广泛性焦虑按照就医顺序分为两组，分别服用丁螺环酮(38例)和阿普唑仑(40例)。疗程6周。于治疗前及治疗第1、2、4、6周末进行汉密尔顿焦虑量表(HAMA)及副反应量表(TESS)评定疗效和不良反应。结果：丁螺环酮和阿普唑仑的疗效相仿，丁螺环酮的不良反应少且轻微，无过度镇静和肌肉松弛作用，不产生药物依赖。结论：丁螺环酮是治疗广泛性焦虑较为理想的药物。     

Effects of human amniotic fluid on cartilage regeneration from free perichondrial grafts in rabbits.

After the chondrogenic potential of free grafts of perichondrium was shown in several experimental studies, perichondrium has been used to reconstruct cartilage tissue in various clinical situations. This study investigates the effects of human amniotic fluid on neochondrogenesis from free perichondrial grafts in a rabbit model. Since this fluid contains high concentrations of hyaluronic acid, hyaluronic acid-stimulating activator, growth factors, and extracellular matrix precursors during the second trimester, it may have a stimulating effect on neochondrogenesis. Perichondrial grafts, measuring 20 x 20 mm2 were obtained from the ears of 144 New Zealand young rabbits and were sutured over the paravertebral muscles. The rabbits were randomly divided into three groups with 48 rabbits per group. In group 1, 0.3 ml human amniotic fluid, and in group 2, 0.3 ml saline were injected underneath the perichondrial grafts. Group 3 formed the control group in which no treatment was given. Histologically, neochondrogenesis was evaluated in terms of cellular form and graft thickness at 2, 4, 6, and 8 weeks after surgery. In group 1, the mature cartilage was generated quickly and the cartilage plate in this group was significantly thick and extensive when compared with groups 2 and 3 at 8 weeks ( p<0.05 ANOVA). In conclusion, our study shows that human amniotic fluid enhances neochondrogenesis from free perichondrial grafts. The rich content of hyaluronic acid and growth factors possibly participate in this result.     

烧伤创面细菌分布对植皮存活率的影响

目的　通过对烧伤病人不同时间的痂下组织细菌定量培养及种类检测 ,探讨手术时间、菌量和菌种与植皮存活率的关系。方法　选择 3 65例病人于手术时取痂下组织以组织匀浆行细菌定量并鉴定菌种。结果　 45 0份标本中 3 90份为阳性 ,共培养出细菌 5 80株 ,以铜绿假单胞菌(2 7.93 %)及金黄色葡萄球菌 (16.2 0 %)为最常见种类 ;手术时间、菌量和菌种对植皮存活率均有不同程度的影响 (P <0 .0 1)。结论　手术时间越早 ,痂下组织细菌含量越少 ,菌种较单一 ,植皮存活率越高 (P <0 .0 1) ;金黄色葡萄球菌感染对植皮存活率影响较大 (P <0 .0 1)。     

脑内出血的治疗进展

脑内出血(ICH)是一种急性、自发性的脑实质内出血过程,占卒中患者的10％～30％,是临床关注的常见病。随着现代医学研究的进展,临床医师对疾病的诊断及治疗转归有了更全面的认识。脑内出血的治疗进展也为临床医师带来许多新的思考。2003年美国国立卫生研究院神经疾病与卒中(NINDS)工作组提出:ICH领域的焦点是急性期     

重症肌无力胸腺切除术后呼吸道管理与并发症的防治

目的 探讨重症肌无力胸腺切除术后呼吸道管理与并发症的防治.方法 32例ICU收治的重症肌无力胸腺切除术后的患者,根据危象预测积分,分为普通组(积分＜12分,n=21)和高危组 (积分＞12分,n=11),对两组患者术后呼吸机支持时间、拔管前后肌力恢复情况、自主呼吸情况、动脉血气分析情况以及两组患者术后体温、胸片和痰培养结果进行统计分析.结果 高危组患者术后呼吸支持时间(18 ～ 30 h,平均26 h)大于普通组患者(4 ～ 28 h,平均14 h),两组有显著性差异(P＜0.01),同时术后发热、胸片渗出影以及阳性痰培养结果的发生率也高于普通组.结论 术后给予高危患者严密的监测和充分的呼吸支持,有助于降低重症肌无力危象的发生率和死亡率,同时应充分重视气道护理和感染的防治.     

实施责任护士竞聘制的做法与成效

目的 :营造良性竞争的机制和氛围 ,全面提高护理质量。方法 :通过资格认定、理论技术考试、民主测评及双项选择 ,由护理部聘任。结果 :较好地进行了人力资源的开发 ,竞聘上岗后的护士有责任感和使命感 ,工作积极主动 ,自觉地成为科室各项工作的带头人。加之岗位工资的兑现 ,更有利于护士长在科室开展工作 ,使科室各项护理工作质量显著提高。结论 :良性的竞争运行机制 ,使优秀护理人才脱颖而出 ,体现能级对应的原则 ,从而使护理质量不断提高。     

Electron microscopical demonstration of horseradish peroxidase by use of tetramethylbenzidine as chromogen and sodium tungstate as stabilizer (TMB-ST method): a tracing method with high sensitivity and well preserved ultrastructural tissue.

Until now methods using tetramethylbenzidine (TMB) for electron microscopy (TMB-EM methods) are all unable to provide a maximum demonstration of transported horseradish peroxidase (HRP) while maintaining good ultrastructural tissue preservation. In order to solve this problem, we have attempted to adapt a newly developed, highly sensitive TMB method using sodium tungstate (ST) as the stabilizer (TMB-ST method) for HRP electron microscopic retrograde and anterograde fiber tracing. The present study shows that the TMB-ST method combined with diaminobenzidine-cobalt (DAB-Co) is more sensitive than existing TMB-EM methods and that ultrastructural details are well preserved with this combined method. The resultant reaction product complex after osmication is stable and is observed as characteristic crystal-like structures which are extremely electron dense and often aggregated into clumps. In contrast, the TMB-ST method without the DAB-Co step frequently produces a moderate electron-dense reaction product. Therefore, we recommend the TMB-ST method combined with DAB-Co for HRP electron microscopy.     

高原地区健康老年人重返平原后外周血T细胞亚群变化的观察

用单克隆抗体测定了移居高原的老年人重返平原后的T细胞亚群的变化结果:①移居西宁(2260m)组、天峻(3000m)组在西宁所测的OKT_3、OKT_4、OKT_8及OKT_4/OKT_8值与在苏州所测的当地老年人无差异。②移居西宁组急返平原后OKT_3、OKT_8水平明显低于返回平原后居住一年以上者(以下简称返回组)(P<0.01～0.001)但OKT_4/OKT_8无差异。③返回组与世居苏州老年人相比,前者OKT_3、OKT_4、OKT_8及OKT_4。OKT_8增高,其中OKT_3、OKT_4增高明显(P<0.01～0.02),作者认为长期移居高原返回平原后T细胞亚群也可能存在一“脱适应”阶段,即机体重新调整重新平衡的一种形式,这一阶段可能需一年以上。     

再生医学技术在烧伤传统治疗无效病人中的应用(附38例报告)

目的：总结重度烧伤传统疗法无效改为再生医学(MEBT/MEB0)技术治疗变化规律和临床验．方法：将我科l995年5月至2002年5月收治的院外采用传统疗法无效改用MEBT/MEBO技术治疗的38例重度烧伤病人临床资料进行回顾性总结，病人一旦入院创面均改用MEBT/MEBO治疗，初始予以彻底清创，规范用药、规范操作，规范认识；全身实行系统综合治疗措施．以临床观察和病人感觉评价治疗效果。结果：本组38例全部治愈，末植皮自行愈合者21例．占55.26％．深Ⅲ度创面自愿要求植皮者17例，占44.74％。经随访多数无增生性瘢痕，部分愈后有局限性瘢癌，质软无残废。结论：重度烧伤经传统疗法久治不愈或疗效欠佳病人．病情复杂，并发症较多治疗难度也较大，再生医学可有效改善以上缺陷和病症．是重度烧伤病人传统治疗无效时的理想疗法。