血浆置换术为主救治“克无踪”农药中毒

农药“克无踪”中毒患者，由于无特效解毒药，治疗上缺乏有效的方法，临床死亡率极高。作者通过对37例“克无踪”中毒患者的治疗观察比较，认为血浆置换（PE）是成功救治“克无踪”中毒的有效方法，明显优于对照组。本文详述“克无踪”中毒机理与PE的治疗作用，为提高“克无踪”中毒的抢救成功率,做出有益的探索。     

游离肩胛皮瓣在深度烧伤创面上的应用(附三例报告)

肩胛皮瓣1980年首先应用于临床以来,因其解剖清楚,可取皮面积大,隐蔽而又不损伤供皮区功能,因而它已成为游离皮瓣首选供区。我科采用肩胛皮瓣游离移植修复深度烧伤创面三例,疗效满意。现报道如下:1　临床资料1)　一般资料:2000年1月以来,我科采用肩胛破瓣游离移植修复深度烧伤创面三例。均为男性。年龄各为23、21、44岁。两例为电烧伤,各在伤后第50天、3天手术;另一例为碳火烧伤,伤后193天手术。手术部位各为:右侧头颅颅骨外露(创面11cm×7cm,右手腕部(腕环形电烧伤),右尺动脉栓塞,旋前方肌坏死等),左小腿及右足部(胫骨远端,跖骨外露,创面14…     

肠内免疫营养对烫伤大鼠内毒素和CD14/肿瘤坏死因子-α mRNA表达的影响

目的研究肠内免疫营养物对烫伤大鼠内毒素和CD14 mRNA、肿瘤坏死因子 (TNF)-α mRNA表达的影响及机制。方法致64只SD大鼠总体表面积(TBSA)30％Ⅲ度烫伤, 随机分为肠内免疫营养组(EIN组,32只)和标准肠内营养组(EN组,32只),另取8只大鼠作为伤前正常对照组(N组)。EIN组和EN组均给予等热量(125 Kcal／dl)肠内营养液。分别于伤前、伤后 1、4、7、10 d抽取静脉血和肝组织,检测血清内毒素和TNF-α浓度,RT-PCR检测肝组织CD14 mR- NA、TNF-α mRNA。结果烫伤后EN、EIN组血清内毒素、TNF-α浓度比伤前血清内毒素 (0．125±0．050)和TNF-α浓度(0．85±0．27)显著升高(P<0．01),且肝组织CD14 mRNA、TNF-α mRNA的表达明显增多;在伤后4、7、10 d,EIN组血清内毒素和TNF-α浓度以及肝组织CD14 mR- NA、TNF-α mRNA的表达均比EN组显著降低(P<0．05或P<0．01)。结论肠内免疫营养与标准肠内营养相比,可明显降低烫伤后血清内毒素水平,减少肝组织CD14 mRNA、TNF-α mRNA的表达,从而降低血清TNF-α浓度,改善烫伤后机体炎症反应。     

25例乳腺癌的X线诊断分析

目的：探讨乳腺钼靶X线检查对乳腺癌的诊断价值。我们收集近年来病理证实为乳腺癌有钼靶x线摄片，结果钼靶摄影显示钙化有20例，有肿块或局部致密影5例。结论：多发细小多形性钙化为导管内癌最常见的x线表现，肿块影界线不清为乳腺癌最常见的表现，乳腺钼靶摄片能早期发现临床触及不到的微小癌，为临床手术提供信息。     

脐血树突状细胞介导的食管癌瘤苗体内抗癌效应

背景与目的:用杂交瘤技术制备脐血树突状细胞(DC)和食管癌细胞的融合瘤苗,探讨其在体内诱导抗肿瘤效应.材料与方法:分离脐血CD34+干细胞诱导扩增为成熟DC,与EC109细胞经聚乙二醇(PEG)法融合;免疫磁珠法筛选EC109-DC,鉴定瘤苗表型和致瘤性;观察该瘤苗的体内成瘤性、保护性免疫反应和免疫治疗效果.结果:融合瘤苗可体外生长,并高表达CD80、CD83、CD86和叶酸受体(FR);瘤苗接种小鼠体内未见肿瘤形成;经瘤苗免疫的小鼠,肿瘤生长的潜伏期较对照组明显延长(P＜0.05),肿瘤的大小和肿瘤重量均明显小于对照组(P＜0.05).用融合瘤苗治疗的荷瘤小鼠,肿瘤的大小和重量也均明显小于对照组(P＜0.05).结论:融合瘤苗EC109-DC同时表达EC109和DC特异性抗原,无体内致瘤性,对EC109细胞的攻击有明显的抵抗作用,对治疗荷瘤小鼠有一定的作用.     

血清肿瘤标志物MG7Ag在胃癌诊断中的意义

胃癌是我国常见的恶性肿瘤之一 ,其病死率居各种恶性肿瘤之首。胃癌的确诊有赖于胃镜和病理检查 ,但血清肿瘤标志物具有简便、快速、重复性好、非介入性、便于动态监测等优点 ,已成为当今胃癌诊断的一种重要手段。免疫ＰＣＲ技术是 1992年Ｓａｎｏ等建立的检测微量抗原的高灵敏度技术 ,在理论上免疫ＰＣＲ可以检测到一个分子抗原。本文用免疫ＰＣＲ技术 ,检测胃癌患者血清中胃癌单抗ＭＧ7相关抗原 (ＭＧ7Ａｇ) ,以探讨其对胃癌的诊断意义。1　材料和方法1·1　对象　所有 10 4例患者都为本院和汕头大学医学院肿瘤医院门诊和住院病人。其中胃…     

双因素理论在护理临床教学管理中的应用

目的探讨护理临床教学的管理模式。方法通过教育培训激励、支持激励、利用双因素理论指导奖金发放、主人翁精神激励、个人发展前途激励等方法调动教师积极性。结果临床教师教学积极性明显提高,表现为学生能从临床带教教师中获得更多的支持,学生基本技能、基础理论知识得到提高。结论应用双因素理论加强护理临床教学管理,能调动教师教学积极性,提高教学质量。     

强化精氨酸肠内营养对烧伤患者营养状况和细胞免疫的影响

Objective To investigate the effects of arginine enriched enteral nutrition (EN) on nu-tritional status and cellular immunity of severely burned patients. Methods Randomized, single blind, parallel and positive control investigation was employed in the study. Thirty severely burned patients were di-vided into enteral immune nutrition (EIN) group and EN group. Sixteen patients in EIN group received en-teral nutrition enriched with arginine, while the other 14 patients in EN group received standard enteral nu-trition. Nutritional support was continued for 14 days. Gastrointestinal reaction of patients in 2 groups was observed. Fasting venous blood was drawn from patients of both groups before receiving nutrition treatment and on the morning of 7th, 14th day of treatment. Level of serum protein, hepatic function parameters, renal function parameters, fasting-blood glucose, and subpopulations of T lymphocytes in peripheral blood were determined. Results (1) Incidence of gastrointestinal side effect in EIN group (25.0%) was close to that of EN group (21.4% , P>0.05). (2) Compared with pre-treatment days, levels of prealbumin and transferrin in serum of patients in 2 groups on 7th and 14th post-treatment days were significantly increased (P<0.05 or P<0.01), but there was no significant difference between 2 groups. The level of total serum protein on 14th day of treatment of patients was significantly increased in both groups, and that of EIN group (66±7 g/L)was significantly higher compared with that in EN group (64 ± 11 g/L, P<0.05). The level of serum albumin (29±5, 32±5 g/L, respectively) of patients in EIN group on 7th and 14th day of treat-ment were significantly higher than that (26±4 g/L, P <0.05) in pre-treatment days, however there was no significant difference in EN group. (3) There was no significant difference in respect of hepatic function, renal function, and fasting-blood glucose between pre-treatment and post-treatment periods in both groups (P>0.05). (4) The ratio of CD4+ , CD8+ on 14th day of treatment in EIN group was close to that of pre-treatment level. In EN group, cell percentage of CD4+ significantly decreased, while that of CD8+ significantly increased (P<0.05), and CD4+ was significantly higher [(56±8) %] in EIN group than that in EN group [(55±12) % , P <0.05]. In both groups, cell percentage of CD3+ was significantly higher than that in pre-treatment days (P<0.05), while there was no obvious change in CD4+/CD8+. Conclusions Arginine enriched enteral nutrition can effectively improve nutritional status and cellular immune function of burn patients.     

加强课题管理提高申报中标率

影响科研基金申报中标率的决定因素有申报课题的管理水平、课题的学术水平以及资助的政策要素等。“九五”期间,某院通过加强申报课题的管理力度,严把学术质量关,使科研项目申报中标率明显上升。“九五”期间该院共承担各类课题146例,其中省部级以上课题10项,厅级课题136项,并获得2个广东省“五个一科教兴医”工程重点专科（风湿病学、心血管病学）。