硫酸镁联合亚低温治疗对大鼠局灶性脑缺血的保护作用

目的　探讨硫酸镁对SD大鼠局灶性脑缺血损伤的保护作用。方法　将 4 0只大鼠随机分成模型对照组、硫酸镁治疗组、亚低温治疗组、硫酸镁联合亚低温治疗组。采用线栓法建立大鼠局灶性脑缺血模型。通过计算大鼠神经功能缺陷评分 ,测量脑梗死体积 ,观察神经元超微结构改变 ,评定硫酸镁联合亚低温治疗作用。结果各治疗组大鼠神经功能评分及脑梗死体积均显著低于对照组 (P <0 0 5 ) ,联合治疗组大鼠明显低于对照组 (P<0 0 1) ;联合治疗组神经元超微结构改变轻微。结论　硫酸镁联合亚低温治疗对大鼠局灶脑缺血有明显保护作用     

Becoming a mother — an analysis of women's experience of early motherhood

This paper presents the results of a qualitative study conducted by midwife researchers into women's experience of new motherhood. Data were collected using focus groups involving 55 first-time mothers and analysed using grounded theory method. The analysis produced six categories: 'realizing', 'unready', 'drained', 'aloneness', 'loss' and 'working it out'. The core category, 'becoming a mother', integrates all other categories and encapsulates the process of change experienced by women. Also explained are factors mediating the often distressing experience of becoming a mother. The analysis provides a conceptualization of early motherhood enabling the development of strategies for midwives, nurses and others helping women negotiate this challenge.     

Antenatal education – where next?

The history of antenatal education throws light on why contemporary class attenders represent only a particular section of the childbearing population. Since Victorian times, the non-availability of the women's network to middle class women has forced them to seek knowledge of their own bodies, confidence in their childbearing capacities and the support of other women through formal educational opportunities. Research suggests that antenatal classes often fail to provide women with a realistic account of birth and parenting to replace the lived experience of earlier decades and may not be facilitated in such a way as to create the support groups which class attenders critically need. Teaching approaches often promote dependency amongst clients rather than nurturing the decision-making skills required by a consumer-driven maternity service.     

中药蝶脉灵注射液在心肺复苏中脑保护作用的实验研究

目的 探讨中药蝶脉灵注射在心脏骤停时对脑复苏的作用。方法 用电刺激导致室颤制备家兔心脏骤停模型，在光镜和电镜下观察大剂量肾上腺素治疗时，蝶脉灵注射液对脑组织的影响。结果 蝶脉灵注射液对脑细胞有明显的保护作用。结论 蝶脉灵注射液能明显改善心脏骤停时脑缺血性损害，因而有利于脑复苏。     

踝部开放性骨折的急症手术治疗

目的探讨踝部开放性骨折的损伤特点及相关的急症手术技术特点。方法2001年8月至2006年4月，急症手术治疗踝部开放性骨折51例，男39例，女12例；年龄18-72岁，平均36岁。伤口Gustilo分度，Ⅰ度3例，Ⅱ度37例，ⅢA度7例，ⅢB度3例，ⅢC度1例。急诊给予有效抗生素治疗，尽早开始手术。冲洗及彻底清创后，根据骨折类型、粉碎程度及伤口情况制定骨折处理的顺序，依次完成骨折复位、固定。结果48例患者获得随访，随访时间8-48个月，平均26个月。无一例发生深部感染。12例伤口发生浅表皮缘坏死，2例伤口延迟愈合，2例伤口发生浅表感染。踝部骨折在10-18周（平均13周）愈合。采用AOFAS踝后足功能评分标准，48例评分在76-100分，平均90分。结论踝部开放性骨折在急症手术时应彻底清创，注意保护皮肤活力。在处理后踝骨折时，可采用胫骨远端脱出法。多数手术应先精确复位、固定外踝骨折，对旋后内收型、外踝严重粉碎的踝部骨折应先进行内踝骨折的复位、固定。对严重的下胫腓联合分离，应直视下复位且常规使用下胫腓螺钉固定。     

National Alliance for Oral Health Consensus Conference on Medically Necessary Oral Health Care: Legal issues

This paper examines medical malpractice law as it applies to medically necessary oral health care. The basic legal concepts and reported cases involving medically necessary oral health care are reviewed. It is concluded that dental professionals and consumer advocates must advance their educational and legislative advocacy efforts so that health professional colleagues and the public will become aware of the importance of these services and insurers will routinely include coverage of medically necessary oral health care in their medical and dental policies. While failure to provide medically necessary oral health care can be violative of patient rights and legally actionable, medical malpractice litigation should always be the behavior modifier of last resort.