企业纵横

◎ “中国医院信息化建设推进工程”项目研讨会在京隆重召开“中国医院信息化建设推进工程”项目研讨会于2004年8月8日上午在北京友谊宾馆隆重召开,卫生部原部长钱信忠、国家发展研究中心局长邓寿鹏、信息产业部电子信息中心副主任刘献军等领导应邀出席了会议。随着信息技术的不断发展和人们对医疗保健水平要求的不断提高,建设数字化医院已越来越引起业内外人士的普遍关注并取得初步成效。但建设速度还落后于时代发展步伐。中国信息化推进联盟医药卫生专业委员会针对当前我国医院信息化建设的实际,与北京中科恒业创新科技有限公司等具有技术…     

整合卫生资源促进健康发展——历下区成立医疗协会

今天，驻历下区省、市、区三级医院和武警、边防、厂矿企业学校及民营医疗机构400余家，在历下大厦4楼会议室隆重聚会，共同祝贺济南市历下区医疗协会正式成立。据悉，县区级成立医疗机构协会组织在济南市乃至全省尚属首家。     

1岁以下小儿腭裂手术麻醉期间呼吸道管理体会

1岁以下小儿腭裂手术麻醉成功与否的关键在于麻醉期间呼吸道管理，本文通过对1999～2003年间我院治疗的28例1岁以下腭裂手术患儿的观察，探讨婴儿腭裂手术麻醉期间呼吸道管理的一些特点。     

不同门奇断流术式对门静脉高压症犬食管下段血管再生的影响

Objective To explore the effect on blood vessel regeneration of distal esophagus in ca-nines of portal hypertension with liver cirrhosis after different procedures with paraesophagastrie devascular-ization. Methods Portal hypertension models were produced in canines by subcutaneous injection of 60% CC14 combined with food restriction. Forty eight model canines were randomly divided into 4 groups: group A, traditional paraesophagastrie devascularization;group B, selective paraesophagastric devascularization;group C, paraesophagastric devascularization plus distal esophageal transaction and reanastomosis with sta-pler;group D,control group. Every group had 12 canines which were randomly divided into A1 ,B1 ,C1 ,D1, A2,B2,C2 and D2 groups after the operation. Canines in groups A1 ,B1 ,C1 and D1 were executed at first month after the operation,and those in groups A2, B2, C2 and D2 were executed at the 6th month after the operation. The distal esophagus was segmented when the canines were executed. The upside and downside of the stoma in group C were distinguished and signed as Ca and Cb. Immunohistochemieal methods were used to detect VEGF,CD34 and FVⅧ-Rag,blood vessel-related factors,in lower esophagus. Results The expres-sion levels of VEGF and CD34 MVD,FⅧ-Rag MVD in groups A1 ,B1 and C1 were lower than those in group D1 one month after the operation (P <0.05). All the indices in group B1 were lower than those in groups A1 and Clb,but higher than those in group Cla (P <0.05). The indices in group Cla were lower than those in group C1b (P < 0.05 ). The indices in groups A2 and B2 were higher than those in groups A1 and B1, re-spectively at the 6th month after the operation (P <0.05). They were higer in outer membrane in group C1a than in group C2a (P <0.05). The indices in group C2b were higher than those in group Clb (P<0.05). Conclusion At the first month after operation, the expression of blood vessel-related factors was declined in three different procedures of paraesophagastric devascularization,which indicated that all three different pro-cedures could diminish the vessels in distal esophagus. The effect in group C was most obvious among all groups. At the 6th month after traditional paraesophagastrie devascularization and selective paraesophagastrie devascularization, the expression of blood vessel-related factors in distal esophagus was declined. But there were no significant changes in the expression of blood vessel-related factors in distal esophagus after parae-sophagastric devascularization plus distal esophageal transaction and reanastomosis with stapler. It indicated that the blood vessel regeneration in paraesophagastric devascularization pins distal esophageal transaction and reanastomosis with stapler was inferior to that in other procedures.     

大鼠心肌缺血再灌注时心肌细胞凋亡caspase-3活性变化规律及药物对其影响

目的　探讨大鼠心肌缺血再灌注 (Ischemiareperfusion ,IR)不同时相的心肌细胞凋亡、caspase 3活性变化规律及caspase 3抑制剂Ac DEVD CHO的影响。方法　Wistar大鼠 12 2只 ,设立IR组 ,IR +Ac DEVD CHO组和假手术对照组并分设缺血 3 0min后再灌注 1、3、6、12、2 4h 5个时相点 ;以缺口末端标记法 (TUNEL)标记凋亡细胞 ,用荧光分析法检测caspase 3活性 ,行TTC染色测定心肌梗死范围。结果　心肌细胞凋亡与caspase 3活性随心肌再灌注不同时相而变化 ,心肌细胞凋亡指数 (Apoptosisindex ,AI)与caspase 3活性于再灌注 12h最高 [AI :( 3 4 83± 9 3 5 ) % ;caspase 3活性 :( 1 3 4±0 2 ) ] ,其后基本维持在平台状态 ;心肌梗死范围随IR时间逐渐增加 ,至 2 4h仍未见下降趋势 ,三者间呈显著正相关 (P <0 0 5 )。IR +Ac DEVD CHO组上述指标虽也明显增高 ,但比IR组明显减小 (P <0 0 5 )。结论　Caspase 3激活及心肌细胞凋亡参与了心肌缺血再灌注损伤过程 ,Ac DEVD CHO减轻心肌缺血再灌注损伤可能部分与其抑制心肌细胞凋亡有关。     

孕产妇的心理护理体会

随着医学模式的转变和护理技术的发展 ,护理对象的心理研究与护理学结合 ,已发展成为护理心理学。运用护理心理学进行心理护理 ,使护患心理达到相互配合的效果 ,提高护理质量 ,已被医护人员所接受和认同。我科护理人员从对孕产妇实施心理护理以来 ,认真做好不同时期的心理护理 ,对病人的妊振、分娩、康复起着至关重要的作用。1　临床资料本组产妇 5 6 3例 ,年龄 2 4～ 31岁 ;平均 2 7.6 3岁。其中孕1产12 74例 ,孕2 产173例 ,孕2 产2 189例 ,孕3 产137例 ;经阴道分娩 387例 ,其中正常分娩 2 4 6例 ,会阴侧切 94例 ,臀位助产 4 7例 ,剖宫产 1…     

静脉输液加药后的微粒变化

本文对我院急诊病人常用的供静脉给药的22种药物、42组配伍情况,制成静脉加药输液,在超净工作台条件下,用KF—4型微粒计数器,测定了168次微粒数,结果显示输液加药后微粒虽有增加,但均在药典规定范围内。输液中加1种、2种、3种药物后所产生的微粒数分别为x_1=5.52(n_1=16);x_2=8.17(n_2=18)、x_3=10.25(n_3=8),经统计处理,三组间无显著差异(P<0.05)。本文对产生微粒的药物、注射器、操作环境等因素进行了分析。     

肝外伤后胆道周期性出血3例报告

1 引言肝外伤后胆道周期性出血是由于创伤引起肝内血管与胆管的病理性沟通的结果。血液通过肝内肝外胆道,进入十二指肠而引起消化道出血,以便血为主。我院1978年5月～1985年6月共收治3例,报告如下。     

加替沙星注射液致过敏性休克1例

1病例资料患者,男,40岁,因右足破溃不愈合20年来我院要求行截肢手术治疗。入院查体T:36.6°C,P:82/min,R∶20/min,BP:140/90mmHg。既往无药物过敏史,青霉素、普鲁卡因皮试均     

实验性猫眼视网膜静脉阻塞后视网膜功能变化的观察

视网膜中央静脉阻塞（CRVO）是常见的高致盲性视网膜血管病，对其病因和自然病程至今未能透彻了解，也一直缺乏确切有效疗法。我们应用光动力方法阻塞猫视网膜全部三支主干静脉，以求尽量模拟人类CRVO所致的视网膜病变表现，观察闪光视网膜电图（FERG）b波变化情况，以期对CRVO的发展过程有更深入了解，现将结果报道如下。