脑立体定向血肿清除术治疗高血压脑出血的术后护理

目的 探讨立体定向血肿清除术治疗高血压脑出血术后护理对策.方法 对126例高血压脑出血病人立体定向血肿清除术后护理作回顾性分析.结果 10例12 h拔管,36例3 d拔管,52例3～5 d拔管,28例5 d 以上拔管.治愈40例,好转76例,死亡10例.结论 对高血压脑出血立体定向血肿清除术后并发症及术后再出血病人采取相应的护理对策可降低病死率.     

重组sCR1在毕赤酵母细胞中的表达、纯化及鉴定

目的:酵母细胞SMD 1168表达人sCR1,并对重组蛋白进行纯化。方法:从人外周血中提取总RNA,应用RT-PCR获得人sCR1全长cDNA,将其克隆入真核表达载体pPIC9K,构建含人sCR1的重组质粒(pPIC9K-sCR1);经测序鉴定正确后,将重组质粒转化入毕赤酵母菌细胞SMD 1168中,经甲醇诱导,表达产物经SDS-PAGE分析及W estern b lot鉴定,并通过N i2+-NTA agarose亲和层析纯化。结果:经甲醇诱导的含pPIC9K-sCR1的酵母细胞表达出重组人sCR1的融合蛋白,48~72 h sCR1融合蛋白表达量最高。此蛋白在凝胶上表现为M r大于31 KDa的蛋白区带,在W estern b lot分析中可被sCR1的CD35单克隆抗体(mAb)识别。经N i2+-NTA agarose亲和层析纯化后得到较纯的sCR1融合蛋白。结论:人sCR1融合蛋白在酵母细胞表达系统中的高水平表达,并且有与人体天然蛋白相同的抗原活性。     

pcDNA3.1-hTERT真核表达载体的构建及其抗肿瘤效应

目的:构建人端粒酶逆转录酶(hTERT)真核表达载体pcDNA3.1-hTERT,并观察其对荷瘤小鼠的抗肿瘤效应.方法:用RT-PCR方法扩增出带有Hind Ⅲ, BamHⅠ酶切位点的hTERT基因片段,与pGEM-T Easy克隆载体连接,筛选出阳性克隆,酶切获得目的片段,与pcDNA3.1载体连接,构建pcDNA3.1-hTERT表达载体.将真核表达载体pcDNA3.1-hTERT注射移植性H22肝癌模型C57BL/6小鼠,并设PBS组及转染空质粒pcDNA3.1组,观察3组的抗肿瘤效应.结果与结论:成功构建pcDNA3.1-hTERT真核表达载体.该载体中的hTERT基因片段全长为951 bp,可编码相对分子量为37 000、由317个氨基酸构成的多肽.该基因片段与GenBank公布的相应基因进行同源性比较,核苷酸序列的同源性为98.73%,编码产物的氨基酸序列的同源性为99.68%.该真核表达载体免疫荷瘤小鼠后,pcDNA3.1-hTERT组肿瘤生长受到抑制,且该组生存期分别长于PBS组及pcDNA3.1组 (P<0.05);pcDNA3.1- hTERT组的IL-2、IFN-γ细胞因子水平也均高于PBS组与pcDNA3.1组(P<0.05).提示该真核表达载体在受试动物体内可有效地诱导特异性抗肿瘤免疫应答.     

Pathological features of gastric cancer in Zhuanghe high-risk area in China during 1992–2005

Objective  To investigate the pathological features and chronological changes of 1003 cases with gastric cancer in Zhuanghe high-risk area during 1992–2005 and the relationship between the changes and etiology factors in order to make a clue for gastric cancer prevention. Methods  A total of 1003 gastric cancer specimens resected surgically between 1992–2005 in Zhuanghe Center Hospital were studied. The specimens were fixed in formalin and diagnosed by routine pathology. Results  The incidence of patients with gastric cancer was highest at age of 60–69, the next high was at age of 50–59 and it was significantly higher in male than in female (P<0.001), the ratio was 3.0:1. During the past 14 years, there were 159 (15.9%) EGC, 195 (19.4%) moderate and 649 (64.7%) advanced gastric cancer detected. In macroscopical features, type III remained dominant in EGC, the next was mixed type in EGC. In advanced gastric cancer the Borrmann’s type III remained the dominant, the next was type II. For nodal metastasis, positive cases were decreasing and negative were increasing in EGC, moreover negative cases were higher than positive ones each year. There was no obvious trend in advanced cancer but positive cases were higher than negative ones each year. In histological features, papillary, moderately and poorly differentiated tubular adenocarcinoma remained downtrend, mucus adenocarcinoma and undifferentiation cancer remained uptrend year after year. The radio of intestinal to diffuse type decreased from 0.78 to 0.62 during the past 14 years. Conclusion  There were significant chorological trends of pathological characteristic of gastric cancer in Zhuanghe high-risk area during the past 14 years. This work was supported by the National “Tenth-Five” Key Technologies R&D Program of China (2004BA703B04-02)     

机械通气治疗急性中毒所致呼吸衰竭35例

各种毒物、药物急性中毒导致呼吸衰竭是临床上常见的疾病之一.机械通气(MV)是抢救此类患者最有效的措施.我科2005年9月～2006年10月抢救急性中毒致呼吸衰竭患者35例,现报告如下. 1 资料与方法     

蜂贝化瘀胶囊对糖尿病微血管病变相关指标的影响

目的观察蜂贝化瘀胶囊对2型糖尿病(DM)大鼠微血管病变的作用及机理。方法将Wistar大鼠分为正常对照组、DM模型组、中药治疗组、中药对照组和西药对照组,测定各组大鼠血糖、血脂、脂质过氧化物、糖基化终末产物、醛糖还原酶(AR)及相关基因表达的变化。结果DM模型组大鼠血糖、甘油三酯、糖化血红蛋白、AR活性、丙二醛和T细胞凋亡率均明显上升,T细胞中Fas配体(FasL)、脂肪细胞中肿瘤坏死因子α(TNF-α)基因表达均明显增高,中药治疗组大鼠以上指标显著降低,与DM模型组比较差异有显著性意义(P<0.05)。结论蜂贝化瘀胶囊能有效降低2型DM模型组大鼠的血糖、血脂、糖化血红蛋白、AR活性和丙二醛含量,减少相关基因表达和T细胞凋亡率,对2型DM微血管病变有较好的治疗作用。     

鼻内窥镜下微波治疗鼻出血

严重鼻出血是耳鼻喉科急症之一，可由鼻腔局部病变和全身病变引起，而对出血的鼻腔血管有效封闭是治疗鼻出血的关键。近年来临床治疗鼻出血的方法很多，我们采用鼻内窥镜引导下微波治疗鼻出血，具有止血准确和迅速、止血效果好、损伤和痛苦小的优点，取得了很好的疗效。现将我科自2001年6月至2004年9月间病例报告如下。     

大剂量东茛菪碱治疗新生儿缺氧缺血性脑病23例

自1995年以来笔者使用大剂量东莨菪碱抢救23例新生儿。缺氧缺血性脑病反复窒息，效果良好。现报告如下：     

先天性副泪小点一例

患者,男,21岁。因双眼痒2周就诊,全身体格检查未见异常。眼科检查:双眼视力1·0;双眼结膜充血( ),睑结膜少量滤泡增生。左眼下睑缘见两个泪小点,位于距内眦约2 mm的睑缘内侧的泪小点开口为椭圆形,约5 mm×1 mm,较难发现(鼻侧),睑缘内侧距内眦约8 mm处的泪小点开口呈圆形,直径约1 mm(颞侧)(图1)。泪道探通术发现两泪小点与各自的泪小管相通,分别距泪囊7 mm、11 mm,均能通达泪囊。冲洗泪道见上泪小点及下两个泪小点均通畅。用泪道探针从颞侧泪小点探入并留针,从鼻侧泪小点用冲洗针头刺入,感觉冲洗针头从探针上方通过(图2)。诊断:左眼先天性副…     

提高消毒供应室质量控制与对策

医院消毒供应室的工作质量直接影响医疗护理质量，也是预防和降低医院感染发生的关键环节。因此，以满足临床需要为服务目标，为临床提供高质量的无菌物品，应加强供应室各个工作环节的质量控制，持续改进工作质量，以适应现代化医院发展的步伐。现将我院具体做法介绍如下：