病例125:25岁男性蛋白尿合并高血压

患者,男,25岁,以"发现蛋白尿3年,头痛、呕吐3d"为主诉入院。3年前体检时发现尿蛋白阳性,未引起重视,1年前开始持续出现泡沫尿,久置难消,未监测血压;3天前无明显诱因出现头痛,呕吐胃内容物数次,伴有乏力,无畏冷、发热,无抽搐,无肉眼血尿,无胸闷、胸痛、心悸、气促,无耳鸣、视力模糊,无阵发性心悸、出冷汗,就诊于福建省宁德市寿宁县医院查颅脑CT平扫未见明显异常,测血压180/135mm Hg(1mm Hg=0.133kPa),最高达220/140mm Hg,予以降压治疗后头痛未见明显改善(具体不详)。福建医科大学附属第一医院门诊查     

浅谈如何提高护生的素质

随着卫生事业的飞速发展，人民生活水平普遍提高，患者对护士的服务意识、服务质量、服务要求及服务标准越来越高。而护生在医院实习是整个护理专业的继续，同时也是走向临床工作的前奏，如何使护生把在学校所学的理论知识运用于临床实践，并且熟练地掌握操作技巧，全面提高护生的业务素质是当务之急，也是我们医院医护人员责无旁贷的责任。     

儿童龋损非创伤性修复治疗技术的临床应用

目的评价非创伤性修复（ART）技术治疗乳牙龋损的临床疗效。方法对93例167颗乳牙龋洞，采用ART技术修复，用FX玻璃离子水门汀充填，1年后随访复查；对其中23例同时用ART技术修复第1恒磨牙31颗，2年后随访。结果根据疗效标准乳牙龋损评判成功143颗，成功率为85．63％，失败24颗，占14．37％；恒牙评判成功26颗，成功率为83．87％，失败3颗，占16．13％。结论ART技术是一种较好的治疗早期龋损的方法，单面洞效果优于复面洞，尤其是恒牙，并能减少牙科畏惧症的产生。     

体外诱导骨髓间充质干细胞向肾小管上皮样细胞分化

Objective To investigate the differentiation of rat bone marrow mesenchymal stem cells (MSCs) to renal tubular epithelial-like cells under different conditions. Methods MSCs were obtained from rat marrow. MSCs were isolated by gradient density centrifugation and plastic adherence and then purified. Surface markers were identified with flow cytometry after amplification in vitro. The purified MSCs of the third passage were cultured respectively as follows: (1) control group: DMEM medium with fetal bovine serum(FBS). (2) all-trans retinoic acid (ATRA) group: DMEM medium with FBS, ATRA and ischemic reperfusion-injured kidney tissue homogenate. (3)combination group: DMEM medium with FBS, ATRA, ischemic reperfusion-injured kidney tissue homogenate, epidermal growth factor (EGF) and bone morphogenetic protein 7 (BMP-7). After 7 days, the MSCs were collected for alkaline phosphatase (AKP) staining, cytokeratin-18 and E-cadherin immunocytochemical analysis. Results The positive rates of the third passage MSCs in CD44, CD90 and CD29 were 97.8%±0.9%, 96.8%±1.4% and 97.6%±2.4%,respectively, but in CD11b/c and CD34 were only 13.2%±0.6% and 1.2%±0.5%. The MSCs in control group were spindle. The MSCs in ATRA group were round and elliptic. The MSCs in combination group became cobblestone-like cells after 7 days. AKP staining showed that tubular epithelial-like cells from MSCs in control group were negative, some above cells in ATRA group were positive and number of above cells increased in combination group. Compared with negative control group, the ratios of cytokeratin-18 positive cells in ATRA group and combination group were respectively increassed by 29.47%±1.08% and 47.52%±2.13% (all P<0.05), the ratios of E-cadherin positive cells in ATRA group and combination group were respectively increased by 14.88%±2.46% and 36.15%±1.13% (all P<0.05). Conclusion MSCs may differentiate by renal tubular epithelial-like cells under the induction of ischemic reperfusion-injured kidney tissue homogenate and ATRA in vitro, which are further differentiated under the combined induction of EGF and BMP-7.     

阿片成瘾戒断机制及治疗的研究现状

阿片类药物具有镇痛作用,临床上常将其用于术后和肿瘤病人的止痛。但阿片类药物长期使用会产生耐受和成瘾,这不仅限制了阿片药物的临床应用,而且还造成吸毒这一世界性的社会问题。阿片成瘾是一种慢性复发性脑病,具有很强的顽固性,可产生精神依赖和身体依赖性,一旦停药将产生戒断综合征。其机制复杂,治疗困难,复发率高,已经成为学术界的普遍共识。     

硫酸依替米星与丹参酮磺酸钠注射液存在配伍禁忌

2008年2月,我科在使用硫酸依替米星和丹参酮磺酸钠注射液时发生配伍禁忌反应1例.现报告如下.     

高压氧舱治疗护理心得

高压氧(HBO)是现代医学中的一门新兴学科,是指患者在高于1个大气压的环境里吸入100%的氧治疗疾病。临床工作中,患者经常吸不到100%的氧,我们也把其叫做高压氧治疗。其主要用于缺氧、缺血性疾病,或因此引起的一系列疾病的辅助治疗,现已被广泛应用于临床并被认可。但因其独特的治疗方法和治疗环境造成患者在接受治疗前出现各种不同的心理问题,对治疗效果可造成一定的影响。治疗前后的得当护理可以缓解或消除患者的不良情绪,对治疗效果至关重要。现将高压氧舱治疗护理的体会总结如下。     

孕16~+周胎膜早破保胎成功一例

早产至今仍是全世界产科领域难以攻克的难题,其发生率有逐年升高的趋势。早产儿具有较高的发病率、病死率和后遗症,是新生儿患病和死亡的主要原因,而胎膜早破是发生早产的主要因素之一。早产性胎膜早破选择继续保胎治疗延长孕周还是放弃保胎终止妊娠一直存在争议,绝大多数孕     

大鼠正畸牙牙周膜中增殖细胞核抗原表达的研究

目的通过观察大鼠正畸牙移动过程中牙周膜内增殖细胞核抗原(proliferating cell nuclear antigen,PCNA)的表达变化,探讨正畸过程中细胞增殖变化的机制。方法选用幼年SD大鼠,建立正畸牙移动模型,分别在加力后24 h、3 d、5 d、7 d、14 d、21 d处死动物,制备标本。进行免疫组化分析。结果对照组大鼠牙周组织中增殖细胞核抗原弱表达,实验组牙周膜中张力侧增殖细胞核抗原24 h时表达上调,3、5 d达最顶峰,7 d后逐渐下调,21 d趋于正常。结论正畸力促进牙周组织中细胞增殖,从而完成牙周组织的改建。