基层护生带教的体会

护理带教工作中的强化计划带教、抓好各种带教、建立健全带教管理制度、因材施教、注重个性发展、充满爱心、热情带教、严格考核、逐项训练.     

液氮冷冻治疗慢性肥厚性鼻炎形态学研究

目的以光镜和电镜观察液氮冷冻治疗慢性肥厚性鼻炎鼻粘膜的变化。方法对３０例病程在１０年左右慢性肥厚性鼻炎患者,于治疗前、第１次治疗后２周和第２次治疗后８～１０周行鼻粘膜活体组织检查,进行光、电镜观察。结果冷冻前鼻粘膜上皮呈不同程度的鳞状化生和增厚。第１次冷冻后２周鼻粘膜上皮退化、脱落,上皮层明显变薄。第２次冷冻后８～１０周鼻粘膜形成新的上皮层,可见较多柱状上皮细胞,并见微绒毛和短纤毛再生,较规整。结论冷冻治疗可改善鼻粘膜病变,从而改善和恢复鼻粘膜生理功能。     

117例女性胸痛患者临床特点分析

目的分析女性胸痛患者的临床特征及冠状动脉造影的特点。方法对我院2000至2004年117例因胸痛入院行冠状动脉造影的女性患者的临床资料及冠状动脉造影结果进行回顾性分析。结果患者平均年龄(68.79±10.27)岁,确诊为冠心病78例,排除39例。典型临床症状的阳性预测值为68%,绝经期后合并高血压、糖尿病发病率高、脂蛋白(Lp)(a)水平较高、血脂、吸烟和家族史对冠心病的预测价值更有意义,围绝经期的4例冠心病均是糖尿病患者。78例冠心病患者中,单支病变18例(23%),2~3支病变57例(73%);简单斑块13例(17%),复杂斑块62例(79%),未见斑块3例(4%)。无创检查中常规心电图、运动试验、超声心动图的阳性预测值分别为74%、90%、95%,准确性分别为70%、59%、74%。结论女性冠心病多见于绝经后的中、老年人群,围绝经期人群中除非伴有糖尿病,通常发病率低,血管病变以多支和复杂斑块的血管病变为主。对并存高血压、糖尿病和Lp(a)水平较高的胸痛患者即使无创检查未发现异常也应尽早行冠状动脉造影检查以明确诊断。     

对七年制临床医学生诊断学的教学管理研究

诊断学教学过程的合理运筹,有利于教学质量的提高.临床医学院完善教学管理机构及诊断学教研室的建设是管理的关键,制订具有符合培养目标的教学大纲,编著内容精炼、可操作性强的教材,采用以突出培养学生学习能力、动手能力为主的教学方式,以及运用序贯教学法和信息技术是保证教学质量管理的重要环节.     

α-甘草酸对肾11β-羟基类固醇脱氢酶的抑制作用

目的观察α-甘草酸降低底物皮质醇的转化率;探讨α-甘草酸对肾脏11β-羟基类固醇脱氢酶(11β-OHSD2)活性和血清K 浓度的影响.方法运用微粒体酶分析技术,在离体和整体实验中观察在α-甘草酸作用下,11β-0HSD2对底物皮质醇转化率的变化,并测定整体实验中豚鼠的血清K 浓度.结果(1)离体实验:在α-甘草酸作用下,11β-0HSD2对底物皮质醇的转化率为38.80%,与阴性对照(71.80%)、β-甘草酸(21.50%)相比,差别均有显著性意义(均P＜0.05).(2)整体实验:α-甘草酸中、高剂量均能明显降低豚鼠的血清KK 度(7.08mmol/L、5.34mmol/L,与阴性对照(8.83mmol/L、β-甘草酸(4.86mmol/L)相比,差别均有显著性意义(均P＜0.05).结论α-甘草酸能抑制豚鼠肾脏11β-0HSD2活性,导致豚鼠血清K 浓度降低,但与β-甘草酸相比,作用较弱.     

Altered lymphocyte subsets and natural killer cells of patients with obstructive jaundice in perioperative period

Summary Sepsis is a common and occasionally lethal complication of obstructive jaundice. The reasons for the increased susceptibility to infection are not fully understood. This study was conducted to examine lymphocyte subsets and natural killer cells of patients with obstructive jaundice in perioperative period. In these patients, when compared with normal controls, there was a significant reduction in the percentage of Leu 4 (pan T lymphocytes), Leu 3a (T helper cells) and Leu 7 (natural killer cells) before operation, and the immune suppression induced by surgical operation was more marked and persistent.     

氯沙坦及其代谢物在汉族朝鲜族和维吾尔族健康人体的药动学比较

目的 研究中国汉族、朝鲜族和维吾尔族健康受试者单剂量口服氯沙坦钾片后原形药物及代谢产物的药动学特征.方法 健康受试者30名(其中汉族、朝鲜族、维吾尔族各10名,男女各半),口服单剂量氯沙坦钾片50 mg;用高效液相荧光法测定氯沙坦及其代谢物E-3174血药浓度,DAS2.0软件程序进行数据处理并采用SPSS13.0软件...     

视网膜色素变性的黄斑局部视网膜电图频谱分析

目的 通过对黄斑局部视网膜电图（ＬＥＲＧ）的Ｆｏｕｒｉｅｒ分析,进一步了解视网膜色素变性（ＲＰ）患者黄斑部光感受器细胞与光感受器后神经元细胞功能异常的情况。方法 ４９例ＲＰ患者的ＩＥＲＧ被记录研究。应用手提眼底镜式局部刺激器通过放大的瞳孔直视眼底监控固视状况,闪烁光频率３１Ｈｚ。结果 与对照组相比,ＬＥＲ的基波（ｆｕｎｄａｍｅｎｔａｌ ｈａｒｍｏｎｉｃ,ｉｆ）与二次谐波（ｓｅｃｏｎｄ ｈａｍｏｎｉ     

Implementation of the pre-operative rehabilitation recovery protocol and its effect on the quality of recovery after colorectal surgeries

Background:Patients’ recovery after surgery is the major concern for all perioperative clinicians. This study aims to minimize the side effects of peri-operative surgical stress and accelerate patients’ recovery of gastrointestinal (GI) function and quality of life after colorectal surgeries, an enhanced recovery protocol based on pre-operative rehabilitation was implemented and its effect was explored.Methods:A prospective randomized controlled clinical trial was conducted, patients were recruited from January 2018 to September 2019 in this study. Patients scheduled for elective colorectal surgeries were randomly allocated to receive either standardized enhanced recovery after surgery (S-ERAS) group or enhanced recovery after surgery based on pre-operative rehabilitation (group PR-ERAS). In the group PR-ERAS, on top of recommended peri-operative strategies for enhanced recovery, formatted rehabilitation exercises pre-operatively were carried out. The primary outcome was the quality of GI recovery measured with I-FEED scoring. Secondary outcomes were quality of life scores and strength of handgrip; the incidence of adverse events till 30 days post-operatively was also analyzed.Results:A total of 240 patients were scrutinized and 213 eligible patients were enrolled, who were randomly allocated to the group S-ERAS (n = 104) and group PR-ERAS (n = 109). The percentage of normal recovery graded by I-FEED scoring was higher in group PR-ERAS (79.0% vs. 64.3%, P < 0.050). The subscores of life ability and physical well-being at post-operative 72 h were significantly improved in the group PR-ERAS using quality of recovery score (QOR-40) questionnaire (P < 0.050). The strength of hand grip post-operatively was also improved in the group PR-ERAS (P < 0.050). The incidence of bowel-related and other adverse events was similar in both groups till 30 days post-operatively (P > 0.050).Conclusions:Peri-operative rehabilitation exercise might be another benevolent factor for early recovery of GI function and life of quality after colorectal surgery. Newer, more surgery-specific rehabilitation recovery protocol merits further exploration for these patients.Trial Registration:ChiCTR.org.cn, ChiCTR-ONRC-14005096