儿童癫痫患者剥夺睡眠—自然睡眠脑电图检查分析

为提高癫痫脑电图的阳性率，我院在1998—03—2004-03共对94例临床诊断为癫痫，而常规清醒时脑电图未见异常的患者进行了剥夺睡眠一自然睡眠时的脑电图监测。现将结果报告如下。     

老年妇科病的临床处理

老年妇女的内科合并症多，因而围手术期危险因素增加，对老年患者要重视围手术期的处理。为了进一步探讨老年妇女围手术期的管理，本文对我院109例施行妇科手术的老年妇女进行了回顾性分析，报告如下。     

健康管理对老年人慢性疾病的干预效果评价

目的 评价健康管理干预手段对老年人慢性疾病的效果,为老年人慢性疾病防治提供建议。方法 招募2013年3～12月到南京市某社区医院进行体检的60岁及以上老年人作为调查对象,筛选患有高血压、糖尿病患者654名,随机分成管理组和对照组,管理组进行为期18个月的健康管理,对照组常规管理,比较管理前后的客观指标和生命质量改变情况。结果 健康管理干预后,管理组与对照组相比,收缩压控制平均降低（5.56±1.66）mmHg、舒张压控制平均降低（2.94±1.24）mmHg、血糖控制平均降低（0.70±0.12）mmol/L,差异均具有统计学意义（均有P<0.05）。生命质量方面,管理组与对照组相比,躯体功能得分平均提高（0.81±0.06）分、心理功能得分平均提高（0.75±0.07）分、社会功能方得分平均提高（0.81±0.09）分、糖尿病特异模块得分平均提高（2.07±0.10）分、生命质量得分平均提高（0.95±0.04）分、而高血压特异模块得分平均降低（0.67±1.12）分,差异均具有统计学意义（均有P<0.05）。由多水平模型可知,在管理期内,管理组生命质量得分每月增加0.03分,对照组生命质量得分每月减少0.04分。老年人慢性疾病患者的生命质量随时间迁移有所提升。结论 健康管理的实施有利于慢性疾病患者对血压及血糖的控制,且对老年人慢性病患者生命质量的提高具有一定的积极作用。     

静脉输注头孢曲松钠致机体过敏的护理

头孢曲松钠是第三代头孢菌素类抗生素，抗菌谱广，变态反应较青霉素少，在临床上应用广泛，但静脉输注头孢曲松钠仍可发生变态反应，一般常见的反应主要表现为全身皮疹、荨麻疹、面部口唇及四肢麻木、头晕眼花、腹痛腹泻等，严重者可发生喉头水肿、过敏性休克，甚至窒息死亡。     

儿童癫痫动态脑电图45例分析

24小时动态脑电图（AEEG）自1978年问世以来已是临床上诊断癫痫不可缺少的检查，大大提高了癫痫病人的痫样放电检出率。本文采集本院2001-2003年常规脑电图（REEG）检查无痫样放电活动患儿，行24小时动态脑电图监测并将结果加以分析，报告如下。     

通视达电子视频喉镜在气管插管全身麻醉中的运用

目的：探讨通视达TSEL-110型电子视频喉镜在经口气管插管中的优势。方法：选择传统直接喉镜喉显露Cormack-Lehane分级为3级的全麻病人50例,随机分成通视达电子喉镜组和传统直接喉镜组各25例,观察两组声门改善率、插管一次成功率及插管并发症。结果：两组声门改善率、插管一次成功率及插管并发症有明显的差异。结论：通视达电子视频喉镜在经口气管插管,特别是困难气道插管中比普通喉镜声门显露更明显,插管成功率高,插管并发症更少、更安全。     

Postcoital administration of asoprisnil inhibited embryo implantation and disturbed ultrastructure of endometrium in implantation window in mice

Asoprisnil, a member of the selective progesterone receptor modulators, exerts high progesterone receptor selectivity, endometrial targeted advantages and significant anti-implantation effect in rats. The purpose of this study was to confirm the anti-implantation effect of asoprisil, investigate the ultrastructural changes of the peri-implantation endometrium in mice and explore the effect of asoprisnil on endometrial receptivity and its targeted contraceptive proficiency. Post-coitus mice were administered with different dosages (0.2, 0.1, 0.05 mg·g -1 ·day -1 ) of asoprisnil from day 1 of pregnancy to day 3. Then 3 animals in each group were killed on day 5 of pregnancy, and uteri were collected to examine the ultrastructural changes of endometria under a transmission electron microscope (TEM). A total of 80 animals were sacrificed on day 8 of pregnancy, and the uterine horns were examined for the presence or absence of nidation sites and the number of implantation embryos. The results showed that the implantation rate and the average number of implantation embryos in asoprisnil groups were statistically significantly decreased as compared with the vehicle control group (P<0.05). The TEM results revealed that, in vehicle control group, the tight junction between the luminal epithelia cells was short and straight, the gap was wide; the luminal epithelia cells were covered with plenty of short, clavate and neatly arranged microvilli; the endometril stromal cells were large with plenty of cytoplasm, and showed significant decidual change; there was more than one nucleus in stromal cells, and the karyotheca was integrity. In low dosage and high dosage asoprisnil groups, the tight junction was longer and more curve than in the vehicle control group; microvilli were uneven and asymmetrically distributed in luminal epithelia; the stromal cells were small and the decidual change was not significant; there were karyopyknosis and karyolysis in stromal cells; there were abnormal thick-wall vessels in the endometrium. It was suggested that asoprisnil changed the ultrastructure of the endometrium in implantation window, disturbed the endometrial receptivity and finally resulted in embryo implantation failure.     

中医药治疗乳腺癌内分泌综合征研究进展

乳腺癌内分泌综合征是乳腺癌患者内分泌治疗后出现的一系列类更年期综合征的临床症候群。其特点是发生几率高、临床症状复杂多样。西医缺乏有效的治疗方法。此病属于中医＂郁证＂＂不寐＂＂百合病＂等范畴,主要病机是肝郁气滞、肝肾不足、阴虚火旺,病位主要在肝、肾。临床多选用疏肝解郁、补益肝肾、调理冲任的治法。但温补肾阳中药是否会提高雌激素水平导致乳腺癌复发还有待进一步研究。