论胸腔积液穿刺留置引流的护理措施

胸腔积液是临床上常见和多发的疾病,可因大量的积液压迫肺组织而引起呼吸困难和胸闷.传统的胸腔积液常采用反复胸腔穿刺抽液,但往往需反复多次,并发症较多,且患者耐受差;我科2006年6月-2011年6月共开展中心静脉导管置管治疗胸腔积液120例,取得满意疗效,且并发症较少,操作简便,现将护理体会报道如下     

后腹腔镜肾癌根治术的技巧与体会

目的:探讨后腹腔镜肾癌根治术的手术技巧。方法:回顾性分析110例后腹腔镜肾癌根治术患者的临床资料。结果:110例中,8例中转开放手术,102例经后腹腔镜获得成功。手术时间60²20 min,术中出血量约20220 min,术中出血量约20¹80 ml。术后随访3180 ml。术后随访3²4个月,未见严重并发症及肿瘤复发或转移。结论:后腹腔镜肾癌根治术具有微创手术解剖清晰、创伤小、出血少、恢复快等优点。术者的经验和熟练的手术技巧可有效降低患者术后并发症。     

Frequency of cognitive impairment and depression in Parkinson's disease: A preliminary case-control study

Background:

This study aimed to determine the frequency of cognitive impairment and depression in our Parkinson''s Disease (PD) and their relationship with disease severity and disability.

Patients and Methods:

A total of 40 PD patients and 40 age-, sex-, and educationally matched controls were studied. The Unified Parkinson Disease Rating Scale (UPDRS) Motor and Activities of Daily Living (ADL) scores and the Hoehn and Yahr (HY) stage were documented. Depression was assessed using the Zung Self-Rating Depression Scale (ZSDS), while cognition was evaluated using a composite score of the mini-mental state examination (MMSE) score and category fluency score.

Results:

A total of 55% (22/40) of PD and 10% (4 of 40) of controls had depression (P<0.001). A total of 60% of PD (24/40) and 5% of controls (2/40) had cognitive impairment (P<0.001). Both NMS coexisted in 16 of 40 PD (40%) compared with none of the controls (P<0.001). UPDRS (motor and ADL) scores and HY stage were significantly worse with impaired ZSDS scores - P 0.001. UPDRS ADL was significantly impaired by the presence of cognitive impairment. Coexisting depression and cognitive impairment were associated with significant worsening of all scores of severity and disability.

Conclusion:

Cognitive impairment and depression accompany our PD and are related to disability and worsening disease severity.     

CXCL1 regulation of oligodendrocyte progenitor cell migration is independent of calcium signaling

Cell migration is an indispensable aspect of tissue patterning during embryonic development. Oligodendrocytes, the myelinating cells of the central nervous system, migrate significantly during development of the brain. Several growth factors have been identified as being critical regulators of oligodendrocyte progenitor migration, including platelet derived growth factor-A (PDGFA), and fibroblast growth factor-2 (FGF2). Further, the chemokine CXCL1 has been shown to play a critical role in regulating the dispersal of oligodendrocyte progenitors during development, although the mechanisms underlying this regulation are unknown. Previous studies have also shown that calcium flux is required for oligodendrocyte progenitor migration. CXCL1 induces calcium flux in cells; therefore, we hypothesized that CXCL1 inhibition of oligodendrocyte progenitor migration is regulated via changes in intracellular calcium flux. The current study shows that CXCL1 inhibition of oligodendrocyte progenitor migration is independent of calcium signaling. Further, we show that CXCL1 inhibition of oligodendrocyte progenitor migration is specific to PDGFA induced migration. Finally, we show that CXCL1 inhibition of oligodendrocyte progenitor migration is independent of activation of the cell cycle. Our results provide intriguing results relevant to specific aspects of patterning of white matter tracts in the central nervous system, and may further the understanding of tissue remodeling seen during disease-related processes.     

有丝分裂阻滞缺陷蛋白2在子宫内膜癌组织中的表达及临床意义

目的研究有丝分裂阻滞缺陷蛋白2(MAD2)在子宫内膜癌组织的表达及其临床意义。方法应用免疫组织化学方法检测60例子宫内膜癌和15例良性增生期子宫内膜组织中MAD2蛋白表达情况,分析其表达与临床特征的关系。结果 MAD2在子宫内膜癌组织中表达强度高于良性增生子宫内膜组织。根据染色强度将子宫内膜癌患者分为高表达组及低表达组,MAD2高表达与淋巴转移、手术病理分期有关,而与患者年龄、病理类型、组织学分化程度及激素受体表达无关。MAD2高表达组患者生存期明显短于低表达组。结论子宫内膜癌组织MAD2表达强度与其肿瘤的生物学行为及预后密切相关。     

新时期培育与弘扬医疗卫生职业精神的思考

通过从精神文明建设、医疗卫生体制改革、和谐医患关系、调动医务人员积极性四个方面阐述新时期培育和弘扬医疗卫生职业精神的重要意义,理解不同时期医疗卫生职业精神的内涵,提出以实施"五心"工程来培育和弘扬医疗卫生职业精神,即实施核心工程,坚持人文精神与科学精神的统一;实施爱心工程,推进人文关怀与理性教育的统一;实施信心工程,把握价值性追求与工具性追求的统一;实施连心工程,实现自我约束和外在监督的统一;实施忠心工程,促进主体性和创造性的统一。     

MSCT增强扫描在儿童肾母细胞瘤诊断中的应用

目的探讨MSCT增强扫描在儿童肾母细胞瘤诊断中的应用价值。方法回顾性分析44例经手术和病理证实为肾母细胞瘤的MSCT表现。所有病例均采用GE公司Lightspeed 16排MSCT机行常规平扫与增强扫描。结果发生于左肾25例,右肾18例,双肾1例。MSCT平扫多表现为肾实质内混杂密度肿块,增强后常表现为强化不均匀的肿块,瘤内常有坏死、囊变,少数有出血、钙化,典型表现为残存肾实质呈＂新月形＂强化。结论 MSCT增强扫描可以清晰地显示儿童肾母细胞瘤的大小、形态、密度、侵犯的范围及转移情况,并对肿瘤的诊断、制定临床治疗方案及估计预后有重要的意义,可作为首选的检查方法。     

外伤性肾上腺血肿的CT诊断分析

目的探讨CT在外伤性肾上腺血肿诊断中的价值。方法搜集并分析我院15例外伤性肾上腺血肿的CT影像表现。结果外伤性肾上腺血肿的直接征象是肾上腺区圆形或类圆形软组织密度灶,增强扫描病灶无强化是本病的特点。结论 CT扫描对外伤性肾上腺血肿的检出和诊断具有重要价值,增强扫描有助于外伤性肾上腺血肿定性鉴别诊断。     

腹股沟皮纹小切口与传统法行小儿腹股沟疝疝囊高位结扎的对比研究

目的:探讨腹股沟皮纹小切口行疝囊高位结扎治疗小儿腹股沟疝的临床价值。方法:回顾分析本院2007年1月-2011年1月117例行小儿腹股沟疝手术患者的临床资料,其中68例行传统腹股沟斜切口治疗,为A组,49例经腹股沟皮纹小切口治疗,为B组,比较两种手术方式在手术时间、术中出血、切口大小、并发症发生、住院时间等方面的差异。结果:两组患儿均全部治愈,在手术时间上两组比较差异无统计学意义(P0.05),切口大小、术中出血、并发症发生及住院时间上B组均优于A组,差异具有统计学意义(P0.05)。结论:腹股沟皮纹小切口疝囊高位结扎术是一种创伤小、操作简单、安全性高、恢复快、并发症少的治疗方法,适合基层推广。     

Inhibition of α-amylase and α-glucosidase activities by ethanolic extract of Telfairia occidentalis (fluted pumpkin) leaf

Objective

To investigate the inhibitory effect of Telfairia occidentalis Hook f. (Curcubitaceae) (T. occidentalis) leaf on key enzyme linked to type-2 diabetes (α - amylase and α - glucosidase) as well as assess the effect of blanching (a commonly practiced food processing technique) of the vegetable on these key enzymes.

Methods

Fresh leaves of T. occidentalis were blanched in hot water for 10 minutes, and the extracts of both the fresh and blanched vegetables were prepared and used for subsequent analysis. The inhibitory effect of the extract on α - amylase and α - glucosidase activities as well as some antioxidant parameter was determined in vitro.

Results

The result revealed that unprocessed T. occidentalis leaf reduce Fe³⁺ to Fe²⁺ and also inhibited α - amylase and α - glucosidase activities in a dose dependent manner. However, blanching of the leafy vegetables caused a significant (P<0.05) increase in the antioxidant properties but decrease their ability to inhibit α - amylase and α - glucosidase activities.

Conclusions

This antioxidant properties and enzyme inhibition could be part of the mechanism by which they are used in the treatment/prevention of type-2 diabetes. However, the blanched vegetable reduces their ability to inhibit both α - amylase and α - glucosidase activity in vitro.