Reducing dust using the electrocautery pencil with suction combined with the infusion catheter in mastectomy

The dust from the vaporized tissue released during a mastectomy presents a hazard to the patients and the operating room personnel. More dust has been noted using the conventional electrocautery pencil in dissecting breast tissue than with the metal knife used in the past. It is very important to reduce the hazardous dust released during mastectomy. For this study 80 patients undergoing mastectomy for breast cancer from March to June 2001 were divided into two groups: 1) those whose dissections were performed with a combination of an electrocautery pencil and suction with an intravenous infusion catheter (40 cases) and 2) those whose dissections were performed with the conventional method in which the electrocautery pencil was handled by the surgeon and the metal suction tube was used separately by an assistant (40 cases). During mastectomy the personal air sampler was affixed to the operator's neck to collect the dust from the vaporized tissue. The concentrations of the total dust were significantly lower in the combined electrocautery-suction method (mean 5.56 +/- 3.26 microg/m3) than in the conventional method (mean 34.81 +/- 4.83 microg/m3) during mastectomy (P < 0.05). Although the operating time and blood loss were less in the combined method than in the conventional method this difference was not statistically significant (P > 0.05). The combined method of using the electrocautery pencil for dissecting breast tissue along with the intravenous infusion catheter reduced the concentrations of the total dust from the vaporized tissue plume. Furthermore this method reduces the hazards of dust to the surgeons and operating room personnel. Additionally the cost of this combined method is lower than that of the conventional method.     

酒依赖患者的个性特点分析与护理对策

目的探讨酒依赖病人的个性特点和相应的护理干预。方法采用中科院心理研究所修订的MMPI—R问卷，对121例酒依赖病人进行个性分析。结果酒依赖病人个性特点为被动依赖、对人疏远、自我为中心、情绪不稳、自控力差、易激惹、低自尊、有反社会行为、焦虑、记忆力减退等。结论针对酒依赖病人个性特点，恰当的护理干预，能使病人早日脱瘾，全面康复。     

湖南省农村实施欧盟生态旱厕项目健康教育效果分析

目的在农村中推广应用生态旱厕、粪便无害化处理与卫生行为干预相结合的模式。方法在项目实施之初,采用随机抽样方法对项目地区进行基线调查;然后,在项目实施的同时,开展知识传播、技能培训、行为干预等一系列健康教育活动。结果项目实施后,调查对象中使用生态旱厕已经达到68.4%,厕所设有洗手设施、家庭设有专用洗澡间、使用安全自来水三项指标分别达到66.8%、51.4%、56.9%;饭前便后洗手、食物隔离、不吸烟、不乱倒生活污水、不乱扔生活垃圾等健康行为形成率分别达到82.7%、83.9%、43.4%、86.0%和66.0%;农村居民及小孩腹泻患病率分别下降到3.0%和3.4%。结论欧盟生态旱厕项目的实施,促进了农村环境卫生面貌的改观和村民健康行为的形成,降低了与粪水相关疾病的患病率,探索了一套在国际卫生项目中开展健康教育工作的模式。     

非体外循环下冠状动脉搭桥术的临床应用

目的分析非体外循环下冠状动脉搭桥术（OPCABG）的优点及疗效。方法对2002年2月～2005年6月所行33例OPCABG患者的临床资料进行总结，患者术前心功能Ⅱ～Ⅲ级，左室射血分数34％-68％，均在非体外循环、心脏跳动状态下完成冠状动脉搭桥术。结果手术患者无一例死亡，术后心绞痛症状均消失，心功能得到不同程度改善。结论OPCABG是一种安全可行、效果良好的治疗冠心病的方法。     

医院发展要重视高技能人才的培养

本文通过对10余所医院高学历人才队伍现状的分析，探讨了医院在人才培养中的误区，提出医院要发展，在重视学历教育的同时，更应重视高技能人才的培养。     

均匀设计优化二元溶剂分散法制备莪术油纳米粒的研究

目的优化二元溶剂分散法制备莪术油纳米粒（ZTO-NP）的制备工艺技术条件，探讨其可行性。方法以形态、粒径、包封率为指标，采用均匀设计，考察分散剂浓度、载体材料用量、有机相体积和搅拌时间等影响因素，筛选出比较理想的制备工艺。结果最佳工作条件为：聚氧乙烯-聚氧丙烯共聚物（普朗尼克F68）0．1％，乳酸-乙醇酸共聚物（PLGA）0．01g，搅拌时间4h，丙酮体积1mL。所制得的纳米粒为圆整的类球形粒子，表面光滑，平均粒径为233．1nm（PDI值为0．047），zeta电位为-22．1mV，包封率为70．01％，载药量为57．55％。结论二元溶剂分散法可用于薮术油类液体药物纳米粒的制备。     

试论我国临床药学的建设与发展

我国的临床药学(Clinical pharmacy,CP)自60年代开始发展到今天,已走过了40年的历程,就其开展的时间而言与美国等发达国家相比差距不大。但其工作现状与发展后劲却不禁令人担忧。中国CP工作怎么开展?出路在哪里?本文就上述问题讨论如下:1美国的CP推广与实施美国作为CP的发源地,1948年全国药学院校联合会(AACP)首次提出以合理用药为核心的CP教学体制和设立临床药师岗位的建议。1957年,Donald Francke首次提出6年制pharm·D临床药师培养教学课程,强调生物医学内容。第一个pharm·D教学大纲在Michigan大学药学院制定出台。在这期间,Ca…     

Loosening of total hip arthroplasty with a prosthesis employing a skirted femoral head.

In total hip arthroplasty, a modular femoral head with a flange increases the head-neck strength and compensates the leg length, but results in a decreased head-to-neck diameter ratio. Studies have shown increased chance of impingement and incidence of dislocation associated with a skirted femoral head component. However, the relation between implant loosening and the skirted neck has not been well demonstrated. We report a 41-year-old male patient with aseptic loosening of total hip arthroplasty due to osteolysis of both acetabular and femoral components 5 years after surgery. The retrieved prostheses demonstrated polyethylene wear due to impingement of the skirted head during hip flexion. Pathologic examination showed prominent foreign body reaction. Prosthetic impingement occurs due to malposition of components and extreme posture. A decreased head-to-neck diameter ratio further compromises prosthetic range of motion. A skirted femoral head component should be used with caution.     

IL-2、IL-6在HBV母婴传播中的作用

目的探讨IL2、IL6在乙型肝炎病毒(HBV)母婴传播中的作用。方法2002年1月至2003年3月中山大学附属第三医院检测53例HBsAg阳性孕妇和13例正常妊娠孕妇及其新生儿的HBV血清标志物、HBVDNA和IL2、IL6。结果与正常妊娠孕妇比较,孕28～29周时HBsAg阳性孕妇其血IL2水平明显降低,IL6水平明显升高,差异有显著性(P<0.05)。使用HBIG行产前阻断治疗后,HBsAg阳性孕妇的IL2水平上升、IL6水平下降,治疗前后差异有显著性(P<0.05)。HBsAg阳性孕妇未使用药物治疗组和正常妊娠组的IL2、IL6水平,孕28～29周和分娩前比较,差异无显著性(P>0.1)。HBsAg阳性孕妇使用HBIG治疗组和未治疗组,宫内感染率分别为6.25%和28.60%,两组差异有显著性(P<0.05)。结论HBsAg阳性孕妇的IL2、IL6水平失衡。产前应用HBIG可改善HBsAg阳性孕妇的IL2、IL6失衡状态,使其向Th1方向发展,这可能是HBIG阻断HBV宫内感染的机制之一。