颈椎术后病人首次下床活动的感受及需求的调查

早期下床活动的必要性已得到大家认可,但术后早期病人常常较虚弱,且下床活动时会引发一些不适,病人也会有一些担心和顾虑,这在一定程度上会影响病人下床活动的积极性。颈椎手术本身有其特殊性,术后对颈部的稳定要求较高,因此此类病人活动有其特点。本研究以颈椎术后已下床活动的病人为研究对象,通过问卷调查,了解颈椎手术后病人首次下床的感受和相关需求,为进一步提高颈椎术后护理质量提供依据。1资料和方法1.1对象采用方便取样,选取2005年4月—2005年6月在某三甲医院因颈椎病入院、术后已下床活动的病人75例。其中男54例,女21例;年龄28岁~7…     

Comparative study of renal sodium transport between ouabain-hypertensive rats and ouabain-nonhypertensive rats

Objective: To compare renal sodium transport, using fractional excretions of lithium(FELi) as a marker of proximal tubule sodium reabsorption, between hypertensive and non-hypertensive ouabain-treated rats and further to elucidate the role of ouabain in pathogenesis of hypertension. Methods: Thirty male Sprague-Dawley rats weighting 180-200 g were randomly divided into normal control group and ouabain treated group. Rats were infused with 1 ml/kg·d normal saline or 27. 8μg/kg·d ouabain in-traperitoneally once a day respectively. Systolic blood pressure (SBP), heart rate and body weight were recorded weekly. Rats were sacrificed 6 weeks after treatment. Blood and 24-hour urine sample were collected to measure the serum and urinary concentration of sodium, trace lithium and creatinine. Endogenous creatinine clearance rate(Ccr), fractional excretions of sodium (FENa), fractional excretions of lithium (FELi) and fractional reabsorption of sodium in the postproximal tubules (FDRNa) were calculated. Ouabain levels of plasma and renal tissue, plasma renin activity, angiotensin I and aldosterone concentration were determined. Results: 65% of the ouabain-treated rats achieved significantly higher SBP after 4 weeks, compared with that of the saline control groups or self baseline (P<0. 01). But in the other 35% of the ouabain-treated rats, their SBP was similar with control group during the experiment (P>0. 05). The body weight, heart rate and food intake between the 3 groups were no significant differences (P> 0. 05). FELi and FDRNa were significantly lower in ouabain-hypertensive group compared with ouabain-non-hypertensive group and control group(P<0. 01 and P<0. 05). The FEu and FDRn, of ouabain-nonhyper-tensive groups were similar with control group(P>0. 05). Ccr and FENa were comparable between the 3 groups (P>0. 05). Plasma and renal tissue ouabain levels, plasma renin activity, angiotensin I and aldosterone contents in ouabain-hypertensive rats were comparable with ouabain-nonhypertensive rats. Conclusion: Increase of proximal tubule sodium reabsorption play an important role in the pathogenesis of ouabain-hypertensive rats. The change of renal sodium transport may result from regulation to renal Na+ , K + -ATPase by ouabain.     

抗菌药物的不良反应

抗菌药物的开发与应用使临床成功防治感染性疾病成为可能 ,使严重感染的预后大为改观。但抗菌药物的应用同时也可引起很多不良反应 ,甚至致残或致死。抗菌药物的不良反应主要包括毒性反应、变态反应、二重感染。1　毒性反应指药物引起的生理、生化等功能异常和 (或 )组织、器官     

Buccal mucosal graft for urethral reconstruction.

Urethral reconstruction with graft substances, such as skin and bladder mucosa, has been previously used when primary anastomosis cannot be achieved. However, stricture and meatal prolapse are associated with these grafts. We report the use of buccal mucosa for the reconstruction of urethral defects in 3 patients. One patient with failed operation for hypospadias received tube buccal mucosal graft for urethral replacement. Two patients with urethral necrosis and stricture received onlay buccal mucosal graft. All patients were disease-free during follow-up (range, 12 to 49 months; mean, 36 months). One patient had a pinhole fistula that was successfully managed with simple repair. This technique appears to be useful for urethral reconstruction when a local graft is not available, even in patients with complicated conditions.     

咳喘"冬病夏治"临床应用

"冬病夏治"法意即冬天易发作的病,在夏天(特指伏天)提前预防性治疗的一种特色疗法.寒性咳喘是我国北方冬季的常见病、多发病.我院针灸科从1983年开始,每年伏天运用针药并用外敷治疗寒性咳喘的"冬病夏治"法,治愈数千例患者,取得了很好的疗效.     

Evaluation of Class I ART restorations in Brazilian schoolchildren: three-year results

Atraumetic Restorative Treatment (ART) has been adopted around the world to avoid unnecessary extractions, especially in non-industrialized countries The development of specific glass ionomer cements marketed for the ART technique has contributed to the technical success rate. In this study. Ketac-Molar^a (3M ESPE. Dental Medzn Germany) was used to restore 150 Class I cavities in 118 Brazilian public school children, aged from 7–12 years. At baseline and at subsequent recalls. CPI probes with a ball-end of 0.5 millimeters (mm) were used to assess loss of restorative material, and photographic color transparencies of restorations were made. After six months. 83 patients returned for follow-up examinations, with 71.8% of their restorations designated as acceptable. After three years. 49 patients with 57 ART-restorations were evaluated, with 21.0% of these restorations graded as acceptable Another 29.8% of their restorations had been replaced by more permanent materials. The main objective of the ART technique is tooth retention; this was achieved for 94.7% of the restored teeth in a high caries risk population who returned for recalls.     

Palmitic acid as an excipient in implants for sustained release of insulin

Sustained-release implants for insulin can be made by compressing a powder admixture with palmitic acid as the excipient. At less than 20%, insulin does not disperse uniformly in the admixture. The size distribution of the excipient particles obtained after grinding for 15 min does not affect the sustained release action. When tested in a 33 d period, an 1/8-size piece (approximately 25 mg) implant cut from a pellet disc containing 20% insulin which is 13 mm in diameter and 1.5 mm thick released 0.12-0.17 mg insulin/d in diabetic Wistar rats. The 1/8-size piece containing 20% insulin or a rod of similar weight with a diameter of 3 mm, which can be inserted by a trocar, was optimal for the implant to provide a service-life of 49 +/- 7 d. The service-life decreased with progressive reduction in implant size. The implant functioned just as well subcutaneously or intraperitoneally and was eroded subcutaneously by 33.6-53.1% in 33 d. The glycosylated haemoglobin contents of diabetic animals on implant therapy which had a blood glucose level of 4.7 +/- 2.5 mmol/l were in a range of 6.2-8.9% compared to the control value of greater than 13% with chronic hyperglycemia. The overall results indicated that the implant was a promising alternative to daily insulin injections.     

Microarray analysis of healing rat Achilles tendon: evidence for glutamate signaling mechanisms and embryonic gene expression in healing tendon tissue.

Tendon healing is a complex process consisting of a large number of intricate pathways roughly divided into the phases of inflammation, proliferation, and remodeling. Although these processes have been extensively studied at a variety of levels in recent years, there is still much that remains unknown. This study used microarray analyses to investigate the process at a genetic level in healing rat Achilles tendon at 1, 7, and 21 days postinjury, roughly representing the inflammation, proliferation, and remodeling phases. An interesting temporal expression profile was demonstrated, identifying both known and novel genes and pathways involved in the progression of tendon healing. Both inflammatory response and pro-proliferative genes were shown to be significantly upregulated from 24 h postinjury through to 21 days. Day 7 showed the largest increase in genetic activity, particularly with the expression of collagens and other extracellular matrix genes. Interestingly, there was also evidence of central nervous system-like glutamate-based signaling machinery present in tendon cells, as has recently been shown in bone. This type of signaling mechanism has not previously been shown to exist in tendon. Another novel finding from these analyses is that there appears to be several genes upregulated during healing which have exclusively or primarily been characterized as key modulators of proliferation and patterning during embryonic development. This may suggest that similar pathways are employed in wound healing as in the tightly regulated progression of growth and development in the embryo. These results could be of use in designing novel gene-based therapies to increase the efficacy and efficiency of tendon healing.     

截骨矫形"∩"形钉内固定治疗关节畸形55例

目的探讨肘、膝、踝关节内外翻畸形的治疗方式。方法对55例8～16岁的关节内、外翻畸形患儿(肘关节30例，膝15例，踝10例)，采用肘外侧切口，踝、膝内外侧切口，截骨矫形，1枚或2枚“∩”形钉内崮定治疗，术后石膏托外固定4周，结果随访50例，随访时间3～24个月，截骨均达到骨性愈合，无一例发生感染，内固定松动临床疗效优48例(96％)，良2例(4％)。结论用“∩”形钉作为截骨矫形内固定材料．具有操作简单、损伤小、效果好的优点。     

双侧内囊前肢毁损术治疗难治性强迫症疗效及随访研究

目的　对难治性强迫症进行双侧内囊前肢毁损术治疗 ,评定手术疗效并进行 2年随访 ,以进一步探索脑外科手术对难治性强迫症的疗效 ,并探讨手术治疗的良好适应症。方法　对 2 8例难治性强迫症患者进行双侧内囊前肢毁损术治疗 ,并分别在手术前、手术后二周、手术后三月、手术后六月、手术后一年、手术后二年进行Y BOCS、HAMA、HAMD量表评定及术后疗效评定。结果　 (1)强迫症患者手术后各期Y BOCS评分、HAMA评分与手术前比较均下降 ,有极显著差异 (P <0 .0 0 1) ;(2 )手术后各期Y BOCS的强迫思维评分均有明显下降 (P <0 .0 0 1) ,强迫行为在手术后 1年和 2年 ,与手术前比较无明显改变 (P >0 .0 5 ) ;(3)手术后 2年的总有效率为 5 3.5 % ,明显低于手术后 3月的总有效率 (P <0 .0 1)。结论　采用双侧内囊毁损术有相当的治疗效果 ,对于难治性强迫症患者可作为一种补充治疗手段 ;手术治疗对强迫行为的长期疗效较差 ,以严重的强迫思维为主的难治性强迫症患者为手术更好的适应症。