儿科护士腰部锻炼操

由于儿科工作的特点，护士经常需要弯腰操作．例如寻找血管静脉输液．人工喂奶等都需要长时间弯腰．操作完毕觉得腰酸背痛，长此以往，腰部肌肉处在紧张状态，得不到适当休息和缓解．造成腰肌劳损．腰背疼痛．重者引发椎间盘突出。为加强劳动保护，笔者自编护士腰部锻炼操．坚持锻炼6个月．可以明垃缓解腰肌疲劳．减少疼痛。     

老年人重度胸外伤合并多发伤51例

随着我国人口老龄化加快，老年人胸外伤逐年增多，1990年9月-2004年2月，我院共收治60岁以上重度胸外伤合并多发伤(ISS≥25)51例，死亡21例，病死率达41．2％。     

浅谈高血压病人的心理护理

高血压病是身心疾病，当机体受到内外环境的不良刺激时，可引起情绪波动，使交感神经兴奋，血管收缩，血压升高，当症状明显，甚至出现并发症等病情变化时，易出现焦虑，抑郁等不良心理反应。不良的心理因素会给疾病带来不利的影响，帮助病人分析造成心理紧张的因素，指出心理紧张与血压的关系了解病人的性格特征等，针对病人的各种情况给予心理上的护理，这对控制血压，提高高血压病人的生存质量起到重要作用。     

妙用硬纸板

随着医学事业的不断发展,输液方法日益普及,但在临床输液治疗中常会遇到因恐惧害怕而不愿意合作的患儿。由于小儿天性好动,自制力差.在输液过程中他们将有意或无意识的手指或手脚乱动,可能导致针头移位致药液外漏或者将针     

失血性大鼠休克后肠、肝、肺组织中细胞因子表达、释放时相及其伴随的病理变化

目的：探讨休克后促炎细胞因子的表达、释放时相及伴随的肠、肝、肺组织病理变化。方法：80只SD大鼠随机均分为失血性休克组和对照组。采用RT-PCR、ELISA方法检测失血性休克后30、60、90min及复苏后30、90min肠、肝、肺组织内TNF-α、IL-6 mRNA表达及血清中TNF-α、IL-6含量；HE和IHC染色检测伴随的组织病理变化。结果：①休克30min时，肠、肝、肺内的促炎细胞因子表达未见升高；60min时肠道先出现TNF-αmRNA表达升高（P〈0．05）：而肝脏在90min开始表达升高（P〈0．05），肺脏则在复苏后30min开始表达升高（P〈0．05）。复苏后90min肠、肝、肺的细胞因子表达都继续显著升高（P〈0．01）。②TNF-α 在肠、肝、肺的表达升高最早，其后为IL-6 mRNA。③30min时门静脉和外周血中TNF-α、IM的含量与对照组相比无显著差异，而60min时门静脉血中含量显著升高（P〈0．01）。④休克后肠黏膜坏死脱落；肝组织结构紊乱、肝窦增宽、肝细胞变性坏死；肺脏间质水肿、炎症细胞浸润。结论：失血性休克时细胞因子的释放顺序是肠道、肝脏和肺脏，推测存在“肠-肝-肺”细胞因子释放轴的可能，有待进一步确定。     

双能量CT头颅血管成像的影像质量、辐射剂量及初步临床应用

Objective To assess the clinical value of dual-energy intracranial CT angiography (CTA).Methods Forty-one patients suspected of intracranial vascular diseases underwent dual-energy intracranial CT angiography, and 41 patients who underwent conventional subtraction CT were enrolled as the control group.Image quality of intracranial and skull base vessels and radiation dose between dual-energy CTA and conventional subtraction CTA were compared using two independent sample nonparametrie test and independent-samples t test, respectively.Prevalence and size of lesions detected by dual-energy CTA and digital subtraction CTA were compared using paired-samples t test and Spearman correlative analysis. Results The percentage of image quality scored 5 was 70.7% (29/41) for dual-energy CTA and 75.6% (31/41) for conventional subtraction CTA.There was no significant difference between the two groups(Z= -0.455, P=0.650).Image quality of vessels at the skull base in conventional subtraction CTA was superior to that in dual-energy CTA, especially for the petrosal and syphon segment (Z=-4.087, P= 0.000).Radiation exposure of dual energy CTA and conventional CTA were (396.54±17.43) and (1090.95±114.29) mGy · cm respectively.Radiation exposure was decreased by 64% (t=-38.52, P=0.000) by dual energy CTA compared with conventional subtraction CTA.Out of the 41 patients,19 patients were diagnosed as intracranial aneurysm, 2 patients as arteriovenous malformation (AVM), 3 patients with Moya-moya's disease, and the remaining 17 patients with negative results.Nine patients with intracranial aneurysm, 2 patients with AVM, 3 patients with Moya-moya's disease, and 2 patients with negative findings underwent DSA or operation, with concordant findings from both techniques.Diameter of aneurysm neck, long axis and minor axis by dual-energy CTA was (2.90±1.61), (5.23±1.68) and (3.83±1.69) nun, respectively; Diameter of aneurysm neck, long axis and minor axis by DSA was (2.95±1.71), (5.10±1.60) ,(3.83±1.65) nan,respectively.There was no significant difference for the diameters of aneurysm between dual energy CTA and DSA ((t=-0.734,1.936,0.12.5 respectively, P=0.482,0.085,0.903 respectively), and good correlation was found between diameter measurements using the two techniques(r=0.964,0.976,0.973, respectively, all P=0.000) Conclusions Compared with conventional subtraction CTA, dual energy CTA has good image quality for intracranial vessels; however, image quality of the skull base vessels is worse, especially for the petrosal and syphon segment.Dual energy CTA has decreased radiation dose and a high diagnostic accuracy, being a practical imaging madality for diagnosis of intracranial vascular lesions.     

腰椎间盘突出症致痛机理探讨

腰椎间盘突出是引起腰腿痛的最常见原因之一。椎间盘是上下两个椎体的连接物,椎间盘的中心为髓核,呈胶冻状,其成分80%为水,髓核的外周包绕一层纤维组织称为纤维环,人到20～30岁后,椎间盘的纤维环开始退变,逐渐出现裂隙。在退变的前提下,遇扭闪外力,髓核或连同纤维环便会凸出到椎管内,压迫相邻的神经根,产生腰椎间盘突出症。     

张景岳"中年求复再振元气"思想

“中年求复，再振元气”是明代著名医家张景岳关于我国中老年医学的一个独具特色的学术思想。对其所提的“中年求复，再振元气”的意义和学术价值进行了探讨，并分析了中年求复，贵在复元惜元的思想和重要意义，以倡其中兴延寿之旨。