6%羟乙基淀粉130/0.4对患者硬膜外复合全麻诱导期肺循环的影响

Objective To observe the effect of pulmonary circulation by 6% hydroxyethyl starch 130/0.4 during induction period from epidural block combined with general anesthesia. Methods Twenty-six hepatobiliary surgical patients with ASA Ⅰ-Ⅱ, aged 32 y-59 y, weighing 54 kg-73 kg, were randomized into 2 groups(n=13): hydroxyethyl starch 130/0.4 group(HS)and complex acetic acid Ringer's solution (RL). Above-mentioned solutions were infused 7 ml/kg respectively before induction. The pulmonary circulation hemodynamic parameters such as pulmonary arterial systolic pressure (PASP), pulmonary arterial diastolic pressure (PADP), mean pulmonary artery pressure(MPAP), pulmonary artery wedge pressure(PAWP), pulmonary vascular resistance(PVR) and right ventricular stroke work(RVSW) were recorded at base value(T0), 10 min after infusion(T1), 5 min after induction(T2), 5 rain after intubation(T3), 10 rain after intubation(T4)and 20 min after intubation(T5). Results PASP、PADP、MPAP、PAWP and CVP were significantly higher in group HS at T, than the values at T0 (P<0.05); PVR in group HS was obviously lower from T1 to T5 than the value at To (P<0.05 or P<0.01); RVSW was significantly higher in two groups at T1 than base value (P<0.05), but that in group HS was lower than base value (P<0.05 or P<0.01); HR obviously decreased in two groups from T2 to T5 as compared with the value at T0 (P<0.05); MAP was lower from T3 to T5 than the value at To (P<0.05 or P<0.01). PVR was obviously lower in group HS from T1 to T5 than that in group RL (P<0.05 or P<0.01); MAP obviously increased from T2 to T5 in group HS as compared with the value in group RL(P<0.05 or P<0.01). Conclusion 6% hydroxyethyl starch 130/0.4 can obviously reduce PVR during induction pe-riod from epidural block combined with general anesthesia. In all, there is no effect on pulmonary circulation by 6% hydroxyethyl starch 130/0.4.     

氯氧消毒法对医院污水处理效果的综合评价

综合性医院排出的污水含有大量的病原微生物、寄生虫卵及酚、洗涤剂等有毒、有害物质。如直接排放 ,势必污染环境和危害人民的健康。目前多采用次氯酸钠法进行消毒 ,但其使用效果及消毒可靠性并不令人满意。湘雅医院在湖南省首先使用ＣＭ -Ａ氯氧发生器进行污水处理。为了解其处理效果 ,进行了本次综合检测评价。现场调查及布点　湘雅医院污水来源包括门诊部、住院部、人解楼、病解楼、洗衣房及中心实验室。传染科污水经加氯消毒处理后再进入污水处理站。选取污水处理站污水进口格栅后水样为处理水样 ,污水排放口水样为处理后水样。分别于5…     

头位胎膜早破对母婴影响180例临床分析

目的：探讨头位胎膜早破对母婴的影响。方法：将180例胎膜早破（PROM）的产妇与随机抽取的260例无PROM产妇作对照。观察两组产程、分娩方式及母婴并发症的发生率。结果：PROM组母亲感染率6.1%,早产率4.4%,新生儿室息率5.6%,新生肺炎1.7%,阴道助产率7.2%,剖宫产率21.7%均高于对照组。结论：PROM是引起母婴并发症的重要原因,早期预防和积极处理PROM对降低围产期母瘿病死率有重要临床意义。     

电镜观察实验性病毒性心肌炎组织改变及其相关因素和治疗探讨

目的探讨病毒性心肌炎不同时期的组织病理改变,为临床用药提供理论根据.材料与方法建立小白鼠柯萨奇病毒B3(CoxB3)心肌炎模型,在病程7、10、14、21、28、35天,分别处死做心脏电镜、病理,同时取血测超氧化物歧化酶(SOD)、丙二醛(MDA)、谷胱甘肽过氧化氢酶(GSH-PX)及抗心肌抗体.结果实验性病毒性心肌炎急性期经电镜观察,可见线粒体模糊,部分嵴空化或消失、Z线模糊,肌纤维溶解破坏.病理切片见心肌细胞气球样变性,局灶性坏死,散在或局部淋巴细胞浸润;同时有MDA升高、SOD及GSH-PX降低;感染35天时,电镜及光镜下心肌仍有病变,可见纤维细胞生成及部分纤维化改变,并有心肌抗体升高.但MDA、SOD及GSH-PX恢复正常.结论病毒性心肌炎急性期应卧床休息、营养心肌及抗氧自由基治疗,感染一个月后,应偏重抗免疫治疗.此时代表自由基的三种酶已经恢复正常,因此,抗氧自由基治疗不应超过一个月.     

高渗氯化钠羟乙基淀粉40注射液高容量血液稀释对大鼠肝脏缺血再灌注损伤的影响

Objective To investigate the effects of hypervolemic hemodilution (HH) with hypertonic saline plus hetastarch solution 40 injectio on hepatic ischemia-reperfusion (I/R) injury in rats. Methods Thirty male Wistar rats weighing 300-350 g were randomly divided into 3 groups ( n = 10 each): group I sham operation (group S); group II I/R and group Ⅲ HH. Partial liver ischemia was produced by clamping hepatic portal vein and left arteria hepatica for 30 min with atraumatic mini-clamp, followed by 2 h of reperfusion in I/R group and HH group. In HH group the animals were infused hypertonic saline plus hetastarch solution 40 injectio 10 ml/kg through vena caudalis over 30 min and then hepatic I/R was performed IS min after the infusion.The animals were killed at 2 h of reperfusion. The left liver was removed and blood sample was taken from inferior caval vein for determination of (1) serum alanine amino transferase (ALT) and aspartate amino transferase (AST) activities; (2) superoxide dismutase ( SOD) activity and malondialdehyde ( MDA) content in the liver; ( 3 ) microscopic examination. Results The serum ALT and AST activities and MDA content in the liver were significantly higher, SOD activity in the liver significantly lower after hepatic I/R and pathological changes in the liver severer in group I/R and HH than in group S. The serum ALT and AST activities and MDA content in the liver were significantly lower, SOD activity in the liver significantly higher after hepatic I/R and pathological changes in the liver milder in group HH than in group I/R. Conclusion Hypervolemic hemodilution with hypertonic saline plus hetastarch solution 40 injectio can ameliorate hepatic I/R injury by decreasing oxygen free radical production in rats.     

通过《护理心理学》培养护生职业心理素质的教学方法研究

目的在《护理心理学》教学中运用多种教学方法,促进护生职业心理素质养成。方法设置《护理心理学》教学实验组和对照组,通过自制调查问卷和课程结业成绩的统计学处理,研究教学方法方法提升护生心理素质的可行性。结果问卷调查及结业成绩实验组明显优于对照组。结论灵活运用师生互动、实践性强的教学方法,可以增强护生的职业心理素质和心理护理能力的培养。     

灯盏花素对人视网膜色素上皮细胞和糖尿病大鼠视网膜VEGF表达的影响

目的:观察灯盏花素对高糖环境下人视网膜色素上皮细胞株ARPE-19中VEGF、VEGFR2和pERK蛋白的表达及对2型糖尿病大鼠视网膜VEGF表达的影响。方法:培养ARPE-19细胞,分为对照组、灯盏花素组、高糖组和高糖+灯盏花素组,ELISA检测VEGF的分泌水平,Western blot检测细胞VEGF、VEGFR2和p-ERK的蛋白水平;取正常大鼠,随机分为正常对照组、灯盏花素组、糖尿病模型组和糖尿病灯盏花素治疗组,16周后取各组大鼠眼球,观察大鼠视网膜的病理变化并评分,免疫组化观察VEGF的表达情况。结果:(1)细胞实验结果显示,灯盏花素组VEGF、VEGFR2和p-ERK的蛋白水平与正常对照组比较均减低(P0.05);高糖组细胞上述蛋白水平与正常对照组比较均增加(P0.05);高糖+灯盏花素组上述蛋白水平与高糖组比较表达均减少(P0.05);(2)大鼠视网膜病理学评分显示糖尿病组与正常对照组、糖尿病灯盏花素治疗组相比差异显著,灯盏花素组与正常对照组相比差异无统计学意义。糖尿病大鼠与正常对照组、灯盏花素组相比,视网膜VEGF的表达增加;糖尿病灯盏花素治疗组中VEGF的表达较糖尿病组有所降低(P0.05)。结论:灯盏花素可以降低ARPE-19细胞VEGF、VEGFR2和p-ERK的蛋白表达水平,抑制糖尿病大鼠视网膜VEGF的表达,提示灯盏花素可能通过降低糖尿病大鼠视网膜细胞和组织中VEGF的表达,缓解其糖尿病视网膜病变进程。     

新疆农牧区哈萨克族3个自然村的牙周病情况调查

目的:探讨新疆哈萨克族牧民引发牙周病的相关因素.方法:对农牧区哈萨克族3个自然村的310名牧民进行口腔检查及问卷调查,用SPSS 17.0软件对10个变量进行多因素logistic回归分析.结果:310名哈萨克族牧民牙周病检出率为21.29％;多因素Logistic回归分析结果显示,最终进入主效应模型的哈萨克族牙周病影响因素是吸烟、体质量指数.结论:合理的膳食结构模式,降低超重、肥胖率、控制吸烟,对该民族牙周病的预防有积极的作用.     

ERK信号通路在神经细胞凋亡中的双重作用

细胞外信号调节激酶（ERK）信号通路参与细胞的多种生物学过程,包括细胞增殖、迁移、分化和死亡。尽管大多数研究证实,神经细胞中的ERK信号通路具有抗凋亡的作用,但是其促进凋亡的作用也已被发现。在本文中,我们将综述ERK信号通路在神经细胞凋亡中的双重作用。