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51.
目的 为了提高护理质量。方法 采用随机抽查500份护理记录的分析方法。结果 发现有种种缺陷118份(26.3%),共178例次。结论 以卫生部颁布的标准为准则,分析缺陷产生的原因,最后以人为本采取加强护士的法律知识学习,业务技术提升,质控队伍建设和医护、护护、护患关系沟通等措施,达到最大限度地减少护理缺陷,全面提高护理质量。 相似文献
52.
目的 总结32例前列腺癌患者新辅助治疗(NHT)的作用。方法 32例前列腺癌患者中药物去势17例,手术去势15例,并联合抗雄激素治疗3个月,统计NHT前后前列腺癌体积、肿瘤大小、PSA、FSH、LH和睾酮水平变化。结果 2组NHT后前列腺体积明显变小、肿瘤变小、变软,甚至消失,PSA和睾酮明显下降,药物去势组睾酮水平在耻骨后前列腺癌根治术(RRP)术后2~3个月可恢复正常,而手术去势组RRP术后睾酮呈持续低水平。结论 NHT可明显缩小前列腺体积,降低PSA,有利于手术操作。药物去势对内分泌影响是可逆的,而手术去势内分泌改变不可逆。 相似文献
53.
Xiaofang Chen Yueji Sun Haiyan Liu Yunqiao Ding Shujuan Liu Jinghua Chen Xueying Wang Zhenpeng Han Fang Qu 《中国神经再生研究》2006,1(8):763-765
BACKGROUND: Cognitive impairment after stroke associates with various factors, such as age, educational years, etc. Besides concerning about the recovery of limb function after stroke, we should also focus on the rehabilitation of cognition. Moreover, we'd better pay attention to the control of all the risk factors of stroke, and improve the quality of life in stroke patients.
OBJECTIVE: To analyze the factors that affect cognitive impairment after stroke.
DESIGN: A related factors analysis.
SETTINGS: Department of Neurology of Dalian Port Hospital and Dalian Second People's Hospital.
PARTICIPANTS: Totally 148 stroke inpatients were selected from Department of Neurology, Dalian Port Hospital and Dalian Second People's Hospital from April 2004 to December 2005, including 100 males and 48 females, aging 45-75 years with an average age of (67±8) years; Their educational years ranged 2-10 years with an average of (6.1±3.7) years; The disease course ranged 15-30 days; All were right-handed. Inclusive criteria: All were accorded with the diagnostic standard set by the Fourth National Academic Meeting for Cerebrovascular Disease; Confirmed by CT or MRI; Informed consents were obtained from all the subjects.
METHODS: After the disease conditions were stable, the patients were assessed with Wechsler memory scale (WMS) and Wisconsin card sorting test (WCST). WMS included forward and backward recitation of numbers and short-term memory (verbal memory, visual recognition). The number of times for correct and wrong classifications in WCST and the time to complete the trail making tests A and B were recorded. The focal volume, area and layer were recorded at 24 hours after admission. The general data of the patients were recorded, including name, sex, age, educational years, history of hypertension, history of diabetes mellitus. Electroencepalograph (EEG) was examined to record the wave shape, blood lipids were detected, and the cognition related indexes were analyzed with the Pearson correlation analysis. The correlation between cognitive indexes after stroke and the influencing factors were analyzed with multiple linear regression analysis.
MAIN OUTCOME MEASURES: ① Correlation between cognitive indexes and imaging indexes; ② Influencing factors for cognitive indexes after stroke.
RESULTS: All the 148 stroke patients were involved in the analysis of results. ① Correlation between cognitive indexes and CT indexes: There were obvious negative correlations between numerical symbol and focal layer (r =-0.234, P < 0.05), as well as between verbal memory and the focal area and volume (r =-0.363, -0.279, P < 0.05); Trail making test A had obvious positive correlation with focal area and volume (r =0.256, 0.256, P < 0.05). Results of multiple linear regression analysis: Correct classification was correlated with triglyceride (partial wave and θ wave (partial regression coefficient=0.231-0.908, P < 0.05); Verbal memory was correlated with EEG α wave, focal volume, sex, educational years and diabetes mellitus (partial regression coefficient=0.219-1.017, P < 0.05-0.01). Visual recognition had correlation with educational years and hypertension (partial regression coefficient=0.326, -1.163, P < 0.01). Trail making tests A and B were correlated with focal volume (partial regression coefficient=4.680, -18.561, P < 0.05).
CONCLUSION: The factors that affect the cognitive function after stroke include sex, age, educational years, hypertension, diabetes mellitus, triglyceride, EEG wave shape, and the focal area, volume and layer 相似文献
54.
Using rare earth element tracers and neutron activation analysis to study rill erosion process. 总被引:1,自引:0,他引:1
Mian Li Zhan-bin Li Weng-feng Ding Pu-ling Liu Wen-yi Yao 《Applied radiation and isotopes》2006,64(3):402-408
Spatially averaged soil erosion data provide little information on the process of rill erosion. The dynamically varied data on the temporal and spatial distributions in the rill erosion process are needed to better understand the erosion process and reveal its innate characteristics. The objectives of this study were to examine the feasibility and effectiveness of rare earth element (REE) tracers and the neutron activation analysis (NAA) method on the study of the rill erosion process and to reveal quantitatively the relationships and characteristics of temporal and spatial distributions of sediment yield in rill erosion. Four REEs were used to study the changeable process of rill erosion at 4 slope positions. Four water inflow rates were applied to a 0.3 x 5 m soil bed at 3 slopes of 10.5%, 15.8% and 21.2% in scouring experiments. All of the runoff was collected in the experiment. Each sample was air-dried and well mixed. Then 20 g of each sample was sieved through 100-mesh and about a 50 mg sample was weighed for analysis of the four elemental compositions by NAA. Results indicate that the REE tracers and NAA method can be used to not only quantitatively determine soil erosion amounts on different slope segments, but also to reveal the changeable process of rill erosion amount. All of the relative errors of the experimental results were less than 25%, which is considered satisfactory on the study of rill erosion process. 相似文献
55.
BACKGROUND/PURPOSE: Abdominal nontuberculous mycobacterial infection is a rare condition. Continuous ambulatory peritoneal dialysis (CAPD)-associated peritonitis is the most common manifestation of infection due to nontuberculous mycobacteria (NTM). There are limited data on the clinical manifestations of nontuberculous mycobacterial infection. This study investigated the diagnostic features, clinical presentation, mycobacteriology, treatment and outcome of all abdominal NTM infections treated over a 7-year period at a major teaching hospital in Taiwan. METHODS: The medical records of all patients with a diagnosis of abdominal NTM infection from January 1997 through to December 2003 were retrospectively reviewed. RESULTS: All 11 patients with abdominal NTM infections identified during the 7-year period were included. Among these patients, six were male and five were female, with a mean age of 64.5 years. The disease manifested as peritonitis (9 patients, 82%), splenic abscess (1, 9%), or perirenal abscess (1, 9%). Most patients (73%) had underlying malignancy, most often hepatoma (45%). Immunocompromised status (liver cirrhosis, malignancy, acquired immunodeficiency syndrome) was noted in 10 patients (91%). None of our patients who developed NTM peritonitis had received CAPD. The peritoneal fluid appearance varied considerably, with no particular predominance of clear, turbid, bloody, or chylous findings. Rapidly growing mycobacteria were the major etiology (46%) of abdominal NTM infection, and Mycobacterium abscessus played a major role (27%). Overall, eight patients died, and only one patient survived longer than 1 year. Seven patients (64%) died before diagnosis. CONCLUSION: Abdominal NTM infection is frequently overlooked because of its rarity and nonspecific symptoms, with consequent delays in diagnosis and treatment. In immunocompromised patients with ascites from any cause (liver cirrhosis, malignant ascites, etc.), NTM peritonitis should be considered early in the differential diagnosis of symptoms including fever, abdominal pain and weight loss. The poor prognosis of abdominal NTM infection appears to be related to the severity of underlying conditions, most often malignancy. 相似文献
56.
BACKGROUND: In recent years some reports have been published propagating microsurgical resection of ventral foramen magnum meningiomas (VFMMs). Operative approaches to these lesions have been studied by various authors, but remain controversial.
OBJECTIVE: To discuss the operative technique and outcome in patients with VFMMs who had been treated via a far lateral suboccipital approach.
DESIGN: Retrospectively clinic case investigation.
SETTING: Department of Neurosurgery, the Ninth People's Hospital, Medical School of Shanghai Jiao Tong University.
PARTICIPANTS: Between January 1997 and June 2003, 10 patients were treated surgically with VFMMs in Department of Neurosurgery, the Ninth People's Hospital, Medical School of Shanghai Jiao Tong University. In the series of 10 patients, ages ranged from 37 to 72 years, mean (53±10) years, were consisted of 6 males and 4 females. All the subjects were informed of the treatment plan and agreed to join the experiment. Early symptoms included headache and upper cervical pain. The time between the first occurrence of symptoms and the diagnosis ranged from 6 months to 17 months, mean (10.3±3.4) months. Main presenting symptoms were unilateral upper extremity sensory and motor deficits in 6 cases, swallowing difficulties in 2 and spastic quadriparesis in 2. VFMMs were demonstrated as round by the computed tomographic (CT) scan and magnetic resonance imaging (MRI) in all patients. The maximum diameter of tumors ranged from 2 to 4 cm, mean (2.55±0.57) cm, including 2 cm in one case, 2.0-3.0 cm in six and 3.0-4.0 cm in three.
METHODS: ①All tumors were removed via the far lateral suboccipital approach. Resection of the posterior 5 mm of the condyle was necessary in one patient whose tumors' diameter were 2 cm. The patient was situated in the lateral decubitus position. The head was fixed in a Mayfield headrest. A C-shaped incision made behind the ear 2 cm medial to the mastoid process, turning vertically down to the level C4, to expose the extradural segment of the vertebral artery (VA). After the dura was opened longitudinally behind VA entry point, the tumor was revealed to identify the complete cranial nerves and the intracranial VA under magnification of the surgical microscope. Every attempt should be made to keep the arachnoid and the dentate ligament was sectioned. Then the tumor was debulked significantly, and dissected away from the cranial nerves and the blood vessels with microsurgical techniques. If it was risk to dissect tumor from the vertebral artery, its branches, or any cranial nerve, the progression was discontinued and portion of the tumor was left behind. After resection of the tumor, the site of its attachment was coagulated and the involved layer of dura was resected. ②The degree of tumor resection was classified based on Al-Mefty's grade into three categories: gross-total resection: excision of the dural attachment and drilling of adjacent bone; near-total resection: a few millimeters of insulated and cauterized tumor were left on the vertebral artery or other vital; subtotal resection: more than 50% of the tumor mass were removed. ③All patients underwent clinical examination for lower cranial nerves or long tract deficits on the first day postoperatively. CT or MRI and neurological examinations were performed at 3 months of follow-up.
MAIN OUTCOME MEASURES: Operative effect.
RESULTS: All ten patients with VFMMs were treated via a far lateral suboccipital approach. Gross total resection was achieved in 6 patients, near-total resection was carried out in 2 and subtotal resection in 2 patients. One patients died in the postoperative period due to acute respiratory distress syndrome, five patients kept normal neurological status, whereas other four patients suffered from lower cranial nerve deficits and aspiration pneumonia was observed in two of them. The data of following up for 3 months showed that 2 patients still had lower cranial nerve deficit and others recovered from their illness. No tumor relapse or increment was found in CT or MRI scans.
CONCLUSION: Most of VFMMs could be totally removed via a far lateral suboccipital approach with or without resection of the occipital condyle according to the tumor size, allowing most of these patients to achieve a good outcome in a 3 months follow-up. 相似文献
57.
Lei Ding Christopher Wilke Bobby Xu Xiaoliang Xu Wim van Drongelen Michael Kohrman Bin He 《Journal of clinical neurophysiology》2007,24(2):130-136
SUMMARY: It is desirable to estimate epileptogenic zones with both location and extent information from noninvasive EEG. In the present study, the authors use a subspace source localization method (FINE), combined with a local thresholding technique, to achieve such tasks. The performance of this method was evaluated in interictal spikes from three pediatric patients with medically intractable partial epilepsy. The thresholded subspace correlation, which is obtained from FINE scanning, is a favorable marker, which implies the extents of current sources associated with epileptic activities. The findings were validated by comparing the results with invasive electrocorticographic (ECoG) recordings of interictal spike activity. The surgical resections in these three patients correlated well with the epileptogenic zones identified from both EEG sources and ECoG potential distributions. The value of the proposed noninvasive technique for estimating epileptiform activity was supported by satisfactory surgery outcomes. 相似文献
58.
目的探讨经尿道等离子双极电切术(PKRP)治疗良性前列腺增生(BPH)术后对阴茎勃起功能的影响。方法PKRP、经尿道前列腺电切术(TURP)治疗BPH各95例,评价其术后1个月、3个月及1年阴茎勃起功能。结果PKRP、TURP术后1个月、3个月及1年阴茎勃起功能障碍(ED)发生率分别是3.2%、2.1%、2.1%和13.7%、10.5%、9.5%。结论PKRP术后ED发生率比TURP低,是一种对阴茎勃起功能较为安全的治疗良性前列腺增生的方法。 相似文献
59.
脑血管意外尿失禁的机制探讨 总被引:4,自引:0,他引:4
目的探讨脑血管意外引起尿失禁的可能机制。方法对42例诊断为脑血管意外伴有尿失禁的患者进行尿动力学检查(包括静止期尿道压测定、充盈期及排尿期膀胱尿道功能测定)并按Burney分类进行分析,同时研究病变部位、脑血管意外性质和病变半球侧与尿动力学的关系。结果42例脑血管意外患者中,表现为逼尿肌反射亢进者31例(73.8%):其中外括约肌无抑制性松弛19例(45.2%),逼尿肌-外括约肌不协调3例(7.1%),逼尿肌-外括约肌协调9例(21.4%);逼尿肌反射减低,外括约肌协调者11例(26.2%);无逼尿肌功能正常者。发生膀胱顺应性减低5例(11.9%),发生尿感缺失者11例(26.2%)。初感尿容量(140.00±46.97)ml;膀胱最大容量(293.20±60.71)ml;最大尿道闭合压(65.14±19.83)cmH2O。逼尿肌最大收缩力(Pdetmax)为(60.98±31.11)cmH2O;最大尿流率时逼尿肌压力(Pdet-Qmax)为(35.98±17.46)cmH2O;逼尿肌收缩时间(Tcon)为(86.07±36.09)sec;最大流量(Qmax)为(9.02±5.62)ml/s。中风后尿失禁患者其发病部位多见于基底节、皮层多灶以及额顶叶,脑出血与脑梗塞患者的尿动力学表现无明显差异,左右半球病变对尿动力学也无明显差异。结论脑血管意外后尿失禁的尿动力学异常主要为逼尿肌反射亢进,部分出现逼尿肌反射减弱,但感觉正常,感觉缺失者较少见;外括约肌功能以无抑制性松弛为主,其次为逼尿肌-外括约肌协调,少数出现不协调;较少出现膀胱顺应性降低。 相似文献
60.
膀胱癌中环氧化酶-2的表达与临床病理的关系(英文) 总被引:4,自引:2,他引:2
目的 探讨环氧化酶 - 2 (COX - 2 )表达与膀胱癌生物学行为的关系及其意义。方法 采用免疫组化SABC法检测 5 4例膀胱癌、2 9例癌旁组织和 10例正常膀胱粘膜中的COX - 2表达 ,结合临床病理资料进行分析。结果 COX - 2在不同膀胱组织中的表达差异有显著性 (P <0 .0 5 ) ,即膀胱癌组织 >癌旁组织 >正常膀胱粘膜。COX - 2表达随膀胱癌病理级和临床分期的增加而增加 (P <0 .0 5、P <0 .0 1) ,且癌组织中COX - 2表达与淋巴转移有关 (P <0 .0 5 )。结论 COX - 2表达与膀胱癌病理分级、临床分期、淋巴转移有关 ,提示它可能在胱癌的发生、发展中扮演重要角色 ,通过抑制COX - 2活性可能为膀胱癌的防治提供新途径。 相似文献