从中日沿海城市部分老年人生活满足感比较看老年社区护理的发展

目的 通过比较中日两围老年人生活满足感，探讨老年人社区护理的发展方向。方法 中国大连市选取60岁以上老年人，进行人户调查，日本滨松市选取俱乐部的65岁以上老年人，填写问卷。结果 除在与亲人、朋友交往及存钱以防万一等方面外，2国老年人在其他生活满足感方面比较，差异均有统计学意义，P〈0．05。结论 中日两国不同的经济基础导致了不同层次需求的差异。在中国发展老年人社区护理，一方面可以借鉴国外经验，从物质基础上改进和完善；另一方面，借助传统文化优势，从社会风气上进行促进。     

Effect of meal on the physiological and physicochemical actions of potassium citrate

The effect of meals on the physiological and physicochemical actions of potassium citrate was examined in 8 patients with nephrolithiasis maintained on a constant metabolic dietary regimen. Potassium citrate (20 mEq. 3 times per day), whether given with food or on an empty stomach, significantly increased urinary pH, citrate and potassium, and decreased urinary calcium and ammonium. Moreover, potassium citrate decreased urinary saturation of calcium oxalate and uric acid, although it slightly increased that of brushite. However, there was no significant difference in these measures when the drug was given with meals from the time when it was given on an empty stomach. Thus, the effect of potassium citrate on urinary risk factors is unaffected by food.     

Multiple medication: problems of the elderly patient.

Elderly persons are apt to receive multiple drugs for many diseases. Prescribers should take extra care in persons aged over 65-70 years, and especially the very old. The main problem of the elderly is the unpredictability of their response to drugs. Self-medication with both prescribed and over-the-counter drugs worsens this problem. Drug actions may be altered by impairment of the liver, kidneys and brain, or acute illness, or both. Unwanted (adverse) drug reactions often produce rapid and unduly severe illness in the old. Some antibacterial antibiotics like the sulphonamides are best avoided. Taking many drugs together promotes adverse interactions between the drugs. Drugs with a narrow therapeutic ratio, such as warfarin, digoxin, the aminoglycosides, and many antiarrhythmic drugs, cause clinical problems. Old persons respond more abruptly to drugs like benzodiazepines, opioid analgesics, and antiparkinsonian drugs. Anaesthesia given on top of psychotropic drugs may damage the central nervous system. The elderly brain is more sensitive to induction agents and short-acting intravenous anaesthetics, like alfentanil and midazolam; the elderly liver is more easily damaged by inhalational anaesthetics like halothane. The overall benefit:risk ratio should be judged for every drug in each patient. Wherever possible, drug treatment should be avoided. If drugs are given, safe drugs with broad therapeutic ratios and tissue- or receptor-specific actions are preferable. Drug doses are usually, but not always, reduced. Benefit from a drug should be assessed early. Severe unpredictable adverse reactions need immediate cessation of the drug and prompt patient support. The practitioner should frequently review the patient's continuing need for drugs.     

腺病毒载体介导CTLA4Ig基因治疗小鼠变应性鼻炎

目的 检测CTLA4Ig-重组腺病毒载体（Ad-CTLA4Ig）在变应性鼻炎治疗中的作用。方法 采用卵清蛋白（OVA）致敏和激发诱导小鼠变应性鼻炎。实验组在OVA激发前30min予以Ad-CTA4Ig腹腔注射。未转CTLA4IgcDNA的腺病毒载体（Adv）作对照。比较各组动物鼻部症状和鼻粘膜形态学改变，并采用ELISA法测定血清中OVA－特异性IgE水平。结果 CTLA4Ig重组腺病毒实验组小鼠鼻部症状和鼻粘膜病理改变不明显，并且血清中OVA－特异性IgE水平明显低于对照组（P＜0.05）。结论 Ad-CTLA4Ig可防治小鼠应变性鼻炎的发生，提示CTLA4Ig-重组腺病毒载体有可能运用于临床变应性鼻炎的治疗。     

Rb基因对人视网膜母细胞瘤株SO-Rb50的影响

目的：探讨视网膜母细胞瘤（Rb）的发生与Rb基因（Rb1）缺失、失活等异常的关系。方法：用逆转录病毒载体pDOR与全长4．7kb野生型Rb1cDNA构建逆转录病毒表达载体pDOR－Rb1+。用脂质体介导法将pDOR－Rb1+转入CRIP包装细胞系。结果：实验产生了0．5X105Cfu具有一次感染能力的重组逆转病毒。利用该病毒感染SO-Rb50，经G418筛选，获得了抗G418细胞群体。运用PCR及Southern杂交技术对转染细胞进行检测，结果表明该抗G418细胞中有完整的外源Rb1存在。Northern杂交发现其Rb1mRNA表达水平有所提高。对细胞群体生长速率、软琼脂集落形成能力的测定表明，外源Rb1的表达使SO-Rb50在软琼脂中集落形成能力降低，而群体生长速率无明显影响。结论：外源Rb1对SO-Rb50恶性表型有一定影响。     

Partial mastectomy with axillary lymph node dissection and radiotherapy as a new treatment modality of breast cancer (I).

This is the first preliminary report among two consecutive papers. Partial mastectomy(PM), axillary lymph node dissection(AD) and radiotherapy (RT) were performed on seventeen operable breast cancer patients who had been admitted from April 1991 to March 1992 to the department of surgery, Yongdong Severance Hospital for improved cosmetic appearance and better survival rate. Of seventeen patients, 47% were T1 lesion and 76% were stage I and II. Extensive intraductal component(EIC) within or around the tumor was also analyzed. Twenty nine per cent of the patients were EIC positive. The mean number of axillary lymph nodes was 21.5 after PM with AD and 20.5 after mastectomy. For radiotherapy, 4,500 rad was delivered to the breast parenchyma and 1,600 rad of boost to the primary tumor site using the electron beam method after surgery. All patients have since been living well without any local recurrence and were satisfied with breast preservation for the one-year follow-up period. We concluded that the PM, AD and RT can be another surgical treatment modality of breast cancer. A longer follow-up data will be followed on the second paper.     

雷达员的目标跟踪能力测验

目的:建立雷达操作员心理选拔系统. 方法:在分析雷达任务的基础上,设计计算机化的目标跟踪能力模拟雷达测验任务,对334名相关被试施测,分析实验结果,评价测试任务的性能指标. 结果:测验结果的数据分布接近正态,变异系数为38%,区分度较好;重测信度系数为0.764(P<0.05);对专家和被试的主观调查表明有较高的内容效度;分别以机械作图和计算机学绩成绩、学习新技术的能力、工作绩效作效标,效度系数为0.273, 0.247, 0.309, 0.445(P<0.05). 结论:本测验可作为雷达员心理选拔的测试项目.     

医院信息系统故障排查思路的建立及实施实例浅析

医疗卫生行业是关系老百姓健康的重要事业,医院信息系统是医疗行业信息化的重要领域.因此,医院的信息化前景不仅是今后医院发展的重要方向,也将是信息技术业界重点关注的领域之一.医院信息系统的安全性和稳定性对于医院正常运营来说至关重要,相关系统故障及时准确的排查又是维护安全性和稳定性的关键.本文通过对我院一个门诊信息故障排查案例,初步探讨医院信息系统日常维护及故障排查的思路和共性问题.     

削梨法在小瞳孔白内障超声乳化术中的应用

目的：探讨小瞳孔状态下应用削梨法超声乳化的手术技巧和注意事项。方法：应用削梨法超声乳化技术对69例(78只眼)小瞳孔白内障行超声乳化。结果：无虹膜后粘连63只眼，术后全部瞳孔恢复原状；15只眼分离粘连机化膜后应用削梨法进行超声乳化，术后13只眼基本恢复圆瞳孔，2只眼瞳孔不规则。术后3个月裸眼视力≥05者43只眼(55．13％)．矫正视力≥05者61只眼(78．21％)。结论：削梨法受瞳孔大小的限制较小，大大降低了手术操作的难度，减少了手术的危险性，不失为小瞳孔白内障超声乳化的好办法。     

载银磷酸锆纱布对烧伤创面常见细菌作用的实验研究

目的 了解载银磷酸锆纱布对烧伤大鼠创面感染常见细菌的抗菌效力。方法制作Wistar大鼠烫伤(以下称烧伤)感染模型，采用试管双倍稀释法测定载银磷酸锆及磺胺嘧啶银的最低抑菌浓度(MIC)及最低杀菌浓度(MBC)。观察大鼠创面用磺胺嘧啶银纱布、普通尢菌纱布、载银磷酸锆纱布(小水洗及水洗20次)后痂下组织的细菌计数和对创面愈合的作用。结果载银磷酸锆对金黄色葡萄球菌、铜绿假单胞菌、大肠竹菌的MIC各为8、8、16mg／L，MBC各为16、8、32mg／L，为磺胺嘧啶银的2～8倍?大鼠创面用未水洗的载银磷酸锆纱布覆盖后，痂下细菌计数比用磺胺嘧啶银纱布低91％，比普通无菌纱布低99％未水洗的载银磷酸锆纱布对创面愈合的作用明显优于其他两种纱布，且其痂下组织细菌计数与水洗20次的效银磷酸锆纱布比较，差异无显著性意义(P＞0．05)。结论载银磷酸锆埘烧伤创面感染常见细菌有较强的抑制和杀灭作用，其敷料可作为治疗措施中新的选择。