蜡样芽孢杆菌引起化脓性脑膜炎的病原学检测及文献复习

正蜡样芽孢杆菌为革兰阳性芽孢杆菌(芽孢不突出菌体),需氧或兼性厌氧,轻微运动性,广泛存在于土壤、灰尘、水和医院环境~[1](如空气过滤和通风设备~[2]、样本收集管、床单~[3]及重复使用的毛巾~[4]、静脉导管[5]、光导纤维支气管镜检设备~[6]等),可因污染土壤和食品作为一种食源性疾病进行报道(食物中毒)~[7]。临床上各种标本(血液、伤口和痰等)分离到该菌时,常被认为是污染菌未鉴定到种或被误鉴为枯草芽孢杆菌,导致     

替普瑞酮对烧伤大鼠胃黏膜热休克蛋白和诱生型一氧化氮合酶表达的影响

替普瑞酮是树木浆液中含有的萜烯衍生物，具有组织修复作用，据文献报道替普瑞酮可诱导产生热休克蛋白(HSP)，以往的研究多集中于其对乙醇、束缚水浸应激、幽门螺杆菌等引起的胃黏膜损害。本研究通过建立烧伤大鼠急性胃黏膜损伤模型，观察替普瑞酮对严重烧伤大鼠胃黏膜HSP60、HSP70和诱生型一氧化氮合酶(iNOS)表达的影响，探讨其保护作用和机制。     

宫腔镜下电切治疗子宫黏膜下肌瘤临床分析

目的分析评价宫腔镜治疗子宫黏膜下肌瘤的临床疗效及安全性。方法回顾性分析2009年11月至2010年4月期间在沧州中西医结合医院治疗的子宫黏膜下肌瘤患者的临床资料。将应用宫腔电切镜切除子宫黏膜下肌瘤的46例患者作为观察组。选择同期应用开腹手术方式治疗的37例患者作对照组。比较分析手术情况、手术效果、及术后并发症情况。结果术后病理均为子宫肌瘤,合并子宫内膜息肉5例,无恶变病例。观察组46例子宫黏膜下肌瘤患者均1次完成手术,无子宫穿孔、出血及肠管损伤发生,对照组亦无手术并发症发生。与对照组相比,观察组手术时间短、术中出血量少、术后住院时间短、术后肛门排气时间早,两组比较差异有统计学意义(P<0.05),术后随访3~12个月,观察组满意率为97.83%,对照组满意率为89.19%,两组比较差异有统计学意义(P<0.05)。结论宫腔镜治疗子宫黏膜下肌瘤较传统开腹手术具有创伤小、术中出血少、术后恢复快、住院时间短等优点,是目前治疗子宫黏膜下肌瘤的理想、有效、安全的方法。     

异位妊娠破裂致失血性休克的抢救与护理

我科自2007年1月—2009年12月共收治异位妊娠合并失血性休克患者60例,所有患者经积极手术抢救,术后精心护理均治愈出院,无1例并发症发生。现将抢救护理体会总结如下。     

超声检查在脂肪肝诊断中的临床应用价值

目的探讨超声检查在脂肪肝诊断中的临床应用价值。方法选择我院超声科接受检查的脂肪肝患者1199例,超声设备选择GELOGIQ.9彩色多普勒超声诊断仪,重点观察肝脏实质及肝静脉情况。结果 1199例脂肪肝患者中,包括轻度脂肪肝738例,中度脂肪肝293例,重度脂肪肝168例。超声表现为肝脏增大,实质回声增强,肝静脉管径变细,血流频谱呈不同程度改变。结论超声可以清晰显示脂肪肝特点,具有很高的应用价值。     

缬沙坦与卡托普利治疗高血压的临床比较观察

目的:观察和评价缬沙坦治疗高血压的疗效。方法:将我院收治的高血压患者428例,观察T组216例服用缬沙坦治疗,对照P组212例服用卡托普利治疗,2组疗程均为6周,观察2组药物治疗前后血压的变化及不良反应情况。结果:T组和P组降压有效率为87.5%和80.18%,不良反应发生率为9.25%和33.49%。结论:缬沙坦是值得信赖的一种安全、有效、耐受性良好的临床一线药物。     

急性心肌梗塞患者的急救与护理体会

目的 探讨急性心肌梗塞的急救与护理,提高临床护理水平.方法 对40例急性心肌梗塞患者的急救与护理,总结护理经验和护理体会.结果 经过对心肌梗塞患者的急救和护理,25例治愈,13例好转,2例死亡.结论 及时有效的急救和护理,对延缓病情进展和挽救患者生命具有重要意义.     

库伯勒·罗斯临终患者心理分期在癌症终末期患者心理护理中的应用

依据库伯勒·罗斯临终患者心理分期,分析临终个体的心理反应,采取个性化心理护理方法,以帮助临终患者认识到死亡的本质,调适对待濒死和死亡的态度与情绪,平静而安详的接受死亡,从而减轻患者死亡之路上的心理挣扎与痛苦;良好的心态正向影响疾病的进展,赢得生命质量的同时亦赢得生命的时间.     

补中益气汤合左归丸、右归丸化裁治疗重症肌无力30例临床观察

目的:探索重症肌无力应用补中益气汤合左归丸、右归丸化裁治疗并证明其有效。方法:辨证将重症肌无力分为脾虚并肾阴虚型及脾虚并肾阳虚型,分别用补中益气汤合左归丸化裁及补中益气汤合右归丸化裁治疗,收集病例30例。结果此法治疗重症肌无力有效率达96.7%。结论:补中益气汤合左归丸、右归丸化裁治疗重症肌无力有确实疗效。     

强化精氨酸肠内营养对烧伤患者营养状况和细胞免疫的影响

Objective To investigate the effects of arginine enriched enteral nutrition (EN) on nu-tritional status and cellular immunity of severely burned patients. Methods Randomized, single blind, parallel and positive control investigation was employed in the study. Thirty severely burned patients were di-vided into enteral immune nutrition (EIN) group and EN group. Sixteen patients in EIN group received en-teral nutrition enriched with arginine, while the other 14 patients in EN group received standard enteral nu-trition. Nutritional support was continued for 14 days. Gastrointestinal reaction of patients in 2 groups was observed. Fasting venous blood was drawn from patients of both groups before receiving nutrition treatment and on the morning of 7th, 14th day of treatment. Level of serum protein, hepatic function parameters, renal function parameters, fasting-blood glucose, and subpopulations of T lymphocytes in peripheral blood were determined. Results (1) Incidence of gastrointestinal side effect in EIN group (25.0%) was close to that of EN group (21.4% , P>0.05). (2) Compared with pre-treatment days, levels of prealbumin and transferrin in serum of patients in 2 groups on 7th and 14th post-treatment days were significantly increased (P<0.05 or P<0.01), but there was no significant difference between 2 groups. The level of total serum protein on 14th day of treatment of patients was significantly increased in both groups, and that of EIN group (66±7 g/L)was significantly higher compared with that in EN group (64 ± 11 g/L, P<0.05). The level of serum albumin (29±5, 32±5 g/L, respectively) of patients in EIN group on 7th and 14th day of treat-ment were significantly higher than that (26±4 g/L, P <0.05) in pre-treatment days, however there was no significant difference in EN group. (3) There was no significant difference in respect of hepatic function, renal function, and fasting-blood glucose between pre-treatment and post-treatment periods in both groups (P>0.05). (4) The ratio of CD4+ , CD8+ on 14th day of treatment in EIN group was close to that of pre-treatment level. In EN group, cell percentage of CD4+ significantly decreased, while that of CD8+ significantly increased (P<0.05), and CD4+ was significantly higher [(56±8) %] in EIN group than that in EN group [(55±12) % , P <0.05]. In both groups, cell percentage of CD3+ was significantly higher than that in pre-treatment days (P<0.05), while there was no obvious change in CD4+/CD8+. Conclusions Arginine enriched enteral nutrition can effectively improve nutritional status and cellular immune function of burn patients.