后循环梗死的临床特点及危险因素分析

目的阐明后循环梗死常见临床症状、体征及危险因素。方法分析2008年10月-2011年10月在本院神经内科住院的急性后循环梗死患者61例资料。结果患者常见的症状头晕(54.1%)、偏侧肢体无力(45.9%)、恶心及呕吐(39.3%)和言语不清(31.1%);少见症状为视物成双(4.9%)、抽搐(4.9%)及记忆障碍(4.9%)。常见的体征为单侧或双侧肢体运动障碍(45.9%)、共济失调(29.5%)、交叉性瘫痪(3.3%)和眼球活动障碍(4.9%)。在所调查的危险因素中,高血压(72.1%)、高脂血症(63.9%)、糖尿病(36.1%)、既往卒中史(31.2%)及心脏病(27.9%)。结论后循环梗死临床表现复杂,常见的症状为头晕、偏侧肢体无力、恶心及呕吐、言语不清,常见体征为肢体运动障碍,高血压为后循环梗死的主要危险因素,特征性临床表现及体征有助于后循环梗死的诊断及治疗。     

纵论教学医院后勤支撑作用的重要性

1 教学医院后勤保障现状 国家对药品的一次次降价,医疗单位以药养医的现状受到很大的冲击,加之医疗单位人员工资的大幅调高、各种开支大幅度增加、财政对卫生医疗单位事业经费投入的逐年减少直至为零,致使医疗单位出现经济生存危机,迫使医院把主要精力、人力、财力放在能创造效益明显的医疗、医技建设上,以期能直接参与医疗市场竞争而求生存、求发展.现在很多医院经过几十年的运行,后勤人员普遍存在素质偏低、年龄偏大等现象,特别是后勤人员专业技术性不强,随着年龄的增长体力减弱,一些传统工作的优势失去,管理好这些正式职工成为医院包袱.     

一套式固定法在鼻饲患者中的应用效果观察

目的探讨一套式固定法在鼻饲患者中的应用效果。方法将112例鼻饲患者随机分为对照组和观察组各56例。对照组采用传统胶布法固定鼻饲管道,观察组采用一套式固定法固定鼻饲管道。比较两组患者鼻饲管脱出率、皮肤过敏发生率及舒适度情况。结果观察组患者鼻饲管脱出率、皮肤过敏发生率低于对照组;舒适度优于对照组,两组比较,均P0.05,差异具有统计学意义。结论应用一套式固定法固定鼻饲管道,可以减少鼻饲管脱出及皮肤过敏的发生率,增加患者舒适度,值得临床推广应用。     

4种治疗阵发性室上性心动过速药物的疗效与并发症分析

在急诊室抢救室上性心动过速(PST)的方法较多，包括超速抑制、机械刺激和药物治疗等。但应用最多的仍是药物治疗。如异搏定、心律平、西地兰和胺碘酮等。这几种药物在临床上疗效的发挥，与病例选择、使用方法的控制和并发症密切相关。自2000年1月至2003年10月我们接诊PST病例52例。根据患者既往用药及合并症情况分别应用上述四种     

甲状旁腺素及骨转运指标的测定在维持性血液透析患者肾性骨病诊断中的意义

目的本研究通过对维持性血液透析(maintenance hemodialysis,MHD)患者的血清全段甲状旁腺素(intact parathyroid hormone,iPTH)、甲状旁腺素1-84(parathyroid hormone1-84,PTH1-84)、骨碱性磷酸酶(bone alkaline phosphatase,BALP)及骨钙素(osteocalcin,OC)浓度的测定,试评价不同的骨转运指标在诊断肾性骨病中的意义。方法选择首都医科大学附属复兴医院维持性血液透析患者74名,采集临床病史及生化系列结果;健康对照组30名。应用酶联免疫吸附试验(enzyme linked immunosorbent assay,ELISA)分别测定2组血清iPTH、PTH1-84、BALP、OC浓度;甲状旁腺素7-84(parathyroid hormone7-84,PTH7-84)浓度由iPTH、PTH1-84相减而得。结果血液透析组患者的血清iPTH、PTH1-84、PTH7-84、BALP均高于正常对照组,差异有统计学意义(P<0.01);血清OC浓度明显高于对照组,差异有统计学意义(P=0.050)。血透患者的iPTH、PTH1-84均与BALP、OC呈显著正相关(P=0.000)。iPTH与PTH1-84呈显著正相关(r=0.691,P=0.000)。结论血液透析组患者的iPTH与PTH1-84浓度升高,并且与BALP、OC显著相关。将甲状旁腺素的测定与BALP、OC等骨转运指标联合应用,对于肾性骨病的临床诊断有一定的意义。     

中药桃胶涂膜在大鼠Ⅱ度烧伤创面治疗中的实验研究

目的：探讨中药桃胶涂膜对大鼠深Ⅱ度烧伤创面愈合的疗效及作用机制。方法：SD大鼠随机分组,制备背部皮肤圆形深Ⅱ度创面,直径4cm,分别外用桃胶涂膜,磺胺嘧啶银糊和湿润烧伤膏,观察创面愈合情况。记录48小时内创面血流改变并取创面组织进行含水量测定,取不同时相的创面组织行羟脯氨酸（OHP）、白介素（IL）6／8含量测定及细胞DNA周期分析。比较创面愈合时间及愈合率并行组织病理学检查。结果：外用桃胶涂膜使创面结痂早,消肿快,愈合时间短,无感染迹象。血流、含水量、OHP、细胞DNA周期测定显示桃胶涂膜能改善创面微循环,促进创面细胞繁殖和胶原增生。IL6和IL8测定显示减少感染及瘢痕增生。病理形态学发现桃胶涂膜促进附件功能恢复及创面皮肤的分化。结论：中药桃胶涂膜具有促进大鼠深Ⅱ度烧伤创面愈合的作用。     

定君生及奥硝唑对需氧菌阴道炎治疗疗效观察

目的观察定君生及奥硝唑对需氧菌阴道炎(AV)的疗效。方法由我院按AV标准诊断AV60例,对比定君生与奥硝唑的疗效。结果治疗7 d时定君生组与奥硝唑组治疗AV的总有效率分别为90%与87%(P>0.05)。结论 AV是一种由需氧菌引起的阴道炎症,用微生态调节剂定君生治疗AV与奥硝唑相比疗效稍优。     

芪桂胶囊在治疗糖尿病性周围神经病变中的应用

目的对芪桂胶囊的制备及应用进行研究和观察。方法采用煎煮和粉碎制备芪桂胶囊。结果经过临床对78例糖尿病性周围神经病变患者进行疗效观察，其治疗总有效率达97．4％。结论本方组方合理，制备工艺简单，质量可靠，疗效好，无不良反应，值得推广应用。     

先天性马蹄内翻足动物模型胚胎后肢(芽)评分系统的建立

Objective Quantification of the severity of congenital clubfoot is essential for its re-search and treatment. Up to date, no scoring system is available for hind limb bud development. In this study,a scoring system was established based on a murine model Methods Sixty female Wistar rats weighing 220～250 g were randomized into the six control groups and six experimental groups. Vaginal sperm plug detection day was considered to be day 0 of gestation. Hind limb buds from fetuses of E13, 14, 15,16,17 and 18 days were removed and processed. Results Morphogenetic differentiation changes were detected in the experimental groups. According the new scoring system, clubfoot-like deformity was present in 80.9% of the experimental fetuses. We were able to quantify the extent morphogenetic diffcrentiation of the hind limb accordingly. Conclusions Congenital clubfoot deformities begin at early developmental stage and become exaggerated as the fetuses mature. The scoring system can quantify the extent of congenital clubfoot deformity and facilitate its management.     

先天性马蹄内翻足动物模型胚胎后肢(芽)评分系统的建立

Objective Quantification of the severity of congenital clubfoot is essential for its re-search and treatment. Up to date, no scoring system is available for hind limb bud development. In this study,a scoring system was established based on a murine model Methods Sixty female Wistar rats weighing 220～250 g were randomized into the six control groups and six experimental groups. Vaginal sperm plug detection day was considered to be day 0 of gestation. Hind limb buds from fetuses of E13, 14, 15,16,17 and 18 days were removed and processed. Results Morphogenetic differentiation changes were detected in the experimental groups. According the new scoring system, clubfoot-like deformity was present in 80.9% of the experimental fetuses. We were able to quantify the extent morphogenetic diffcrentiation of the hind limb accordingly. Conclusions Congenital clubfoot deformities begin at early developmental stage and become exaggerated as the fetuses mature. The scoring system can quantify the extent of congenital clubfoot deformity and facilitate its management.