浙江宁波市与湖南永州市两地城乡变应性鼻炎的流行病学调查

目的:调查变应性鼻炎(AR)在浙江宁波市与湖南永州市两地城乡的流行情况.方法:2006年10月～2007年6月随机抽取2市15个调查点(村或居民小区以及2个医院体检中心),采用描述性研究中的现况研究方法,现场发送自填问卷与面访问卷调查相结合,对有AR症状的患者进行专科检查予以确诊.结果:①抽取4 294户(11 231人),实际调查3 803户(9 969人),AR患病人数303人;②2市AR患病率:宁波市4.10%,永州市1.65%(经性别校正后分别是4.10%、1.64%,经年龄校正后分别是4.33%、1.58%),海岛居民患病率最低0.73%;③AR并发哮喘8%;有家族史12%.结论:AR患病率宁波市高于永州市(均P<0.05);城市高于农村;以青少年(36岁以下)患病率为高.AR患者有可能并发哮喘和受遗传因素影响.AR有治愈的可能.     

逆行荧光标记观察猫上橄榄复合体向内耳的投射

Objective To investigate the distribution and projective feature of cat olivocochlear neurons. Methods Eleven adult cats were divided into two groups randomly. The experimental group of eight cats was injected of I% cholera toxin B (CTB) to the left cochlea, while injected of 5% fluoro gold (FG) to the right cochlea. The control group of three cats was injected of saline to bilateral cochlea. After a survival time of 7 days, serial frozen sections were cut in the cat brainstem. All the sections were processed by immunofluoreseent procedure for CTB and FG, and the labeled olivocochlear neurons were observed byfluorescent microscope. Results In the experimental group, the mean total of olivocochlear neurons labeled by CTB and FG was 3210 ± 168, including lateral olivocochlear neurons (LOC, 2298 ± 120) and medial olivocochlear neurons (MOC,913 ± 64). The labeled neurons were divided into three different types according to their feature of projection: neurons which only projected to the ipsilateral cochlea, neurons which only projected to the contralateral cochlea, and double-labeled neurons which projected both to the ipsilateral and contralateral cochlea, but the double-labeled neurons comprised 3.9% and 15. 1% in the LOC and MOC system respectively. No labeled neurons were found in the control group. Conclusions There are three types of neurons in the cat olivocochlear system. The neurons which projected to the bilateral cochlea may distribute both in the LOC and MOC system.     

逆行荧光标记观察猫上橄榄复合体向内耳的投射

Objective To investigate the distribution and projective feature of cat olivocochlear neurons. Methods Eleven adult cats were divided into two groups randomly. The experimental group of eight cats was injected of I% cholera toxin B (CTB) to the left cochlea, while injected of 5% fluoro gold (FG) to the right cochlea. The control group of three cats was injected of saline to bilateral cochlea. After a survival time of 7 days, serial frozen sections were cut in the cat brainstem. All the sections were processed by immunofluoreseent procedure for CTB and FG, and the labeled olivocochlear neurons were observed byfluorescent microscope. Results In the experimental group, the mean total of olivocochlear neurons labeled by CTB and FG was 3210 ± 168, including lateral olivocochlear neurons (LOC, 2298 ± 120) and medial olivocochlear neurons (MOC,913 ± 64). The labeled neurons were divided into three different types according to their feature of projection: neurons which only projected to the ipsilateral cochlea, neurons which only projected to the contralateral cochlea, and double-labeled neurons which projected both to the ipsilateral and contralateral cochlea, but the double-labeled neurons comprised 3.9% and 15. 1% in the LOC and MOC system respectively. No labeled neurons were found in the control group. Conclusions There are three types of neurons in the cat olivocochlear system. The neurons which projected to the bilateral cochlea may distribute both in the LOC and MOC system.     

重组人粒细胞巨噬细胞刺激因子药物利用评价标准的建立与应用

目的 建立注射用重组人粒细胞巨噬细胞刺激因子(Recombinant Human Granulocyte/Macrophage Colony-stimulating Factor for Injection, rhGM-CSF)药物利用评价标准,为临床合理应用rhGM-CSF提供参考。方法 以rhGM-CSF药品说明书为基础,参考相关指南和文献,并通过与临床专家讨论建立药物利用评价标准,采用回顾性调查方法,对漳州市某医院2019年6月～2022年6月使用rhGM-CSF的住院患者病历进行评价。结果 共纳入157份病历,用药合理率为66.24%,不合理用药情况主要为给药剂量不适宜(13.38%)、给药时机不适宜(10.83%)、超说明书用药(7.01%)等方面。结论 建立的rhGM-CSF药物利用评价标准有较强的科学性、实用性和可行性,在给药剂量、给药时机等管理方面可进一步优化。     

头孢呋辛钠治疗老年慢性阻塞性肺病合并感染的临床效果

选择收治的老年COPD合并感染患者100例,随机分为试验组和对照组各50例,分别在常规治疗COPD基础上,对照组给予常规青霉素治疗,试验组采用头孢呋辛钠治疗,比较两组治疗效果。试验组平均临床症状消失时间为5.1±1.1d,体温和血象指标恢复时间分别为2.2±1.0d和3.4±1.3d,X线胸片消失时间为6.3±1.4d,试验组的各项临床指标和恢复时间与对照组比较,均有显著性差异,且差异具有统计学意义(P0.05)。试验组总有效率为86.0%,对照组为78.0%,两者差异具有统计学意义(P0.05)。采用头孢呋辛钠治疗老年COPD合并感染患者取得了良好的临床效果,可有效抵抗感染,改善临床症状。     

那些花儿

那是实习的第一个星期,带着难以言表的热情和好奇,每次下班后,我们都在寝室讨论病房的新鲜事.而每次大家都不约而同地提到了16床的病人,和他床头柜上的那些花儿!     

逆行荧光标记观察猫上橄榄复合体向内耳的投射

目的 探讨猫橄榄耳蜗神经元的分布和向内耳的投射特征.方法 11只成年猫随机分为两组,实验组8只,左侧耳蜗鼓阶内注射1%霍乱毒素B亚单位,右侧耳蜗鼓阶注射5%荧光金,对照组3只,双侧耳蜗均注射生理盐水.动物饲养7 d后处死,脑干连续冰冻切片,免疫荧光处理,荧光显微镜观察被标记的橄榄耳蜗神经元.结果 实验组每只动物被霍乱毒素B亚单位和荧光金标记的橄榄耳蜗神经元平均总数为(3210±168)个,分为外侧橄榄耳蜗神经元[(2298±120)个]和内侧橄榄耳蜗神经元[(913±64)个].根据投射特征可将被标记的神经元分为三种不同类型:只投射到同侧耳蜗的神经元,只投射到对侧耳蜗的神经元,既向同侧又向对侧耳蜗投射的双标记神经元,其中双标记神经元在外侧橄榄耳蜗神经元和内侧橄榄耳蜗神经元中分别占3.9%和15.1%.对照组未观察到被标记的檄榄耳蜗神经元.结论猫的橄榄耳蜗系统中存在三种不同投射特征的神经元,其中双侧投射的神经元在外侧橄榄耳蜗神经元和内侧橄榄耳蜗神经元中均有分布.     

胃镜下取上消化道异物126例体会

上消化道异物是消化内科常见急症之一,易引发消化道出血、穿孔、梗阻等而危及生命,随着内镜的普及应用,内镜下取异物已成为上消化道异物治疗的首选方法。我院自2008年1月至2010年12月在胃镜下取上消化道异物126例,均获成功且无并发症发生。现将其病例资料和临床体会报道如下：     

品管圈对降低胃肠外科患者失禁性皮炎发生率的影响

目的 探讨品管圈手法在降低胃肠外科患者失禁性皮炎(incontinence associated dermatitis,IAD)发生率的应用效果,减少患者痛苦及住院时间,提高患者满意度。 方法 蚌埠医学院第一附属医院胃肠外科从2014年1—10月成立失禁性皮炎品管圈小组,确定以“降低胃肠外科患者失禁性皮炎发生率”为活动主题,通过制定查检表,1～3个月查检患者120例应用脑力激荡方法查检影响失禁性皮炎发生的因素,应用鱼骨图、柏拉图、柱状图等分析患者、家属、医护人员等因素对失禁性皮炎的影响,学习相关理论进行皮肤评估,改进护理工具,对护理流程进行培训,要因进行汇总,制定真因查检表查检真因后确定对策实施与检讨,最后制定标准化流程在全院进行推广。 结果 本小组解决了在实施过程中遇到的压疮高危,更换尿垫不及时,局部皮肤潮湿,护理评估不准确、不及时的问题的应用现状。 结论 品管圈活动在提高个人素质修养、解决问题的能力、个人责任心、积极性、自信心、团队凝聚力及与患者的沟通协调能力等方面都有所提升,使护理质量得到持续改进,其发展趋势是广泛应用品管圈这个平台来完善护理措施、细化工作流程、提高优质护理服务质量。      

硫糖铝、654-2治疗溃疡期褥疮的体会

我们于 1995年 10月至 2 0 0 2年 4月试用硫糖铝、6 5 4 2治疗溃疡期褥疮 2 3例 ,具有较好疗效 ,现报告如下。临床资料一、一般资料　 4 6例溃疡期褥疮患者均系我院住院患者 ,符合溃疡期褥疮诊断标准 ,其中男 17例 ,女 2 9例 ,平均年龄 5 6 2 8岁 ;病情分类 :脑血管病 30例 ,恶液质 8例 ,重度衰竭 5例 ,高位截瘫 3例。褥疮部位 :骶尾部 33例 ,髋部 6例 ,肩胛部 4例 ,足跟部 1例 ,外踝 1例 ,肘部 1例。按《护理学基础》褥疮标准评定 ,确定其面积、深度 ,溃疡面积 :最小17mm× 2 8mm ,最大 10 0mm× 88mm ,平均 ( 5 2 88± 4 7 76 )mm。Ⅲ…