急性酒精中毒患者宜常规检测血糖(附112例分析)

我院2003年5月-2005年4月共收治由于饮酒过量引起的急性酒精中毒（乙醇中毒）112例,检测血糖发现部分患者血糖低,现报告如下。     

持续质量改进在提高产房助产士会阴伤口缝合技术中的应用效果分析

目的分析持续质量改进在提高产房助产士会阴伤口缝合技术中的应用效果。方法选取我院产房2019年5月-2019年9月接收的64例产妇,随机分为两组,对照组行常规护理,观察组进行持续质量改进,观察患者术后3天、术后7天以及产后1个月会阴伤口愈合情况。结果观察组三次伤口愈合结果显著优于对照组(P<0.05)。结论通过持续质量改进提高产房助产士会阴伤口缝合技术,可有效改善产妇产后伤口恢复情况。     

靶点射频热凝治疗顽固性颈型颈椎病的临床观察

目的 观察靶点射频热凝治疗顽固性颈型颈椎病的临床疗效和不良反应.方法 78例顽固性颈型颈椎病患者行靶点射频热凝治疗,采用简化Mcgill疼痛问卷评定患者治疗前、治疗后3d及治疗后1个月疼痛程度,采用Odom疗效评判法评定治疗疗效.结果 治疗后3d及治疗后1个月患者疼痛评分明显低于治疗前,差异有显著性(P＜0.05),治疗有效率分别为91.0％和93.6％.治疗中及治疗后患者均未发生严重不良反应.结论 靶点射频热凝是一种治疗顽固性颈型颈椎病有效而且安全的方法.     

TOLL样受体4拮抗剂干预周围神经损伤后的瓦勒变性

BACKGROUND: The mechanism underlying Wallerian degeneration following peripheral nerve injury is complex. Immune regulation on Wallerian degeneration is beneficial for early repair of perpheral nerve injury. OBJECTIVE: To investigate the effects of Toll-like receptor 4 (TLR4) antagonist on Wallerian degeneration and axonal regeneration after early peripheral nerve injury in rats. METHODS: Fifty male Wistar rats were recruited and randomly divided into treatment group (n=20), model group (n=20) and sham group (n=10). The right sciatic nerves of rats in treatment and model groups were cut and sutured end-to-end, while the sciatic nerves of rats in sham group were only exposed. In the treatment group rats were intravenously injected with 0.15 mg/kg TAK-242 via tail vein 1 hour preoperatively and 7 days postoperatively, and the rats in the other two groups were given intravenous injection of the same volume of normal saline. The sciatic nerves were removed at 24 hours, 3, 4 and 7 days after surgery. RESULTS AND CONCLUSION: Real-time PCR indicated that the mRNA expressions of interleukin-1β and monocyte chemoattractant-1 were significantly increased in the model group compared with the sham group at 24 hours after surgery (both P < 0.001), while the expressions were significantly decreased after TAK-242 injection (both P < 0.001). Immunofluorescence showed that compared with the model group, down-regulated expression of CD68+ and iba1+ cells appeared in the treatment group at 3 days after surgery (P < 0.01, P < 0.05). Luxol fast blue staining revealed that demyelination at the sciatic nerve stump appeared in both model and treatment groups at postoperative 7 days, but myelin debris clearance in the treatment group was significantly reduced compared with the model group (P < 0.05). Hematoxylin-eosin staining showed that a lot of inflammatory cells, Schwann cells and regenerated nerve fibers at the sciatic nerve stump were found in the model group, while there were few inflammatory cells, Schwann cells and regenerated nerve fibers in the treatment group at 7 days after surgery. Immunohistochemistry found that the expression of growth-associated protein-43 in the treatment group was significantly lower than that in the model group at 4 days postoperatively (P < 0.05). Besides, compared with the model group, a significantly decreased sciatic functional index was found in the treatment group at 20, 30 and 40 days after surgery (P < 0.05). These results show that TLR4 antagonists delay early nerve regeneration in rats after sciatic nerve injury probably by inhibiting the TLR4 signaling pathway. 中国组织工程研究杂志出版内容重点：组织构建;骨细胞;软骨细胞;细胞培养;成纤维细胞;血管内皮细胞;骨质疏松;组织工程     

膀胱肉瘤样癌临床病理学特征及预后分析

目的总结国内膀胱肉瘤样癌87例临床病理学特征及预后,以期提高对膀胱肉瘤样癌的认识和诊治水平。方法复习解放军总医院1999—2010年间经病理确诊的膀胱肉瘤样癌,并结合国内1994年以来文献报道病例的临床、病理及随访资料进行复习,采用Kaplan meier法计算患者的生存率,并用Log-Rank检验分析各临床病理特征与预后的关系。结果我院确诊的膀胱肉瘤样癌13例,加上国内报告具完整资料的膀胱肉瘤样癌74例,总计87例。其中男性69例,女性18例,年龄13～89岁,中位年龄66岁;45例肿瘤发生于膀胱侧壁,12例肿瘤位于膀胱三角区;81例行手术切除;肿瘤直径为2～15 cm,平均5.1 cm。形态学表现为具有向上皮和间叶双向分化的恶性肿瘤,76例见有高级别尿路上皮癌成分;44例具有明确的浸润深度资料,其中23例浸润肌层,18例累及膀胱壁全层,3例伴局部脏器累及。免疫组化染色示肉瘤样癌区域vimentin和CK(+)。87例中69例获得随访结果,其中38例死亡,中位生存期为10个月,1、3、5年生存期分别为48%、23%和21%。性别、年龄、临床症状、肿瘤解剖部位、大小、手术方式、上皮癌类型、浸润深度均与预后无统计学相关性。结论膀胱肉瘤样癌多发生于老年男性,就诊时即为高级别、高分期,恶性程度高,预后不良。早期诊断和采用手术切除仍是首选治疗方式,但术式与患者生存期无关,临床分期与生存期的关系有待于进一步研究。     

颅内消瘀汤治疗颅脑损伤的临床观察

目的研究颅内消瘀汤对颅脑损伤患者神经功能的影响。采用简单随机方法将60例颅脑损伤患者分为治疗组30例和对照组30例,治疗组常规治疗加颅内消瘀汤,对照组常规治疗。结果治疗4周后,治疗组神经功能恢复情况与对照组比较差异有显著性（P〈0.05）。结论颅内消瘀汤可促进神经功能的恢复,提高临床疗效。     

双目手术显微镜与耳内镜下对行人工镫骨手术患者围术期指标、听力恢复及并发症的影响

目的 观察双目手术显微镜与耳内镜下对行人工镫骨手术患者围术期指标、听力恢复及并发症的影响.方法 选取遂宁市中心医院行人工镫骨手术患者160例, 依据术中放大设备差异分为A组 (n=80) 与B组 (n=80) , A组采用双目手术显微镜, B组采用耳内镜, 比较2组围术期指标 (手术时间、术后苏醒时间、住院时间) , 并观察2组术前与术后3个月听力变化、并发症情况.结果 A组手术时间与术后苏醒时间均明显短于对照组 (P<0.05) , 2组住院时间比较差异无统计学意义 (P>0.05) ;术后3个月, 2组气导听阈、气骨导间距均较术前明显降低 (P<0.05) , 且组间比较差异无统计学意义 (P>0.05) ;2组术后并发症总发生率比较差异无统计学意义 (P>0.05) , 所有并发症经对症处理后完全消失.结论 与耳内镜相比, 双目手术显微镜下行人工镫骨手术, 手术时间短, 术后麻醉苏醒快, 2种放大设备在恢复患者听力方面的疗效相当, 且并发症均较少.     

β-七叶皂甙钠治疗46例脑水肿疗效观察

我科于1995年10月～1996年5月间使用山东烟台绿叶制药有限公司生产的β-七叶皂甙钠治疗脑外伤、脑出血以及开颅手术后等所致的脑水肿患者46例，经临床观察，疗效显著。现报告如下。1．一般资料：46例中男29例，女17例；年龄最小9岁，最大68岁，平均41岁。其中脑外伤引例，脑出血15例；因上述疾病而行开颅手术23例，合并四肢骨折7例。全部病例均行颅脑CT检查。2用药方法：成人每日15～30mg，加入10％葡萄糖液50On。l分2～3次给药。7～10d为～疗程。囚病情需要可连用2个以上疗程。一般每l。I剂量不超过O，sn。s／ks，儿童用药量为O．Zms／…     

神经妥乐平治疗早期外伤性脑梗死136例疗效观察

我科1999年7月～2003年10月用神经妥乐平注射剂治疗早期外伤性脑梗死患者136例，观察其疗效．现报告如下。