四参三根二花汤治疗鼻咽癌放疗不良反应80例临床观察

放射治疗（放疗）是鼻咽癌患者首选的治疗方法。在放疗过程中，许多患者经常出现口咽部反应，如咽部充血、疼痛、白膜、口腔粘膜溃疡等不良反应，轻者影响进食，重者迫使放疗停止，直接或间接地影响患者的治疗效果和生存期。笔者在临床中自拟四参三根二花汤在鼻咽癌患者放疗中使用，进行临床观察，收到良好效果，现总结如下：     

单纯2型糖尿病患者的风险分层：对冠状动脉钙化成像联合选择性心肌灌注成像的前瞻性评价

目的:确定在单纯2型糖尿病患者中亚临床动脉粥样硬化和心肌缺血的患病率和临床预测因素,并评价其与近期临床预后的关系。方法和结果:以501例无心血管疾病史的无症状2型糖尿病患者(年龄53±8岁,61%为男性)为研究对象,前瞻性检测受试者的已知危险因素和冠状动脉钙化(CAC)评分。所有CAC评分>100Agatston单位(AU)的患者(n=127)以及CAC≤100AU患者中的随机抽样(n=53),接受心肌灌注成像(M PS)检查。46.3%的患者有明显的CAC(>10AU)。在中位期为2.2年的随访(IQR1.9～2.5)中,共发生20例次事件,分别为2例冠状动脉性死亡、9例非致死性心肌梗…     

急性中毒的临床调查及原因分析

急性中毒是急诊常见的危重疾病之一，具有发病急、病情重、变化迅速的特点，而且毒物量越大，毒性越强，病人受损脏器越多。若不及时治疗可危及生命。它的发生给病人及其家人均带来极大的痛苦与伤害，严重影响着其身心健康。因此，加强健康教育，预防和减少中毒的发生非常重要。通过临床对急性中毒发生的年龄特点及原因与毒物种类进行分析，现将其报告如下。     

弥漫性轴索损伤病人的护理

弥漫性轴索损伤（diffuse axonal injury，DAI）是以胼胝体、脑十等中线部位局灶性病变及脑白质广泛性轴索损伤为主，以原发昏迷时间长而又缺乏神经定位体征为其临床特征的一组原发性弥散性脑损伤。在重型颅脑损伤中占20％，病死率高达42％～62％。最常见于车祸颅脑损伤病人，也可见于高处坠落伤者。病人多合并其他部位损伤，特点为伤情重、变化快、并发症和休克发生率高，且病死率高。护理时矛盾多，易顾此失彼，影响临床治疗效果。为更好地总结对该类损伤病人的救治，     

穴位注射结合中药外洗治疗疣效果观察

目的 探讨黄芪注射液穴位注射结合中药外洗治弃疣的疗效。方法 将169例疣患者随机分为治疗组（92例）和时照组（77例）。对照组用聚肌胞注射液肌内注射，治疗组采用黄芪注射液穴位注射及苡仁、板蓝根、莪术等中药外洗。结果 治疗组有效率90．22％．对照组有效率68．83％．两组比较，差异有显著性意义（P〈0.01）。结论 穴位注射结合中药外洗治疗疣效果良好．且方法简单。     

Persistent fifth aortic arch associated with 22q11.2 deletion syndrome.

BACKGROUND: Chromosome 22q11.2 deletion is frequently associated with conotruncal malformations and aortic arch anomalies. This study investigated the association of chromosome 22q11.2 deletion with clinical manifestations in four pediatric patients with persistent fifth aortic arch. METHODS: Four patients with persistent fifth aortic arch treated between July 1997 and June 2004 were included in this retrospective study. There were two girls and two boys, aged 2 days to 11.3 years, with persistent fifth aortic arch and cardiac conotruncal malformations. Chart recordings, plain chest films, two-dimensional and Doppler echocardiograms, cardiac catheterization with angiograms, surgical findings, and cytogenetic study were analyzed. RESULTS: Clinically, all four patients had the cardinal phenotypic features of 22q11.2 deletion syndrome, including cardiovascular malformations (conotruncal malformations and aortic arch anomalies), abnormal facies, thymic hypoplasia, canopy anomaly of the palate (high-arched palate, rather than cleft palate), and hypocalcemia (or hypoparathyroidism). All four patients were confirmed to have chromosome 22q11.2 deletion. CONCLUSION: Congenital conotruncal malformations, including tetralogy of Fallot with pulmonary atresia or stenosis, and aortic arch anomalies including a persistent fifth aortic arch or a right aortic arch, should lead to suspicion of chromosome 22q11.2 deletion when manifested together with any one of the other four cardinal phenotypic features.     

癌症病人化疗过程真实体验的质性研究

[目的]了解癌症化疗病人在接受化疗过程中内心真实体验，以引导护士更好地为病人提供全身心护理。[方法]采用深度访谈法收集14例个案资料，用现象学分析法进行分析。[结果]癌症病人化疗期间真实体验主要包括抑郁与勉强接受、痛苦与忍耐、健康信息需求、照顾与支持需求。[结论]医护人员在为癌症病人化疗时应全面了解其身心需要，开展全方位护理。     

脓汁查抗酸阳性杆菌感染一例报道

患者，王丽莹，女，47岁，患者主诉，左侧乳房始终有一溃疡，并流脓汁，看过好多地方，用过好多抗菌素，始终未治愈。     

我院2000-2004年医院感染革兰阴性杆菌耐药性趋势的研究

[目的]了解2000年～2004年院内感染革兰阴性杆菌分布及其耐药性。[方法]主要使用MicroScan-4微生物鉴定及药敏仪对2000年1月～2004年12月引起院内感染革兰阴性杆菌进行鉴定及药物敏感试验，结果录入Whonet5．3软件进行分析、统计。[结果]5年间，革兰阴性杆菌所致医院感染中，大肠埃希菌比例最高，在32．8％～38．1％之间，阴沟肠杆菌、不动杆菌比例呈上升趋势。细菌的耐药率在逐年上升，其中阴沟肠杆菌和鲍曼不动杆菌，耐药性高于其它革兰阴性杆菌（P〈0．05），对第三代头孢菌素耐药率分别达到60％～80％、40％～70％。对亚胺培南耐药的菌株日益增多。[结论]细菌的耐药性逐渐增强，阴沟肠杆菌、鲍曼不动杆菌成为非常重要的医院感染病原菌，医务工作者要重视医院感染，加强耐药性监测，合理使用抗生素。     

Relationship between Mandarin speech reception thresholds and pure-tone thresholds in the geriatric population.

BACKGROUND/PURPOSE: In the geriatric population, the reliability of pure-tone threshold (PTT) is sometimes poorer than that in young adults because of various reasons. This study assessed the relationship between Mandarin speech reception thresholds (SRTs) and PTTs in the aged and developed SRT as a measure for corroborating PTT. METHODS: This prospective study enrolled 46 consecutive subjects over 60 years of age. The results of SRT and PTT were collected from one ear randomly selected from each subject. Simple linear and multiple regressions were used to determine the correlation and linear regression coefficients between SRTs and PTTs at various frequencies. RESULTS: In the simple regression analysis, the correlation coefficient was highest at 1000 Hz (r = 0.949) and 500 Hz (r = 0.922), followed by 250 Hz (r = 0.850) and 2000 Hz (r = 0.792). In the multiple regression model with SRT as the dependent variable and PTTs as predictor variables, the resultant multiple correlation coefficient R was 0.967, while R2 was 0.936. In this model, PTTs at the frequencies of 500 Hz and 1000 Hz contributed significantly to the variance in SRTs with p values of 0.029 and < 0.001, respectively. These results demonstrated that the Mandarin SRT is strongly associated with PTTs at the frequencies of 500 Hz and 1000 Hz. CONCLUSION: This study established the agreement between Mandarin SRTs and PTTs in the low tone area of speech frequencies in the geriatric population. In clinical settings, SRT test can be rapidly and easily performed and is relatively inexpensive. It is a vital indicator of the accuracy of PTT measurement.