真空采血试管在开启易拉式静脉输液袋中的应用

临床护理工作中，开启易拉式输液袋是每天实施频率较高的一项操作，直接以手指开启输液袋时容易造成操作者手指红肿，甚至可造成手指皮肤损伤。笔者发现，应用真空采血试管能很方便地开启易拉式静脉输液袋。方法：将真空采血试管代替手指，从易拉环紧贴袋口处插入，超过袋口对侧边，利用杠杆作用轻抬试管，即可轻易拉开易拉环。优点：（1）手指不接触拉环，不会造成手指皮肤损伤；（2）此方法利用杠杆作用，达到了省力的作用，在需要开启大量输液袋的配置中心更加适合；（3）取材方便，操作简单。     

颅内动脉瘤介入治疗的并发症及处理分析

目的探讨血管内栓塞治疗颅内动脉瘤并发症的防治,提高血管内栓塞治疗颅内动脉瘤的安全性。方法回顾性分析我院介入治疗颅内动脉瘤73例,2例发生动脉瘤破裂出血,3例发生血栓形成,6例发生血管痉挛,分别进行对症处理。结果因并发症而出现的神经功能障碍1例,其余患者经积极处理后预后良好。结论栓塞技术的提高,栓塞材料的改进,术中发生情况的正确处理,有助于降低并发症的发生率。     

神经生长因子促再生坐骨神经血管生成的作用

BACKGROUND： It remains to be determined whether nerve growth factor （NGF） can promote angiogenesis in regenerating peripheral nerves during repairing peripheral nerve injury.
OBJECTIVE： To evaluate the effects of NGF on angiogenesis, and to analyze the influencing mechanisms of NGF, according to the expression patterns of CD34, von Willebrand factor （vWF）, vascular endothelial cell growth factor （VEGF）, and the NGF receptor TrkA in proliferating vascular endothelial cells from a rat model of sciatic nerve injury.
DESIGN, TIME AND SETTING： Randomized, controlled study performed at the Research Institute of Field Surgery, Daping Hospital affiliated to the Third Military Medical University of Chinese PLA, between October 2003 and July 2005.
MATERIALS： Forty-five healthy, adult, Wistar rats underwent sciatic nerve injury. The rats were randomly divided into four groups： NGF ＋ chitosan （n = 15）, NGF ＋ chitosan ＋ anti-VEGF （n = 10）, chitosan （n = 10）, and physiological saline （n = 10）. METHODS： A 1 -cm defected sciatic nerve was bridged with a silica gel conduit. NGF ＋ chitosan group： 100 μ L chitosan and 5 μ L NGF （20 mg/L） were injected into the silica gel conduit; NGF ＋ chitosan ＋ anti-VEGF group： an additional 5μ L anti-VEGF monoclonal antibody （1 g/L） was injected into the silica gel conduit; chitosan group： 100μL chitosan and 5 μL physiological saline were injected into the silica gel conduit; physiological saline group： only 5μL physiological saline was injected into the silica gel conduit.
MAIN OUTCOME MEASURES： CD34 and vWf were used to label blood capillaries and large-diameter blood vessels in the regenerating peripheral nerves, respectively. At day 14 following surgery, immunohistochemistry was used to detect and semi-quantitatively analyze expressions of CD34, vWf, VEGF, and TrkA in proliferating vascular endothelial cells in the regenerating sciatic nerve. A confocal laser microscope was used to determine co-expression. RESULTS： Expressions of TrkA, CD34, vWf, and VEGF in the NGF ＋ chitosan group were significantly greater than the physiological saline and chitosan groups （P 〈 0.05-0.01）. Expressions of CD34 and VEGF in the NGF ＋ chitosan ＋ anti-VEGF group were completely inhibited, while expressions of vWf and TrkA gradually decreased, compared with the NGF ＋ chitosan group （P 〈 0.01）. Confocal microscopy revealed strong co-expression of VEGF and CD34 in the regenerating sciatic nerve, and CD34 expression positively correlated with VEGF expression. In addition, VEGF expression was greater than CD34 expression, and coexpression of VEGF and vWf was also strong.
CONCLUSION： VEGF was expressed in blood capillaries and large-diameter blood vessels, while exogenous NGF promoted VEGF expression in regenerating sciatic nerves, thereby increasing angiogenesis.     

颅内动脉瘤术中脑栓塞后成功溶栓1例

患者男,55岁。因＂突发前额部爆炸样胀痛、恶心、呕吐2天＂于2010年02月20日入院。头颅CT诊断：右侧额叶脑出血、蛛网膜下腔出血。既往有高血压病史3年余。体检：血压155/89mmHg,脑膜刺激征（＋）。血凝4项、肝肾功能、CEA、AFP血液生化等常规化验正常;心电图、胸片、     

利多卡因胶浆在小儿尿道扩张术中的应用

[目的]探讨利多卡因胶浆用于小儿尿道扩张术的效果。[方法]选择2004年2月—2006年6月尿道下裂尿道成形术后尿道狭窄患儿50例,随机分为对照组(用常规尿道扩张方法)和实验组(尿道扩张前尿道内注入利多卡因胶浆)。观察患儿疼痛程度、尿道黏膜损伤及一次插管成功率。[结果]实验组疼痛轻,尿道黏膜损伤率低,一次插管成功率高。[结论]利多卡因胶浆应用于小儿尿道扩张术可减轻疼痛,避免尿道损伤。     

三妙散加味治疗血栓性浅静脉炎58例临床观察

血栓性浅静脉炎属中医“脉痹”“瓜藤缠”之范畴，临床多见于下肢，以行走不便，病变处红肿疼痛，沿静脉走行有条索状斑块的硬结为主证。笔者自1998年10月至2006年10月以三妙散加味治疗血栓性浅静脉炎58例，取得较好疗效。现报道如下。     

胃痛治疗刍议

胃痛为常见病，而无通治胃病之方，固患病有新久之殊，体质有阴阳之异，辨证有精粗之差，胃痛有兼夹之分。故在临床中，只有谨守病机、精于辨证，才能收到较好的疗效。①脏腑之间互影响，生克乘侮须深究，其一为肝犯胃，木土相仇，其二为胃病及肺，母病及子，其三胃病及心肾，其四脾胃俱病，其五胃肠同病。②脾湿阴虚相交错、燥湿滋阴须兼顾，常以滋阴的养胃方（自拟方）与燥湿的二陈汤同用。③诊断手段为多种，察舌观苔较实际，阴明胃腑，多气多血，胃中气血每挟邪气上潮于舌，则形成各种舌苔。④胃病原因系多端，兼证波及勿轻视，其中兼饮阴明、便秘、食滞、吐酸、吐血、中虚，皆随证治之，才能服到胃病与兼证两痊之功。     

重症肝炎中医治疗的体会

重症肝炎中医治疗的体会张玉波山东省桓台县妇幼保健所（２５６４００）１概述重症肝炎的范围包括黄疸型肝炎中的急性或亚急性肝坏死、慢性肝炎并发肝细胞大块坏死。在中医属急黄的范畴。初起可有恶寒、发热、疲乏、纳差、呕吐，随即出现全身黄染，并逐渐加深，甚至涕、泪...