胰岛素干预治疗非高血糖急性脑梗死的临床研究

目的 研究胰岛素对非高血糖(血糖≤7.0mmol/L)急性脑梗死的治疗作用及预后的影响.方法 将75例不合并高血糖的急性脑梗死患者随机分为对照组和治疗组,治疗组40例给予常规治疗加胰岛素治疗即每2～4g低浓度糖注射液中加入1U胰岛素治疗10～14d,对照组35例患者只给予常规治疗,两组所有患者都于入院当日、治疗7d、治疗30d用中国卒中量表对神经系统症状和体征进行评估,根据评分比较两组疗效.结果 治疗7d和30d治疗组有效率分别为52.5%、92.5%.对照组分别为28.6%、68.6%,经统计学处理治疗组与对照组疗效有差异性(P均<0.05).结论 胰岛素干预治疗对非高血糖急性脑梗死病情的恢复和改善预后有积极影响.     

中医适宜技术在社区卫生服务中的应用

中医作为祖国的瑰宝,在广大居民中有广泛的群众基础,做为基层医生在提倡"人人享有卫生保健"大趋势下,掌握适当的中医适宜技术,充分发挥中医"简、便、验、廉"的特色优势.为缓解人民群众看病难,看病贵,更好地完成基础保健服务,保障人民群众健康做出努力.     

灰毡毛忍冬花蕾挥发油成分研究

金银花为我国常用中药 ,具有清热解毒、凉散风热的功能 ,常用于外感风热、流行感冒、疖疮痛肿、乳腺炎、痢疾诸病。金银花在我国分布广泛 ,植物来源复杂。据报道 [1,2 ]全国有 2 0余种植物的花蕾在不同地区当金银花入药 ,均为忍冬科 Caprifoliaceae忍冬属 Lonicera植物。其中 ,灰毡毛忍冬 L. macrathoides Hands.-Mazz.在西南地区大量栽培使用 ,为西南地区金银花主流商品之一。挥发油是金银花的活性成分 ,山东产忍冬 L.japonica Thunb.及其变种花蕾的挥发油成分研究已有文献报道 [3～ 5] ,但灰毡毛忍冬干燥花蕾的挥发油成分尚未见报道。…     

北京市10-14岁儿童少年的人格类型及影响因素

目的：认识和探讨10-14岁儿童少年人格类型及其影响因素。方法：本实验于2001—10／11以问卷调查形式进行采用艾森克人格问卷(中国版少年式)对北京市1551名10～14岁儿童少年进行测试。结果：10～14岁的儿童少年人格类型所占比例为外向稳定31．5％、外向不稳定25．8％、内向不稳定24．2％、内向稳定18．5％。在性别特点上，内向不稳定的女生人数多于男生，而男生比女生表现出更多的外向稳定人格类型。在年级特点上，小学生更多地表现出内向稳定的人格特点，而初中生则更多地表现出外向不稳定的人格倾向。在人格类型与学习成绩的关系上，学习成绩优秀的儿童少年在性格上表现出最多的外向稳定特点，内向不稳定的儿童少年成绩中等及以下的人数最多。生活在家庭收入较低环境中的儿童少年，性格最为内向稳定，而当家庭收入在3000元以上时，儿童少年表现出最多的外向稳定特点。父亲、母亲化程度与儿童少年人格类型的关系表现出一致性。当父或母化程度在初等及以下水平时，他们的孩子性格最为内向稳定，而当受过高等教育，他们的孩子表现出最多的外向稳定型人格特点。结论：10～14岁儿童少年外向稳定人格类型所占的比例最高，内向稳定人格类型所占的比例最低。性别、年级、学习成绩、家庭经济收入及父母的受教育水平与儿童少年的人格类型相关。     

短期铁缺乏对大鼠甲状腺功能的影响

目的 研究短期铁缺乏对大鼠甲状腺功能的影响,并探讨其机制,为碘缺乏病的防治工作提供新的线索和思路.方法 选择健康SPF/VAF级初断乳SD雄性大鼠22只,按体质量随机分为对照组(饲料含铁量为65 mg/kg)和铁缺乏组(饲料含铁量为15 mg/kg),每组11只.喂养4周后,测定大鼠体质量和甲状腺质量,并计算甲状腺相对质量.取大鼠全血并分离血清,采用生化法检测血红蛋白、血清铁水平和总铁结合力;化学发光法检测血清游离三碘甲腺原氨酸(FT3)、游离甲状腺素(FT4)和促甲状腺激素(TSH)水平.甲状腺常规固定包埋切片后,免疫组化染色观察甲状腺过氧化物酶(TPO)蛋白表达情况.结果 铁缺乏组大鼠体质量[(214.3±18.1)g]比对照组[(243.8±16.4)g]减轻(t=4.002,P＜0.01),甲状腺绝对质量[(11.9±1.6)mg]比对照组[(13.4±1.3)mg]降低(t=2.369,P＜0.01),但甲状腺相对质量[(0.055±0.004)g/kg]与对照组[(0.055±0.006)g/kg]比较未见明显变化(t=0.162,P＞0.05).铁缺乏组大鼠血红蛋白水平[(100.4±8.9)g/L]和血清铁水平[(7.0±0.8)μmol/L]比对照组[(146.5±16.3)g/L、(26.1±5.1)μmol/L]降低(t值分别为8.233、12.277,P均＜0.01),总铁结合力[(124.8±6.3)μmol/L]比对照组[(74.0±4.6)μmol/L]升高(t=21.531,P＜0.01).铁缺乏组大鼠血清FT3、FT4和FT3/FT4[(4.71±0.53)、(29.69±2.63)pmol/L、0.16±0.02]均较对照组[(5.69±0.61)、(31.98±2.49)pmol/L、0.18±0.01]降低(t值分别为4.044、2.096、3.255,P＜0.01或＜0.05).铁缺乏组大鼠TPO蛋白表达强度较对照组减弱.结论 铁缺乏可导致甲状腺功能低下,可能与铁缺乏状态下TPO活性降低有关,碘铁联合补充可能会改善铁缺乏地区碘缺乏病防治的效果.

Abstract：

Objective To explore the effect of short-term iron deficiency on thyroid function of rat and its mechanism, and to provide new clues and ideas for prevention and control of iodine deficiency disorders. Methods Twenty-two healthy SPF/VAF level weaning male SD rats were randomly divided into control group(iron content in diet was 65 mg/kg) and iron deficiency group(iron content in diet was 15 mg/kg) by body weight, and 11 in each group respectively. After 4 weeks feeding, body weight and thyroid glands weight were measured, and the relative weight of thyroid gland was calculated. Rat whole blood was collected and serum was separated. Hemoglobin, serum iron levels and total iron binding capacity were tested using biochemical assay;serum free iodine thyroid three original acid (FT3), free thyroxine (FT4) and thyroid stimulating hormone (TSH) levels were detected by chemiluminescence;after thyroid were fixed in formalin, embedded with paraffin and sectioned regularly, and immunohistochemical stained, the protein expression of thyroid peroxidase(TPO) was observed. Results Compared with control group [(243.8 ± 16.4)g], iron deficiency group of animals had less body weight[(214.3 ± 18.1 )g, t = 4.002, P ＜ 0.01];there was a lower absolute thyroid weight in iron deficiency group[(11.9 ± 1.6)mg]than in control group[(13.4 ±1.3)mg, t = 2.369, P ＜ 0.01], but no significant changes of the relative weight of thyroid gland between the two groups[(0.055 ± 0.004),(0.055 ± 0.006)g/kg, t = 0.162, P ＞ 0.05]. Hemoglobin and serum iron in iron deficiency group were ( 100.4 ± 8.9)g/L and (7.0 ± 0.8)μmol/L, which were less than that in control group[( 146.5 ±16.3)g/L, (26.1 ± 5.1 )μmol/L, t = 8.233,12.277, all P ＜ 0.01]. Total iron binding capacity in control group was (74.0 ± 4.6)μ mol/L and that in iron deficiency group[(124.8 ± 6.3)μmol/L], and the difference was significant (t = 21.531, P＜ 0.01). At the same time, their serum hormones FT3, FT4 and FT3/FT4[(4.71 ± 0.53), (29.69 ±2.63)pmol/L, 0.16 ± 0.02]were lower than that in control group[(5.69 ± 0.61),(31.98 ± 2.49)pmol/L, 0.18 ±0.01, t = 4.044,2.096,3.255, P ＜ 0.01 or ＜ 0.05]. The expression of TPO protein decreased in iron deficiency group than in control group. Conclusions Iron deficiency reduces thyroid function, which perhaps is due to the reduction of TPO activity. Combined supplementation of iodine and iron will possibly improve the prevention effect on iodine deficiency disorder in iron deficiency areas.     

产科子宫切除术38例原因分析

目的探讨降低产科子宫切除术及并发症发生的可能性。方法对我院近14年所行的38例产科子宫切除术作回顾性分析。结果产科子宫切除术发生率0．13％，其中剖宫产子宫切除占71．1％，阴道分娩子宫切除占23．7％，引产子宫切除占5．2％。子宫切除术主要指征：胎盘因素、子宫收缩乏力、子宫破裂、羊水栓塞、妊娠急性脂肪肝。结论做好孕产妇保健和计划生育，提高产科工作质量，正确掌握剖宫产手术指征，可以有效地降低产科子宫切除率。     

碘铁联合缺乏大鼠动物模型的制备

目的通过饮食控制碘铁摄人量,建立典型碘铁联合缺乏的大鼠动物模型。方法断乳sD雄性大鼠按体重随机分为对照组和模型组,每组30只．分别饲以正常和缺碘缺铁饲料,饮用去离子水。饲养6周后,测量体重和观察发育状态;处死后摘取甲状腺组织称重。过硫酸铵消化砷铈催化分光光度法测定大鼠尿碘,化学发光法测定血清甲状腺激素水平,生化方法测定血红蛋白浓度,血清铁,总铁结合力。其余大鼠12周后进行同样处理。结果饲养6周后模型组大鼠皮肤较对照组苍白,皮毛粗糙稀疏,体重减轻,甲状腺重量明显增加,尿碘水平（22．5μg／L）较对照组（163．8μg／L）明显降低,与碘摄入量基本平行,血红蛋白浓度和血清铁[（69．2±7．4）g／L,（4．9±1．4）umol／L]较对照组[（161．1±9．4）g／L,（27．3±6．5）μmol／L]降低,总铁结合力[（176．3±4．4）μmol／L]较对照组[（99．1±9．0）ixmol／L]增加,游离T4,反T3[（19．45±1．97）pmol／L,（0．20±0．03）nmol／L]较对照组[（34．01±3．28）pmol／L,（0．32±0．06）nmoL／L]降低,模型组大鼠TSH亦有明显增高[（3．11±1．52）VS（1．96±0．83）mU／L],两组问比较差异均有统计学意义（P〈0．05）。饲养12周后,大鼠各项检测指标数据与6周时相似。结论此模型同时具有明显碘缺乏和铁缺乏特征。通过饮食控制大鼠碘铁摄入量可以成功制备典型的碘铁联合缺乏大鼠动物模型。     

PICU实施基于单元的综合安全项目的效果

目的 研究儿科重症学病房实施基于单元的综合安全项目的效果。方法 选取于 2020 年 10 月至 2022 年 11 月在我院儿科重症学监护病房工作的 30 名护理人员与就诊的 10 例儿科重症监护室患儿进行回顾性分析。将全部护理人员作为调查对象,并对基于单元的综合安全项目实施前后护理人员的安全文化调查的回答率、护理质量达标情况、护理过程中不良事件以及家属对护理满意度评价情况进行对比。结果 实施后护理人员对安全文化调查的积极性显著高于实施前（P<0.05）。实施后,护理人员对患儿的护理质量,显著提升,促进患儿机体发育（P<0.05）。实施过后能有效降低不良事件发生率（P<0.05）。 结论 基于单元的综合安全项目的实施,能有效提高护理人员积极性,提高儿科重症学病房患儿的护理质量,能够有效提高安全性。     

新疆阿克苏地区重点人群碘营养和智力水平调查

Objective To investigate the iodine nutritional status of school children, lactating women and infants in iodine deficient areas of Baicheng and Wushi Counties in Xinjiang Autonomous Region. Methods According to the geographic location of east, south, west and north of county, 10 primary schools of 8 townships were selected. In each school, 10 children among each gender and age group from 8 to 10 years old were selected. A total of 300 school children were chosen. One hundred and four infants aged 0-2 years old and their mother were selected in 8 townships. Iodine content in edible salt at household level, the urinary iodine in school children and lactating women, total goiter rate(TGR) and the status of the intelligence quotient (1Q) of school children, the status of psychological development of infants were observed. Direct titration assay for testing the salt iodine, colorimetric ceric-arsenic assay and vitriolic ammonium assimilation were used for testing urinary iodine. The size of thyroid gland was measured by palpation. The Combined Raven Test for Chinese Rural was used to test the IQ. The psychological development of infants was tested by Danver Development Screening Test (DDST). Results The coverage rate of iodized salt at household level was 73.1% (123/182), however, the proportion of households using adequately iodized salt was 64.1% (118/182). The medium of urinary iodine in school children was 103.7 μ/L, with 47.8%(75/157) less than 100 μg/L and 28.0% (44/157) less than 50 μg/L; it was 123.0 μg/L in Baieheng County, with 44.4%(28/63) less than 100 μg/L and 33.3%(21/63) less than 50 μg/L; it was 100.3 μg/L in Wushi County, 50.0%(47/94) less than 100 μg/L and 24.5%(23/94) less than 50 μg/L. The medium of urinary iodine in locating women was 143.3 μg/L, it was 119.7 μg/L and 184.6 μg/L in Baicheng and Wushi Counties, respectively. The total rate of goiter in school children was 14.3%(43/300), it was 10.8%(13/120) and 16.6%(30/180) in Baicheng and Wushi Counties, respectively. The average IQ in school children was 80.6±11.6, it was 83.0±11.6 and 79.0±11.7 in Baicheng and Wushi Counties, respectively. The proportion of mental retardation in school children (IQ≤69) was 13.0% (39/300), it was 6.7% (8/120) and 17.2%(31/180) in Baicheng and Wushi Counties, respectively. In addition, the proportion of psychological development in infants being normal, suspicious and abnormal was 78.8%(82/104), 12.5% (13/104) and 8.7%(9/104), respectively. Conclusion This study confirms the fact that there is also existence of mental retardation in children and infants, caused by iodine deficiency.     

北京市10～14岁儿童少年的人格类型及影响因素

目的:认识和探讨10～14岁儿童少年人格类型及其影响因素。方法:本实验于2001-10/11以问卷调查形式进行采用艾森克人格问卷(中国版少年式)对北京市1551名10～14岁儿童少年进行测试。结果:10～14岁的儿童少年人格类型所占比例为外向稳定31.5%、外向不稳定25.8%、内向不稳定24.2%、内向稳定18.5%。在性别特点上,内向不稳定的女生人数多于男生,而男生比女生表现出更多的外向稳定人格类型。在年级特点上,小学生更多地表现出内向稳定的人格特点,而初中生则更多地表现出外向不稳定的人格倾向。在人格类型与学习成绩的关系上,学习成绩优秀的儿童少年在性格上表现出最多的外向稳定特点,内向不稳定的儿童少年成绩中等及以下的人数最多。生活在家庭收入较低环境中的儿童少年,性格最为内向稳定,而当家庭收入在3000元以上时,儿童少年表现出最多的外向稳定特点。父亲、母亲文化程度与儿童少年人格类型的关系表现出一致性。当父或母文化程度在初等及以下水平时,他们的孩子性格最为内向稳定,而当受过高等教育,他们的孩子表现出最多的外向稳定型人格特点。结论:10～14岁儿童少年外向稳定人格类型所占的比例最高,内向稳定人格类型所占的比例最低。性别、年级、学习成绩、家庭经济收入及父母的受教育水平与儿童少年的人格类