摆脱光环下的抑郁阴影

"Leslie的气息已经永远留在装满你我的空气里,他可以死亡,但永远都不会离去."这是哥哥离开两周年的日子--2005年愚人节,一个网友发的纪念帖.     

肝硬化部分脾动脉栓塞患者的康复指导

肝硬化门脉高压患者约83％合并有不同程度的脾功能亢进，严重影响着患者的生命质量。目前应用部分脾动脉栓塞术治疗脾功能亢进因为能改善脾亢症状，还能降低门静脉压力，改善患者的肝功能，且创伤小，病人痛苦小，操作简单，并发症少且轻，疗效好且费用低，临床应用日渐广泛，治疗上取得很好疗效的同时，临床宣教及护理工作也积累了较多的经验。     

西部民族地区留守老年人心理健康状况与心理干预

[目的]调查西部民族地区留守老年人的心理健康状况,并进行心理干预,以减轻他们的心理压力,保持心理健康。[方法]选取湘、鄂、渝、黔四省（市）西部边区290名留守老年人进行问卷调查并对132名老人进行心理干预。[结果]有290名留守老年存在不同程度的心理应激,经常焦虑86名,占29.7,经常有不同程度的兴趣下降146名,占50.3;132名老年人经心理干预后心理健康状况明显改善。[结论]对西部民族地区留守老年人应加强关心,进行心理调节,并及时对他们进行心理疏导。     

有创血压在ICU中监测与护理探讨

有创血压监测就是通过压力监测仪直接测量动脉压的方法。它有以下的优点：可及时准确地反应患者动脉血压的动态变化，协助病情分析；间接用于判断血容量、心肌收缩力、周围血管阻力以及心脏压塞等情况；应用于心脏病患者手术以及重症患者能够及时反应病情的发展状态，指导血管活性药物的使用和调节；可随时抽取动脉血行血气分析，避免频繁穿刺给患者带来疼痛或血管壁的损伤。     

职场新鲜人：停看听三步走

社会新鲜人找到工作的喜悦，很快会被上班带来的惶恐给冲淡，毕竟学校与职场大不相同，将让充满理想有冲劲的新鲜人面临种种挑战，例如能否胜任工作、压力调解、人际关系以及利益冲击等。     

Influence of moderate hypothermia on cerebral oxygenation in pigs with intracranial hypertension

BACKGROUND: Moderate hypothermia is one of the effective therapeutic methods for head injury in recent years, there are many mechanisms of moderate hypothermia for brain protection, and its influence on cerebral oxygenation is also one of them. OBJECTIVE: To observe the influence of moderate hypothermia on cerebral oxygenation of animals with acute intracranial hypertension, and further investigate the protective mechanism of moderate hypothermia. DESIGN: A randomized controlled trial. SETTING: Department of Neurosurgery, Renji Hospital affiliated to the Medical College of Shanghai Jiao Tong University. MATERIALS: Twenty healthy little pigs, either male or female, weighing 4.5–5.5 kg, were used. Neurotrend-typed multiparameter monitoring system (Diametrics Company, British); CMA/100 micro-injection pump (Carnegie Company, Sweden). METHODS: The experiment was conducted in the Changzheng Hospital affiliated to the Second Military Medical University of Chinese PLA in November, 2001. The pigs were randomized into two groups: the normothermia group (control group, n =10) and moderate hypothermia group (n =10). ① Bilateral femoral arteries were separated, one was connected to pressometer for monitoring mean arterial pressure (MEP), and the other for analysis of blood gases [including peripheral blood pH value, arterial partial pressure of carbon dioxide (PaCO2), arterial partial pressure of carbon dioxide (PaCO2), HCO3–]. ② Rectal temperature was monitored with mercurial thermometer. ③ Intracranial pressure was monitored using Camino optic ICP probe placed in the subdural space. ④ Neurotrend multiparameter monitoring sensor was inserted into the white matter for about 4 cm to determine cerebral perfusion pressure (CPP, CPP=MAP(ICP), brain tissue partial oxygen pressure (PO2), partial pressure of carbon dioxide (PCO2), HCO3– and brain temperature. The rectal temperature of animals in the moderate hypothermia group was lowered to 34 ℃ using ice bags, and the body temperature was maintained at 33–35 ℃ for 2 hours. The changes of the parameters were observed continuously, and the pigs in the normothermia group were not treated with cooling. MAIN OUTCOME MEASURES: ① MAP, ICP, rectal temperature, CCP; Indexes of cerebral oxygenation detected with Neurotrend-typed multiparameter monitoring system; ② Results of blood gases analysis in the moderate hypothermia group. RESULTS: All the 20 pigs were involved in the analysis of results. ① MAP, ICP, rectal temperature, CCP and indexes of cerebral oxygenation: In the moderate hypothermia group, the ICP after cooling was obviously lower than that before cooling [(3.31±1.19), (5.33±0.95) kPa, P < 0.05], CCP was higher, brain tissue PCO2 [(12.03±1.73), (10.59±2.01) kPa, P < 0.05], and brain tissue pH value was higher [(7.03±1.63), (9.40±1.30) kPa, P < 0.05], whereas the brain temperature was decreased as compared with that before cooling [(34.9±0.3), (37.2±0.2) ℃, P < 0.05]. ② Results of blood gases analysis in the moderate hypothermia group: There were no significant differences in the parameters of peripheral arterial blood gases analysis before and after cooling in the moderate hypothermia group (P > 0.05) CONCLUSION: Moderate hypothermia will not impair the cerebral oxygenation, and it can reduce brain tissue CO2 and decrease brain tissue acidosis.     

护士工作压力现状分析

护士工作压力作为一个突出的问题，近年来已受到越来越多的国内外学者的关注，相关报道更是层出不穷。护士这个被公认为是“高级保姆”的职业，能引起社会各界和相关学者的关心，笔者作为护士中的一员深感欣慰，但现实是护士压力状况在一定条件下并没有得到切实的改善。以儿科为例：工作现状更是让人担忧。就此，笔者调查了两家大医院的儿科护理工作者的现状。     

神经外科NICU护士的职业压力与释放

目的：进一步分析探讨NICU护士的职业压力，并寻求相应的对策，以减轻护士压力，保持身心健康。方法：2007年6月-2008年6月，每月定期应用Zung焦虑白评量表（SAS）对NICU护士进行焦虑问卷调查。结果：根据问卷调查显示NICU护士所承受的不同压力，采取应对方式，使护士压力得到有效的释放。结论：了解NICU护士工作中主要的压力源及应对策略，为有效地帮助护士减轻工作压力，保持身心健康提供依据。     

血小板在血管生成中的作用

血管生成（angiogenesis）是指在原有微血管的基础上通过出芽或其它方式形成新血管的过程，在机体的生理或病理过程中起着重要的作用。研究发现，血小板也参与了血管生成。文中就血小板在血管生成中的作用方式及与肿瘤血管生成的关系作一综述。