创伤性气胸胸腔闭式引流的相关护理

目的探讨分析创伤性气胸胸腔闭式引流的临床相关护理。方法选取2009年2月至2012年4月来我院就诊治疗的80例创伤性气胸行胸腔闭式引流患者,对此80例患者进行全面系统的护理,观察统计患者护理过程中的并发症发生情况及患者满意度情况。结果 80例患者在护理过程中有28例患者发生了并发症包括管周疼痛、皮下气肿及导管滑脱,其中护理满意患者71例,患者满意度达88.8%。结论创伤性气胸行胸腔闭式引流患者进行全面系统的护理,密切关注患者病情,及时对症处理,可以有效改善患者的痛苦,提高患者满意度。     

Patients’ role in reporting adverse drug reactions

This review discusses the involvement of patients in the reporting of adverse drug reactions (ADRs). Patients benefit from drugs but also experience their adverse effects. Since concerns about the safety of drugs are also patients’ concerns, the patient could also play a part in decreasing the risks of drug therapy. Patient interest in the safety aspects of drugs is evident. At an international level, the merits of patient reports are being considered. To date, the literature does not yet provide any actual results in relation to the detection of ADRs by patients. Different considerations regarding ADR reporting by patients are discussed. The authors conclude that we should positively value patients’ involvement in drug therapy and their concern regarding possible adverse effects. As a consequence, patients’ reports on ADRs should be accepted.     

微创手术治疗自发性气胸的临床观察

目的探讨微创手术治疗自发性气胸的临床治疗效果。方法本次临床研究以2011年1月至2011年12月之间在我院就诊的40例自发性气胸患者为观察对象,所有患者均依据随机分组法分为对照组和实验组,对照组患者行常规的后外侧切口手术治疗,实验组患者行微创手术手术治疗,回顾两组患者的临床治疗效果。结果实验组患者治疗成本、术后胸引量、术中失血量、术后住院时间、切口疼痛程度和手术时间等各项临床指标均显著优于对照组患者,两组患者手术治疗效果对比统计学差异显著(P<0.05)。讨论微创手术治疗自发性气胸,与常规的临床治疗方法相比,治疗效果更加理想,且具有费用低、恢复快和手术创伤小等显著优势,因而临床应用价值较高。     

Fas/FasL系统在RSA患者蜕膜与绒毛组织的表达及临床意义

目的探讨反复自然流产患者蜕膜与绒毛组织Fas/fasL的表达和研究其临床意义。方法采用免疫组化法检测33例反复自然流产患者绒毛组织Fas/FasL的表达水平,并以30例健康早孕组为对照。结果反复自然流产患者蜕膜与绒毛组织FasL低于对照组,数据经统计学比较具有显著差异（P〈0.05）,蜕膜组织Fas数据经统计学比较具有（P〉0.05）,而绒毛组织却无显著差异。结论反复自然流产患者蜕膜与绒毛组织的Fas/FasL失衡可能是反复自然流产的原因之一,需加以重视。     

Secondary heat, but not mechanical, hyperalgesia induced by subcutaneous injection of bee venom in the conscious rat: effect of systemic MK-801, a non-competitive NMDA receptor antagonist

Subcutaneous (s.c.) administration of bee venom into the plantar surface of one hind paw in rats has been found to produce an immediate single phase of persistent spontaneous nociceptive responses (continuously flinching, licking or lifting the injected paw) for 1-2 h accompanied by a 72-96 hour period of primary heat and mechanical hyperalgesia in the injection site and a spread of heat, but not mechanical, hyperalgesia in the non-injected hind paw (Chen et al., 1999b). To gain insight into the underlying mechanisms of the bee venom-induced hyperalgesia in particular, we further identified a heat, but not mechanical, hyperalgesia in an area (paw pad) distant from the injection site induced by s.c. injection of bee venom into the posterior leg 0.8-1.2 cm proximal to the heel measured by paw withdrawal reflex to radiant heat or von Frey monofilament stimuli in conscious rats. In the bee venom-treated hind limb, however, significant reduction in both thermal latency and mechanical threshold of withdrawal reflex was identified for a period of more than 96 h in the heel with a similar characteristic to the primary heat and mechanical hyperalgesia identified in the injection site previously. The time course of the heat hyperalgesia identified in the paw pad of the bee venom-treated side was shorter and lasted for less than 48 h, which was in parallel with the reduction in thermal latency of the withdrawal reflex identified in the non-injected hind paw. Moreover, pre- or post-treatment with a single dose of MK-801 (0.01 mg/kg, i.p.), a non-competitive N-methyl-D-aspartate (NMDA) receptor antagonist, completely blocked the occurrence, and reversed the established process of the heat hyperalgesia identified in either the bee venom-treated or non-treated paw pads, while the same treatments with the drug did not produce any influence upon the development and maintaining of the heat and mechanical hyperalgesia identified in the heel of the injected hind limb. Taken together with our previous results following s.c. intraplantar bee venom injection, we conclude that: (1) in addition to the well-identified primary heat and mechanical hyperalgesia in the injection site and its adjacent area, s.c. bee venom is also able to produce a secondary heat hyperalgesia in a region distant from the injection site which has a similar characteristic to the contralateral heat hyperalgesia; (2) NMDA receptors are involved in either development or maintenance of the secondary and the contralateral heat hyperalgesia, but without any role in those processes of the primary heat and mechanical hyperalgesia; (3) the secondary heat hyperalgesia seen in the injected hind limb is likely to share the same neural mechanisms with that identified in the non-injected side via co-activation of NMDA receptors.     

Effects on Smoking Cessation: Naltrexone Combined with a Cognitive Behavioral Treatment Based on the Community Reinforcement Approach

A promising option in substance abuse treatment is the Community Reinforcement Approach (CRA). The opioid antagonist naltrexone (NTX) may work in combination with nicotine replacement therapy (NRT) to block the effects of smoking stimuli in abstinent smokers. Effects of lower doses than 50 mg/dd. have not been reported. A study was conducted in Amsterdam in 2000/2001 with the objective to explore the effects of the combination NTX (25/50-mg dd.), NRT, and CRA in terms of craving and abstinence. In a randomized open label, 2 × 2 between subjects design, 25 recovered spontaneous pneumothorax (SP) participants received 8 weeks of treatment. Due to side effects, only 3 participants were compliant in the 50-mg NTX condition. Craving significantly declined between each measurement and there was a significant interaction between decline in craving and craving measured at baseline. The abstinence rate in the CRA group was nearly double that in the non-psychosocial therapy group (46% vs. 25%; NS) at 3 months follow-up after treatment.     

多孔细管联合负压吸引治疗自发性气胸临床观察

目的：观察多孔细管联合负压吸引治疗自发性气胸的疗效及并发症。方法：将118例自发性气胸患者随机分为治疗组（65例）和对照组（53例）,治疗组采用多孔细管联合负压吸引闭式引流治疗,对照组采用普通胸管闭式引流治疗,观察两组临床疗效及并发症发生情况。结果：两组治愈率差异无统计学意义（P〉0.05）,但治疗组并发症少于对照组（P〈0.05）。结论：多孔细管联合负压吸引闭式引流治疗自发性气胸安全、有效,促进肺复张,且操作简单、舒适,患者易耐受,值得推广应用。     

Spontaneous fracture of an implanted posterior chamber polyimide intraocular lens haptic: A case report

A 57-year-old male patient visited our clinic for decreased visual acuity in the right eye for 10 days. He denied any trauma history, but recalled that the symptom developed after straining. He had undergone uncomplicated phacoemulsification and posterior chamber intraocular lens (IOL) implantation in the bag of the right eye 11 years ago. The IOL was a three-piece silicone polyimide-haptics design. On slit-lamp examination, the IOL optic and proximal part of nasal fractured haptic were found in the anterior chamber. The distal part of fractured haptic was observed in the capsular bag. He underwent IOL exchange. The fracture site of the haptic was near the optic–haptic junction. This is the unique case report of a spontaneous fracture of an implanted posterior chamber polyimide IOL haptic, which implies the possibility of IOL haptic fracture in various haptic materials.     

The neuroprotective effects of intraperitoneal injection of hydrogen in rabbits with cardiac arrest

Objective

The purpose of this study was to investigate the neuroprotective effects of intraperitoneal injection of hydrogen (H₂) in rabbits with cardiac arrest (CA).

Methods

A rabbit model of CA was established by the delivery of alternating current between the esophagus and chest wall to induce ventricular fibrillation. Before CA, the animals were randomly divided into four groups: a sham group (no CA), a CA group, a CA + low dose (10 ml/kg) H₂ group (CA + H₂ group 1), and a CA + high dose (20 ml/kg) H₂ group (CA + H₂ group 2). In the first experiment, animals were observed for 72 h after the restoration of spontaneous circulation (ROSC). The neurological scores were assessed at 24, 48 and 72 h after ROSC. The rabbits that survived until 72 h were sacrificed using an overdose of anesthetic, and the brain tissues were collected and Nissl-stained to observe nerve cell damage in the hippocampal CA1 area. In addition, TUNEL assay was performed to detect apoptosis. In the second experiment, animals were observed for 6 h after ROSC. Blood samples and brain hippocampal tissues were collected, and differences in oxidative stress indicators were compared among the four groups.

Results

Intraperitoneal injection of H₂ improved the 72-h survival rate and neurological scores, reduced neuronal injury and inhibited neuronal apoptosis. Intraperitoneal injection of H₂ reduced oxidative stress indicators in the plasma and hippocampal tissues and enhanced antioxidant enzyme activity. No significant difference was observed between the two CA groups treated with different doses of H₂.

Conclusions

Intraperitoneal injection of H₂ is a novel hydrogen administration method and can reduce cerebral ischemia-reperfusion injury and improve the prognosis of cardiopulmonary cerebral resuscitation in a rabbit model of CA.