咽旁间隙肿瘤手术并发症分析及防治措施

目的 探究咽旁间隙肿瘤手术并发症分析及防治措施.方法 收集在某院就诊的咽旁间隙肿瘤患者的临床资料,统计患者在术后出现各类并发症的情况,并分析各类并发症产生的原因、提出相应的预防措施.结果 200例患者中术后出现术腔感染3例、神经损伤15例、血管损伤12例、腮腺漏2例;其中,颈颌入路和颞骨加腮腺入路两种手术方式对血管和神经的创伤更大,所引起的并发症也较多.结论 经颈侧切开入路适用于绝大多数的咽旁间隙良性肿瘤,但是为了有效的控制和减少术后并发症的发生,仍需要根据患者具体的病情选择合理的手术入路.     

蛛网膜下腔阻滞不影响脐血单个核细胞向神经细胞的分化

背景：有学者认为麻醉状态可提高脐血采集分离质量,目前尚无蛛网膜下腔阻滞对脐血单个核细胞向神经干细胞及星形胶质细胞分化影响的研究。 目的：观察蛛网膜下腔阻滞对新生儿脐血单个核细胞向神经干细胞及星形胶质细胞方向分化的影响。 方法：选择顺产新生儿及蛛网膜下腔阻滞剖宫产新生儿脐血标本各20份,分别列为对照组及研究组,在胎儿娩出后抽取脐血分离接种脐血单个核细胞,并进行体外培养,每份标本常规培养3 d后分别进行非诱导分化培养和向神经细胞方向诱导分化培养。对培养前后细胞进行神经干细胞、星形胶质细胞标志性Nestin、GFAP抗原免疫组化鉴定。 结果与结论：蛛网膜下腔阻滞剖宫产新生儿脐血单个核细胞诱导分化培养后表达 Nestin、GFAP 抗原阳性细胞,与顺产新生儿比较差异无显著性意义（P 〉0.05）。结果显示蛛网膜下腔阻滞对新生儿脐血单个核细胞向神经干细胞及星形胶质细胞方向分化没有影响。     

应用宫腔镜技术治疗子宫腔内良性占位性病变的安全性及临床效果观察

目的 探讨宫腔镜治疗子宫腔内良性占位性病变手术的安全性及临床效果.方法 2010年1月至2013年1月在我院住院治疗的子宫腔内良性占位性病变患者210例,均行宫腔镜检查,同时行电切术治疗;其中72例行宫腔息肉切除术,70例行子宫肌瘤切除,68例行妊娠组织残留清除术.术后随访6个月～2年,观察分析其疗效.结果 210例患者均一次手术成功,手术时间11～39 min,平均15min,术中出血5～70 ml,无术中并发症发生.术后1个月有94.1％ （191/203）的患者月经恢复正常,痛经改善率达87.7％ （178/203）;术后6个月96.1％ （195/203）的患者月经正常,痛经改善率91.6％（186/203）.2例宫腔息肉切除术后复发,再次行电切治愈.结论 宫腔镜治疗宫腔内良性占位性病变能保留子宫的完整性,疗效满意,安全可靠;患者损伤小、痛苦轻,恢复快,可作为治疗宫腔良性占位性病变的首选治疗方法.     

Medication communication through documentation in medical wards: knowledge and power relations

Health professionals communicate with each other about medication information using different forms of documentation. This article explores knowledge and power relations surrounding medication information exchanged through documentation among nurses, doctors and pharmacists. Ethnographic fieldwork was conducted in 2010 in two medical wards of a metropolitan hospital in Australia. Data collection methods included participant observations, field interviews, video‐recordings, document retrieval and video reflexive focus groups. A critical discourse analytic framework was used to guide data analysis. The written medication chart was the main means of communicating medication decisions from doctors to nurses as compared to verbal communication. Nurses positioned themselves as auditors of the medication chart and scrutinised medical prescribing to maintain the discourse of patient safety. Pharmacists utilised the discourse of scientific judgement to guide their decision‐making on the necessity of verbal communication with nurses and doctors. Targeted interdisciplinary meetings involving nurses, doctors and pharmacists should be organised in ward settings to discuss the importance of having documented medication information conveyed verbally across different disciplines. Health professionals should be encouraged to proactively seek out each other to relay changes in medication regimens and treatment goals.     

化学灼伤合并吸入性损伤56例早期治疗分析

目的:探讨化学灼伤合并吸入性损伤的救治方法,以提高治愈率,降低并发症发生率及病死率。方法:回顾分析56例化学灼伤伴吸入性损伤患者的临床资料。结果:56例患者中,肺部感染25例(44.6%),治愈52例(92.9%),病死4例。结论:对于化学烧伤合并吸入性损伤患者,应重视现场洗消和早期急救处理,及时解除呼吸道梗阻,应用纤维支气管镜清除呼吸道内异物,应用呼吸机维持有效气体交换。对于深度创面,应早期行切削痂植皮术或皮瓣移植术,以减少吸收中毒,降低致残率。     

下颌骨矢状劈开后退术对咽腔间隙及舌骨位置的影响

目的 :CBCT测量分析下颌后退手术治疗下颌前突畸形,对舌骨位置和气道间隙变化的影响。方法 :选取单纯下颌前突畸形患者50例为研究对象,均接受经口内下颌骨升支矢状劈开截骨术,于正颌手术前1周、术后2周、术后6个月拍摄锥形束CT,测量治疗前后咽腔最窄处的矢状径、冠状径、截面积,同时舌骨点的三维位置,分析咽腔间隙大小及及舌骨体位置变化。测量数值配对t检验。结果:所有患者术后咽腔间隙均呈现缩窄趋势。舌骨发生了后下移位,其中术后2周向后、向下平均移动距离分别为2.64、1.56 mm,术后6月向后、向下移位分别为0.97、0.99 mm。术后2周咽腔的矢状径、冠状径及咽腔间隙分别为11.71 mm、3.05 mm、320.67 mm~2,术后6月时分别为14.64 mm、3.23 mm、414.85 mm~2。即随时间推移,舌骨位置及咽腔间隙有恢复正常范围的趋势。结论:双侧下颌骨升支矢状劈开截骨后退术后,舌骨向后下移位,咽腔气道缩小,有可能导致睡眠呼吸暂停综合征的发生,临床需予以重视。     

Design of a process for localization system in ubiquitous space

The purpose of the present paper is to show the interactive design process for the ubiquitous middleware platform on the Personal Area Network (PAN). The middleware platform is composed of a distributed system that supports sensors and actuators on PAN. Generally, in the case of middleware for ubiquitous computing, the structure is formulated by a simple design pattern in a shared program language. On the other hand, new media art or commercial game contents have specified methodologies such as extreme programming for these developments, and so it is difficult to share information among these products. In the present paper, we propose a new design process for the ubiquitous environment on the PAN to adapt different software methodologies and construct an interactive product of new media art using the proposed method. The design process consists of the artist’s proposal for media artwork, the engineer’s analysis, simulation, and testing. Each cycle is considered as an individual project, and interactive products such as middleware services are provided to the artist after the project is finished. We implemented interactive audio-visual prototype by the design process.     

民族药岩白菜的化学成分研究

目的研究民族药岩白菜（Bergenia pururascerns）的化学成分。方法利用硅胶、凝胶等色谱技术对岩白菜块根的甲醇提取物进行分离纯化,利用波谱学阐明结构。结果从岩白菜块根中分离得到9个争体化合物,分别鉴定为岩白菜素（Bergenin,1）、齐墩果酸（Oleanicacid,2）、熊果苷（Arbutin,3）、阿夫儿茶精（Afzelechin,4）、11-O-没食子酰岩白菜素（11-0-galloylbergenin,5）、没食子酸（Gallicacid,6）、BreyniosideA（7）、Diethyldisulfi~xide（8）、（＋）-儿茶素（（＋）一Catechin,9）。结论化合物4、7、8首次从该种植物中分离得到,化合物8为首次从该属植物中分离得到的含硫化合物。