“吃”掉你的疑虑

也许是压力太大，也许是期许过高，多疑的人都有些紧张，紧张的人都有些神经质，而神经质的人通常都不快乐，甚至常受失眠的困扰。     

健康“透支”始于疲劳

近年来,随着我国经济的快速发 展,各种竞争日趋激烈,人们面临的生存压力正在逐步加大,面对的各种诱惑也在不断增多,许多人为了房子、车子、医疗、养老和子女的教育费用而拼命地工作,不断地“透支”自己的健康,致使慢性疲劳综合征的发病率在我国呈逐年上升的趋势。　　　　当您经常感到身心疲惫,而且经过休息仍然不能消除时,慢性疲劳综合征可能正在悄悄地袭击您……     

薄壁构件的高温低周疲劳寿命的预测与验证

提出了文题的计算模型,它采用非线性弹塑性蠕变有限元法,计算构件危险点在高温及周期保载的交变载荷谱作用下的应力应变响应,以应变范围区分法累积损伤,从而求出构件的疲劳寿命,并以带孔矩形薄板为例作了计算与验证,结果吻合较好,可供工程应用。     

经闭孔尿道中段无张力吊带术(TVT-O)治疗女性能压力性尿失禁的临床护理

女性压力性尿失禁(SUI)是一常见病,近年女性尿失禁发生率为51.7%[1],该病给患者带来一系列社会、精神、家庭、职业、体力和性生活方面的困扰,生活质量受到明显影响。我院2005年2月至2007年3月采用经阴道无张力尿道悬吊术(TVT-0)治疗女性压力性尿失禁16例,效果良好。现将护理体会报告如下。     

Surgical strategy of one stage surgery of anterior release combined with posterior correction in treatment of severe scoliosis

Objective: Severe scoliosis refers to scoliosis with serious and stiff curve. It always combins with trunk imbalance in coronal and sagittal contour. Besides complex pathological changes, cardiopulmonary deficits and other concomitant diseases increase treatmental difficulties. So the treatment of severe scoliosis is always a great challenge to spine surgeon. Methods :Thirty-six patients with severe scoliosis received one stage posterior correction followed by anterior release during July 1997 to January 2003, including 9 males and 27 females. Mean age was 17.2 years. Of them, 33 was idiopathic scoliosis and 3 was neurofibromatosis scoliosis( Cobb angle: 85-116 degree); 20 cases were abnormal in sagital plane. Three-dimensional devised instrumentation were applied such as CD, CD-Horizon, TSRH or Isola in posterior procedure followed by anterior release during the same anesthesia. 31 cases of this group received thorac icplasty. Results: The correction in the frontal plane achieved an average of 48.5%. In the sagittal plane, the pathological shape of the spine was reduced and distinctly ameliorated. 80. 6% of the patients maintained or achieved balance of sagittal plane. There were no complications of severe neurological deficit, hook displacement, rod broken, and deep infection at follow-up. One case occurred traumatic pleurisy after operation and another appeared pseudarthrosis 2 years later. One case demonstrated imbalance 11 months after operation. One patient was presented loss of correction more than 10 degree at one year follow-up and 5.2 degree in average. Conclusion:The study indicates that the one stage posterior correction combined with anterior release in treatment of severe scoliosis can achieve satisfactory correction. Appropriate choice of cases, preoperational detailed assessment and application of SEP and wake-up test during operation can possibly reduce severe complication. The long-term outcomes still need further observation.     

静脉穿刺后并发皮下渗血及血肿的预防

静脉穿刺后造成皮下渗血甚至血肿并非罕见，尤其是选用较大号针头作静脉抽血后更是如此。通常拔针在拔针前先用一支棉棒横压针眼至拔针后约5分钟。这种方法会增加针头对血管壁的磨擦及损伤。棉棒只压迫了皮肤的针眼而未压迫静脉壁的针眼，易造成静脉壁针眼渗血。在寒冷季节受术者穿衣较多，尤其是袖口有松紧带者，当袖口拉起至上臂时，如同上血带使局部受压。另外拔针后短时间内术侧过度用力，均可使静脉压力升高，也是穿刺拔针后皮下渗血甚至形成血肿的原因。     

家有独苗压力大

鲁迅先生曾疾呼：“救救孩子!”如今这种呼声愈来愈强烈了，原因在于独生子女存在一系列令人担忧的现象，如“三高现象”，即心理障碍率较高、犯罪率较高、离家出走或轻生率较高。     

两种不同方法测定低水平压力支持通气时气道阻断压与自主呼吸时常规方法测定值的相关性分析

目的 拟比较以两种不同方法测定低水平压力支持通气（pressure support ventilation，PSV）病人的气道阻断压（P0．1）与自主呼吸时常规方法测定值的相关性。方法 12例机械通气病人，断开呼吸机自主呼吸时以常规方法测定P0．1得到P0．1-SB：在PSV水平为5cmH20，以常规方法和按压呼气末暂停键测定P0．1分别得到P0．1-PSV5和P0．1-PSV5eeo．分析后二者与前者之间的相关性。结果 P0．1-SB与P0．1-PSV5之间差异无显著性，P0．1-PSV5ee0分别小于P0．1-SB与P0．1-PSV5，差异有显著性；P0．1-PSV5eeo与P0．1-PSV5和P0．1-SB之间的相关系数均为0．97。结论 按压呼气末暂停键测定PSV水平为5cmH2O的P0．1值与常规方法测定的PSV水平为5cmH2O以及自主呼吸时的测定值相比，其值偏小,但前者与后二者之间具有良好的相关性。     

PFMT仍是压力性尿失禁的首选治疗

荷兰的研究人员称，不适当骨盆底部肌肉训练（PFMT）后使用度洛西汀（duloxetine）（Ⅰ）可为压力性尿失禁患者提供更多的健康裨益，但比单独采用PFMT昂贵的多。