“分步给药”在低氧易感患者无痛苦胃镜检查中安全性的探讨

目的 探讨在低氧易感患者无痛苦胃镜检查中采用分步给药的安全性和镇静/镇痛效果.方法 接受胃镜检查的180例患者,其中有鼾症、或咳嗽、咳痰症状的患者120例单双号随机入选Ⅰ组(分步给药组)和Ⅱ组(普通组),60例无鼾症、咳嗽、咳痰症状的患者为Ⅲ组(常规给药组),Ⅰ组采用分步给药法,Ⅲ组采用常规给药法对患者实施胃镜检查前的镇静/镇痛术,Ⅱ组则进行普通胃镜检查,分析2种镇静法对SBP、DBP、SpO2、HR、清醒时间、患者反应、患者对检查过程的感受以及是否愿意再次接受检查的影响,评价分步给药法在低氧易感患者无痛苦胃镜检查中的安全性和镇静/镇痛效果.结果 Ⅰ组、Ⅲ组检查中SBP、DBP变化无明显差异(均P＞0.05),Ⅰ组检查前、中SpO2的变化小于Ⅲ组(均P＜0.01);Ⅰ组进镜时咽部受刺激产生的恶心咽吐、流涎、咳嗽、躁动反应多于Ⅲ组(均P＜0.01),但较Ⅱ组少(均P＜0.01);Ⅰ组对胃镜检查的评价与Ⅲ组无明显差异(P＞0.05),与Ⅱ组相比有明显差异(P＜0.01).结论 分步给药法是一种适用于低氧易感患者无痛胃镜检查的安全、有效的镇静/镇痛方法.     

多种措施并举,加强学风建设

多种措施并举,加强学风建设,包括以师德师风促学风建设、健全教育管理制度、构建具有自身特色的学生工作机制、建立行之有效的激励机制、实施本科生导师制和学导制、丰富教育形式、严肃考风考纪、积极开展课外科技文化活动等,获效显著:学生学习风气良好,自觉遵守校规校纪;学习气氛浓厚,学习成绩提高;涌现出了一大批先进集体和先进个人;优秀大学生先进群体引起社会各界强烈反响;创新与实践能力得到提升.     

ENDOSCOPIC MUCOSAL RESECTION AND SUBMUCOSAL DISSECTION METHOD FOR LARGE COLORECTAL TUMORS

The goal of endoscopic mucosal resection (EMR) is to allow the endoscopist to obtain tissue or resect lesions not previously amenable to standard biopsy or excisional techniques and to remove malignant lesions without open surgery. In this article, we describe the results of conventional EMR and EMR using an insulation‐tipped (IT) electrosurgical knife (submucosal dissection method) for large colorectal mucosal neoplasms and discuss the problems and future prospects of these procedures. At present, conventional EMR is much more feasible than EMR using IT‐knife from the perspectives of time, money, complication, and organ preservation. However, larger lesions tend to be resected in a piecemeal fashion; and it is difficult to confirm whether EMR has been complete. For accurate histopathological assessment of the resected specimen en bloc EMR is desirable although further experience is needed to establish its safety and efficacy. Further improvements of in EMR with special knife techniques are required to simply and safely remove large colorectal neoplasms.     

双环法旋转圆锥状腺体蒂乳房缩吊术

目的改进传统的双环法在乳房缩小术、乳房悬吊术术后外形扁平，凸度不足，上极瘪陷，提升不够等缺点。方法采用双环切口。“扇”形分离、切除皮下部分脂肪，“楔”形切除适量的外上象限腺体，螺旋状旋转剩余腺体成圆锥状，将其固定在第2肋软骨膜上，矫正轻中度乳房肥大和下垂。结果术后随访20例患者1～3个月，乳房上极较丰满，形态好，乳头乳晕功能正常，切口瘢痕轻，乳房肥大和下垂的矫正获得了满意的效果。结论双环切口，螺旋状旋转剩余腺体成圆锥状，并固定于第2肋软骨膜上，可较好地塑形并悬吊乳房，其切口相对隐蔽，术后乳房高凸，上极略饱满，乳头微上翘，乳晕形态合适，是矫正轻中度乳房肥大下垂的一种较理想的术式。     

实习期医学生心理健康状况、应对方式及压力状况的调查

目的探讨实习期医学生心理健康状况、应对方式及压力状况。方法将进入临床实习期的364名临床医学生作为研究组,而选取379名非实习期的临床医学生作为对照组,问卷评定采用症状自评量表(SCL-90)、应对方式问卷及心理身体紧张松弛测试表。结果研究组SCL-90的人际关系敏感、强迫、抑郁、焦虑、敌对因子得分显著高于对照组(t=2.25~5.17,P<0.05);与对照组相比,研究组的应对方式中解决问题因子分有显著性降低,自责、退避因子分则有显著性增高(t=-1.97~2.89,P<0.05);研究组的心理压力状况明显差于对照组,且差异具有显著性意义(χ2=56.03,P<0.05)。结论实习期的临床医学生存在不同程度的心理问题,应予以足够重视。     

改良点式剥脱术治疗下肢浅静脉曲张临床报告

目的：评估改良点式剥脱术治疗下肢浅静脉曲张的临床疗效。方法：摒弃输精管钳改用蚊式钳，术中采用弹拔法寻找静脉，准确快捷，副损伤小。结果：采用改进术式治疗198例共208条肢体，经近10年随访疗效良好。结论：在现阶段改良点式剥脱术是较为实用简便的治疗方式。     

STANDARD IMAGING TECHNIQUES OF ENDOSCOPIC ULTRASOUND‐GUIDED FINE‐NEEDLE ASPIRATION USING A CURVED LINEAR ARRAY ECHOENDOSCOPE

Standard imaging techniques using a curved linear array echoendocope are summarized to facilitate the attainment of expertise in endoscopic ultrasonography and endoscopic ultrasound‐guided fine needle aspiration, and to promote the widespread use of this diagnostic and therapeutic tool. Typical images of the mediastinal organs, the bilio‐pancreatic systems and neighboring organs by scanning from the esophagus, stomach, duodenal bulb, and descending portion of the duodenum, are shown in a sequential manner. The basic techniques of endoscopic ultrasound‐guided fine needle aspiration are also presented.     

Selective parity RARE imaging.

This work describes a novel method for rapid acquisition with relaxation enhancement (RARE)/fast spin-echo (FSE) imaging that removes the constraint of compliance with the Carr-Purcell-Meiboom-Gill (CPMG) condition. In a multiecho sequence, echoes with either odd or even parities are acquired. The refocusing angles are chosen using a recursive algorithm, so that the signal amplitude satisfies a predetermined modulation function. In the examples given in this article an exponential decay to a plateau is used. At each echo the echo parity that gives the desired signal amplitude for the minimum refocusing angle is selected. It is further shown that in the presence of an initial magnetization having an arbitrary phase distribution, the complex conjugate of the signal of one echo parity has to be taken and its k-space coordinates reversed. T(2) (*)-weighted images are presented and initial applications to diffusion-weighted imaging (DWI) and functional imaging shown.     

吸附澄清法在中药水提液澄清中的应用研究

采用吸附澄清法使中药水提液澄清,从工艺稳定性,成分分析,药效学实验及效益分析四方面分析了两种工艺,吸附澄清法同水提醇沉法相比,能更有效地保留中药总固体物含量及有效成分,提高制剂成品的内在质量;成品稳定性好;成本低;生产周期短;劳动强度低,可望产生良好的社会经济效益。     

农村已婚育龄妇女节育措施落实状况调查

<正> 计划生育工作的重点在农村。为了解农村妇女节育措施落实情况,提高节育、避孕率及避孕效果,