弥漫性轴索损伤行亚低温治疗的护理

弥漫性轴索损伤（diffuse axonal injury DAI）是外伤直接引起的脑白质广泛性轴索损伤，是闭合性颅脑损伤中最严重的原发性损伤之一，占重型颅脑损伤20％，占死亡病人的29％-43％。其临床特点为病情危重，昏迷时间长，并发症多，这就给临床治疗和护理提出了更高要求，早期行亚低温治疗并给予护理干预，将大大提高病人的生存率，降低死亡率，提高病人的生命生存质量。     

Changes in T .lymphocyte subsets after severe traumatic brain inJury

BACKGROUND： Besides local changes of cranial parenchymal cells, hemorrhage, etc., severe traumatic brain injuries also cause the changes of total body fluid and various functions, and the changes of lymphocytes and T lymphocyte subsets should be paid more attention to. OBJECTIVE： To reveal the changing laws of T lymphocyte subsets after severe traumatic brain injury, and compare with mild to moderate brain injury. DESIGN： A comparative observation. SETTINGS： Department of Neurosurgery, Longgang District Buji People＇s Hospital of Shenzhen City; Central Laboratory of Shenzhen Hospital of Prevention and Cure for Chronic Disease. PARTICIPANTS： All the subjects were selected from the Department of Neurosurgery, Longgang District Buji People＇s Hospital of Shenzhen City from August 2002 to August 2005. Thirty patients with severe brain injury, whose Glasgow coma score （GCS） was ≤ 8 points, were taken as the experimental group, including 21 males and 9 females, aging 16 - 62 years. Meanwhile, 30 patients with mild traumatic brain injury were taken as the control group （GCS ranged 14- 15 points）, including 18 males and 12 females, aging 15 -58 years. All the subjects were in admission at 6 hours after injury, without disease of major organs before injury Informed consents were obtained from all the patients or their relatives. METHODS： （1） The T lymphocytes and the subsets in peripheral blood were detected with immunofluorescent tricolor flow cytometry at l, 3, 7 and 14 days after injury in both groups. （2） The conditions of pulmonary infections were observed at 4 days after injury. The differences of measurement data were compared with the t test. MAIN OUTCOME MEASURES： Changes of T lymphocytes subsets at 1 - 14 days after severe and mild or moderate traumatic injury. RESULTS： Finally, 28 and 25 patients with mild to moderate traumatic brain injury, whereas 25 and 21 patients with severe traumatic brain injury were analyzed at 7 and 14 days respectively, and the missed ones died due to the development of disease. （1） Changes of T lymphocyte subsets： At 1 and 3 days after injury, CD3, CD4, CD8, CD4/CD8 began to decrease, whereas CD8 increased in the experimental group, which were very significantly different from those in the control group （t =2.77 - 3.26, P 〈 0.01）, and began to recover at 7 days, which were significantly different from those in the control group （t = 2.06 - 2.24, P 〈 0.05）, and generally recovered to the normal levels at 14 days （P 〉 0.05）. （2） Conditions of pulmonary infections： At 4 days after injury, the rate of pulmonary infection was significantly different between the experimental group and control group [73% （22/30）, 0, x2=37.29, P 〈 0.01]. CONCLUSION： Patients with severe traumatic brain injury suffer from damages of cellular immune function at early period （within 7 days）, and they are easily to be accompanied by pulmonary infections.     

结核病的化学治疗

抗结核化学治疗是结核病治疗最主要的方法。在确定化疗方案时应依据患者的既往治疗情况(包括初治或复治、抗结核药配伍和应用情况)、排菌情况、耐药情况、病变范围和有否伴发病、并发症等制定或选择化疗方案。尽管因病情而采用的治疗方案和治疗形式各异，但都必须遵循“早期、规律、全程、联合、适量”的治疗原则。     

流行性脑脊髓膜炎治疗原则

一 普通型，1．1 一般治疗卧床休息，流质饮食，必要时鼻饲或静脉补液。     

人血管生长素的亚细胞定位

已有大量研究表明血管生成素（angiogenin，ANG）与肿瘤的快速生长和转移有密切的关系，肺癌、胰腺癌、乳腺癌等患者的外周血血清中，ANG的水平明显升高，血清ANG的水平与这些肿瘤的发展及转移呈显著正相关，因此，可以检测血清中ANG的水平来预测肿瘤的发生与发展情况。此外，ANG对于创伤、烧伤及血循环较差的股骨头、半月板等损伤的修复具有较大的临床应用价值。在本研究中我们构建了人ANG真核表达质粒，转染人脐静脉内皮细胞（HUVEC）进行表达，并作了初步的亚细胞定位。     

北京大学儿童青少年卫生研究所承担科技攻关项目“学校卫生标准体系建设研究”

为加强卫生标准的管理，完善卫生标准体系，北京大学儿童青少年卫生研究所承担科技部攻关项目“学校卫生标准体系建设研究”。北京大学儿童青少年卫生研究所是卫生部全国学校卫生标准委员会的挂靠单位。作为卫生部14个专业卫生标准委员会之一，学校卫生标准委员会承担了“学校卫生标准体系建设研究报告”研究工作。     

亚低温治疗重型颅脑损伤病人的临床观察及护理

目的探讨如何降低重型颅脑损伤病人的致残率和病死率。方法2004年10月至2006年9月，我科采用北京康联医用设备研究所生产的ICE—I系列医用控温毯，对高热病人实施亚低温（32-34℃）治疗58例。亚低温治疗期间密切观察意识、瞳孔、生命体征、颅内压的变化及上消化道出血征象，发现异常及时处理；并加强基础护理、严格无菌操作、定时翻身按摩、预防褥疮及冻疮、防止感染。结果治愈30例．轻残12例，中、重残4例，死亡12例。较2004年10月以前同类病人的病死率同比下降了14％。结论低温治疗可使机体处于休眠和低温状态，从而降低组织代谢，特别是降低脑代谢，减少耗氧量，因而可防止或减轻脑水肿，降低颅内压力，改善脑的缺氧状态，有利于受伤脑细胞的恢复，从而使病死率降低。     

过敏性鼻炎-哮喘综合征新概念

随着医学的进展，已经认识到过敏性鼻炎和哮喘病往往同时存在。临床上有些患者以过敏性鼻炎为主而哮喘未确诊或处于亚临床状态，而更多的病人则可两种疾病同时存在。因此近年来提出了过敏性鼻炎-哮喘综合征（combined allergic rhinitis and asthmasyndrome）这个新的医学术语。     

病人不舒适的原因分析及护理原则

不舒适是指个人身心不健全或有缺陷，周围环境有不良刺激，对生活不满，身心负荷过重的一种感觉。不舒适表现为烦躁不安、紧张、精神不振、不能入睡、消极失望、以及身体无力，难以坚持日常工作和生活。所以护理人员直接为病人提供护理服务，运用护理程序的方法来发现、分析不舒适的因素，提供适当的护理措施，具有积极的意义。     

浅谈中药库房管理

进入秋季,我国大部分地区,气温逐渐变得凉爽宜人。空气温度降低,人的食欲逐渐增强,消化力也提高,正是弥补由于夏天气温炎热造成营养不足的好季节。同时这个时候又是收获的季节,各种动物肉肥味美,蔬菜瓜果种类齐全,数量又多,是安排饮食的最好季节。不过,如果安排不当,也容易由于营养过剩或是食性不当而伤身,那么秋季安排饮食要注意什么呢?1.要注意防止热能过剩。一般人到了秋季,由于气候宜人,食物丰富,往往进食过多。摄入热量过剩,会转化成脂肪堆积起来,使人发胖,俗话叫“长秋膘”,这样不好。在秋季饮食中,要注意适量,而不能放纵食欲,大吃大…