表达谱基因芯片筛选体外循环前后心肌细胞因子的变化

Objestive Systemic inflarmmation may be triggered by injury, hypothermia, ischemia-reperfusion and the contact of the blood with foreign body during cardiopulmonary bypass (CPB). To determine the application values of gene chip technique in the clinical practice and the study of cardiovascular stagery, as well as to provide clues to the study of inflammatory responess during CPB, microarry for gene expression profiles was used to identify the differences in the gene expression of myocardium between pre-and post- CPB. Methods Six adult patients who underwent CPB from March to May in 2003 were involved. Samples of right atrium were col- lected before and at immediate end of CPB. BD AtlasTM cDNA Expression Arrays was used to identify the differences in the gene ex- pression of cytokines. The results were compared with that of semi-quantative RT-PCR. Resellts The mean age of 6 patients (5 males and 1 female) was (32.67± 11.72) years. The baseline heart function was gradeⅡin 3 cases and grade Ⅲ in 3 other cases. The baseline left ventricular ejection fraction(LVEF)was (58.17±7.91)%. The mere duration was (91.67±43.88) minutes for CPB and was (58.67±43.46) minutes for aorta blocking. The minimum nasopharynx/rectal temperture was (29.37±1.90)℃/ (32.15±1.52)℃. Gene expression profiles of cytokines in the myocardium pre- and post-CPB were analysed successfully. The ex- pression of IL-6, IFN-γ,Wnt5a, TNFRSF1B, a member of tumor necrosis factor receptor superfamily, PIGF and MFNG in the myo- cardium were unpregulated after CPB. Conclusion Microarray technique is applicable in the study of cytokines changes dying CPB. cDNA microarray identified pleliminarily the differences in the gene expression between pre- and post-CPB. These genes may be in- valved in inflammation and other psthophysiological responses incuced by CPB. The myocardiym is probably one of the major sources of cytokines during CPB. Further study may be helpful in understanding the llngthe development of inflammation during CPB, and eventually, reducing the post-operative complications.     

剖宫产术后并发下肢静脉栓塞的护理及预防

通过对20例剖宫产术后并发下肢静脉栓塞病人的观察,分析了发生静脉栓塞的原因,提出了相应的护理、观察、预防等一系列措施.     

老年人股骨颈骨折术后并发症的预防护理

压疮、肺部感染、泌尿系统感染、深静脉栓塞是骨科术后常见并发症,尤其高龄患者,体质弱,各种脏器机能减退,上述并发症发病率高.做好术后护理直接影响手术的成功率,正确及时地护理能有效地预防或减少上述并发症发生.2003年1月至2006年9月,对我院骨科收治的80例老年人股骨颈骨折术后进行精心护理,效果满意,现将护理体会报道如下.     

四肢骨折小夹板固定术后的护理

四肢骨折是临床常见的一种损伤。应用小夹板固定治疗四肢骨折是临床常用的一种治疗方法，其方法简单、取材方便、固定可靠、效果理想。在配合医生实施小夹板固定的术后护理，有效的保证了治疗效果。     

高龄前列腺病人电切术的康复护理

近几年来，我科对高龄病人实施TURP术治疗前列腺增生取得了较好的临床效果。它具有出血少、痛苦小、恢复快等优点。现将自2003～2005年89例高龄前列腺增生患者行TURP术临床护理总结报告如下：     

甲状腺术后出现甲状旁腺功能低下致纠纷1例

1病史摘要某女，22岁，于2002年8月1日入住某县医院。主诉于入院前1年余始，无明显诱因下出现心悸、性情急躁、怕热、多汗、食欲明显增强，但人渐消瘦、体重减轻，诊断为“原发性甲亢”，给予服用抗甲状腺药物治疗，服药期间出现全身皮肤瘙痒及皮疹，改用“心得安、卢戈氏液”，     

中医药与肝纤维化免疫研究

肝纤维化是肝脏受到各种慢性损伤的愈合反应。其特点是汇管区和肝小叶内大量纤维组织异常增生沉积，其结果导致肝脏结构变形，从而引起或进一步加重肝脏损伤。近年来，大量实验及临床研究证明肝纤维化与免疫关系密切。应用中医药，通过调整免疫抗肝纤维化，已经成为治疗肝纤维化的有效途径。     

静脉留置针在围术期的临床应用

资料与方法 1一般资料自2003～2005年6月我科共使用静脉留置针4260例，其中5岁以下小儿327例，70岁以上老人203例，侧卧及俯卧位526例。673例病人术后留置。     

罗哌卡因联合芬太尼与布比卡因在腰—硬联合麻醉中用于剖宫产术的比较

目的:探讨罗哌卡因联合芬太尼腰—硬联合麻醉用于剖宫产术的优越性。方法:通过罗哌卡因联合芬太尼与布比卡因在腰—硬联合麻醉中对照,观察在麻醉效果、血流动力学等不良反应及术后恢复等方面的差别。结果:应用罗哌卡因联合芬太尼用于剖宫产术麻醉效果确切,对循环影响小,不良反应少,术后恢复快。结论:罗哌卡因联合芬太尼腰—硬联合麻醉用于剖宫产术效果满意,利于术后恢复。