抗返流引流袋在卧床老年患者中的应用

目的观察抗返流引流袋在长期卧床患者中的应用。方法将96例长期卧床的需留置导尿管的老年患者分为两组,一组为使用一次性尿袋每天更换1次（对照组）,另一组为抗返流引流袋每7天更换1次（观察组）,在相同天数下或拔除尿管前用无菌注射器按无菌原则抽吸法采集两组患者的尿液进行细菌培养。结果对照组的细菌阳性率较高,观察组的细菌阳性率较低,差异有统计学意义（P〈0．05）。结论留置导尿管患者使用一次性引流袋每天更换增加了感染机会,用抗返流引流袋每7天更换一次,不仅节省了护士的工作量、护理时间,还减少医院用于废弃物品的处理费用,减少环境污染。     

人参皂苷Re促进自然衰老大鼠学习记忆作用及其机理的研究

目的研究人参皂苷Re对自然衰老大鼠学习记忆功能的影响,并初步探讨其作用机制。方法采用Morris水迷宫法观察人参皂苷Re对大鼠学习记忆功能的影响,同时采用电生理学方法观察人参皂苷Re对大鼠突触长时程增强(LTP)的作用。结果人参皂苷Re能显著对抗自然衰老引起的记忆获得障碍,对麻醉大鼠海马齿状回基础突触传递有增强作用,且能形成突触长时程增强形象。结论人参皂苷Re有改善大鼠学习记忆障碍的作用,该作用可能与其增强基础突触传递、促进LTP形成有关。     

屈光参差性弱视与斜视性弱视临床疗效的比较

目的:分析比较屈光参差性与斜视性弱视的治疗效果。方法:前瞻性研究。2018-07/2020-01在我院门诊确诊的并首次接受治疗的单眼弱视患者46例,平均年龄9±3岁,其中男26例,女20例,按照临床诊断分为斜视性弱视组(无屈光不正),共23例,平均年龄9±3岁,其中男12例,女11例。以及屈光参差性弱视组,共23例,平均年龄9±3岁,其中男14例,女9例。对两组患者采用遮盖及精细训练治疗弱视,于治疗前及治疗后采用国际标准视力表检测视力、用Titmus图谱行立体视锐度的检测。比较两组患者经弱视治疗前后最佳矫正视力及立体视恢复的差异。结果:治疗前两组患者弱视眼的最佳矫正视力无差异(t=-0.475,P>0.05),但斜视性弱视患者的立体视功能明显低于屈光参差性弱视患者(t=-3.919,P<0.001);通过2mo的治疗,两组患者最佳矫正视力提高值有明显差异(t=-2.946,P<0.01),而两组患者立体视提高值无差异(t=1.305,P>0.05);通过6mo的治疗,两组患者最佳矫正视力提高差值有明显差异(t=-2.353,P<0.05),两组患者立体视提...     

Influence of Cross-Section Shape and FRP Reinforcement Layout on Shear Capacity of Strengthened RC Beams

The evaluation of the shear capacity of an FRP-strengthened reinforced-concrete beam is challenging due to the complex interaction between different contributions provided by the concrete, steel stirrup and FRP reinforcement. The shape of the beam and the FRP inclination can have paramount importance that is not often recognized by the models that are suggested by codes. The interaction among different resisting mechanisms has a significant effect on the shear capacity of beams, since it can cause a reduction in the efficiency of some resisting mechanisms. A comparative study of the performance in the shear resistance assessment provided by three models with six different effectiveness factors (R) is performed, considering different cross-section shapes, FRP wrapping schemes, inclination and anchorage systems. The results revealed that the cross-section shape, the FRP inclination and the efficiency of the FRP anchorages have a significant effect on the shear strength of beams. The analysis results show that the three models are able to provide an accurate average estimation of shear strength (but with a coefficient of variation up to 0.35) when FRP reinforcement orthogonal to the beam axis is considered, while a significant underestimation (up to 19%) affected the results for inclined FRP reinforcement. Moreover, all the models underestimated the resistance of beams with a T section.     

驻闽部队手部多汗症流行病学调查及分析

目的调查驻闽部队军人手部多汗症患病率及中重度手部多汗症对部队战斗力的影响。方法采用整群抽样的方法,对1164名驻闽军人进行问卷调查,主要内容包括手部多汗症患病情况和手部多汗症是否对操作、站岗、体能训练、成绩、比赛和情绪面有影响等。对部队战斗力影响数据采用χ2检验和Fisher精确检验法。结果 1164名驻闽军人中患中重度手部多汗症45例。中重度与轻度手部多汗症相比,从操作、站岗、体能训练、成绩、比赛和情绪等对部队战斗力产生显著影响（P〈0.01）。结论驻闽军人中重度手部多汗症患病率为3.9%,中重度手部多汗症严重影响部队战斗力,提示卫生勤务部门和军事部门应重视对军人手部多汗症的识别和防治,以提高部队战斗力。     

Economic evaluation: A comparison of methadone versus buprenorphine for opiate substitution treatment

Background

The cost of opiate substitution is usually considered lower in cost when methadone is used, as compared to that of buprenorphine, however the overall cost effectiveness of substitution programmes comparing the two drugs remains largely unknown.

Methods

We evaluated the treatment cost and effectiveness of methadone and buprenorphine when used in an opiate substitution programme in Norfolk, UK. All programme costs, estimated from the perspective of the drug treatment clinic, were collected on 361 opiate-dependent participants over a six-month period. Total costs comprised medication (methadone or buprenorphine) costs, pharmacy supervision and dispensing costs, and drug service clinic costs. Effectiveness was measured in terms of (1) each programmes ability to retain participants in the programme for six months, and (2) the ability of the programme to accomplish complete abstinence from illicit opiate consumption.

Results

Overall, mean medication-only costs of methadone were lower than that of buprenorphine, however, pharmacy and clinic costs were lower for the buprenorphine programme. The covariate-adjusted mean total cost of the two programmes was not significantly different. Mean six-month retention rates were higher on the methadone programme, therefore, the methadone programme “dominates” the buprenorphine programme as it was slightly more effective for the same cost. Conversely, when ability to stop taking illicit opiates concomitant with opiate substitution medication was considered, the buprenorphine programme was more effective with an additional cost of £903 per individual who stopped illicit opiate use.

Conclusions

The provision of buprenorphine should be considered an appropriate treatment if cessation of illicit opiate use, concomitant with programme retention is considered an important outcome.     

高原护唇膏对家兔皮肤长期毒性的实验研究

目的观察动物对高原护唇膏的急性及长期毒性反应,为临床用药的安全剂量提供参考。方法 （1）急性毒性试验：采用最大给药量法测定小鼠口服高原护唇膏的最大耐受量。（2）长期毒性试验：将家兔按体重性别随机分为3组,采用2个剂量组（480mg/kg、160mg/kg）和赋形剂组连续涂抹家兔皮肤90d,观察家兔的一般情况。剩余动物停药恢复7d后重复上述检查。结果小鼠口服高原护唇膏最大给药量为含药量1.5%,120ml/kg。家兔连续给药90d后护唇膏大、小剂量组对家兔的一般情况、血液、血液生化学、脏器系数均无明显影响,未发现长期毒性及中毒靶器官,恢复期亦无延迟性毒性反应。结论高原护唇膏在规定剂量下使用是安全可靠的。     

品管圈在降低长期卧床老年鼻饲患者误吸中的应用效果分析

目的 探讨品管圈活动在降低长期卧床老年鼻饲患者误吸中的效果.方法 成立品管圈小组、确定活动主题为降低长期卧床老年鼻饲患者误吸的发生率,通过现状调查与原因分析,按照80/20定律选定真因,通过头脑风暴法找出对策:自制并应用床头角度测量仪;辅导员做留置胃管置入长度相关护理新进展培训;圈长做鼻饲注食量、注食速度标准化讲座;提高床头抬高角度的精确性;提高护士置入胃管长度的正确性;提高护士宣教能力及患者家属(护工)的依从性.结果 根据误吸判断指标比较活动前后误吸的发生率,长期卧床老年鼻饲患者误吸的发生率由活动前77.0％降至21.1％.结论 品管圈活动不仅降低了长期卧床老年鼻饲患者误吸的发生率,还提高了圈员的工作积极性、团队意识、解决问题能力.     

康瑞保凝胶治疗增生性瘢痕疙瘩的疗效观察

目的观察康瑞保凝胶预防及治疗增生性瘢痕疙瘩的疗效及安全性。方法随机抽取39例病例,其中男性16例,女性23例,年龄为12~62岁。观察总有效率及不良反应。结果39例增生性瘢痕疙瘩使用康瑞保凝胶每日1次,连续6个月。结果显效率74.36%,有效率20.51%.总有效率94.87%。此药无明显不良反应。结论康瑞保凝胶预防及治疗增生性瘢痕疙瘩疗效显著。     

银杏达莫注射液治疗急性脑梗死的疗效及远期效果研究

目的：探讨银杏达莫注射液治疗急性脑梗死的疗效及远期效果。方法选取2009年1月—2013年1月宁武县人民医院收治的急性脑梗死患者146例,随机分为试验组与对照组,各73例。试验组患者予以银杏达莫注射液治疗,对照组患者予以复方丹参注射液治疗。观察两组患者治疗前、治疗结束时、治疗后6、12个月的神经功能缺损评分（ NIHSS）、日常生活活动能力（ ADL）评分及不良反应发生情况。结果治疗前两组患者NIHSS及ADL评分比较,差异无统计学意义（ P>0.05）,治疗结束时、治疗后6、12个月试验组患者NIHSS低于对照组,ADL评分高于对照组,差异均有统计学意义（ P<0.05）,试验组患者不良反应发生率低于对照组,差异有统计学意义（ P<0.05）。结论银杏达莫注射液治疗急性脑梗死的疗效显著,可改善患者神经功能及日常生活能力,且不良反应少,远期效果好。