复方海蛇注射液的配制及其临床应用

对复方海蛇注射液的配制，成分及氨基酸分析进行了报道，并对其抗风湿机理进行了初步探讨，临床观察表明，对５００例痹症患者的总有效率为９８．４％，其中对风湿性关节炎疗效最佳，梨状肌综合症次之。     

Assessment of myocardial blood volume and water exchange: theoretical considerations and in vivo results.

The measured signal response in contrast-enhanced myocardial perfusion imaging has been shown to be affected by the rate of water exchange between the intravascular and extravascular compartments, the effect being particularly significant when intravascular contrast agents are used. In the present study, the T(1) relaxation rates were measured in eight pigs in blood and myocardium using a Look-Locker sequence after repeated injections of the intravascular contrast agent NC100150. The selection of myocardial region of interest was automated based on a minimum chi-square method. The intra- and extravascular water exchange rates and the myocardial blood volume were calculated from the measured relaxation rates by applying a two-compartment water exchange limited model that accounts for biexponential longitudinal relaxation. The following (mean +/- SD) values were obtained for the exchange frequency (f), the extravascular residence time (tau(e)), the intravascular residence time (tau(i)) and blood volume (BV), respectively: f = 1.39 +/- 0.52 s(-1), tau(e) = 708 +/- 264 ms, tau(i) = 107 +/- 63 ms, and BV = 11.2 +/- 2.1 mL/100 g. The mean value of f was found to be about 15% higher if biexponential relaxation was not accounted for, supporting the hypothesis that significant biexponential relaxation in tissues with large blood volume can lead to an overestimation of water exchange rates unless corrected for.     

白血病鞘内注射的护理

目的 :研究鞘内注射甲氨蝶呤或阿糖胞苷 ,对提高中枢神经系统白血病患者生存质量的意义。方法 :为 2 2例急性淋巴细胞性白血病患者行腰穿鞘内注射甲氨蝶呤或阿糖胞苷。结果 :患者头痛症状明显减轻或消失 ,有效地延长了患者的生存期。结论 :白血病鞘内注射操作简便 ,并发症少 ,做好术前、术中、术后护理是保证鞘内注射成功的重要环节。     

Genitourinary spheroidal membrane (GSM) for the treatment of female stress urinary incontinence

Fourteen female patients with stress urinary incontinence were implanted with the genitourinary spheroidal membrane (GSM) device (Bard), a percutaneous implantable spheroidal membrane for the treatment of urinary incontinence through localized tissue expansion. Most patients had undergone previous pelvic surgery and suffered from significant medical problems. The placement of the GSM was performed under local anesthesia, with the help of fluoroscopy, cystoscopy and digital examination. The GSM was inserted and inflated close to the posterior urethra, causing its coaptation. Mean patient follow-up is 33 months. Eight patients are now completely dry (57.1%) and 2 are significantly improved (14.3%), with a success rate of (71.4%). The remaining 4 patients (27.6%) are considered failures. Migration of the GSM into the bladder was noticed on three occasions. Two extrusions into the vaginal wall were encountered. GSM replacements were performed without ill effects. Preliminary findings suggest that the GSM prosthesis may be a simple and safe alternative for the treatment of female stress urinary incontinence. The device is still in the experimental stage and further studies in Europe have been started.     

Patient-perceived outcomes in the treatment of stress urinary incontinence: focus on urethral injection therapy

Intervention for stress urinary incontinence (SUI) is generally focused on minimizing urinary leakage. However, the overall impact of SUI therapy on patients’ quality of life is, arguably, more important than leakage outcomes. We performed a literature search to investigate the effect of urethral injection therapy on quality of life. Significant quality-of-life improvements have been observed with a number of injectable agents, while there is a distinct lack of correlation between subjective and objective outcomes. Two studies comparing urethral injection therapy with surgical intervention found superior objective efficacy with surgery, but no significant differences in quality-of-life improvements. Personal goals of patients undergoing urethral injection are yet to be explored, but there may be willingness to trade a lower success rate in favor of a more minor treatment procedure. In conclusion, quality-of-life improvements after urethral injection appear significant and comparable to those obtained with surgery. Further study of patients’ own perceptions, pre- and posttreatment, would be valuable.     

Dynamic compartmental model of trends in Australian drug use

A five-state compartment model of trends in illicit drug use in Australia is parameterized using data from multiple sources. The model reproduces historical prevalence and supports what-if analyses under the assumption that past trajectories of drug escalation and desistance persist. For fixed initiation, the system has a unique stable equilibrium. The chief qualitative finding is that even though some users escalate rapidly, regular injection drug use still adjusts to changes in incidence with considerable inertia and delay. This has important policy implications, e.g., concerning the timing of reductions in drug-related social cost generated by interventions that reduce the social cost per injection user versus those that cut drug initiation.     

缓解患者对注射与穿刺心理紧张方法探讨

目的：探讨缓解患对注射与穿刺心理紧张的有效方法。方法：2002年1月至6月，将住院接受注射或浅静脉穿刺的患460例，随机分为观察组249例，对照组2ll例，观察组在患注射或浅静脉穿刺前、中、后给予综合缓解心理紧张的方法，即注意力分散法、遮挡法、希望法、激励法、鼓励法、开导法等。对照组常规心理护理。结果：两组患对注射或浅静脉穿刺在诊疗期初次、第2次、3次以后心理紧张例数，以及浅静脉一针见血成功率，经统计学处理，差异有高度显性(P＜0．005)。结论：综合缓解方法是解除患对注射与穿刺心理紧张的有效方法。     

我国中西部农村基层卫生服务机构过度使用注射情况分析

目的 了解农村医疗机构过度使用注射的严重程度及其对处方费用的影响.方法 本文以我国中西部9省市农村基层卫生服务机构为对象,对乡村两级基层医疗机构用药处方进行分析.结果 我国中西部农村医疗机构的处方注射使用率为25.8%～62.2%,平均值为45.1%,显著高于WHO标准(13.4%～24.1%),滥用注射情况严重;滥用注射导致处方费用增加,过度使用注射与基层卫生机构所在地的经济水平有关,也和卫生机构自身的规模和提供的医疗卫生服务量有关.结论 建议政府卫生部门加强管理,制定相应的政策和措施,加强医护人员的培训,加强群众的健康教育,结合实际探讨农村地区行之有效的注射管理模式,减少滥用注射.     

Ventrogluteal versus dorsogluteal site selection: A cross-sectional study of muscle and subcutaneous fat thicknesses and an algorithm incorporating demographic and anthropometric data to predict injection outcome

BackgroundThe dorsogluteal and ventrogluteal intramuscular injection sites both have their use in clinical practice; however, it has not been established in whom one or the other should be preferentially targeted or avoided. There is a need for an evidence-based approach towards site selection for a successful intramuscular injection outcome and to avoid unwanted injection outcomes of inadvertent subcutaneous injection or bone contact. Injection outcome is dependent on injection site subcutaneous fat thickness and muscle thickness; these are likely influenced by gender and anthropometry.ObjectivesTo determine whether subcutaneous fat, muscle, and total tissue thicknesses differ between the dorsogluteal and ventrogluteal sites, and whether theoretical injection outcome (intramuscular, subcutaneous, or bone contact) can be predicted by demographic and anthropometric data and described by an algorithm.DesignCross-sectional study design.SettingsUniversity in Australia.Participants145 volunteers (57% female) of at least 18 years of age recruited through the university community.MethodsAnthropometric data was collected and subcutaneous fat and muscle thicknesses were quantified by ultrasonography. Anthropometric differences between theoretical injection outcome groups (bone contact versus intramuscular versus subcutaneous at the ventrogluteal and dorsogluteal sites) was determined for each gender (ANOVA). Multiple regression analysis was conducted to determine the influence of demographic and anthropometric data on theoretical intramuscular injection outcome. An algorithm to guide site selection was developed for each gender, based on the anthropometric measures that best discriminated between injection outcomes.ResultsSubcutaneous fat, muscle and total tissue were significantly thicker at the dorsogluteal site than the ventrogluteal site, and subcutaneous fat was significantly thicker in females than males at both sites (all p < 0.001); there was no gender difference for muscle or total tissue thickness at either site. Female gender, and waist and hip circumference were significant predictors of subcutaneous fat thickness at both sites; male gender was a significant predictor of dorsogluteal site muscle thickness (all p < 0.05). In the algorithm developed for site selection based on theoretical injection outcome, the best discriminators were: weight, BMI and waist circumference for females, and weight and distance between the iliac tubercle and anterior superior iliac spine for males.ConclusionsThe algorithm describes when each of the ventrogluteal and dorsogluteal sites is appropriate or should be avoided, based on easily obtained anthropometric data. This has direct relevance in clinical practice in evidence-based site selection for gluteal intramuscular injections for optimal medication and health outcomes.