An expert system to teach troubleshooting of common problems associated with the automated anesthesia recordkeeper

Automated anesthesia recordkeepers have been used to monitor patients during surgery in up to 90% of cases at The Ohio State University. The record-keeping devices are complex and can be difficult to troubleshoot. The 1st-CLASS Fusion Program, an expert system shell-program, has been programmed to allow the resident or nurse anesthetist to solve the two most common types of problems associated with the recordkeeper: printer problems and patient monitor problems. Use of this program allows the resident or nurse anesthetist to troubleshoot the recordkeeper quickly and accurately and promotes in the user a sense of competence and control over the technology.     

Sexual Knowledge,Experience and Feelings Among People with Disability

The current study was designed to evaluate the sexual knowledge, experience, feelings and needs of people with intellectual disability or physical disability, and compare them to people from the general population. Sixty people with mild intellectual disability (28 males, 32 females, mean age=27.62 years), 60 people with physical disability (33 males, 27 females, mean age=28.65 years) and 100 people from the general population (40 males, 60 females, mean age=30.10 years) participated in the study. Each respondent completed the Sexual Knowledge, Experience and Needs Scale (SexKen). This scale assesses levels of knowledge, experience, feelings and needs in 12 different areas of sexuality. The results demonstrated that people with intellectual disability experienced lower levels of sexual knowledge and experience, more negative attitudes to sex and stronger sexual needs than people with physical disability, in all areas of sexuality. People with physical disability demonstrated these same trends when they were compared to people from the general population. An interpretation of these results as they relate to the sexuality of people with intellectual or physical disability is provided.     

Previous maternal experience potentiates the effect of parturition on oxytocin receptor mRNA expression in the paraventricular nucleus

In sheep, central oxytocin release at parturition induces maternal behaviour which is thought to be mediated by changes in the expression of central oxytocin receptors. The distribution, effects of parturition, previous maternal experience and hormonal status on the distribution of an oxytocin receptor was investigated using immunocytochemistry and in situ hybridization. In ewes with no previous maternal experience, parturition induced significant increases in oxytocin receptor mRNA expression in the anterior olfactory nucleus, medial preoptic area, ventromedial hypothalamus, lateral septum, medial amygdala, bed nucleus of the stria terminalis and diagonal band of Broca. In maternally experienced ewes, parturition induced additional increases in two areas, the paraventricular nucleus and the Islands of Calleja. The changes in progesterone and oestrogen that occur during late pregnancy and parturition appear to contribute to increases in expression in the anterior olfactory nucleus, Islands of Calleja, medial preoptic area, ventromedial hypothalamus, bed nucleus of the stria terminalis and diagonal band of Broca, but not in the paraventricular nucleus, lateral septum and medial amygdala. These results demonstrate that progesterone and oestrogen priming enhance oxytocin receptor mRNA expression in a number of regions in the olfactory system, hypothalamus and limbic brain. These effects appear to be independent of maternal experience. Parturition increases oxytocin receptor mRNA expression in all the areas influenced by hormonal priming and the lateral septum, medial amygdala and paraventricular nucleus. Maternal experience also enhances expression of oxytocin receptor mRNA in the paraventricular nucleus and the Islands of Calleja. Because the paraventricular nucleus is the main source of oxytocin release in the brain, this upgrading of autoreceptors as a result of maternal experience may serve to enhance release of this peptide in projection sites regulating maternal behaviour.     

The impact of nurses' encounters with cancer on their attitudes towards the disease

Summary

• ? A study to develop understanding of nurses' knowledge, confidence and educational needs in relation to cancer care was undertaken.
• ? Data from this study on nurses' attitudes and the effect of professional encounters with cancer on such attitudes are presented.
• ? A cancer attitude scale was completed by 127 nurses, and 68 of the sample were interviewed in depth.
• ? Data presented reveal a pervasive negative attitude towards cancer amongst these nurses, and the important negative impact that professional encounters with cancer have on nurses' feelings about the disease.
• ? Data presented are taken from a larger study, which is reported elsewhere (Corner, 1990; Corner & Wilson-Barnett, 1992).

     

舌状浆肌瓣覆盖—食管胃粘膜吻合术治疗食管癌100例临床体会

作者用“舌状浆肌瓣覆盖——食管胃粘膜吻合术”治疗食管癌100例,随访1—10个月,无吻合口狭窄及返流性食管炎。本组无吻合口瘘及手术死亡。本组经验:保持舌状浆肌瓣的完整和保证吻合口良好血供是本手术成功的关键。     

从中医对热病的认识看SARS患者治疗之得失

通过观察SARS恢复期的各种临床表现，结合中医对外感热病的认识，提出SARS患者疾病早期要宣散清透，喘脱期仍要注意疏利，恢复期不可一味补益，要注意调畅气机。     

张家维教授针灸治疗小儿多动症380例临床研究

目的　探讨针灸治疗小儿多动症的临床疗效、对异常脑电图的改变情况、疗效与证型的关系、疗效与年龄的关系等。方法　将 5 92例患者分为针灸组及中药组。结果　针灸组总有效率为 84 .4 % ,中药组为 78.77% ,前者疗效优于后者 (P<0 .0 5 ) ;针灸组对异常脑电图的改变率优于中药组 (P<0 .0 5 ) ;针灸组中肝肾不足型、肝郁气滞型两型间的疗效有显著性差异(P<0 .0 1) ;肝郁气滞型较佳。疗效与年龄之间有非常显著性关系 (P<0 .0 1) ,年龄小者针刺疗效较佳。结论　针灸治疗小儿多动症可取得较好疗效 ,其总有效率及对异常脑电图的改善优于内服中药 ,肝郁气滞型及年龄小者疗效较好     

王泽涛教授治疗泌尿生殖疾病经验举隅

收集整理王泽涛教授曾在俄罗斯医疗队工作期间用针灸治疗阳萎、无精症、遗精、遗尿、癃闭、石淋等病的临床治疗宝贵经验.文中体现中医辨证分型,异病同治,取穴少而精,疗效显著等特点.     

叶桂治脾胃经验浅析

叶桂继承并发展了李果的脾胃学说，在其《临证指南医案》、《未刻本叶氏医案》中记述了治脾胃经验，概括起来有如下几个方面：温中健脾法，理气和胃法，脾胃同治法，清养胃阴法，调肝治中法。     

广东省中医院治疗非典型肺炎临床经验

[目的]观察中西医结合治疗严重急性呼吸综合症(SARS)的临床疗效。[方法]对103例确诊SARS患者采用中西医结合的治疗方案。中医采用卫气营血和三焦辨证 ,按病情分为早期、中期、极期 (高峰期 )、恢复期4期 ;西医方案主要采取营养支持、吸氧、呼吸机辅助通气、抗感染、免疫增强、激光抗炎及对症处理等措施。[结果]103例中治愈96例 (93.21 % ) ,死亡7例 (6.79 % ) ;退热时间为 (6.72±3.95)d ;肺部病灶完全消失94例 (91.26 % ) ,胸部X片显示病灶吸收时间为(18.13±8.99)d;2例呈纤维索条状改变。[结论]采用中西医结合治疗在干预病程、减轻中毒症状、缩短发热时间和住院时间、减少后遗症、减轻并发症和西药副作用方面有明显的作用