头低位卧床对肺血流影响的试验研究

目的观察-6°头低位卧床(HDT-6°)对肺循环血流的影响,并探讨其与肺弥散功能的关系。方法采用YK-10循环系统监测仪和HP2500超声诊断仪,对16名健康男性受试者90minHDT-6°卧床及21dHDT-6°卧床前、后及卧床不同时间肺循环血流、肺血容量、右心输出量等有关指标分别进行了测试。结果在90min卧床试验中,HDT-6°卧床肺血容量较卧床前坐位显著增加,随卧床时间延长,肺血容量渐减少,90min左右已显著少于平卧位水平。在21d卧床中,第3天最低,第7天测量仍显著低于卧床前平卧位对照值,以后保持相对稳定。起床后第3天平卧位测量仍低于卧床前。右心输出量在卧床第3天即显著下降,之后保持相对稳定,在起床第3天测量基本恢复;每搏量在卧床第7天显著降低,一直持续到起床第3天,而在这个阶段,心率则逐渐增加,卧床第20天和起床第1、3天均比卧床前有显著增加。结论头低位卧床使肺血流量增加的同时,增加了肺循环的灌注压,有肺间质水肿的潜在危害。同时肺动脉压升高,以及机体通过神经体液的自我调节,反过来减少了肺灌注,肺毛细血管血量的减少,有自我保护的作用。     

张锡纯论治冲胃气逆疾病述要

常见的冲胃气逆疾病有脑充血、呕吐、吐衄、喘证、膈证、倒经等,张锡纯认为引起此类疾病的病理基础是肾虚、肝火、胃气虚弱等。对于此类疾病,张锡纯喜用降逆药物配合对症的补益之药治疗。降逆药物,张锡纯常取代赭石、半夏,认为两药皆是镇降冲胃气逆的良药,补益药物,能恢复脏腑的正常生理,从根本上治疗引起冲胃气逆的病理基础,另外张锡纯还用升提大气的方法治疗冲胃气逆引起的倒经等病。     

预防跌倒/坠床管理流程在神经外科病房的应用

目的建立神经外科住院患者预防跌倒/坠床管理流程,降低住院患者跌倒/坠床的发生率。方法使用住院患者跌倒/坠床危险因子评估表,对患者住院期间的跌倒/坠床危险因素进行预见性及动态评估,对评分≥4分的住院患者,制定并落实护理安全管理措施与监控。结果预防跌倒/坠床管理流程实施后,护士、患者及家属安全防范意识增强,跌倒/坠床发生率明显降低。结论预防跌倒/坠床管理流程的实施,能提高护士、患者及家属对患者意外跌倒/坠床的安全关注意识,减少患者意外跌倒/坠床的发生,提高住院患者的护理安全。     

Eating Down in Pregnancy: Exploring Food-Related Beliefs and Practices of Pregnancy in Rural Nepal

Adequate nutrition during pregnancy, vital for the health of the mother and the newborn, may be influenced by pregnancy-related food beliefs. This study explores food-related beliefs and practices specifically related to reducing food intake in pregnancy in a rural community in Nepal by combining ethnographic and quantitative data collected from pregnant Nepali women.

A large proportion (60%) of women reported reducing rice intake during pregnancy but the reduction was related to food aversions and being unwell (66%), rather than the desire to have smaller babies or other cultural beliefs (18%). Only 10–20% reported reducing intakes of other nutrient-rich foods during pregnancy. Such foods were generally consumed in inadequate amounts due to seasonal variation or because of their high cost. In a multivariate analysis, maternal characteristics that were associated with decreasing food intake during pregnancy included literacy, poor appetite, socio-economic status, and presence of night blindness, caused by vitamin A deficiency.

We conclude that eating down to prevent difficult deliveries may not be very common in rural Nepal but women may reduce food intake for reasons of aversion to food, lack of appetite, or feeling unwell. A decline in the consumption of foods rich in protein and micronutrients was not evident; such foods appear to be chronically low in the diets of poor women in this setting.     

银杏露镇咳、祛痰及平喘的药效学研究

目的：观察银杏露的镇咳、祛痰及平喘作用。方法：采用小鼠氨水引咳法及气管酚红排泌法观察银杏露的镇咳及祛痰作用,采用哮喘发作潜伏期及离体气管平滑肌松弛试验观察银杏露的平喘作用。结果：银杏露能抑制氨水引起的小鼠咳嗽,促进小鼠气管酚红排泌,对磷酸组胺引起的豚鼠哮喘具有保护作用,能明显延长哮喘潜伏期;对磷酸组胺引起的豚鼠气管收缩具有抑制作用。结论：银杏露具有镇咳、祛痰及平喘作用。     

Pilot randomised controlled trial of face-down positioning following macular hole surgery

Objective

This was a pilot randomised controlled trial (RCT) to investigate the effect of post-operative face-down positioning on the outcome of macular hole surgery and to inform the design of a larger definitive study.

Methods

In all, 30 phakic eyes of 30 subjects with idiopathic full-thickness macular holes underwent vitrectomy with dye-assisted peeling of the ILM and 14% perfluoropropane gas. Subjects were randomly allocated to posture face down for 10 days (posturing group) or to avoid a face-up position only (non-posturing group). The primary outcome was anatomical hole closure.

Results

Macular holes closed in 14 of 15 eyes (93.3% 95% confidence interval (CI) 68–100%) in the posturing group and in 9 of 15 (60% 95% CI 32–84%) in the non-posturing group. In a subgroup analysis of outcome according to macular hole size, all holes smaller than 400 μm closed regardless of posturing (100%). In contrast, holes larger than 400 μm closed in 10 of 11 eyes (91% 95% CI 58–99%) in the posturing group and in only 4 of 10 eyes (40% 95% CI 12–74%) in the non-posturing group (Fisher''s exact test P=0.02).

Conclusion

Post-operative face-down positioning may improve the likelihood of macular hole closure, particularly for holes larger than 400 μm. These results support the case for a RCT.     

推拿联合温针灸治疗髌下脂肪垫损伤性膝痛87例

[目的]探索适宜基层社区医院开展的髌下脂肪垫损伤性膝痛保守治疗方法。[方法]采用髌下滑动推拿施刑技术手法,联合温针灸方法对87例髌下脂肪垫损伤性膝痛进行治疗。[结果]治愈63例,好转24例,无效0例,总有效率100%。[结论]本方法简单、经济、有效、适宜基层社区医院开展。     

乳香诱导急性非淋巴细胞白血病细胞凋亡中对Bcl-2基因调节

研究乳香诱导急性非淋巴细胞白血病细胞凋亡中对Bcl-2基因蛋白的影响。采用DNA片段百分率及免疫组化法检测30例急性非淋巴细胞白血病细胞及白血病细胞株HL60细胞经100μg/ml乳香处理前、后Bcl-2基因蛋白表达水平。结果：乳香具有诱导急性非淋巴细胞白血病细胞及HL60细胞凋亡^[1]及下调Bcl-2基因蛋白表达水平。结论：乳香具有诱导急性非淋巴细胞白血病细胞及HL60细胞凋亡作用及下调Bcl-2基因蛋白。Bcl-2基因蛋白表达水平下调可能是乳香提取物诱导急性非淋巴细胞白血病细胞凋亡重要机制之一。     

小鼠Leydig肿瘤细胞膜受体LHR减量调节中受体基因转录变化及其机制

膜受体的减量调节是受体在转导跨膜信号的同时，其数目呈进行性下降的一种细胞生物学行为。本文运用ＲＴＣＲ、放免分析及“ｒｕｎｏｎ”等技术研究小鼠Ｌｅｙｄｉｇ 细胞株ＬＨ 受体（ＬＨＲ） 减量调节过程中ＬＨＲ ｍＲＮＡ 水平变化及其调控机制。结果揭示，在ｈＣＧ作用后ＬＨＲ 减量调节的过程中，ＬＨＲｍＲＮＡ 水平发生了“升高降低”的变化，这种变化是ＬＨＲ基因转录活性的变化决定的，与ＬＨＲｍＲＮＡ 的降解无关，ｃＡＭＰ 以“正相关”的方式调控着ＬＨＲ基因的转录速率。