《现代护理学》的创造者 伟大的南丁格尔女士传略(连载)

十八、“现代护理工作”的创始人,《概述》一书的印行. 十九世纪中叶,英国在医务界出了三个有名人物,他们在治病救苦方面做出了杰出超人的贡献.辛伯森,氯仿麻醉的引进家;利斯德,抗菌外科的发明     

《现代护理学》的创造者伟大的南丁格尔女士传略(连载)

二十.印度英军和全印医疗、卫生、保健工作的改善南丁从1860年起,开始收集英军驻印部队和印全     

肾混合性上皮间质肿瘤和成人囊性肾瘤的临床病理学观察

Objective To study the clinicopathologie features,immunophenotype and differential diagnosis of mixed epithelial and stromal tumor of kidney ( MEST) and adult cystic nephroma ( CN).Methods Five cases of MEST and 4 cases of CN were retrospectively analyzed.Immunohistochemical study was carried out and the literature was reviewed.Results All of the five patients with MEST were females.Their median age was 45 years.For CN,there were 3 males and 1 female and their median age was 41 years.All patients presented with loin pain and hematuria.On gross examination,MEST was well-circumscribed but non-encapsulated.There was no evidence of haemorrhage or necrosis.Three of the cases were solid in nature.One was composed of a mixture of solid and cystic elements,while the remaining case showed a multicystic cut surface bridged by thick fibrous septa.On the other hand,CN were well-circumscribed and encapsulated.They were multiloculated cystic in nature.The cystic spaces were separated by thin septa and there was no significant solid or necrotic component.Histologically,MEST consisted of proliferation of cystically dilated glands admixed with spindly stromal cells with various cellularity and growth patterns.Both the glandular and stromal elements were well-differentiated with no cytologic atypia identified.The glandular structures in 2 of the cases were partially lined by endometrial or tubal epithelium.In contrast,the thin-walled cystic spaces in CN were lined by a single layer of epithelium.Immunohistochemical　study showed that the epithelial cells were positive for pan-cytokeratin and epithelial membrane antigen.The spindle cells in MEST expressed vimentin (5/5 ) ,smooth muscle actin (3/5 ),desmin (4/5 ),CD10 (5/5),estrogen receptor (4/5) and progesterone receptor (4/5).They were negative for HMB45,CD34,CD117 and S-100 protein.On the other hand,the spindle cells in CN were variably positive for vimentin (4/4),smooth muscle actin (4/4),desmin (1/4),estrogen receptor (3/4) and progesterone receptor (1/4).They were negative for CD10,HMB45,CD34,CD117 and S-100 protein.Conclusions Both MEST and CN are uncommon renal neoplasm.Most of them run a benign clinical course.The stromal cells in MEST show smooth muscle or myofibroblastic differentiation.Areas demonstrating Miillerian features also existed in some cases.MEST and CN share overlapping histological and immunohistochemical features,and may represent spectrum of the same group of lesions.     

224例成人麻疹临床分析

近两年来 ,我院收治麻疹患者共 5 2 8例 ,其中 18周岁以上成人麻疹患者 2 5 5例 ,占 4 8 3% ,资料较完整的有 2 2 4例。现将其临床特点总结报道如下。1　临床资料1 1　一般资料　本组资料为 2 0 0 0年 1月至 2 0 0 2年 1月的住院患者 ,诊断均符合《传染病学》的相关标准[l] 。     

计划免疫健康教育的目的与实施方式探讨

健康教育是为计划免疫工作创造良好社会环境不可缺少的工作环节和手段,是做好计划免疫工作的重要保障。在基层农村有组织、有计划地对家长进行计划免疫健康教育非常有必要,能使所有的儿童受益,提高人群免疫水平,以促进计划免疫工作的顺利开展。现结合湖北省建始县开展计划免疫的实际情况,探讨计划免疫健康教育的组织与服务模式。     

供应室工作人员职业感染防护行为的特点分析及干预对策

目的研究医院供应室人员对医院感染知识及防护办法的了解程度,并制定相应的干预对策,以降低感染率。方法采取访谈及自行设计的问卷调查表,对医院消毒供应室的17名人员进行防护行为调查,根据调查结果对消毒供应室人员进行相关职业防护教育,采用培训、考核制度,观察并比较干预前后供应室人员防护行为。结果干预后工作人员对防护知识的了解有了很大提高,从干预前的41.18%～88.24%上升至干预后的88.24%～100.00%(P<0.05);供应室人员职业感染防护行为显著提高(P<0.05)。结论供应室人员职业感染是多因素导致的,重视对相关人员的防护知识培训,并制定相关的政策,对防护医院感染有很重要的作用。     

滋木软肝方治疗肝炎肝硬化的疗效研究

目的：观察中药滋木软肝方治疗肝炎肝硬化的临床效果。方法80例肝炎肝硬化患者，随机分为治疗组和对照组各40例。对照组采用现代医药学综合治疗，治疗组在现代医学综合治疗基础上加用滋木软肝方治疗，连续口服6个月。观察2组门静脉宽度、转氨酶、黄疸指数、白蛋白、谷酰转肽酶、腹水的指标变化。结果治疗组总有效率为门静脉宽度82.5％，转氨酶80.0％，黄疸指数80.0％，白蛋白77.5％，谷先转肽酶87.5％，腹水92.5％，明显优于对照组的55.0％、75.0％、57.5％、70.0％、80.0％和77.5％，差异有统计学意义（ P＜0.05）。结论滋木软肝方治疗肝硬化的效果从一个侧面显示中药复方在调控细胞、间质的生态平衡及有关功能性基因方面的优势，对肝纤维化复杂的病理生物学改变具有一定的针对性。有待获得更严格、规范的临床研究资料，以指导临床作用。     

持续质量改进提高手术室护士术前访视能力效果探讨

目的 提高手术室护士术前访视能力.方法 将持续质量改进方法应用于术前访视能力的培训中,根据护士知识能力的现状,通过学习、不同年资护士间互相学习评价、阶段评价改进等方法实施.结果 经过1年的持续质量改进,护士在理论知识、技能运用、效果评价等方面均有提高,其中护龄在10年内的护士理论知识提高明显.差异有统计学意义(P＜0.05);患者的满意度及手术的顺从性提高,改进前后比较有统计学意义(P＜0.01).结论 持续质量改进对提高护士术前访视能力效果显著,患者满意度及手术顺从性也有显著改善.     

医疗设备固定资产分类及信息化管理方法

本文分析了医疗设备固定资产分类管理的现状,介绍了常用的分类方法及优缺点,提出了基于医疗设备原理和功能分类的管理方法,指出了固定资产信息化管理的发展趋势。     

医疗器械流通现状分析与医疗机构的对策

本文主要以医院为视角,从医疗器械流通的发展、流通领域的管理现状以及存在的问题等方面进行分析,探讨了针对性的管理措施,以提升医院医疗器械的管理水平。