内外合治颜面部疔疮两例

<正>1病例资料1.1病例1患者,女,41岁。患者左侧鼻翼"迎香"穴处起粟粒样脓头7 d,周围红肿疼痛,挤压后,红肿蔓延扩散,伴高热寒战、头痛、烦躁不安、目赤、口干苦、大便4 d未解,故来我处求治。检查:体温38.8℃,神志清醒,面部疔疮如粟米大小,疮顶有脓头、周围皮肤色紫黯,肿势波及头面、鼻部,左侧颌部、颈部浅淋巴结均轻度肿大,舌红、苔黄厚,脉数。血常规:白细胞计数22×109/L,中性粒细胞     

医嘱微机化管理的体会

我院从2001年对病房实行微机化管理，经过两年多的运行取得了良好效果。现就医嘱微机化管理中的主要做法与体会介绍如下。     

高校素质教育的思想政治教育方法论原则初探

思想政治教育在高校素质教育中起着什么的作用，以及在素质教育中思想政治教育应坚持什么样的方法论原则，这是本文作者所思考和要解决的问题。     

Graves病碘海醇封闭后放射性核素治疗1例

患者男,32岁。因心悸、手颤、消瘦伴间断四肢无力于2004年3月第1次入院,确诊为Graves病,予丙基硫氧嘧啶300mg/d治疗12d,症状改善出院。出院15d因粒细胞缺乏再次入院,经治疗后血象恢复正常,拟行放射性核素治疗。其间因5次周期性麻痹发作,行胸腺CT,并使用碘海醇〔商品名Omnipaque(欧米帕克)〕。     

喘息性疾病患儿家长焦虑与社会支持的调查

目的 了解喘息性疾病患儿家长焦虑、社会支持水平的相关性及其影响因素.方法 采用状态焦虑与社会支持问卷时226名喘息性疾病患儿的家长进行调查.结果 患儿家长焦虑评分为30～68(48.47±9.35)分,焦虑与社会支持呈负相关(r=-0.20,P＜0.01).其性别、年龄、文化程度对状态焦虑水平有影响.文化程度对社会支持有影响.结论 喘息性疾病患儿家长入院时焦虑水平较高.需对其进行相关健康教育和心理疏导,帮助其积极调动社会支持,助于患儿临床恢复.     

胰岛素强化治疗对严重创伤患者炎性反应及预后的影响

Objective To investigate the effects of intensive insulin therapy on inflammatory re-sponse and prognosis of patients with severe trauma. Methods Eighty severely injured patients were di-vided into intensive insulin therapy group (n = 40, IT) and routine therapy group (n = 40, RT) in random pair. At the time of admission, a continuous infusion of insulin (2 -4 U/h) was pumped into the patients of IT group to maintain blood glucose level at 6 -8 mmol/L. Patients in RT group were given routine treatment without administration of insulin. Fever, organ injury, and mortality of patients in 2 groups were recorded. Venous blood was drawn from patients of 2 groups on the morning of post treatment day (PTD) 1, 3, 5, and 7. Values of TNF-α, C-reactive protein (CRP), IL-2, and IL-10 in plasma were assayed. Results High fever appeared in 9 patients in IT group, and WBC exceeded 10.0×109 for more than 3 days in 17 patients in this group, versus 20 and 29 patients respectively in RT group. Dysfunction of 1 organ appeared in 31 pa-tients in IT group and 30 patients in RT group. Dysfunction of 3 organs appeared in 10 patients in IT group and 19 patients in RT group. Dysfunction of 4 organs appeared in 7 patients in IT group and 12 patients in RT group. In IT group, 4 patients died within 3 post-injury day (PID), and 1 patient died after PID 3 (total case fatality: 12.5% ). In RT group, 5 patients died within 3 PID, and 4 patient died after PID 3 (total case fatality: 22.5%). Plasma levels of TNF-α and CRP of patients in IT group were significantly lower than those of patients in RT group on PID 3 - 7 ( P<0.05 or P<0.01 ), while levels of IL-2 and IL-10 of patients in IT group were significantly higher than those of patients in RT group ( P<0.05 or P<0.01 ). Plasma levels of TNF-α ( 1.3±0.6 μg/L) and CRP (55±16 mg/L) of patients in IT group on PTD 7 were lowered to the trough level, and they were significantly lower than those of patients in RT group (3.0±0.8μg/L, 89±20 mg/L, respectively, P <0.01 ). Conclusions Intensive insulin therapy can mitigate systemic inflammatory response and improve prognosis of patients with severe trauma.     

肝病患者血清诱导间充质干细胞表达肝细胞特异性标志物的实验研究

目的：观察重型肝病患者血清对人骨髓间充质干细胞（MSCs）的诱导分化作用，探讨人MSCs分离培养、体外扩增的条件和方法。方法：从肋骨分离、培养人骨髓MSCs、体外扩增培养、鉴定，并采用重型肝病患者血清诱导培养，分别在诱导培养0、7、14、21、28天时留取细胞，并采用免疫细胞化学方法检测肝特异性标志物（AFP、Alb、CK-18）、用PAS进行糖原染色实验。结果：诱导后5天、MSCs表现为肝细胞样细胞，随着诱导培养时间的延长，肝特异性标志物逐渐出现和成熟。AFP在7天时表达水平最高，培养14、21、28天时表达逐渐减弱；Alb、CK- 18和糖原随着诱导时间的延长，表达逐渐增强。结论：密度梯度离心，贴壁培养和消化时间控制相结合，是一种较为有效的分离纯化方法。重型肝病患者血清能诱导骨髓MSCs表达肝细胞的特异性标志物。     

揿针针刺耳穴治疗青少年近视635例临床分析

近年来，青少年近视问题已经成为社会关注的热点问题，近视的治疗也显得越来越重要。1985～1994年，我们采用揿针针刺耳穴治疗青少年近视635例，效果较好，现报告如下。     

缩短产程处理产时胎心率减速

本文就我院2002年12月～2004年3月应用HEWLETT PACKARDMl351A型胎心监护仪所获52例产时胎心减速图形、分娩方式及其因果进行分析和评价。