Vestibular Function Measurement Devices

Vestibular function laboratories utilize a multitude of diagnostic instruments to evaluate a dizzy patient. Caloric irrigators, oculomotor stimuli, and rotational chairs produce a stimulus whose accuracy is required for the patient response to be accurate. Careful attention to everything from cleanliness of equipment to threshold adjustments determine on a daily basis if patient data are going to be correct and useful. Instrumentation specifications that change with time such as speed and temperature must periodically be checked using calibrated instruments.     

腰硬联合镇痛及患者自控镇痛对产程及分娩结局的影响

目的 探讨腰硬联合(CSEA)及患者自控镇痛(PCEA)对产程及分娩结局的影响。方法 随机选取2014年1~12月足月待产、无妊娠合并症和并发症初产妇996例,其中503例产妇于活跃期实施CSEA+PCEA镇痛(分娩镇痛组),493例未行分娩镇痛(对照组),分别记录并比较两组产妇各产程时间、子宫收缩、镇痛效果、运动神经阻滞程度、产程中缩宫素的使用率、产后出血率、羊水Ⅲ度污染率、新生儿Apgar评分、产钳助产和剖宫产率。结果 分娩镇痛组第一产程、第二产程较对照组有所延长,差异有统计学意义(P<0.05);第三产程无明显改变;子宫收缩力减弱;分娩镇痛组较对照组镇痛效果显著,差异有统计学意义(P<0.05);运动阻滞程度低;缩宫素使用率、产后出血率、羊水Ⅲ度污染率、及新生儿Apgar评分及产钳助产和剖宫产率两组比较,差异均无统计学意义(P>0.05)。结论 腰硬联合分娩镇痛可能会使第一产程、第二产程延长,对子宫收缩力有一定的影响,但并未增加缩宫素的使用率及产钳助产和剖宫产率,其镇痛效果显著,运动阻滞程度低,对分娩结局无不良影响。     

中华传统文化视角下疾病终末期患者尊严模型解析

目的:解析加拿大Chochinov疾病终末期患者尊严模型在中华文化情境下的适用性,并基于此对模型进行调适。方法:采用内容分析法,按照选定分析范围、抽取样本、确定分析单位和分析框架、资料分析四步完成。首先检索中、英文数据库中以中华文化背景下临终尊严为主题的文献,然后以尊严模型为框架对文献内容进行编码、归纳和分析。结果:尊严模型包含的多数主题符合我国临终患者的认知,如身体功能、医疗不确定性、死亡焦虑、隐私界限、照护要旨、他人负担、后事担忧等。但也出现了矛盾的主题,如忍受痛苦、自主性等,以及新的主题,包括家庭支持、病耻感和财务担忧。结论:加拿大版疾病终末期患者尊严模型并不完全符合中国文化,调适后的尊严模型更具我国文化特色,但仍需实证研究对模型进行验证。     

天文潮汐对心脏病患者心力衰竭发生率影响的研究

目的　研究天文潮汐对心脏病患者发生心衰的影响。方法　分析 118例心脏病患者发生心衰在各潮汐期的分布。结果　在强天文潮汐期内心脏病患者发生心衰显著多于其余时期 ,而且在朔、望期发生的人数多于上、下弦期。结论　护理人员要了解天文潮汐的变化规律 ,教育心脏病患者在强天文潮汐期内要保持情绪稳定 ,必要时在强天文潮汐期内可给予心脏病患者适量的镇静剂和安眠药。     

青年人群血清流感抗体水平纵向监测

通过对北京４０５例青年１９９２～１９９４年流感抗体的纵向监测结果表明，３年中Ｂ型流感表现很活跃，抗体分别在１９９３年和１９９４年春出现高峰。Ａ型流感抗体在１９９３年春出现高峰。其中２１８例个体连续３年６次抗体检测，据抗体波动提示：３年中流感３个亚型总的感染频率为４４０％，每个体每年平均为１．４次，其中Ａ１型感染频率最高，每个体３年内平均１．８次；Ａ３型次之为１．５２；Ｂ型为１．０６。流感３个亚型抗体在机体内有６７％～７３％高水平抗体个体可在０．５～１年内下降至≤２０的低水平。２１８例个体中Ａ１型抗体３年内长期低水平者有３％，Ａ３有９％，Ｂ有３８％。     

Experience with Cyclosporine in Children with Chronic Idiopathic Urticaria

Abstract: Background: The identification of an autoimmune mechanism for many patients with chronic idiopathic urticaria (CIU) was used as a rational for a controlled clinical trial of cyclosporine for adults with CIU not responsive to usual measures. That randomized placebo controlled clinical trial demonstrated clinical efficacy, acceptable safety, and a suggestion of inducing remission in such patients. Objective: To report our experience with cyclosporine in pediatric patients with CIU. Methods: Fifty‐four patients with CIU were referred to us during the period from 2000 through June of 2005. Seven of those, aged 9–16, failed therapy with high dose antihistamines even with the addition of alternate morning prednisone. Neoral brand of cyclosporine, 3 mg/kg/day divided b.i.d., was initiated in these patients. Cyclosporine serum concentrations, blood urea nitrogen (BUN), creatinine, and blood pressure were routinely monitored. Results: All had cessation of hives. This occurred after 1–4 weeks for six of the seven and 8 weeks for one. While some experienced relapses, all were eventually off of all medications and free of hives. None of the seven experienced any adverse effects. Conclusions: Our experience in children is consistent with a previous controlled clinical trial in adults and supports the efficacy and safety of cyclosporine for CIU. However, we recommend that it be reserved for those whose CIU that is resistant to conventional measures and that patients be carefully monitored with cyclosporine serum concentrations and measures of renal function.     

肝硬化患者凝血障碍与内毒素血症

本文通过多项止凝血实验指标和鲎试验对20例失代偿性肝硬化患者进行动态观察,发现血浆内毒素水平和ⅧR:Ag均增高.其他凝血因子和ATⅢ减低.纤维蛋白连接素减低.结果提示:(1)止凝血功能障碍与内毒素血症(ETM)并存,并与疾病的进展密切有关;(2)ETM的发生率和严重程度与肝硬化失代偿的程度有关;(3)ETM和止凝血功能异常的动态观察可作为判断预后的一项参考指标     

Effects of an exercise intervention for older heart failure patients on caregiver burden and emotional distress.

BACKGROUND: The impact of exercise programmes for heart failure on those close to the patient is largely unknown. We examined the effect of a hospital and home-based exercise intervention on burden, anxiety and depression of informal caregivers. DESIGN: The study was a randomized, controlled trial. Heart failure patients were randomized to a seated 12-week hospital-based exercise programme. Caregiver measures were gathered at baseline, 3 months later and 6 months following baseline. METHODS: Sixty caregivers (mean age 63.4 years, 65% female) of heart failure patients (n = 82, mean age 80.5 years, 44% female) participating in a trial of an exercise intervention were recruited. Caregiver burden, anxiety and depression were assessed. RESULTS: There were no differences in caregiver burden, depression or anxiety between the two groups of caregivers at baseline (caregiver burden, patient control 33.1 versus patient exercise 34.1; anxiety 4.1 versus 5.5; depression 2.8 versus 3.8). At 3 months there were no differences between caregivers in the two groups on outcomes. At 6-month follow-up caregivers of heart failure patients in the exercise group had burden scores that were significantly worse than the control group. There were no differences between the carers of exercise and control groups in anxiety and depression. Levels of anxiety and depression in the entire carer sample were marginally higher than reference values in a healthy non-clinical sample. CONCLUSION: The present exercise interventions for frail older patients did not benefit caregivers and was associated with an increase in caregiver burden. We suggest that future exercise interventions for heart failure patients should actively incorporate informal caregivers into research designs.