蒙药绿松石的质量标准研究＊

目的 建立蒙药绿松石的质量标准。方法 收集不同产地绿松石，共10批。观察绿松石样品和粉末的性状并进行理化鉴别；按2020年版《中国药典》（四部）通则方法测定绿松石样品中水分、浸出物含量；采用原子吸收光谱法测定绿松石样品铜元素含量。结果 绿松石为不规则、周围带有黑石的块状物，表面蓝绿色，体重，质硬脆，难砸碎，断面呈贝壳状，蜡样光泽，粉末呈灰绿色，无臭，味淡；理化鉴别结果显示，呈铜盐反应；10批次样品中水分含量为0.41%-3.94%（SD=1.37%），浸出物含量为0.21%-0.81%（SD=0.21%），铜元素含量为3.03%-4.63%（SD=0.63%）。结论 初步拟定绿松石中水分含量不得超多5.0%、浸出物含量不得低于0.10%，铜元素含量应为2.60%-4.84%，制定的标准可用于蒙药材绿松石的质量控制。     

Dry eye in chronic stroke patients with hemiplegia: A cross-sectional study

ABSTRACT

Objective: Dry eye is reported to be associated with several neurological diseases. The aim of this study is to evaluate the patients with hemiplegia after stroke for dry eye and compare their results with a control group.

Materials and methods: Forty-five patients with hemiplegia and 45 individuals as the control group were included in the study. Tear function tests (Schirmer and tear breakup time) and a dry eye questionnaire for dry eye symptoms (ocular surface disease index) were performed and the results of the two groups were compared.

Results: Schirmer test results were significantly lower in the post-stroke hemiplegia group compared to the control group (11.3 ± 8.2 mm and 20.6 ± 11.6 mm, respectively, p < .001). Tear breakup time results were significantly lower in the post-stroke hemiplegia group compared to the control group (7.9 ± 3.1 s and 12.1 ± 4.3 s, respectively, p < .001). Ocular surface disease index scores were not significantly different between hemiplegia and control groups (21.6 ± 20.0 and 19.8 ± 13.9, respectively, p = .635). Schirmer scores lower than 10 mm (60% and 30%, p < .001) and tear breakup time results lower than 10 s (65.6% and 28.9%, p < .001) were also higher in the hemiplegia group compared to control group.

Conclusion: We found lower Schirmer test and tear breakup time results and similar OSDI scores in hemiplegia patients compared to controls. Hemiplegia patients may have dry eye without typical symptoms. This should be taken into consideration in the follow-up and rehabilitation of post-stroke hemiplegia patients.     

Subscapularis Transthoracic Versus Posterolateral Approaches in the Surgical Management of Upper Thoracic Tuberculosis: A Prospective,Randomized Controlled Study

The objective of the present study was to evaluate the clinical, radiological, and functional outcomes of a subscapularis transthoracic surgical approach and a posterolateral surgical approach with debridement, bone graft fusion, and internal fixation for the treatment of upper thoracic tuberculosis.There is currently debate over the best surgical approach for the treatment of upper thoracic tuberculosis. Traditionally, the subscapularis transthoracic approach has been preferred; however, the posterolateral approach has gained popularity in the past few years.A prospective, consecutive cohort of 43 upper thoracic tuberculosis patients with a mean age of 39 years (range: 20–52 years) was followed up for a minimum of 12 months (range: 12–60 months). Patients were randomly divided into 2 groups. Group A (n = 21) was treated by the subscapularis transthoracic approach and group B (n = 22) was treated by the posterolateral approach. All cases were evaluated for clinical, radiological, and functional outcomes. Intraoperative blood loss, operative duration, intraoperative and postoperative complications, hospital stay, the cure rate, fusion time, and the Frankel scale were used for clinical and functional evaluation, whereas the kyphosis angle was used for radiological evaluation.Grafted bones were fused by 10 months in all cases. There was no statistically significant difference between groups before surgery in terms of gender, age, segmental tuberculosis, erythrocyte sedimentation rate (ESR), Frankel scale, or Cobb''s angle (P > 0.05). The average operative duration for Group B was lower than that of Group A. There were no significant differences in intraoperative blood loss, intraoperative and postoperative complications, hospital stay, grafted bone fusion time, or cure rate between groups (P > 0.05). The Cobb''s angle correction rate for group B (68.5%) was significantly better than that of group A (30.9%). The neurological score showed significant postoperative improvement in both groups, with no significant difference between the groups.The subscapularis transthoracic approach and the posterolateral approach with debridement, bone graft fusion, and internal fixation are both sufficient and satisfactory for the surgical treatment of upper thoracic tuberculosis. However, the posterolateral approach is superior to the subscapularis transthoracic approach in terms of surgical trauma, operative time, and kyphosis correction.     

对血吸虫病患者心理护理问题的思考

长期以来,对血吸虫病患者心理护理方面重视不够。鉴于此,根据湖北省孝感市血吸虫病防治所2003~2004年收治的251例血吸虫病患者的心理状况观察资料,浅谈对不同病型血吸虫病患者心理护理的对策。1不同类型血吸虫病患者的心理特点1.1急性血吸虫病这类患者以新感染者为主。患者对血吸虫病比较陌生,医护人员及家属一举一动直接影响其心理活动。具体表现为:情绪紧张,对该病不了解,经常找医生打听病情,担心病情过重难以医治,因而造成失眠纳差,情绪不安,植物神经功能紊乱等。1.2慢性血吸虫病这类患者多数是疫区20~50岁的青壮年,均为家庭的主要劳动力…     

医源性胆管狭窄X线表现

本文报道了１３例医源性胆管狭窄，分析其影像表现。特点为：环形狭窄；线样狭窄，包括规则的和不规则的线样狭窄；闭塞性狭窄；胆管闭塞和胆管中断分离。ＥＲＣＴ和ＰＣＴ对狭窄的形态，位置及长度显示优于ＣＴ和ＵＳ。     

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％。     

授权科室成员质量控制对护理质量的影响

目的探索授权科室成员进行护理质量控制的效果.方法本着"质量控制,人人有责"原则,授权科室成员参与质量控制,并将科室成员划分为5个质控小组,即护理服务组、重患手术组、文件书写组、安全消毒组和基础护理组.各组负责科室各环节护理质量控制.比较质量控制组成立前后的效果.结果质量控制组成立后护士的"三基"理论水平、护理质量、患者满意率均高于成立前,差异有显著性意义(均P<0.05).结论授权科室成员进行质量控制,是全面提升护理质量的有效管理方法.     

中风毒邪论与神经保护治疗的研究

中风毒邪论是一种与传统中医中风病理有所不同的理论 ,在中风毒邪论指导下形成解毒通络方是较为理想的神经保护剂 ,可解决目前神经保护治疗的主要障碍 ,有望成为提高中医治疗中风急性期疗效的关键