医院文化建设的误区分析及思考

当前，医院文化的建设越来越受到重视，但是一 些医院的文化建设还存在一些误区，需要加以认真 分析和思考。     

圆孔外面的观察和测量及其面积的回归方程

60具成人颅骨颅底外面的圆孔观察和测量结果表明:圆孔多呈圆形,其次是卵圆形,其它形较少见.据圆孔与翼突外侧板根部延长线的位置关系,分圆孔位置为三型.圆孔外面观的各项测值左右间均无统计学差异,但其中管性圆孔管长度个体差异较大.圆孔的面积左右比较对称者占3.33±2.34%,左>右者占65.51±6.30%,右>左者占34.48±6.30%.圆孔面积左右对称性比较,对临床诊断疾病有参考意义.其面积的回归方程可由其长、宽径乘积推算 .     

BDBPH—Zn Mn Cd双核配合物的稳定常数及其形态研究

目的测定BDBPH-Zn、Mn、Cd双核配合物的稳定常数,分析不同pH条件下各物种的存在形式及变化规律.方法温度25.0±0.10℃、离子强度0.100mol/L、N2保护下用NaOH标准溶液滴定大环配体BDBPH-金属离子(12)酸性溶液,滴定pH范围2～12,高精度酸度计记录pH值,BEST程序计算稳定常数,SPE和SPEPLOT程序绘制样品分布曲线.结果BDBPH-金属配合物的稳定常数分别为17.72(LogKLZn2),11.58(LogKLMn2),14.28(LogKLCd2).结论配体BDBPH能够与金属离子(Zn、Mn、Cd)形成稳定的双核配合物.     

二苯并—18—冠—6和三苯基氧化膦协同萃取Co（Ⅱ）机理研究

目的　研究二苯并 18 冠 6和三苯基氧化膦的 1,2 二氯乙烷溶液 ,从KSCN KCl介质中对Co(Ⅱ )协同萃取。方法　用斜率法确定配合物组成及平衡常数。结果　协萃配合物组成为K(DB18C6 ) 2 ·TP PO·Co(NCS) 3,协萃平衡常数为K′ex=3.4× 10 8(2 5± 0 .5℃ )。结论　TPPO对Co(Ⅱ )萃取有协同效应。     

左氧氟沙星致大疱性皮疹

患者男,26岁。因急性胆囊炎,于2004年1月20日夜到我院急诊科治疗。患者既往无药物过敏史。给予盐酸左氧氟沙星150mg 5%葡萄糖注射液250mL静滴,1次/d。治疗的初始2d,患者无明显不适,第3d,患者自觉全身瘙痒,四肢皮肤出现直径为1～5cm左右大小不等的灼烧样红斑,深红色,并在皮疹中心部分形成水疱和大疱,疱液为浆液性,伴有局部疼痛,尤以右下肢足背为著。立即给予抗过敏、抗感染治疗:5%葡萄糖注射液250mL 地塞米松20mg静滴,10%葡萄糖注射液250mL 10%葡萄糖酸钙注射液20mL静滴,0.9%氯化钠注射液250mL 维生素C注射液2g静滴,同时抽出疱疹内的液体,…     

早发型重度妊高征的临床研究

目的:探讨发生在较小妊周的重度妊高征之发生率、临床特征、治疗原则、终止妊娠时机及对母婴的影响。方法:选择妊娠≤34周的重度妊高征病例45例,按治疗方式的不同分成治疗组(遵循妊高征的治疗原则,同时给予营养支持和促胎肺成熟药物)和观察组。结果:两组病例均没有孕产妇死亡和子痫发生,但合并症、并发症的发生率高达95.24％。治疗组围产儿死亡率及发病率明显低于观察组。结论:早发型重度妊高征在终止妊娠前短期的保守治疗是安全有效的,给予积极治疗能明显减少围产儿死亡率、提高生存率。     

抑郁在老年胃肠肿瘤患者睡眠与术前衰弱间的中介效应

目的探讨抑郁在老年胃肠肿瘤患者睡眠与术前衰弱间的中介作用。方法采用便利抽样法选取219例老年胃肠肿瘤患者,采用一般资料问卷、匹兹堡睡眠质量指数、患者健康问卷抑郁量表及Tilburg衰弱量表调查抑郁、睡眠与术前衰弱的关系。结果抑郁和睡眠对术前衰弱有显著正影响(β=0.326、0.179,t=3.905、1.977,P 0.05)。抑郁在睡眠与术前衰弱间起部分中介作用(β=0.179,VAF=47.97%,P=0.043)。结论抑郁、睡眠与术前衰弱关系密切,睡眠可直接或通过抑郁间接影响术前衰弱的发生。医护人员应重视老年患者术前睡眠及抑郁状态,对术前睡眠质量差且无法改善的患者,可以通过缓解患者术前抑郁情绪来降低术前衰弱的发生率。     

联合应用消化道干预措施对新生儿黄疸的影响

目的:探讨联合应用消化道干预措施对降低新生儿黄疸的效果。方法:将192例正常足月新生儿随机分为直接消化道干预组、间接消化道干预组、综合组。间接消化道干预组应用游泳并抚触措施、直接消化道干预组应用早期通便措施、综合组联合应用游泳并抚触及早期通便两种措施,比较3组胎粪初排时间、胎粪转黄时间、每日排便次数、生后1～6d黄疸指数及病理性黄疸发生率。结果:综合组胎粪初排时间及胎粪转黄时间较直接消化道干预组和间接消化道干预组提前(P<0.01),每日排便次数较其他两组增多(P<0.01),生后3～6d黄疸指数及病理性黄疸发生率比两组降低(P<0.01)。结论:联合应用消化道干预措施能有效降低新生儿黄疸,减少病理性黄疸的发生率。     

2型糖尿病患者血清维生素D水平变化的分析

目的比较2型糖尿病患者与血糖正常者体内血清25-羟维生素D(25-OH Vit D)水平的差异,分析25-羟维生素D与2型糖尿病的关系。方法选择2013年7月~2014年11月在我科住院的2型糖尿病患者50例为病例组,同期在我科住院的血糖正常者60例为对照组。测定25-OH Vit D及相关临床生化指标并统计分析。结果血清25-OH Vit D在病例组和对照组中存在统计学差异(P<0.05),血清25-OH Vit D与空腹血糖呈负相关(P<0.05)。结论血清25-OH Vit D在2型糖尿病患者中低于血糖正常者。且血清25-OH Vit D与空腹血糖呈负相关,即空腹血糖越高,血清25-OH Vit D越低。     

Influence of butyphthalide combined with urinary kallikrein in ACI treatment on neuro-cytokines and vascular endothelial function and its clinical effect

Abstract

Objective: To study the influence of butyphthalide combined with urinary kallikrein in acute cerebral infarction (ACI) treatment on neuro-cytokines and indicators of vascular endothelial function, observe the curative effect and adverse effects, and discuss its safety and feasibility.

Method: 110 ACI patients were chosen as the objects, and classified into observation group (55 cases) and control group (55 cases) according to the method of random number table. Butyphthalide injection combined with urinary kallikrein was adopted for the observation group based on conventional treatment, while cinepazide maleate injection combined with alprostadil injection was applied for the control group based on conventional treatment. The following indicators of both groups were compared before and after treatment: neurotrophic factor (NTF), nerve growth factor (NGF), neuron specific enolase (NSE); content of CXC chemotactic factor ligand 16 (CXCL16), soluble CD ligand (CD40L), Fibulin-5 and high mobility group box B1 (HMGB1); the content of indicators of vascular endothelial function including plasma endothelin ?1 (ET-1) and no therapeutic effects and adverse effects were recorded.

Results: NSE of both groups after treatment decreased obviously, and the content of NTF and NGF increased obviously. NSE content of observation group was lower than that of control group. NTF content and NGF content of observation group were higher than those of control group. The differences had statistical significance (p?<?0.05). The levels of CXCL16, CD40L, Fibulin-5 and HMGB1 declined obviously, compared with pre-treatment, and the levels of observation groups were significantly lower than those of control grip. The differences had statistical significance (p?<?0.05). ET-1 level rose significantly after treatment, and NO level declined obviously after treatment. ET-1 level of observation group was significantly higher than that of control group, and NO level of observation group was significantly lower than that of control group. The difference had statistical significance (p?<?0.05). Clinical effect of observation group was significantly higher than that of control group. The difference had statistical significance (p?<?0.05). The comparison difference of both groups in the occurrence rate of adverse effects had no statistical significance (p?>?0.05).

Conclusion: The application of butyphthalide combined with urinary kallikrein in ACI treatment can effectively inhibit secretion and release of neuro-cytokines, and improve patients’ vascular endothelial function, with significant treatment effect and high safety. Therefore, it deserves to be promoted clinically.