互联网形势下医院离退休干部管理工作探索

当前我国科技技术进一步提升,国民生活水平也在不断地进步,对于医院离退休干部管理服务的要求也越来越高。对于医院的工作来说,处理好医院的退离休老干部是一项十分重要的工作,所以医院工作管理人员需要提高对于离退休老干部管理工作的重视。而在传统意义下医院离退休干部的管理服务,存在着较多的问题,而当前在互联网的形势下却能够实现更加具有科学化、合理化的服务。通过创新服务理念,对于管理方式进行改革,可以有效地改善当前对于医院离退休干部的管理服务水平,青年团员可以自行组成相应的志愿者,加强对于退休老人的关心,了解老干部在生活以及学习中出现的问题,并且采取有效的措施进行解决。本文通过以阐述我国当前离退休干部管理工作的现状作为切入点,进行分析探究,进一步提出互联网模式下提高我国医院离退休干部管理的对应措施。     

丹参对持续癫痫幼鼠脑损伤保护作用的实验研究

目的 探讨丹参对持续癫痫发作诱发幼鼠脑神经元损伤是否具有保护作用。方法 皮下及腹腔注射贝美格针诱发健康幼龄鼠癫痫持续状态发作。光镜下观察神经元病变情况；电镜观察海马神经元超微结构的改变。结果 持续癫痴组幼鼠脑组织光镜下可见明显的神经元病变。电镜下可见海马区神经元的超微结构病变。丹参治疗组神经元病变均轻于持续癫痴组；而正常对照组未见类似病变。结论 丹参在组织、细胞和亚细胞水平对持续癫病幼鼠脑神经元损伤具有一定的保护作用，为临床有效防治小儿惊厥性脑损伤提供了可靠的实验依据。     

医患诚信现状剖析

近几年来,诚信缺失现象大量涌现,信用问题日益凸现,医疗行业也深陷其中。医患诚信问题严重地挫伤了医患感情,医患间不信任情绪不断加深。关注和研究我国医患关系中的诚信伦理问题已刻不容缓。     

Generalized Convulsive Status Epilepticus in the Adult

Summary: Status epilepticus (SE) is denned as recurrent epileptic seizures without full recovery of consciousness before the next seizure begins, or more-or-less continuous clinical and/or electrical seizure activity lasting for more than 30 min whether or not consciousness is impaired. Three presentations of SE are now recognized: recurrent generalized tonic and/or clonic seizures without full recovery of consciousness between attacks, nonconvulsive status where the patient appears to be in a prolonged "epileptic twilight state," and continuous/repetitive focal seizure activity without alteration of consciousness. Generalized convulsive status epilepticus (GCSE) encompasses a broad spectrum of clinical presentations from repeated overt generalized tonic-clonic seizures to subtle convulsive movements in a profoundly comatose patient. Thus, GCSE is a dynamic state that is characterized by paroxysmal or continuous tonic and/or clonic motor activity, which may be symmetrical or asymmetrical and overt or subtle but which is associated with a marked impairment of consciousness and with bilateral (although frequently asymmetrical) ictal discharges on the EEG. Just as there is a progression from overt to increasingly subtle clinical manifestations of GCSE, there is also a predictable sequence of progressive EEG changes during untreated GCSE. A sequence of five patterns of ictal discharges has been observed: discrete electrographic seizures, waxing and waning, continuous, continuous with flat periods, and periodic epileptiform discharges on a relatively flat background. A patient actively having seizures or comatose who exhibits any of these patterns on EEG should be considered to be in GCSE and should be treated aggressively to stop all clinical and electrical seizure activity to prevent further neurological morbidity and mortality.     

Therapeutic options for severe, refractory status asthmaticus: inhalational anaesthetic agents, extracorporeal membrane oxygenation and helium/oxygen ventilation

Despite improvements in supportive care, the mortality and morbidity of asthma remain constant. The risks and incidence of morbidity related to barotrauma remain high in patients that require mechanical ventilation. The authors present three alternative strategies including the inhalation of anaesthetic agents, helium/oxygen ventilation, and extracorporeal membrane oxygenation which may be beneficial when 'conventional therapies' fail in the intubated patient with status asthmaticus.     

Treatment of Status Epilepticus in Adults: Guidelines of the Italian League Against Epilepsy

Summary:  Status epilepticus (SE) is a medical emergency which can lead to significant morbidity and mortality and requires prompt diagnosis and treatment. SE is differentiated into generalized or partial SE on the basis of its electro-clinical manifestations. The guidelines for the management of SE produced by the Italian League against Epilepsy also distinguish three different stages of SE (initial, established and refractory), based on time elapsed since the onset of the condition and responsiveness to previously administered drugs. Treatment should be started as soon as possible, particularly in generalized convulsive SE, and should include general support measures, drugs to suppress epileptic activity and, whenever possible, treatments aimed at relieving the underlying (causative) condition. Benzodiazepines are the first line antiepileptic agents, and i.v. lorazepam is generally preferred because it is associated with a lower risk of early relapses. If benzodiazepines fail to control seizures, i.v. phenytoin is usually indicated, though i.v. phenobarbital or i.v. valproate may also be considered. Refractory SE requires admission to an intensive care unit (ICU) to allow adequate monitoring and support of respiratory, metabolic and hemodynamic functions and cerebral electrical activity. In refractory SE, general anesthesia may be required. Propofol and thiopental represent first line agents in this setting, after careful assessment of potential risks and benefits.     

大鼠癫痫持续状态后水通道蛋白-4的表达

目的 探讨癫痫持续状态（SE）后大鼠水通道蛋白-4（AQP4）的表达变化与脑水肿形成之间的关系。方法 54只SD大鼠随机分为对照组（n=6），SE后6h，12h，24h，48h，72h，96h，120h，168h组（n=6）。腹腔注射锂-匹罗卡品建立大鼠SE模型，免疫组织化学染色和逆转录PCR方法检测AQP4蛋白和基因在SE形成后的表达。结果 SE后AQV4蛋白和mRNA24h表达水平明显增加，48h达到高峰，持续72h后下降，168h时仍有表达。SE后AQP4表达变化和脑水肿形成过程在时间上呈明显的正相关（r=0．73，氏0．05）。结论 SE后AOP4表达明显增强，在时间上与脑水肿形成呈正相关，提示AQP4在SE后脑水肿形成过程中起着重要作用。     

Changes in microtubule-associated protein-2 (MAP2) expression during development and after status epilepticus in the immature rat hippocampus

In this study, we analyzed the spatiotemporal expression patterns of the high-molecular weight (MAP2a and b) and low-molecular weight (MAP2c and d) cytoskeletal microtubule-associated protein-2 (MAP2) isoforms with Western blotting, and the cellular localization of the high-molecular weight MAP2 isoforms with immunocytochemistry in the hippocampi of 1- to 21-day-old rats. Moreover, the temporal profile (from 30 min to 1 week) of MAP2 isoform reactivity to kainic acid-induced status epilepticus was studied in P9 rats. During development, the expression of the high-molecular weight MAP2 isoforms significantly increased, while the low-molecular weight isoforms decreased, the most prominent changes occurring during the second postnatal week. This developmental increase in the high-molecular weight MAP2 expression was also confirmed with immunocytochemistry, which showed increased immunoreactivity, particularly in the molecular layers of the dentate gyrus, and in CA1 and CA3 stratum radiatum. In 9-day-old rats, status epilepticus resulted in a rapid transient increase (about 210%) in the high-molecular weight MAP2 expression, without any effect on the low-molecular weight MAP2. Moreover, disturbed dendritic structure in the CA1 and CA3 stratum radiatum was manifested as formation of varicosities 3h after the kainic acid treatment. The strictly developmentally regulated MAP2 isoform expression suggests different functional roles for these proteins during the postnatal development in the rat hippocampus. Moreover, high-molecular weight MAP2s may play a role in nerve cell survival during cell stress.     

人工全髋表面置换技术的历史与现状

作为全髋置换术(THR)的一种替代技术,全髋表面置换术(THSR)通过保留股骨头、颈骨块而恢复髋关节正常的生物力学特性及关节的稳定性,并由于未破坏股骨髓腔结构而具有易翻修的潜力。在其发展长达半个多世纪的三个技术时期中,通过不断积累经验,使得假体系统在材料、设计及固定方法等技术参数方面获得长足改进。但仍存在尚待解决的问题。新一代金-金全髋表面假体系统的问世是髋关节置换术的一个重要历程碑,在不到10年的临床随访中其早期疗效非常满意,但中、长期疗效尚不确定,需待与其它方法作进一步长期的、随机化对照性研究。     

消化内镜病毒污染的现状及对策

从乙型肝炎病毒、丙型肝炎病毒和人类免疫缺陷病毒污染情况综述了消化内镜病毒污染的现状，分析了污染的原因以及消化内镜消毒现状。