Objective To analyze the therapeutical effects and prescription patterns in medical record treated by professor ZHOU Zhong-ying.Methods Statistical analysis on drug choices and dosages was performed by investigating the documented cases treated by professor ZHOU.Results 97 cases in this study were involved in over forty disease categories,most of which were serious and complicated.In 96.9% cases,each patient was treated by one prescription with slight modification.The average amount of the herbal medicine varieties used in the first prescription was(15.0±3.3),the average weight of each herbal medicine was(10.8±2.0)g,and the average amount of the herbal medicine varieties used during the entire medication period was(20.8±5.4).36 cases(37.1%) were cured or significantly improved and 61 cases(69.2%) were considered clinically effective.Conclusion The diseases treated by professor ZHOU are various,serious and complicated,whereas his therapies are very effective and precise with low rate of prescription changes.
Objective To explore the roles of cell adhesion in multidrug resistance(MDR) of colon cancer cell line SW480.Methods The cell adhesion assay,MTT assay,Adriamycin(ADR) accumulation and retention and Annexin V/PI staining were used to illuminate the drug resistance of colon cancer cell line SW480 after adhesion to laminin(LN).Results After adhesion to LN,SW480 cells exhibited a significantly higher IC50,medicine pumping rate and a reduction of drug sensitivity,apoptosis index induced by chemotherapeutics and accumulation and retention of ADR(P0.05).Conclusion Adhesion to LN may promote MDR phenotype of colon cancer cells by two means: The adhesion of SW480 to LN may promote the drug transport ability and decreases the accumulation of chemotherapeutic drugs in tumor cells;The adhesion may elevate the capability of anti-apoptosis and inhibit the apoptosis induced by chemotherapeutic drugs.
Objective To explore clinical characteristics of severe burns combined with blast injury of the lungs to sum up the experience and lessons of management and diagnosis.Methods The clinical manifestations,management methods and effectiveness of 31 patients with severe burs combined blast injury of the lungs were summarized and analyzed.Results All 31 patients were cured.The laboratory results of these patients on admissin showed that the heart and pulmonary function were abnormal,especially pulmonary dysfunction.The functions of liver and kidney were normal.Ddimer level of blood plasma was strikingly abnormal,while platelet count were within normal limits.19 cases with acute lung injury and hypoxemia were received immediate tracheotomy and protective ventilation to correct hypoxemia.There were 16 cases complicated with pulmonary infection,5 cases with sepsis,4 cases with acute respiratory distress syndrome,and 4 cases with heart failure.Conclusion Severe burns combined with blast injury of the lungs are often accompanied with multiple organ damage.The clinical process is so complicated that it is necessary to achieve early diagnosis and early treatment.Early broncheotomy,mechanical ventilation and the protection of organ function is an important prognostic measures,and combined therapy is the key to successful treatment.
Objective To analyze the causes of cardiac arrest during liver transplantation,and investigate the preventive measures.Methods Clinical records of 4 patients with cardiac arrest in liver transplantation were studied retrospectively.Results Occurrence of cardiac arrest was 2.9%(4/136).All of events happened at 1-3 min after graft reperfusion.All of them had postreperfusion syndrome,hyperkalemia,hypocalcemia and metabolic acidosis.Three cases recovered successfully,one case died.Conclusion The causes of cardiac arrest during liver transplantation were possibly induced by postreperfusion syndrome,hyperkalemia,hypocalcemia and metabolic acidosis.
Objective To observe the stability of breviscapine in six solutions.Methods Breviscapine were dissolved in 0.9% sodium chloride,5% glucose,10% glucose injection,glucose and sodium chloride,10% invert sugar and fructose soluton respectively.The physical changes of the solutions were observed and measured.Results Breviscapine is stable and compatible in 0.9% sodium chloride,5% glucose,and 10% glucose solution.However,it produced cream yellow precipitates and the components such as scutellarin,decreased in clarity when blended with glucose and sodium chloride injection,10% invert sugar and fructose solution.Conclusion Breviscapine is stable in 0.9% sodium chloride,5% glucose and 10% glucose solution.pH value of solution should be taken into account when using breviscapine.
Objective To investigate the feasibility and safety of isobaric bupivacaine and ropivacaine in continuous spinal anesthesia for abdominal surgery.Methods 60 paitents(ASAⅠ～Ⅱ) for abdominal surgery were randomly divided into 3 groups,20 patients were included in each group.GroupⅠ: 0.5% bupivacaine solutions,GroupⅡ: 0.5% ropivacaine solutions,Group Ⅲ: 0.75% ropivacaine solutions.First intrathecal injection bupivacaine or ropivacaine 3ml and adding 0.5～1 ml to achieve T4 plane of analgesia.The following variables were measured: the highest analgesic level,time to reach complete plane of analgesia,analgesia effects,and extent of muscle blockade.Mean arterial pressure,heart rate,oxygen saturation were recorded.Resluts There was no statistical difference among the basic conditions(P0.05).Compare group Ⅱand Ⅲ with groupⅠ,all the observed indexes including the onset time and duration of motor blockade showed significant difference,except the anesthetic level was similar.The anesthesia effects of groupⅠ and groupⅢ were significantly better than groupⅡ,but the mean arterial pressure(MAP) in groupⅠdecreased obviously after the intrathecal injection than the other groups(P0.05).Conclusion The 0.75% isobaric ropivacaine used during continuous spinal anesthesia in the abdominal surgery produces a suitable and a more controllable anesthesia,but there need advanced study and more clinical data in the true sea rescue and surgery.
Objective To investigate the morbidity and risk factors of backleg pain in fighter pilots and find the clue to prevent the backleg pain.Methods The morbidity and risk factors of backleg pain in 536 fighter pilots were analyzed.Results The morbidity rate of backleg pain in fighter pilots was 31.5%.The main etiopathogenisis was lumbar muscle strain and lubar intervertebral disc protrusion.The risk factors included age,flight time and smoking.Conclusion The backleg pain influences the health of fighter pilots.We should strengthen the propaganda,education,ask pilots to train psoas,and make more research about protective measures.
Purpose: Solid pseudopapillary tumor (SPT) of the pancreas is a rare benign or low-grade pancreatic neoplasm with distinct clinicopathologic features. The purpose of this study was to evaluate the clinical presentation of SPT and to examine the etiology of this tumor by performing immunohistochemical staining. Methods: From October 1994 to March 2005, 35 cases of SPT who underwent operations were retrospectively reviewed. The clinicopathologic findings and late results of treatment were studied in 7 cases of borderline malignant SPT and in 28 cases of the benign SPT. Immunohistochemical staining was performed for alpha1-antitrypsin, alpha1-antichymotrypsin, neuron specific enolase, chromogranin, synaptophysin, vimentin and cytokeratin. Results: The mean age of the patients was 31.8 years. SPT's were more common in women (77.1%) and the tumors were usually located in the body and the tail of the pancreas (68.6%). There were statistically significant differences in the men (P=0.016), for the masses with calcification (P=0.029), and for the solid masses (P=0.018) between the malignant SPT (including the borderline malignant SPT) and the benign SPT (P=0.014). The SPTs stained positive for alpha1- antitrypsin, neuron specific enolase, and vimentin in all cases, and they were alpha1-antichymotrypsin positive in 94.1% (16/17), chromogranin positive in 18.8% (3/16), synaptophysin positive in 12.5% (2/16), and cytokeratin positive in 18.2% (2/11). All 35 patients underwent curative resection and they are all alive without any evidence of recurrence at a mean follow-up of 44.2 months. Conclusion: SPT is a rare tumor that behaves less aggressively than other pancreatic tumors, and surgical resection can result in cure. This tumor thought to originate from a stem cell capable of differentiating into endocrine cells or exocrine cells. (J Korean Surg Soc 2006;70:385-389)
本文从医院野战医疗队参加上级赋予的重大保障任务实践中,得出批量伤员检伤分类,快速通过的启示有:一是加强卫勤理论知识学习;二是制定卫勤保障预案;三是建立高效指挥体系;四是合理部署卫勤力量;五是抓好日常卫勤演练;六是加快卫勤信息化研究.
目的 分析本地区新入伍战士血清生化指标, 为新兵体检结果的判读提供参考依据.方法 对本地区2008年底新入伍战士1 720人血样进行生化项目检测,通过统计分析,得出其参考值区间.结果 部分如葡萄糖、总蛋白、γ-谷氨酰转移酶、载脂蛋白等项目与现有参考值区间接近;部分项目在现有参考值区间范围内,如尿素、肌酐、总胆固醇等;部分项目偏高,如尿酸、丙氨酸氨基转移酶、天冬氨酸氨基转移酶、总胆红素、肌酸激酶、乳酸脱氢酶、甘油三酯等.结论 新入伍战士血清生化指标与现行实验室参考值区间存在一定的差异,应不断积累数据,建立符合本地区新入伍战士血清生化指标参考值区间.
目的 探讨欣母沛加宫腔填塞纱条在防治剖宫产术中产后出血的疗效.方法 对76例用欣母沛加宫腔填塞纱条防治剖宫产术中有出血高危因素及产后出血患者资料进行回顾性分析.结果 用欣母沛加宫腔填塞纱条成功止血75例,24 h后纱条经阴道顺利取出,无一例发生感染及晚期产后出血.仅有1例术中予以纱条填塞、欣母沛及结扎子宫动脉后无效行次全子宫切除术.结论 欣母沛加宫腔填塞纱条是防治剖宫产术中产后出血的一种简单、快速的有效方法,具有保留子宫的特点.
目的 探讨腰骶角与下腰痛的相互关系,为部队司乘人员的合格选才提供客观的量化依据.方法 选择某部卫生队反复以腰痛和(或)下肢放射痛为主诉的驾驶员52例,对照组50例.对每个研究对象采用改良Ferguson法测量腰骶角度,并和下腰痛进行相关性分析.结果 与对照组比较,下腰痛组的腰骶角度显著大于对照组(P<0.01).结论 腰骶角的大小与下腰痛的发生率呈正相关,我们在对司乘人员选才的时候,可以把腰骶角作为一项客观依据,以减少部队司乘人员下腰痛的发病率,有效提高部队作战能力.
目的 探讨WHOQOL-BREF量表应用于基层部队军人生命质量评价中的信效度问题.方法 采用多阶段分层整群随机抽样方法,抽取某军区全部5个分部保障体系范围内的5支基层部队的2500名现役军人为本次调查的研究样本.用内部一致性信度Cronbach'a系数分析量表的信度,用因子分析方法分析量表的效度.结果 WHOQOL-BREF量表总体应答率为96.2%,经过剔除后的总体有效率为95.84%;内部一致性信度Cronbach'a系数为0.889,各领域的Cronbach'a系数范围为0.501～0.869;在因子分析中,采用因子分析法经最大方差旋转后,保留了特征根≥1的因子后,产生4个主成分,累计贡献率为56.13%.结论 WHOQOL-BREF量表在基层部队军人人群中应用可接受性良好,具有较好的信度、效度,可用于基层部队军人的生命质量评价,具有一定的应用和推广空间.
中暑仍是部队军事训练的严重伤病之一,本文从环境、不同个体的热耐受差异、体温的动态观察及干预研究进行综述,提出目前部队中暑预防研究应重在探讨适宜的预案并注重实践中的严密观察和适时修订.
本文针对国庆阅兵集训期间卫勤保障工作特点,提出了阅兵卫勤保障工作的一些做法,以探讨做好阅兵训练医疗保障的经验.
目的 了解南通市区0～6岁儿童血铅水平及铅中毒流行情况,为防治儿童铅中毒提供科学依据.方法 应用原子吸收光谱法对南通市区2 569名0～6岁儿童进行血铅水平测定并统计分析.结果 不同性别间儿童血铅水平均值和铅中毒率差异均无显著性 ( P>0.05),不同年龄组儿童血铅水平均值及铅中毒检出率差异有显著性 ( P＜0.05).结论 南通市区 0～6 岁儿童血铅水平较高,应引起儿童家长及全社会的高度重视.
目的 探讨军队中小医院与地方乡镇卫生院军民共建共赢融合式生存与发展的新路子.方法 与4市12县71个乡镇卫生院签订军民共建协议,对32所乡镇卫生院组建战时卫勤保障急救分队进行重点帮带与训练.结果 重点帮带的32所乡镇卫生院战时卫勤保障急救分队,7年间外出执行紧急卫生救援任务8 064起,成功抢救伤病员9 677名,直接创造经济效益6 690万元.军队医院在院病人由5年前最高的223增加到今年的618人,医疗收入由300万元增加到9 900万元.结论 重点帮带训练的32所乡镇卫生院医疗技术与战救技术水平得到显著提高,军队医院有固定病人来源,医院建设达到历史高峰,军民融合式发展路子达到了军民共建和谐共赢持续发展的目的.
目的 了解某部新兵在入伍基础军事训练期间发生的下腰痛的特点,为部队制定相应的预防措施提供科学依据.方法 调查了该部队2006年度535名新兵的入伍基础军事训练情况,设计下腰痛调查表,通过问卷调查了解下腰痛发病情况,并进行分类调查统计.结果 参训新兵446人在基础军事训练期间发生下腰痛135人,患病率为30.27%.在新兵基础训练期间,在第1个月末和第2个月末各有一个发病高峰.结论 训练负荷过大所导致的软组织过劳性损伤最为重要.因此,在平常的军事训练中,应该加强健康宣教工作,在新兵训练过程中要注意科学施训,循序渐进,减少下腰痛的发生.
中国心身健康量表自研制以来,已在国内80余家单位使用,被10余本专著收录,被公开发表的论著引用达40余次.主要被应用于部队普通官兵、新兵、驾驶员、演习官兵、维和官兵和大学生、在职脑力劳动者、老年功能性消化不良患者等的心身健康状况研究,普通居民的流行病学调查;还被应用于不同职业、年龄、军龄、文化等心身健康相关因素研究,与SCL-90作为筛查工具的应用和适用性比较,以及临床疗效和心理干预效果的评价等.因此,本工具为我国心身医学研究及心身障碍的评估提供了重要手段,促进了我国心身医学的发展,具有很大的经济和社会效益,值得推广使用.
老干部进入"两高期"后,大病重病日渐增多,急病恶性病经常发生,心理问题也较突出,医疗保健已成为他们晚年生活的首要需求[1].特别是远离体系医院的边远地区干休所,老干部患病后送路程远、时间长、途中存在风险,因病情需要转往体系医院时,往往是老干部自己不愿转,家属子女反对转,医护人员不敢转,但按现行的保障体系又不得不转.为解决边远地区干体所老干部医疗问题[2],2007年以来,我们在江苏省泰州军分区、安徽省宿州军分区进行医疗保障模式研究,摸索出一条老干部医疗社会化保障新路子,明显缓解了老干部就医难的矛盾,受到老干部的广泛好评.
