Objective To emphasize the great role of mechanical ventilation in the emergency management of flail chest and primary brain stem injury.Method There were 12 cases in our group.Lateral flail chest and the primary brain stem injury existed simultaneously.While being hospitalized,9 patients′ GCS was 3,the rest were of 5.Mechanical ventilation support was taken at once as soon as the patients were admitted,dopamine was transfused (3～6 μg·kg -1 ·min -1 ) until mechanical ventilation was ceased.Naloxone was injected intravenously(4 mg q8h),mild hypothermic management was performed in 8 patients(33 0±1 8)℃.Fine nutritional support was given,while growth hormone was injected in 3 patients.Serum neurone specific enolase(NSE) was determined from the lst day to 5th day after the trauma.As soon as the patient′s situation trended better,hyperbaric oxygen therapy was taken at once.Results Three patients died,and 9 patients survived in this group.Mechanical ventilation lasted for (8.8±0.9)days,hyperbaric oxygen therapy began in (14 0±5.2)days after the trauma and lasted for (29 0±1.8)days,mild hypothermic treatment lasted for (6.8±1.1)days.Naloxone was transfused for (16.1±3.2)days.The survived patients showed a (19±10)μg/L level of serum PPH,PPH went down gradually from the 5th days after the injury.The average NSE level of the three dead cases was (37±14)μg/L(P0.05),no downtrend was showed.Conclusion Mechanical ventilation relieves hypoxaemia due to flail chest,and it helps nervous function recover from primary brain stem injury rapidly.Mechanical ventilation is equal to hyperbaric oxygen therapy performed immediately when the brain stem was injured.
Objective:To study the expression of PTEN, nm23 H1 and epithelial cadherin proteins in the tissues of breast cancer and to investigate their value in clinical application. Methods: The expressions of the above proteins in infiltrating breast cancer tissues were measured by S P immunohistochemical technique including ductal carcinoma ( n =54) and lobular carcinoma ( n =26). Results: The expression of PTEN was high in normal breast tissues. In the distant metastasis group, the high expression rate of PTEN was lower than that of the no metastasis group ( P 0.05). There was statistical difference between the two groups. The expression level of PTEN was not associated with the age, maximum diameter of a tumor, lymph node metastasis, histological grade and types. However, the lower expression rate of PTEN in the lower age group and the lymph node metastasis group had a increasing tendency. The lower expression of nm23 H1 protein may be associated with prognosis of breast cancer. It is easy to recur and metastasize in distance. Patients who have lower expression of nm23 H1 are likely to metastasize or recur ( P 0.05). The expression of E cadherin has no correlation with the lymph node metastasis and recurrence, but it has correlation with the types of histological types ( P 0.05). The expression level of lobular carcinoam is low. Conclusion: The measurement of PTEN and nm23 H1 proteins expression at the same time may have a guiding significance in evaluating the prognosis of breast cancer. E cadherin is not ideal in evaluating the index of the prognosis. It can be used as an accessory index in identifying lobular carcinoma and ductal carcinoma.
Objective: To establish high performance liquid chromatography (HPLC) for the content determination of desoloratadine tablets as the basis of drug quality control. Methods: Reversed-phase HPLC Dikma ODS C18 chromatographic column was used. The mobile phase was acetonitrile-phosphate buffer solution ([50 mmol/L NaH2PO4 solution, H3PO4 was adjusted to pH3.0] [33:67]), the flow rate was 1.0 ml/min and the detection wavelength was 275 nm. Results; There was no interference on the tablets analysis and determination. Desoloratadine had a good linear relationship within 5.0140.06 μg/ml. The average recovery rate was 99.67%. The CV of reproducible experiment was 0.82% (n =6) and the precision of daytime was 0.84% (n =9). Conclusion; This method is simple and accurate, and has good reproducibility; it can be used as the content determination of the desoloratadine tablets.
Objective: To determine the blood concentration of cyclosporin A (CsA) by establishing reversed high performance liquid chromatography (HPLC). Methods: Chromatography column: kromasil C18 (5μ, 4.6 mm×250 mm). Mobile phase: mixture of acetonitrile and water (80∶20). Flow rate: 1.4 ml/min. Column temperature: 70℃. Wavelength: 215 nm. Results: The lowest detected concentration of the whole blood was 10 ng/ml. CsA blood concentration had good linear relationship with the peak area from 46 ng/ml to 1472 ng/ml. The average recovery rate was 95.16±3.87%. The coefficient of variation (CV) within a day was ≤6.8% and between days was≤9.6% ( n =5). Conclusion: This method is easy, fast and accurate. It can be used in the pharmacokinetics study of CsA.
Objective:To discuss the principles of medical aid for severe multiple injuries in emergency department. Methods:The clinical materials of 570 severe multiple injury patients in emergency department were analyzed retrospectively. Among the patients, first aid treatment was performed in 374, the joint operation in 474 and the first phase operation in 10. Results:The successful rate of emergency treatment on the spot was 80%. The successful rate of the operation was 72%. Conclusion:The principles of emergency treatment for severe multiple injuries is to treat the fatal injury positively in emergency department. When a joint operation is performed, the sequence of the operation should be arranged rationally. The first phase operation on a dying patient should be performed in emergency department. The above steps can decrease the risk and increase the successful rate during the emergency treatment.
Objective: To study the effect of L arginine (L Arg) in the prevention and treatment of asthmatic guinea pigs. Methods: Ovalbumin (OVA) was injected into guinea pigs abdominally and aerosol inhalation was used to make asthmatic animal model. The asthmatic reaction of the animals was observed. After the sensitization evoked for three times, the animals were anesthetized by urethane. The arterial blood was taken for blood gas analysis, bronchoalveolar lavage fluid (BALF) was used to count eosinophils (EOS), and NO 2/NO 3 - was measured. Part of the lung tissues was taken from the paraffin imbedding sections, and the numbers of EOS were counted by microscope under every 20 high power field. Results: The numbers of EOS counted under every 20 high power field and NO 2/NO 3 - measured by BALF showed that there were no significant differences between the L Arg group and the positive control group ( P 0.05), but all other parameters showed significant difference ( P 0.05 ). Conclusion: L Arg has good effect in the prevention and treatment of asthma.
Objective: To investigate the psychosomatic health and influential factors in cadets in a military medical college. Methods: The subjects investigated were the cadets of professional training in a military medical college. The symptom checklist 90 (SCL 90), BECK self rating depressive scale (SDS) questionnaire, life events scale of the cadets and coping strategies scale were used to evaluated them. Results: Of the 524 cadets, 46 of them (8.8%) had psychosomatic disorders. There was difference between the different grades. The scores of SCL 90 of the cadets were slightly higher than that of the normal youth models, and slightly lower than the cadets in military colleges. The scores of compulsion and paranoia were significantly higher than the normal youth models. The scores of cadets in somatic symptom, depression and psychosis were significantly lower than those in military colleges. The life events, depression and negative coping style were the main factors affecting the cadets. Conclusion: Generally speaking, the status of psychosomatic health in the investigated medical college is good, but there are still a lot of cadets with various problems of psychosomatic health. They are mainly the second and third year cadets. This is closely associated with their life events, depression and negative coping style.
为探讨各种类型的痔、陈旧性肛裂、肛乳头状纤维瘤、肛瘘及直肠息肉的治疗方法,用特制的高频电容场治疗钳、电刀、电凝钳对以上疾病进行治疗.552例全部治愈,治愈率100%.并发症:直肠息肉术后继发出血1例,Ⅳ期内痔术后继发出血2例.该疗法简单,病人痛苦小、疗效好、并发症少,值得临床推广.
Objective: To investigate the difference of speech resolving power between in the ear (ITE) hearing aids and behind the ear (BTE) hearing aids in users through speech recognition. Methods: A CD player was used to play the language testing materials. The methods of listening, speaking, repeating (open method), listening and distinguishing pictures (close method) were used. The users of type 32 ITE and type 30 BTE hearing aids had the similar power and functions. The language test with one ear listening was performed. Words were chosen as the type of speech, and each ear was tested with 20 monosyllabic and disyllabic words, respectively. Results: Comparing the efficacy of the users' ITE and BTE hearing aids, there were no significant differences in speech resolving power, no matter whether it was an open one or a close one, monosyllabic words or disyllabic words ( P 0.05). When the hearing aids users applied both monosyllabic and disyllabic words in comparison to the resolving power under the conditions of open status, there were significant differences between monosyllabic words and disyllabic words ( P 0.05), while under the conditions of close status, there were no significant differences between them ( P 0.05). Conclusion: Speech audiometry has an effect that cannot be replaced in choosing hearing aids, but it is always affected by many factors in the real practice.
Objective: To study the relationship between the changes of Wushensu (WSS) tablets induced cAMP and cGMP content in spleen lymphocytes in mice and cytotoxicity. Methods: Fifty mice were divided into five groups (each group had 10 mice). The experimental groups were divided into high, medium and low doses of WSS tablets; the control groups were cyclophosphamide positive control group and saline negative control group. Results: WSS tablets (a compound tablet which consists of Acanthopanax senticosus Harms, Mylabris and cordyceps sinensis Sacc) had the significant effect of increasing cAMP/cGMP content in spleen lymphocytes in mice and cAMP/cGMP ratio. As compared with the control groups, there was significant difference ( P 0.01); and as compared with the control group, the cyclophosphamide group had significant reducing effect ( P 0.01). The determined results of NK cytotoxicity also showed that the WSS tablets had significant effect in increasing the NK cytotoxicity. As compared with the control group or the cyclophosphamide group, there were also significant differences ( P 0.01).Conclusion: As a new molecular inhibitor for regulating and controlling cancer cells, WSS tablets can significantly increase the cAMP/cGMP content in spleen lymphocytes in mice and cAMP/cGMP ratio. This result may be closely associated with the increasing of NK cytotoxicity, and its process may be associated with membrane receptor, the effect of protein kinases cascade amplification and protein phosphatase system.
临床实习是护生理论与实践相结合的重要途径,加强对临床教育过程中各个环节的管理,以提高护生综合能力,提高带教质量.主要从护生入科阶段教育管理、注重临床护理重点环节的带教及重视出科评估三方面进行了探讨.
血清总蛋白(TP)和白蛋白(ALB)含量测定对临床疾病诊断、病情随访及预后判断有重要意义.由于各个地区人群的生活习惯、饮食结构、居住环境等方面存在差异,其参考值水平会存在差异.文章调查了1284例健康人群,以求建立适应本地区的TP、ALB参考值范围.
枕大神经痛是一种常见的非遗传神经内科疾病,临床表现以单侧持续性或阵发性加剧的针刺痛为主,自枕部向头顶部放射.该病病因较复杂,诊断主要依靠病史及症状,神经学检查无阳性结果,影像学检查对鉴别诊断有价值.目前主要治疗方法有:药物治疗、穴位治疗、手法治疗、神经阻滞术及神经松解减压术等.
了解临床分离的84株葡萄球菌葡萄球菌对10种常用抗生素的敏感性.采用纸片扩散法进行药敏试验,结果金黄色葡萄球菌52株,其中MRSA 40株(占77%),凝固酶阴性的葡萄球菌32株,其中MRSCoN 21株(占66%).甲氧西林耐药的葡萄球菌对大多数抗生素敏感率低于50%,未发现万古霉素耐药株.临床对葡萄球菌进行耐药监测有助抗生素的选用,万古霉素可作为葡萄球菌感染治疗的首选药物.
卵巢成熟性畸胎瘤分为成熟性囊性畸胎瘤及成熟性实性畸胎瘤.后者极为罕见,成熟性囊性畸胎瘤又称为皮样囊肿,是卵巢常见的肿瘤之一,仅次于卵巢囊腺瘤.为探讨其临床及病理特点,我们对1992年1月～2002年1月10年间所收治的卵巢成熟性畸胎瘤218例的存档资料进行回顾性随访分析.
为评价影像学检查基本程序设计在学员临床实习中的作用.对87名实习学员进行问卷调查及实际考评,了解学员对影像学检查基本程序的掌握情况,结果掌握优良16%,一般48%,差36%.在这种情况下,设计了影像学检查基本程序并进行专题讲座.掌握优良72%,一般28%.作者认为,影像学检查基本程序设计作用明显,可提高实习学员合理使用影像学检查手段和实际工作能力.
为探讨思密达治疗小儿口疮的临床疗效,对60例患儿进行了分组治疗,分别为思密达组(外用思密达)和对照组(外用锡类散),治疗3 d和7 d后,思密达组痊愈率40%,总有效率90%,平均治愈天数(2.733±1.258)d;对照组痊愈率20%,总有效率70%,平均治愈天数(3.600±1.673)d.经统计学处理,两组有显著差异,P＜0.05,思密达组显著优于对照组.充分说明思密达可在临床推广使用.
水母蜇伤引起水母皮炎严重危害着人们身体健康.通过48例水母皮炎临床分析,阐述了水母皮炎的特点及有效治疗方法,讨论水母活动的特点及水母毒素在人体内溶血、心脏毒性、神经毒性等作用,对怎样预防水母蜇伤有较为积极的作用.
总结自发性食管破裂17例手术前后的护理经验.及时有效地实施手术治疗,严格做好手术前后护理,确保引流效能,控制感染,可提高手术治愈率.经严格的手术前后护理及抢救治疗,治疗效果满意,痊愈出院15例.因术后发生吻合口瘘及术后并发多脏器功能衰竭死亡2例,病死率11.8%.护士应充分了解病因,切实加强手术前后护理,细致入微地做好心理护理,控制感染,减少并发症,是保证手术效果、提高治愈率的关键.
观察小剂量恬尔心针剂对老年人心肌缺血的疗效.选用恬尔心针剂50 mg加入葡萄糖液静脉滴注,治疗老年人冠心病心肌缺血.提示缓解及减轻心悸、胸闷、心绞痛的效果显著(有效率97%),心电图缺血图形亦见较明显改善(有效率70%).小剂量恬尔心针剂静脉滴注治疗老年人心肌缺血疗效明显且安全,有临床使用价值.
