目的 为压疮患者选择一种简便、经济、高效的治疗方法,促使压疮部位尽快愈合.方法 选择II期压疮患者60例,分成2组.对照组30例患者进行局部常规换药治疗;实验组30例进行80μg/mL的三氧蒸馏水局部湿敷密封30分钟.以7天为一个疗程,观察两组的效果如此循环.结果 实验组创面愈合情况明显优于对照组,差异有统计学意义.结论 三氧蒸馏水局部湿敷密封法治疗压疮的效果明显优于常规换药治疗.缩短了压疮的愈合时间、缩短了住院时间、降低了治疗费用,希望能在临床广泛推广应用.

目的:加强儿科临床试验项目实施过程中试验用药品管理的规范性,提升儿科临床试验质量.方法:应用根本原因分析法对我院2010-2013年儿科临床试验实施过程中发现的药品管理相关问题进行分析,并依据试验用药品管理的复杂多样性及儿童生理特性、用药特点,应用PDCA质量改善循环法于2014-2017年期间完善药品管理流程,规范操作细节,加强人员培训,对比管理改善前后临床试验问题数量、种类等数据,研究改进效果.结果:管理改善后,我院儿科临床试验用药品管理质量大幅提高,临床试验问题数量由39个降为5个,问题种类由6种降为3种.同时,GCP中心药房管理工作获得了研究者和申办者的一致好评.结论:运用PDCA循环法改善药品管理有助于提升儿科临床试验质量.

目的:探索临床试验用药品中心化管理质量与效率共赢的工作模式.方法:药物临床试验机构设计并构建具有我院特色的临床试验中心药房信息化系统(investigational drug service,IDS).结果:我院临床试验中心药房实现了试验用药品管理、临床试验项目管理、中心药房管理的一体化管理模式,服务能力与服务质量显著提升,工作效率显著提高、人力成本显著降低,获得研究者、申办方、监管部门等的高度认可.结论:具有我院特色的信息化系统指导临床试验中心药房药师高质量、高效率地完成了试验用药品管理工作,为临床试验的顺利实施提供了有力保障.

目的 研究在医院护理管理中加强应用风险管理的影响.方法 选取我院于2014.02～2015.02月间实施常规护理管理模式,在2015年3月～2016年3月间在常规护理管理模式基础上重点注意风险管理的应用,同时选取同时段70例患者,分成风险组与对照组,各为35例,观察其满意评分.结果 对照组满意评分低于后组,P＜0.05.结论 科室重点注意加强风险管理模式,建立以护士长为首的风险管理小组,共同分析科室现存风险因素,并制定相关护理流程预防,患者对于此项管理模式感到满意.

目的 探讨损伤控制理论在颈椎骨折脱位合并脊髓损伤急救中的应用效果.方法 回顾性分析2013年1月～2017年1月我院骨科救治的183例颈椎骨折脱位合并脊髓损伤患者临床资料及护理措施.结果 全部病例均通过有效、正确的急救处理措施,控制了并发症及继发损伤的发生.结论 损伤控制理论应该贯穿于颈椎骨折脱位合并脊髓损伤急救中每一个环节.方可减少并发症,提高患者生存质量.

目的 探讨手术室护士在工作中避免医疗纠纷的方法,提高自我保护意识.方法 回顾性分析近五年我院手术室护理工作中遇到的医疗纠纷,总结提高手术室护士自我保护意识.结果 手术室护理工作中出现的医疗纠纷,绝大多数是由于手术室护士的法律意识淡薄,不熟悉国家的法律法规,工作中出现疏忽,相关制度不完善,管理上缺失等原因造成.结论 手术室护士应认真学习丰富自己的法律知识,提高自我保护意识,防止差错事故,避免医疗纠纷.

Objective To investigate the early emergency treatment and nursing precautions of lower cervical fracture and dislocation with spinal cord injury, and its influence on prognosis. Methods A total of 183 cases of cervical fracture and dislocation combined with spinal cord injury were enrolled, which included 120 males and 63 females, aged 17-81 years old with mean age of 36.5. All of cases were hospitalized within 3 days after injured with mean hours of 26(2-68 hours), all of which were varying degrees of quadriplegic. Frankel grades were grade A(95 cases), grade B(28 cases), grade C(20 cases) and grade D(40 cases), respectively. Spinal cord injury levels were C2(3 cases), C3(11 cases), C4(29 cases), C5(84 cases), C6(37 cases) and C7(19 cases), respectively. The types of injuries were 21 cases of falling and 162 cases of traffic accident. Results The Japanese Orthopaedic Association(JOA) scores were (4.2 ± 1.8) points preoperative, (7.9 ± 2.2) points 1-week after surgery, and (10.0 ± 2.0) points of last follow-up, which were statistically differences (P<0.01). There were 65 cases of methylprednisolone impact treatment within 8 hours, 38 of tracheotomy, 110 of anterior surgery, 42 of posterior surgery, and 31 of combined anterior, respectively. It was occurred that three patients died; 20 patients showed hypoproteinemia; 6 patients showed lung infection; 2 patients showed deep vein thrombosis. Conclusion It is demonstrated that the early and correct treatment could effectively cure cervical spine fracture and dislocation combining with spinal cord injury, and reduce the incidence of complications.

流行病学研究显示，高密度脂蛋白胆固醇（ HDL-C）水平降低是冠心病的独立预测因子， HDL-C水平增高与心血管疾病的发生率呈负相关，甚至在 LDL-C 水平低于1.82 mmol／L的患者中，高HDL-C水平对冠心病仍然具有保护作用。因此HDL是抗动脉粥样硬化领域研究的又一靶点，升高HDL水平可能为冠心病的防治提供新的治疗手段。目前认为 HDL 通过介导胆固醇逆转运（ reverse cholesterol transportation ，RCT），将胆固醇从外周血管的动脉粥样硬化斑块转运到肝脏进行排泄，从而减少脂质在血管壁的沉积，以及改善内皮功能、抗氧化、抗炎等作用发挥抗动脉粥样硬化（ artherosclerosis ，AS）作用。

Objective To improve the result of cervical vertebra fracture dislocation and spinal cord trauma. Methods Through review and analyze the cure of 183 cervical vertebra fracture dislocation and spinal cord trauma. Results All patients are cured by right method and control the complication. Conclusion We must pay attention to every link in cure the patients who has cervical vertebra fracture dislocation and spinal cord trauma.

目的 探讨人工全膝关节置换术的术前、术后护理,术后康复训练和方法.方法 针对患者术前心理状态与病情进行心理疏导,术后采取有效的护理措施,如:抬高患肢、合理饮食,指导患者进行早期功能锻炼,以有效地预防并发症.结果与结论 系统的临床护理是人工全膝关节置换术成功的关键环节.

目的 建立和谐的医患关系,实现医学事实与医学价值、医学知识和人性目的的和谐统一.方法 从政府、公安、医院、患者各方面提出减少不和谐医患关系应努力的方向.结果与结论 医患关系需要政府、社会、医院及患者的共同参与和努力.

目的提高手术室护士的应变能力及手术配合质量。方法扎实专业理论,实际操作技能,手术抢救后进行讨论,对手术室护士进行基本素质和应急情况的处理,重症抢救等内容的培训。结果实际应变能力测评成绩显著提高。结论手术室护士只有具备扎实的专业理论知识,良好的心理素质和沟通技巧,敏锐的观察力,突出的应变能力才能确保各类手术的顺利进行。

<正>近四、五十年来,心脏瓣膜病的常见病因发生了很大改变。本世纪以来,瓣膜病的常见病因如下:遗传性结缔组织病(马凡氏综合征、埃当综合征、成人多囊性肾病、二尖瓣脱垂);先天性心脏病(主动脉瓣二瓣畸形);炎症性或免疫性疾病(风湿热、艾滋病、川崎病、梅毒、血清阴性脊柱关节病、系统性红斑狼疮、抗磷脂综合征);心内膜疾病(非

目的 探讨住院慢性心力衰竭（CHF）患者TBil水平与远期预后的关系。方法 回顾性分析140例CHF急性加重患者入院24h内血液学检查及心脏结构及功能参数，平均随访28.5个月，分析远期死亡的预测因子。结果 入院时TBil≤12.8mmol/L组、TBil＞12.8～18.2mmol/L组、TBil＞18.2mmol/L组远期病死率分别为12.2％、17.9％和38.9％（P=0.002），脉压分别为（55.5±17.3、48.9±13.1、46.1±13.7）mmHg（1mmHg=0.133kPa）（P=0.008）。相关性分析显示TBil与右室内径、左室舒张末期内径明显相关（r分别为0.34、0.23）。多因素分析显示TBil和利钠肽是死亡的独立预测因子（P值分别为0.038、0.027）。结论 CHF急性加重时，TBil水平增高预测其远期病死率增加。

OBJECTIVE:To analyze the relationship between serum total bilirubin coincident with congestive heart failure (CHF) exacerbation and subsequent long-term mortality in patients with CHF.METHODS:The study population consisted of 140 consecutive patients admitted for CHF exacerbation with left ventricular ejection fraction ≤ 45%. They were divided into 2 groups according to whether death attacked or not in the following 28.5 months. Binary logistic regression analysis was used to investigate independent predictors of death from clinical parameters on admission or within 24 hours.RESULTS:Serum TBil and B-type natriuretic peptide (BNP) levels on admission were independent predictors of subsequent death after hospital discharge. According to increasing textiles of TBil stratified by the level of 12.8 and 18.2 mmol/L, the patients were divided into 3 groups: lower-level group (TBil ≤ 12.8 mmol/L), moderate-level group(TBil > 12.8 ∼ 18.2 mmol/L) and higher-level group (TBil > 18.2 mmol/L), with the death rates after 28.5 months of 12.2%, 17.9% and 38.9%, respectively(P = 0.002). Meanwhile, the pulse pressure decreased to (55.5 ± 17.3) mm Hg (1 mm Hg = 0.133 kPa), (48.9 ± 13.1) mm Hg and (46.1 ± 13.7) mm Hg, respectively (P = 0.008). TBil on admission had significant correlation with echocardiography-measured left ventricular endo-diastolic diameter (r = 0.34, P = 0.000) and right ventricular diastolic diameter (r = 0.23, P = 0.011).CONCLUSIONS:Increased TBil coincident with cardiac decompensation predicts a worse long-term death of CHF, presumably through the potential liability to both decompensated RV function and lower cardiac output syndrome occurred simultaneously when HF deteriorates.

老年人是一组特殊的社会群体,由于老年人身体器官机能逐渐老化,同时会伴有心、脑、肺、肾,内分泌等疾病。因此术中应根据老年人的不同问题,采取相应的护理措施,是渡过手术难关的重要环节。

目的观察异丙酚复合舒芬太尼在人工流产中的疗效。方法对100例早孕妇女,在常规消毒的同时,静脉注射异丙酚复合芬太尼(丙泊酚200mg/支及舒芬太尼50ug/支)8～14ml。观察其麻醉效果。并分别记录推药前、入睡后、手术时、清醒后P、SPO2参数,以及苏醒情况。结果异丙酚复合舒芬太尼应用于人工流产术,起效快,镇痛效果显著,麻醉效果满意,苏醒早,正常脉搏、SPO2无明显变化,出血量无差异。结论异丙酚镇静作用强,有抗恶心、呕吐作用,舒芬太尼镇痛作用强,二者半衰期均短,复合应用,取长补短,是人工流产术中适宜的麻醉方法之一,在临床上值得推广应用。

OBJECTIVE To evaluate the bioequivalence of domestic cilnidipine capsules and commercially available cilnidipine tablets in healthy Chinese volunteers. METHODS Twenty healthy male Chinese volunteers were enrolled and orally administrated 10 mg cilnidipine capsules or tablets randomly and the concentrations of cilnidipine in plasma were determined by HPLC-MS/MS. RE-SULTS The pharmacokinetic parameters of two cilnidipine productions were as following: ρ_(max) (11.08±4.42 )and (2.94±3.44) μg·L~(-1), t_(max)(1.30±0.56)and(2.21±1,25)h, t_(1/2)(3.99±1.90) and (4.55±1.75) h,AUC_(0-16h)(35.28±14.63) and (13.22 ±12.44) μg·h·L~(-1) ,AUC_(0-∞)(38.05±16.49) and (15.43±13.59) μg·h·L~(-1) ,respectively. There were significant differences in ρ_(max), t_(max), AUC_(0-t) and AUC_(0-∞) between the two formulations. CONCLUSION The domestic cilnidipine capsules were not bio-equivalent to the marketed cilnidipine tablets in China.

Angiopoietin-1 (Ang1) is a ligand for the endothelial-specific tyrosine kinase receptor Tie2 and has been shown to play an essential role in embryonic vasculature development. There have been many studies about the anti-inflammatory effects of Ang1, most of which focus on endothelium cells. In the present study, we explore the role of Ang1-Tie2 signaling in the activation of macrophages upon lipopolysaccharide (LPS) stimulation. We found that Tie2 receptor is expressed on macrophages and Ang1 could inhibit LPS-induced activation of macrophages, as evidenced by cell migration and TNF-alpha production, specifically through Tie2 receptor. We further investigated the mechanism and found that Ang1-Tie2 could block LPS-induced activation of NF-kappaB which has been shown to be necessary for macrophage activation with LPS treatment. Thus, we described, for the first time, the role of Ang1-Tie2 signaling in macrophage activation and the possible mechanisms in response to immune stimulation.

Background Radiation is a promising treatment for in stent restenosis and restenosis following percutaneous transluminal coronary angioplasty, which has troubled interventional cardiologists for a long time. It inhibits neointima hyperplasia, vascular remodeling, and increases the mean luminal diameter. The mechanism of intracoronary brachytherapy for restenosis is not well understood. Endogenous gaseous transmitters including nitric oxide and carbon monoxide are closely related to restenosis. Hydrogen sulfide, a new endogenous gaseous transmitter, is able to inhibit the proliferation of vascular smooth muscle cells and vascular remodeling. This study aimed to clarify the effect of radiation on cystathionine-γ-lyase/hydrogen sulfide pathway in rat smooth muscle cells. Methods We studied the effect of radiation on the cystathionine-γ-lyase/hydrogen sulfide pathway. Rat vascular smooth muscle cells were radiated with 60 Co γ at doses of 14 Gy and 25 Gy respectively. Then the mRNA level of cystathionine-γ-lyase was studied by quantitative reverse-transcription competitive polymerase chain reaction. Hydrogen sulfide concentration in culture medium was determined by methylene blue spectrophotometry. Cystathionine-γ-lyase activity in vascular smooth muscle cells was also studied. Results 60 Co γ radiation at a dose of 1 Gy did not affect the cystathionine-γ-lyase/hydrogen sulfide pathway significantly. However, 60 Co γ radiation at doses of 14 Gy and 25 Gy decreased the hydrogen sulfide synthesis by 21.9% ( P <0.05) and 26.8% ( P <0.01) respectively. At the same time, they decreased the cystathionine-γ-lyase activity by 15.1% ( P <0.05) and 20.5% ( P <0.01) respectively, and cystathionine-γ-lyase mRNA expression by 29.3% ( P <0.01) and 38.2% ( P <0.01) respectively. Conclusion Appropriate 60 Co γ radiation inhibits the H2S synthesis by inhibiting the gene expression of cystathionine-γ-lyase and the cystathionine-γ-lyase activity.