目的:了解新型冠状病毒肺炎上门排查工作人员的心理状态,为工作人员心理疏导提供依据.方法:采用症状自评量表(SCL-90)对上川社区工作人员进行心理现状调查,并分析不同特征的工作人员SCL-90量表得分情况.结果:60例工作人员SCL-90量表总分为(139.01±36.84)分,高于2018年全国常模(P<0.05);其中女性工作人员量表总分为(142.34±44.39)分,高于男性的(134.96±39.46)分(P<0.05);本科及以上工作人员量表总分为(126.12±23.01)分,低于专科及以下工作人员的(143.02±30.13)分(P<0.05);而不同年龄、婚姻状态工作人员量表总分无统计学差异(P>0.05).结论:疫情期间上门排查社区工作人员存在一定的心理应激反应,对于专科及以下学历及女性工作人员需予更多理解,采取必要的心理疏导等措施缓解其不良情绪.

目的应用中医"治未病",在社区健康服务"全科诊疗"中的具体操作与应用,将中医"治未病"思维与社区健康服务的"全科诊疗"流程有机的结合,研究中医"治未病"在社区健康服务中的实用价值,再根据流程提取模式形成具有中医特色的全科诊疗。方法以社区健康服务的"全科诊疗"为切入点,以点概面的研究方法,选取"上呼吸道感染"为病种研究对象,根据不同的医师资质对这一病种的干预措施,随机动态双盲进行试验,以1年的时间为研究时间段,以诊断为"上呼吸道感染"的社区居民,作为样本量提取。应用医学统计分析研究方法,以同病发病率、复诊率、诊疗次均费用、抗生素使用率,应用医学统计分析研究结果。结果实验组的同病发病率、复诊率、诊疗次均费用、抗生素使用率,与对照组相比较,明显降低。结论中医"治未病"在社区健康服务"全科诊疗"中的应用,具有明显的优势,明显提高社区居民健康素质,降低医疗费用,节约医疗资源,是解决看病贵、看病难的有效途径,操作简便,适宜大范围推广。

在探索生命奥秘的历史进程中,中西医都在尽其所能的努力着,都在为生命的进程提供着医学服务,维护着生命进程的健康有序,中医"治未病"是中医的重要特色和优势,代表着中医对医学的独特认识和精辟见解,中医"治未病"的"未病先防,既病防变,瘥后防复",几千年来一直指导着后世医家的诊疗思维与处方原则,也指导着中华民族在几千年的历史进程中与疾病进行的斗争。中医"治未病"是一种理念,是一种思维模式,也是一种能减少疾病的发生与修复疾病所造成的损害,达抗衰防病,延年益寿,提高生存能力的预防保健模式。中医"治未病"理念是中医的精髓之一,是每个中医人必备的技能。而全科诊疗则完全不同,全科诊疗是全科医生必备的技能,是全科医生为社区居民提供医学健康服务的手段,是分类医学经过多年发展后的结果,所以现代医学将全科医学称为"社会-心理-生物"的医学思维模式。如果将中医"治未病",在西医学的全科诊疗模式中得到充分的应用,并指导着全科诊疗,那么西医的变革与发展轨迹将更快更捷。

Objective To discuss the occurrence of depression and nursing measures among pregnant women who underwent termination of pregnancy due to abnormal fetus.Methods 256 pregnant women admitted to our department from January 2007 to January 2008 for termination of pregnancy for abnormal fetus were chosen for Self-rating Depression Scale test.Reasons for depression after the termination of pregnancy and nursing methods were analyzed.Results Among 256 pregnant women,65 patients were found depressed after the test.Depression was removed in all depressed patients after individualized nursing.And confidence of another pregnancy was regained.Conclusion Several factors are responsible for the occurrence of depression among pregnant women who underwent termination of pregnancy for abnormal fetus.In clinical,nursing measures should interfere timely so as to reduce the occurrence of depression and help pregnant women to regain the confidence of another pregnancy.

Objective To study the correlation between cholelithiasis and the infection of HCV.Methods 32 formalin - fixed and paraffin - embedded gallbladder samples of cholelithiasis patients and 20 gallbladder samples of noncholelithiasis patients were investigated using the polyme rase chain reaction - Ethidium bromide(PCR - RT) assay.The 52 patients were positive to HCV serologic markers.Results The results showed that HCV - RNA was found in 13 gallbladder samples of 32 cholelithiasis patients(40.63%),significantly higher than that in 3 gallbladder samples of 20 noncholelithiasis patients (15%).Conclusion The infection of HCV and the formation of cholelithiasis are correlated.

急性胰腺炎是临床常见的急腹症.一般认为,其发病主要是由于胰液和胰酶损害胰腺及胰周组织所致,胆石症是其主要病因之一.笔者观察了本单位自2003年3月至2008年3月共收治的42例胆源性水肿型胰腺炎的治疗情况,现结合病例探讨胆源性水肿型胰腺炎的治疗.

目的对比观察碳酸氢钠溶液、生理盐水腹腔冲洗(IOPL)治疗十二指肠穿孔性腹膜炎的效果。方法18只SD大鼠分为对照组(6只)、碳酸氢钠组(6只)、生理盐水组(6只),治疗24 h后处死,取材,测定腹腔液pH值、血清C反应蛋白,计算白细胞中毒指数,测定腹腔液与血清D-Lactata差值。结果碳酸氢钠溶液与生理盐水比较:腹腔液pH值升高,D-Lactata差值增大,差别有显著性,血清C反应蛋白显著增高。结论在十二指肠穿孔早期引起的化学性腹膜炎中,使用生理盐水做IOPL治疗有效;使用1.25%碳酸氢钠溶液做IOPL治疗可能加重病情,影响治疗效果。

目的 探索外伤性脾破裂的诊断和治疗.方法 回顾分析外伤性脾破裂的临床资料.结果 术前63例中确诊有的61例(97%),2例剖腹探查术中确诊.手术治疗分为脾切除术、脾部分切除术脾修补术和脾切除加脾组织移植术,全部病例均治愈出院.结论 有外伤史结合B超加腹穿抽出不凝血检查,诊断可明确.选择手术治疗的原则为:救命为先,保脾为次.

OBJECTIVE To discuss the methods of prevention and management of serious comlications in thyroidectomy for hyperthyroidism. METHODS 148 cases of hyperthyroidism undergone thyroidectomy admitted from 1990 to 2006 were analyesd retrospectively.RESULTS The rate of complication was 3.5%(5/148). The complications included 2 cases of hypoincisional hematoma,1 case of hypertensive crisis,1 case of injury of recurrent laryngeal nerve,1 case of injury of parathyroid gland,2 patients died from there. CONCLUSIONS The prevention of complication in operations on hyperthyroidism must attach importance to each segment of perioperation. It is more safe to carry out general anaesthesia than to do anaesthesia of cervical plexus in the operations. Some patients being in tense emotion may be carried"stolen extraction",so as to avoid drastic changes of vital signs.

Objective To understand the effect of intraoperative peritoneal lavage with Natii Bicarbonate on acute peritonitis. Methods A animal model of experimental acute bacterial peritonitis in rats was established.The changes of peritoneal fluid PH,serum C-reactive protein(CRP),leukocyte toxic index,and D-Lactate in peritoneal fluid and serum were observed. Results The murine peritoneal fluid was acidic before treatment(PH:6.93±0.22).Various indexes in peritoneal lavage group were significantly superior to the control group(P0.05).No significant difference was observed between gentamycin group and control group(P0.05),showing that intraoperative peritoneal lavage(IOPL) was effective on acute peritonitis.Various indexes in NaHCO3 group were superior to NS groups(P0.05),showing that IOPL with NaHCO3 was more effective on acute bacterial peritonitis than with NS.It was also observed that IOPL with NaHCO3 and Gentamycin had synergetic effect . Conclusion IOPL with NaHCO3 can change peritoneal acidic environment during acute bacterial peritonitis.It prevents a series reactions from occurrence under acidic condition and enhances antibiotics effect.This method can improve the outcome in treatment of acute bacterial peritonitis.

Objective To investigate the effects of antitumor effect of dendritic cells modified by antisense-IDO-AFP with controling tryptophan metabolism in vitro and in vivo.Methods DCs were cul- tured from bone marrow cells and modified by antisense-IDO-AFP.Spleen lymphocytes of mice were acti- vated by modified DCs and the cytotoxicity was detected by ~(51)Cr release method.Modified DCs,pure DCs and control DCs were injected into mice beating H22 liver cancer cells to observe the levels of IL-10,IFN-γin serum and the alteration of proportions of CD8~+-IFN-γ~+ and CD8~+-IL-10~+ cells,CD4~+-IFN-γ~+ and CD4~+-IL-10~+ cells.Results DCs modified by antisense-IDO-AFP could activate spleen lymphocytes and the latter could specifically kill H22 cells,and the lyse rate to H22 cancer cells was 89.3%,but not to Ehrilich ascite carcinoma cells.Modified DC could improve the host's antitumor effect of DCs modified by antisense-IDO-AFP with controling tryptophan metabolism in vitro and in vivo,and the increased propor- tions of Th1 cells could inhibit tumor growth.Conclusion DCs transfected with antisense-IDO-AFP gene could induce specific cytotoxic T lymphocytes and strikingly raise DCs' antigen present function,and have specific CTL killing activity.

Objective Based on Miles operation, double U-shape myoplasty was applied to treat rectum and anal canal cancer with reconstructing anus in situs.Methods Seventy-two cases of rectum and anal canal cancer were treated with U-shape myoplasty to reconstrute anus in situs with musculus puborcctalia, in the meaning time, valve and angle of rectum also were up-built.Results There were feelings of defecating 4-6 days after operation in all 72 cases of patients,consciousness of controlling stools.The number of defecating was 1-2 times.According to classification described by Zhang Qinrong,41 cases were excellent,91 good 19,and 12 bad within 1 year.Conclusion The operation is based on Mile's to reconstruct anus in situs with U-shape myoplasty.It can remove tumor radically,and satisfy function of defecating.

目的:了解深圳市宝安区二甲以上各医院体检科护士对针刺伤的认识和针刺伤后的心理状态.方法:采用目标抽样法,对深圳市宝安区各医院的196位体检科护士进行问卷调查.结果:71%的护士认为刺伤不可避免;59.3%护士认为被污染针头刺伤后感染机率大;84.7%的护士认为针刺伤后最害怕的是感染HIV、肝炎;56.3%的护士对针刺伤持"无所谓"的态度;86.4%的护士认为被污染针头刺伤后"害怕但不可避免".结论:多数体检科护士针刺伤后心理状态为非常害怕且消极无奈,可能原因是意识到针刺伤的危险性,但针刺伤不可避免以及刺伤后不够重视;少数体检科护士对针刺伤认识不足.

Objective: To explore clinic value of combination aerosol inhalation with postural drainage increasing sputum expectoration. Methods: 102 cases of bronchiectasis and lung abscess were randomly subdivided into three groups, group A: only postural drainage treatment (n = 34); group B: simply aerosol inhalation treatment (n = 34) and group C: combined aerosol inhalation with postrual drainage treatment (n = 34). The volume of sputum expectoration were observed daily, the days of body temperature back to normal and hospitalization were monitored in groups. Results: The volume of sputum in the group C were significantly more than the other two groups, and the days of temperature back to normal and hospitalization were significantly shortened than the other two groups. Conclusion: Combination aeroeal inhalation with postural drainage can increase sputum expectoration and make a quick recovery.

肿瘤的主动免疫治疗(Active immunotherapy)一直是肿瘤治疗研究的热点.然而有关肿瘤的免疫逃避、肿瘤特异抗原以及肿瘤治疗中免疫的合适方法、路径等都是研究者必须妥善解决的问题.树突状细胞(Dendritic cell，DC)是摄取、加工、呈递抗原的重要专职抗原呈递细胞(Antigen presenting cell，APC),它呈递抗原的能力最强.近年来随着人们了解的深入,树突状细胞作为肿瘤免疫治疗的新方法越来越受关注.