This study was conducted to observe the effect of transcutaneous electrical acupoint stimulation (TEAS) on the postoperative sleep quality of patients undergoing gastrointestinal tumor surgery and to verify the possible mechanism. Eighty-three patients were allocated to the TEAS or Sham group. Patients in the TEAS group received TEAS treatment (disperse-dense waves; frequency, 2/100 Hz) on bilateral Shenmen (HT7), Neiguan (PC6) and Zusanli (ST36) points for 30 min each time, total three times in the perioperative period. In the Sham group, electrodes were placed; however, no current was given. Sleep quality was assessed on the day before surgery (P1) and the first and third days after surgery (D1 and D3) using the Pittsburgh Sleep Quality Index (PSQI) and Athens Insomnia Scale (AIS). Postoperative pain was assessed using visual analog scale (VAS) 72 h postoperatively. The incidences of abdominal distension, dizziness, postoperative nausea and vomiting (PONV) and pulmonary complications were recorded. Serum levels of inflammatory cytokines and the expression of key factors of oxidative stress and key molecules of the nuclear factor erythroid 2-related factor 2/antioxidant response element (Nrf2/ARE) signal pathway were measured. TEAS ameliorated sleep quality at D1 and D3 (PSQI P < 0.05, AIS P < 0.05) and decreased postoperative pain as demonstrated by lower VAS scores compared to the Sham group (P < 0.05). The incidences of abdominal distension and PONV were also lower in the TEAS group. Markers of oxidative stress were increased (P < 0.05), and the serum concentration of interleukin-6 (IL-6) was significantly lower in the TEAS group. The key mediators of the Nrf2/ARE pathway were enhanced after TEAS. Perioperative TEAS improved postoperative sleep quality, reduced postoperative pain and alleviated postoperative adverse effects in patients undergoing laparoscopic gastrointestinal tumor surgery resection. This may be associated with activating Nrf2/ARE signal pathway and decreasing its inflammatory actions. Chinese Clinical Trial Registry ( http://www.chictr.org.cn/index.aspx ), ChiCTR2100054971.

目的 探讨胃腔注气联合变换体位法在高龄老年患者置入三腔喂养管中的应用.方法 采用胃腔注气联合变换体位法在床旁为高龄老年患者置入三腔喂养管.结果 应用变换体位、胃腔注气法为3例高龄老年患者成功留置三腔喂养管.结论 胃腔注气联合变换体位法置入三腔喂养管可回避内镜或X射线引导置管带来的风险,适用于高龄老年患者的床旁置管.

目的 探讨28~30℃和36~38℃管饲营养液对老年患者胃肠道功能的影响,为老年患者泵入合适温度的营养液提供依据.方法 选取留置胃管需肠内营养的老年患者60例,按入院先后顺序分为观察组和对照组各30例,观察周期15 d,对照组营养液通过热水加温及加热棒的方法将温度控制为36~38℃,观察组仅使用加热棒加热营养液,温度控制为28~30℃,两组均采用鼻饲泵持续泵入,观察两组患者腹部并发症及胃潴留的发生情况.结果 两组营养液温度引起老年患者腹部并发症及胃潴留的发生情况比较,差异无统计学意义(P>0.05).结论 两种温度的管饲营养液均适用于老年长期管饲患者,28~30℃营养液临床控温方法更加省时、便捷.

Objective To normalize the treatment behaviors by monitoring the medical expenditures of ser-viceman.Methods By using the system platform for medical expenditure audit of the serviceman, to set up the treatment behaviors regulation, to count and analyze the irregularities.Results The existing problems include the mismatch between the actual and support information card, the incomplete of the data, and the overweight of drug use.The rational medical care of serviceman is assured by the rectifying and reform measures.Conclusions The monitoring on medical expenditure of serviceman is beneficial to optimize service process, normalize the treatment behaviors, and promote the rational deployment of military medical expenditures.

目的探讨内收型股骨颈骨折使用股骨近端锁定钢板治疗的疗效。方法使用股骨近端锁定钢板治疗内收型股骨颈骨折16例,术后观察骨折愈合和股骨头坏死情况。结果本组14例获骨性愈合,愈合率为87.5%;2例骨折未愈合,后行髋关节置换手术。采用Harris评分:优12例,良2例,差2例。结论使用股骨近端锁定钢板治疗内收型股骨颈骨折固定牢固,螺钉应力分散,可有效地防止螺钉逆转、滑动和退出。

Objective To observe the clinical effect of pneumatically ballistic extracorporeal shockwave on chronic nonspecific low back pain.Methods 66 cases with chronic nonspecific low back pain were randomly divided into treatment group(n=33) and control group(n= 33).There were 1 case drop-out in the treatment group and 2 in the control group.The treatment group accepted pneumatically ballistic extracorporeal shockwave,and the control group accepted hot magnet for 2 weeks.They were assessed with Visual Analogue Scale(VAS) and Finger-floor Distance(FFD) before and after treatment.Results The scores of VAS and FFD improved in both groups after treatment(P< 0.05),and the difference before and after treatment were more in the treatment group than in the control group(P<0.05).Conclusion The pneumatically ballistic extracorporeal shockwave is more effective on chronic nonspecific low back pain than hot magnet.

An idea of field medical equipment base training is put forward for the mobile medical team to solve the problems due to lacking training field.The abilities of the staffs to utilize,repair and maintain the equipment are enhanced greatly,and thus the requirements of the accompanied support by the mobile medical team can be satisfied.

Objective To investigate the influence of the plateau portable folding pressurized cabin(PPFPC) on some physiological signs of the persons entering the plateau with an altitude of 4 430 m,including blood oxygen saturation(SaO2),heart rate(HR) and blood pressure(BP),and to analyze the effect of the cabin on the acute high altitude reaction(AHAR).Methods Twenty servicemen,entering the plateau with an altitude of 4 430 m from the plain with an altitude of 480m,were measured for the SaO2,HR and BP before and 15 min,30 min and 30 h after entering the cabin and after being out of the cabin,and the measured values were compared.Results There were significant differences between the measured values of SaO2 and HP before and after entering the plateau,with P0.01,and the BP on the plateau was higher than that in the plain.There was significant differences between the measured values of SaO2 and HP before and after entering the cabin,with P0.01,and no significant difference for the values of BP.Conclusion The plateau portable folding pressurized cabin can make SaO2 increased and HR decreased,and thus improve the symptoms of AHAR.

Objective To investigate the materials and equipment storing mode for military provincial medical & epidemic-prevention corps.Methods With the missions as well as the equipment and materials of military provincial medical & epidemic-prevention corps analyzed,the mode of replacing the warehouse with the truck and functional module was put forward.Results The deployment speed of military provincial medical & epidemic-prevention corps was enhanced greatly.Conclusion The support ability of military provincial medical & epidemic-prevention corps is improved.

回顾分析本院2011年12月~2012年12月收治208例乙型肝炎患者。病理检查结果根据肝纤维化程度分为A组为肝纤维化程度无或者轻度的,定义为S0~1,B组为肝纤维化程度中度以上,定义为S2~4。其中A组121人,B组87人。结果在超声探查评估慢性乙型肝炎患者的检查中的各类的指标中,肝的边缘以及肝的使之回声等对肝纤维化的程度在中度以上的具有非常大的意义。

目的 检测Glypican-3和Glypican-6在巨大儿胎盘组织中表达,探讨其与巨大儿发病的关系.方法 采集216例正常新生儿胎盘组织,153例巨大儿胎盘组织作为研究对象,采用RT-PCR和Western Blot方法,分别从mRNA水平和蛋白水平检测Glypican-3和Glypican-6的表达,统计学分析差异.结果 Glypican-3无论在mRNA水平还是蛋白水平,巨大儿组都稍低于正常新生儿组,两组差别有统计学意义(P＜0.05).Glypican-6在两组间无统计学差异.结论 胎盘组织中Glypican-3水平的变化可能与巨大儿的发生有关.

The fire disaster medical rescue by Hebei Provincial Medical Epidemic-prevention Unit is introduced,along with the problems and countermeasures.The ability for fire disaster medical rescue of provincial medical epidemic-prevention unit is enhanced greatly.

随机选择42例急性脊柱创伤患者,所有患者都经过X线拍片、CT与MRI检查进行诊断,并给予后路椎弓根固定手术治疗。经过检查,12例确诊为胸椎损伤,28例确诊为腰椎损伤,2例确诊为胸椎与腰椎同时受损,所有患者都为外伤引起的骨折导致脊柱损伤。所有患者手术完成顺利,进行1年的随访调查,未发现后路椎弓根固定失败、并发症与致死亡的患者。经有效治疗,所有患者椎体压缩高度恢复的平均水平为40.1°,畸形角恢复的平均水平为19.1°,38例患者的神经功能已恢复到D级与E级水平。X线拍片、CT与MRI检查各有优缺点,有效地将三者结合起来对诊断创伤性脊柱损伤有重要意义,通过对患者行后路椎弓根固定术,其治疗效果较好,并发症少,致死率得到有效降低,后路椎弓根固定术是治疗外伤性骨折引起的急性胸、腰椎脊柱创伤的有效治疗手段,值得临床推广。

选择140例外科手术患者,随机分成两组,对照组患者在麻醉之前不进行心理干预,观察组进行麻醉之前实施心理干预,观察两组的麻醉效果和患者心理情况。观察组患者出现焦虑、抑郁、恐惧的情况和麻醉效果明显优于对照组,差异有统计学意义。麻醉效果和患者心理因素密切相关,做好术前心理干预可明显提高麻醉效果。

目的研究采用骨水泥强化椎弓根钉内固定联合椎体成形术治疗重度骨质疏松性脊柱压缩骨折的临床效果。方法采用上述方法治疗脊柱重度骨质疏松性压缩骨折20例。结果 20例术后进行疼痛VAS评分,治疗成功率为95.11%,随访发现无伤椎再发疼痛和骨折,无神经症状出现。结论采用骨水泥强化椎弓根钉内固定联合椎体成形术治疗重度骨质疏松性脊柱压缩骨折是一种治疗彻底、安全有效的新方法。

<正>近年来,我院多次抽组应急机动卫勤分队赴海拔3500~4500 m高寒山地进行野外驻训,同时担负部队野外驻训的卫勤保障任务。在环境恶劣、疫情复杂的情况下,我抽组应急机动卫勤力量有效保证了官兵的健康和训练任务的完成。本文围绕应急机动卫勤力量急进高原如何保证官兵健康、提

Objective To explore the using of field shelter hospital medical rounds module in the earthquake relief.Methods Based on the relief mission execution in Wenchuan and Yushu earthquake,medical rounds squad constituted of 4 to 6 persons was set up to do the medical rounds work regularly for the earthquake victims,the relief forces,the local relief workers and students and teachers of the temporary schools,and the use of medical equipment and personnel division were proposed.Results Medical rounds facilitated the early detection of the disease,and also the health education,health and epidemic prevention and the psychological counseling work.Conclusion The configuration of medical rounds module in the field shelter hospital meets the security needs of the hospital earthquake relief medical care.

Objective To observe the effect of silver needle acupuncture in the treatment with chronic soft tissue pain of knee joint after operation.Methods Twenty patients with chronic soft tissue pain of knee joint after operation were measured by temperature recorder of infrared thermography and visual analog scale(VAS) on the pretreatment,the moment of treatment and 30d after treatment.Results After 30d of treatment,the changes of VAS index were significantly improved and the volume of temperature in patients' tissue were increased significantly(P<0.01).Conclusion Silver needle acupuncture treatment has the significant long-term effects on patients with chronic soft tissue pain of knee joint after operation

目的探讨短节段骨水泥强化椎弓根钉内固定治疗脊柱单椎体骨质疏松性压缩骨折的临床效果。方法应用短节段骨水泥强化椎弓根钉内固定治疗单椎体骨质疏松性压缩骨折22例。结果本组获随访12～24个月,术后疼痛20例完全缓解,1例部分缓解,1例轻微缓解,无原椎体再发塌陷,未出现神经再受累症状。结论短节段骨水泥强化椎弓根钉内固定治疗脊柱单椎体骨质疏松性压缩骨折,内固定可靠,是一种相对微创、有效的治疗方法。

目的 探讨在关节镜和C型臂X线机辅助下经皮复位内固定治疗Schatzker Ⅰ、Ⅱ型胫骨平台骨折的临床应用价值.方法 对39例Schatzker Ⅰ、Ⅱ型胫骨平台骨折首先使用C型臂X线机透视下大致确定骨折块的位置,再使用关节镜对合并半月板损伤的进行处理,对骨折断端进行牵引、克氏针撬拨复位,经皮通过拉力螺钉固定,骨折块塌陷明显者进行植骨.结果 39例获随访12～24个月,术后4～6个月骨性愈合,疗效按Rasmussen评分标准:良36例,可3例,总平均分为(26±3)分.结论 治疗Schatzker Ⅰ、Ⅱ型胫骨平台骨折时,在关节镜和C型臂X线机监测下复位内固定,经皮切口创伤极小,对于关节腔内的其他损伤可以同时一期处理,不破坏关节血运,骨折愈合快、膝关节的活动恢复良好.