目的 分析2017年高原藏区某部参加新训的新兵疾病谱,为优化卫生资源配置提供科学依据.方法 对新兵进行问卷调查,同时收集并统计研究对象在3个月新训期内入院情况.通过调查问卷,分析新兵户籍、入伍地海拔及吸烟、饮酒史等对各系统疾病发生率的影响,并考察新兵对新训的适应情况.结果 居前5位的系统疾病分别为呼吸系统疾病(46.65％)、骨骼肌肉结缔组织疾病(25.14％)、皮肤及皮下组织疾病(12.01％)、消化系统疾病(6.01％)和循环系统疾病(4.75％).70％以上的新兵可以较好地适应训练,同时入伍地海拔等因素影响不同系统疾病的发生率.结论 明确驻高原藏区新兵新训时的常见疾病,可以丰富新训卫勤保障理论体系,提高武警部队新训质量和水平.

目的 探究急性心梗患者的心理特征,针对性地给予护理干预,分析护理干预的效果.方法 选取我院2000年3月至2017年8月收治的急性心梗患者30例作为研究对象,采用回顾性分析法对全部患者的心理特征进行分析,根据分析的结果采取相应的护理对策.结果 急性心梗患者的心理特征以负面心理为主,全部患者均存在不同程度的焦虑恐惧、孤独忧郁、自卑绝望、放弃拮抗等负面心理,同时经调查有小部分患者存在一定的积极心理,包括期待转归型、眷恋欲望型.结论 急性心梗患者的心理特征以负面心理为主,绝大部分患者都存在不同程度的负面心理,导致疾病的康复受到负面影响,针对性地采取护理措施,可以在一定程度上缓解患者的负面心理,提高患者的心理健康水平.

Objective To investigate the value of electronic bronchoscopy in the diagnosis of sputum bacteria resistant pulmonary tuberculosis in the elderly. Methods The clinical data of 60 elderly patients with suspected sputum negative bacterial tuberculosis treated in our hospital was analyzed retrospectively. Results Brush biopsy was positive in 37 cases (61.67％ ), lavage fluid in 32 cases (53.33％ ), biopsy in 34 cases (28.33％ ), including 19 cases (31.67％ ) whose biopsy and brush biopsy were both positive. There was no statistically significant difference (X2 = 3.01 = 0.07) between the positive rate of lavage fluid and that of brush lavage. The positive rate of brushing combined with BALF was higher than that of brushing or BALF alone, and the difference was statistically significant (X2 respectively 11.59 and 24.60,all P ＜0.05). Conclusions The clinical symptoms of senile pulmonary tuberculosis are not typical. Bronchoscopy and brushing tests are of diagnostic value for bacterial negative pulmonary tuberculosis, and bronchoscopy should be performed as early as possible.

Objective To study changes in T lymphocyte subsets of features and cytokine interleukin hormone(IL)-6,IL 8,tumor necrosis factor(TNF-α) in patients with chronic obstructive pulmonary disease(COPD) and the clinical significance.Methods Peripheral blood T cell subsets and serum IL-6,IL-8,TNF-α level were detected in admitted 80 patients with acute exacerbation of COPD and a control group of 30 healthy subjects.Analysis and comparison of the differences,and correlation with forced expiratory volume in one second(FEVI) were made.Results In COPD group,total T cells(CD3+),Th cells,Th / Ts ratio,natural killer(NK) cells were lower than those in control group,the difference was statistically significant(P 0.05).COPD group at time of admission had significantly higher serum IL-8,IL-6 and TNF-α levels,the difference was statistically significant(P 0.05);there were negative correlation between IL-6,IL-8,TNF-α and FEV1(r =-0.74,-0.69,-0.76,P 0.05,respectively).Conclusion T lymphocyte subsets and cytokine are jointly involved in the inflammatory reaction in COPD,these changes play an important role in the development of COPD process,and can be used as an important indicator for monitoring of the disease.

Objective To study the effect of high-flux hemodialysis combined with levocarnitine on uremic pationts with refractory anemia.Methods Fifty-six patients with refractory anemia in maintenance hemodialysis were randomly divided into 4 groups: normal group(14 cases) underwent conventional hemodialysis,3 times a week;L-carnitine group(14 cases) was given levocarnitine 1 g on common hemodialysis basis,3 times a week;high-flux dialysis group(14 cases) received high-flux hemodialysis,3 times a week;high-flux hemodialysis plus L-carnitine group(14 cases) was given levocarnitine 1 g on high-flux hemodialysis basis,3 times a week.Blood routine and biochemical indicators were examined after treatment for 3 and 6 months,and statistical analysis was made.Results The conventional hemo dialysis group and L-carnitine group had no improvement in anemia;high-flux hemo dialysis group and high-flux hemodialysis plus L-carnitine group improved in anemia,with statistically significant difference,compared with the conventional hemodialysis group(P < 0.05);high-flux hemodialysis combined with L-carnitine group,compared with high-flux hemodialysis group,had remarkable curative effect,with statistically significant difference(P < 0.05).Conclusion High-flux hemodialysis combined with L-carnitine is effective in the treatment of uremic patients with refractory anemia

1 临床资料 1.1 一般资料 本组23例,男15例,女8例;年龄32～82岁,平均56岁.梗塞部位:广泛前壁10例,前壁+下壁6例,前间壁+高侧壁4例,前壁+正后壁3例.按Killip泵功能分级[1],Ⅴ级泵衰竭(心源性休克+急性肺水肿)1例,Ⅳ级泵衰竭(心源性休克)2例,Ⅲ级泵衰竭(急性肺水肿或双肺啰音≥1/2肺野)5例,Ⅱ级泵衰竭(双肺啰音<1/2肺野)8例,Ⅰ级泵衰竭(无明显心衰征象)7例.