新型眼盾保护蓝光照射治疗新生儿黄疸的应用

新生儿黄疸是指新生儿时期由于胆红素代谢异常引起血中胆红素水平升高,而出现皮肤、巩膜、黏膜黄染的临床现象［1］。业已证明蓝光照射可以治疗新生儿黄疸,效果明显,因为蓝光能够降低血清未结合的胆红素,是治疗新生儿黄疸的重要手段之一。但蓝光照射时,如不遮盖新生儿的双眼,蓝光极易伤害新生儿眼视网膜和角膜［2］。作者采用本院眼科研制新型眼盾［3］（见图1、图2）,于蓝光照射时遮盖新生儿的双眼保护视网膜和角膜36例,效果满意,现报告如下。     

新生儿光疗的安全隐患与预防对策

目的:采用双面蓝光照射治疗新生儿黄疸。方法:对126例新生儿高胆红素血症患儿采用双面蓝光治疗,针对可能会出现的安全隐患进行细心预防、监护及改进护理方法。结果:126例新生儿黄疸经蓝光治疗均痊愈出院,无1例发生不良后果。结论:蓝光照射能有效降低新生儿胆红素水平,而针对光疗可能出现的安全隐患进行精心的监护,是将光疗不良反应降到最低的关键。     

双面与单面蓝光照射治疗新生儿高胆红素血症疗效比较

目的:探讨双面与单面蓝光照射治疗新生儿高胆红素血症的疗效及护理方法.方法:将新生儿高胆红素血症患儿88例随机分为双面照射组和单面照射组各44例,对其疗效、副作用及护理问题进行对比研究.结果:双面蓝光照射组与单面蓝光照射组在光疗相同时间内,血清胆红素值有显著性差异(P＜0.05),光疗副作用也有显著性差异(P＜0.05).结论:双面蓝光照射在相同时间内使胆红素异构化速度加快,对减少核黄疸有重要意义.     

2种蓝光照射治疗高胆红素血症的效果比较

目的 比较2种不同的蓝光照射法对治疗新生儿高胆红素血症的效果.方法 将130例新生儿黄疸患者随机分为对照组和观察组,每组65例,观察组采用间歇蓝光照射法,对照组采用传统的连续蓝光照射法,比较2组患儿退黄效果、每天胆红素下降幅度和疗程.结果 2组患儿退黄效果、每天胆红素下降幅度、疗程比较,差别均无统计学意义(均p>0.05).结论 间歇蓝光照射治疗新生儿高胆红素血症的疗效满意.     

防撞鸟巢式护理对蓝光照射治疗新生儿黄疸患儿睡眠及胆红素水平的影响

目的:探讨防撞鸟巢式护理对蓝光照射治疗新生儿黄疸患儿睡眠及胆红素水平的影响.方法:将2018年4月—2019年10月收治的228例新生儿黄疸患儿分为对照组和观察组各114例,对照组在蓝光照射治疗中采用常规护理,观察组在蓝光照射治疗中采用防撞鸟巢式护理.比较两组患儿黄疸指数、血清胆红素变化、临床指证、睡眠情况和不良反应发生情况.结果:护理后观察组患儿黄疸指数和血清胆红素水平低于对照组(P<0.05);观察组患儿血氧饱和度、排便次数高于对照组,体温波动幅度、心率低于对照组(P<0.05);观察组患儿哭闹时间、黄疸消退时间短于对照组,睡眠时间长于对照组(P<0.05).结论:新生儿黄疸患儿在蓝光照射治疗期间接受防撞鸟巢式护理,可有效改善临床指证和睡眠状况,降低血清胆红素水平以及不良反应风险.     

蓝光照射加口服枯草杆菌二联活菌颗粒治疗新生儿黄疸的疗效观察

[目的] 观察蓝光照射加口服枯草杆菌二联活菌颗粒治疗新生儿黄疸的疗效.[方法]将60例出生1 min Apgar评分≥7分,出生后48 h血清总胆红素达140.0 μmol/L±14.5 μmol/L新生儿随机分为对照组和观察组,每组30例,对照组采用蓝光照射治疗,观察组采用蓝光照射加口服枯草杆菌二联活菌颗粒治疗.比较两组新生儿治疗第2天～第5天的血清胆红素变化情况.[结果] 观察组新生儿第2天～第5天的血清胆红素水平均低于对照组(P＜0.05).[结论] 蓝光照射加口服枯草杆菌二联活菌颗粒治疗新生儿黄疸优于单纯蓝光照射治疗.     

蓝光照射治疗新生儿黄疸的护理

新生儿黄疸是新生儿较常见的疾病之一,其病因持续而复杂,血中未结合胆红素过高可引起胆红素脑病(核黄疸),从而影响新生儿的身心健康.为了提高新生儿生存质量,预防新生儿高胆红素血症,蓝光照射治疗新生儿黄疸能有效降低患儿血胆红素,而正确、精心的护理是蓝光照射治疗的关键.     

2种蓝光照射治疗高胆红素血症的效果比较

目的比较2种不同的蓝光照射法对治疗新生儿高胆红素血症的效果。方法将130例新生儿黄疸患者随机分为对照组和观察组,每组65例,观察组采用间歇蓝光照射法,对照组采用传统的连续蓝光照射法。比较2组患儿退黄效果、每天胆红素下降幅度和疗程。结果 2组患儿退黄效果、每天胆红素下降幅度、疗程比较,差别均无统计学意义（均p〉0．05）。结论间歇蓝光照射治疗新生儿高胆红素血痘的疗效满意。     

蓝光照射加口服枯草杆菌二联活菌颗粒治疗新生儿黄疸的疗效观察

[目的]观察蓝光照射加口服枯草杆菌二联活菌颗粒治疗新生儿黄疸的疗效。[方法]将60例出生1 min Apgar评分≥7分,出生后48 h血清总胆红素达140.0μmol/L±14.5μmol/L新生儿随机分为对照组和观察组,每组30例,对照组采用蓝光照射治疗,观察组采用蓝光照射加口服枯草杆菌二联活菌颗粒治疗。比较两组新生儿治疗第2天~第5天的血清胆红素变化情况。[结果]观察组新生儿第2天~第5天的血清胆红素水平均低于对照组(P<0.05)。[结论]蓝光照射加口服枯草杆菌二联活菌颗粒治疗新生儿黄疸优于单纯蓝光照射治疗。     

间断与持续蓝光照射治疗新生儿黄疸临床疗效对比

目的对比间断与持续蓝光照射治疗新生儿黄疸的临床疗效。方法选取2015年9月～2017年9月我院收治的新生儿黄疸患儿68例,按照随机原则分为观察组和对照组各34例,对照组给予持续性蓝光照射,观察组给予间断性蓝光照射。观察并比较两组临床疗效。结果观察组临床治疗总有效率与对照组比较,无显著性差异(P0.05),观察组蓝光照射治疗时不良反应发生率显著低于对照组,差异具有统计学意义(P0.05);治疗前,两组血胆红素水平比较无显著性差异(P0.05);治疗后,两组血胆红素水平均明显下降(P0.05)),但组间比较无显著性差异(P0.05)。结论间断、持续蓝光治疗新生儿黄疸均可有效降低患儿血清胆红素含量,改善患儿黄疸症状,但间断蓝光照射治疗安全性相对于持续蓝光照射更高,应作为新生儿黄疸临床蓝光照射治疗的首选。     

Guns and Knives in New Mexico: Patterns of Penetrating Trauma, 1978–1993

Objective: To identify patterns of nonfatal and fatal penetrating trauma among children and adults in New Mexico using ED and medical examiner data.
Methods: The authors retrospectively sampled in 5-year intervals all victims of penetrating trauma who presented to either the state Level-1 trauma center or the state medical examiner from a 16-year period (1978–1993). Rates of nonfatal and fatal firearm and stabbing injury were compared for children and adults.
Results: Rates of nonfatal injury were similar (firearm, 34.3 per 100,000 person-years; stabbing, 35.1). However, rates of fatal injury were significantly different (firearm, 21.9; stabbing, 2.7; relative risk: 8.2; 95% confidence interval: 5.4, 12.5). From 1978 to 1993, nonfatal injury rates increased for children (p = 0.0043) and adults (p < 0.0001), while fatal penetrating injury remained constant. The increase in nonfatal injury in children resulted from increased firearm injury rates. In adults, both stabbing and firearm nonfatal injury rates increased.
Conclusions: Nonfatal injury data suggest that nonfatal violence has increased; fatal injury data suggest that violent death rates have remained constant. Injury patterns vary by age, mechanism of trauma, and data source. These results suggest that ED and medical examiner data differ and that both are needed to guide injury prevention programs.     

Dissociable correlates of two classes of retrieval processing in prefrontal cortex

Although substantial evidence suggests that the prefrontal cortex (PFC) implements processes that are critical for accurate episodic memory judgments, the specific roles of different PFC subregions remain unclear. Here, we used event-related functional magnetic resonance imaging to distinguish between prefrontal activity related to operations that (1) influence processing of retrieval cues based on current task demands, or (2) are involved in monitoring the outputs of retrieval. Fourteen participants studied auditory words spoken by a male or female speaker and completed memory tests in which the stimuli were unstudied foil words and studied words spoken by either the same speaker at study, or the alternate speaker. On "general" test trials, participants were to determine whether each word was studied, regardless of the voice of the speaker, whereas on "specific" test trials, participants were to additionally distinguish between studied words that were spoken in the same voice or a different voice at study. Thus, on specific test trials, participants were explicitly required to attend to voice information in order to evaluate each test item. Anterior (right BA 10), dorsolateral prefrontal (right BA 46), and inferior frontal (bilateral BA 47/12) regions were more active during specific than during general trials. Activation in anterior and dorsolateral PFC was enhanced during specific test trials even in response to unstudied items, suggesting that activation in these regions was related to the differential processing of retrieval cues in the two tasks. In contrast, differences between specific and general test trials in inferior frontal regions (bilateral BA 47/12) were seen only for studied items, suggesting a role for these regions in post-retrieval monitoring processes. Results from this study are consistent with the idea that different PFC subregions implement distinct, but complementary processes that collectively support accurate episodic memory judgments.     

Interprofessional approaches to creating safe,high quality health care

Three supplementary perspectives are presented arguing that interprofessional collaboration is both necessary and desirable. Nonetheless, there are often too many serious intra-professional barriers and obstacles to interprofessional collaboration to make it successful. Some of these barriers, it is argued and illustrated, are found in the multiple ways in which professional identity is tacitly acquired and embodied in the practitioners' habitual, everyday practice. The paper then explores ways in which reflection, especially Second order reflection, can help to elucidate and overcome these obstacles, as well as increasing professional adaptability and competence.     

Systematic Reviews Published in the January 2011 Issue of The Cochrane Library

ABSTRACT

The Cochrane Library of Systematic Reviews is published quarterly as a DVD and monthly online. The January 2011 issue (first quarterly DVD for 2011) contains 4515 complete reviews, 1985 protocols for reviews in production, and 13,521 one-page summaries of systematic reviews published in the general medical literature. In addition, there are citations of 641,000 randomized controlled trials, and 14,018 cited papers in the Cochrane methodology register. The health technology assessment database contains over 9300 citations. One hundred and seven new reviews have been published in the last 3 months, of which five have potential relevance for practitioners in pain and palliative medicine.     

Determination of creatine kinase isoenzyme MB activity in serum using immunological inhibition of creatine kinase M subunit activity. Activity kinetics and diagnostic significance in myocardial infarction.

This is a new method for the determination of creatine kinase isoenzyme MB activity in serum. The method uses direct activity measurement of creatine kinase B subunit activity after blocking of CK-M subunit activity by inhibiting antibodies. The test takes no longer than 15 min. The method yields an intra-serial C.V. of 2.0-12.9%, and a C.V. from day to day of 5.5%. The detection limit is 3.4 U/l creatine kinase MB. In the 95 cases with proven myocardial infarction several types of creatine kinase MB activity kinetics could be determined. The percentage of creatine kinase MB of peak CK-total is 6-25%, with a mean of 11.1%. The amount of creatine kinase MB with respect to total CK activity after reinfarction is higher than the amount after initial infarction.     

Modified micro-superior percutaneously-assisted total hip: early experiences & case reports

Because of the extensile nature and familiarity of the standard posterior-lateral approach to the hip, a family of "micro-posterior" approaches has been developed. This family includes the Percutaneously-Assisted Total Hip (PATH) approach, the Supercapsular (SuperCap) approach and a newer hybrid approach, the Supercapsular Percutaneously-Assisted Total Hip (SuperPATH) approach. Such approaches should ideally provide a continuum for the surgeon: from a "micro" (external rotator sparing) posterior approach, to a "mini" (external rotator sacrificing) posterior approach, to a standard posterior approach. This could keep a surgeon within his comfort zone during the learning curve of the procedure, while leaving options for complicated reconstructions for the more practiced micro-posterior surgeons. This paper details one author's experiences utilizing this combined approach, as well as permutations of this entire micro-posterior family of approaches as applied to more complex hip reconstructions.     

Structure and function of "metalloantibiotics"

Although most antibiotics do not need metal ions for their biological activities, there are a number of antibiotics that require metal ions to function properly, such as bleomycin (BLM), streptonigrin (SN), and bacitracin. The coordinated metal ions in these antibiotics play an important role in maintaining proper structure and/or function of these antibiotics. Removal of the metal ions from these antibiotics can cause changes in structure and/or function of these antibiotics. Similar to the case of "metalloproteins," these antibiotics are dubbed "metalloantibiotics" which are the title subjects of this review. Metalloantibiotics can interact with several different kinds of biomolecules, including DNA, RNA, proteins, receptors, and lipids, rendering their unique and specific bioactivities. In addition to the microbial-originated metalloantibiotics, many metalloantibiotic derivatives and metal complexes of synthetic ligands also show antibacterial, antiviral, and anti-neoplastic activities which are also briefly discussed to provide a broad sense of the term "metalloantibiotics."