手指长短，预示疾病

拇指应至食指第三节的一半，不及，提示其人易动肝火；食指以达中指第一指节一半为度，短小者往往脾胃不佳；中指低于无名指和食指之人易患心脏疾患，而过长则常见于腰痛；无名指短于食指可能心脑功能不佳；     

食指背侧岛状皮瓣修复拇指远端及指腹缺损17例

拇指远端及指腹缺损在手外伤中多见.2002年9月～2005年9月,我们对17例拇指远端及指腹缺损行食指背侧岛状皮瓣修复,取得了较好疗效,现报告如下.     

食指背侧岛状皮瓣修复拇指远端及指腹缺损17例

拇指远端及指腹缺损在手外伤中多见.2002年9月～2005年9月,我们对17例拇指远端及指腹缺损行食指背侧岛状皮瓣修复,取得了较好疗效,现报告如下.     

不一样的运动,甩掉"鼠标手"

"鼠标手"医学上被称为腕管综合征,是指人体的正中神经、进人手部的血管,在腕管处受到压迫后所产生的症状,主要表现为食指和中指僵硬疼痛、麻木,拇指肌肉无力.     

双叶皮瓣修复拇指脱套伤

拇指脱套伤是手外伤中的常见损伤,因拇指在手功能中占有特别重要的地位,所以它的功能要获得良好恢复,必须有良好的感觉和外观〔1〕。我科1995年1月至1998年5月收治的拇指脱套伤中有3例利用食指尺侧及中指桡侧带血管神经双叶皮瓣瓦合修复,获得满意疗效。皮瓣均成活,拇指外观及功能恢复良好,现在报告如下。临床资料　本组共3例3指,女性2例,男性1例,年龄18～35岁。左拇指1例,右拇指2例。致伤原因均为机器绞伤后的逆行皮肤撕脱伤。创面均用带血管神经的食指尺侧和中指桡侧双叶皮瓣瓦和修复,其中食指尺侧指动脉岛状皮瓣的面积最大为60ｃｍ×30ｃ…     

每日摸脉可早发现心律失常

摸脉的方法很简单.通常采用端坐位,把一侧的上臂手心向上平放到桌面上,然后把对侧手的食指、中指和无名指的指尖并排轻放到该侧手腕的拇指一侧,这时候往往稍加寻找就会清晰地触摸到自己的脉搏.     

自制药贴减轻腱鞘炎

我最近总感觉右手食指疼,屈指时尤其明显,早晨醒来时偏重,医生说是腱鞘炎.想请专家推荐一个缓解该病的偏方.点评：腱鞘炎多与急慢性损伤、产后受凉有关,一般表现为手掌部疼痛、患指伸屈活动受限,清晨醒来时尤其明显,活动后减轻或消失,多见于妇女及手工劳动者,好发于拇指、中指和食指,起病缓慢.     

静脉滴注琥珀酰明胶注射液致过敏性休克一例

我院2006年5月至2008年5月为167例患者施行足趾移植再造手指术,效果满意。现将护理体会报告如下。 1临床资料 本组167例,男性103例,女性64例,年龄5～60岁。缺如部位：拇指110例,食指14例,中指6例．食指与中指22例．食指与中指、环指、小指四指6例,一手五指9例。缺如原因：外伤性158例,先天性9例。成功率100％。功能优良率为99.2％。     

102例次足背动脉直接穿刺进行透析的体会

我院透析室,自1989年以来,对急需血液透析患者,采用直接足背动脉穿刺,建立血管通路进行透析,收到有如内、外瘘一样的透析效果,一次穿刺成功率96.5％,每周透析2～3次,每次透析3～5小时,透析血流量均能达到100～160ml/分。在穿刺实践中,我们的体会是:直接穿刺足背动脉做为血管通路进行血液透析的关键在於首次穿刺成功率要高,具体操作方法:(1)常规碘酒、酒精消毒穿刺处皮肤;(2)铺无菌孔巾,操作者戴无菌手套;(3)用左手食指触到动脉搏动点后,用左手拇指和食指固定穿刺点,选择好穿刺的深度,以45°角进针;(4)见回血后,用胶布固定,即可进行透析。     

蟾酥注射液治疗淋巴结结核和淋巴结炎

我们采用蟾酥注射液注入肿大的淋巴结内并刺破其包膜治疗颈淋巴结结核和淋巴结炎,获得较满意的效果。兹简介于下: 一、适应症;颈、颏、颌下、腋下、腹股沟淋巴结炎及淋巴结结核的结节型病例。对脓肿溃瘘型无效。二、治疗方法:肿块处常规皮肤消毒,术者以拇指、食指、中指呈三角形按压固定肿块,右手持注射     

远端带锁髓内针治疗肱骨干骨折术后并发桡神经损伤原因分析

目的探讨肱骨干骨折应用远端带锁髓内针内固定治疗术后并发桡神经损伤的特点及病因分析。方法本院2009年4月～2012年1月收治肱骨干骨折患者42例,应用远端带锁髓内针内固定治疗术后并发桡神经损伤3例,分析其临床表现、致病原因、诊治方法。结果并发桡神经损伤病例均随访半年,其中2例完全恢复,另1例肌电图示完全性损伤,神经功能无恢复。结论解剖层次不清、髓内针锁钉特点、骨折部位是应用远端带锁髓内针治疗肱骨干骨折损伤桡神经的主要原因。熟悉解剖和改进医疗器械可能避免和减少损伤。     

Permeability of latex and polyvinyl chloride gloves to fluorouracil and methotrexate

The permeability of latex surgical and polyvinyl chloride (PVC) examination gloves to fluorouracil and methotrexate was studied using a radiotracer method. Drug-tracer solutions for both drugs were prepared by combining tritiated fluorouracil or methotrexate with fluorouracil or methotrexate injection, respectively. Drug-free solutions were also prepared to be as similar as possible to the vehicles of the commercial injections. Each half of a total of 40 equilibrium-dialysis cells (20 for each glove type) was filled with either the drug-tracer solution or the drug-free solution. The cell halves were then sealed with glove membranes cut from each type of glove and fastened together so that the drug-tracer and drug-free solutions of each respective drug were opposite one another. Samples were collected after 5 to 45 minutes from each dialysis-cell well and analyzed for drug using liquid scintillation counting techniques. Microgram levels of both drugs were detected in the drug-free dialysis wells for both glove types at each sampling time. Except for the methotrexate drug-labeled well sealed with the PVC glove membrane, the amount of drug in the dialysis wells was significantly different at different sampling times. The variability in results using gloves from different lots was also significantly different for both types of gloves. Overall, latex gloves were significantly less permeable than PVC gloves to fluorouracil, and PVC gloves were significantly less permeable to methotrexate than latex gloves. The latex and PVC gloves used in this study both exhibit time-dependent permeability to fluorouracil and methotrexate.(ABSTRACT TRUNCATED AT 250 WORDS)     

Permeability of nitrile rubber, latex, polyurethane, and neoprene gloves to 18 antineoplastic drugs.

The permeability of four glove materials to various antineoplastic drugs was studied. Eighteen antineoplastic drugs posing potential health hazards to handlers were prepared at the highest concentrations normally encountered by hospital personnel. Four glove materials-nitrile rubber, latex, polyurethane, and neoprene-were exposed to the drugs for 30, 60, 90, and 120 minutes. Glove thickness was measured with an electronic digital caliper. Random samples of material were selected from the glove fingertips, and triplicate samples were tested for each drug at each interval. For a majority of the drugs, a bacterial mutagenicity assay was used to measure the amount of drug (if any) that permeated the material. High-performance liquid chromatography was used for drugs not tested with the bacterial assay. The nitrile gloves were the thinnest (0.12 mm), and the latex gloves were the thickest (0.18 mm). The four materials were generally impermeable to each drug. One sample of the nitrile gloves appeared to have a defect, allowing >5% of the drug solution to pass through at 30 minutes. One sample each of the latex, polyurethane, and neoprene gloves demonstrated minimal permeability (< or =1%): One latex glove sample was permeated by carmustine, and paclitaxel permeated one sample each of the polyurethane and neoprene materials. Nitrile rubber, latex, polyurethane, and neoprene gloves were impermeable to 18 antineoplastic drugs in most, but not all, cases.     

Permeability of 13 different gloves to 13 cytotoxic agents under controlled dynamic conditions.

PURPOSE: The permeability of 13 different gloves to 13 cytotoxic agents under controlled dynamic conditions is described. METHODS: Thirteen cytotoxic agents were prepared at the highest concentrations normally encountered by pharmacy personnel. Four glove types--neoprene, natural rubber latex, nitrile, and vinyl--were exposed to the cytotoxic agents for 15, 30, and 60 minutes. Tests were conducted using the middle finger of each glove. Linearity, reproducibility, and sensitivity were evaluated for each drug tested. Assays were run using liquid chromatographic tandem mass spectrometry (LC/MS/MS) and high-performance liquid chromatography with ultraviolet light (HPLC-UV). Permeability testing was conducted using an original system designed to evaluate dynamic constraints, such as rubbing, stretching, and tension. RESULTS: Linearity by LC/MS/MS and HPLC-UV was confirmed at concentrations up to 1000 ng/mL for all drugs. Most glove materials were permeable at rates below ASTM recommendations over the one-hour testing period. Vinyl was the most permeable material. Carmustine permeated the widest variety of materials. Due to the high sensitivity of the analytic methods, all materials displayed low but significant permeability for at least one drug after one hour. Higher resistance to permeation was recorded for all neoprene, some natural rubber latex, and one nitrile glove. CONCLUSION: Neoprene, natural rubber latex, and nitrile gloves displayed the highest resistance to permeation of the 13 cytotoxic agents studied. Additional factors, such as duration of exposure, glove thickness, and drug liposolubility and molecular weight, also affected permeability.     

Permeation of cytotoxic formulations through swatches from selected medical gloves.

The permeability of selected medical glove materials to various cytotoxic agents is described. Fifteen cytotoxic agents were prepared at the highest concentrations normally encountered by hospital personnel. Four single-layer and two double-layer glove systems made of two materials--latex and neoprene--were exposed to the drugs for 30, 60, 90, 120, 150, and 180 minutes. Circular sections of the glove material were cut from the cuff and evaluated without any pretreatment. Permeability tests were conducted in an apparatus consisting of a donor chamber containing the cytotoxic solution and a collection chamber filled with water (the acceptor medium). The two sections were separated by the glove material. Permeating portions, collected in water as the acceptor medium, were analyzed by either ultraviolet-visible light spectrophotometry or high-performance liquid chromatography (HPLC). Permeation rates were calculated on the basis of the concentration of the cytotoxic agent in the acceptor medium. Spectrophotometric measurements were taken every 30 minutes, and HPLC analysis was performed at the end of the three-hour period. Average permeation rates for 14 drugs were low (< 0.2 nmol/[min.cm2]) or no permeation was detected in all glove materials. All glove materials tested were impermeable to most of the cytotoxic agents over a period of three hours. Carmustine was the only agent that substantially permeated single-layer latex glove materials. Permeation of most tested cytotoxic formulations was low through swatches of material from various medical gloves.     

Aseptic technique as a safety precaution in the preparation of antineoplastic agents

A subject of concern among personnel working in cancer chemotherapy treatment areas is the occupational hazard posed by the antineoplastic drugs. A review of the literature reveals a number of proposed safety precautions, including glove boxes, vertical air-flow hoods, masks, gloves, gowns, and routine medical examinations. The concept of using aseptic technique as a safety precaution is presented, with particular emphasis on the importance of maintaining negative pressure in vials. We also discuss the use of ultraviolet light to detect antineoplastic drug spills in a working environment and as a training and evaluation procedure.     

不同类别医务人员对中成药合理应用的认知现状调查与分析

目的:了解不同类别医务人员对中成药合理应用的认知现状,分析存在的问题,为进一步研究合理应用中成药对策提供依据.方法:通过专家采访与指导,制定调查问卷,以北京地区为主并面向全国医务人员进行中成药合理应用的认知现状调查,对调查结果进行统计分析.结果:共有791名医务人员参与本调查,包括中医师、中药师、西医师、西药师和护师....     

Permeability of latex and polyvinyl chloride gloves to 20 antineoplastic drugs

Permeability of latex and polyvinyl chloride (PVC) gloves to 20 injectable antineoplastic drugs was studied. Four types of gloves were evaluated: latex surgical gloves, latex examination gloves, and PVC gloves in two thicknesses. Each glove material was exposed to each drug for 90 minutes, and permeation was tested using a mutagenicity assay. Individual fingertips of thin PVC gloves and latex surgical gloves were tested for permeability at five time points (2-30 minutes) using a doxorubicin coloration assay. All drugs permeated the thin PVC gloves. Latex surgical gloves were definitely permeable to two drugs (carmustine and thiotepa) and exhibited borderline permeability to mechlorethamine hydrochloride. The thick PVC gloves were definitely permeable to four drugs (carmustine, thiotepa, mechlorethamine hydrochloride, and daunorubicin hydrochloride) and exhibited borderline permeability to two drugs (doxorubicin and mercaptopurine). The latex examination gloves were permeable to carmustine, thiotepa, mechlorethamine hydrochloride, and cyclophosphamide. Doxorubicin permeation of individual fingertips of thin PVC gloves varied in time and amount. Doxorubicin did not permeate the latex surgical glove material, but testing with thiotepa showed that individual fingertips of this material also varied in permeability. Glove thickness was a major determinant of permeability; latex surgical gloves were the least permeable and thin PVC gloves the most permeable to the antineoplastic drugs tested. Within individual gloves and glove types, time and amount of permeation were not uniform.     

乌饭树叶醇提取物对四氯化碳致小鼠急性肝损伤的保护作用

目的观察乌饭树叶醇提取物对四氯化碳致小鼠急性肝损伤的保护作用。方法60只小鼠随机分为六组：正常对照组、模型组、联苯双酯组、乌饭树叶醇提取物低、中、高剂量组,用四氯化碳造成小鼠急性肝损伤模型,测定血清谷丙转氨酶（ALT）、谷草转氨酶（AST）、肝组织超氧化物歧化酶（SOD）活性、丙二醛（MDA）含量。肝组织常规HE染色观察。结果急性肝损伤小鼠血清ALT、AST水平以及肝组织MDA含量显著升高,伴SOD活性明显下降,与正常对照组比较有显著差异。预先给予乌饭树叶醇提取物能显著改善小鼠肝损伤,降低血清ALT、AST水平以及肝组织MDA含量,并升高组织SOD活性。结论乌饭树叶醇提取物对四氯化碳致小鼠急性肝损伤有明显保护作用,机制可能与其抗氧化效应和清除自由基的作用有关。     

阿法替尼在EGFR突变的晚期非小细胞肺癌患者治疗中的预算影响分析

目的 在EGFR突变的晚期非小细胞肺癌患者的治疗中,通过评估阿法替尼（Giotrif^®）纳入中国医保报销系统将对社会总治疗费用产生的影响,为医疗保险部门提供决策依据。方法 构建预算影响分析模型,评估将阿法替尼纳入中国医保报销系统后3年（2018-2020年）对医保预算的影响。结果 阿法替尼纳入医保之前与纳入之后相比,3年内医保支付将分别减少3 644,6 632,9 620万元,3年总治疗费用支出将减少19 896万元。结论 该分析预计,将阿法替尼纳入中国医疗报销系统用于EGFR突变的晚期非小细胞肺癌患者的治疗,将降低医保总支出。