急性上呼吸道感染患者抗菌药物应用的回顾性分析

目的:分析急性上呼吸道感染患者抗菌药物的合理性应用.方法:对本院2010年6月份520例上呼吸道感染患者的门急诊处方进行回顾性分析.结果:520张处方中,应用抗菌药物450例,使用率为66.5%,多为单一口服用药,部分联合静脉滴注左氧氟沙星注射液或者头孢曲松、头孢唑林等.阿莫西林分散片居首位,其次为大环内脂类的阿奇霉素分散片、罗红霉素颗粒、喹诺酮类的左氧氟沙星、头孢菌素类、B-内酰胺类加酶抑制剂.结论:我院医师在治疗急性上呼吸道感染时,这种滥用现象值得重视.医院更应加强对临床医师抗菌药物知识的培训与再教育,提高抗菌药物的临床合理应用水平.     

探讨抗消化性溃疡药物的合理应用

目的:探讨抗消化性溃疡药物的合理应用,总结经验.方法:通过对消化性溃疡药物的选用原则、合理应用、综合治疗等方面来论述,减少药物不良反应的发生.结果:抗消化性溃疡药物的合理应用可以使患者得到及时、合理、有效的治疗.结论:消化性溃疡药物的合理应用值得临床推广.     

围手术期抗菌药合理使用及临床效果分析

目的:评价医院外科围手术期抗菌药物应用的合理性并对合理用药的临床效果进行评价,以期为临床合理用药提供依据.方法:对本院外科2010年6月-12月符合围手术期要求的160份病历进行回顾性分析,统计用药合理性比例以及合理用药的临床效果.结果:本院外科围手术期合理用药比例较低,仅占20.62%.比较术后感染发生率、住院时间以及住院费用不合理用药组明显高于合理用药组.结论:针对调查中发现的问题,应加强对抗菌药物临床应用的监督管理,从而提高抗菌药物应用的合理性,尽最大可能地减少药源性疾病及细菌耐药性的发生,提高临床药物治疗水平.     

口服头孢克洛胶囊致血尿1例

本文报告的患儿之前无血尿病史,而且之前有服用头孢类药物史并无不良反应发生.头孢克洛胶囊属第二代头孢菌素类,在临床中因其抗菌谱广,作用强,毒性低,对葡萄球菌(包括产酶菌株)、化脓性链球菌、肺炎链球菌、大肠埃希菌、奇异变形杆菌,流感嗜血杆菌等有良好的抗菌作用.且因价格低廉,在社区医院应用较广.     

浅谈盆腔炎性疾病的中医疗法

目前西医对盆腔炎的治疗主要是抗生素药物治疗,大多流于急性期的抗炎治疗,往往能起到一定的效果,但对于一些顽固的,慢性迁延期的盆腔炎并无切实有效的良法.且西药抗菌局部吸收效果欠佳,长期使用还容易导致菌群失调和耐药性.祖国医学在长期发展过程中,对本病已经有了系统的认识,中医药治疗本病方法多样,疗效明显,并可避免长期使用抗生素引起的一系列不良反应,具有较大的优势.本人在临床上对本病的临床治疗也取得了一定效果同,现以下介绍几种特色中医疗法.     

探讨药师合理应用抗菌药物的临床要点

目的:探讨临床药师如何在医院抗菌药的合理用药中发挥作用.方法:临床药师通过参与抗菌药物合理使用监测、制定抗菌药物临床应用实施细则、临床查房、开展药学讲座等方法,开展药学服务.结果:规范了医院抗菌药物的预防使用,使临床抗感染疗效大为提高.结论:临床药师积极参与临床药学服务,促进了医院抗菌药物的合理、安全使用.     

抗组胺药物的合理联合用药探讨

抗组胺药物自1937年开发以来,在临床上的应用越来越频繁.在临床的不断试验中,抗组胺药物对患者的不良反应也逐渐被人们所重视,随着产生了2代、3代抗组胺药物.由于1代、2代、3代抗组胺药物各自的作用特点不同,因此,我们要深入了解抗组胺药物的分类及药理作用,合理用药,减少不良反应.     

浅谈护士给药安全隐患

给药是临床护理工作中的主要护理技能之一,也是临床治疗疾病的重要手段.近年来,大量药物不断进入医院,在人类防病、治病、保障身体健康方面发挥了重要作用,但大多数药物都或多或少有一些不良反应,由于疾病对药物的疗效、不良反应都有不相同,当患者遵守医师确定的治疗方案及药师对其服用药物方面的指导时,因此,护士提高患者用药指导,采取有效的防范措施,严格遵守各项规章制度和标准操作规程,保障临床患者的用药安全,降低药物不良反应的发生率,是护士对患者义不容辞的责任和义务.     

清洁手术抗菌药物预防使用情况分析

目的:了解清洁手术抗菌药物预防使用情况,分析存在问题,以促进抗菌药物的合理使用.方法:采用回顾性调查方法,对3种清洁手术(甲状腺手术、乳腺手术、疝气修补术)186例中预防用抗菌药物的使用品种、使用频率、使用时间等进行调查分析.结果:清洁手术抗菌药物预防使用存在多方面不合理性.结论:清洁手术抗菌药物预防使用需进一步规范管理.     

围手术期抗菌药物合理应用依从性调查分析

目的:对各种因手术而住院的患者在应用抗菌性药物的情况及合理性进行调查分析.方法:对2007年3月到2011年3月在我院就诊的213例手术患者,就抗菌性药物的应用种类、联合用药方式等几方面进行统计学分析.结果:通过加强对围手术期抗菌性药物的用药的管理工作,并制定可行的规章制度结合定期监测及结果反馈等手段,发现我院手术患者的抗菌性药物总使用率以经达到95.98%,其中单独使用、二联、三联及以上的患者百分比分别为45.83%,44.91%,44.86%,9.23%预防性应用达到89.73%,分析认为合理应用抗菌性药物占39.41%,基本合理的应用抗菌性药物占35.62%,其中有23.98%的患者没有合理的使用抗菌性药物.结论:对使用抗菌性药物的患者加强管理,对围手术期抗菌性药物的应用执行规范的使用原则是非常重要的药物的使 用原则非常重要.     

Voices of fear and anxiety and sadness and depression: The effects of speech rate and loudness on fear and anxiety and sadness and depression.

Two studies investigated the role of expressive vocal behavior (specifically, speech rate and loudness) in fear and anxiety and in sadness and depression. In the 1st study, participants spoke about personally experienced fear and anxiety-arousing and neutral events using 3 different voice styles: fast and loud, normal, and slow and soft. In the 2nd study, participants spoke about personally experienced sad or depressing and neutral events using the same 3 voice styles. In both studies, the participants' highest levels of subjective affective and cardiovascular (CV) arousal occurred when they spoke about the emotional events in a mood-congruent voice style: fast and loud in the case of fear and anxiety, and slow and soft in the case of sadness or depression. Mood-incongruent voice styles canceled the heightened levels of CV arousal normally associated with these negative emotions. The voice-style manipulation had no significant effect on the participants' levels of CV arousal during the neutral discussions. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Synthesis and analysis of mixed chlorinated-fluorinated dibenzo-p-dioxins and dibenzofurans and assessment of formation and occurrence of the fluorinated and chlorinated-fluorinated dibenzo-p-dioxins and dibenzofurans

Despite the use of multimodal therapy, higher-grade glioma is still uniformly fatal in the adult population. There is a considerable difference between the length of survival in each given patient, even within the same tumor type and malignancy grade group, suggesting that there are factors that might differentially influence outcome. To identify such factors, 107 patients with anaplastic or malignant glioma were retrospectively investigated. Clinical parameters and paraclinical data on the p53, mdm2, and EGFR genes at the DNA or protein level were evaluated by univariate analysis and Cox proportional hazards regression modeling. Kaplan-Meier survival estimation demonstrated that immunohistochemical positivity for mdm2 protein in patients with anaplastic astrocytoma or with glioblastoma multiforme was associated with a shorter survival time (p = 0.02). P53 gene mutations and immunopositivity for the epidermal growth factor receptor (EGFR) protein were not significantly related to poor prognosis. The Cox proportional hazards model revealed immunohistochemical positivity for p53, mdm2, or for both of them, the presence of postoperative irradiation, and the extent of surgical resection of tumor to be variables significantly associated with prolonged survival. EGFR overexpression, age over 60 years, and Karnofsky performance score below 40 points did not significantly shorten survival time. In conclusion, the present study identified immunohistochemically detected mdm2-protein overexpression as a statistically significant negative prognostic parameter in patients bearing anaplastic or malignant glioma. Association analysis of variables revealed a possible correlation between mdm2 and p53, which is also consistent with the biological interaction mode of both proteins in vivo.     

Sexuality and aging--usual and successful

BACKGROUND: As aging research increasingly reflects an effort to dissociate true time-driven changes from those that can be improved, sexuality in later life remains largely unexplored. Several problems are evident. There is a lack of normative data, a lack of a conceptual framework relating to the biology, psychology, and sociology of sex, and an attitudinal resistance that obscures the entire topic. METHODS: We conducted a three-part instructional series on major topics involved with sexuality and aging. We surveyed our group of attendees (n 158, average age 68 for males, 65 for females) before and after the series. RESULTS: A remarkably robust sex life was evidenced by both the men and the women, even until advanced old age. Yet, a substantially decreased involvement was reported from 10 years earlier. Despite current activities, people of both sexes wished they were participating even more than they currently were. Impotency was identified as the major negative feature for the men; relationship problems were for the women. A questionnaire 6 months after the series reported improved sexual attitudes, but no change in sexual activities from the earlier survey. CONCLUSION: Sexuality is a major quality-of-life issue which persists into old age. Our study showed that the usual sexual practices reported by our group were not considered by them to be ideal. The intervention of this instructional series provided improved sexual attitudes but not performance. Additional studies are encouraged.     

Larks and owls and health, wealth, and wisdom

OBJECTIVE: To test the validity of Benjamin Franklin's maxim "early to bed and early to rise makes a man healthy, wealthy, and wise." DESIGN: Cross sectional analysis of sleeping patterns in a nationally representative group of elderly people, and longitudinal investigation of mortality. SETTING: Eight areas in Britain (five in England, two in Scotland, and one in Wales). SUBJECTS: 1229 men and women aged 65 and over who in 1973-4 had taken part in a survey funded by the Department of Health and Social Security and for whom data on sleeping patterns, health, socioeconomic circumstances, and cognitive function had been recorded. MAIN OUTCOME MEASURES: Self reported income, access to a car, standard of accommodation, performance on a test of cognitive function, state of health and mortality during 23 years of follow up. RESULTS: 356 people (29%) were defined as larks (to bed before 11 pm and up before 8 am) and 318 (26%) were defined as owls (to bed at or after 11 pm and up at or after 8 am). There was no indication that larks were richer than those with other sleeping patterns. On the contrary, owls had the largest mean income and were more likely to have access to a car. There was also no evidence that larks were superior to those with other sleeping patterns with regard to their cognitive performance or their state of health. Both larks and owls had a slightly reduced risk of death compared with the rest of the study sample, but this was accounted for by the fact that they spent less time in bed at night. In the study sample as a whole, longer periods of time in bed were associated with increased mortality. After adjustment for age, sex, the presence of illness, and other risk factors, people who spent 12 or more hours in bed had a relative risk of death of 1.7 (1.2 to 2.5) compared with those who were in bed for 9 hours. The lowest risk occurred in people who spent 8 hours in bed (adjusted relative risk 0.8; 0.7 to 1.0). CONCLUSION: These findings do not support Franklin's claim. A "late to bed and late to rise" lifestyle does not seem to lead to socioeconomic, cognitive, or health disadvantage, but a longer time spent in bed may be associated with increased mortality.     

Spondylolysis and spondylolisthesis and sports

Spondylolysis and spondylolisthesis occur predominantly in the lower lumbar spine. Besides congenital defects such as predisposition of spondylolysis the correlation between competitive sports activities and an increased incidence of spondylolysis is proved. In early stages, complete healing can be achieved by conservative treatment (abstinence from sports activities for 3 months, orthesis). Persistence of pain, neurologic symptoms and progression of vertebral slipping are indications for operative treatment (reconstruction of the isthmus, dorso-ventral spondylodesis). The exercise tolerance depends on the extent of instability, progression of vertebral slipping and clinical symptoms. The limits of exercise tolerance vary among the individual athletes and require the decision of the physician. Backstroke swimming, abdominal and back muscle strengthening exercises, and types of sport involving smooth movements are advisable. Sports education in school is possible without restriction in patients with stable spondylolysis and in those with spondylolisthesis without unfavourable concomitant factors.     

IQ and ego-resiliency: Conceptual and empirical connections and separateness.

The constructs of intelligence and ego-resiliency are discussed. The personality implications of "pure intelligence" and "pure ego-resilience" were identified. Intelligence (IQ) was indexed by the Wechsler Adult Intelligence Scale-Revised (WAIS—R) and ego-resiliency by an inventory scale. Residual scores measuring "pure intelligence" and "pure ego-resilience" were correlated with the items of the observer based California Q-sort, used to describe participants. Persons relatively high on ego-resilience tend to be more competent and comfortable in the "fuzzier" interpersonal world; persons defined primarily by raw IQ tend to be effective in the "clearer" world of structured work but tend also to be uneasy with affect and less able to realize satisfying human connections. Gender differences exist in the relations of ego-resilience and intelligence and in their adaptive relevance. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Conserving and retaining equalities and inequalities through observation and correction.

Investigated the effects of modeling and corrective feedback on the conservation of equalities and inequalities, with items spanning 3 stimulus dimensions (length, number, and 2-dimensional space). Ss were 48 kindergartners (24 boys, 24 girls). Brief observation of a model, briefer correction training (joining positive feedback with verbal rule provision), and the combination of observation and correction were all successful in producing learning and, without further training, transfer and retention of conservation. Unlike the controls (who also never correctly answered any equality items), the trained experimental Ss gave evidence of spontaneously generalizing their new learning to a task that required nonverbal behavior to manifest conservation. (17 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Reasoning and food and contamination.

Examines strategies that are used to reason about food and contamination. In Exp 1, Ss refrained from choosing a substance that had been given a "poison" label when the intent of the labeler was ambiguous or malicious but preferred this substance when a rationale was provided that dispelled the implication that there once might have been contaminants present. Exp 2 was designed to compare the effects of safety on conditional reasoning in food and food-irrelevant contexts. When the safety issue was relevant to food in the form of contamination, Ss were most likely to use formal logic in reasoning. A similar pattern of responses was found in Exp 3 on tasks for which Ss' ratings of their experience of contexts were matched for plausibility, experience, and danger. Results are discussed in terms of an adaptive constraint that facilitates rationality in reasoning within the food domain (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

深云立交桥梁检测及加固改造

根据深云立交桥梁的检测结果，对该桥目前的整体状况、工作状态，及其使用情况做出综合评价，对桥的病害原因进行了分析，并提出合理的加固方案。