某医院新建放射中心职业病危害放射防护预评价

目的 对某二级医院新建放射中心的射线装置进行放射防护预评价,探讨射线装置项目的评价模式。方法 收集该工程项目的基础资料,按照相应的标准及评价目的要求,对理论估算及现场调查进行综合评价。结果 该项目的设计、布置基本合理;通过放射卫生的理论估算,放射人员和公众接受的最大剂量估算值小于国标规定的年剂量限值要求。结论 该二级医院新建放射中心的射线装置的放射防护基本符合国家规定。     

福建省急救中心116例院前猝死的流行病学研究

目的 回顾性调查分析我中心116例院前猝死的流行病学资料,探讨有效提高本地区猝死综合防治能力的策略.方法 回顾性分析我中心2007-01～2009-01间院前猝死116例流行病学资料,分析患者发病的年龄、性别、时间、地点、死因、现场心电图表现、反应时间.结果 本组116例猝死患者中男女比例为1.7∶1;平均年龄66.6岁;每日多发时段为8∶00～11∶00(28.45%)及16∶00～19∶00时(20.7%);且约3/4的患者发生在家中(74.14%),现场无一例目击者行心肺复苏术;死因主要为心脑血管疾病(68.98%);现场心电图多为室颤(42.24%)、心室停搏(46.55%);我中心平均反应时间为8.34 min.结论 通过本研究分析,我们提出"四早",即早期预防、早期监测、早期复苏、早期除颤,这对于提高本地区院前猝死的综合防治能力有重要意义.     

尼美舒利对慢性萎缩性胃炎COX-2及P16表达的影响

目的观察尼美舒利对慢性萎缩性胃炎（CAG）COX-2及p16蛋白表达的影响。方法用甲基硝基亚硝基胍（MNNG）建立CAG大鼠模型,免疫组化等方法观察尼美舒利对CAG中环氧合酶-2（COX-2）和P16蛋白表达的影响。结果尼美舒利能有效降低CAG中COX-2表达水平,同时能上调MNNG诱导的肿瘤抑制基因P16蛋白表达。结论尼美舒利可能在降低胃癌的发生中具有一定的作用。     

面神经瘤27例临床分析

目的:分析面神经瘤患者的临床表现和诊断,讨论不同部位面神经瘤手术方法的选择。方法:对1999-09-2006-12临床资料完整的27例面神经瘤患者进行回顾性研究。结果:27例面神经瘤患者经术后病理证实20例为面神经鞘膜瘤(74.1%),4例为面神经纤维瘤(14.8%),3例为面神经血管瘤(11.1%)。病程中表现为面瘫23例(85.2%);听力下降和耳鸣各11例(40.7%);表现为耳下肿块,且有耳痛、眩晕、耳闷、面部麻木、抽搐5例(18.5%)。24例(88.9%)CT或MRI提示为面神经来源肿瘤。24例(88.9%)累及2个或2个以上的面神经节段,其中累及乳突段处占87.5%(21/24),累及鼓室段处占70.8%(17/24),累及膝状神经节处占62.5%(15/24),累及内耳道占4.2%(1/24);只累及面神经的1个节段占11.1%(3/27)。27例均手术完整切除肿瘤,其中13例进行了同期面神经重建术,包括11例腓肠神经移植术,1例面-舌下神经吻合术,1例面神经端端吻合术。2例在切除肿瘤的同时保留了面神经解剖结构的完整性。结论:面神经瘤是一种较少见的良行肿瘤,临床症状多样,CT、MRI等影像学检...     

我国八个大中城市院前急救流行病学调查分析

Objective To investigate the epidemiological information of patients in pre-hospital medical care for our large and medium-sized cities and probe the patients' characteristic. Method The data in 2008 were exported from the computer databases of 8 large and medium-sized cities' emergency medical centers in our country.The thorough records of data were conducted to statistical analysis. Results ( 1 ) The scheduling time, running time, rescue time, returning time, total time and service radius in the pre-hospital medical care group were 2.16± 1.10(min), 14.01 ±6.82(min), 12.12±5.96(min), 14.08± 6.85(min), 42.34± 20.21(min)and 8.50±4.18(km), and the above parameter in the non-death group were 2.19 ± 1.13(min), 14.15 ± 7.14(min),11.60±6.72(min), 14.92 ±6.89(min), 41.86± 19.53(minutes) and 8.63±4.31(Km), and the above parameter in the death group were 2.10± 1.08(min), 13.68 ± 7.14(min), 25.25 ± 12.34(min), 13.75±6.48(min), 54.74 ± 25.47(min) and 7.86± 3.91(Km), and the above parameter in the non-sudden cardiac death group were2.09± 1.03(min), 13.58±6.78(min), 25.53± 12.34(min), 13.60± 6.54(min), 53.79±23.77(min) and 7.67 ± 3.86(Km), and the above parameter in the sudden cardiac death group were 2.12 ±1.02(min), 14.10±7.05(min), 24.79± 12.08(min), 13.79±6.61(min), 54. 80 ± 25. 36( min) and 7.90±3.92(Km) respectively. The scheduling time, running time, returning time and service radius in the death group were less than those of the non-death group, but the rescue time and total time of the former were more than those of the latter respectively ( P ＜ 0.05 or P ＜ 0. 001 ). The scheduling time and returning time didn' t have significant difference between the sudden cardiac death group and the non-sudden cardiac death group respectively ( P ＞ 0.05), but the running time, total time and service radius of the sudden cardiac death group were more than those of the non-sudden cardiac death group, and the rescue time of the former was less than that of the latter respectively ( P ＜ 0.05 or P ＜ 0.001 ). (2)The patients' amount in pre-hospital medical care group, the non-death group, the death group, the non-sudden cardiac death group and the sudden cardiac death group were at most in first quarter, and the least time slice of patients' amount were 4:00～ 6:00, 4:00～6:00, 4:00～ 6:00, 22:00～ 24:00, 2:00～4:00 respectively, and the most time slice of patients' amount were 20:00～ 22:00, 20:00～22:00, 8:00～ 10:00, 2:00 ～ 4:00, 8:00 ～ 10:00 respectively. (3)In 241 876 cases of pre-hospital medical care group, the patients' amount of trauma was at most, whose age grades was by far among21 ～50, and the others in sequence were nervous system, circulatory system, other group, digestive system, respiratory system and poisoning group respectively, whose age grades in nervous system, circulatory system and respiratory system was by far above 51, especially above 70. The patients' age grades in other group and digestive system had two climax age groups, which the one was 21 ～ 30, and the other was above 70. The patients' age grades in poisoning group was by far among 21 ～ 50, which the patients' amount of acute alcoholism was at the most. (4) In 12 568 cases of death group, the death amount of circulatory system, other group, respiratory system, nervous system and digestive system ranked at the lst,2nd,4th,5th 8th respectively, whose age grades was by far above 51, especially above 70,and the patients' amount of sudden cardiac death was at the most in the death amount of circulatory system. The death amount of trauma and poisoning group ranked at the 3rd, 6th respectively, whose age grades was by far among 21 ～ 50. (5)The total amount, the death amount and the sudden cardiac death amount of male patients were more than those of female patients. (6)The percentage of the death group to the pre-hospital medical care group was 5.20%, and the percentage of the sudden cardiac death group to the pre-hospital medical care group was 1.29%,and the percentage of the sudden cardiac death group to the death group was 24.87 %, and the percentage of the sudden cardiac death group to the circulatory system group was 67.33 %. Conclusions ( 1 )The trauma and the sudden cardiac death are the overriding reason of disease and the overriding reason of death in our large and medium-sized cities respectively. (2) It is very important to cut the death rate of the middle-old age patients by strengthening prevention and cure of cardiovascular and cerebrovascular diseases, discerning the critical illness early and improving the level of pre-hospital medical care. (3)It is a strong method to decrease the total amount and the death amount of the trauma, especially in traffic accident, by strengthening safety in production, observing traffic regulation and enhancing the legal awareness.     

单纯注射A型肉毒杆菌毒素与注射A型肉毒杆菌毒素联合支架置入治疗贲门失弛缓症的疗效比较

目的比较单纯注射A型肉毒杆菌毒素(注射组)和注射A型肉毒杆菌毒素联合短期置入镍钛记忆合金支架(联合组)治疗贲门失弛缓症的近、远期疗效。方法将检查确诊为贲门失弛缓症的25例患者,分为两组,即单纯注射A型肉毒杆菌毒素组(注射组)和注射A型肉毒杆菌毒素联合短期置入防反流镍钛记忆合金支架组(联合组)。治疗后通过对临床症状、X线钡餐检查等进行分析,并进行随访。结果注射组和联合组在术前1周钡餐检查结果中吞钡后5 min钡柱的高、宽之间差异无显著性。术后1周和术后12个月时吞钡后5 min钡柱的高、宽之间差异有显著性。结论联合组无论在早期,还是在中远期,治疗效果较单纯注射A型肉毒杆菌毒素明显,且无严重并发症,值得临床推广。     

右腋下切口心脏不停跳术在小儿先天性心脏外科的应用

目的报告右腋下切口心脏不停跳术在小儿先天性心脏外科的应用。方法65例患者均采用右侧腋中线切口长约8～12cm,经第3或4肋间进胸,在心脏跳动下行房间隔缺损修补术32例,室间隔缺损修补术26例,法乐三联症矫治术5例,肺动脉瓣狭窄成形术2例。结果全组无围手术期死亡,无空气栓塞所致的并发症。1例ASD患者术后左肺不张。所有患者出院前复查心脏彩超检查结果满意。结论右腋下切口心脏不停跳术治疗小儿先天性心脏病简化了操作程序,最大限度地避免了再灌注损伤;切口隐蔽,无胸部的畸形愈合及钢丝残留,减轻了患者的心理负担。     

护理本科与专科实习生对临床护理实践教学需求的调查分析

[目的]了解护理本科与专科实习生对临床护理实践教学需求的状况和差异性,为今后科学制订临床实习计划和合理安排临床护理带教老师提供理论依据。[方法]随机抽取2008年6月来我院实习的本科和专科护理实习生各60人,采用自制问卷对其进行有关临床护理实践教学需求情况调查。[结果]护理本科实习生与专科实习生在带教方式、教学内容、带教老师要求的某些方面存在差异（P〈0.05）,对总实习时间、教学环境及带教老师学历和职称的要求无差异（P〉0.05）。[结论]护理本科与专科实习生对临床实践的需求不同,临床护理教学管理人员应根据护生的需求制订切实可行的教学实习计划,提高临床带教老师的整体素质,以提高临床教学质量和护生的实习满意度。     

川芎嗪诱导大鼠骨髓间充质干细胞分化为神经元样细胞:最佳诱导剂量筛选

背景:目前用于体外诱导骨髓间充质干细胞向神经元样细胞分化的诱导剂众多,但多数化学诱导剂具有毒性不适合用于人体.目的:观察中药川芎嗪对大鼠骨髓间充质干细胞分化为神经元样细胞的影响,并寻找川芎嗪诱导分化的最佳浓度.方法:SD大鼠麻醉后无菌条件下取出股骨和胫骨,离心后弃上清液,加入含体积分数为15%胎牛血清的L-DMEM培养基重新悬浮细胞并转入培养瓶培养传代,用免疫细胞化学方法检测第5代骨髓间充质干细胞CD44、CD45的表达;取含1.00,1.25,1.50 g/L 3种剂量盐酸川芎嗪注射液的无血清L-DMEM培养基对体外培养的第5代骨髓间充质干细胞进行诱导.倒置相差显微镜下观察细胞形态变化,免疫细胞化学方法检测已诱导细胞巢蛋白、神经元特异性烯醇化酶和胶质纤维酸性蛋白的表达,比较3种剂量盐酸川芎嗪注射液诱导神经元样细胞抗原表达率.结果与结论:①原代细胞接种3 d后多数细胞贴壁,传代后细胞贴壁速度和增殖更快,第5代基本纯化为骨髓间充质干细胞,细胞呈放射状或漩涡状排列.②第5代骨髓间充质干细胞(98.02±0.81)%CD44表达阳性,CD45表达阴性.③诱导后细胞出现类似神经元细胞样形态;免疫细胞化学方法检测显示多数细胞巢蛋白、神经元特异性烯醇化酶阳性表达,1.25 g/L浓度组细胞的神经元特异性烯醇化酶阳性表达率最高.提示川芎嗪可诱导骨髓间充质干细胞分化为神经元样细胞,1.25 g/L为最适诱导剂量.     

我国大中城市院前心脏性猝死流行病学调查分析

目的调查我国大中城市院前心脏性猝死患者流行病学情况,探讨院前心脏性猝死病例特点。方法从我国8个大中城市急救中心系统数据库中导出2008年度全部死亡数据,就其有完整记录的资料进行统计分析。结果①院前心脏性猝死的调度时间、到达时间、现场时间、返回时间、总时间、急救半径分别为（2．12±1．02）min、（14．10±7．05）min、（24．79±12．08）min、（13．79±6．61）min、（54．80±25．36）min、7．90±3．92（km）;②院前心脏性猝死的病例数以第一季度为最多,且最多时间段是8：00～10：00,最少时间段是2：00～4：00;③男性院前心脏性猝死明显多于女性,但年龄明显小于女性;④院前心脏性猝死目击者CPR为4．48％,医护人员现场CPR成功率2．26％。结论①心脏性猝死已成为我国大中城市最常见的院前死亡原因;②加强心血管病防治,提高中老年患者的常见急危重症早期识别与院前急救水平以及普及公众CPR对降低死亡有重要意义。