62例老年鼻出血患者的护理体会

鼻出血是耳鼻喉科的常见急诊，特别老年人鼻出血的发病率高，对失血的耐受性差，容易发生休克或心力衰竭，甚至危及病人的生命。因此，护理人员应积极配合医生止住鼻出血，严密观察病情变化，采取得当的护理措施，防止再出血。现将护理体会总结如下。     

糖尿病酮症酸中毒患儿氧化应激状况及影响因素分析

Objective To investigate the oxidative stress state in children with diabetic ketoacidosis (DKA),and analyze whether any observed abnormalities were related to metabolic disturbances.Methods Four groups of subjects were studied,comprising with 22 patients with DKA(group 1),18 diabetic children with medium metabolic control,whose glycated hemoglobin(HbAlc) below 9%(group 2),22 children with poorly controlled diabetes,whose Hbal c above 9%(group 3),and 36 healthy control children(group 4).Malondialdehyde(MDA),nitrate oxidase(NO),glutathione peroxidase(GSH-Px),superoxide dismutase(SOD),and metabolic parameters such as fasting blood glucose,HbAlc,blood gas analysis,serum ion,renal function of the subjects were measured.Results Mean serum MDA value was significantly higher in group 1 than in group 2(P ＜0.01) and group 4(P ＜0.01),but was not different from that in group 3 (P ＞0.05).Serum levels of NO were significantly higher in group 1,2 and 3 compared with group 4(P＜0.01).Serum levels of GSH-Px were significantly lower in group 1,2 and 3 than in group 4(P＜0.01).There were no significant differences of serum SOD value among the four groups(P＞0.05).Both serum MDA and NO values in the diabetic patients(groups 1 +2 +3) were positively related to HbAlc(r=0.375,P ＜0.01;r=0.250,P ＜0.05),and serum SOD values in the DKA patients were negatively related to HbAlc(r= -0.507,P＜0.05),there were not any significant relationship between the other oxidative markers and metabolic parameters.Conclusion There is an increase of oxidative stress and decrease of antioxygenic ability in DKA children,and these changes tend to correlate more with markers of diabetic imbalance than with parameters of acute metabolic disturbances of DKA.     

基体改进剂在尿镉测定中的应用

镉是对人体有害的金属之一。随着现代工业的发展，人们接触镉的机会不断增高。人体吸收的镉主要经肾脏从尿排出，因此尿镉的测定可以反映人长期接触镉的水平。测定尿镉常用的方法有石墨炉原子吸收光谱法。尿样是一种基体成分非常复杂的生物材料，测定结果极易受到基体的干扰。本文以氯化钯一硝酸铵为基体改进剂，能有效消除尿镉测定中的基体干扰。     

胚胎干细胞来源神经前体细胞在缺氧缺血性脑损伤海马内的分化

目的 研究胚胎干细胞（ESC）来源的神经前体细胞移植入缺氧缺血性脑损伤（HIBD）脑内后，在海马的迁移和分化。方法小鼠ESC体外培养和诱导分化，制作小鼠HIBD模型。术后第2～3天，将细胞植入损伤侧侧脑室。对脑组织进行病理学、聚合酶链反应（PCR）、X-gal和免疫荧光组化染色等检测。结景小鼠ESC在特定条件下，能成功诱导分化为神经前体细胞。细胞移植后，经PCR检测和X-gal染色发现能长期存在于脑内，并迁移、分布于受损海马，构成海马结构，经进一步免疫荧光检测发现可分化为神经元；同时病理学检测亦发现细胞移植后受损海马内的神经细胞数量明显增加。结论体外经过特定的诱导分化后。ESC被定向诱导分化为神经前体细胞，植入HIBD小鼠脑内后，能迁移至损伤海马，分化为神经元，替代损伤或坏死的神经细胞。是其发挥治疗作用的可能机制之一。     

人T-bet基因的克隆及序列分析

目的：克隆人T-bet基因全长编码区的cDNA，并进行豁定和测序分析，为从转录水平研究Th1／Th2平衡及其与免疫相关性疾病发生发展的关系奠定基础。方法：采用RT-PCR方法，从人外周血淋巴细胞获得T-bet基因的cDNA；连接至pGEM-Teasy载体，导入大肠杆菌DH5α并选择阳性克隆；应用M13F／R通用引物进行双向反应测序，以作序列鉴定。结果：扩增得到的T-bet基因cDNA全长1670 bp，包括编码区1607 bp，编码530个氨摹酸残基，与Genbank中发表的序列完全一致。结论：获得了人T-bet基网的克隆，为进一步研究其生物学功能构建了基础平台，为寻找多种免疫性疾病的有效治疗提供新思路。     

重组人促红细胞生成素在肝癌行肝移植患者中的应用

目的评价重组人促红细胞生成素在纠正原发性肝癌而预行原位肝移植术受者的术前贫血状态的疗效,以及减少受者在原位肝移植手术中和手术后异体血液输注量的效果.方法对诊断为原发性肝癌准备肝移植的受者,20人随机分为治疗组和对照组,治疗组应用人重组促红细胞生成素-β皮下注射,同时口服琥珀酸亚铁.对照组单纯口服琥珀酸亚铁.分别测定研究对象在用药前、用药结束、第4天的外周血指标,记录研究对象术中和术后失血量、异体血液输注量和研究期间可能出现的用药相关性并发症.结果患者用药前治疗组和对照组基础参数值亦无差别(P＞0.05),用药后对照组无明显变化(P＞0.05),而治疗组用药后各参数指标均明显提高,;术后第4日各参数指标比较两组有差别,治疗组略高于对照组(P＜0.05);术中失血量两组无差别(P＞0.05),而治疗组异体输血量为510±255ml,对照组为925±239ml,两组比较有明显差别(P＜0.01),治疗组明显小于对照组.治疗组和对照组术后输注异体血液的人数,治疗组均少于对照组.结论应用重组人促红细胞生成素可以明显改善肝移植受者术前存在的贫血状态,减少术中异体血液的输注量和术后继续需要输注异体血液的可能.     

60例糖尿病下肢血管彩色多普勒超声诊断分析

目的：探讨糖尿病患者下肢血管病变发生率及时间。方法：60例糖尿病均进行下肢血管超声检查。结果：糖尿病患者下肢血管发生明显病变，以足背动脉显著，胫后动脉、胭动脉次之，动脉损害均为双侧及多节段性的。结论：彩色多普勒超声对糖尿病患者下肢血管病变的早期诊断、疗效观察及预防下肢坏疽的发生有重要临床价值。     

糖尿病酮症酸中毒患儿氧化应激状况及影响因素分析

Objective To investigate the oxidative stress state in children with diabetic ketoacidosis (DKA),and analyze whether any observed abnormalities were related to metabolic disturbances.Methods Four groups of subjects were studied,comprising with 22 patients with DKA(group 1),18 diabetic children with medium metabolic control,whose glycated hemoglobin(HbAlc) below 9%(group 2),22 children with poorly controlled diabetes,whose Hbal c above 9%(group 3),and 36 healthy control children(group 4).Malondialdehyde(MDA),nitrate oxidase(NO),glutathione peroxidase(GSH-Px),superoxide dismutase(SOD),and metabolic parameters such as fasting blood glucose,HbAlc,blood gas analysis,serum ion,renal function of the subjects were measured.Results Mean serum MDA value was significantly higher in group 1 than in group 2(P ＜0.01) and group 4(P ＜0.01),but was not different from that in group 3 (P ＞0.05).Serum levels of NO were significantly higher in group 1,2 and 3 compared with group 4(P＜0.01).Serum levels of GSH-Px were significantly lower in group 1,2 and 3 than in group 4(P＜0.01).There were no significant differences of serum SOD value among the four groups(P＞0.05).Both serum MDA and NO values in the diabetic patients(groups 1 +2 +3) were positively related to HbAlc(r=0.375,P ＜0.01;r=0.250,P ＜0.05),and serum SOD values in the DKA patients were negatively related to HbAlc(r= -0.507,P＜0.05),there were not any significant relationship between the other oxidative markers and metabolic parameters.Conclusion There is an increase of oxidative stress and decrease of antioxygenic ability in DKA children,and these changes tend to correlate more with markers of diabetic imbalance than with parameters of acute metabolic disturbances of DKA.     

城区居民对生活垃圾收集与处理认知水平调查

近年来，随着经济的发展和城市化进程的加快，城市环境的保护和可持续发展愈来愈成为国家和社会关注的议题。做好城市生活垃圾收集与处理问题一直是城市建设的一个重要环节。而城市居民对生活垃圾分类收集与处理的认知水平是这一环节的基础。本通过对西宁市城西区居民就生活垃圾分类收集与处理认知水平的调查分析，掌握和了解城西区居民对生活垃圾分类收集与处理认知水平状况，为进一步落实、搞好城市生活垃圾分类收集与处理提供可靠的理论依据。     

注射液不溶性微粒检查中纯化水处理

目的制备可供不溶性微粒检查用纯化水。方法在超净台下,对纯化水用0.45μm密闭滤器过滤处理,用微粒分析仪检测10μm以上的粒子数。结果检验处理前与处理后的纯化水5个批次,含有10μm以上的粒子数,均达中国药典每100ml含10粒以下的要求。结论该法操作简单,处理后的纯化水达到中国药典2000年版规定的纯化水要求,提高了检验的准确性。