内外合治颜面部疔疮两例

<正>1病例资料1.1病例1患者,女,41岁。患者左侧鼻翼"迎香"穴处起粟粒样脓头7 d,周围红肿疼痛,挤压后,红肿蔓延扩散,伴高热寒战、头痛、烦躁不安、目赤、口干苦、大便4 d未解,故来我处求治。检查:体温38.8℃,神志清醒,面部疔疮如粟米大小,疮顶有脓头、周围皮肤色紫黯,肿势波及头面、鼻部,左侧颌部、颈部浅淋巴结均轻度肿大,舌红、苔黄厚,脉数。血常规:白细胞计数22×109/L,中性粒细胞     

窒息新生儿出生体重与血清同型半胱氨酸关系

目的探讨窒息新生儿出生体重对其血清中高同型半胱氨酸血症及低叶酸水平的关系。方法同期出生的新生儿分为正常组和窒息组,并分别分为正常体重及低体重组。应用酶联免疫吸附实验方法检测血清中Hcy水平。应用放射免疫法测定血中叶酸浓度。结果窒息组正常体重儿血清同型半胱氨酸为(10.50±2.19)μmol/L,低体重儿为(15.82±2.51)μmol/L,对照组正常体重儿血清同型半胱氨酸为(7.73±0.61)μmol/L,低体重儿为(7.45±0.43)μmol/L。在窒息组内低体重儿血清同型半胱氨酸水平明显高于正常体重儿(P<0.001),且窒息低体重组儿血清同型半胱氨酸水平明显高于正常对照组儿,不论其出生体重如何(P<0.001)。血清叶酸水平检测结果显示窒息组正常体重儿血清叶酸水平为(2.74±0.16)μg/L,低体重儿为(2.29±0.25)μg/L,对照组正常体重儿血清叶酸为(3.33±0.23)μg/L,低体重儿为(3.02±0.29)μg/L。窒息组患儿无论正常体重儿还是低体重儿其血清叶酸水平变化均不显著(P>0.05)。结论缺氧窒息合并低出生体重者血清同型半胱氨酸水平显著升高。     

医嘱微机化管理的体会

我院从2001年对病房实行微机化管理，经过两年多的运行取得了良好效果。现就医嘱微机化管理中的主要做法与体会介绍如下。     

小儿注射性坐骨神经损伤的脊髓运动诱发电位诊断

目的利用肌电图常规电刺激器测定脊髓运动诱发电位（MEP）技术，建立小儿注射性坐骨神经损伤诊断的新方法。方法采用英国Medelec公司生产的MS6型肌电图机，刺激器采用本机所配刺激器，刺激电压250～300mv，脉宽0．5～1ms。刺激电极为表面鞍型电极。刺激部位：负极处于L1棘突间，正极处于其上方。刺激方式为单次手动触发。记录部位为健、患侧胫前肌群及腓肠肌群。记录电极采用2支单极针电极。结果7例患儿主要异常形式表现为：诱发波的振幅降低，潜伏时延迟。结论测定表明该方法具有直接测定损伤段神经，异常表现出现早等优点。     

高校素质教育的思想政治教育方法论原则初探

思想政治教育在高校素质教育中起着什么的作用，以及在素质教育中思想政治教育应坚持什么样的方法论原则，这是本文作者所思考和要解决的问题。     

Graves病碘海醇封闭后放射性核素治疗1例

患者男,32岁。因心悸、手颤、消瘦伴间断四肢无力于2004年3月第1次入院,确诊为Graves病,予丙基硫氧嘧啶300mg/d治疗12d,症状改善出院。出院15d因粒细胞缺乏再次入院,经治疗后血象恢复正常,拟行放射性核素治疗。其间因5次周期性麻痹发作,行胸腺CT,并使用碘海醇〔商品名Omnipaque(欧米帕克)〕。     

喘息性疾病患儿家长焦虑与社会支持的调查

目的 了解喘息性疾病患儿家长焦虑、社会支持水平的相关性及其影响因素.方法 采用状态焦虑与社会支持问卷时226名喘息性疾病患儿的家长进行调查.结果 患儿家长焦虑评分为30～68(48.47±9.35)分,焦虑与社会支持呈负相关(r=-0.20,P＜0.01).其性别、年龄、文化程度对状态焦虑水平有影响.文化程度对社会支持有影响.结论 喘息性疾病患儿家长入院时焦虑水平较高.需对其进行相关健康教育和心理疏导,帮助其积极调动社会支持,助于患儿临床恢复.     

单极法运动诱发电位的测定方法

目的 本文提出了利用常规肌电图机用电刺激器,采用单极法进行MEP测定的技术方法.方法 单极法:刺激器采用英产MS-6型肌电图机用电刺激器,通过两个自制直径为1.5cm分离的圆盘状电极经皮对大脑皮质及脊髓进行单次超强刺激.结果 单极法有49个肢体呈现为中枢性传导阻滞,阻滞率为40.83%.单极法有61个肢体呈现为中枢性传导阻滞和延迟,异常率为50.83%.结论 通过测定及统计分析表明,该方法具有以下优点:(1)刺激量小,病人易接受.(2)无需专用刺激嚣,经济实用易于推广.(3)定位性能可靠.(4)通过单、双极两种方法的阻滞率和异常率比较,说明单极法更敏感,更易检出异常者.     

胰岛素强化治疗对严重创伤患者炎性反应及预后的影响

Objective To investigate the effects of intensive insulin therapy on inflammatory re-sponse and prognosis of patients with severe trauma. Methods Eighty severely injured patients were di-vided into intensive insulin therapy group (n = 40, IT) and routine therapy group (n = 40, RT) in random pair. At the time of admission, a continuous infusion of insulin (2 -4 U/h) was pumped into the patients of IT group to maintain blood glucose level at 6 -8 mmol/L. Patients in RT group were given routine treatment without administration of insulin. Fever, organ injury, and mortality of patients in 2 groups were recorded. Venous blood was drawn from patients of 2 groups on the morning of post treatment day (PTD) 1, 3, 5, and 7. Values of TNF-α, C-reactive protein (CRP), IL-2, and IL-10 in plasma were assayed. Results High fever appeared in 9 patients in IT group, and WBC exceeded 10.0×109 for more than 3 days in 17 patients in this group, versus 20 and 29 patients respectively in RT group. Dysfunction of 1 organ appeared in 31 pa-tients in IT group and 30 patients in RT group. Dysfunction of 3 organs appeared in 10 patients in IT group and 19 patients in RT group. Dysfunction of 4 organs appeared in 7 patients in IT group and 12 patients in RT group. In IT group, 4 patients died within 3 post-injury day (PID), and 1 patient died after PID 3 (total case fatality: 12.5% ). In RT group, 5 patients died within 3 PID, and 4 patient died after PID 3 (total case fatality: 22.5%). Plasma levels of TNF-α and CRP of patients in IT group were significantly lower than those of patients in RT group on PID 3 - 7 ( P<0.05 or P<0.01 ), while levels of IL-2 and IL-10 of patients in IT group were significantly higher than those of patients in RT group ( P<0.05 or P<0.01 ). Plasma levels of TNF-α ( 1.3±0.6 μg/L) and CRP (55±16 mg/L) of patients in IT group on PTD 7 were lowered to the trough level, and they were significantly lower than those of patients in RT group (3.0±0.8μg/L, 89±20 mg/L, respectively, P <0.01 ). Conclusions Intensive insulin therapy can mitigate systemic inflammatory response and improve prognosis of patients with severe trauma.