疼痛管理在创伤骨科护理管理中的应用价值

目的探究创伤骨科护理管理中疼痛管理的应用价值。方法 82例患者选取于2017年6月-2018年6月,所有患者均来源于本院骨科收治的住院患者,数字表为患者分组原则,常规组41例,疼痛组41例,分别予以常规护理、常规护理+疼痛管理,比较满意度、疼痛评分及平均住院时间。结果疼痛组满意度92.68%比常规组73.17%高,差异具有统计学意义(χ^2=5.513,P <0.05),患者干预后的疼痛评分低于常规组,平均住院时间短于常规组,差异存在统计学意义(P<0.05)。结论疼痛管理用于创伤骨科护理管理中,患者疼痛明显减轻,患者满意度高,缩短了患者的平均住院时间。     

基础医学综合实验与实验设计课程教学改革实践

本着以课程为中心的原则，研究组在基础医学综合实验课程建设、运行方式、教学方法改革等方面积极探索；以联系疾病、联系应用为导向，广泛开展基于疾病动物模型制备及干预过程的实验教学；增加"创新性"实验项目，确保课程内容体现出前沿性和时代性；以生物医学前沿方法训练引领课程建设，着力培养学员的学习能力、实践能力和创新能力。此外，在优化以实践应用、创新性为导向的课程内容建设的基础上，打造虚拟仿真实验项目，尝试线上线下混合式教学，全方位提升学员的实践运用能力。     

抑郁症康复技能训练程式在基层医院推广应用的价值研究

背景　抑郁症的康复技能训练是一种很好的辅助治疗方法，本课题通过引进成熟的抑郁症康复技术，使基层医务人员熟练掌握，为辖区内广大抑郁症患者开展康复训练，以期提高抑郁症患者的疗效，降低自杀风险。目的　探讨抑郁症康复技能训练程式在基层医院推广应用的价值。方法　选取门头沟区龙泉医院2018年1-9月门诊就诊的65例抑郁症患者为研究对象。入选患者全部接受康复训练，分别于训练前和训练结束3个月后采用汉密尔顿抑郁量表（HAMD）、社会功能缺陷筛选量表（SDSS）、服药依从性、自杀风险评估量表（nurses' global assessment of suicide risk，NGASR）和自杀风险问卷对患者进行评估。结果　共61例患者完成研究，与训练前比较，训练结束3个月后患者HAMD、SDSS评分明显降低，服药依从性除自行停药外均明显提高，自杀风险明显降低，差异有统计学意义（P<0.05）。结论　抑郁症康复训练程式能有效提高患者服药依从性，改善抑郁症状，减少自杀观念，在基层医院有推广价值。     

有关医院空调水系统若干问题的探讨

主要阐述空调水系统利用平衡阀调节系统阻力,保持系统水力稳定;利用软启动器实施水泵的平滑软启动;压差旁通阀的作用及选型安装;系统管道热膨胀等问题。     

大鼠小肠缺血再灌注后血中NO,SOD浓度及肺中Bax,Bcl-2表达的改变

目的：研究大鼠小肠缺血再灌注后后血中一氧化氮（NO），超氧化物歧化酶（SOD）的浓度变化以及肺组织中Bax,Bcl-2的表达，探讨小肠缺血再灌注后对肺组织的损伤，方法：建立小肠缺血再灌注模型，分对照 ，再灌注后0，30min，1，2h,1,3,7d共8组，于各时点检测血中Bax,Bcl-2的表达情况。结果：大鼠小肠缺血再灌注后NO浓度0min明显升高，2h时降低，随后升高，7d时达高峰，SOD浓度0min明显下降，2h 时升高，随后下降，7d时达最低，Bax,Bcl-2免疫阳性细胞主要位于肺组织中血管内皮细胞和肺泡上皮细胞，再灌注0min,Bax,Bcl-2阳性细胞率增多，30min时Bax,Bcl-2阳性细胞率均升高分别为17．1％和78．1％，Bcl-2表达高于Bax，两者差别显著（P＜0．01），2h时降低，其后升高，7d时阳性细胞率达高峰分别为94．1％和83．4％，Bax表达明显高于Bcl-2，两者差异显著（P＜0．01）。结论：大鼠小肠缺血再灌注后可引起血中NO，SOD的浓度变化和Bax及Bcl-2阳性细胞在肺组织中的表达改变并可能引起肺组织细胞凋亡和损伤。     

组织多肽特异性抗原在原发性肝癌中的临床应用

OBJECTIVE: To evaluate the clinical value of serum tissue polypeptide specific antigen (TPS) for primary hepatic cancer in comparison with alpha-fetoprotein (AFP). METHODS: TPS and AFP were measured by enzyme-linked immunosorbent assay (ELISA) in 85 patients with primary hepatic cancer, 19 with metastatic hepatic cancer, 35 with liver cirrhosis, 22 with chronic hepatitis and 50 healthy control subjects. RESULTS: Serum AFP levels were elevated in patients with hepatocellular carcinoma in comparison with that in cholangiocarcinoma patients (P=0.037), but the difference was not significant (P=0.737). Serum TPS levels were significantly correlated with the tumor size (P=0.001), but not with the number of the tumors, portal invasion, extrahepatic metastasis, clinical stage or histological differentiation (P>0.05). A significant correlation was observed between AFP level and tumor size (P=0.028), portal invasion(P=0.005), and histological differentiation (P=0.000). CONCLUSION: TPS alone offers no more clues than AFP for the diagnosis of primary hepatic cancer, though it can be helpful for the diagnosis of cholangiocarcinoma. It has only limited clinical utility as a marker for primary hepatic cancer.     

脂质体阿霉素为主方案治疗高龄非霍奇金淋巴瘤的临床研究

目的 观察脂质体阿霉素联合治疗高龄非霍奇金淋巴瘤患者的有效性和安全性.方法 应用脂质体阿霉素联合COP为主的方案化疗或联合利妥昔单抗等其他治疗方案治疗34例患者,观察患者应用脂质体阿霉素过程中及其后的毒副反应及疗效.结果 全组34例患者共接受176个疗程化疗,平均每个患者累计应用脂质体阿霉素127.0 mg治疗,总有效率(CR+PR)为88.2%(30/34),其中CR 24例(70.6%),PR 6例(17.7%),SD 1例(2.9%),PD 3例(8.8%).毒副反应主要为骨髓抑制,未出现严重感染.心脏毒性发生率14.7%(5/34),无化疗相关死亡.结论 脂质体阿霉素联合治疗高龄非霍奇金淋巴瘤具有较高的安全性和有效性.     

Isoflurane Preconditioning Improves Long-term Neurologic Outcome after Hypoxic-Ischemic Brain Injury in Neonatal Rats

Background: Preconditioning the brain with relatively safe drugs seems to be a viable option to reduce ischemic brain injury. The authors and others have shown that the volatile anesthetic isoflurane can precondition the brain against ischemia. Here, the authors determine whether isoflurane preconditioning improves long-term neurologic outcome after brain ischemia.

Methods: Six-day-old rats were exposed to 1.5% isoflurane for 30 min at 24 h before the brain hypoxia-ischemia that was induced by left common carotid arterial ligation and then exposure to 8% oxygen for 2 h. The neuropathology, motor coordination, and learning and memory functions were assayed 1 month after the brain ischemia. Western analysis was performed to quantify the expression of the heat shock protein 70, Bcl-2, and survivin 24 h after isoflurane exposure.

Results: The mortality was 45% after brain hypoxia-ischemia. Isoflurane preconditioning did not affect this mortality. However, isoflurane preconditioning attenuated ischemia-induced loss of neurons and brain tissues, such as cerebral cortex and hippocampus in the survivors. Isoflurane also improved the motor coordination of rats at 1 month after ischemia. The learning and memory functions as measured by performance of Y-maze and social recognition tasks in the survivors were not affected by the brain hypoxia-ischemia or isoflurane preconditioning. The expression of Bcl-2, a well-known antiapoptotic protein, in the hippocampus is increased after isoflurane exposure. This increase was reduced by the inhibitors of inducible nitric oxide synthase. Inducible nitric oxide synthase inhibition also abolished isoflurane preconditioning-induced neuroprotection.