目的 设计并验证适合Beckman AU5811全自动生化分析仪试剂针和搅拌棒的交叉污染分析方法,找到产生的原因并制定有效的污染避免措施。方法 以反应盘内圈项目(ALT、TBIL、GGT、ALB、TBA、LDH1、CK、Cr、GLU、CO2、TC、HDL-C、APOA1、Ca 、Fe、Cu、HCY 、AFU、PA)作为实验项目,按设计的检测顺序进行交叉污染实验,各项目间的污染率以不超过95%～105%为判断标准。结果 内圈项目中TC、HCL-C对TBA分别存在试剂针和搅拌棒的污染,Ca对Cr存在搅拌棒的污染,Cu对Fe存在试剂针的污染,GGT、ALB、LDH1对CO2都有搅拌棒的污染,TC、TBIL对Cu也存在搅拌棒的污染。结论 采用该方法能有效快速地对Beckman AU5811生化分析仪上的所有项目进行交叉污染实验,确定交叉污染产生的关联项目并采取污染避免措施减少交叉污染,保证检验结果的准确。

Objective To design and verify an analytical method for the cross contamination of Beckman AU5811 automatic biochemical analyzer's reagent needle and stir bar and find the reasons, and make effective measures to avoid contamination. Methods Use the inner ring items (ALT,TBIL,GGT,ALB, TBA,LDH1,CK,Cr,GLU,CO2,TC,HDL-C,APOA1,Ca,Fe,Cu,HCY,AFU,PA) as theexperiment objects and do the cross contamination experiment according to the test order. The standard for the cross contamination level is limited to 95-105% among all items. Results TC and HCL-C were found to have contaminated TBA both in reagent needle and stir bar model, Ca contaminated Cr in the stir bar model; Cu contaminated Fe in the reagent needle model; GGT,ALB and LDH1 contaminated CO2 in stir bar model; TC and TBIL contaminated Cu in the stir bar model. Conclusion The method used in this experiment can effectively identify and analyze the cross contamination of all the items in Beckman AU5811 automatic biochemical analyzer. In addition, it can help to adopt corresponding measures to reduce cross contamination.

目的 评价急性心肌梗塞患者转往有条件医院行PCI治疗前应用替罗非班(血小板Ⅱb/Ⅲa受体拮抗剂)的临床疗效与安全性。方法 选取从2013年1月—2014年9月诊断为急性心肌梗塞行PCI治疗的患者共66例。随机分为观察组(确定转院行PCI治疗前在我院应用替罗非班) 34例、对照组(转运到花都区人民医院心内科行PCI治疗后应用替罗非班) 32例。观察比较两组患者首次造影的冠脉血流情况与术后的冠脉血流情况、PCI时心电图抬高的ST回落情况与心肌标志物峰值前移情况、住院期间与随访30天期间不良心血管事件(MAGC)的发生情况(支架内血栓与二次血运重建发生率、再梗塞率、心绞痛、死亡率)以及两组的不良反应。结果 观察组首次造影的冠脉血流优于对照组;术后的冠脉血流观察组优于对照组(P<0.05);PCI时心电图ST回落≥1/2的情况与TNI、CK-MB峰值前移情况优于对照组(P<0.05);不良心血管事件发生率较对照组少(P<0.05);不良反应发生率差异无统计学意义(P>0.05)。结论 急性心梗转院PCI患者,转院前应用替罗非班比转院后应用获益更大,安全性尚可。这类病人,在确定转院之时即时应用替罗非班是合理时机。

目的 探讨标准化术前访视在前列腺等离子电切术中的应用价值。方法 回顾性分析我科在2012年1月—2014年9月期间实施的120例择期经尿道前列腺等离子电切手术资料。根据术前接受的护理方式,患者被分为对照组(n=48)和观察组(n=72)两组。对照组患者接受传统的术前访视,观察组患者则接受标准化术前访视。结果 两组患者术前焦虑评分及等级分布有差异(P<0.05),观察组情况好于对照组。对照组手术知识问卷平均得分为(67.9±12.5)分,观察组平均得分为(81.6±10.8)分,两组间比较,差异有统计学意义(t=4.258, P=0.045)。对照组手术相关护理满意度平均评分为(70.8±13.5)分,观察组平均评分为(83.5±9.8)分,观察组得分高于对照组(t=5.002, P=0.038)。结论 标准化术前访视可缓解患者的术前焦虑情绪,提高患者对手术知识的了解,提升患者对手术护理的满意度。

目的 探讨颈动脉残端压(SP)联合电生理监测在颈动脉内膜切除术(CEA)中的应用价值。方法 回顾性分析19例CEA患者临床资料,通过监测SP、体感诱发电位(SEP)和运动诱发电位(MEP),以确定术中是否放置转流管;比较术前和术后6月美国国立卫生院卒中量表(NIHSS)评分和改良Rankin量表(mRS)评分变化情况。结果 10例患者SP≥50mmHg,SEP和MEP监测无异常,术中未放置转流管;5例患者SP<50 mmHg,SEP波幅下降>50％,MEP监测正常,予以放置转流管;3例患者SP≥50 mmHg,SEP波幅下降>50％,MEP监测正常,予以放置转流管;1例患者SP>50 mmHg,SEP监测正常,MEP波幅下降>50％,未放置转流管。所有患者手术均获得成功,无手术死亡率。患者术后6月NIHSS评分和术前无统计学差异(P>0.05),但术后6月mRS评分较术前下降(P<0.05)。结论 通过术中SP、SEP和MEP联合监测,有助于避免CEA术后缺血性脑卒中的发生,提高CEA手术的安全性。

Objective To investigate the value of stamp pressure(SP), somatosensory and motor evoked potentials(SEP,MEP) monitoring in carotid endarterectomy. Methods 19 patients with carotid endarterectomy were retrospectively analyzed.SP, SEP and MEP were monitored during the operation.National Institutes of Health Stroke Scale (NIHSS) and Modified Rankin Scale (mRS) were used to evaluate the neurological function before and 6 months after surgery. Results Intraluminal shunting was not performed in 10 patients with normal SP, SEP and MEP.However, intraluminal shunting technique was used in 5 patients (SP<50 mmHg and SEP fluctuation decreased by 50％) and 3 patients (SP≥50 mmHg and SEP fluctuation decreased by 50％).1 patient showed the fluctuation of MEP decreased by 50％, while SP and SEP was normal, no shunting was performed.All patients were successfully operated, and no mortality occurred.The mRS score, not the NIHSS score, revealed statistically difference between preoperation and 6 months after surgery (P<0.05). Conclusion The combination of SP, SEP and MEP monitoring maybe useful for preventing ischemic stroke after carotid endarterectomy, increasing the safety of surgery.

目的 通过测试获取脑瘫外翻足患儿的足底压力参数特征,为设定步态康复训练方案提供参考。方法 根据纳入和排除标准,选择脑瘫患儿和健康儿童各15人,通过足底压力测试仪测得足底各部位压力分布、区域压力峰值及步态时相百分比,将两组结果进行统计学比较。结果 比较发现在足底接触面积、足底压力值,以及步态时相所占时间长短三方面均有指标存在差异,均有统计学意义(P<0.05)。结论 足底压力测试技术可使临床步态分析更加量化、精确化,为设定更有针对性的康复训练提供依据。

Objective Through the assessment to get the plantar pressure features of cerebral palsy children with talipes valgus, in order to design suitable treatment plan. Methods According to the inclusion criteria and exclusion criteria, we chose 15 cerebral palsy children with talipes valgus in experimental group, and 15 healthy children in control group. Through the test to get the plantar contact area, pressure parameters and the percent of gait phase. the two groups were compared with statistics method. Results There were significant differences between two groups on the plantar contact area, pressure parameters and the percent of gait phase. Conclusion Plantar pressure measurement makes clinic gait analysis more quantized and accurate, it will provide the evidence to plan the suitable treatment plan.

目的 探讨经皮微创技术应用股骨近端解剖锁定钢板治疗高龄骨质疏松粗隆间骨折的治疗。方法 我院自2009年12月—2013年6月共收治高龄骨质疏松粗隆间骨折56例,男35例,女21例;年龄76～94岁,平均81岁。所有患者应用股骨近端解剖锁定钢板通过经皮微创置入技术治疗。根据Harris髋关节功能评分对治疗效果进行评定。结果 56例手术时间30～90 min,平均45 min;术中失血量70～250 mL,平均110 mL。全部患者获随访,时间6～13.5个月,平均9.5个月。X线骨折愈合时间3～6个月,平均3.5个月。其中优41例,良12例。结论 对于高龄骨质疏松患者粗隆间骨折,采用经皮微创置入股骨近端解剖锁定钢板内固定治疗,具有手术创伤小、出血少、安全可靠等优点,有良好的临床应用价值。

Objective To study the application of proximal femur anatomic locking plate with minimally invasive percutaneous plate osteosynthesis (MIPPO) techniques in the treatment of senile osteoporosis curative effect of intertrochanteric fractures in elderly patients. Methods We have treated 56 elderly patients of senile osteoporosis intertrochanteric fractures in December 2009 to June 2013, including 35 male and 21 female cases, aged 76~94, the average of 81. All patients were applied in the proximal femur anatomic locking plate with minimally invasive percutaneous plate osteosynthesis technology according to Harris hip joint function scale curative effect. Results 56 cases of operation time 30~90 min, an average of 45 min. Intraoperative blood loss was 70~250 ml, an average of 110 ml. All patients received follow-up from 6 to 13.5 months, an average of 9.5 months. The X-ray fracture healing time was from 3~6 months, 3.5 months on average. According to the Harris hip joint function scale: 41 cases was excellent, 12 cases was good. Conclusion For the senile osteoporosis intertrochanteric fracture, using the proximal femur anatomic locking plate with minimally invasive percutaneous plate osteosynthesis technology can make minimal trauma, less bleeding reliable fixation,and has good clinical application value.

随着医院后勤管理企业化和社会化进程的加快,医院后勤系统逐渐面对着自主经营、自我约束、自立发展的新格局。本文分析了目前医院后勤管理方面存在的问题,介绍了依托医院信息平台建设的医院后勤综合运营管理信息系统。通过质量管理、二级库房管理,被服管理等模块,理顺医院后勤业务流程,提高医院后勤业务工作的质量和效率,达到提升医院后勤业务综合管理水平之目的,并对医院后勤管理信息系统的发展方向和实施办法进行了探讨。

With the acceleration of hospital logistics management enterprise and socialization process, hospital logistics system gradually facing self-management, self-restraint, self-development of a new pattern. This paper analyzes the current hospital logistics management problems introduced relying on hospital information platform of integrated logistics operation and management of hospital information systems. Through quality management, two warehouse management, clothing management module, streamline hospital logistics business processes, improve the quality and efficiency of the hospital's logistics operations, to enhance the purpose of the hospital management level of integrated logistics services, logistics management and hospital information system direction and implementation methods were discussed.

KOA是临床上最常见,发病起源于关节软骨的慢性退行性关节疾病。近年来,应用黄芪治疗KOA的报道不断增多,并且开展了大量的机制研究。本文综述了黄芪在KOA治疗中的应用现状及研究进展,同时指出从PPAR-γ信号通路探索黄芪干预KOA的具体分子机制具有积极的理论和实践意义。

目的 探讨光棒引导与传统喉镜气管插管在不稳定型颈椎骨折患者中的应用效果。方法 不稳定型颈椎骨折患者80例,按照随机数字表法随机分成光棒引导组和传统喉镜组各40例,记录两组患者的插管时间、插管总成功率,入室安静后(T0)、诱导后插管前(T1)、气管插管后即刻(T2)、气管插管后3 min(T3)时的收缩压(SBP)、舒张压(DBP)、心率(HR)、血浆去甲肾上腺素(NE)、肾上腺素(E) 和血管紧张素Ⅱ(ATⅡ)的变化和插管时气道并发症。结果 两组间插管时间(光棒组29.63±11.04s vs.喉镜组62.41±19.49 s)有统计学意义(P<0.001)。两组插管总成功率无统计学意义(P=0.305)。光棒组T2、T3时刻SBP、DBP、HR 、NE、E和ATⅡ均低于喉镜组(P<0.001)。光棒组气道并发症低于喉镜组无统计学意义(P>0.05)。结论 光棒引导气管插管较传统喉镜气管内插管插管时间短,对血流动力学和应激激素水平影响较轻。

目的 探讨孕母产前应用盐酸氨溴索对新生儿呼吸窘迫综合征(NRDS)发病影响。方法 选取我院自2012年10月—2014年10月间收治的有早产征象的孕妇248例作为研究对象,根据孕周情况将其分成两组,即A组孕妇的孕周≤35周,B组孕妇孕周＞35周,又将两组患者随机分成两组,即A-对照组患者,A-观察组;B-对照组和B-观察组,分别对其对照组孕妇行常规药物治疗,观察组患者采用盐酸氨溴索进行治疗,对比4组新生儿的呼吸窘迫发生情况。结果 A-对照组新生儿窘迫的发生率为 (18)29.03%,B-对照组该数据为(25)40.32%;A-观察组新生儿呼吸窘迫的发生率为(8)12.90%,B-观察组该数据为(14)22.58%,两组数据对比有统计学意义,P＜0.05。结论 孕周＜35周是产前应用盐酸氨溴索预防新生儿呼吸窘迫的最佳时机。

Objective To investigate maternal antenatal ambroxol hydrochloride incidence of neonatal respiratory distress syndrome affected. Methods Since our hospital between October 2012-2014 October has admitted 248 cases of pregnant women with preterm labor signs as research subjects, according to the gestational age of the case will be divided into two groups, Group A pregnant woman's gestational age ≤35 weeks Group B pregnant gestation> 35 weeks, patients were randomly divided into two groups in turn, that the patients in the control group A-, A-observation group; B-B-observation group and control group, respectively, to its line of conventional drugs for pregnant women in the control group treatment, observation group were treated with ambroxol hydrochloride for treatment, compared to four groups of neonatal respiratory distress happen. Results A-control group incidence of neonatal distress (18) 29.03%, B-group the data (25) 40.32%; A-observation group incidence of neonatal respiratory distress (8) 12.90%, B-The data for the observation group (14) 22.58%, comparing two sets of data were statistically significant difference, P<0.05. Conclusion gestational age <35 weeks is ambroxol hydrochloride prenatal prevention of neonatal respiratory distress best time.