目的 探讨拉米夫定治疗对乙肝活动的肺结核病人抗结核治疗中的临床价值。方法 通过回顾性分析159例初治肺结核乙肝表面抗原(HBsAg)阳性、HBV-DNA定量阳性病人,所有病例在抗结核前查肝功能均正常,分为两组,治疗组:在抗结核及护肝治疗过程中,加用拉米夫定抗乙肝病毒治疗;对照组:没用任何抗乙肝病毒药物;分别在抗结核治疗前、治疗2周、4周及8周复查肝功能,对比两组间肝损发生率,及肝损发生时间及严重程度。抗结核治疗4周后复查HBV-DNA定量,对比两组间HBV-DNA定量下降例数。结果 治疗组的肝损发生率仅20.5%,对照组病人抗结核治疗后肝损的发生率为53.1%,两者间差异有统计学意义。治疗组肝损出现时间多为大于4周,而且多数是轻度肝损。治疗组出现肝损中断抗结核治疗的病例数低于对照组。抗乙肝病毒治疗后复查HBV-DNA定量降低例数高于对照组。结论 拉米夫定抗乙肝病毒治疗,能抑制乙肝病毒复制,降低乙肝合并肺结核病人的肝损发生率并减轻肝损严重程度,提高病人对抗结核药物的耐受性。

目的 观察自体巩膜倒扣包裹羟基磷灰石(HA)义眼台一期植入术临床效果、术后并发症及随访预后情况。方法 选取我院2012年7月—2014年3月期间26例需植入HA义眼台患者,采用进口材料HA义眼台,直径18~22 mm,重量约2 g,施行眼球摘除术后,予眼内容剜除,自体巩膜壳倒扣包裹于HA义眼台前端,一期植入肌锥的方法。结果 随访2～20个月,2例发生结膜充血水肿(7.69%),3例发生结膜创口愈合不良(11.54%),行保守治疗或于手术室清创缝合后痊愈,余未发生义眼台排斥、暴露、感染、移位及眼球假体固定。结论 羟基磷灰石(HA)义眼台具有高度的生物相容性,无毒性、无抗原性,纤维结缔组织可长入内联多孔,不引起明显异物排斥反应,是目前较理想的眼座材料。自体巩膜倒扣包裹HA的应用减少了义眼台植入术后并发症的产生,术后眼窝饱满,眼球假体活动度可,外观恢复满意,临床效果好,是眼眶整形术中较为理想的方法。

目的 研究进展性脑梗塞与超敏 C-反应蛋白(hs-CRP)、纤维蛋白原(FIB)、血清胱抑素C(CysC)的相关性。方法 选择82例脑梗塞患者作为观察组,根据患者临床表现分为进展性脑梗塞组和非进展性脑梗塞组,另选择70例非脑血管病患者作为对照组;分别检测血清hs-CRP和FIB、CysC水平。结果 观察组患者血清hs-CRP和FIB、CysC含量较对照组升高(P<0.01);进展性脑梗塞组血清hs-CRP和FIB、CysC含量高于非进展性脑梗塞组(P<0.05)。经Spearman 相关分析发现,进展性脑梗塞组的血清hs-CRP、FIB、CysC水平与美国国立卫生研究院卒中量表(NIHSS)评定的神经功能缺损评分呈正相关。结论 血清hs-CRP、FIB、CysC水平检测有助于进展性脑梗塞患者的早期诊断,对预后有评估作用。

目的 探讨颅脑超声在高危新生儿颅内疾病的诊断应用。方法 2010年7月—2014年6月间在我院新生儿重症监护室(NICU)813例新生儿应用百胜Mylab Five型彩色多普勒超声诊断仪,探头频率5～7.5 MHz,进行常规颅脑超声检查。患儿取仰卧位,经前囱作矢状切面及冠状切面按顺序扫查,重点扫查几个标志性切面。头皮留置针遮盖前囟者先予拔除,以保证检查顺利进行。结果 超声异常者85.73%(697/813)。其中颅内出血45.62%(318/697)。早期脑室周围—脑室内出血(PIVH)88.05%(280/318),以I级和II级为多;大脑出血4.40%(14/318);丘脑出血2.22%(7/318);小脑出血1.89%(6/318);蛛网膜下腔出血1.89%(6/318);硬膜下出血1.57%(5/318)。缺氧缺血性脑损伤(HIHB) 36.01%(251/697)。足月儿缺氧缺血性脑病(HIE)67.33%(169/251),轻度HIE52.59%(132/251),中重度HIE14.74%(37/251)。早产儿缺氧缺血性脑病(PVL)33.67%(82/251),化脓性脑膜炎3.30%(23/697)。脑积水15.06%(105/697),以外围性脑积水多见。出院前复查: I度及II度PIVH大部分吸收,III级及IV级PIVH可见侧脑室扩大、脑实质液化性囊腔。大脑出血、丘脑出血、小脑出血均有不同程度吸收,严重者遗留液化性囊腔,蛛网膜下腔出血及硬膜下出血亦有不同程度地吸收。轻度HIE大部分恢复正常,中重度HIE 均有脑室扩大、脑萎缩、液化性囊腔。PVL后期见囊泡性改变。化脓性脑膜炎后期可见硬膜下积液及梗阻性脑积水。结论 颅脑超声便携,可床边,价廉,可重复,具有较实用临床应用价值。适用于新生儿颅内疾病的筛查及诊断。对脑中线部位脑室周围—脑室内出血,对脑积水的程度、预后具有特异性诊断价值。它可提示颅内病变类型、程度、部位及动态监测病情进展情况。对某些颅内病变如蛛网膜下腔出血,硬膜下腔出血,小脑出血则需要结合CT、MRI等其它影像技术,为临床诊断提供依据。

目的 探讨不同用药方案治疗慢性阻塞性肺病所致肺部感染的药物经济学。方法 本次医学研究选择我院2012年1月—2014年1月收治的200例慢性阻塞性肺病所致肺部感染患者为观察对象,随机将其分为A组、B组、C组和D组,A组观察对象接受盐酸莫西沙星治疗,B组观察对象接受硫酸依替米星治疗,C组观察对象接受头孢哌酮钠治疗,D组观察对象接受他唑巴坦钠/哌拉西林钠治疗,回顾分析四组观察对象药物经济学。结果 四组观察对象药物敏感度对比差异有统计学意义(P<0.05),而临床治疗效果和不良反应发生率对比则差异无统计学意义(P>0.05)。结论 慢性阻塞性肺病所致肺部感染患者接受C方案治疗,具有理想的临床效果和较高的药物经济学效率。

目的 研究探讨小儿支气管肺炎应用穿心莲内酯磺化物雾化吸入治疗的临床疗效及安全性。方法 选取2012年7月—2014年6月我院收治并确诊的128例小儿支气管肺炎患儿为研究对象,将所有患儿随机分为对照组和观察组各64例。两组患儿均给予常规退热,消炎、镇咳、平喘、抗病毒感染等治疗,对照组患儿在常规治疗基础上采用红霉素、青霉素和头孢等药物治疗,观察组患儿在常规治疗基础上采用喜炎平注射液雾化吸入治疗,观察两组患儿治疗后退烧时间、肺部啰音消失时间、咳嗽消失时间、临床总有效率以及住院天数。结果 治疗后观察组患儿的各症状消失时间以及住院天数均短于对照组患儿,差异有统计学意义(P<0.05)。观察组患儿总有效率为96.88%高于对照组的85.94%,两组差异有统计学意义(P<0.05)。结论 采用喜炎平注射液雾化吸入治疗小儿支气管肺炎有效果,能效缓解患儿的临床症状,值得大力推广。

Objective To Study and investigate the curative effect and security using nebulizer inhalation of Andrographolide Sulfonate to children's bronchopneumonia. Methods From July,2012 to June, 2014, we chose 128 children who had been diagnosed as bronchopneumonia by our hospital as our research subjects, and divided them into the contrast group and the observation group randomly with 64 children each. The both groups were all treated by using the methods of Antipyretic,anti-inflammatory,antitussive,antiasthmatic,anti-viral infection, treated by using erythromycin, penicillin and cefotaxime in the contrast group,treated the observation group by using Xiyanpin injection by nebulizer inhalation, of cause these two treatment were all on the basis of the conventional treatment. After treatment, we recorded the exact time of when the fever was gone, the disappearing time of pulmonary rales and their cough, the total effective rate and the time of being in hospital of the two groups. Results The time of all the observation group's symptom disappearing and being in hospital was obviously shorter than that of the contrast group after treatment. The difference between both groups was statistically significant(P<0.05). The total effective rate for the observation group was 96.88%, and it's higher than the contrast groups',which was 85.94%. The difference was statistically significant(P<0.05)too. Conclusion Using Xiyanpin injection by nebulizer inhalation for children's bronchopneumonia could effectively relieve the children's clinical symptom. It is worth popularizing for its good clinic medical value.

目的 通过分析6例阴茎折断患者术后主要护理的要点,以提高阴茎折断患者术后的护理水平。方法 回顾性分析阴茎折断患者术后护理。对6例术后患者进行心理辅导,病情观察,正确体位的摆放,出院指导等护理干预。结果 6例患者在明确诊断后均急诊行阴茎血肿清除加白膜修补术,其中1例另外行尿道修补术。住院时间10~15天,平均9天,住院期间伤口愈合良好,无出现术后并发症。术后随访2~12个月,平均8个月。5例患者阴茎外观正常,性生活满意,无阴茎弯曲、痛性勃起、尿道狭窄等并发症。1例阴茎外观有轻度弯曲,但不影响性生活。结论 目前阴茎折断治疗的方法主要是手术治疗,护理人员帮助患者消除手术顾虑保持良好心态积极面对手术是手术成功的关键, 重视术后局部的护理以及病情观察,预防并发症的发生;指导患者积极进行功能锻炼和配合治疗,促进患者恢复。

Objective To summarize the experience of nursing intervention in diagnosis and treatment of penile fracture, and to improve the level of nursing of penile fracture. Methods The clinical data of 6 cases with penile fracture were retrospectively analyzed, the nursing intervention mode and significance in diagnosis and treatment were evaluated. 6 patients have emergency surgery after the diagnosis, and one patient urethra accepted surgical repair. Results The hospitalized period varied from 10 to15 days(average 9 days), and the patients were followed up for 2~12 months(average 8 months). 5 patients showed a very good outcome without complications, such as the penile deviation, pain, ED and urethral stricture, and 1 patient with penile deviation did not impede sexual activity. Conclusion Prompt surgical intervention of penile fracture showed a satisfied long-term outcome and get better therapeutic effects. Nursing intervention is important to improve the success rate of surgical, and targeted nursing after surgical can reduce complications.

目的 根据产后不同时期的乳房的生理特点,采用中医综合疗法及护理进行回乳,观察其疗效。方法 选取哺乳期断乳的妇女57例,随机分为治疗组30例及对照组27例,治疗组采用中医综合疗法回乳,对照组口服溴隐亭回乳。结果 治疗组回乳效果优于对照组,出现乳房胀痛及乳腺炎的发生率低于对照组,且无不良反应。结论 中医综合疗法回乳安全,效果显著,对回乳时出现的乳房胀痛等兼证有很好的改善,对乳腺炎的发生起了更好的预防作用。

Objective According to the physiological characteristics of postpartum breast, through the combined treatment of traditional Chinese medicine and nursing for delactation,and to observe the effects. Methods A total of 57 women who wanted for delactation, were selected and randomly divided into two groups, there are 30 cases in the treatment group and 27 cases in the control group, the treatment group were treated with traditional Chinese medicine and nursing, while the control group used oral bromocriptine for delactation. Results The treatment group is better than the control group, the incidence of mastitis and breast swelling in treatment group is lower than the control group, and there was no adverse reaction. Conclusion The treatment of delactation with combined treatment of traditional chinese medicine and nursing is safe and effective, it can reduce suffering of women and prevent the occurrence of mastitis.

目的 随着人们生活水平的提高,中医药在养生保健上的作用日益为人们所接受。由于人们对中医药养生保健知识和理论了解较少,本次调查为了解江苏地区居民对中医药保健知识的普及现状。方法 通过派发调查问卷,用随机抽样的方式了解中医药保健知识普及的现状。结果 了解了江苏地区人们对中医药保健知识普及的现状。结论 通过调查,团队得出中医药保健事业的弘扬与发展非一日之功,需要大家共同的努力,政府应当提高中医药保健人员的资格认定标准,各类医院也当负起宣传中医药保健知识的责任,媒体和出版机构宣传正规中医药养生保健知识。

Objective As people's living standards improved, traditional Chinese herbal medicine used in health care becomes well accepted by some fake Chinese herbal medicine doctors. So that, the knowledge of traditional medicine still needs to be popularized. The research is about how well the public know about traditional Chinese herbal medicine in Jiangsu area. Methods We random selected certain amount of citizens to be the informed of the cognition degree of traditional Chinese medicine in public by letting the finish questionnaire. Results We get to know about the current situation of Chinese medicine health care knowledge in Jiangsu area. Conclusion Through the investigation, we need common efforts, carrying and inheriting traditional Chinese medicine. The government should improve the personnel qualification standard of Chinese medicine health care. Hospital will also promote Chinese medicine health care knowledge, and the media and publishing agencies has responsibility to advocate correct Chinese medicine health care knowledge.

目的 探讨妇女阴道健康状况及阴道分泌物清洁度、线索细胞及唾液酸酶法检测细菌性阴道病(BV)的相关性。方法 随机抽取2013年4月—2014年6月本院妇科疑似细菌性阴道病患者标本835例,分别采用生理盐水直接涂片及分泌物直接涂片进行革兰氏染色两者相结合检查清洁度、线索细胞;唾液酸酶法检测BV。结果 清洁度Ⅰ～Ⅱ占27.55%,BV阳性率为2.40%,线索细胞检出率1.32%;清洁度Ⅲ～Ⅳ占72.45%,病原菌阳性率为46.23%,其中BV阳性率为30.55%,线索细胞检出率为23.48%。结论 清洁度异常率比正常率偏高;清洁度正常不一定没有细菌性阴道病; BV的出现严重威胁妇女身体健康,正确的诊断有重要意义,唾液酸酶法检测BV虽有快速、操作简单、显色结果易判断,但温度、时间、取材问题等受多种因素影响。

Objective To explore the correlation between the health of women's vagina and vaginal cleanness, clue cells and bacterial vaginosis(BV)which is tested by the sialic acid enzymatic method. Methods Randomly select 835 suspected cases of bacterial vaginosis in our hospital gynecology department in April 2013-June 2014. Every case was respectively done saline direct smear and vaginal secretion direct smear gram staining to check vaginal cleanness and clue cells. BV is tested by sialic acid enzymatic method. Results The cleanness of I-II accounted for 27.55%, BV positive rate was 2.40%, the positive rate of clue cells was 1.32%;the cleanness of degree III-IV accounted for 72.45%, the positive rate of pathogenic bacteria was 46.23%, the positive rate of BV was 30.55%, the positive rate of clue cells leads to 23.48%. Conclusion The rate of abnormal vaginal cleanness is higher than the normal.The nomal vaginal cleaness does not show no bacterial vaginosis. The emergence of BV seriously affects women's health, so the correct diagnosis is of great importance. Although the of the saliva acid enzyme to test BV is fast, operates easily and the color results are easily to be judged, but it can be influenced by other factors such as temperature, time, materials issues.