简介：

简介：客观：没有主要肺的损害，在机械通风治疗以后与尖锐服的损害在病人的唾沫检测dipalmitoylphosphatidyl胆碱(DPPC)的层次。方法：在有尖锐服的损害，但是没有肺的损害的35个病人的唾沫的DPPC层次在通风和16-20的开始与高效液体层析被检测在通风以后的天，21-40天，和41-60天分别地。结果：没有在在通风以后的16-20天之间的DPPC层次的重要差别(3.36±0.49)并且在通风(3.37±0.58)的开始(P>0.05)。DPPC的Themean层次在21-40天显著地减少了(2.87mg/ml±0.26nig/ml，P<0.05)and41-60天(1.93mg/ml±0.21mg/ml，P<0.01)在通风以后与那相比在通风的开始。在一样的时期，吸入的压力和平均数航线迫使的山峰显著地增加了，而静态的依从和在动脉的氧的部分压力显著地减少了。在收到了通风超过20天的25个病人之中，(32%)8在通风的开始与那相比在动脉有氧的稍微减少的部分压力。结论：DPPC铺平的机械通风罐头减少，减少肺依从和增加航线压力，甚至与尖锐服的损害损害氧化功能住院病人。反常DPPC是主要原因之一联系ofventilator的肺损害。

简介：

简介：

简介：Objective:Todetecttheconcentrationofmonocytechemoattractantprotein-1(MCP-1)intheserumofpatientswithincompletespinalcordinjuryandevaluateitsrelationwiththepathologicclassificationofthespinalcordinjury.Methods:MCP-1concentrationintheserumofpatientswithincompletespinalcordinjury(iSCI),singlespinecompressionandhealthysubjectsweredetectedbyELISA,respectivelyinthepresentstudyandthemagneticresonanceimagingdataofthesepatientswerestudiedatthesametimeonablindbase.Results:SerumlevelofMCP-1iniSCIpatientswas428pg/ml±11pg/mlbyELISA,whichwashigherthanboththatofthepatientswithsinglespinecompressionandofcontrols,withtheconcentrationof184pg/ml±21pg/mland124pg/ml±15pg/ml,respectively.Therewassignificantdifferencebetweenanytwogroups(P<0.01).iSCIpatientswithnormalMRIshowedalowerserumlevelofMCP-1as312pg/ml±30pg/ml.Pathologicalclassificationofspinalcordedemaandhematomacorrespondedto390pg/ml±16pg/mland508pg/ml±24pg/mlintheconcentrationofMCP-1.Conclusions:MCP-1mayinducesecondaryinflammatoryresponsebyrecruitinginflammatorycellstotheinjurysiteandthusaffecttheprognosisofspinalcordinjury.

简介：客观：为了评估Porthsmouth的适用性，在预言经历新潮的联合关节造形术的病人的死亡为死亡和病态(P负鼠)的枚举修改了生理、起作用的严厉分数。方法：A总数of141病人(75男性和66女性，变老63.22年±一般水准上的14.45年)在2002年1月和2005年3月期间经历新潮的联合关节造形术与P-POSSUM.Their平均生理的分数回顾地被学习，起作用的严厉分数分别地是17.48±5.16和12.43±3.05。有P负鼠的预言的手术后的死亡与观察价值相比。亚群分析被执行调查P负鼠的预兆的能力。POSSUMscoring系统被用作控制。结果：三个病人实际上在这研究在操作以后死了。平均生理的分数在幸存组是在死亡组和17.16±4.56的32.33±9.87。前者显然比后者高，它显示出二个组之间的统计差别(Wilcoxon等级和测试，P<0.05)。同意在观察死亡数字和预言的死亡数字之间被发现的完成式由P负鼠计算了(2测试的Cochran-Mantel-Haenszelχ~，P>0.05)，不过，负鼠过高估计全面mortality.Conclusions；P负鼠能在经历新潮的联合关节造形术的病人精确地预言死亡，它比负鼠优异。

简介：Objective:Toevaluatetheoutcomeoftotalhiparthroplasty(THA)withcementlesscupsandfemoralheadautograftsforpatientswithhipdysplasiaandosteoarthritis.Methods:Between1995and2002,weimplanted23cementlesscupsandfemoralheadautograftsin20patientswithhipdysplasiaandosteoarthritis.Inthisstudy,aretrospectivestudywasmadeon21hipsin20patients(18femalesand2males,aged50yearsonanaverage)withdevelopmentalhipdysplasiatreatedbyTHAwithacementlesscupandfemoralheadautograft.Theacetabularcupwasplacedatthelevelofthetrueacetabuinmandallthepatientsrequiredautogenousfemoralheadgraftsduetoacetabulardeficiency.Theaveragerateoftheacetabularcupcoveredbythefemoralheadautograftwas31%(rangingfrom10%to45%).Eighthipshadlessthan25%cupcoverageandthirteenbetween25%and50%.Theaveragefollow-upperiodwas4.7years(range,1-8years).ThereplacingoutcomewasevaluatedbymodifiedHarrishipscore.Preoperativeandfollow-upradiographsweremade.Results:Alltheautograftswereunitedtothehostbones.Noautograftwascollapsedornocomponentfromthehipwasloosedinallthepatients.AccordingtothemodifiedHarrishipscore,theaveragehipscoreincreasedfrom46beforeoperationto89atthefinalreview.Beforeoperation,theleg-lengthdiscrepancywasgreaterthan2cminallthepatientsexceptonewithbilateralhipdysplasia.Afteroperation,only2outof20patientshadaleg-lengthdiscrepancygreaterthan1cm.Threehipsshowedminorboneresorptioninthelateralportionofthegraft,whichdidnotsupportthecup.ThreehipsdevelopedGrade1BrookerheterotopicossificationandonedevelopedGrade2.Conclusions:THAwithacementlesscupandafemoralheadautograftforpatientswithosteoarthritisresultedfromhipdysplasiacanresultinfavorableoutcomes.Thismethodcanprovidereliableacetabularfixationandrestoretheacetabularbonestockinpatientswithdevelopmentalhipdysplasiawhenthe

简介：Mostpatientswithtrauma-hemorragicshock,priortoICUadmission,havebeenresuscitatedandstabilizedintheemergencyroom(ER)and/oroperationroom(OR).Manyofthemsufferfromsystemicedema.Thisextra-vascularfluidiscausedbymassiveinfusionoffluidandbloodforthemaintenanceofbloodpressure.Duringtherecoverystage,thepatientsexhibitspontaneousdiuresisfollowedbynegativefluidbalance.Urinevolumesofsomepatientsaremorethan10000ml/d.Doweneedtomaintainabalancebetweendailyinputandoutputofwateratthissituation?

简介：Objective:Tocomparativelystudythedifferenteffectsofopenheartsurgeryonbraintissuesofpatientswithcongenitalandrheumaticheartdisease.Methods:Fortypatientswithcongenitalheartdisease(CHD,CHDgroup,n=20)orrheumaticheartdisease(RHD,RHDgroup,n=20)underwenton-pump(cardiopulmonarybypass,CPB)heart-beatingopenheartsurgery.BloodsamplesbeforeCPB,and20minutes,1hour,24hoursand7daysafterCPBwerecollected,andthelevelsofneuron-specificenolase(NSE)andproteinS-100bintheplasmaweredeterminedwithenzyme-linkedimmunoadsorbentassay(ELISA),respectively.Allthepatientswereexaminedwithelectroencephalogram(EEG)beforeand1weekafteroperation.ThechangesofNSE,S-100bandEEGcomparedtoverifythedifferenceofpostoperativecerebralinjurybetweenCHDcasesandRHDcases.Results:TheplasmalevelofS-100bincreasedsignificantly20minutesafterCPBandwasstillhigherthanthepreoperativelevelat24hoursafteroperationinbothgroups(P<0.01).TheplasmalevelofNSEincreasedmoresignificantlyintheCHDgroupthanintheRHDgroup20minutesafterCPBanditreturnedtothenormallevel24hoursafterCPBintheCHDgroupbutremainedatahighlevelintheRHDgroup(P<0.01).ThelevelsofNSEandS-100breturnedtothenormallevelsonthe7thdayafterCPB.AbnormalEEGwasfoundin75%ofthepatientsintheCHDgroupand60%intheRHDgroup.Conclusions:On-pumpheart-beatingopenheartsurgerycancausecertaincerebralinjuryinthepatientswithCHDorRHD.TheinjurywasmoresevereandrecoveredmorequicklyintheCHDgroupthanintheRHDgroup.

简介：

简介：Objective:Tostudytheeffectofmildhypothermiaonglucosemetabolismandglycerolofbraintissueinpatientswithseveretraumaticbraininjury(STBI)usingclinicalmicrodialysis.Methods:Thirty-onepatientswithSTBI(GCS≤8)wererandomlydividedintohypothermicgroup(GroupA)andcontrolgroup(GroupB).Microdialysiscatheterswereinsertedintothecerebralcortexofperilesionalandnormalbraintissue.AllsampleswereanalyzedusingCMAmicrodialysisanalyzer.Results:Incomparisonwiththecontrolgroup,lactate/glucoseratio(L/G),lactate/pyruvateratio(L/P)andglycerol(Gly)inperilensionaltissueweresignificantlydecreased;L/Pinnormalbraintissuewassignificantlydecreased.Incontrolgroup,L/G,L/PandGlyinperilensionaltissuewerehigherthanthatinnormalbraintissue.Inthehypothermicgroup.L/Pinperilensionaltissuewashigherthanthatinrelativenormalbrain.Conclusions:MildhypothermiaprotectsbraintissuesbydecreasingL/G,L/PandGlyinperilensionaltissueandL/Pin'normalbrain'tissues.Theenergycrisisandmembranephospholipiddegradationinperilensionaitissueareeasiertohappenaftertraumaticbraininjury,andmildhypothermiaprotectsbrainbetterinperilensionaltissuethaninnormalbraintissue.

简介：

简介：Objective:Toevaluatetheeffectsofhyperbaricoxygen(HBO)therapyonpatientswithpostbraininjuryneuralstatus.Methods:Twoto4coursesofHBOtherapyand/ormedicationswereusedtotreat320patientswhowererandomlydividedintotwogroups.Assessmentwasmadewith99mTc-ethylcysteinatedimer(99mTc-ECD)singlephotonemissioncomputedtomography(SPECT)beforeandaftertreatment.Results:TherewasasignificantdifferencebetweentheHBOtherapygroupandthenon-HBOtherapygroup.HBOtherapywassuperiortomedicationtreatmentaloneintherecoveryofclinicalsymptoms,controlofepilepsy,andresolutionofhydrocephalus(P<0.01).Conclusions:HBOtherapyhasspecificcurativeeffectsonpatientswithpostbraininjuryneuralstatus,and99mTc-ECDSPECTcouldplayanimportantroleindiagnosingpostbraininjuryneuralstatusandmonitoringthetherapeuticeffectsofHBO.

简介：Objective:ToanalyzethedynamicchangeofserumproteinS100binpatientswithtraumaticbraininjuryanditsclinicalvalueinassessingbraindamage.Methods:AccordingtoGlasgowcomascale(GCS),102casesoftraumaticbraininjuryweredividedintomildbraininjurygroup(GCS≥13,n=31,GroupA),moderatebraininjurygroup(8

简介：Objective:　Toexploretheregulationofearlybraintissuemetabolicchangingafterbraininjuriesandtheclinicalsignificance.　　Methods:　Therewere17patientswithbraininjuries.EarlydirectmonitoringofPtiO2,PtiCO2,pHandbraintemperature,dynamicobservationoftherelationbetweenvariousparametersandclinicsafterbraininjurieswereperformed.　　Results:　EarlychangesofPtiO2,PtiCO2andpHwerecloselycorrelatedwithoutcome.ThedeathrateobviouslyincreasedwhenPtiO2wascontinuouslylowerthan9mm?Hgwithin24hoursafterinjuries.Secondarybraininjuryprolongedandaggravatedbraintissuemetabolicdisturbance.Whenintracerebralpressurewasover30mm?HgPtiO2begantodecrease.Thebraintemperatureinbraindeathpatientswasevidentlylowerthanaxillarytemperature.　　Conclusions:　ThedirectmonitoringofPtiO2,PtiCO2,pHandbraintemperatureissafeandaccurateandcanfindearlyanoxiadamagetobraintissueandprovidereliablebasisforclinicaltherapy.Ithasaninstructivesignificanceinselectingandstudyinganewtreatmentmethodinbraininjuries.Anditcanbetakenasacriterioninclinicaljudgingbraindeaths.

简介：

简介：[摘要]目的：分析整体护理理念在肛肠手术患者中的应用价值。方法：选取我院2019年3月～2021年12月收治的采取肛肠手术的患者114例作为实验研究对象，将114例患者分为实验组和对照组，对照组采取常规护理，实验组实施整体护理，对比两组患者护理后的手术指标改善情况、护理满意度以及治疗效果。结果：实验组患者术后排尿时间、术后排便时间、术后VAS评分和平均住院时间均低于对照组，两组患者的手术指标对比具有差异表示统计学有意义。实验组患者的护理满意度高于对照组，两组患者不同护理干预后，患者对自身护理模式的满意度也有很大的差异，P〈0.05表示统计学有意义。实验组患者的治疗有效率高于对照组，两组患者治疗效果对比具有差异表示统计学有意义。结论：为肛肠手术治疗患者实施整体护理干预，不仅能够改善患者的手术治疗指标，还能提高患者对护理的满意，保证手术治疗效果，对促进患者具体康复和生活质量都有重要意义。

简介：摘要：经导管主动脉瓣膜置换术具有创伤性小、术后并发症和致死率较低的优势，因此该手术具有极高的治疗安全性，成为了治疗复杂高危的主动脉瓣狭窄患者的主要治疗手段，根据相关学者的研究，为复杂高危主动脉瓣狭窄患者实施经导管主动脉瓣膜置换术治疗后的情况进行随访调查，证实了该手术用于治疗的安全性和与有效性。为患者实施手术治疗的时候，需要帮助患者完善各项检查，通过多学科协同评估患者的机体状态，制定合理的治疗方案，并且为患者实施个性化的护理方案，改善患者的心肾功能。护理人员需要充分了解经导管主动脉瓣膜置换术的流程、注意事项和潜在的危险，检测患者的病情，为患者术后实施呼吸支持，维持体循环等手段，降低并发症发病率。