PICC置管在颅脑损伤患者中的应用

对于颅脑损伤术后患者经外周静脉置入中心静脉导管(PICC)置管术,不仅有效防止术后脑组织水肿,颅内高压而危及患者生命,而且减轻了高渗性液体对血管壁的刺激,减少了静脉炎的发生。此项操作护理人员可独立完成。     

血液透析患者3种深静脉置管临床效果比较及护理体会

目的探讨锁骨下静脉置管、颈内静脉置管和股静脉置管3种深静脉置管对血液透析患者的临床效果及其护理。方法将我院透析治疗中心2009年收治的120例血液透析患者随机分为3组,分别行锁骨下静脉置管、颈内静脉置管和股静脉置管,分析比较3组临床效果。结果锁骨下静脉、颈内静脉、股静脉3种置管穿刺成功率分别为90.00%、95.00%、97.50%,组间比较P>0.05,无显著差异,并发症发生率分别为10.00%、22.50%、22.50%,经统计学处理,锁骨下静脉置管与其他2组比较,P<0.05,并发症发生率明显低于其他2组。结论锁骨下静脉置管并发症发生率低,是进行血液透析慢性肾衰患者临时血管通路的最佳选择。     

PICC在肿瘤护理的临床应用

目的 探讨外周静脉置入中心静脉导管(PeripherallyInsertedCentralCatheterPICC)在肿瘤护理方面的临床应用。方法 PICC置管方法,置管后并发症的原因、预防与处理。结果 PICC在肿瘤病人的化疗、静脉高营养等输液方面解决了反复穿刺给患者造成的痛苦、肿瘤化疗药物及其外渗等对外周血管的损害,减少并发症。结论 PICC操作简单、使用方便、安全、维护简单,在肿瘤护理领域的应用前景广阔。     

右锁骨下静脉穿刺术的改良及116例临床应用体会

目的为提高穿刺成功率,减少穿刺并发症,探索锁骨下静脉穿刺中心静脉置管术穿刺方法的改良。方法36例患者采用穿刺点为锁骨中点下缘下方2cm偏内1cm,向胸锁关节后上角穿刺;80例患者根据患者锁骨与肋骨的间隙,胸廓的前后径选择锁骨中点下方2cm左右偏内或外1cm,向胸锁乳突肌胸骨头与锁骨头之间区域、颈总动脉内侧穿刺,比较2种穿刺方法的穿刺成功率及并发症。结果经典方法单针道穿刺置管20(36)例,成功率为55.6%,改进后单针道穿刺置管成功63(80)例,成功率为为78.8%,单针道穿刺成功率差异有显著性(P<0.05),总穿刺置管成功率分别为88.9%、98.8%;经典方法置管操作时间为(38.5±6.2)min,改进后为(26.3±5.6)min;原方法并发症发生率19.4%,改进后为7.5%,差异均有显著性(P<0.01)。结论改进的右锁骨下静脉穿刺置管术进针点及进针方向较充分考虑了胸廓的变异及颈部血管的走向差异,可以提高穿刺成功率,减少并发症。     

PICC在胃肠癌化疗中的应用研究

目的观察胃肠癌患者经外周穿刺中心静脉置管(PICC)在胃肠癌化疗中的应用研究并分析原因。方法分析2007年1月至2010年1月60例晚期胃肠癌患者实施PICC置管术的临床资料,胃肠癌患者采用PICC配合便携式化疗泵持续给药及常规输液给药2种方法进行分析比较。结果观察组与对照组2组给药方法治疗比较,有效率有显著性差异(P<0.05)。结论 PICC置管在提高近期疗效、提高生活质量,减轻抗癌药毒性反应方面取得满意效果,能有效减轻患者的痛苦,延长置管时间,保证静脉治疗的顺利完成。     

209例肿瘤患者深静脉置管术并发症的护理对策

肿瘤患者在接受化疗、胃肠外营养、输血或血制品、标本采集等治疗时,需行深静脉穿刺置管术,但置管后出现的并发症,需引起高度的重视,恰当的护理对策,能有效地避免深静脉穿刺置管术后并发症,减轻患者的痛苦。     

腋静脉留置针在早产儿中的应用

目的探讨早产儿腋静脉穿刺置人留置针的保留时间及不良反应。方法从2008年2月至2009年8月,68例留置针在早产儿输液对象中的33例采用腋静脉输液,35例采用外周静脉输液,对2组一次穿刺成功率、导管脱出、保留时间进行分析。结果腋静脉穿刺置管留置时间明显长于外周静脉,也无明显不良反应。结论腋静脉置管大大减少了患儿的痛苦和护士的工作量,是一种既安全又经济的给药途径,可以在新生儿病房和NICU广泛使用。     

颈外静脉留置针在心血管内科病人中的应用

目的探讨一次性静脉留置针经颈外静脉穿刺置管的方法及优点。方法对心血管内科中遇到的危重病人采用一次性静脉留置针经颈外静脉穿刺进行输液治疗。结果观察78例病人,其中3例穿刺失败。结论使用一次性静脉留置针经颈外静脉穿刺输液具有操作简便,一次穿刺置管成功率高,完成时间短,并发症少及固定牢固,不易脱出等优点,是一种安全简便实用的静脉输液方法。     

留置中心静脉导管治疗恶性胸腔积液的护理

目的总结留置中心静脉导管引流恶性胸积液的护理措施及注意事项。方法对23例恶性肿瘤合并胸腔积液患者在B超定位下经皮穿刺胸腔内留置中心静脉导管,间断抽吸或引流胸腔积液后注入化疗药物,并做好导管留置期间护理。结果23例均能成功置管,顺利完成治疗,置管时间最长32d,最短7d,平均16.5d,无一例发生并发症。结论做好个性化的心理护理和健康教育,术后严密观察病情并加强引流管的护理、引流液的观察、穿刺点的保护,协助患者更换体位,保持导管固定通畅,防止导管脱落是治疗成功的关键。     

476例深静脉置管患者的导管护理体会

深静脉穿刺置管术已被广泛应用于临床,可用作中心静脉压监测、输血、补液、肿瘤化疗及胃肠外营养的通道,建立一条高质量的可重复使用的静脉通道,不仅可以减少患者多次穿刺的痛苦,减轻患者对输液的压力,更重要的是为抢救患者赢得时间。     

Insect antifeedant properties of anthranoids from the genusVismia

Vismiones and ferruginins, representatives of a new class of lypophilic anthranoids from the genusVismia were found to inhibit feeding in larvae of species ofSpodoptera, Heliothis, and inLocusta migratoria.     

Direct observation of freeze-thaw instability of latex coatings via high pressure freezing and cryogenic SEM

Despite its industrial importance, the subject of freeze-thaw (F/T) stability of latex coatings has not been studied extensively. There is also a lack of fundamental understanding about the process and the mechanisms through which a coating becomes destabilized. High pressure (2100 bar) freezing fixes the state of water-suspended particles of polymer binder and inorganic pigments without the growth of ice crystals during freezing that produce artifacts in direct imaging scanning electron microscopy (SEM) of fracture surfaces of frozen coatings. We show that by incorporating copolymerizable functional monomers, it is possible to achieve F/T stability in polymer latexes and in low-VOC paints, as judged by the microstructures revealed by the cryogenic SEM technique. Particle coalescence as well as pigment segregation in F/T unstable systems are visualized. In order to achieve F/T stability in paints, latex particles must not flocculate and should provide protection to inorganic pigment and extender particles. Because of the unique capabilities of the cryogenic SEM, we are able to separate the effects of freezing and thawing, and study the influence of the rate of freezing and thawing on F/T stability. Destabilization can be caused by either freezing or thawing. A slow freezing process is more detrimental to F/T stability than a fast freezing process; the latter actually preserves suspension stability during freezing. Presented at the 82nd Annual Meeting of the Federation of Societies for Coatings Technology, October 27–29, 2004 in Chicago, IL. Tied for first place in The John A. Gordon Best Paper Competition.     

Ethanol and (−)-α-Pinene: Attractant Kairomones for Bark and Ambrosia Beetles in the Southeastern US

In 2002–2004, we examined the flight responses of 49 species of native and exotic bark and ambrosia beetles (Coleoptera: Scolytidae and Platypodidae) to traps baited with ethanol and/or (−)-α-pinene in the southeastern US. Eight field trials were conducted in mature pine stands in Alabama, Florida, Georgia, North Carolina, and South Carolina. Funnel traps baited with ethanol lures (release rate, about 0.6 g/day at 25–28°C) were attractive to ten species of ambrosia beetles (Ambrosiodmus tachygraphus, Anisandrus sayi, Dryoxylon onoharaensum, Monarthrum mali, Xyleborinus saxesenii, Xyleborus affinis, Xyleborus ferrugineus, Xylosandrus compactus, Xylosandrus crassiusculus, and Xylosandrus germanus) and two species of bark beetles (Cryptocarenus heveae and Hypothenemus sp.). Traps baited with (−)-α-pinene lures (release rate, 2–6 g/day at 25–28°C) were attractive to five bark beetle species (Dendroctonus terebrans, Hylastes porculus, Hylastes salebrosus, Hylastes tenuis, and Ips grandicollis) and one platypodid ambrosia beetle species (Myoplatypus flavicornis). Ethanol enhanced responses of some species (Xyleborus pubescens, H. porculus, H. salebrosus, H. tenuis, and Pityophthorus cariniceps) to traps baited with (−)-α-pinene in some locations. (−)-α-Pinene interrupted the response of some ambrosia beetle species to traps baited with ethanol, but only the response of D. onoharaensum was interrupted consistently at most locations. Of 23 species of ambrosia beetles captured in our field trials, nine were exotic and accounted for 70–97% of total catches of ambrosia beetles. Our results provide support for the continued use of separate traps baited with ethanol alone and ethanol with (−)-α-pinene to detect and monitor common bark and ambrosia beetles from the southeastern region of the US.     

Many Drugs of Abuse May Be Acutely Transformed to Dopamine,Norepinephrine and Epinephrine In Vivo

It is well established that a wide range of drugs of abuse acutely boost the signaling of the sympathetic nervous system and the hypothalamic–pituitary–adrenal (HPA) axis, where norepinephrine and epinephrine are major output molecules. This stimulatory effect is accompanied by such symptoms as elevated heart rate and blood pressure, more rapid breathing, increased body temperature and sweating, and pupillary dilation, as well as the intoxicating or euphoric subjective properties of the drug. While many drugs of abuse are thought to achieve their intoxicating effects by modulating the monoaminergic neurotransmitter systems (i.e., serotonin, norepinephrine, dopamine) by binding to these receptors or otherwise affecting their synaptic signaling, this paper puts forth the hypothesis that many of these drugs are actually acutely converted to catecholamines (dopamine, norepinephrine, epinephrine) in vivo, in addition to transformation to their known metabolites. In this manner, a range of stimulants, opioids, and psychedelics (as well as alcohol) may partially achieve their intoxicating properties, as well as side effects, due to this putative transformation to catecholamines. If this hypothesis is correct, it would alter our understanding of the basic biosynthetic pathways for generating these important signaling molecules, while also modifying our view of the neural substrates underlying substance abuse and dependence, including psychological stress-induced relapse. Importantly, there is a direct way to test the overarching hypothesis: administer (either centrally or peripherally) stable isotope versions of these drugs to model organisms such as rodents (or even to humans) and then use liquid chromatography-mass spectrometry to determine if the labeled drug is converted to labeled catecholamines in brain, blood plasma, or urine samples.     

Novel polyurethane coating technology through glycidyl carbamate chemistry

Glycidyl carbamate chemistry combines the excellent properties of polyurethanes with the crosslinking chemistry of epoxy resins. Glycidyl carbamate functional oligomers were synthesized by the reaction of polyfunctional isocyanate oligomers and glycidol. The oligomers were formulated into coatings with several amine functional crosslinkers at varying stoichiometric ratios and cured at different temperatures. Properties such as solvent resistance, hardness, and impact resistance were dependent on the composition and cure conditions. Most coatings had an excellent combination of properties. Studies were carried out to determine the kinetics of the curing reaction of the glycidyl carbamate functional oligomers with multifunctional and model amines. Detailed kinetic analysis of the curing reactions was also undertaken. The results indicated that the glycidyl carbamate functional group is more reactive than a glycidyl ether group. Presented at the 82nd Annual Meeting of the Federation of Societies for Coatings Technology, on October 27–29, 2004, in Chicago, IL.