探讨献血告知的注意事项

目的 探讨献血告知应注意的事项.方法 对献血告知的方式和要求作了陈述.结果 告知人员应有过硬的专业知识和良好的语言表达能力,对献血者信息保密,献血者才能对采血机构信任.结论 只有把献血告知工作做好,才能推动无偿献血健康而持续发展.     

献血反应原因分析及护理对策

对77例献血反应者,查明原因后实施有效的护理.献血者因素导致的献血反应发生率为69.93%,采血护士因素导致的献血反应发生率为27.27%,环境因素占2.59%.认为针对性的护理及有效的处理献血反应,对保证献血者的身体健康和采血工作的顺利进行有着重要的意义.     

稀土纳米晶及红外线诊断早期癌症肿瘤及心脑血管病变

<正>美国罗格斯大学发明一种新的医学成像方法,比现有方法能更早检测出癌症等其他病变,处理速度更快且不需要进行耗时较长的活检。这种纳米技术可诊断人体内微小的癌病变和心脑血管病变,在挽救人类生命方面潜力巨大。罗格斯大学药学院和工程学院的研究人员的早期试验已经看到了该项技术成功的曙光。罗格斯大学的科学家们将这项研究成果发表在了《自然通讯》杂志上。该项目的研究组长Prabhas Moghe称,这种新的荧光成像模式,目的不仅仅在于发现早期病变,还在于手术前更仔细地了解这些病变。罗格斯大学新泽西     

Impaired brain microcirculation may trigger Alzheimer's disease

A working hypothesis on the pathogenesis of Alzheimer's disease (AD) is presented. The model is based on recent ultrastructural and classic histologic findings showing extensive and characteristic distortion of brain capillaries in Alzheimer brains. Brain capillary distortion induces normal laminar flow to become microturbulent or "disturbed", an outcome which over the course of many years can modify hemorheologic and hemodynamic flow patterns. As flow patterns become disturbed, micronutrient delivery to the brain is reduced thus compromising neurono-glial interaction. Catabolic outflow of CNS waste products is also depressed. When ischemic sensitive neurons, particularly in the CA1 sector, are unable to meet energy demands from lowered energy supply, they release astroglial mitogens signalling reactive astrocytes to proliferate. The resulting neuronal energy crisis is consequently complicated by the increased density of reactive astrocytes which ostensibly contribute to senile plaque development and neurofibrillary tangle formation as competition for nerve tissue space increases. The suboptimal delivery of glucose, oxygen, essential nutrients and protease regulators in AD brain becomes progressively unpredictable and in time yields to a linear decline of neurochemical, morphologic and cognitive functions.     

Effect of alpha-methyldopa and alpha-methyl-m-tyrosine on the amount of noradrenaline in the heart and brain of irradiated rats

Effect of alpha-methyldopa and alpha-methyl-m-tyrosine on the amount of noradrenaline in the heart and brain of rats irradiated with 850 R was investigated. It was established that the application of alpha-methyldopa to the animals irradiated with 650 R caused significant decrease of noradrenaline stores in the heart and brain. Meanwhile, when alpha-methyldopa was applied to the animals irradiated with 850 R, there was no further decreasing of noradrenaline. The different effects may be tentatively explained: in animals irradiated with 650 R the processes of biosynthesis are still going on, while after the dose of 850 R, biosynthesis of catecholamine is badly damaged and the further inhibition of decarboxilase is probably impossible. Alpha-methyl-m-tyrosine caused, also, the strong discharge of noradrenaline storage in the heart and brain of irradiated animals. It is interesting to note there is no significant difference in inhibitory effect on animals irradiated with 650 and 850 R, respectively.     

Retrograde blood circulation and ischemic heart disease

The author performed experiments on 350 dogs and X-ray postmortem studies of 1520 corpses of subjects who had died of various diseases and injuries. It was found that in occlusive great vessels in the ischemic organs and tissues, retrograde circulation developed, which completely maintained their viability under definite conditions. Retrograde venous blood flow to diseased organs and tissues drastically increased in insufficient retrograde arterial blood circulation. Under certain conditions, surplus venous blood influx caused edema and their dysfunctions. The mechanisms of retrograde circulation account for asymptomatic occlusion of the great vessels.     

脑血管意外并枕大神经痛诊疗一例体会

枕大神经痛为后枕部阵发性或持续性疼痛,也可在持续痛基础上阵发性加剧.常因风寒、感冒引起,也可因颈部外伤、增生性颈椎病等颈椎病变所致.临床表现为一侧或两侧后枕部或兼含项部的针刺样、刀割样或烧灼样疼痛.此患者血压高引起头昏、头晕入院,入院后一天出现头痛,多考虑脑血管意外,但经头颅CT及腰穿可排外,结合患者曾患感冒,故此患者诊断明确,治疗有效.临床上头痛原因很多,所以我们临床医生要熟练掌握常见多发病的诊疗,也要熟悉少见疾病,避免漏诊.     

Diltiazem blood cardioplegia in patients of severe valvular heart disease

This study was undertaken to analyze the effect of diltiazem blood cardioplegia (D-BCP) in patients of valvular heart disease with severe left ventricular dysfunction (EF = 56.3%, FS = 26.0%, CI = 2.241/min/m3), they were satisfied with NYHA functional class 3 and 4, also cardiothoracic ratio over 65%. By negative choronotropic action of D, the heart rates in D added group tend to be less than those of D free group 4 to 16 hours postoperatively, although that may diminish the incidence of ventricular arrhythmia postoperatively. D-BCP improved better functional recovery (mPAWP-LVSWI relation) during the early postoperative period than those seen in preoperatively. The pulmonary vascular resistance index of D added group showed significantly lower levels than those in the preoperative period, 0 to 16 hours after surgery. Consequently, D-BCP might be safe and provide superior protection for severe valvular heart disease.     

Right ventricular function in congenital heart disease: pressure and volume overload lesions

The right ventricle is often subject to both pressure and volume overload in congenital heart disease. Evaluating right ventricular function in both the native lesion and after surgery in light of these loading conditions, presents a unique challenge for investigators studying these misshapen hearts. The purpose of this article is to briefly delineate what is generally known about right ventricular function in congenital heart disease and to touch on some noninvasive imaging modalities which have helped shed some light on this matter.     

Current treatment of brain abscess in patients with congenital cyanotic heart disease

OBJECTIVE: The goal of this study was to define clearly the role of management in patients with cyanotic heart disease and brain abscesses by evaluating retrospectively the factors influencing poor outcome in these patients. METHODS: This study included 62 patients with cyanotic heart disease and brain abscesses diagnosed in the computed tomography era. Basic characteristic parameters (number, size, location, computed tomographic classification and organism type of abscess, convulsion, type of cyanotic heart disease, age distribution, immunocompromised status, pretreatment neurological state, and intraventricular rupture of brain abscess [IVROBA]) and therapeutic parameters (type of antibiotics and duration of administration, steroid medication and therapeutic modalities, aspiration with or without cerebrospinal fluid drainage, total extirpation after aspiration, or primary extirpation and medical treatment) were evaluated as independent predictors of poor outcome (totally disabled state or death) by using univariate and multivariate logistic regression analysis. We also statistically estimated the possible causes of IVROBA and the multiplicity of brain abscess. RESULTS: Although there were no statistically significant correlations between patients with good and poor outcomes in regard to other basic characteristic and therapeutic parameters, patients with poor outcomes were older (P < 0.02), more frequently had IVROBA (P < 0.005), and had a higher frequency of neurological deterioration (P < 0.01) than those with good outcomes. Multiple logistic regression analysis predicted that poor outcome increased the relative risk of IVROBA by a factor of 18.9 (odds rate, 18.9; 95% confidence interval, 1.7-211.6; P < 0.02). More patients with multiple abscesses had positive immunocompromised states than those with single abscesses (P < 0.01). Deep-located abscesses also more frequently had IVROBA (P < 0.005) and abscesses located in the parieto-occipital region ruptured into the occipital horn of the lateral ventricle in a short period (P < 0.02). CONCLUSIONS: Our findings suggest that IVROBA strongly influences poor outcome in patients with cyanotic heart disease. The key to decreasing poor outcomes may be the prevention and management of IVROBA. To reduce operative and anesthetic risk in these patients, abscesses should be managed by less invasive aspiration methods guided by computed tomography. Abscesses larger than 2 cm in diameter, in deep-located or parieto-occipital regions, should be aspirated immediately and repeatedly, mainly using computed tomography-guided methods to decrease intracranial pressure and avoid IVROBA. IVROBA should be aggressively treated by aspiration methods for the abscess coupled with the appropriate intravenous and intrathecal administration of antibiotics while evaluating intracranial pressure pathophysiology.