使用低分子肝素钙出现腹部肌间血肿1例护理

低分子肝素钙是一种低相对分子质量的肝素,由普通肝素解聚而成,皮下注射后能形成有效的血浆肝素浓度发挥其高凝状态的抗血栓形成的作用,疗效显著,临床应用不需连续进行实验室监测[1]。因此,在临床上被广泛应用于心、脑血管,呼吸系统及肾脏等疾病中预防血栓形成。

The curative effect of zoledronic acid and pamidronic acid on treating ostealgia in malignant tumor with bone metastases and its side effects on serum calcium and phosphorus

Objective： Bisphosphonates were widely used with the rate of malignant tumor with bone metastases increasing rapidly. The aim of this study was to evaluate zoledronic acid and pamidronic acid on treating ostealgia of malignant tumor with bone metastases and serum calcium, phosphorus and alkaline phosphorus movement. Methods： One Hundred cancer patients with bone metastases were diagnosed according to pathological and imaging methods. After zoledronic acid or pamidronic acid intravenous infusion one and two months, ostealgia degree, serum calcium, serum phosphorus and alkaline phosphorus were observed before bisphosphonates treatment, one and two months after treatment, respectively. Results： Ostealgia degree did not change significantly after diphosphonates treatment from one to two months （P 〉 0.05）. The linear correlation between serum calcium and serum phosphorus on bone metastases cancer patients before therapy was dismissed after bisphosphonates treatment one month and did not recover in two months. The incidence of hypo-calcium after diphosphonate treatment one month （54%） and two months （56%） were significantly increased than that before treatment （36%） （X2 = 6.55, P = 0.011; X2 = 8.05, P = 0.005）. Serum calcium and serum phosphorus were both decreased after treatment one month （t = 4.39, P = 0.000; t = 2.50, P = 0.014） and two months （t = 4.32, P = 0.000; t = 2.49, P = 0.010）. There had no difference between zoledronic acid and pamidronic acid on treating of ostealgia and serum calcium and phosphorus changing. Conclusion： Zoledronic acid and pamidronic acid can relief ostealgia of cancer patients with bone metastases and induce hypo-calcium, break the linear relationship between calcium and phosphorus. There have no difference between zoledronic acid and pamidronic acid on treating ostealgia and inducing hypo-calcium and hypo-phosphorus.

视网膜变性大鼠视网膜神经节细胞变化及其触发因素探讨

目的观察探讨视网膜变性大鼠视网膜神经节细胞（RGCs）的变化及其触发因素。方法出生后21、60、90d含色素的RoyalCollegeofsurgeons（Rcs）-p’视网膜变性大鼠各6只，RCS-rdy＋-p＋无视网膜变性大鼠各6只。立体定位下行大鼠上丘和外膝体荧光金逆行标记RGCs，荧光显微镜下观察RGCs细胞形态并计数。作视网膜铺片和切片，采用激光共聚焦显微镜观察RGCs细胞内钙成像情况，分析RGCs细胞内钙浓度的变化。结果荧光显微镜观察发现，出生后90d，无视网膜变性大鼠RGCs分布于整个视网膜，细胞大小均一，细胞胞体和突起清晰可见；视网膜变性大鼠RGCs分布稀疏，细胞大小不一，细胞突起分枝数和范围减小，出现杆状或碎屑细胞。出生后21、60、90d，视网膜变性大鼠RGcs数量分别为（5421.0±72．1）、（4195．0±136．4）、（2906．0±133．2）个／mm2。与无视网膜变性大鼠比较，出生后21d时其RGCs数量间差异无统计学意义（t=-1．301，P〉0．05）；出生后60、90d时其RGCs数量显著减少，差异有统计学意义（t=16．172，30．131；P〈O．05）。出生后21d有无视网膜变性大鼠RGCs细胞内钙荧光强度比较，差异无统计学意义（t=-1．545，P〉0．05）；出生后60、90d视网膜变性大鼠RGCs细胞内钙荧光强度较无视网膜变性大鼠明显增强，差异有统计学意义（t=-18．058，-15．015；P〈0．01）。结论视网膜变性大鼠RGCs发生变性死亡，细胞形态和数量受到显著影响。RGcs细胞内钙浓度的变化可能是视网膜变性中RGCs继发变性、死亡的触发因素。