开发与整合图书馆的文献资源

从用户信息需求变化探讨了高校图书馆馆藏资源开发整合的可行性及必要性.在对馆藏资源进行开发整合时,应把工作的重心和主要精力放在学校的重点学科建设上,借助用户的专业优势取得整合工作的成功.     

探索灰色文献

在概述了灰色文献的起源、内涵、外延及其他特征的基础上,对各国学者对灰色文献的研究进行了比较分析,对灰色文献的自身价值和社会作用进行了分析评价.     

Endoscopic internal drainage for the management of leak,fistula, and collection after sleeve gastrectomy: our experience in 617 consecutive patients

BackgroundEndoscopy plays a pivotal role in the management of adverse events (AE) following bariatric surgery. Leaks, fistulae, and post-operative collection after sleeve gastrectomy (SG) may occur in up to 10% of cases.ObjectivesTo evaluate the efficacy and safety of endoscopic internal drainage (EID) for the management of leak, fistula, and collection following SG.SettingRetrospective, observational, single center study on patients referred from several bariatric surgery departments to an endoscopic referral center.MethodsEID was used as first-line treatment for the management of leaks, fistulae, and collections. Leaks and fistulae were treated with double pigtail stent (DPS) deployment in order to guarantee internal drainage and second intention cavity obliteration. Collections were treated with endoscropic ultrasound (EUS)–guided deployment of DPS or lumen apposing metal stents.ResultsA total of 617 patients (83.3% female; mean age, 43.1 yr) were enrolled in the study for leak (n = 300, 48.6%), fistula (n = 285, 46.2%), and collection (n = 32, 5.2%). Median follow-up was 19.5 months. Overall clinical success was 84.7% whereas 15.3% of cases required revisional surgery after EID failure. Clinical success according to type of AE was 89.5%, 78.5%, and 90% for leak, fistula, and collection, respectively. A total of 10 of 547 (1.8%) presented a recurrence during follow-up. A total of 28 (4.5%) AE related to the endoscopic treatment occurred. At univariate logistic regression predictors of failure were: fistula (OR 2.012), combined endoscopic approach (OR 2.319), need for emergency surgery (OR 1.755), and previous endoscopic treatment (OR 4.818).ConclusionEarly EID for the management of leak, fistula, and post-operative collection after SG seems a safe and effective first-line approach with good long-term results.     

网络环境下提高外文期刊文献保障能力的实践与体会

以广州中医药大学图书馆为例，分析总结了网络环境下提高外文期刊文献保障能力的经验：购买引进电子期刊、开发网络免费电子期刊资源、通过馆际互借与文献传递、建立高校协作组、开展国际期刊交流等。     

Asynchronous Testing of 2 Specimen-Diversion Devices to Reduce Blood Culture Contamination: A Single-Site Product Supply Quality Improvement Project

ObjectiveBlood culture contamination above the national threshold has been a consistent clinical issue in the ED setting. Two commercially available devices were examined that divert an initial small volume of the specimen before the collection of blood culture to reduce skin contamination.MethodsProspectively, 2 different blood culture–diversion devices were made available in the unit supplies to ED clinicians at a single site during 2 different periods of time as a follow-up strategy to an ongoing quality improvement project. Blood samples were collected in the emergency department over a period of 16 months. A retrospective record review study was conducted comparing the use of the 2 specimen-diversion devices with no device (control group) for blood culture contamination rates. The main outcome of monthly blood culture contamination per device was tested using a Bayesian Poisson multilevel regression model.ResultsA total of 4030 blood samples were collected and analyzed from November 2017 to February 2019. The model estimated that the mean incidence of contaminated blood draws in the device A group was 0.29 (0.14-0.55) times the incidence of contaminated draws in the control group. The mean incidence of contaminated blood draws in the device B group was 0.23 (0.13-0.37) times the incidence of contaminated draws in the control group, suggesting that initial-diversion methods reduced blood culture contamination.ConclusionInitial specimen–diversion devices supplement present standard phlebotomy protocols to bring down the blood culture contamination rate.     

儿科血培养两种采集方法标本污染比较分析

目的：分析比较外周静脉留置针穿刺采血与直接静脉穿刺采血血培养标本污染发生率。方法对儿科病房2012年4月～2013年9月送检的血培养标本结果进行回顾性调查，比较两种不同方法采集血培养标本发生的污染率。结果3016份送检的血培养标本中，判断为污染菌的有67例，总污染率为2．2％。外周静脉留置针穿刺采血594例，判断为污染12例，污染率为2．0％；直接静脉穿刺采血2422例，判断为污染54例，污染率2．2％。结论外周静脉留置针穿刺采血与直接静脉穿刺采血，血培养标本污染的发生率差异无显著意义。儿科血培养的采集可以在新置入的外周静脉留置针内采血。     

Quel « PRP » pour traiter les tendinopathies chroniques ?

Plasma rich platelets (PRP) consist of blood plasma with a high concentration of platelets autologous constituting a huge reservoir of growth factors. The clinical use of the PRP is widespread in various medical applications. Even it is very popular with athletes, the use of PRP in tendinopathies is still scientifically discussed, particularly related to a disparity in the products called PRP. In order to optimize employment, it should be interested in the different stages of obtaining of the PRP. In this literature review, we analyzed in particular 8 parameters that can influence the quality of the PRP: (1) anticoagulants used to preserve the best feature of platelet; (2) centrifuge speeds used in order to extract platelets; (3) platelet concentrations and the presence of leukocytes and erythrocytes in the PRP; (4) the platelet activators for the mast of platelets and thus the release of growth factors; (5) use of local anesthetics to achieve infiltration, in addition to these parameters, it might be interesting to analyze other variables like: (6) employment or not of buffer to neutralize the acidity caused by anticoagulants; (7) injection under US guidance or not; and (8) volume of PRP injected to determine their influence on the healing potential.     

Improvement of Oral Bioavailability and Anti-Tumor Effect of Zingerone Self-Microemulsion Drug Delivery System

This study sought to prepare a self-microemulsion drug delivery system containing zingerone (Z-SMEDDS) to improve the low oral bioavailability of zingerone and anti-tumor effect. Z-SMEDDS was characterized by particle size, zeta potential and encapsulation efficiency, while its pharmacokinetics and anti-tumor effects were also evaluated. Z-SMEDDS had stable physicochemical properties, including average particle size of 17.29 ± 0.07 nm, the zeta potential of -22.81 ± 0.29 mV, and the encapsulation efficiency of 97.96% ± 0.02%. In vitro release studies have shown the release of zingerone released by Z-SMEDDS was significantly higher than free zingerone in different release media. The relative oral bioavailability of Z-SMEDDS was 7.63 times compared with free drug. Meanwhile, the half inhibitory concentration （IC50）of Z-SMEDDS and free zingerone was 8.45 μg/mL and 13.30 μg/mL, respectively on HepG2. This study may provide a preliminary basis for further clinical research and application of Z-SMEDDS.     

Myocardial Fibrosis and Inflammation by CMR Predict Cardiovascular Outcome in People Living With HIV

ObjectivesThe goal of this study was to examine prognostic relationships between cardiac imaging measures and cardiovascular outcome in people living with human immunodeficiency virus (HIV) (PLWH) on highly active antiretroviral therapy (HAART).BackgroundPLWH have a higher prevalence of cardiovascular disease and heart failure (HF) compared with the noninfected population. The pathophysiological drivers of myocardial dysfunction and worse cardiovascular outcome in HIV remain poorly understood.MethodsThis prospective observational longitudinal study included consecutive PLWH on long-term HAART undergoing cardiac magnetic resonance (CMR) examination for assessment of myocardial volumes and function, T1 and T2 mapping, perfusion, and scar. Time-to-event analysis was performed from the index CMR examination to the first single event per patient. The primary endpoint was an adjudicated adverse cardiovascular event (cardiovascular mortality, nonfatal acute coronary syndrome, an appropriate device discharge, or a documented HF hospitalization).ResultsA total of 156 participants (62% male; age [median, interquartile range]: 50 years [42 to 57 years]) were included. During a median follow-up of 13 months (9 to 19 months), 24 events were observed (4 HF deaths, 1 sudden cardiac death, 2 nonfatal acute myocardial infarction, 1 appropriate device discharge, and 16 HF hospitalizations). Patients with events had higher native T1 (median [interquartile range]: 1,149 ms [1,115 to 1,163 ms] vs. 1,110 ms [1,075 to 1,138 ms]); native T2 (40 ms [38 to 41 ms] vs. 37 ms [36 to 39 ms]); left ventricular (LV) mass index (65 g/m² [49 to 77 g/m²] vs. 57 g/m² [49 to 64 g/m²]), and N-terminal pro–B-type natriuretic peptide (109 pg/l [25 to 337 pg/l] vs. 48 pg/l [23 to 82 pg/l]) (all p < 0.05). In multivariable analyses, native T1 was independently predictive of adverse events (chi-square test, 15.9; p < 0.001; native T1 [10 ms] hazard ratio [95% confidence interval]: 1.20 [1.08 to 1.33]; p = 0.001), followed by a model that also included LV mass (chi-square test, 17.1; p < 0.001). Traditional cardiovascular risk scores were not predictive of the adverse events.ConclusionsOur findings reveal important prognostic associations of diffuse myocardial fibrosis and LV remodeling in PLWH. These results may support development of personalized approaches to screening and early intervention to reduce the burden of HF in PLWH (International T1 Multicenter Outcome Study; NCT03749343).     

论中医类书《医部全录》

《医部全录》为《古今图书集成》的一部分,是我国历代以来最大的一部医学类书.全书内容包括医经注释、诊法、脏腑身形、各科疾病的理论经验,以及有关医学的艺文、记事和名医传等,内容丰富,眉目清楚,是一部常用的中医工具书,对医学工作者学习和研究中医具有很高的参考价值.