国产恩丹西酮预防化疗引起恶心呕吐80例临床观察

采用随机对照法观察了恩丹西酮对８０例顺铂及非顺铂类化疗药的止吐作用，化疗第１周期用恩丹西酮或胃复安，第２周期交换。结果显示，恩丹西酮对控制急性呕吐的有效率为９１．３％，而胃复安仅为５８．８％（Ｐ〈０．０１），其对非顺铂类的止吐作用，前２天优于顺铂（Ｐ〈０．０５），它对迟发性呕吐的疗效也优于胃复安，本研究认为，恩丹西酮控制顺铂及非顺铂类化疗引起的恶心呕吐均有良好的疗效，副作用少。     

Severe acute respiratory syndrome-associated coronavirus genotype and its characterization

Objective To study the severe acute respiratory syndrome (SARS)-associated coronavirus genotype and its characteristics.Methods A SARS-associated coronavirus isolate named ZJ01 was obtained from throat swab samples taken from a patient in Hangzhou, Zhejing province. The complete genome sequence of ZJ01 consisted of 29 715 bp ( GenBank accession : AY297028, version : gi : 30910859). Seventeen SARS-associated coronavirus genome sequences in GenBank were compared to analyze the common sequence variations and the probability of co-occurrence of multiple polymorphisms or mutations.Phylogenetic analysis of those sequences was done.Results By bioinformatics processing and analysis, the 5 loci nucleotides at Z J01 genome were found being T, T, G, T and T, respectively. Compared with other SARS-associated coronavirus genomes in the GenBank database, an A/G mutation was detected besides the other 4 mutation loci( C: G: C: C/T: T: T: T) involved in this genetic signature. Therefore a new definition was put forward according to the 5 mutation loci. SARS-associated coronavirus strains would be grouped into two genotypes (C:G:A: C: C/T: T: G: T: T), and abbreviated as SARS coronavirus C genotype and T genotype. On the basis of this new definition, the ZJ01 isolate belongs to SARS-associated coronavirus T genotype, first discovered and reported in mainland China. Phylogenetic analysis of the spike protein gene fragments of these SARS-associated coronavirus strains showed that the GZ01 isolate was phylogenetically distinct from other isolates, and compared with groups F1and F2 of the T genotype, the isolates of BJ01and CUHK-Wl were more closely related to the GZ01 isolate. It was interesting to find that two(A/G and C/T) of the five mutation loci occurred in the spike protein gene, which caused changes of Asp to Gly and Thr to lie in the protein, respectively.Conclusion Attention should be paid to whether these genotype and mutation patterns are related to the virus‘ s biological activities,epidemic characteristics and host clinical svmotoms.     

基于CDIO案例结合护理团队参与对翼状胬肉术后疼痛的管理

目的探讨基于CDIO的案例与病例融合结合护理团队管理翼状胬肉患者术后疼痛的效果。方法选取2016年12月至2018年6月在湖南省某综合性三甲医院眼科诊治的原发性翼状胬肉患者80例80眼为研究对象,按随机数字表法分为观察组和对照组,各40例。观察组采取基于CDIO的案例与病例融合团队全程管理,对照组采取常规管理。对两组患者:术后当天、1 d及2 d采用疼痛量表(NRS)评分,术前、术后当天及1 d采用焦虑自评量表(SAS)评分,术后当天及1 d采用自制不适耐受度表评分,观察并比较两组患者的NRS、SAS评分、术后不适耐受度情况。结果观察组各时间点疼痛评分均低于对照组,差异有统计学意义(P<0.05);观察组术后当天及1 d的焦虑评分均低于对照组,差异有统计学意义(P<0.05);观察组术后不适耐受度高于对照组,差异有统计学意义(P<0.05)。结论对翼状胬肉患者采取基于CDIO的案例与病例融合团队全程管理,能有效缓解患者疼痛,减轻焦虑,提高不适耐受程度。     

磁共振血管成像后处理新技术在脑动脉瘤诊断和治疗中的价值

目的 利用最新磁共振血管成像后处理技术诊断和观察动脉瘤。方法 经手术和血管造影证实脑动脉瘤３８例共４３个,所的病例都进行脑部磁共振成像和磁共振血管成像,血管成像序列包括三维时间飞跃法（３Ｄ ｔｉｍｅ ｏｆ ｆｌｉｇｈｔ,３Ｄ ＴＯＦ）或合并零位差值技术（ｚｅｒｏｆｉｌｌ ｉｎｔｅｒｐｏｌａｔｉｏｎ ｐｒｏｃｅｓｓｉｎｇ,ＺＩＰ）,后处理技术包括常规技术即最大强度投影（ｍａｘｉｍｕｍ ｉｎｔｅｎｓｉ     

营养支持治疗在老年慢性阻塞性肺疾病中的应用

目的探讨营养支持治疗对老年慢性阻塞性肺疾病（c0PD）患者的应用价值。方法将82例老年COPD患者按照人院顺序分为干预组和对照组，每组41例。2组均给予COPD常规治疗，在此基础上对照组接受饮食指导，干预组采用营养支持治疗。治疗1个月后，比较2组患者的症状疗效，治疗前后血清白蛋白（Alb）与转铁蛋白（TRF）的变化，并观察肱三头肌皮褶厚度（TSF）、上臂围长（MAc）及理想体质量（IBW）比率的变化。结果治疗1个月后，干预组总有效率显著高于对照组，差异有统计学意义。治疗后，2组AlL与TRF水平都有所升高，但干预组升高幅度更大；2组TSF、MAC及IBW比率都有所增加，但干预组IBM比率增加程度更大，差异均有统计学意义。结论在常规治疗基础上应用营养支持治疗可有效改善老年COPD患者的临床症状，促进机体功能恢复，提高临床有效率，改善生活质量，值得临床广泛应用。     

精神分裂症临床护理路径标准化管理

临床护理路径(clinical nursing pathway,CNP)在临床护理工作中的作用已经得到了充分的肯定,它是最适当、有顺序性和时间性的护理,可以减少康复的延迟与资源的浪费,使服务对象获得最佳的照顾质量;可明显促进护理水平的提高,改善护理质量,提高病人生活质量。精神分裂症是精神科常见疾病之一,是反复发作的慢性迁延性疾病。为使精神分裂症病人得     

胸腔镜下行肺癌根治术的围手术期护理体会

目的 探讨胸腔镜下行肺癌根治术的有效护理方法及效果.方法 将90例胸腔镜下行肺癌根治术的患者按照护理的方法的不同分为观察组和对照组,对照组采用常规护理,观察组在对照组的基础上采用舒适护理,比较两组的术后恢复情况及护理护理满意度.结果 观察组的胸腔引流管拔管时间、住院时间及并发症的发生率显著少于对照组(P＜0.05).观察组在宣教、环境、态度等护理项目方面的满意度均显著高于对照组(P＜0.05).结论 在胸腔镜下肺癌根治术中应用舒适护理可最大限度的满足患者的生理、心理需求,促进术后恢复,提高满意度.     

光线性角化病的皮肤镜特征研究进展

光线性角化病（AK）是皮肤长期暴露于日光下所引起的一种癌前病变,有发展为鳞癌的风险,皮肤镜已广泛应用于AK的诊断与鉴别诊断,其皮肤镜特征包括: 基底假网状红斑、毛囊口周围白晕、毛囊口黄色角栓等,本文对AK的皮肤镜表现及鉴别诊断进行了综述。     

Clinical Manifestations in Paroxysmal Kinesigenic Dyskinesia Patients with Proline-Rich Transmembrane Protein 2 Gene Mutation

Background and Purpose

Given the diverse phenotypes including combined non-dyskinetic symptoms in patients harboring mutations of the gene encoding proline-rich transmembrane protein 2 (PRRT2), the clinical significance of these mutations in paroxysmal kinesigenic dyskinesia (PKD) is questionable. In this study, we investigated the clinical characteristics of PKD patients with PRRT2 mutations.

Methods

Familial and sporadic PKD patients were enrolled and PRRT2 gene sequencing was performed. Demographic and clinical data were compared between PKD patients with and without a PRRT2 mutation.

Results

Among the enrolled PKD patients (8 patients from 5 PKD families and 19 sporadic patients), PRRT2 mutations were detected in 3 PKD families (60%) and 2 sporadic cases (10.5%). All familial patients with a PRRT2 gene mutation had the c.649dupC mutation, which is the most commonly reported mutation. Two uncommon mutations (c.649delC and c.629dupC) were detected only in the sporadic cases. PKD patients with PRRT2 mutation were younger at symptom onset and had more non-dyskinetic symptoms than those without PRRT2 mutation. However, the characteristics of dyskinetic movement did not differ between the two groups.

Conclusions

This is the first study of PRRT2 mutations in Korea. The presence of a PRRT2 mutation was more strongly related to familial PKD, and was clinically related with earlier age of onset and common non-dyskinetic symptoms in PKD patients.