Porocarcinoma coexisting at a site of Bowen disease in a 63‐year‐old woman

Porocarcinoma is an unusual, locally aggressive and potentially fatal neoplasm. Several cutaneous malignancies have been described in association with porocarcinoma, including squamous cell carcinoma, basal cell carcinoma and tricholemmal carcinoma. Previous reports have indicated that the occurrence of malignant tumours in combination with porocarcinoma is extremely rare, in particular with regard to Bowen disease (BD). We report an uncommon case of porocarcinoma occurring synchronously in a single BD lesion in a 63‐year‐old woman with multiple BD lesions. The clinical and histological findings confirmed this diagnosis.     

门诊和病房电脑鼠标细菌污染情况调查

目的调查门诊和普通病房电脑鼠标不同时段的细菌污染情况。方法随机抽取某院门诊及普通病房的各16个电脑鼠标，分别于8∶00、10∶30、13∶00、15∶30进行采样，样本接种培养后对菌落计数并筛查多重耐药菌。结果32个鼠标共计采样128次，最高菌落数达121 CFU/cm2，平均菌落数为23.9 CFU/cm2。随着时间的推移，同一鼠标的细菌计数逐渐增多。不同时段门诊和病房的电脑鼠标菌落数比较，在10∶30、13∶00、15∶30三个时间点，病房鼠标的菌落数均高于门诊（均P≤0.05）。64个病房电脑鼠标标本中检出耐甲氧西林金黄色葡萄球菌（MRSA）和耐碳青霉烯类鲍曼不动杆菌（CRAB）各1株。结论加强鼠标日常清洁消毒及监测工作非常重要，应增加清洁消毒频率或更换长效消毒剂，加强病房环境的清洁消毒。     

电针对缺血性脑卒中大鼠记忆功能及脑内突触囊泡蛋白的影响

观察电针对缺血性脑卒中大鼠记忆功能及脑内突触囊泡蛋白（synaptic vesicular protein，SYN）的影响，探讨其可能的作用机制。方法 选取90 只SD大鼠随机分为模型组、电针组、假手术组，每组各30只。线拴法制作急性大脑中动脉缺血大鼠模型。电针组取“百会”“水沟”“内关”“三阴交”穴位，应用“醒脑开窍”法进行电针，每天电针30 min，连续电针6 d休1 d，7 d为一个疗程，首次电针干预在造模成功24 h后进行。模型组和假手术组不进行电针干预。大鼠分别按7、14、21 d 3个亚组进行运动及记忆功能评分，TTC染色测定脑梗死体积、Western blot检测脑内SYN的蛋白表达。结果 电针组运动功能评分较模型组显著降低（P<0.01），电针组进入隐藏区潜伏期时间较模型组显著缩短（P<0.01），电针组脑梗死率较模型组显著缩小（P<0.01），SYN的蛋白表达电针组较模型组明显增强（P<0.01）。假手术组无神经功能缺损及脑梗死灶，SYN表达最弱。结论 电针干预能减小脑梗死体积，上调脑内SYN的表达，进而促进缺血性脑卒中大鼠的记忆及运动等神经功能的恢复。     

吉林辽宁两省18年来的目标设置对突发公共卫生事件应急工作落实情况的关联研究

目的本研究立足于项目组前期研究的成果上，积极探索吉林辽宁两省目标设置水平的差异，并进一步探究受目标设置影响下的工作落实结果情况，探讨产生差异的原因。 方法以系统穷尽的方式收集吉林辽宁两省2000至2017年有关目标与工作落实情况的指标，利用Spearman相关和线性回归分析吉林辽宁两省目标设置对于突发应急工作落实情况的影响。 结果吉林辽宁两省突发应急领域的目标设置水平与工作落实情况总体均呈现上升趋势，截至2017年，吉林目标设置水平与工作落实情况分别为46%与60%，辽宁为60%与53.3%，且目标设置水平与工作落实呈正相关。 结论有公众需要为依据且定量可考的目标设置对于工作落实、推进、完善具有积极的正反馈作用，建立科学量化的突发应急目标设置评价体系是适宜可行的。     

临床检验不合格血液标本产生原因及质量改进研究

目的:分析临床检验不合格血液标本的原因为何,研究相应的质量改进方法。方法:本课题自我院检验血液标本样本中抽取140份,其中2018年2月~2019年3月的70份命名成对照组,2019年4月~2020年3月的70份命名成试验组,前一组未进行质量改进,后一组进行质量改进,比较检验结果有何不同。结果:试验组这组的检验标本不合格率要比对照组那组的检验标本不合格率低,数据上是P<0.05的情况,即表明有统计学意义。结论:凝血反应、溶血反应、样本问题、送检失误、抗凝不全等是导致临床检验不合格血液标本的原因所在,实施质量改进可将血液标本质量提高。     

Network Meta-Analysis of Randomized Controlled Trials: Efficacy and Safety of UDCA-Based Therapies in Primary Biliary Cirrhosis

Major ursodeoxycholic acid (UDCA)-based therapies for primary biliary cirrhosis (PBC) include UDCA only, or combined with either methotrexate (MTX), corticosteroids (COT), colchicine (COC), or bezafibrate (BEF). As the optimum treatment regimen is unclear and warrants exploration, we aimed to compare these therapies in terms of patient mortality or liver transplantation (MOLT) and adverse events (AE).PubMed, the Cochrane Library, and Scopus were searched for randomized controlled trials up to August 31, 2014. We estimated the hazard ratios (HRs) for MOLT and odds ratios (ORs) for AE. A sensitivity analysis based on the dose of UDCA was also executed.Thirty-one eligible articles were included. Compared with COT plus UDCA, UDCA (HR 0.38, 95% confidence interval [CI] 0.09–1.39), BEF plus UDCA (HR 0.29, 95% CI 0.02–4.83), COC plus UDCA (HR 0.39, 95% CI 0.07–2.25), MTX plus UDCA (HR 0.28, 95% CI 0.05–1.63), or OBS (HR 0.49, 95% CI 0.11–2.01) all provided an increased risk of MOLT. With respect to drug AE profile, although not differing appreciably, BEF plus UDCA was associated with more AEs compared with UDCA (OR 3.16, 95% CI 0.59–20.67), COT plus UDCA (OR 2.27, 95% CI 0.15–33.36), COC plus UDCA (OR 1.00, 95% CI 0.09–12.16), MTX plus UDCA (OR 2.03, 95% CI 0.23–17.82), or OBS (OR 3.00, 95% CI 0.53–20.75). The results of sensitivity analyses were highly consistent with previous analyses.COT plus UDCA was the optimal UDCA-based regimen for both MOLT and AEs. BEF plus UDCA was most likely to cause AEs, whereas monotherapy with UDCA and coadministriation of COT plus UDCA appeared to be associated with the fewest AEs for PBC treatment.