四磨汤口服液对脾虚便秘小鼠肠黏膜结构的影响

目的探讨四磨汤口服液对脾虚便秘小鼠肠黏膜结构损伤的修复作用。方法通过灌胃番泻叶水煎液7 d,控制饮食、饥饱失常8 d建立小鼠脾虚便秘模型,造模成功后,治疗组给予四磨汤口服液灌胃,治疗5 d,模型组和正常组给予等量无菌水灌胃,取肠道组织进行病理切片观察。结果四磨汤能修复损伤的空肠、回肠黏膜结构,减轻炎症细胞浸润,且能增加盲肠的杯状细胞数目。结论四磨汤口服液治疗脾虚便秘,其作用可能与修复小鼠肠黏膜结构相关。     

A allele of SNP12 in <Emphasis Type="Italic">estrogen receptor 1</Emphasis> was a risk factor for cryptorchidism in Asians: a systematic review with meta-analysis and trial sequential analysis

Objective

Some studies have been carried out to evaluate the association between SNP12 in estrogen receptor 1 and cryptorchidism, but the results remain inconsistent. We carried out a meta-analysis to explore the association between this polymorphism and cryptorchidism risk.

Methods

All eligible studies were searched in PubMed, Web of Science, Embase and Cochrane Library. Pooled odds ratios, with 95 % confidence intervals, were assessed for the association using fixed- and random-effects models.

Results

Overall, four case–control studies (363 cases, 415 controls) were included in the meta-analysis. No significant publication bias (P _Begg = 0.308, P _Egger = 0.288) was found. A allele of SNP12 in estrogen receptor 1 was protective factor to cryptorchidism in allele model, dominant genetic model and heterozygote comparison in Caucasians, but the result was turned out to be false positive by trial sequential analysis. However, A in allele model was risk factor to cryptorchidism in Asians (odds ratio 2.02, 95 % confidence interval 1.03–3.01, p = 0.946 for heterogeneity) and the result was turned out to be true positive by trial sequential analysis, even though there were merely two original studies.

Conclusions

The results of this meta-analysis suggest that A allele of SNP12 in estrogen receptor 1 may increase the risk of cryptorchidism in Asians. Meanwhile, further well-designed studies with large sample sizes are required to confirm the present findings, especially in Caucasians.

     

ICU患者家属不同阶段照护体验的质性研究

目的探讨ICU患者家属在疾病不同阶段的照护体验。方法采用现象学研究法,对36名处于不同照护阶段的ICU患者家属进行非结构式访谈,用质性研究分析法对资料进行分析。结果ICU患者家属不同阶段的照护体验分别为:诊断期,应激反应强烈;治疗期,信息支持不足;转科准备期,缺乏人性化管理;临终期,提倡临终关怀。结论患者入住ICU期间,患者家属在不同照护阶段的需求是动态变化的,医护人员应针对性地提供个性化服务,不断提高医疗服务质量。     

肝内Glissonian鞘外离断法行腹腔镜左半肝切除术

目的探讨肝内Glissonian鞘外离断法实施腹腔镜左半肝切除的可行性。方法对一例73岁左肝癌女性患者实施全腹腔镜左半肝切除术,肿瘤直径5.5 cm,采用五孔法,先在左侧肝蒂上缘切开一小口,用一"金手指"顺脐板钝性分离,并从尾状叶前Arantius韧带处穿出,先带入一丝线控制左侧肝蒂,左半肝呈明显缺血性改变,再用内镜血管切割闭合器取代丝线夹闭左肝蒂,并击发离断,肝实质的离断采用超声刀配合单、双极电凝刀,用内镜血管切割闭合器离断左肝静脉,术中无须阻断第一肝门。结果总的手术时间180 min,术中出血量50 ml,切缘阴性,术后恢复良好,无胆漏及出血,术后4 d出院,术后病理提示肝细胞癌(T1N0M0)。结论在选择的患者,全腹腔镜左半肝切除术安全和可行,采用肝内Glissonian鞘外解剖方法预先离断左侧肝蒂,简化了手术过程,有利于减少术中出血,值得推广应用。     

海藻生物胶体外抗炎作用的实验研究

目的探讨海藻生物胶用于体外抗炎的作用效果。方法采用二甲苯致小鼠耳廓肿胀实验、角叉菜胶致大鼠足肿胀实验及小鼠棉球肉芽肿增生实验探索海藻生物胶的抗炎作用。设立模型对照组,阳性对照组和海藻生物胶高、中、低剂量组,喷涂患处,每天1次,连续7 d。结果海藻生物胶显著抑制小鼠耳廓肿胀,与模型对照组相比,海藻生物胶高、中、低剂量组均显著抑制小鼠耳廓肿胀(P<0.05);与阳性对照组相比,海藻生物胶高剂量组显著抑制小鼠耳廓肿胀(P<0.05),海藻生物胶在不同给药时间均抑制角叉菜胶致大鼠足肿胀(P﹤0.05)。与模型对照组相比,海藻生物胶可抑制棉球诱发所致小鼠炎症的肉芽增生作用(P<0.05);与阳性对照组相比,海藻生物胶高剂量组也可抑制小鼠棉球肉芽肿增生。结论海藻生物胶具有体外抗炎的作用。     

生殖衰老过程中抑郁症状的4年随访发生率及影响因素研究

目的 前瞻性观察女性生殖衰老过程中抑郁症状的4年累积发生率,探讨其与生殖衰老阶段、血清激素水平变化及绝经相关症状的相关性.方法 便利抽样北京市西城区228名30～54岁未绝经、且符合STRAW+ 10分期纳入标准的健康、无抑郁症状女性,随访4年,内容包括一般人口学特征、血清FSH和E2水平、抑郁及绝经相关症状及月经情况.主要评估工具包括:医院焦虑抑郁量表(HADS)、绝经生活质量问卷(MENQOL)和月经日记记录表.结果 抑郁症状4年累积发生率22.4％,绝经过渡期的持续期发生比例最高.条件logistic回归显示:血清FSH水平升高(OR=1.10,P=0.008),血管舒缩症状(OR=3.54,P=0.033)和躯体症状得分(OR=5.89,P=0.032)增加与抑郁症状的发生密切相关;但未发现血清E2水平变化和性问题症状对抑郁症状有显著影响(P＞0.05).结论 绝经过渡持续阶段抑郁高发.躯体症状、血管舒缩症状和以FSH水平升高为标志的垂体-卵巢轴功能改变可能是影响生殖衰老阶段抑郁症状发生的重要原因.     

Clinical Features of Adult/Adolescent Atopic Dermatitis and Chinese Criteria for Atopic Dermatitis

Background:

Atopic dermatitis (AD) is an inflammatory skin disease characterized by chronic recurrent dermatitis with profound itching. Most patients have personal and/or family history of atopic diseases. Several criteria have been proposed for the diagnosis of AD. Although the clinical features of childhood AD have been widely studied, there has been less large-scale study on adult/adolescent AD. The aim of this study was to investigate the clinical features of adult/adolescent patients with chronic symmetrical eczema/AD and to propose Chinese diagnostic criteria for adult/adolescent AD.

Methods:

A hospital-based study was performed. Forty-two dermatological centers participated in this study. Adult and adolescent patients (12 years and over) with chronic symmetrical eczema or AD were included in this study. Questionnaires were completed by both patients and investigators. The valid questionnaires were analyzed using EpiData 3.1 and SPSS 17.0 software.

Results:

A total of 2662 valid questionnaires were collected (1369 male and 1293 female). Of all 2662 patients, 2062 (77.5%) patients had the disease after 12 years old, while only 600 (22.5%) patients had the disease before 12 years old, suggesting late-onset eczema/AD is common. Two thousand one hundred and thirty-nine (80.4%) patients had the disease for more than 6 months. One thousand one hundred and forty-four (43.0%) patients had a personal and/or family history of atopic diseases. One thousand five hundred and forty-eight (58.2%) patients had an elevated total serum IgE and/or eosinophilia and/or positive allergen-specific IgE. Based on these clinical and laboratory features, we proposed Chinese criteria for adult/adolescent AD. Of all 2662 patients, 60.3% were satisfied with our criteria, while only 48.2% satisfied with Hanifin Rajka criteria and 32.7% satisfied with Williams criteria, suggesting a good sensitivity of our criteria in adult/adolescent AD patients.

Conclusion:

Late-onset of eczema or AD is common. The clinical manifestations of AD are heterogeneous. We have proposed Chinese diagnostic criteria for adolescent and adult AD, which are simple and sensitive for diagnosis of adult/adolescent AD.     

基于环介导等温扩增技术建立的假丝酵母菌快速检测方法

目的  基于环介导等温扩增技术（LAMP）建立一种假丝酵母菌的快速检测方法。方法  依据假丝酵母属18 S rDNA基因保守序列,采用Primer Explorer V4软件设计引物,建立LAMP扩增方法和反应体系,对体系的4种关键参数和3项性能指标进行优化和探讨,并用临床样本进行方法验证。结果  6种常见假丝酵母菌LAMP法检测均为阳性;最适扩增条件为：温度63～65℃、Bst酶活性4 IU、Mg2+浓度4 mol/L、扩增时间1 h;7种对照菌种及人全血DNA样本LAMP扩增结果均为阴性;检测限为102～107 CFU/ml。经52例临床样本验证,该法敏感性为100%,特异性为95%。结论  该研究建立的LAMP假丝酵母菌检测方法具有实用、简便、快速、特异和敏感的特点,可为临床提供一种新的假丝酵母菌诊断方法。

     

复方黄柏液联合美沙拉嗪对溃疡性结肠炎及肠道菌群和血清炎症因子的影响

目的  探讨复方黄柏液灌肠联合美沙拉嗪口服治疗溃疡性结肠炎（UC）疗效及对患者肠道菌群和血清炎症因子的影响。方法  选取2014年1月-2014年12月于该院接受治疗的120例UC患者作为研究对象,按照随机数字表法随机分为对照组60例和观察组60例。常规治疗基础中,对照组给予美沙拉嗪口服治疗,观察组在对照组的基础上联合给予复方黄柏液灌肠治疗。随访6个月,比较两组患者临床疗效。疗程结束后,比较两组肠道菌群及血清炎症因子情况。治疗期间,观察不良反应发生情况。结果  随访6个月,观察组和对照组总有效率分别为93.3%和80.0%,组间比较差异有统计学意义（P <0.05）,观察组总有效率高于对照组。疗程结束后,两组患者粪便中肠球菌、乳酸杆菌、双歧杆菌含量,肿瘤坏死因子-α（TNF-α）、白介素-6（IL-6）、白介素-8（IL-8）水平差异有统计学意义（P <0.05）,观察组粪便中肠球菌、乳酸杆菌及双歧杆菌含量高于对照组,TNF-α、IL-6、IL-8水平低于对照组。结论  复方黄柏液灌肠联合美沙拉嗪口服治疗UC疗效可靠,能够提高临床疗效,有效调节肠道菌群,减轻机体炎症反应,且不良反应轻微。