早产儿视网膜病变研究新进展

早产儿视网膜病变是一种病理性新生血管增殖并伴纤维化改变的早产儿眼底疾病,是当前发展中国家和发达国家儿童可预防性失明的重要原因,其研究进展一直是眼科和儿科的临床关注热点。随着对早产儿视网膜病变发病机制更清晰的认知,其基础和临床研究日益增多,其抗血管内皮生长因子治疗及手术治疗方式较为成熟,同时多种治疗药物如胰岛素样生长因子-1、转化生长因子-β、多不饱和脂肪酸、β-肾上腺素受体阻滞剂等也取得一定进展,现就早产儿视网膜病变相关研究进展做一综述。     

北美国际护理诊断定义与分类(2018-2020)修订解读

将北美国际护理诊断定义与分类(2018-2020)中护理诊断的名称、护理诊断的定义与护理诊断的指标与北美国际护理诊断定义与分类(2015-2017)进行了比较,从护理诊断的名称变更、定义与指标的修订,了解全球护理发展趋势.我国护士可参照北美国际护理诊断定义与分类(2018-2020),对临床病情判断精准性的提高、建立本土化的护理诊断分类系统及找到护理科研的选题素材,起到积极的意义.     

Clinical study of transcatheter occlusion in treating ventricular septal defect combined with right coronary cusp bulge

Background: Perimembranous ventricular septal defect combined with right coronary cusp bulge generally should be treated with surgical thoracotomy, owing to the potential aortic regurgitation. However, the minimally invasive method of transcatheter closure has always attracted the attention of cardiologists and patients. The present study aimed to apply transcatheter occlusion in treating ventricular septal defect with right coronary cusp bulge and further evaluate the clinical effect through follow-up.Materials and methods: A total of 40 children diagnosed as having a ventricular septal defect with right coronary cusp bulge, examined using transthoracic echocardiography and cardiovascular angiography, were enrolled in this study. The ventricular septal defects were closed by placing occluders through transcatheter occlusion treatment. During the operation process, the children underwent angiography and transthoracic echocardiography examinations to check the position of the occlude and the extent of aortic regurgitation. The influence of occlusion on the conduction system was evaluated using a surface electrocardiogram. The children were followed up after their procedures.Results: All 40 patients were immediately and successfully occluded. Three patients with filament residual shunts were observed during the operations. No major surgical complications occurred during the perioperative period. During the follow-up period, the positions of all the occluders were good, the residual shunts in the three patients disappeared, and no new or aggravated aortic regurgitation occurred. Electrocardiogram did not reveal any atrioventricular blocks. Only one patient suffered from an incomplete right bundle branch block.Conclusions: Children diagnosed with ventricular septal defect combined with right coronary cusp bulge could be considered for transcatheter occlusion. With appropriate indications and methods, the effect may be favorable.     

腹腔镜与传统开腹胆囊切除术的临床疗效对比分析

目的对比传统开腹与腹腔镜胆囊切除术的差异,分析腹腔镜胆囊切除术的临床疗效。方法采用对照研究的方法将2007年1月—2011年7月期间于该院行胆囊切除术的226例患者随机分为对照组和研究组,每组113例,对照组采用传统开腹进行胆囊切除,研究组采用腹腔镜进行治疗,比较两组患者的手术耗时、术中出血量、术后排气时间、住院天数以及并发症发生等情况。结果研究组患者手术耗时、术中出血量、术后排气时间以及住院天数均少于对照组,差异有统计学意义;研究组并发生发生率低于对照组,差异有统计学意义。结论腹腔镜胆囊切除术可有效降低患者并发生发生率,具有良好的治疗效果,值得临床应用。     

孕中期弓形虫感染对孕鼠血清孕酮及雌三醇含量的影响

目的探讨孕中期弓形虫感染对孕鼠血清孕酮(progesterone)及雌三醇(estriol)含量的影响。方法孕中期BALB/c孕鼠随机分为染虫组和健康对照组,染虫组经腹腔无菌接种纯化的RH强毒株弓形虫速殖子,健康对照组注射等量0.01mol/LPBS。分别于妊娠第10、12、14、16、18d,摘孕鼠眼球取血,经放射免疫法测定血清孕酮和雌三醇含量。结果在孕第10、12、14d,孕鼠血清孕酮和雌三醇含量染虫组与对照组比较差异无统计学意义(P>0.05);在孕第16、18d,两组比较差异有统计学意义(P<0.01)。结论孕中期弓形虫感染可引起孕鼠血清孕酮和雌三醇含量下降,这可能是弓形虫感染致胚胎发育迟缓、胎盘组织炎性病变及滋养层细胞凋亡增加的结果,也可能是胚胎发育迟缓、滋养层细胞凋亡增加的原因。     

川崎病与支原体感染的相关性研究

目的研究川崎病(Kawasaki disease,KD)与支原体感染(Mycoplasma pneumomiae,MP)的相关性。方法回顾性分析2012年3月~2014年2月于我院被确诊为KD的84例患儿的病历资料,其中按照患者是否有支原体感染分为观察组和对照组。观察组KD患者为有支原体感染(43例),对照组KD患者无MP感染(41例)。对两组患者分别进行血白细胞计数(WBC)、超敏C反应蛋白(CRP)、红细胞沉降率(ESR)、血红蛋白(HB)以及血小板计数(PLT)的检测和分析。对两组患者是否存在冠脉损伤进行分析比较。结果观察组无冠脉损伤者占34.9%(15/43),明显低于对照组的58.5%(24/41),观察组冠脉损伤者占比65.1%(28/43),显著高于对照组的41.5%(17/41),差异均有统计学意义(P<0.05);观察组的CRP指标水平为(68.9±14.7)mg/L,明显高于对照组的(52.8±8.2)mg/L,观察组的ESR指标水平为(42.6±15.9)mm/h,显著高于对照组的(21.6±6.1)mm/h,差异均有统计学意义(P<0.05)。结论MP感染为KD的病因之一,MP感染与患者冠脉损伤呈正相关,MP感染引起的免疫介导损伤和炎症反应是发生KD的重要途径。     

HPLC法同时测定磺啶新林胶囊中4个成分的含量

目的:建立同时测定磺啶新林胶囊中盐酸溴己新、盐酸氯丙那林、磺胺甲噁唑和甲氧苄啶含量的方法。方法:采用高效液相色谱法,Ecosil-C₁₈色谱柱（4.6 mm×250 mm,5μm）,以乙腈-0.001 5 mol·L^-1十二烷基硫酸钠的0.1%三乙胺溶液（用磷酸调pH值至3.0）（52:48）为流动相,流量1.0 mL·min^-1,检测波长为215 nm。结果:4个成分的峰面积与浓度的线性关系良好（r>0.999 9）;加样回收率为98.85%⁹9.58%。结论:该方法可用于磺啶新林胶囊中盐酸溴已新、盐酸氯丙那林、磺胺甲噁唑和甲氧苄啶4个成分的含量测定。     

Guidelines for tuberculosis prophylaxis during anti‐tumour necrosis factor‐α treatment: Indian Rheumatology Association

India is home to a large patient population of both rheumatoid arthritis (RA) and tuberculosis (TB). As the usage of biologic agents in RA increases in India, the issue of TB reactivation and prophylaxis becomes very pertinent. The consensus view of an expert group from the Indian Rheumatology Association is presented. Tuberculin testing has limited utility in India and isoniazid prophylaxis seems to be a reasonable option. It is hoped that this report shall pave the way for formal guidelines.     

复方利多卡因软膏减轻1型糖尿病患儿胰岛素泵置管疼痛的效果观察

目的 探讨利多卡因软膏外涂减轻儿童1型糖尿病胰岛素泵置管疼痛的效果。 方法 选取2016年1月-2017年12月年龄>3岁的新诊断并首次接受胰岛素泵治疗的1型糖尿病患儿135例,采用自身对照法进行实验。穿刺前20min,实验组采用2.5％复方利多卡因软膏涂抹于穿刺部位,对照组采用0.9%氯化钠溶液涂抹于穿刺部位,比较2组患儿行胰岛素泵置管疼痛程度的评分。结果 干预后,实验组不同年龄段患儿疼痛评分均低于对照组。 结论 复方利多卡因软膏外涂能减轻1型糖尿病患儿胰岛素泵置管的穿刺操作性疼痛。