活血化瘀汤加减辨治急性期狼疮性肾炎的疗效观察

目的 观察活血化瘀汤加减辨治急性期狼疮性肾炎临床效果.方法 将65例急性期狼疮性肾炎患者随机分成对照组和观察组.对照组32例予常规西药治疗,观察组33例加用活血化瘀汤加减治疗.3d后观察其治疗效果.结果 观察组的基础痊愈率42.42％和总有效率90.91％均高于对照组的28.12％、65.62％（P＜0.05）;治疗后两组的狼疮活动积分和尿蛋白量、尿红细胞、血浆蛋白、舒张压较治疗前均有显著改善（P＜0.05）;观察组更优（P＜0.05）.结论 活血化瘀汤加减辅助常规西药能提高急性期狼疮性肾炎临床效果,改善临床症状.     

促性腺激素释放激素激动剂联合左炔诺孕酮宫内缓释系统治疗子宫腺肌病的临床观察

目的探讨促性腺激素释放激素激动剂（GnRH—a）联合左炔诺孕酮宫内缓释系统（LNG—IUS）在治疗子宫腺肌病中的作用。方法回顾性分析45例子宫腺肌病患者（宫腔深度超过11cm）的临床病理资料,其中26例患者接受GnRH—a针3．6mg。每4周1次,并在第3次注射后放置LNG—IUS环联合治疗设为观察组．19例患者接受了月经来潮7d内放置LNG—IUS环设为对照组。分别统计两组痛经患者治疗前、治疗后3个月、6个月、12个月、2年时的患者的痛经缓解程度,月经过多的患者血红蛋白变化及两组患者子宫体积变化、LNG—IUS环下移率、阴道点滴出血并发症是否有差异。结果观察组中随着治疗时间延长,患者痛经的临床缓解率逐渐提高,但与对照组比较,差异均无统计学意义（X^2分别=0．23、0．12、0．23、1．46,P均〉0．05）;观察组患者血红蛋白逐渐上升,与治疗前比较,差异均有统计学意义（t分别=2_49、3．12、3．14、3．07,P均〈0．05）;观察组中经过治疗后,复查B超子宫体积明显缩小,与治疗前比较,差异均有统计学意义（t分别=1．87、1．81、2．02、2．32,P均〈0．05）,观察组在治疗后3个月时观察组的子宫体积明显小于对照组,差异有统计学差异（￡：1．93,P〈0．05）．而治疗后6个月起子宫体积大小差异不明显,差异均无统计学意义（t分别：1．02、1．53、1．36,P均〉0．05）;观察组出现LNG—IUS环下移及脱落和引起阴道点滴出血情况明显少于观察组,差异均有统计学差异（X^2分别=5．83、4．18,JP均〈0．05）。结论联合GnRH—a与LNG—IUSg可有效治疗大子宫腺肌病合并疼痛与月经过多,并可减少在大子宫中LNG—IUS环下移、阴道点滴出血等并发症。     

利用品管圈降低门诊药房调剂内差的实践与体会

目的:降低门诊药房处方调剂中的内差件数。方法:将品质管理中的品管圈手法应用于门诊药房调剂差错的控制,分析引起调剂差错的原因,制订相应的对策,总结活动开展前后的结果并评估有形成果(内差件数)和无形成果(圈员能力评分)。结果:开展品管圈活动后,门诊药房处方调剂内差件数明显下降,由开展前的54.5件/周下降到开展后的26.0件/周,圈员能力评分由平均1～3分上升到4～5分。结论:品管圈手法可用于药房管理并能发现及解决问题,使药房的服务质量得以持续改进。     

微创治疗Pilon骨折28例临床分析

目的探讨经皮微创钢板内固定治疗Pilon骨折的临床疗效。方法选择28例Pilon骨折患者做为观察组,给予经皮微创钢板内固定技术治疗。选择同期住院治疗的20例Pilon骨折患者做为对照组,给予解剖型钢板固定治疗。随访10～22个月,比较两组患者踝关节功能评分、骨折愈合时间及并发症。结果观察组踝关节功能评定优良率为89.3％（25／28）,对照组为75．0％（15／20）,观察组显著优于对照组,差异具有统计学意义（P〈0．01）;观察组患者x线骨痂出现时间为（5．83±0．86）周,骨折愈合时间为（16．37±2．19）周,对照组分别为（7．25±0．98）周、（18．92±3．27）周,观察组显著优于对照组（P〈0．01）;观察组与对照组并发症发生率分别为7．1％、30．O％,差别有统计学意义（P〈0．01）。结论经皮微创钢板内固定治疗Pilon骨折,具有对机体损伤小、骨折愈合快以及并发症少的特点,是治疗Pilon骨折的理想方法。     

巴曲酶联合丁苯酞治疗急性脑梗死80例临床观察

目的临床观察巴曲酶联合丁苯酞治疗急性脑梗死的疗效。方法将150例急性脑梗死患者随机分组,对照组70例给予巴曲酶＋奥扎格雷钠治疗,治疗组80例给予巴曲酶＋丁苯酞治疗,治疗后观察临床疗效。结果治疗后治疗组总显效率为82．5％,对照组为62．9％,两者比较差异有显著性（P〈0．05）;治疗后神经功能缺损程度评分治疗组和对照组相比差异有显著性（P〈0．05）,治疗组疗效优于对照组。结论巴曲酶联合丁苯酞治疗急性脑梗死疗效显著,无明显不良反应,可以考虑临床推广。     

内镜治疗胆总管结石术后复发的危险因素分析

目的分析内镜治疗胆总管结石术后复发的危险因素。方法回顾分析187例行经内镜乳头括约肌切开术（EST）治疗胆总管结石患者的临床资料。结果6例（3．21％）出现近期并发症,28例（14．97％）出现远期并发症,其中胆总管结石复发26例（13．90％）;体重指数高、胆管炎史、胆总管直径增大及血清胆固醇含量升高是结石复发的危险因素（P〈0．05）;乳头切口小（约1．0cm）是结石复发的保护因素（P〈0．05）。结论体重指数、胆管炎史、胆总管直径、乳头切口大小及血清胆固醇含量与EST术后结石复发相关。     

Modern pig farming in the People's Republic of China: growth and veterinary challenges

Cyclical oversupply and non-profitability situations have led to pig industry consolidations in the People's Republic of China, with many smaller farmers leaving the industry. In 2007, pork supply worsened due to outbreaks of 'high fever blue-ear disease', a complex disease issue that includes highly virulent porcine reproductive and respiratory syndrome, porcine circovirus and classical swine fever. Best estimates suggest that 50 million pigs were affected. More recent natural disasters (earthquakes/freezing winters) have also limited pig production in some areas. Overall expansion of the Chinese breeding herd is now continuing at a good pace and is likely to be sufficient to supply the predicted 7% annual increase in demand for pork. High prices of feed ingredients (cereals and soybean) continue to create cost-of-production issues. Authorities have instigated many helpful measures over the past decade, including insurance for farm breeder stock, direct subsidies for farm expansions and breeding programmes, free supplies of some vaccines, and taxation exemptions. Specific challenges remaining include: the high levels of spread, persistence and on-farm impact of key virus infections on single-site farm systems; the variable titre and potency of some local vaccines; the low level of technical capacity in laboratories and the lack of training and expertise among farm staff; and the lack of a distinctive representative voice for pig farmers.     

高效液相色谱法同时测定黄酒中4种人工合成甜味剂的研究

目的:建立黄酒中糖精钠、安赛蜜、阿斯巴甜和甘素等4种人工合成甜味剂的高效液相色谱同时测定方法。方法:样品经去醇和脱色后,采用C18色谱柱,以乙酸-乙酸铵缓冲液(0.02 mol/L,pH=5.5)/甲醇为流动相,采用梯度洗脱分离,在紫外230 nm波长进行检测。结果:4种人工合成甜味剂的加标回收率在84%~99%范围,其相对标准偏差在1.4%~4.7%范围,安赛蜜和甘素在0.05 mg/L~10.0 mg/L范围具有良好的线性,糖精钠和阿斯巴甜在0.25 mg/L~50.0 mg/L范围具有良好的线性,其回归系数均大于0.999,最低定量检出限(LOQ)为0.6 mg/kg~4.0 mg/kg范围。结论:本方法简便、灵敏、重现性好,能满足黄酒中4种人工合成甜味剂的监测要求。     

肾结石患者血清中LncRNA TapSAKI表达及其与预后的关系

目的 探究长链非编码RNA(LncRNA)TapSAKI在肾结石患者血清中的表达水平及预后的关系。 方法 选取2017年1月—2019年6月宁波市医疗中心李惠利医院收治的144例肾结石患者为肾结石组,并选取同期本院148例健康体检者为正常组。以实时荧光定量PCR法(qRT-PCR)检测所有受试者血清中LncRNA TapSAKI水平;酶联免疫吸附法(ELISA)检测所有受试者血清单核细胞趋化蛋白-1(MCP-1)、白介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)水平;分析肾结石患者行经皮肾镜碎石术预后情况;比较2组不同预后患者血清LncRNA TapSAKI、MCP-1、IL-6、TNF-α水平;分析肾结石患者血清LncRNA TapSAKI与MCP-1、IL-6、TNF-α水平的相关性;分析肾结石预后的影响因素。采用SPSS 22.0统计学软件进行分析。 结果 肾结石组患者血清LncRNA TapSAKI、MCP-1、IL-6、TNF-α水平均明显高于正常组(均P<0.05);术后不良并发症发生率为23.61%(34/144);预后不良组患者血清LncRNA TapSAKI、MCP-1、IL-6、TNF-α水平均明显高于正常组(均P<0.05);肾结石患者血清LncRNA TapSAKI与MCP-1、IL-6、TNF-α水平均呈正相关(均P<0.05);LncRNA TapSAKI与MCP-1、IL-6、TNF-α均为肾结石患者预后不良的危险因素(均P<0.05)。 结论 肾结石患者血清LncRNA TapSAKI呈高表达,高水平LncRNA TapSAKI可能是肾结石患者不良预后因素,可作为评估肾结石预后的参考指标。      

The bone mineral content alterations in pediatric patients medicated with levetiracetam,valproic acid,and carbamazepine

AimThe negative effect of antiepileptic drugs on bone health has been previously documented. However, which antiepileptic drug is safer in regard to bone health is still questionable. Our aims were to investigate the bone mineral density alterations in pediatric patients who receive antiepileptic medication for a minimum of two years and to compare the results of these drugs.Materials and methodsFifty-nine patients (32 males, 27 females; mean age: 8.6 ± 4.6 years) and a control group (13 males, 7 females; mean age: 7.6 ± 3.3 years) were included in the study. The patients were receiving necessarily the same antiepileptic drugs (AEDs) for at least two years, and none of the patients had mental retardation or cerebral palsy. The patients were divided into three groups: group 1 (patients receiving levetiracetam (LEV), n = 20), group 2 (patients receiving carbamazepine (CBZ), n = 11), and group 3 (patients receiving valproic acid (VPA), n = 28). Plasma calcium (Ca), phosphorus (P), parathyroid hormone (PTH), alkaline phosphatase (ALP), vitamin D levels, and bone mineral density (BMD) values of femur and vertebras (L1-4) and z-scores (comparative results of BMD values of the patients with the age- and gender-matched controls in device database) of the groups were compared.ResultsThe differences between P, PTH, ALP and age, Ca and BMD results, and vitamin D levels of the patients in all four groups was not statistically significant according to Kruskal–Wallis test (p > 0.05). The z-score levels of all the patient and control groups were also not statistically significantly different compared with each other.ConclusionIn contrast to previous reports in pediatric patients, our study has documented that there is not a considerable bone loss in patients receiving long-term AED medication. Although levetiracetam has been proposed as bone-protecting medication, we did not observe any difference between AEDs regarding bone mineral density after two years of treatment.