区域性大型医疗设备预防性维护规范探讨

目的：大型医疗设备是医院医教研工作的重要保障,也是医院体现诊疗水平的主要手段和工具。因此,保持医院中大型医疗设备安全有效的运行是一项十分重要的工作,研究做好大型医疗设备的预防性维护是保证设备良好运行状态的一项重要措施。方法：分析探讨CT、MR和DSA设备各部件及外围环境要求。结果：建立了CT、MRI和DSA等区域性大型医疗设备的预防性维护规范。结论：给出预防性维护计划表格制定方案,为医院开展这项工作提供了参考。     

正中神经脑干躯体感觉诱发电位和经颅短串电刺激运动诱发电位联合术中监护在颈髓手术中的应用

目的研究在异丙酚全静脉麻醉方案下,联合应用正中神经脑干躯体感觉诱发电位(MN-BSEP)和经颅短串电刺激运动诱发电位(STTES-MEP)对颈髓手术实施术中监护的可行性。方法通过变换不同的刺激条件、记录条件、技术参数,分别摸索MN-BSEP和STTES-MEP的可靠检测方法,并按照总结得到的技术规范,选择我科15例接受颈髓手术的病人,进行术中联合监护,对照分析术前和术后脊髓功能的改变和诱发电位变化之间的关系。结果MN-BSEP基本不受麻醉影响,术后的改变与术后病人感觉功能的转归情况相吻合;STTES-MEP与麻醉方案有关,在异丙酚麻醉下,可记录到清晰、稳定的运动诱发电位,其术后的变化与术后病人肌力的转归情况相吻合。结论选用异丙酚全静脉麻醉,联合应用MN-BSEP和STTES-MEP实现对颈髓功能的术中监护是可行的,其效果优于单纯应用体感诱发电位或运动诱发电位进行监护。     

Safety and efficacy of oral nemonoxacin versus levofloxacin in treatment of community-acquired pneumonia: A phase 3, multicenter,randomized, double-blind,double-dummy,active-controlled,non-inferiority trial

Background/Purpose

Nemonoxacin is a novel nonfluorinated quinolone with excellent in vitro activity against most pathogens in community-acquired pneumonia (CAP), especially Gram-positive isolates. The purpose of this study was to assess the efficacy and safety of nemonoxacin compared with levofloxacin in patients with CAP.

Decreased frequency of a novel T-lymphocyte subset,CD3+CD4−CD7+CD57− T cells,in hepatitis B virus-related end-stage liver disease might contribute to disease progression

CD7 and CD57 are related to the differentiation and functional stages of CD8⁺ T cells. However, the role of their combined presence in CD8⁺ T cells in patients with chronic hepatitis B virus (HBV) infection, especially those with end-stage liver disease, remains unclear. Blood samples from healthy volunteers and patients with chronic hepatitis B were analyzed via Luminex assay and ELISA to measure plasma cytokine levels. Further, recombinant IL-22 was used to stimulate peripheral blood mononuclear cells from healthy volunteers, and the frequency of CD3⁺CD4⁻CD7⁺CD57⁻ T cells and apoptosis rates were investigated via flow cytometry. Patients with end-stage liver disease, particularly those with acute to chronic liver failure, showed decreased CD3⁺CD4⁻CD7⁺CD57⁻ T cell frequency. Furthermore, the prevalence of CD3⁺CD4⁻CD7⁺CD57⁻ T cells was negatively correlated with disease severity, prognosis, and complications (ascites). We also observed that IL-22 promoted apoptosis and brought about a decrease in the number of CD3⁺CD4⁻CD7⁺CD57⁻ T cells in a dose-dependent manner. CD3⁺CD4⁻CD7⁺CD57⁻ T cells displayed a B and T lymphocyte attenuator (BTLA)^highCD25^highCD127^high immunosuppressive phenotype and showed low interferon-γ, tumor necrosis factor-α, granzyme A, and perforin expression levels. The present findings will elucidate the pathogenesis of HBV-related end-stage liver disease and aid the identification of novel drug targets.     

Observations on the curative effect of acupuncture on cardiac vegetative neuropathy of diabetes

将36例糖尿病Ⅱ型患者分为西药组和针刺组,分别予降糖药物和针刺治疗.治疗前患者血糖、HbA1,各项心脏植物神经功能试验均异常.治疗1个月西药组血糖及HbA1显著下降,而其余各项指标均无显著变化.针刺组血糖HbA1无显著变化,但乏氏指数、立卧位心率差、30/15R-R期间比值、异常项目数均显著改善.说明针刺可以改善心脏植物神经功能.     

Giant cell polymyositis associated with myasthenia gravis and thymoma

We report a case of a 40-year-old woman who developed generalized muscle weakness over a period of 2 months. Physical examination revealed palpable masses in her arms and hands. Serum creatine kinase levels were elevated. Electromyography showed myopathic changes and 3 Hz repetitive nerve stimulation revealed a decremental pattern on repetitive nerve stimulation. Muscle MRI demonstrated increased signal intensity in the biceps brachii on T1-weighted images. Chest CT scan showed a mediastinal mass suggestive of thymoma. Muscle biopsy revealed giant cell polymyositis. The patient was treated with cholinesterase inhibitors and corticosteroids with improvement of strength, and subsequently underwent thymectomy followed by radiotherapy.     

获得性免疫缺陷综合征与炎症的抗逆转录病毒治疗进展

抗逆转录病毒治疗（ART）可抑制人免疫缺陷病毒（HIV）的复制，减少机会性感染的发生，但不能完全抑制HIV引起的炎症和免疫激活，残留的炎症导致一系列疾病（HIV并存病）。本文简要综述近几年来国内外HIV与炎症的ART进展。     

Human urinary kallidinogenase in treating acute ischemic stroke patients: analyses of pooled data from a randomized double-blind placebo-controlled phase IIb and phase III clinical trial

ABSTRACT

Objectives: Intravenous thrombolysis and thrombectomy are recommended for patients whose stroke onsets are within first 6 h, and very few options are available for patients whose stroke onset is more than 6 h, which includes most ischemic stroke patients. Human urinary kallidinogenase (HUK) showed potential clinical benefits in acute ischemic stroke patients. This study aims to investigate the safety and clinical benefits of HUK in ischemic stroke patients.

Patients and methods: Patients were recruited for a multicenter double-blind, placebo-controlled phase II b and phase III trial. Neurophysiological outcomes were assessed by the European Stroke Scale (ESS) and the functional outcomes were assessed by the activity of daily living scale (ADL). Safety was monitored by recording adverse events.

Results: The improvements in ESS scores and ADL scores in the HUK group were significantly greater than that in patients receiving placebo. Furthermore, HUK treatment was also associated with a lower rate of disable, according to ADL. HUK-related adverse events occurred at a low rate, in 1.73% of HUK-treated patients.

Conclusion: HUK is safe and provides potential clinical benefits as a treatment for acute ischemic stroke. Further large post-marketing observational studies are needed.