GC法测定一次性肠外营养输液袋中乙酸乙烯酯迁移量

目的:建立GC法测定一次性肠外营养输液袋中乙酸乙烯酯的迁移量.方法:以DB-624毛细管色谱柱为固定液;程序升温:起始温度90℃,维持5 min,以每分钟50℃的速率升温至250℃,维持5 min;进样口温度为220℃;检测器温度为250℃;流速为1.0 mL·min-1;分流比为10:1.结果:本法可将溶剂、空白溶液与乙酸乙烯酯单体较好分离,乙酸乙烯酯在4.47~10.44μg·mL-1(r=0.9993)浓度范围内线性关系良好,回收率为100.4%,RSD为1.25%.结论:本法灵敏度高,操作简单、快速、准确,适合输液袋中乙酸乙烯酯单体迁移量的监测.     

Anti‐Müllerian hormone as a marker of ovarian reserve: What have we learned,and what should we know?

Ovarian reserve reflects the quality and quantity of available oocytes. This reserve has become indispensable for the better understanding of reproductive potential. Measurement of the serum anti‐Müllerian hormone (AMH) level allows quantitative evaluation of ovarian reserve. It has been applied to a wide range of clinical conditions, and it is well established that the measurement of serum AMH levels is more useful than qualitative evaluation based on the menstrual cycle. AMH levels are monitored during infertility treatments; in patients undergoing medically assisted reproductive technology; and in the diagnosis of ovarian failure, polycystic ovarian syndrome, and granulosa cell tumor. It is also useful in the evaluation of iatrogenic ovarian damage. Population‐based studies have indicated a potential role for serum AMH in the planning of reproductive health management. While AMH is currently the best measure of ovarian reserve, its predictive value for future live births remains controversial. Furthermore, there is a serious practical issue in the interpretation of test results, as currently available assay kits use different assay ranges and coefficients of variation due to the absence of an international reference standard. The pros and cons of the serum AMH level as a definitive measure of ovarian reserve merits further review in order to guide future research.     

儿童扁桃体切除术后疼痛的非药物性护理干预

目的探讨儿童扁桃体切除术后疼痛的非药物性护理干预效果。方法将行双侧扁桃体切除术的108例患儿,按时间段分为对照组56例和观察组52例。对照组实施常规口腔护理、饮食指导和冰袋颌下冷敷;观察组在对照组的基础上改进颌下冷敷装置,并结合知识讲授、注意力转移等措施。应用视觉模拟评分表(VAS)分别在术后6h、术后1~3d对患儿进行疼痛评估。结果观察组术后6h、1d、2d及3d疼痛程度显著轻于对照组(均P0.01)。结论对扁桃体切除术后患儿采用改进颌下冷敷装置联合其他非药物性干预可有效缓解疼痛。     

方差分析法优选生蒲黄包煎袋及其提取液热稳定性考察

目的：优选生蒲黄包煎提取工艺中包煎袋的材料、层数和装量容积比,并对生蒲黄提取液进行热稳定性考察。方法：采用HPLC法同时测定香蒲新苷、异鼠李素-3-O-新橙皮苷含量。以香蒲新苷、异鼠李素-3-O-新橙皮苷和溢出率为评价指标并进行综合评分。在SPSS 22.0软件上,以综合评分为数据资料,采用方差分析法对包煎袋的材料、层数和装量容积比进行单因素方差分析并多重比较。通过测定不同受热温度和时间下香蒲新苷、异鼠李素-3-O-新橙皮苷含量的变化,考察蒲黄提取液的热稳定性。结果：蒲黄应置于装量容积比为1∶4的两层无纺布袋中,按已优选的醇提工艺提取。回收乙醇后的提取液在高温或长时间受热下易降解,提取液应采用减压浓缩。结论：蒲黄提取工艺应避免高温或长时间受热,浓缩工艺应采用减压浓缩,以降低成分的降解。优选的蒲黄包煎袋材料、层数、装量容积比合理可行、稳定科学,适合于该制剂的工业化生产。     

南京地区33家医院2014～2016年分子靶向抗肿瘤药应用分析

摘 要 目的：分析分子靶向抗肿瘤药的使用情况,为临床合理使用提供参考。方法：采用回顾性调查方法,对南京地区33家医院2014～2016年分子靶向抗肿瘤药物的用药金额、用药频度(DDDs)、限定日费用(DDC)及排序比(B/A)进行分析。结果：南京地区33家医院分子靶向抗肿瘤药销售金额由2014年的8 082.23万元增加至2016年的10 970.18万元,增长了35.73%。其中,单克隆抗体药的销售金额构成比逐年上升,酪氨酸激酶抑制药的销售金额构成比逐年下降。利妥昔单抗各年度销售金额均排名前列。吉非替尼连续3年DDDs排名第1,DDDs较高。大部分药物DDC相对稳定,B/A值大于1,销售金额与用药频度同步性总体较好。结论：2014～2016年南京地区分子靶向抗肿瘤药应用呈上升趋势,分子靶向药物越来越得到临床认可。     

自制双层盐袋固定袋应用于永久起搏器植入术后压迫的效果分析

摘要 目的：探讨自制双层盐袋固定袋在永久起搏器植入术后患者切口压迫中的效果。方法： 2015年1月～2016年6月间在心内科行永久起搏器植入术的患者,随机进行分组。对照组患者术后使用两个500g普通盐袋压迫12～24 h,观察组患者术后采用自制的双层盐袋固定袋压迫切口6～12 h。观察患者术后并发症、心理、睡眠状况、舒适度,患者和护士对压迫工具的满意度。结果：观察组与对照组相比,观察组患者术后并发症少、患者心理、睡眠状况及术后舒适度更好,患者和护士的满意度高（P＜0.05）。结论：使用自制的双层盐袋固定袋压迫切口处,临床使用效果满意,有效降低术后并发症,提高患者的睡眠质量。 关键词 盐袋;永久起搏器;切口压迫;并发症;舒适度     

Risk of opportunistic infections in patients treated with alemtuzumab for multiple sclerosis

Introduction: Alemtuzumab is a monoclonal anti CD-52 antibody recently approved for use in relapsing-remitting multiple sclerosis(MS). Given that the targeted antigen is primarily expressed on B and T lymphocytes, the administration of this biological drug is associated with rapid but protracted peripheral lymphopenia.

Areas covered: The impact on infective risk of this immune impairment is still to be fully understood. In this review, we attempt to summarize all the available literature concerning opportunistic infections occurring in patients with MS receiving alemtuzumab. Infective adverse events were observed in more than 70% of patients in phase 2/3 RCTs, mainly of mild-to-moderate severity. Nevertheless, several post-marketing reports documented cases of serious, rare, and unexpected infections.

Expert Opinion: Predictive risk factors and prognostic features of opportunistic infections in this setting still need to be exactly assessed. At present, the only recommended preventive measures consist in anti-herpetic prophylaxis, Listeria-free diet, Tuberculosis prophylaxis and annual Papillomavirus screening. Given the non-negligible risk of unpredicted infective events, we advise physicians to take into account patients’ history of infectious diseases and vaccine status and to consider supplementary prophylactic strategies, including screening for Toxoplasma gondii and viral hepatitis serostatus as well as pre-emptive approaches to avert CMV reactivation and Pneumocystosis.     

Do athletes have a right to access data in their Athlete Biological Passport?

The Athlete Biological Passport (ABP) refers to the collection of data related to an individual athlete. The ABP contains the Haematological Module and the Steroidal Module, which are used for the longitudinal monitoring of variables in blood and urine, respectively. Based on changes in these variables, a statistical model detects outliers which indicate doping use and guide further targeted testing of the athlete. Presently, athletes can access their data of the Haematological Module in the Anti‐Doping Administration and Management System (ADAMS). However, granting athletes access to this data has been a matter of debate within the anti‐doping community. This article investigates whether an athlete has a right to access the contents of their ABP profile. We approached this discussion by comparing the nature of ABP data with that of forensic and medical data and touched on important concerns with ABP data disclosure to athletes such as potentially allowing for the development of alternative doping techniques to circumvent detection; and making athletes vulnerable to pressure by the media to publicly release their data. Furthermore, given that ABP data may contain medically relevant information that can be used to diagnose disease, athletes may over‐interpret its medical significance and wrongly see it as a free health check. We argue that safeguarding the integrity of the ABP system must be seen as the most essential element and thus a departure from immediate data disclosure is necessary. Two different strategies for delayed data disclosure are proposed which diminish the chances of ABP data being misused to refine doping techniques.     

气囊仿生助产技术联合分娩球在产妇助产中的应用价值分析Analysis of the application value of balloon bionic assisted birth technique combined with delivery ball in maternal midwifery 顾彩琴

目的：观察产妇助产应用气囊仿生助产技术联合分娩球的临床价值。方法：选取2021年3月到2022年3月收治的87例产妇进行研究,对照组采取常规助产技术,观察组采取气囊仿生助产技术联合分娩球。结果：观察组第一、第二、第三产程时间以及总产程时间、产后出血量、疼痛评分、新生儿窒息、羊水污染发生率均低于对照组,新生儿APgar评分、自然分娩率、护理满意度高于对照组(P＜0.05)。结论：通过采取气囊仿生助产技术联合分娩球,完成助产,能够提高产妇自然分娩率,可帮助产妇缩短产程,有利于改善产妇疼痛情况,减少出血量,有利于确保新生儿安全,使产妇更加满意。