小儿健脾开胃合剂联合赖氨酸维B12颗粒治疗小儿厌食症的临床研究

目的研究小儿健脾开胃合剂联合赖氨酸维B_(12)颗粒治疗小儿厌食症的临床疗效。方法选取2017年12月—2018年12月青海省妇女儿童医院收治的80例厌食症患儿为研究对象,将所有患儿随机分为对照组和治疗组,每组各40例。对照组患儿口服赖氨酸维B_(12)颗粒,1～5岁,0.5袋/次,2次/d,6～12岁,1袋/次,2次/d;治疗组患儿在对照组治疗的基础上口服小儿健脾开胃合剂,10 mL/次,2次/d。两组患儿持续治疗30 d。观察两组的临床疗效,比较两组的微量元素、生化指标水平。结果治疗后,对照组和治疗组的总有效率分别为82.50%、95.00%,两组比较差异有统计学意义(P0.05)。治疗后,两组患儿铁、钙和锌水平均显著升高,同组治疗前后比较差异有统计学意义(P0.05);并且治疗组患儿铁、钙和锌水平均明显高于对照组,两组比较差异有统计学意义(P0.05)。治疗后,两组患儿血红蛋白(Hb)、血清淀粉酶(AMS)、血清铁蛋白(SF)水平均显著升高,同组治疗前后比较差异有统计学意义(P0.05);并且治疗组患儿Hb、AMS、SF水平明显高于对照组,两组比较差异有统计学意义(P0.05)。结论小儿健脾开胃合剂联合赖氨酸维B_(12)颗粒治疗小儿厌食症具有较好的临床疗效,能改善患儿贫血症状,调节血清微量元素水平,具有一定的临床推广应用价值。     

癫痫康胶囊联合左乙拉西坦治疗癫痫的临床研究

目的研究癫痫康胶囊联合左乙拉西坦片治疗癫痫的临床疗效。方法选取2017年3月—2018年3月西宁市第一人民医院收治的112例癫痫患者为研究对象,利用双盲法将患者随机分为对照组和治疗组,每组各56例。对照组口服左乙拉西坦片,初始剂量5 mg/(kg·次),2次/d,之后每周增加10 mg/(kg·d),至25 mg/(kg·d)维持。治疗组在对照组治疗的基础上口服癫痫康胶囊,3粒/次,3次/d。两组患者持续治疗12周。观察两组的临床疗效,比较两组的癫痫发作频率、生活能力、智力水平和血清学指标。结果治疗后,对照组和治疗组的总有效率分别为80.36%、92.86%,两组比较差异有统计学意义(P0.05)。治疗后,两组患者阵挛发作、强直发作、失神发作频率均显著下降,同组治疗前后比较差异具有统计学意义(P0.05);且治疗组患者阵挛发作、强直发作、失神发作频率均明显低于对照组,两组比较差异具有统计学意义(P0.05)。治疗后,两组患者日常生活能力(ADL)评分明显降低,而韦氏智力量表(WISC-R)评分明显升高,同组治疗前后差异具有统计学意义(P0.05);且治疗后治疗组患者ADL评分明显低于对照组,WISC-R评分明显高于对照组,两组比较差异具有统计学意义(P0.05)。治疗后,两组患者血清S-100β蛋白(S-100β)、超敏C-反应蛋白(hs-CRP)和丙二醛(MDA)水平均明显降低,同组治疗前后差异有统计学意义(P00.5),且治疗组患者血清S-100β、hs-CRP和MDA水平明显低于对照组,差异具有统计学意义(P0.05)。结论癫痫康胶囊联合左乙拉西坦片治疗癫痫具有较好的临床疗效,可改善临床症状,降低血清学指标,改善患者生活能力和智力水平,具有一定的临床推广应用价值。     

丙型肝炎病毒不同基因型核心蛋白对肝母细胞瘤细胞凋亡影响的比较

目的比较HCV不同基因型核心蛋白(core)在肝母细胞瘤细胞凋亡中的作用。方法构建6a基因型HCV core的表达载体pcDNA3.1/myc-His(-)-core(6a)[pCore(6a)];分别将1b、3a和6a基因型HCV core质粒以及空质粒pcDNA3.1/myc-His(-)(pNC)瞬时转染HepG2细胞,48小时后利用流式细胞术检测细胞凋亡发生的情况;利用Real-time PCR检测胱冬肽酶-3的mRNA水平变化;利用化学发光法检测胱冬肽酶-3的活性变化,比较HCV不同基因型core对细胞凋亡作用的差异。结果成功构建了6a基因型HCV core的表达载体pcDNA3.1/myc-His(-)-core(6a)[pCore(6a)];与pNC组相比,表达1b、3a和6a基因型HCV core的HepG2细胞中,Annexin V+细胞数均显著减少,其中6a基因型core较1b和3a基因型core作用显著(P=0.000、0.001);同时实验组中凋亡效应分子胱冬肽酶-3的mRNA水平及其活性较对照组均降低;其中与1b和3a基因型core相比较,6a基因型core显著降低胱冬肽酶-3的mRNA水平,而在抑制胱冬肽酶-3活性方面无显著差别。结论 HCV不同基因型core对细胞凋亡的作用不同;基因6a型core对细胞凋亡的抑制作用更为显著;HCV基因6型核心蛋白可能更易导致肝癌的发生,有待进一步研究。     

静态张应力作用下人牙周膜干细胞核心结合因子Cbfa1表达的变化

目的检测静态张应力作用对人牙周膜干细胞核心结合因子Cbfa1表达变化的影响。方法有限稀释法克隆化培养纯化人牙周膜干细胞(hPDLSCs),应用内外双层套筒式硅胶膜细胞加力装置对人牙周膜干细胞加力,加力时间点为0、3、6、12、24小时。采用原位杂交和实时定量PCR检测各加力时间点Cbfa1 mRNA的表达;蛋白免疫印迹法(Western blot)检测人牙周膜干细胞受力后Cbfa1蛋白的表达。结果人牙周膜干细胞受到静态张应力作用后3小时、6小时、12小时Cbfa1 mRNA表达均升高(P0.05),且以加力3小时最为明显,6小时后开始下降,24小时后基本恢复到不加力时的表达水平。加力3小时Cbfa1蛋白表达未见明显升高,加力6小时后Cbfa1蛋白逐渐升高,一直持续到加力24小时(P0.05)。结论静态张应力作用下,人牙周膜干细胞核心结合因子Cbfa1在RNA水平和蛋白水平的表达均发生变化,说明Cbfa1在机械力促使人牙周膜干细胞向成骨细胞方向分化的过程中起到了重要作用。     

Core features of suicide. Gender,age, alcohol and other putative risk factors in a low-incidence population

The aim of the study was to elucidate some supposed core features of suicide through a study of suicide in a low-incidence population. The material covered all suicides and undetermined deaths 1945–2004 in the Faroe Islands (a low-incidence population) and the study made use of all available information. Results showed that suicide rate had been low since the Second World War. However, there was an increase throughout the 1970s and 1980s. Supposed core features of suicide, such as gender, marital status, former psychiatric admittance, former suicidal behaviour, alcohol and method preference were confirmed. Others were not, such as an increasing rate with old age. In diagnostics, the role of psychiatric disorders was confirmed, but so was a substantial role of “no disorder”. Increase period revealed a high proportion of cases with alcohol involved and a substantial part included males, in age groups 25–64 years, unmarried, divorced and alcohol intoxicated. The main conclusion was that a low-incidence population of suicide population confirmed some supposed core features of the suicide phenomenon. Others, related to age and psychiatric disorders, were only partially confirmed. In periods of increase, the most vulnerable were the young and middle-aged males, unmarried, divorced, and alcohol played a crucial role.     

海南百岁老人12项肥胖相关指标与全因死亡的关联研究

目的描述和分析BMI、腰围、腰臀比、腰高比、小腿围、腰围小腿围比值(WCR)、脂质蓄积指数(LAP)、内脏脂肪指数(VAI)、中国内脏脂肪指数(CVAI)、身体形态指数、中国身体形态指数(CABSI)和身体圆度指数与海南百岁老人全因死亡间的关联。方法整群抽样方法抽取的海南百岁老人共1 002人。随访时间的M(Q1, Q3)为4.16(1.31, 5.04)年, 结局为全因死亡, 使用Cox比例风险回归分析各肥胖相关身体测量指标与全因死亡的关联, 并使用受试者工作特征曲线曲线下面积(AUC)进行比较。结果总人群中小腿围对全因死亡的判定能力最强, AUC为0.61(95%CI:0.57～0.64), 分性别结果与总人群一致(P<0.05)。WCR次之(AUC为0.58), 再次是BMI、LAP和腰围, AUC分别为0.55、0.55和0.54, 而CABSI、腰臀比和VAI的判定能力较弱, AUC分别为0.51、0.50和0.50。结论本研究比较了12项肥胖相关指标与海南百岁老人全因死亡间的关联, 发现小腿围的预测判定能力最好, 且呈剂量反应关系, 提示可作为长寿老人死亡风险预测的参...     

Exploring the research domain of consultant practice: Perceptions and opinions of consultant radiographers

AimThis paper reports on one part of a larger study. The aim was to explore what the core domain of research means to consultant radiographers in clinical practice and to identify the key factors that facilitate or hinder research activity by this staff group.Design and methodGrounded theory research methodology was employed. This first part of the study involved electronic questionnaires being sent to all those known in consultant radiographer posts in the United Kingdom.ResultsResults indicate there are variations across clinical specialties as to the amount and level of research undertaken by consultant radiographers, and not all agreed that research should be a core domain of consultant practice.Main facilitators to research were noted as: time; skills and knowledge of the researcher; a well defined research question.Main barriers to research were noted as: lack of allocated time; lack of skills/experience; clinical workload.ConclusionResearch is one of the four core domains of consultant allied health professional and nursing roles but, as yet, it is not fully embedded into those of all consultant radiographers. Many consultant radiographers appear to spend more of their time on the ‘clinical expert’ element of their role at the expense of the research domain.This study concludes that there is an urgent need for consultant radiographers to understand that research is one of the four core domains and to recognise the need to embed research into their clinical practice.     

三级综合医院护理质量敏感性指标的构建

目的构建三级综合医院护理质量敏感性指标,为医院护理质量评价提供相关依据。方法通过证据总结与半结构式访谈法对护理质量敏感性指标进行初步设计,通过德尔菲法进行专家函询确定最终护理质量敏感性指标。结果最终构建的护理质量敏感性指标包含一级指标3个,二级指标20个。3轮专家函询积极系数为94.12%~100.00%,权威系数为0.84,变异系数为0.00~0.22,协调系数为0.09~0.24(均P0.01)。结论通过循证、半结构式访谈及德尔菲法构建的护理质量敏感性指标具有科学性、严谨性,对护理管理及临床护理工作具有一定的指导意义。