妇科急腹症中的超声临床诊断研究

目的:探讨妇科急腹症中的超声临床诊断研究。方法:纳入40例患者作为研究样本,40例患者均为2017年3月-2019年7月入院接受治疗的妇科急腹症患者,采用随机分组的方式,将40例患者分为两组,每组各20例患者,两组患者接受不同的诊断方式,对照组接受常规诊断,研究组接受超声诊断,对比两组患者诊断准确率。结果:观察并对比两组患者的数据,常规诊断以及超声诊断的临床准确率对比,研究组的准确率高于对照组,两组患者的组间数据对比,表明本次研究具有统计学意义(P<0.05)。结论:妇科急腹症中采用超声诊断,对急腹症类型的诊断效果较为准确,为患者后续的临床治疗提供诊断依据,证实了超声诊断对妇科急腹症在临床诊断上具有重要作用,应提倡将其纳入常规诊断之中。     

BNT162b2 mRNA COVID-19 vaccine Reactogenicity: The key role of immunity

We examined the impact of pre-existing SARS-CoV-2-specific cellular immunity on BNT162b2 mRNA COVID-19 vaccine reactogenicity. Of 96 healthcare workers (HCWs), 76% reported any vaccine reaction (first dose: 70%, second dose: 67%), none of which was severe. Following first dose, systemic reactions were significantly more frequent among HCWs with past infection than in infection-naïve individuals, and among HCWs with pre-existing cellular immunity than in those without it. The rate of systemic reactions after second dose was 1.7 and 2.0-times higher than after first dose among infection-naïve HCWs and those without pre-existing cellular immunity, respectively. Levels of SARS-CoV-2-specific T-cells before vaccination were higher in HCWs with systemic reactions after the first dose than in those without them. BNT162b2 vaccine reactogenicity after first dose is attributable to pre-existing cellular immunity elicited by prior COVID-19 or cross-reactivity. Reactogenicity following second dose suggests an immunity-boosting effect. Overall, these data may reduce negative attitudes towards COVID-19 vaccines.Study Registration.The study was registered on clinicaltrials.gov, NCT04402827.     

纳米药物递送系统在结核病治疗中的研究进展

目前,结核病防治形势仍十分严峻。然而,传统抗结核药物治疗方案存在疗程长、药物不良反应多以及患者依从性差等问题,常导致治疗失败,故亟需可以控制结核病的新药或新剂型。装载抗结核药物的纳米药物递送系统可以将抗结核药物主动或被动靶向到被感染的细胞或病灶部位内,杀菌的同时,还具有缓释给药、减少给药频率、减少剂量依赖性不良反应等优势。本文综述了纳米递药系统在结核病治疗方面的应用情况及前景。     

四肢烧伤患者行急诊负压封闭引流术的疗效观察

目的探究应用急诊切痂植皮配合负压封闭引流术治疗四肢烧伤的临床疗效。方法按随机抽取法将医院2018年2月—2019年1月间收治的57例四肢烧伤患者分为常规组和实验组,常规组28例,实验组29例。给予常规组患者急诊切痂植皮,用常规换药配合治疗,而实验组在常规组的基础上用负压封闭引流术配合治疗。比较常规组患者和实验组患者的临床效果、疼痛程度评分。结果两组患者的总有效率对比,实验组总有效率吗,明显高于常规组的总有效率,实验和常规组差异具有统计学意义(P<0.05)。常规组患者的疼痛评分高于实验组患者,差异具有统计学意义(P<0.05)。结论四肢烧伤患者通过应用急诊切痂植皮配合负压封闭引流术治疗后,临床效果得到有效改善,质量生活水平得到提高。     

Therapeutic landscapes and wellbeing in later life: Impacts of blue and green spaces for older adults

This paper extends the concept of therapeutic landscapes by investigating how green and blue spaces affect older adult health and wellbeing. We draw on interview data from participants aged 65–86 years old who described their everyday experiences with green and especially blue spaces across Metro Vancouver, Canada. Landscapes embedded with therapeutic qualities included parks, gardens, street greenery, lakes, and the ocean. Interactions with these spaces influenced participants' perceived physical, mental, and social health. Issues of safety, accessibility, and personal perception complicated this relationship. Overall, the findings indicate that nature plays a nuanced and influential role in the everyday lives of older adults. Better understanding how older adults experience health and landscape is critical towards developing everyday contact with nature that can improve quality of life for ageing populations.     

基于超声技术检测60例2型糖尿病患者心脏舒张功能的效果分析

目的：探讨超声技术检测单纯2型糖尿病患者心脏舒张功能的临床应用效果。方法指定具有专业知识及丰富经验的临床医学影像检查人员完成T2DM组2型糖尿病患者、IFG组空腹血糖受损者、IGT组糖耐量异常者、对照组健康人群超声检查工作,项目包括LVEF、E、A、E/A值、Em、Am、Em/Am值、E/Em值。分析方法为查阅相关病历资料、询问当事医护人员、询问患者及家属等。记录两组心脏舒张功能检查结果,给予统计学分析后得出结论。结果T2DM组、IFG组、IGT组、对照组经超声技术检测心脏舒张功能可知,T2DM组2型糖尿病患者LVEF、E、E/A、Am、Em、Em/Am等检测结果均显著低于对照组健康人群,而其E/Em值则显著高于对照组,对比结果具有统计学意义(P<0.05)。结论临床医生应准确掌握2型糖尿病患者超声检查心脏舒张功能特点,根据检查结果准确判断心脏受损情况并给予积极干预措施,保障患者生活质量及生命安全。     

Pathophysiological mechanisms involved in non-alcoholic steatohepatitis and novel potential therapeutic targets

Non-alcoholic fatty liver disease (NAFLD) is a major health care problem and represents the hepatic expression of the metabolic syndrome. NAFLD is classified as non-alcoholic fatty liver (NAFL) or simple steatosis, and non-alcoholic steatohepatitis (NASH). NASH is characterized by the presence of steatosis and inflammation with or without fibrosis. The physiopathology of NAFL and NASH and their progression to cirrhosis involve several parallel and interrelated mechanisms, such as, insulin resistance (IR), lipotoxicity, inflammation, oxidative stress, and recently the gut-liver axis interaction has been described. Incretin-based therapies could play a role in the treatment of NAFLD. Glucagon-like peptide-1 (GLP-1) is an intestinal mucosa-derived hormone which is secreted into the bloodstream in response to nutrient ingestion; it favors glucose-stimulated insulin secretion, inhibition of postprandial glucagon secretion and delayed gastric emptying. It also promotes weight loss and is involved in lipid metabolism. Once secreted, GLP-1 is quickly degraded by dipeptidyl peptidase-4 (DPP-4). Therefore, DPP-4 inhibitors are able to extend the activity of GLP-1. Currently, GLP-1 agonists and DPP-4 inhibitors represent attractive options for the treatment of NAFLD and NASH. The modulation of lipid and glucose metabolism through nuclear receptors, such as the farsenoid X receptor, also constitutes an attractive therapeutic target. Obeticholic acid is a potent activator of the farnesoid X nuclear receptor and reduces liver fat content and fibrosis in animal models. Ursodeoxycholic acid (UDCA) is a hydrophilic bile acid with immunomodulatory, anti-inflammatory, antiapoptotic, antioxidant and anti-fibrotic properties. UDCA can improve IR and modulate lipid metabolism through its interaction with nuclear receptors such as, TGR5, farnesoid X receptor-α, or the small heterodimeric partner. Finally, pharmacologic modulation of the gut microbiota could have a role in the therapy of NAFLD and NASH. Probiotics prevent bacterial translocation and epithelial invasion, inhibit mucosal adherence by bacteria, and stimulate host immunity. In animal models, probiotics prevent obesity, decrease transaminase levels, and improve IR and liver histology in NASH.     

中药防治肺动脉高压研究现状及创新药物研发＊

肺动脉高压为恶性肺血管疾病或临床综合征，发病机理涉及复杂的生物学过程和多种分子机制，临床仍缺乏有效治疗药物。尽管单靶点药物的联合应用可有效改善其临床症状，但不能阻止病程进展，且价格昂贵，药物不良反应问题一直未能解决。中药因多成分协同作用、多靶点发挥药效、多途径整合调节疾病的特点，在肺动脉高压的治疗中发挥独特优势，具有良好应用前景和创新药物开发潜力。本文旨在全面系统地梳理近30年中药防治肺动脉高压的研究进展，分析创新药物研发的瓶颈及策略，以期为肺动脉高压的创新药物研发提供有益参考。     

泌尿外科后腹腔镜手术的临床探讨

目的探讨泌尿外科后腹腔镜手术的治疗效果，以供临床参考。方法选取2008年4月-2013年3月广东省清远市中医院泌尿外科收治的患者153例作为研究对象，随机分为两组。A组接受开放手术治疗，B组接受后腹腔镜手术治疗。对比两组患者手术时间、术中出血量、住院时间、手术并发症的差异性。结果与A组对比发现，B组术中出血量较少，住院时间明显较短，手术并发症发生率明显较低，差异有统计学意义（P〈0.05）。对比两组手术时间发现，两组间差异无统计学意义。结论后腹腔镜手术在泌尿外科的治疗中具有创伤小、恢复快等优势，值得临床推广应用。