138例红花黄色素注射液临床使用分析

目的调查研究红花黄色素注射液的临床使用情况,完善使用方案,为临床合理用药提供参考。方法采用回顾性研究方法,对138例红花黄色素注射液病例进行统计分析。结果如严格按照说明书给药,本次调查病例中,仅有22．46％病例为合理用药。结论有必要加强红花黄色素注射液在临床应用的监测,提高合理用药水平。     

Variation in academic preparation and progression of nurses across the continuum of care

BackgroundChanging health care needs are driving new models of care that emphasize care coordination, health promotion, and disease management by registered nurses (RNs). A skill-mix favoring professional (baccalaureate or above) over technical (less than baccalaureate) education is promoted by national initiatives.PurposeTo examine the academic preparation and progression of general practice RNs in practice settings across the care continuum.MethodSecondary analyses of data from the Texas Board of Nurses RN Licensure databases in 2008 and 2014.FindingsOverall the professional skill-mix for general practice RNs improved from 47.1% to 50.2%. Disparities were identified in home health (31.6%), long-term care (27.8%) and nonmetropolitan areas (31.7%). Role change was the strongest correlate of academic progression.DiscussionNon-hospital and rural practice settings may be vulnerable to the effects of an undereducated RN workforce. More effective reimbursement policies and employer incentives are needed to drive academic progression and address disparities across practice settings.     

Comparison of serum lipid profile in type 2 diabetes with and without adequate diabetes control in Sudanese population in north of Sudan

Background

Diabetes mellitus (DM) is a major health problem in Sudan and is a leading cause of morbidity and mortality. Dyslipidemia is a major complication of diabetes and an important risk factor for cardiovascular disease (CVD). The objective of this study was to determine the prevalence of dyslipidemia and its co-relation with the glycemic control in individuals with diabetes in River Nile State, Sudan.

淮河水系毛毕吸虫自然疫源地调查报告

目的 调查淮河水系是否存在毛毕属吸虫及其尾蚴性皮炎流行。方法 取现场采集和实验室感染的耳萝卜螺压片、镜检，分离母胞蚴、子胞蚴和尾蚴，并将分离获得的尾蚴接种雏鸭；收集淮河沿岸家鸭和人工感染的雏鸭粪便，用水洗沉淀法查找虫卵、孵化分离毛蚴，并用此毛蚴感染实验室饲养的耳萝卜螺；解剖家鸭和人工感染的雏鸭分离成虫。对沿岸部分村民作现场查询和体检，以确定有无该皮炎表现及伴随症状。结果 现场采集耳萝卜螺的感染率为0．39％（71／18000）；家鸭粪便毛毕吸虫卵阳性率为33．50％（201／600），雏鸭接种23d后，从粪中可查见虫卵，且所获虫卵可孵化出毛蚴；解剖部分虫卵阳性家鸭和经尾蚴感染的雏鸭可分离出成虫。从虫卵、毛蚴、尾蚴及成虫形态观察，均属毛毕属吸虫。沿岸村民接触有鸭活动的水体后，在胸腹部及下肢等处皮肤可见弥漫性突出皮肤的红色丘疹，周围有红晕，并可见成片的风疹团，患处刺痒或奇痒。结论 淮河水系存在毛毕属吸虫，并有血吸虫尾蚴性皮炎流行。     

黄甲综合征一例并文献复习

目的 提高对黄甲综合征（YNS）的认识。方法 报道1例YNS，并结合国内文献中报道的9例YNS患者的临床资料进行分析。结果 YNS是一种罕见的疾病，临床主要表现黄甲、淋巴水肿、胸膜肺疾病三联征。病理机制可能是淋巴回流障碍。结论 在胸腔积液的鉴别诊断中应考虑到黄甲综合征的可能。YNS大多预后良好，目前尚无有效的治疗方法，对胸腔积液可反复胸穿排液或行胸膜固定术。     

黄热病病毒检测方法学的研究进展

本文对黄热病病毒检测方法进行了综述。黄热病病毒的检测技术对该病的快速诊断,流行病学调查以及接种人群血清抗体的有效监测意义重大。正确快速地检测出黄热病病毒对保障我国人民健康安全和经济发展均有重大意义。     

From the Cover: Salt stress-induced Ca2+ waves are associated with rapid,long-distance root-to-shoot signaling in plants

Their sessile lifestyle means that plants have to be exquisitely sensitive to their environment, integrating many signals to appropriate developmental and physiological responses. Stimuli ranging from wounding and pathogen attack to the distribution of water and nutrients in the soil are frequently presented in a localized manner but responses are often elicited throughout the plant. Such systemic signaling is thought to operate through the redistribution of a host of chemical regulators including peptides, RNAs, ions, metabolites, and hormones. However, there are hints of a much more rapid communication network that has been proposed to involve signals ranging from action and system potentials to reactive oxygen species. We now show that plants also possess a rapid stress signaling system based on Ca²⁺ waves that propagate through the plant at rates of up to ∼400 µm/s. In the case of local salt stress to the Arabidopsis thaliana root, Ca²⁺ wave propagation is channeled through the cortex and endodermal cell layers and this movement is dependent on the vacuolar ion channel TPC1. We also provide evidence that the Ca²⁺ wave/TPC1 system likely elicits systemic molecular responses in target organs and may contribute to whole-plant stress tolerance. These results suggest that, although plants do not have a nervous system, they do possess a sensory network that uses ion fluxes moving through defined cell types to rapidly transmit information between distant sites within the organism.Plants are constantly tailoring their responses to current environmental conditions via a complex array of chemical regulators that integrate developmental and physiological programs across the plant body. Environmental stimuli are often highly localized in nature, but the subsequent plant response is often elicited throughout the entire organism. For example, soil is a highly heterogeneous environment and the root encounters stimuli that are presented in a patchy manner. Thus, factors including dry or waterlogged regions of the soil, variations in the osmotic environment, and stresses such as elevated levels of salt are all likely to be encountered locally by individual root tips, but the information may have to be acted on by the plant as a whole.In animals, long-range signaling to integrate activities across the organism occurs through rapid ionic/membrane potential-driven signaling through the nervous system in addition to operating via long-distance chemical signaling. Plants have also been proposed to possess a rapid, systemic communication network, potentially mediated through signals ranging from changes in membrane potential/ion fluxes (1–3) and levels of reactive oxygen species (ROS) (4, 5) to altered hydraulics in the vasculature (6). Even so, the molecular mechanisms behind rapid, systemic signaling in plants and whether such signals indeed carry regulatory information remains largely unknown. Suggestions that Ca²⁺ channels play a role in signals that occlude sieve tube elements (7), or that mediate systemic electrical signaling (2) in response to remote wounding, highlight Ca²⁺-dependent signaling events as a strong candidate for mediating some of these long-range responses. Similarly, cooling of roots elicits Ca²⁺ increases in the shoot within minutes (8), suggesting systemic signals can elicit Ca²⁺-dependent responses at distal sites within the plant. However, despite extensive characterization of Ca²⁺ signals (reviewed in ref. 9), their roles in a possible plant-wide communication network remain poorly understood. Therefore, to visualize how Ca²⁺ might act in local and systemic signaling, we generated Arabidopsis plants expressing the highly sensitive, GFP-based, cytoplasmic Ca²⁺ sensor YCNano-65 (10). We observed that a range of abiotic stresses including H₂O₂, touch, NaCl, and cold shock triggered Ca²⁺ increases at the point of application. However, NaCl also elicited a Ca²⁺ increase that moved away from the point of stress application. Propagation of this Ca²⁺ increase was associated with subsequent systemic changes in gene expression. We also report that this salt stress-induced long-distance Ca²⁺ wave is dependent on the activity of the ion channel protein Two Pore Channel 1 (TPC1), which also appears to contribute to whole-plant stress tolerance.     

Delta内镜下腰椎减压融合术治疗巨大型腰椎间盘突出症的疗效

目的 探讨Delta内镜下腰椎减压融合术治疗巨大型腰椎间盘突出症（GILDH）的临床疗效。方法 选择2020年4月-2022年5月该院36例GILDH患者作为研究对象。其中,DELTA组18例,开放组18例。两组患者性别、年龄和责任节段比较,差异均无统计学意义。比较两组患者手术时间、围手术期指标和临床疗效。结果 Delta组术中出血量和术后引流量少于开放组,切口长度和住院时间短于开放组,椎旁肌损伤程度轻于开放组,手术时间长于开放组,差异均有统计学意义（P <0.05）;两组患者术后各时段腰痛视觉模拟评分法（VAS）较术前明显降低,腰椎功能日本骨科协会（JOA）评分较术前明显升高,差异均有统计学意义（P <0.05）;DELTA组术后各时段腰痛VAS明显低于开放组,腰椎功能JOA评分明显高于开放组,差异均有统计学意义（P <0.05）;两组患者术后末次随访时,改良MacNab标准比较,差异无统计学意义（P> 0.05）。结论 Delta内镜下腰椎减压融合术治疗GILDH,疗效显著,具有出血量少、手术切口小和术后康复快等优势;在跨越Delta内镜学习曲线和优化手术流...