Clinical outcomes of bypass-first versus endovascular-first strategy in patients with chronic limb-threatening ischemia due to infrageniculate arterial disease

Background

Chronic limb-threatening ischemia (CLTI), defined as ischemic rest pain or tissue loss secondary to arterial insufficiency, is caused by multilevel arterial disease with frequent, severe infrageniculate disease. The rise in CLTI is in part the result of increasing worldwide prevalence of diabetes, renal insufficiency, and advanced aging of the population. The aim of this study was to compare a bypass-first with an endovascular-first revascularization strategy in patients with CLTI due to infrageniculate arterial disease.

护理干预对急性心肌梗死患者负性情绪的影响

目的总结并归纳护理干预对急性心肌梗死患者负性情绪的影响。方法本文挑选100例医院急性心肌梗死患者(2017年2月—2018年2月)为对象。按建档时间分组,对照组50例患者(常规护理),分析组50例患者(加用人文性护理)。比较两组对疾病的了解程度及护理前后焦虑、抑郁等负性情绪的评分,随访1年,比较两组复发率。结果护理后分析组对疾病了解程度高于对照组(P<0.05);护理前分析组焦虑、抑郁评分同对照组无显著差异(P>0.05),提示可比;护理后,分析组焦虑、抑郁评分低于对照组(P<0.05);护理后分析组1年内复发率(8.00%)低于对照组(24.00%)(P<0.05)。结论在急性心肌梗死患者的护理中,人文性护理干预可显著改善患者负性情绪,改善患者预后,且可有效降低患者复发率。     

认知行为干预在冠心病患者护理中的应用效果

目的观察认知行为干预在冠心病患者护理中的应用效果。方法选取本院2016年12月～2018年2月期间收治的53例冠心病患者,根据住院号奇偶性情况将其随机分为观察组(n=27)和对照组(n=26),对照组予以常规护理,观察组予以认知行为干预。比较两组患者控制态度评分、心理状况评分、生活质量改善情况及依从性。结果观察组控制态度评分、心理状况评分、生活质量改善情况及依从性与对照组比较,差异有统计学意义(P0.05)。结论在冠心病患者护理中给予认知行为干预应用效果极佳,可作为临床干预首选措施。     

STRmix™ put to the test: 300 000 non-contributor profiles compared to four-contributor DNA mixtures and the impact of replicates

Probabilistic genotyping approaches are increasingly used for the interpretation of DNA mixtures. To explore the specificity of one of these systems (STRmix^™), we conducted an extensive study using 24 complex mixtures: all were known or apparent 4-person mixtures with at least one contributor representing less than 20% of total DNA, and all mixtures had at least one contributor with suboptimal DNA quantity. Those mixtures were either generated in-house or from casework. All the mixtures were compared to 300,000 virtual non-contributors, resulting in a dataset of 7.2 million comparisons. The great majority of the non-contributor comparisons led to a LR lower than 1 for a specificity of 99.1%. The effect of using replicate amplifications to calculate the LR of non-contributors was also assessed as triplicates were used and led to an increased specificity of 99.8%. The very large extent of the analyzed data shows that STRmix^™ has an excellent ability to discriminate non-contributors from complex DNA mixtures.     

邹城市预防艾滋病健康教育效果评价

目的评价预防艾滋病健康教育与行为干预效果。方法采用问卷方式对社区居民进行预防艾滋病信息的可及性及知信行的调查。结果社区居民艾滋病知晓率为97.41%,熟悉艾滋病传播途径的87.78%,62.78%的认为艾滋病病人或感染者和正常人享有一样的入学/就业权,38.70%的人愿意与感染艾滋病的同事继续共事,60.19%的人愿意与感染艾滋病的家人继续共同生活,最近3次性行为100%使用安全套者为26.48%,82.04%的人有医疗用血安全意识,64.81%的人有医疗器械安全意识。最想获取艾滋病预防措施、传播途径、病理知识、症状表现、治疗方法、检测途径及检测方法、疫情信息,新闻、电视公益广告、专题报道、反映艾滋病病人生活的电影或电视剧、科普材料、大型公益演出人们最喜欢。结论政府重视,多部门合作,组织机构健全,宣传教育广泛,干预措施到位,成效显著。     

前尿道代后尿道成形术治疗男性复杂性后尿道狭窄

目的探讨长段复杂性后尿道狭窄治疗新方法。方法采用分期前尿道代后尿道成形术治疗3例复杂性后尿道长段狭窄（6．5—10．0cm）患者。第一期行阴茎转位尿道端端吻合术，术后3—6个月行二期阴茎伸直、尿道会阴造口术，6个月后行第三期前尿道成形术（Johanson Ⅱ期尿道成形术）。结果例1术后排尿通畅，膀胱尿道造影检查示尿道通畅，双侧输尿管返流近消失，最大尿流率18．8ml／s，随访2年，最大尿流率18ml／s，无剩余尿。例2术后排尿通畅，最大尿流率19．5ml／s，无剩余尿，尿道扩张可顺利通过22F尿道探子。例3经会阴一耻骨联合径路行第一期阴茎转位尿道端端吻合术、尿道直肠瘘、尿道会阴瘘切除、修补术，术后尿道直肠瘘及尿道会阴瘘治愈，但因耻骨联合切口感染致吻合口狭窄，有待进一步治疗。结论分期前尿道代后尿道加前尿道重建方法是治疗男性长段复杂性尿道狭窄的有效方法。     

心理干预对行体外受精病人的影响

体外受精(IVF)治疗对不育夫妇既是一种生理负担又是一种心理负担,在IVF各个时期均表现出心理应激,其中胚胎移植后至妊娠试验前和IVF失败后应激最强,出现负性心理反应,以焦虑、抑郁多见。研究表明,通过心理干预能有效缓解患者的负性心理,并可能提高妊娠率和降低治疗中断率。