浅谈SAP在医院应用的现况与展望

随着高新技术不断应用于医疗领域和医疗现代化的不断推进,医院的耗材种类不断的增多,耗材的科技含量也日趋增加,设计的领域逐步扩大。在目前许多的综合医院之中,医用耗材的管理包括耗材的盘点,库存的管理以及人员不足的问题,直接影响到了医疗工作的质量,所以加强医院耗材的现代化管理势在必行。本文旨在浅析SAP上线对于医院耗材库存管理的改变和展望。     

大剂量赤芍治疗重症急性胰腺炎疗效观察

[目的]探讨大剂量赤芍治疗早期重症急性胰腺炎(SAP)的临床疗效。[方法]将符合SAP诊断标准的52例患者随机分成2组,对照组24例应用常规西医治疗方法(包括:加强监护、禁食、胃肠减压、生长抑素、抗感染等);治疗组28例在常规治疗的基础上应用大剂量赤芍煎剂,予胃管内注入。观察2组腹痛、发热、恶心呕吐症状消失的时间,血淀粉酶、白细胞、血钙、血糖恢复正常的时间及并发症的发生率。[结果]治疗组腹痛、发热、恶心呕吐症状消失时间及血淀粉酶、白细胞、血糖恢复正常时间均快于对照组(均P<0.05);2组血钙恢复正常时间比较,差异无统计学意义(P>0.05);治疗组并发症的发生率低于对照组(P<0.05)。[结论]早期应用大剂量赤芍治疗SAP,可尽快改善患者的症状和实验室指标,明显减少并发症的发生。     

Significance of measurement of high-sensitivity C-reactive protein in acute pancreatitis

Background: Determination of the severity of acute pancreatitis is difficult in the early phase after onset, and we often encounter difficulties in making decisions to initiate intensive care during the early phase. Therefore, there is real need for a simple and inexpensive method that can precisely evaluate the severity of acute pancreatitis. Methods: In the present study, we measured serum C-reactive protein (CRP) levels in 20 patients with acute pancreatitis, using a high-sensitivity CRP (hs-CRP) assay method. Results: CRP levels were as low as 1.0, 0.4, and 0.3 mg/dl in cases 2, 3, and 9, respectively, with severe acute pancreatitis. These three patients were hospitalized within 24 h after the onset of pancreatitis. Cases 2, 3, and 9 showed high hs-CRP levels, of 209 000, 68 600, and 154 000 ng/ml, respectively, and their interleukin (IL)-6 levels were above 500 pg/ml. The mean hs-CRP level was 222 760 ± 32 197 ng/ml in patients with severe acute pancreatitis and 22 798 ± 8216 ng/ml in patients with mild to moderate pancreatitis, with a significantly higher level in the severe cases. Cases 14, 16, and 20, with mild to moderate pancreatitis, had hs-CRP levels of 83 400, 1800, and 55 400 ng/ml, respectively. Conclusions: Measurement of hs-CRP levels is a simple and inexpensive method. The hs-CRP levels were found to significantly increase in the early phase of severe acute pancreatitis, suggesting that hs-CRP could possibly serve as an early indicator of the progression of acute pancreatitis into a serious state. Received: February 1, 2002 / Accepted: May 31, 2002 Reprint requests to: S. Tanaka     

Evaluation and management of acute pancreatitis in Spain

Introduction

The aim of this systematic review is to summarize epidemiological data and areas of future acute pancreatitis research in Spain.

Endoscopic intervention and cholecystectomy in pregnant women with acute biliary pancreatitis decrease early readmissions

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Molecular regulation of dendritic spine dynamics and their potential impact on synaptic plasticity and neurological diseases

The structure and dynamics of dendritic spines reflect the strength of synapses, which are severely affected in different brain diseases. Therefore, understanding the ultra-structure, molecular signaling mechanism(s) regulating dendritic spine dynamics is crucial. Although, since last century, dynamics of spine have been explored by several investigators in different neurological diseases, but despite countless efforts, a comprehensive understanding of the fundamental etiology and molecular signaling pathways involved in spine pathology is lacking. The purpose of this review is to provide a contextual framework of our current understanding of the molecular mechanisms of dendritic spine signaling, as well as their potential impact on different neurodegenerative and psychiatric diseases, as a format for highlighting some commonalities in function, as well as providing a format for new insights and perspectives into this critical area of research. Additionally, the potential strategies to restore spine structure–function in different diseases are also pointed out. Overall, these informations should help researchers to design new drugs to restore the structure–function of dendritic spine, a “hot site” of synaptic plasticity.     

清胰汤治疗重症急性胰腺炎46例

目的:探讨清胰汤治疗重症急性胰腺炎的临床疗效。方法:将98例患者随机分成2组,治疗组采用清胰汤中西结合治疗,对照组采用常规治疗,观察比较两组的疗效。结果:治疗组10d的总体临床效果明显优于对照组,而且并发多脏器功能衰竭、中转手术治疗及死亡率均低于对照组。结论:中西医结合治疗重症急性胰腺炎可提高治愈率,减少并发症及降低死亡率。     

Timely awareness and prevention of emerging chemical and biochemical risks in foods: Proposal for a strategy based on experience with recent cases

A number of recent food safety incidents have involved chemical substances, while various activities aim at the early identification of emerging chemical risks. This review considers recent cases of chemical and biochemical risks, as a basis for recommendations for awareness and prevention of similar risks at an early stage. These cases include examples of unapproved genetically modified food crops, intoxications with botanical products containing unintentionally admixed toxic herbs, residues of unapproved antibiotics and contaminants in farmed aquaculture species such as shrimp and salmon; and adverse effects of chemical and biological pesticides of natural origin. Besides case-specific recommendations for mitigation of future incidents of the same nature, general inferences and recommendations are made. It is recommended, for example, to establish databases for contaminants potentially present within products. Pro-active reconnaissance can facilitate the identification of products potentially contaminated with hazardous substances. In international trade, prevention and early identification of hazards are aided by management systems for product quality and safety, rigorous legislation, and inspections of consignments destined for export. Cooperation with the private sector and foreign authorities may be required to achieve these goals. While food and feed safety are viewed from the European perspective, the outcomes also apply to other regions.     

Effects of the food contaminant semicarbazide following oral administration in juvenile Sprague–Dawley rats

Semicarbazide (SEM) is an azodicarbonamide by-product present in glass jar packaged foods including babyfoods, in bleaching steps and flour treatment. Experimental data showed SEM acting as osteolathyrogen agent, but few toxicological data are available in susceptible life-stages. This study aimed to evaluate effects of SEM oral administration for 28 days at 0, 40, 75, 140 mg/kg bw day during the juvenile period in Sprague–Dawley rats. Histopatological examinations of: epiphyseal cartilage – potential target of SEM lathyrogen action - testes, ovary, uterus, thyroid, thymus, spleen, adrenals, representative of the main developing organs relevant to juvenile toxicity, and neurobehavioural tests in males, were performed. Mortality at high and mid dose levels and significantly decreased body weight gain were observed in males even at the lowest dose. Lack of mineralization in cartilage at all dose levels was present. Marked alterations of spontaneous motor and exploratory behaviours were evident even at 40 mg/kg. Histological alterations were observed in all tissues; thyroid and ovary effects were present also at 40 mg/kg. The present study indicate that the NOAEL in juvenile rats is lower than 40 mg/kg for SEM oral administration. SEM administration during juvenile period exerted pleiotropic effects and further studies are suggested to elucidate mechanisms.     

清胰汤对重症急性胰腺炎营养状况的疗效观察

目的:观察中药清胰汤在重症急性胰腺炎患者的营养代谢中的治疗作用。方法:收集2006年7月～2010年7月收治的急性反应期SAP病人80例,分为清胰汤治疗组(治疗组)42人和常规治疗组(对照组)38人,观察、比较病人入院时、3d、7d、14d后的总蛋白、白蛋白、前白蛋白的血清水平变化。结果:治疗组和对照组的血清总蛋白、白蛋白、前白蛋白水平在住院第7d均上升,治疗组上升更快,两组比较在第7d、14d有显著性差异(P0.05)。结论:SAP患者早期能量消耗剧烈,患者表现为能量失衡状态。中西医结合治疗可以更好的维持早期SAP患者的营养状态。