临床护理路径在腹腔镜下全子宫切除术中的运用

目的探讨临床护理路径在腹腔镜下全子宫切除术中的运用效果。方法将60例在腹腔镜下全子宫切除术的患者按随机数字表法分为对照组和观察组,各30例。其中对照组给予常规护理,观察组按临床护理路径实施护理,比较两组患者术后排气时间、下床时间、住院时间、护理缺陷发生率以及患者满意度。结果观察组患者术后下床时间、排气时间及住院时间均短于对照组(P<0.05);观察组患者的护理缺陷发生率低于对照组(P<0.05);观察组患者的护理满意度高于对照组(P<0.05)。结论临床护理路径有助于护理操作的流程化和规范化,提高工作效率,缩短患者住院时间,降低护理缺陷发生率,提高患者满意度。     

Ivor Lewis和Sweet术式治疗食管癌疗效及安全性的Meta分析

目的:探讨食管癌切除术Ivor Lewis和Sweet两种术式的临床治疗效果及心肺保护作用。方法:检索PubMed、Web of Science、The Cochrane Library、EMBASE、CNKI、Wanfang Data、VIP和CBM数据库，最终纳入24篇文献，其中包括21篇病例对照研究、3篇随机对照研究(RCT)，总共包含5 082例患者，其中行Ivor Lewis术式患者2 241例，行Sweet术式患者2 841例。采用RevMan5.3进行Meta分析。结果:术后心血管并发症发生率Meta分析结果得出［OR=0.50，95%CI(0.25,1.01)，P=0.05］，差异有统计学意义。术后肺部并发症发生率Meta分析结果得出［OR=0.69,95%CI(0.48,0.99)，P=0.04］，差异有统计学意义。术后吻合口瘘发生率Meta分析结果得出［OR=0.83,95%CI(0.51,1.35)，P=0.45］，差异无统计学意义。术后喉返神经损伤发生率Meta分析结果得出［OR=1.57，95%CI(0.75,3.27)，P=0.23］，差异无统计学意义。3年生存率Meta分析结果得出［OR=1.91，95%CI(1.29,2.81)，P=0.001］，Ivor Lewis组患者术后3年生存率高于Sweet组，差异有统计学意义。手术时间Meta分析结果得出［MD=30.61,95%CI(14.48,46.74),P=0.000 2］，差异有统计学意义。淋巴结清扫数目Meta分析结果得出［MD=5.81,95%CI(4.63,6.99),P＜0.001］，差异有统计学意义。术中出血量Meta分析结果得出［MD=4.54,95%CI(-4.54，13.63)，P=0.33］，差异无统计学意义。术后住院天数Meta分析结果得出［MD=-0.59,95%CI(-1.80,0.61),P=0.33］，差异无统计学意义。结论:与Sweet手术相比，Ivor Lewis手术在淋巴结清扫、心肺并发症发生率以及生存率方面有较大优势。而在手术时间方面，传统Sweet手术更具优势。     

地黄相关药物专利研发竞争态势及启示

目的 通过探索地黄相关专利保护的技术布局、主题分布等方面的规律与特征，为地黄药物研发和生产机构的管理运营及知识产权保护提供参考与建议。方法 以国内外专利为数据源，利用智慧芽专利分析平台和EXCEL软件对近20年来地黄相关药物的专利年度申请态势、技术布局、主要申请机构及其运营情况进行统计与分析。结果 地黄相关专利从2010开始快速增长，但授权发明少；在地黄的种植栽培方面，专利的申请量较少，有待加大该领域专利布局力度。在地黄的加工炮制和药物新用途方面，原始创新有着较大空间。结论 建议地黄研发机构应围绕核心产品对其专利进行全面布局，分析专利价值并进行分类管理和运营，关注该领域专利申请动态预警和防范侵权和被侵权，同时应注重“知识产权”先行，开拓国际市场。     

铁皮石斛组培苗规范化生产标准操作规程(SOP)＊

根据《中药材生产质量管理规范》（GAP）的要求，对铁皮石斛组培苗生产的物种选择、种质特征、生态习性、组织培养、瓶内炼苗、移栽炼苗、出圃、装框、运输和档案记录等方面进行规定，明确各个生产过程的最优方法和指标，以规范铁皮石斛组培苗的生产流程，为保障铁皮石斛组培苗的质量提供理论指导和技术支撑。     

基于“血不利则为水”理论探讨乳腺癌术后上肢淋巴水肿辨治

“血不利则为水”乃《金匮要略》提出的著名论断,由此形成的“血水同治法”极大丰富了水肿病治疗。本文结合乳腺癌术后上肢淋巴水肿的临床特点,通过探讨“血不利则为水”的内涵及其病变过程中因“血不利”而致上肢肿胀的机理,认为活血利水法是防治乳腺癌术后上肢淋巴水肿的关键大法,具体应用中当结合益气行气、滋阴清热、疏肝健脾、化痰通络等法。     

An eco-friendly HPLC-UV method for the determination of risedronate in its bulk and tablet dosage form with application to content uniformity,dissolution and stability testing

Risedronate is a nitrogen-containing bisphosphonate for the treatment and prevention of postmenopausal osteoporosis. The current work aims to develop a novel green HPLC-UV method for the rapid analysis of risedronate sodium in bulk and tablet formulation. The analyzed samples were separated on Waters Atlantis dC18 (150 mm × 3.9 mm; 5 μm) column using a green mobile phase consisting of potassium phosphate buffer pH 2.9 and potassium edetate buffer pH 9.5 in a ratio of 1:2, the final pH was adjusted to 6.8 with phosphoric acid, the mobile phase was pumped at a rate of 1.0 mL/min, with column temperature set at 30 °C, eluted samples were detected at 263 nm and the chromatographic run time was 3.0 min. The method was found to be linear over the concentration range of 14–140 μg/mL with a correlation coefficient (r²) of 0.9994. Accuracy and precision were evaluated from three QC samples (LQC, MQC and HQC) together with the five calibrators where the percentage accuracy was found to be 101.84%. Processed quality control samples of risedronate sodium were tested for stability at different conditions, short term, long term and freeze- thaw stability. The current method was further extended to study the content uniformity of Actonel® tablets following United States Pharmacopoeia (USP) guidelines. The proposed method was fully validated as per ICH guidelines.     

Genicular Artery Embolization for the Treatment of Knee Pain Secondary to Osteoarthritis

PurposeTo evaluate the efficacy and safety of embolization of hyperemic synovial tissue for the treatment of knee pain secondary to osteoarthritis (OA).Materials and MethodsTwenty patients with radiographic knee OA and moderate-to-severe pain refractory to conservative therapy were enrolled in a prospective, 2-site pilot study. Genicular artery embolization (GAE) was performed with 75- or 100-μm spherical particles. Patients were assessed with magnetic resonance imaging at baseline and at 1 month and with the Visual Analogue Scale (VAS) and the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) at baseline and at 1, 3, and 6 months. Adverse events were recorded at all timepoints.ResultsEmbolization of at least 1 genicular artery was achieved in 20/20 (100%) patients. Mean VAS improved from 76 mm ± 14 at baseline to 29 mm ± 27 at 6-month follow-up (P < .01). Mean WOMAC score improved from 61 ± 12 at baseline to 29 ± 27 at 6-month follow-up (P < .01). Self-limiting skin discoloration occurred in 13/20 (65%) patients. Two of 20 (10%) patients developed plantar sensory paresthesia that resolved within 14 days.ConclusionsGAE to treat knee pain secondary to OA can be performed safely and demonstrates potential efficacy. Further randomized comparative studies are needed to determine true treatment effect versus placebo effect.     

品管圈在提高护理非无菌操作中手卫生的应用

目的研究品管圈对提升妇科护理人员在测量生命体征、发放口服药,做微波、红外线治疗等非无菌操作中,手卫生依从性的临床价值。方法选取2018年5月-2018年12月实施品管圈活动期间科室护理人员手卫生依从性数据为研究组,另选取2017年9月-2018年4月未实施品管圈活动期间科室护理人员手卫生依从性数据为对照组,护理人员与研究组为同一组,对照组采用常规护理,研究组实施品管圈活动,比较两组实施效果。结果研究组洗手依从性为72.71%,对照组37.50%,差异有统计学意义(P<0.01)。研究组正确洗手率为81.95%,对照组43.89%,差异有统计学意义(P<0.01);研究组开展品管圈后解决问题能力、凝聚力、QC手法评分高于对照组,差异有统计学意义(P<0.01)。结论品管圈活动开展,有助于提升护理人员对手卫生重要性的认识,获得了较高手卫生依从性。