脑卒中患者安宁疗护需求的范围综述

目的 对脑卒中患者安宁疗护需求相关文献进行范围审查,旨在为未来相关研究提供参考。方法 聚焦脑卒中患者安宁疗护,以范围综述方法为框架,系统检索中文和英文数据库及灰色数据库,检索时限为建库至2022年2月20日,对纳入文献进行汇总分析。结果 共纳入28篇文献,结果显示脑卒中患者安宁疗护需求大,但尚未得到广泛关注及应用,其主要影响因素包括人口学因素、疾病因素、家属因素、医护人员因素及医院/政策因素5个方面。结论 脑卒中患者安宁疗护研究分布不均衡,脑卒中患者安宁疗护需求繁多且复杂,其安宁疗护需求受多项因素影响,医院需重视脑卒中患者安宁疗护需求,同时加强医护人员相关知识与技能,不断满足患者及家属对安宁疗护需求。     

头孢菌素致尿毒症透析患者神经精神症状12例

随着医疗卫生制度的改善,医疗技术的提高,长期维持透析的群体日益增加,临床上,在其他患者中少见的药物不良反应在该类患者中出现的几率明显增加。头孢菌素类药物目前广泛应用于临床,由于     

提高临床医学专业实习生外科临床技能的探讨

目的探讨不断循环的个体化培训方案在临床医学专业实习生外科临床技能培训中的价值。方法42名实习生按人院临床技能考试成绩分为A（优）、B（中）、c（差）3个组,分别进行常规培训、统一强化训练和专人强化训练,在实习全过程中进行6次考查记分。结果与入院时比较,毕业时成绩为优秀的人数明显增加,而成绩较差的人数大幅减少。结论不断循环的个体化培训方案结合有效的统一考核措施,有助于提高临床医学专业实习生的外科实践能力。     

Antipyretic Effect of Herba Ephedrae-Ramulus Cinnamomi Herb Pair on Yeast-Induced Pyrexia Rats: A Metabolomics Study

Objective: To investigate the antipyretic mechanism of Herba Ephedrae(Eph)-Ramulus Cinnamomi(RC) herb pair on yeast-induced pyrexia in rats. Methods: Totally 30 qualified male SD rats were randomly assigned to the normal control(NC) group, the pyrexia model(model) group, the Eph, RC and Eph-RC treatment groups by a random digital table, 6 rats in each group. Each rat received a 20% aqueous suspension of yeast(10 m L/kg) except the NC group. The 3 treatment groups were administered 8.1, 5.4 and 13.5g/kg Eph, RC and Eph-RC respectively at 5 and 12h after yeast injection, the NC group and the model groups were administered equal volume of distilled water. Rectal temperatures were measured at 0,6,8,10,12,15,18,24 and 30h and urine was collected prior to yeast injection and at 6, 10, 18, 24, 30, and 36 h after yeast injection. Then urine metabolomic profiling by gas chromatography tandem mass spectrometry, coupled with multivariate statistical analysis and pattern recognition techniques were used to explore the antipyretic effects of Eph-RC. Partial least squares discriminate analysis was used to analyze the metabolomics dataset including classification and regression in metabolomics plot profiling. Results: Compared with the NC group, rectal temperatures were significantly higher in the model group(P0.01), while 3 treatment groups decreased significantly compared with the model group(P0.05 or P0.01). Rectal temperatures of Eph-RC-treated rats started to go down at 6 h, and markedly decreased at 8, 12, 15, 18 and 24h(P0.05 or P0.01), while those of the Eph and RC groups had decreased firstly at 8 h and were markedly lower at 12h(P0.05 or P0.01). Seventeen potential biomarkers related to pyrexia were confirmed and identified, including pyruvic acid, L-phenylalanine, L-tyrosine, phenylacetic acid, hippuric acid, succinic acid, citrate and so on. Eight potential alterations of metabolic pathways including phenylalanine metabolism, citrate cycle, tryptophan metabolism, biosynthesis of valine, leucine and isoleucine, were identified in relation to the antipyretic effects of Eph-RC using MetPA software. Conclusion: The antipyretic effect of Eph-RC herb pair on yeast-induced pyrexia in rats involved correction of perturbed amino acid, fatty acid, and carbohydrate metabolism according to the metabolic pathway analysis with MetPA.     

残胃癌的临床病理特征

目的 探讨残胃癌的临床病理特征及其治疗方法.方法 回顾性分析9年间收治的25例良性病变行胃次全切除术后发生残胃癌手术患者的病理和临床资料.结果 残胃癌男女比例约为5:1,发生于首次手术后12～35年,平均24.5年,首次手术为Billroth Ⅱ式者占80.0%.患者就诊时为进展期,淋巴结转移以残胃大弯侧、空肠系膜为主.均行手术治疗,行根治性手术切除14例(56.0%),姑息性切除11例(44.0%).术后辅以辅助化疗18例.随访3～12年,1,3,5年总体生存率分别为72.0%,56.0%,36.0%.根治性手术后为78.5%,71.4%,50.0%;姑息性手术后为63.6%,36.3%,18.1%(P＜0.05).手术联合化疗组的5年生存率为44.4%(8/18),显著高于单纯手术治疗组的14.3%(1/7)(P＜0.05).结论 残胃癌以手术联合辅助化疗的治疗方案仍能获得较好的临床效果.     

ERCP术后胰腺炎的诊断与治疗

目的探讨ERCP术后并发胰腺炎的诊断与治疗。方法回顾性分析2824例行ERCP患者的有关临床资料。统计高淀粉酶血症与PEP的发生率,观察ERCP后血淀粉酶变化的规律。结果高淀粉酶血症与PEP是ERCP后最常见的并发症,本组总发生率达87．3％。结论ERCP术后并发胰腺炎一般较轻,经保守治疗后均能恢复。重症胰腺炎的发生率较低,但愈后较差。     

单侧甲状腺结节216例的临床分析

目的探讨甲状腺腺叶切除术治疗单侧甲状腺结节的效果.方法回顾性分析216例单侧甲状腺结节病人的临床资料.结果216例患者施行甲状腺腺叶切除或腺叶加峡部切除术.术后病理检查诊断为滤泡状和乳头状囊性腺瘤178例,结节性甲状腺肿30例,甲状腺癌8例.术后随访3月～3a,无1例复发,无甲状腺功能减退症状发生,临床疗效满意.结论单侧甲状腺结节常规施行腺叶切除术是一种安全有效的治疗方式.     

造血干细胞移植治疗消化系统肿瘤进展

造血干细胞移植（HSCT）通过造血和免疫重建功能可支持患者接受大剂量化疗（HDC）和放疗，并通过其移植物抗肿瘤（GVT）反应，提高治疗中晚期消化系统肿瘤的疗效。     

造血干细胞移植治疗消化系统肿瘤进展

造血干细胞移植(HSCT)通过造血和免疫重建功能可支持患者接受大剂量化疗(HDC)和放疗,并通过其移植物抗肿瘤(GVT)反应,提高治疗中晚期消化系统肿瘤的疗效。