健康人群血清骨钙素影响因素的研究 —— 以北京市海淀区为例

目的了解健康人群血清OC的变化及与能量代谢的关系。方法根据排除标准筛选115名受试者(男60人,女55人),用电化学发光法和终点法检测血清OC,能量代谢指标水平,并分析血清OC与TC、TG、HDL-C、LDL-C、FINS、FPG、HOMA-IR之间的关系。结果绝经后女性OC水平与男性、绝经前女性差异存在统计学意义(P0.05)。相关性分析中,男、女性年龄与血清OC之间均呈显著负相关(r_男=-0.517和r_女=-0.568)。男、女性BMI与血清OC之间均呈显著负相关(r_男=-0.286和r_女=-0.453)。男性HDL-C与血清OC之间呈显著正相关(rHDL-C=0.271)。女性TG与血清OC之间呈显著负相关(r_(TG)=-0.340);女性HDL-C与血清OC之间呈显著正相关(rHDL-C=0.275)。男性FINS、HOMA-IR与血清OC之间呈显著负相关(r_(FINS)=-0.295,rHOMA-IR=-0.28)。女性FPG、FINS、HOMA-IR与血清OC之间无显著相关性。结论在选取的受试者中,绝经后女性血清OC水平明显低于绝经前女性,绝经后女性出现肥胖较明显。年龄、BMI与血清OC呈显著负相关,即血清OC可能导致肥胖。血清OC与机体能量代谢相关。     

虞坚尔教授辨治小儿重度胆汁淤积性黄疸经验*

虞坚尔教授应用中医药治疗小儿疾病积累了丰富的临床经验。在小儿难治性疾病中，特别是重度胆汁淤积性黄疸，虞教授提倡中西医结合，西医治标，中医治本，标本兼顾，各取所长。在中医治疗方面，虞教授专注于“利胆退黄、调脾疏肝、活血祛瘀、扶正固本”四个方面，辨病与辨证相结合，扶正与祛邪并举，正气复而黄自去。     

Efficacy of non-pharmacological interventions to treat malnutrition in older persons: A systematic review and meta-analysis. The SENATOR project ONTOP series and MaNuEL knowledge hub project

IntroductionWe aimed to perform a review of SRs of non-pharmacological interventions in older patients with well-defined malnutrition using relevant outcomes agreed by a broad panel of experts.MethodsPubMed, Cochrane, EMBASE, and CINHAL databases were searched for SRs. Primary studies from those SRs were included. Quality assessment was undertaken using Cochrane and GRADE criteria.ResultsEighteen primary studies from seventeen SRs were included. Eleven RCTs compared oral nutritional supplementation (ONS) with usual care. No beneficial effects of ONS treatment, after performing two meta-analysis in body weight changes (six studies), mean difference: 0.59 (95%CI -0.08, 1.96) kg, and in body mass index changes (two studies), mean difference: 0.31 (95%CI -0.17, 0.79) kg/m2 were found. Neither in MNA scores, muscle strength, activities of daily living, timed Up&Go, quality of life and mortality.Results of other intervention studies (dietary counselling and ONS, ONS combined with exercise, nutrition delivery systems) were inconsistent. The overall quality of the evidence was very low due to risk of bias and small sample size.ConclusionsThis review has highlighted the lack of high quality evidence to indicate which interventions are effective in treating malnutrition in older people. High quality research studies are urgently needed in this area.     

Conversion of a renewable bio-resource to a functional composite material: Product design,comprehensive characterization and adsorption of 2,4-D herbicide

Based on the opinion of “utilizing waste resources to treat waste”, a sustainable resource waste was transformed into a useful and functional material by a comprehensive experimental setup. A high surface area lentil processing waste-based activated carbon was synthesized by microwave-assisted K₂CO₃ chemical activation and then successfully converted into a ferrospinel composite. The ferrospinel composite was characterized with BET, FTIR, XRD, XPS, FE-SEM, EDX mapping, Raman and VSM techniques and the detailed characterization analysis confirmed the successful formation of the ferrospinel composite. It was also applied as an effective adsorbent material in the treatment of 2,4-dichlorphenoxyacetic acid herbicide bearing wastewater. The pseudo-second order model better defined the kinetic pathway of the adsorption while the isothermal data indicated the best suitability to Langmuir model. The maximum adsorption capacity of the ferrospinel composite towards 2,4-dichlorophenoxyacetic acid was 400 mg/g at 45 °C. Thermodynamic studies showed the favorability and spontaneity of the adsorption process.     

侧卧手术体位对老年患者眼压变化的影响及护理观察要点

目的探讨使用有效的测量工具和在适合的测量时间段采集侧卧手术体位老年患者基础数据,找出患者眼压变化随体位变化的规律,旨在制订有效的护理预防措施。方法选取2019年3—6月在首都医科大学附属北京同仁医院中心手术室完成胸科胸腔镜手术的老年患者31例。使用icare回弹式眼压计分别于患者入手术室后、全身麻醉插管后、侧卧5 min、侧卧30 min、术中1 h、术中2 h、术中3 h、翻身拔管、出室前9个时间点测量双眼眼压,同时记录每个时间点患者的血压、心率数据,记录手术过程中液体出入量、特殊用药等。结果患者侧卧5 min、侧卧30 min、术中1 h、术中2 h、术中3 h的血压与入室后比较,差异有统计学意义(P<0.05);不同时间点的心率比较,差异无统计学意义(P>0.05)。麻醉插管后患者双眼眼压均低于入室时眼压,差异有统计学意义(P<0.05);侧卧30 min、术中1 h、术中2 h、术中3 h的双眼眼压与入室后眼压比较,差异有统计学意义(P<0.05);侧卧5 min、侧卧30 min、术中1 h、术中2 h、术中3 h的受压侧眼压与非受压侧眼压比较,差异有统计学意义(P<0.05)。Pearson相关分析显示,患者平均动脉压与受压侧眼及非受压侧眼的眼压均无相关性(r值分别为-0.1138、0.0179,P>0.05)。进入手术间时患者测试视力与术后6 h回病房后测试视力比较,差异无统计学意义(P>0.05)。结论胸腔镜手术老年患者的眼压随手术体位变化而波动,从侧卧5 min开始眼压出现变化,2 h内受压侧眼眼压达到高峰,体位恢复平卧位后,眼压随即恢复到入室时水平。本研究未发现血压与眼压变化的相关性。     

医院信息化建设网络安全与防护问题研究

医院信息系统是医院业务不可或缺的部分，加强计算机网络安全治理与防护对医院信息化具有重要意义。从分析当前国内医院网络安全现状出发，总结医院网络安全存在的隐患和面临的挑战，提出纵深防御体系，网络架构演进和人员安全风险意识以及能力培养等方面的治理策略。