限制液体复苏在创伤失血性休克患者急救中的应用效果

目的观察限制液体复苏在创伤失血性休克患者急救中的应用效果。方法选取福建医科大学附属南平市第一医院收治的76例创伤失血性休克患者作为研究对象,依据入院前后顺序将其分为对照组(n=38)和观察组(n=38),对照组接受积极液体复苏方案,观察组接受限制液体复苏方案,比较两组治愈率、治疗后各指标水平、液体输入量及并发症发生情况。结果观察组治愈率明显高于对照组,液体输入量明显低于对照组,差异有统计学意义(P<0.05);治疗后观察组乳酸、凝血酶原时间、平均动脉压及血红蛋白水平均明显优于对照组,差异均有统计学意义(P<0.05);观察组并发症发生率为15.8%,明显低于对照组的36.8%,差异有统计学意义(P<0.05)。结论限制液体复苏应用在创伤失血性休克患者急救中,可提高患者的治愈率,改善乳酸、凝血酶原时间等指标水平,降低并发症发生率的效果优于积极液体复苏应用效果。     

Novel fabrication of fluorescent silk utilized in biotechnological and medical applications

Silk fibroin (SF) is a natural polymer widely used and studied for diverse applications in the biomedical field. Recently, genetically modified silks, particularly fluorescent SF fibers, were reported to have been produced from transgenic silkworms. However, they are currently limited to textile manufacturing. To expand the use of transgenic silkworms for biomedical applications, a solution form of fluorescent SF needed to be developed. Here, we describe a novel method of preparing a fluorescent SF solution and demonstrate long-term fluorescent function up to one year after subcutaneous insertion. We also show that fluorescent SF labeled p53 antibodies clearly identify HeLa cells, indicating the applicability of fluorescent SF to cancer detection and bio-imaging. Furthermore, we demonstrate the intraoperative use of fluorescent SF in an animal model to detect a small esophageal perforation (0.5 mm). This study suggests how fluorescent SF biomaterials can be applied in biotechnology and clinical medicine.     

产后阴道炎应用妇肤康喷雾剂治疗效果观察

目的：探讨妇肤康喷雾剂在产后阴道炎治疗中的应用效果。方法选择2012年7月至2013年6月该院80例产后阴道炎患者作为研究对象。对照组患者采用甲硝唑栓治疗，试验组患者采用妇肤康喷雾剂治疗。比较两组患者在治疗效果和不良反应方面的差异性。结果与对照组比较，试验组总有效率明显较高，不良反应发生率明显较低，组间比较差异有统计学意义（P＜0．05）。结论妇肤康喷雾剂在产后阴道炎治疗中具有良好的应用效果，疗效确切、不良反应小，值得临床推广应用。     

糖尿病动态血糖监测系统的临床应用研究进展

糖尿病属于临床高发的代谢性疾病,该疾病无法被彻底治愈,需长期通过调控机体血糖水平控制疾病,在该疾病的治疗过程中血糖的监测属于重中之重的措施,随着医疗技术的不断发展、完善,临床现推出一种血糖监测系统为动态血糖监测系统,可对血糖全天的动态变化进行监测,显著规避了传统监测方式间断性的缺点,对疾病治疗效果以及患者机体代谢控制情给予更客观的评价,特别是对于突发的餐后高血糖以及低血糖等并发症给予有效监测。现为探究将其应用于临床实践操作中的具体价值,本文从将该检测方式应用至临床治疗中的效果方面展开论述,为具体实施效果提供参考。     

“厚薄”教学理念在病理教学中的应用研究

病理学理论课教学是灌输病理学基础知识的基本手段,是医学教育的关键组成部分,普遍应用LBL教学模式。如何让传统病理学理论教学模式从被动灌输方式转化为主动学习的过程,充分调动教学双方的内在动机,拓展学生的思维能力,这是病理学理论教学研究的重要内容。文章尝试"把书读厚及把书读薄"的教学思想有效应用到病理学教学中,通过引入"思维导图"优化相关教学内容;结合双师型培训机制,灵活做到将病理学"教薄教厚";积极创建网络互动平台,提升学生的动手操作能力,实现把病理学"学薄学厚"。     

引导性反馈在内科模拟教学中的应用分析

目的探讨引导性反馈在内科模拟教学中的应用价值。方法此次研究所纳入的内科实习生均自2017年1月—2019年1月份进入本院,抽选量为80例。以随机数字表法完成分组,将应用常规内科模拟教学的40例内科实习生设立为参照组,将联合引导性反馈的40例患者设立为观察组。两组均由同组教师进行授课教学,教学后进行考核。经考核成绩分析和发放教学满意度问卷,比对两组实习生的教学情况。结果观察组的操作技巧、人文关怀、应急能力、理论知识分值更高,与参照组差异有统计学意义(P<0.05)。观察组的教学满意度更高,与参照组差异有统计学意义(P<0.05)。结论在内科模拟教学中开展引导性反馈,可强化学生对学习的反思,使学生教学积极性得到提高,有效提高学生教学成绩,改善教学质量。     

电设备应用策略管理对层流手术室PM2.5及切口感染的影响

目的探讨电设备应用策略管理对层流手术室PM2.5及切口感染的影响。方法将200例患者按是否实施层流手术室电设备应用策略管理分为两组,每组100例。对照组采用层流手术室电设备常规管理,管理组在对照组基础上采用层流手术室电设备应用策略管理,统计两组术中手术室内人员数、手术时间、术中出血量、术后切口感染发生情况,检测患者切口及口鼻周围PM2.5浓度。结果两组术中手术室内人员数、手术时间、术中出血量比较差异无统计学意义(P>0.05)。管理组距离切口1 cm、5 cm、10 cm、20 cm和距离患者口鼻5 cm处PM2.5浓度显著低于对照组(P<0.01),切口感染率显著低于对照组(P<0.05)。切口感染患者距离切口1 cm、5 cm、10 cm、20 cm和距离患者口鼻5 cm处PM2.5浓度显著高于无切口感染患者(P<0.05)。相关分析显示,层流手术室PM2.5浓度与切口感染率呈显著正相关(P<0.05)。结论电设备应用策略管理有助于降低层流手术室PM2.5浓度及切口感染发生率。     

Bioequivalence of diclofenac sodium 2% and 1.5% topical solutions relative to oral diclofenac sodium in healthy volunteers

Background. Topical formulations of nonsteroidal anti-inflammatory drugs (NSAIDs) are generally considered to be safer alternatives to oral NSAIDs due to lower systemic absorption. We conducted randomized, crossover studies that compared the pharmacokinetics (PK), bioequivalence and safety of topical diclofenac sodium 2% twice daily (BID), diclofenac sodium 1.5% four times daily (QID) and oral diclofenac sodium in healthy subjects. Methods. The results of three bioequivalence studies are reviewed. Healthy adult subjects (n = 76) applied topical diclofenac sodium 2% solution (40.4 mg/2 mL) BID; or 1.5% solution (19.3 mg/40 drops) QID to each knee for 7.5 consecutive days separated by a washout period. Subjects (n = 22) in one study also received oral diclofenac sodium 75 mg BID for 7.5 days. Plasma diclofenac concentrations were determined from serial blood samples collected on Days 1 and 8 (steady state), and diclofenac PK parameters were estimated by noncompartmental methods. Results. The studies demonstrated comparable bioequivalence between the 2% and 1.5% topical solutions as well as lower systemic exposure compared to oral dosing (approximately 93% less). Daily systemic exposure was comparable between the two formulations with only a 12% difference in the AUCss_0-24 (p = 0.140). Furthermore, both topical solutions demonstrated delayed elimination with a t_1/2 of 4- to 6-fold longer, as compared to oral diclofenac. The 2% solution provided more consistent dosing relative to the 1.5% solution when comparing AUCss_0-24 and C_maxss across studies. Mild application site reactions were the most common treatment-emergent adverse event reported with topical diclofenac. Conclusions. The steady-state PK profile of topical diclofenac 2% solution administered BID is similar to that of the 1.5% solution administered QID. Systemic exposure to diclofenac is substantially lower after topical application as compared to oral administration. (Study 2 was registered with ClinicalTrials.gov; NCT01202799; https://clinicaltrials.gov/ct2/results?term=01202799&;Search=Search).     

预见性护理干预在不稳定心绞痛中的应用效果

目的研究预见性护理干预在不稳定心绞痛的应用效果。方法选取本院2016年6月—2019年12月收治的108例不稳定心绞痛患者,根据护理方式分成两组,对照组(n=54)应用常规护理干预,观察组(n=54)加强常规护理干预,实施预见性护理干预,比较两组护理方法的应用效果。结果观察组患者总有效率(98.15%)临床疗效与对照组(79.63%)比较差异有统计学意义(P<0.05)。两组患者护理后心绞痛稳定状态、疾病认知度、心绞痛发作情况、躯体活动受限程度评分比较,差异有统计学意义(P<0.05)。观察组患者护理后心绞痛稳定状态、疾病认知度、心绞痛发作情况、躯体活动受限程度评分与对照组比较差异有统计学意义(P<0.05)。观察组患者对护理满意度(100%)与对照组(85.19%)比较差异有统计学意义(P<0.05)。结论预见性护理干预是不稳定心绞痛的一种优秀护理方法,具有较高临床价值。