eCASH理念结合早期活动在ICU机械通气患者的应用研究

目的探讨eCASH理念结合早期活动在ICU机械通气患者中的应用效果。方法将96例ICU机械通气患者按入院时间分为对照组和观察组各48例,对照组给予常规镇痛镇静及护理,观察组实施基于eCASH理念的舒适化浅镇静管理结合早期活动。结果观察组谵妄发生率和ICU获得性衰弱发生率显著低于对照组,MRC肌力评分显著高于对照组,机械通气时间和ICU住院天数显著短于对照组(P0.05,P0.01)。结论 eCASH理念结合早期活动应用于ICU机械通气患者,可降低患者谵妄和ICU获得性衰弱,缩短机械通气和ICU入住时间,促进患者康复。     

Percutaneous radiofrequency ablation versus open surgical resection for spinal osteoid osteoma

BACKGROUND CONTEXT

Both open surgical resection (OSR) and radiofrequency ablation (RFA) have been reported for spinal osteoid osteoma (OO).

三镜联合治疗胆总管结石患者基于决策辅助的术前教育

目的探讨基于决策辅助的术前教育在三镜联合治疗胆囊并胆总管结石患者加速康复外科中的应用效果。方法选取行三镜联合治疗胆囊并胆总管结石患者60例,采用随机数字表法将患者分成干预组和对照组各30例。对照组采取常规术前教育,干预组采取基于决策辅助的术前教育。结果干预结束时,干预组决策参与满意度得分和术后治疗依从性得分显著高于对照组,干预组术后首次排气时间、引流时间和住院时间显著短于对照组(P0.05,P0.01)。结论基于决策辅助的术前教育有助于提高三镜联合治疗胆囊并胆总管结石患者的决策参与满意度、术后治疗依从性,有利于促进患者术后恢复。     

Effect of sevoflurane preconditioning on astrocytic dynamics and neural network formation after cerebral ischemia and reperfusion in rats

Astrocytes, the major component of blood-brain barriers, have presented paradoxical profiles after cerebral ischemia and reperfusion in vivo and in vitro. Our previous study showed that sevoflurane preconditioning improved the integrity of blood-brain barriers after ischemia and reperfusion injury in rats. This led us to investigate the effects of sevoflurane preconditioning on the astrocytic dynamics in ischemia and reperfusion rats, in order to explore astrocytic cell-based mechanisms of sevoflurane preconditioning. In the present study, 2,3,5-triphenyltetrazolium chloride staining and Garcia behavioral scores were utilized to evaluate cerebral infarction and neurological outcome from day 1 to day 3 after transient middle cerebral artery occlusion surgery. Using immunofluorescent staining, we found that sevoflurane preconditioning substantially promoted the astrocytic activation and migration from the penumbra to the infarct with microglial activation from day 3 after middle cerebral artery occlusion. The formation of astrocytic scaffolds facilitated neuroblasts migrating from the subventricular zone to the lesion sites on day 14 after injury. Neural networks increased in the infarct of sevoflurane preconditioned rats, consistent with decreased infarct volume and improved neurological scores after ischemia and reperfusion injury. These findings demonstrate that sevoflurane preconditioning confers neuroprotection, not only by accelerating astrocytic spatial and temporal dynamics, but also providing astrocytic scaffolds for neuroblasts migration to ischemic regions, which facilitates neural reconstruction after brain ischemia.     

注射用血栓通中三七元素迁移的规律

目的:分析注射用血栓通中三七从原料到成品全过程的元素迁移规律,以便更好地控制成品中元素杂质。方法:采用ICP-MS法全面分析三七药材、三七总皂苷(中间体)和注射用血栓通中21种元素的含量。结果:21种元素的标准曲线相关系数r均在0. 999以上,回收率在92. 71%～107. 07%之间,RSD均在5%以内。三七药材中铝、铁含量较高,铅、砷、汞、镉、铜符合中华人民共和国药典的相关规定,三七总皂苷(中间体)和注射用血栓通中多数元素均未检出或含量极低。结论:注射用血栓通的提取工艺可有效去除三七中大部分元素,重金属及有害元素也降到较低水平。