基层对手部损伤的不正确处理分析

随着我国工农业机械化的发展，机械化生产在农村已广泛采用。但由于生产防护设备差，操作者技术不熟练，注意力不集中等原因，容易造成劳动者手部损伤。另外手部损伤也多见于交通事故和生活意外情况等。手部损伤虽然很少威胁伤员生命，但严重的外伤或一般的手外伤处理不当，使手在原来损伤的基础上丧失更多的功能，均可导致患者丧失部分甚至全部生活和工做能力。笔者根据基层工作经验，就我院2000年8月～2010年1月共收治手部外伤病人98例，随访1例。结合临床资料分析基层医院对手部外伤患者不正确处理常见情况分析如下。     

Universal distribution of protein evolution rates as a consequence of protein folding physics

The hypothesis that folding robustness is the primary determinant of the evolution rate of proteins is explored using a coarse-grained off-lattice model. The simplicity of the model allows rapid computation of the folding probability of a sequence to any folded conformation. For each robust folder, the network of sequences that share its native structure is identified. The fitness of a sequence is postulated to be a simple function of the number of misfolded molecules that have to be produced to reach a characteristic protein abundance. After fixation probabilities of mutants are computed under a simple population dynamics model, a Markov chain on the fold network is constructed, and the fold-averaged evolution rate is computed. The distribution of the logarithm of the evolution rates across distinct networks exhibits a peak with a long tail on the low rate side and resembles the universal empirical distribution of the evolutionary rates more closely than either distribution resembles the log-normal distribution. The results suggest that the universal distribution of the evolutionary rates of protein-coding genes is a direct consequence of the basic physics of protein folding.     

举臂靠头法纠正早产儿PICC异位于颈静脉的效果观察

目的：分析举臂靠头法在早产儿经外周静脉穿刺置入中心静脉导管( PICC)异位于颈静脉的处理效果。方法选取2013年6月到2014年10月行PICC置管导管尖端异位于颈静脉的早产儿42例作研究对象,随机选取22例为实验组,采用举臂靠头法对异位的导管进行调整,监测调整后效果,其余20例为对照组,以常规方法调整。结果实验组调整次数及成功率与对照组相比较,两者有统计学意义(t=3.89,χ2=78.49,均P<0.05),而两组机械性静脉炎的发生率比较无统计学意义(χ2=0.874, P>0.05)。结论采取举臂靠头法对PICC异位于颈静脉进行正位,操作简单、方便,减少病人的痛苦,减轻家庭负担。     

对于试纸法检测HCG阳性结果的正确认识

试纸法检测HCG已成为当今实验室检测的主要手段，本文主要探讨试纸法HCG的正确操作和结果解释。     

Prognostic Value of Radiotracer-Based Perfusion Imaging in Critical Limb Ischemia Patients Undergoing Lower Extremity Revascularization

ObjectivesThe purpose of this study was to evaluate the prognostic value of single-photon emission computed tomography (SPECT)/computed tomography (CT) imaging of angiosome foot perfusion for predicting amputation outcomes in patients with critical limb ischemia (CLI) and diabetes mellitus (DM).BackgroundRadiotracer imaging can assess microvascular foot perfusion and identify regional perfusion abnormalities in patients with critical limb ischemia CLI and DM, but the relationship between perfusion response to revascularization and subsequent clinical outcomes has not been evaluated.MethodsPatients with CLI, DM, and nonhealing foot ulcers (n = 25) were prospectively enrolled for SPECT/CT perfusion imaging of the feet before and after revascularization. CT images were used to segment angiosomes (i.e., 3-dimensional vascular territories) of the foot. Relative changes in radiotracer uptake after revascularization were evaluated within the ulcerated angiosome. Incidence of amputation was assessed at 3 and 12 months after revascularization.ResultsSPECT/CT detected a significantly lower microvascular perfusion response for patients who underwent amputation compared with those who remained amputation free at 3 (p = 0.01) and 12 (p = 0.01) months after revascularization. The cutoff percent change in perfusion for predicting amputation at 3 months was 7.55%, and 11.56% at 12 months. The area under the curve based on the amputation outcome was 0.799 at 3 months and 0.833 at 12 months. The probability of amputation-free survival was significantly higher at 3 (p = 0.002) and 12 months (p = 0.03) for high-perfusion responders than low-perfusion responders to revascularization.ConclusionsSPECT/CT imaging detects regional perfusion responses to lower extremity revascularization and provides prognostic value in patients with CLI (Radiotracer-Based Perfusion Imaging of Patients With Peripheral Arterial Disease; NCT03622359)     

秦岭七药植物资源的调查研究

目的对秦岭七药植物基原、药用部位、功效以及生境等进行资源学系统性调查研究。方法通过文献查阅、实地调查、标本采集和鉴定等进行归纳、总结和订正。结果秦岭七药共约122种,其基源植物分属于46科92属,包含126种、11个变种和1个亚种,以蓼科、毛茛科、菊科、百合科、兰科来源的植物较多。结论秦岭七药植物资源丰富、临床功效好,系统性调查为其资源合理开发、利用和保护提供帮助。     

Agilent50胎儿监护仪的基本功能及正确使用

为了使产科工作人员对Agilent50胎儿监护仪有较全面的了解 ,本文就仪器的基本功能、主要功能键、正确使用及日常维护等作一讨论。     

根充长度对根管治疗疗效的影响对比研究

目的 研究在根管治疗中根充长度对疗效的影响.方法 对200颗根充治疗后18个月的上前牙进行X光片检查,根据根充长度分为3组:恰填132颗,欠填40颗,超填28颗,应用根尖周指数(PAI)并综合临床检查,对其疗效进行评价.结果 根管治疗成功率为77.5%,恰填组根管的成功率(90.1%),欠填组成功率(65.0%),超填组成功率(37.7%).恰填组成功率明显高于欠填组及超填组,欠填组高于超填组(P＜0.01).结论 根管治疗时,根充长度明显影响治疗效果.     

严格治理医药回扣 促进纠风工作深入开展

治理医药回扣，是当前纠正医药行业不正之风的焦点问题。也是纠风的重点。其治理的举措：坚持教育先行；坚持制度控制；坚持源头治理。