药店新三板的“少数派报告”

上市后的大连锁药店携资本扩张,将对区域型的中小连锁产生更大的威胁,再加上医药电商也进入了爆发期,陷入立体战的中小连锁面临前所未有的压力,一方面要守住线下城池,一方面要应对线上挑战、同时积极介入线上市场。这个时候,同样处在爆发期的新三板,自然吸引了一部分中小连锁的关注和追捧。     

IVF/ICSI-ET术后双胎妊娠的临床结局及预防对策

目的:分析体外受精 (in vitro fertilization,IVF)/卵细胞浆单精子注射-胚胎移植 (intracytoplasmic sperm injection-embryo transfer,ICSI-ET)术后双胎妊娠的临床生殖结局,探讨降低辅助生殖技术中多胎率的有效治疗措施?方法:回顾性分析IVF/ICSI-ET术后获得双胎妊娠的425例孕妇的妊娠并发症?分娩方式和围产期结局?结果:①行IVF/ICSI-ET 4 603个治疗周期,双胎率23.35%,流产率9.18%,妊娠并发症发生率13.41%,出生缺陷发生率1.60%;②活胎双胎组孕周[(29.66 ± 3.64周) vs. (30.69 ± 3.47周)]? 出生体重[(2.64 ± 0.45)kg vs. (3.12 ± 0.64)kg]低于活胎单胎组,剖宫产率(97.68% vs. 77.38%)?早产率(41.06% vs. 16.67%)?低体重儿发生率(42.05% vs. 19.05%)高于活胎单胎组,两组间比较差异有统计学意义;③多胎减胎组和自然减胎组比未减胎组获得良好的生殖结局,孕周[(38.00 ± 2.03)周?(37.89 ± 2.46)周 vs. (36.43 ± 1.77)周)]和出生体重[(3.05 ± 0.65)kg?(3.15 ± 0.63)kg vs. (2.64 ± 0.45)kg]?早产率(13.64%?15.71% vs 37.24%)等方面比较,差异均有统计学意义?结论:在辅助生殖技术中,双胎较单胎妊娠发生早产?低出生体重不良风险高,需重视其围生期保健和产前检查?临床早期预测并进行减胎等补救性手段是安全有效的干预措施?     

Effects of Electroacupuncture of Different Intensities on Energy Metabolism of Mitochondria of Brain Cells in Rats with Cerebral Ischemia-Reperfusion Injury

Objective: To observe the effects of electroacupuncture (EA) of different intensities on lactate dehydrogernase (LDH), succinate dehydrogenase (SDH) and ATPase in brain tissue of rats with cerebral ischemia-reperfusion injury (CI/R). Methods: Forty male SD rats were uniformly randomized into sham operation group (group A), CI/R group (group B), CI/R+5 mA EA (group C), CI/R+3 mA EA (group D) and CI/R+1 mA EA (group E) groups with eight rats in each group. Transient general brain ischemia was induced by four-vessel occlusion and reperfusion. The rats in group C, group D and group E were punctured and stimulated at Baihui (GV20), Mingmen (GV4) and Zusanli (ST36) with the same intermittent and rarefaction-dense wave (30 to 50 Hz) and different electric current intensities: 5 mA , 3 mA and 1 mA for 20 min after CI/R. Then the activities of Na+-K+-ATPase, SDH and LDH in mitochondria of brain tissue were measured by spectrophotometry. The ischemic cerebral cortex tissue was taken for observing the ultrastructure changes of impaired nerve cells. Results: Compared with group A, the activities of LDH, SDH and Na+-K+-ATPase were lowerer in the group B (P<0.05 or P<0.01). However, the activities of LDH, SDH and Na+-K+-ATPase were higher in the group D than those in the group B (P<0.05 or P<0.01). In group A, the anatomical structure of the cerebral cortex cells was basically normal; in group B, the neuronal cellular structures were severely damaged, the neuronal mitochondria got swelling, the mitochondrial cristae were broken, the medullated nerve fibers were not integrated. In group C, group D and group E, the ultrastructure of impaired neuron were improved. Group D was the best among three groups above. Conclusion: EA of 3 mA intensity could strengthen aerobic metabolism by elevating the activities of SDH and LDH, meanwhile maintaining the ionic equilibrium in the exterior and interior brain cell and relieving the cellular edema by reinforcing the activities of Na+-K+-ATPase.     

老年腹部术后患者睡眠障碍的影响因素及护理对策

目的：分析老年腹部术后患者睡眠障碍的影响因素,探讨有针对性的护理干预措施以改善患者的睡眠质量。方法对2012年10月至2013年10月我院收住的62例老年腹部术后睡眠障碍患者采用匹兹堡睡眠质量表进行调查,并用自制调查表对患者进行问卷调查,分析影响因素。结果影响62例老年腹部术后患者睡眠质量的因素为：老龄化因素、手术创伤及麻醉因素、疼痛因素、环境因素、心理因素。对该类患者采取包括围术期护理、舒适护理、心理护理、药物治疗等护理措施,效果令人满意。结论明确老年腹部术后患者睡眠障碍的原因所在,采取针对性的护理对策,能改善患者睡眠质量促进早日康复。     

左冠状动脉主干及其分支间的夹角与左冠状动脉斑块形成的相关性分析

目的利用冠状动脉(冠脉)CT血管成像(CT angiography,CTA)探讨左冠脉主干(left main coronary artery,LM)、左前降支(left anterior descending branch,LAD)、左回旋支(left circumflex branch,LCX)三者间的夹角与局部斑块形成和分布特征之间的相关性。方法对127例行冠脉CTA检查患者进行回顾性研究,分为正常组44例和左冠脉病变组83例,病变组进一步分为LM组(18例)、近段组(57例)、中远段组(8例)。在重建图像上测量LM、LAD、LCX三者之间的夹角,分析左冠脉夹角与局部斑块形成和分布特征之间的相关性。结果 127例患者LM与LAD间的夹角和LAD与LCX夹角(分支角)呈负相关(r=-0.356,P<0.05);LM与LCX间的夹角和分支角也呈负相关(r=-0.662,P<0.05)。近段组分支角(90.9°±20.0°)与正常组(72.7°±16.7°)比较差异有统计学意义(P<0.05)。近段组LM与LCX夹角(117.8°±16.0°)与正常组(129.5°±15.9°)比较有明显差异(P<0.05)。LAD近段斑块形成与分支角呈正相关,和LM与LCX夹角呈负相关。当分支角>70°时,左冠脉斑块形成概率将会增加。结论分支角、LM与LCX间夹角均与LAD近段斑块的形成和分布相关,利用多层螺旋CTA能够为左冠脉斑块形成、风险预测及介入治疗术前提供无创、准确、快捷的相关特征信息。     

医院公共卫生应急决策特色智库构建模式初探

应急情报作为公共卫生应急管理决策支持的核心要素,在医院应对重大新发传染病等方面起到了事前预判准备、事中有效应对和事后分析评估的全方位信息情报支持。以智库模式打造的郑州人民医院疫情防控办公室多元协同研究小组在应对新冠肺炎应急信息监测、预警、预防、处理、评估过程中健全了情报处理标准规范,建立了特色防控知识平台,提升了协同小组人员素养,实现了跨部门跨院区智慧防控联动决策支持,值得同类医院借鉴参考。     

基于SWOT分析的医学网络在线考核方法的策略

运用SWOT法对新形势下医学网络在线考核从优势（strength）、劣势（weakness）、机会（opportunity）和威胁（threat）4个维度展开探讨,并把各因素相互匹配加以分析,提出SO、WO、ST和WT四类战略,以期能为医学考核方式未来的发展提供思路与建议。