一例卵巢过度刺激综合征并发脑梗死的护理

<正>卵巢过度刺激综合征(OHSS)为辅助生育技术治疗的主要并发症之一,是促排卵及诱导排卵过程中产生的医源性疾病[1]。近年来,随着辅助生殖技术的广泛开展,OHSS的发病率有逐年上升的趋势,1996年文献报道发生率为1%~14%[2],2004年报道发生率为20%~23%[3]。我科于2014年5月12日收治1例促排卵治疗后并发OHSS和脑梗死患者,经过积极的治疗和精心的护理,患者病情稳定,     

Alcohol liver disease: A review of current therapeutic approaches to achieve long-term abstinence

Harmful alcohol drinking may lead to significant damage on any organ or system of the body. Alcoholic liver disease (ALD) is the most prevalent cause of advanced liver disease in Europe. In ALD, only alcohol abstinence was associated with a better long-term survival. Therefore, current effective therapeutic strategy should be oriented towards achieving alcohol abstinence or a significant reduction in alcohol consumption. Screening all primary care patients to detect those cases with alcohol abuse has been proposed as population-wide preventive intervention in primary care. It has been suggested that in patients with mild alcohol use disorder the best approach is brief intervention in the primary care setting with the ultimate goal being abstinence, whereas patients with moderate-to-severe alcohol use disorder must be referred to specialized care where detoxification and medical treatment of alcohol dependence must be undertaken.     

妊娠期中重度OSAHS患者血凝参数变化及临床意义

目的探讨妊娠合并OSAHS患者凝血参数的变化及临床意义。方法应用sysmex全自动血凝仪对正常妊娠组、妊娠合并OSAHS组妇女凝血酶原时间(PT)、活化部分凝血酶时间(APTT)、血浆纤维蛋白原(FIB)、D-二聚体(D-D)检测,同时妊娠合并OSAHS组妇女分轻、中、重组,对其也进行以上四项指标的监测。结果妊娠合并OSAHS组较正常妊娠组PT、APTT明显缩短(P0.01),FIB、D-D增高(P0.01),差异有统计学意义;妊娠合并中重度OSAHS患者较妊娠合并轻度OSAHS患者PT、APTT明显缩短(P0.05),FIB、D-D增高(P0.05),差异有统计学意义。结论妊娠合并中重度OSAHS者的血液呈现高凝状态,应给予充分干预,以尽量降低相关不良反应的发生。     

The Association of a Mediterranean-Style Diet Pattern with Polycystic Ovary Syndrome Status in a Community Cohort Study

Polycystic ovary syndrome (PCOS) is a common condition in reproductive-aged women. While lifestyle management is first-line treatment in PCOS, the dietary intake of women with PCOS is unclear and there is no research assessing dietary patterns of women with and without PCOS. The aim of this study was to examine dietary patterns in a large cohort of women with and without PCOS. Data were from 7569 participants in the 1973–1978 cohort of the Australian Longitudinal Study on Women’s Health population assessed at 2009 (Survey 5) (n = 414 PCOS, n = 7155 non-PCOS). Dietary patterns were evaluated using factor analysis and multiple logistic regressions assessed their associations with PCOS status. Three dietary patterns were identified that explained 27% of the variance in food intake between women with and without PCOS: Non-core foods; Meats and take-away and Mediterranean-style. The Mediterranean-style dietary pattern was independently associated with PCOS status. On adjusted analysis for each 1 SD increase in the Mediterranean-style dietary pattern, there was a 26% greater likelihood that women had PCOS. This may indicate an improvement in the quality of dietary intake following a diagnosis of PCOS. Future research should examine the contribution of dietary patterns to the incidence and severity of PCOS and the potential for modification of dietary patterns in the lifestyle management of PCOS.     

水化护理对急性冠脉综合征介入诊疗患者造影剂肾病的影响

目的 探讨水化护理对急性冠脉综合征（ACS）介入诊疗患者造影剂肾病（CIN）的预防效果。方法 采用回顾性的研究方法,选择2013年1～12月在厦门市某心脏专科医院心内CCU行CAG和PCI的ACS患者,分析造影剂肾病的发病率、水化护理对CIN效果的影响及CIN的危险因素。结果 366例ACS患者的CIN发病率为6.3%,经logistic回归分析发现,eGFR（OR=1.036,95%CI为1.019～1.053,P=0.000）,使用IABP（OR=6.371,95%CI为1.452～27.949,P=0.014）是CIN的危险因素;术前水化量和水化时间与Scr（血清肌酐值）的变化无关（F=1.635,P=0.182）。结论 充分的水化是预防CIN的关键,术前对发生CIN危险因素充分评估,术后早期尿量观察,是预防和早期发现CIN的关键。     

Are Hypomethylating Agents Replacing Induction-Type Chemotherapy before Allogeneic Stem Cell Transplantation in Patients with Myelodysplastic Syndrome?

Cytoreductive treatment before allogeneic hematopoietic stem cell transplantation (allo-SCT) with the objective of reducing the incidence of disease relapse post-transplant in patients with myelodysplastic syndrome (MDS) is a matter of debate. The achievement of complete remission (CR) before allo-SCT improves post-transplantation outcome, although it is not clear whether this reflects the selection of patients with more responsive disease or is related to a reduction in disease burden. Higher CR rates in patients with MDS are obtained with induction chemotherapy (ICT) than with hypomethylating agents (HMAs), although HMAs may be active in patients with complex karyotypes in whom ICT almost invariably fails. Furthermore, HMAs have a good toxicity profile compared with ICT and may therefore be considered especially in older patients and in patients with comorbidities. However, all interventions aimed at reducing disease burden before allo-SCT expose patients to the risk of complications, which may prevent them from undergoing transplantation. Therefore, up-front allo-SCT is an option, particularly for patients with life-threatening cytopenias. In this review we discuss the main pretransplant therapeutic approaches and propose a decision-model based on clinical considerations. However, only prospective randomized trials can address the issue definitively.