自然疗养因子的作用机制研究进展

自然疗养因子所涵盖的内容丰富,其生物学效应及形成复杂。现代疗养学在形成过程中相继提出自然疗养因子对机体作用的理论或假说。随着医学模式的转变和现代医学的发展,自然疗养因子作用机制研究从分子、细胞到组织器官,涉及机体物质代谢、神经系统、内分泌和免疫等功能的相互作用,形成整体的各个水平产生适应的作用机制;研究证实自然疗养因子的作用最根本的表现为改善机体内环境稳态和机体与外环境间的平衡,是靠机体的适应性反应机制实现的;其次与祖国医学“天人合一”整体观一脉相承。近年来,研究证实环境因素通过基因的重返表达对表观遗传产生影响,同时疗养因子参与机体的生物节律调控不断深入,机体对自然疗养因子的应答反应是受到多种因素的影响,包括机体状态、疗养因子的种类、性质、作用剂量、应用时间、季节及个体差异等。本文主要对自然疗养因子的作用机制及对机体的作用等方面进行总结。     

临床护理路径在心血管患者静脉留置针中的研究分析

目的:提高静脉留置针使用有效期,保证心血管患者得到及时用药,有效开放静脉抢救通道。方法:建立了心血管患者静脉留置针的临床护理路径(Clinical Nursing Pathway,CNP)。选择我院2018年1-12月期间接诊的静脉留置针心血管患者为研究对象,共100例,随机分组,即对照组(50例,常规护理)与实验组(50例,在常规护理基础上辅以临床护理路径),比较两组护理效果,包括留置时间、不良反应情况、患者满意度等。结果:护理后,两组患者留置时间无明显差异,但实验组不良反应发生率、静脉炎发生率低于对照组,差异有统计学意义(P<0.05);实验组满意度、一次性置管成功率高于对照组,而非计划性拔管率则低于对照组,差异有统计学意义(P<0.05)。结论:心血管患者静脉留置针护理中辅以临床护理路径,可减少不良反应,预防静脉炎,延长置管时间,提高护理满意度,值得优选。     

养气调血护理法对产后缺乳的临床疗效观察

目的:研究探索养气调血护理法对产后缺乳的临床疗效。方法:将符合纳入标准的120例产后缺乳的剖宫产产妇随机分为实验组(予穴位按摩联合常规护理)和对照组(常规护理),每组60例。观察对比患者的乳房充盈度评分、乳汁粘稠度、乳汁淤积程度。结果:实验组在乳房充盈度评分、泌乳量评分、乳汁瘀积程度、乳汁粘稠度与对照组相比,差异均有统计学意义(P<0.05)。结论:穴位按摩这种养气调血护理的方法对产后缺乳有一定的疗效,值得临床推广,机制有待进一步探讨。     

广西壮族自治区男男性行为者HIV非职业暴露后预防效果分析

目的 分析广西壮族自治区南宁、柳州市MSM使用抗病毒药物进行HIV非职业暴露后预防（nPEP）效果。方法 搭建社会组织-CDC/医院-药店（“三位一体”）的服务合作模式，通过社区宣传倡导，现场招募研究对象。收集入组研究满28 d参加者的基本信息、药物使用情况和随访检测情况，采用描述性统计进行分析。结果 2017年9月至2019年3月，共有213名男男性行为者咨询暴露后预防用药，其中159人符合预防用药标准，接受服药154人。入组研究满28 d的132人，其中连续服药满28 d的118人、未服药满28 d的10人、因失访无法证实是否完成服药的4人。服药满28 d的服务对象中，94.1%（111/118）于暴露后4～6周接受了HIV随访检测，75.4%（89/118）于暴露后3个月接受了HIV随访检测，结果均为阴性。结论 在“三位一体”模式下，发生HIV非职业暴露后尽早使用抗病毒药物预防可以降低HIV感染的风险，在一定程度上减少HIV新发感染数。     

Male Sexual Function After Pediatric Kidney Transplantation—A Cross-sectional Nationwide Study

BackgroundData on adult sexual functioning after kidney transplantation (KTx) during childhood or adolescence are scarce.AimTo assess the long-term sexual and psychosocial quality of life after pediatric KTx.Methods29 young men (median age 27.1 years) were examined 18.7 years (median) after KTx. 56 age-matched healthy men (median age 30.0 years) served as controls.OutcomeWe studied the influence of sociodemographics, previous renal replacement therapy, current reproductive hormonal serum levels, testicular size, and data on several validated mental and physical questionnaires on participants' Derogatis Interview for Sexual Functioning self-report scores.ResultsThe KTx recipients had significantly poorer sexual functioning than their healthy peers. KTx men had less frequent sexual activity with a partner (P = .03) and poorer orgasms (P = .002) than the controls but no erectile dysfunction (P = .5).Clinical implicationsDepressive symptoms, relationship status, and longer dialysis duration predicted poor adult sexual functioning in KTx recipients, whereas age at transplantation or at the time of the study did not.Strengths & LimitationsThis study contributes extended follow-up data to the very scarce literature on adult sexual functioning in pediatric KTx recipients. Relatively small population and low participation rate limit the comprehensive data interpretation in a population-based cohort of male KTx recipients.ConclusionSexual functioning is often impaired in young men after pediatric KTx, emphasizing the need for long-term monitoring of sexual health and sexuality as important dimensions of quality of life.Tainio J, Jahnukainen T, Jalanko H, et al. Male Sexual Function After Pediatric Kidney Transplantation—A Cross-sectional Nationwide Study. J Sex Med 2020;17:2104–2107.     

补肾填髓汤对股骨骨折术后延迟愈合的效果观察

目的:观察和分析补肾填髓汤对股骨骨折术后延迟愈合的效果。方法:回顾分析了2014年4月-2017年4月期间在我院进行了股骨骨折术后延迟愈合治疗的40例患者的治疗过程,分为对照组(20例)和观察组(20例)。对照组患者予常规治疗,观察组则在对照组治疗的基础之上加入补肾填髓汤进行治疗。治疗后,对比两组患者之间的疗效以及骨代谢指标。结果:治疗前,两组患者骨代谢指标之间差异无统计学意义(P>0.05)。治疗后,观察组患者代谢指标改善情况优于对照组,P<0.05,两组之间差异存在统计学意义。治疗后,观察组疗效高于对照组,P<0.05,差异存在统计学意义。结论:使用补肾填髓汤治疗股骨骨折术后延迟愈患者能够大幅度提高患者疗效,提升治疗过程中的安全性,值得推广。     

Effects of COVID-19 in South African health system and society: An explanatory study

Background and aimsThe underestimation of the severity of COVID-19 by the South African government resulted in delayed action against the pandemic. Ever since WHO declared COVID-19 a pandemic preventive action was comprehensively upgraded worldwide. This prompted South African authorities to implement physical distancing, self-isolation, closure of non-essential services, schools, travelling restrictions and recursive national lockdowns to mitigate the impact of COVID-19. This explanatory study sought to review the effects of COVID-19 in the South African health system and society.MethodsThe study applied literature research of COVID-19 reports, policies from the National Department of Health, WHO, Africa CDC, and articles from Google Scholar, Science Direct, Web of Science, Scopus and PubMed.ResultsThe South African health system is affected by the lack of PPEs, increased mortality rates, mental health problems, substance abuse, resurgent of NCDs. The closure of international borders, global demand meltdown, supply disruptions, dramatic scaling down of human and industrial activities during lockdown cause socio-economic problems. The prolonged effects of lockdown on psychosocial support services resulted in the outbursts of uncertainties, acute panic, fear, depression, obsessive behaviours, social unrests, stigmatization, anxiety, increased gender-based violence cases and discrimination in the distribution of relief food aid.ConclusionTo slow down the spread of COVID-19, massive testing must be adopted, contact tracing, isolation, and home quarantine guidelines for asymptomatic cases which promote behavioural change and reviewing of policy on food relief.     

黄芪甲苷对大鼠肺缺血再灌注后氧化应激损伤的影响

目的：研究黄芪甲苷对大鼠肺缺血再灌注损伤后氧化应激的影响。方法将50只实验用大鼠随机分为假手术组、模型组和黄芪甲苷(20、40、80 mg/kg)组,每组10只。采用夹闭左肺门45 min后松夹的方法制备肺缺血再灌注损伤大鼠模型,各组分别于术前30 min腹腔注射给药。再灌注2h后,测定各组大鼠肺组织湿/干重比,测定肺组织中抗氧化酶(超氧化物歧化酶、谷胱甘肽过氧化物酶、过氧化氢酶)活性,测定血清中总抗氧化能力、髓过氧化物酶活性和丙二醛含量,通过HE染色法观察肺组织形态结构变化,TUNEL 法观察肺组织细胞凋亡状况并计算凋亡指数,采用Western blot法测定肺组织中核转录因子κB蛋白表达并进行半定量分析。结果与模型组比较,黄芪甲苷(40、80 mg/kg)组大鼠肺组织湿/干重比显著降低,肺组织中超氧化物歧化酶、谷胱甘肽过氧化物酶、过氧化氢酶活性显著升高,血清中总抗氧化能力升高,髓过氧化物酶活性、丙二醛含量降低,肺组织形态结构变化和肺细胞病变显著减轻,肺细胞凋亡状况明显改善,肺细胞凋亡指数降低,肺组织中核转录因子κB蛋白表达量降低,差异均有统计学意义(P<0.05或P<0.01)。结论黄芪甲苷具有抑制肺缺血再灌注损伤大鼠氧化应激的作用,作用机制可能与黄芪甲苷能够改善肺组织和血清中抗氧化酶活性、提高氧自由基清除能力以及下调核转录因子κB蛋白表达、抑制肺细胞凋亡有关。