集束化干预联合闭环管理对ICU多重耐药菌感染的防控效果

目的 探讨集束化干预策略联合闭环管理模式对ICU多重耐药菌感染的防控效果。方法选取2020年1~12月EICU住院患者275例作为对照组，实施常规管理；2021年1~10月EICU住院患者239例作为观察组，在常规管理基础上实施集束化干预策略联合闭环管理。结果实施后，观察组多重耐药菌感染发生率明显低于对照组；患者住院日显著低于对照组，4项护理措施执行率(隔离标识、手卫生、环境消毒、医务人员相关知识知晓)、病原学送检率显著高于对照组（均P<0.05）。结论集束化干预联合信息化闭环管理可有效降低EICU多重耐药菌感染发生率。     

Management of hip fracture in COVID-19 infected patients

Given that the global population of elderly individuals is expanding and the difficulty of recovery, hip fractures will be a huge challenge and a critical health issue for all of humanity. Although people have spent more time at home during the coronavirus disease 2019 (COVID-19) pandemic, hip fractures show no sign of abating. Extensive studies have shown that patients with hip fracture and COVID-19 have a multifold increase in mortality compared to those uninfected and a more complex clinical condition. At present, no detailed research has systematically analyzed the relationship between these two conditions and proposed a comprehensive solution. This article aims to systematically review the impact of COVID-19 on hip fracture and provide practical suggestions. We found that hip fracture patients with COVID-19 have higher mortality rates and more complicated clinical outcomes. Indirectly, COVID-19 prevents hip fracture patients from receiving regular medical treatment. With regard to the problems we encounter, we provide clinical recommendations based on existing research evidence and a clinical flowchart for the management of hip fracture patients who are COVID-19 positive. Our study will help clinicians adequately prepare in advance when dealing with such patients and optimize treatment decisions.     

放疗干预对宫颈癌荷瘤小鼠的抑瘤作用及对Th1/Th2免疫细胞比例的影响

目的探讨放疗干预对宫颈癌荷瘤小鼠的抑瘤作用及其对辅助性T细胞1(Th1)/Th2细胞比例的影响。方法建立宫颈癌荷瘤小鼠模型,随机分为荷瘤组和放疗组,每组各10只,另设对照组10只。放疗组进行放疗干预14天,荷瘤组和对照组不治疗。放疗后4、6、8、10、12、14天测量肿瘤体积;末次治疗后,ELISA法测定血清干扰素-γ(IFN-γ)、白介素-2(IL-2)、IL-4、IL-10含量;计算抑瘤率、胸腺指数和脾脏指数;HE染色观察肿瘤组织学变化;TUNEL染色观察肿瘤组织细胞凋亡情况;流式细胞术检测脾脏Th1/Th2细胞比例;RT-qPCR和Western blot检测脾脏T盒子转录因子(T-bet)、GATA结合蛋白3(GABA-3)mRNA和蛋白表达。结果与荷瘤组比较,放疗组小鼠4、6、8、10、12、14天肿瘤体积及瘤质量减小,血清IL-2、IFN-γ升高,IL-4、IL-10降低,胸腺指数、脾脏指数升高,Th1细胞比例、Th1/Th2增加,Th2细胞比例减少,T-bet mRNA和蛋白及T-bet/GATA-3表达升高,GATA-3 mRNA和蛋白表达降低(P<0.05)。HE染色显示,荷瘤组肿瘤细胞数量较多,核大深染,无明显坏死;放疗组肿瘤细胞数量减少,出现大量坏死组织。TUNEL染色显示,荷瘤组TUNEL阳性细胞较少,放疗组TUNEL阳性细胞明显增多。结论放疗对宫颈癌荷瘤小鼠具有明显抑瘤作用,可能是通过调节T-bet/GATA-3表达,促进Th1/Th2分化平衡,增强机体免疫功能发挥作用。     

MR引导放疗在胰腺癌中的应用

放疗是治疗胰腺癌的重要手段。但受胰腺运动等因素影响,放疗疗效难以充分发挥。更高效的胰腺癌放疗有赖于运动管理方式的改进与高质量的图像引导。新兴的MR引导放疗技术软组织分辨率高、无额外辐射、能进行功能成像,经过大量研究评估与验证,其在靶区与危及器官的精准勾画、辅助运动管理和自适应放疗等方面有着巨大优势,有望更好地发挥放疗在胰腺癌治疗中的作用。本文就MR引导放疗在胰腺癌治疗中的应用作一综述和展望。     

基于CiteSpace的中医体质辨识研究可视化计量分析＊

目的 以“中医体质辨识”为主题开展系统的可视化分析，探索中医体质辨识领域的发展现状、研究热点、发展趋势，为后续研究提供借鉴。方法 以中国知网（CNKI）数据库为数据源检索相关文献，并将所得数据文件导入CiteSpace软件，对作者、机构和关键词进行共现分析并得到相关知识图谱。结果 共纳入1099篇文献，通过CiteSpace共现分析找到中医体质辨识领域研究的高产机构、具有代表性的研究者以及高频关键词。研究发现各个研究者及机构缺乏沟通合作，研究热点主题有体质研究、治未病、健康管理、与现代生物医学相结合。结论 中医体质辨识领域的研究逐年增加，知识图谱揭示了中医体质辨识在健康管理、与现代生物医学相结合将是未来的研究趋势。     

外泌体在血液肿瘤微环境中的作用及其诊治意义

外泌体是细胞外囊泡的一类主要成分，是正常生理情况下组织细胞间信号传递的重要介质；在多种血液肿瘤研究中发现外泌体是骨髓微环境各成分间相互作用的关键载体，由于其广泛存在并含有特定的核酸、蛋白等分子，外泌体被作为潜在的生物标志物和治疗靶点/载体，在血液肿瘤诊治中的重要性近年正逐步受到关注。     

The efficacy and safety of Xiangsha Liujunzi decoction in the treatment of chronic non-atrophic gastritis: A protocol for a systematic review and meta-analysis

Background:Chronic non-atrophic gastritis is the most common type of chronic gastritis. Even if treated with current standard pharmacotherapy, the efficacy is not very satisfactory due to many factors. Traditional Chinese Medicine decoctions are increasingly used in the treatment of chronic gastritis, and many studies have shown that Xiangsha Liujunzi decoction is effective and safe in the treatment of chronic non-atrophic gastritis. However, it is controversy if Xiangsha Liujunzi decoction can provide an evidence-based clinical efficacy and safety in the treatment of chronic non-atrophic gastritis.Methods:We will go through 8 databases, and conduct a systematic review of Xiangsha Liujunzi decoction and health-related outcomes in chronic non-atrophic gastritis patients according to the Preferred Reporting Items for Systematic Reviews. The primary objective is to assess the impact of Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines on clinical outcomes relevant to chronic non-atrophic gastritis patients, such as clinical effective rate,Helicobacter pylori eradication rate, efficacy under endoscopy, 1-year recurrent rate, and number of reported adverse events. Cochrane Risk Assessment Tool will be used to assess the quality of eligible studies according to the Cochrane handbook.Results:The results of this systematic review will provide a synthesis of current evidence of Xiangsha Liujunzi decoction and we have a specific opportunity to determine the efficacy and safety of it.Conclusion:This study will explore whether or not Xiangsha Liujunzi decoction can be used as one of the complementary and alternative therapies in the treatment of chronic non-atrophic gastritis.Registration number:Identifier: DOI 10.17605/OSF.IO/TX27U (https://osf.io/tx27u/).