连续性血液净化治疗心脏术后急性肾衰竭效果及预后观察

目的：观察连续性血液净化（CBP）治疗心脏术后急性肾衰竭（ARF）的临床效果及预后。方法：选择心脏术后ARF21例,其中,合并全身炎症反应综合征（SIRS）10例（A组）,合并多器官功能障碍综合征（MODS）11例（B组）。行连续性静脉静脉血液滤过（CVVH）治疗。比较两组治疗前后氧合指数、心率（HR）、平均动脉压（MAP）、pH、血肌酐（Scr）、中心静脉压（CVP）、血尿素氮（BUN）等指标,以及急性生理功能和慢性健康状况评分（APACHEⅡ）和急性肾小管坏死一个体严重程度指数评分（ATN—ISI）等的变化情况。结果：治疗24h后,两组在氧合指数、BUN、Scr及APACHEⅡ分值等方面,均较治疗前有显著改善（P〈0．05）。A组MAP、pH,治疗前后比较差异显著（P〈0．05）;HR、CVP等指标及ATN-ISI分值,治疗前后比较差异不显著（P〉0．05）。B组MAP、pH、HR、CVP等指标及ATN—ISI分值,治疗前后比较均差异不显著（P〉0．05）。结论：连续性血液净化治疗可有效改善心脏术后ARF患者病情,并维持了酸碱平衡,在一定程度上改善了患者的心肺功能。     

小儿血液净化治疗的难点及护理对策

目的 分析血液净化治疗时小儿与成人的不同点及难点,以采取相应的护理对策.方法 分析小儿血液净化治疗血管通路建立困难,体重轻、病情变化快,不配合治疗,治疗参数的确定和调整需细腻等特点,在治疗前、中、后实施有效的护理措施.结果 4例进行血液净化患儿治疗每次2～8 h,7～73例次.1例心力衰竭纠正,水肿减轻,症状缓解;1例顺利度过自体干细胞移植危险期;2例因费用原因终止治疗.结论 了解小儿的生理特点,选择适宜材料和透析用物,维持血容量的稳定,给予科学严谨的监护,认真细致的观察,详细通俗的宣教、指导,是确保小儿血液净化治疗顺利进行的关键.     

影响植物栽培的空问飞行因素

植物栽培是空间站和空间生保系统的重要研究课题,因其不仅可以参与水气循环维持系统的稳定,而且可以为航天员提供新鲜蔬菜,供应多种维生素和微量元素,并有一定的抗辐射和抗氧化作用,对航天员的生理和心理健康都有积极意义.进行空间植物栽培必须要考虑到空间飞行因素对植物生长发育的影响.空间飞行因素主要可分为三类:外部因素(宇宙辐射、真空、温度),动态(微重力、加速度、振动、噪声)和飞船内部因素(密闭隔离,合成气环境、地磁场缺失、温度与气压波动等).本文详细介绍了这些因素对植物的影响.     

浅谈血液净化室的护理安全隐患及防范措施

护理安全是指在实施护理的全过程中,患者不发生法律和法定的规章制度允许范围内以外的心理、机体结构或功能上的损害、障碍、缺陷或死亡[1]。护理安全是护理质量的基础,是优质服务的关键,也是防范和减少医疗事故及纠纷的重要环节。血液净化室是接受患者进行血液透析治疗的场所,     

新疆哈密市2020年畜间布病检疫净化效果评估及防控建议

为全面了解新疆哈密市畜间布病流行情况,评估布病检疫净化效果,为周边布病检疫净化地区的布病防控工作提供有价值的参考,本研究采用虎红平板凝集和试管凝集试验相结合的方式,对2020年哈密市1区2县的1 672 896份未免疫牛羊血清样品开展两轮布病全检,从不同季节、不同区县和不同畜种三方面对检测结果进行统计学分析。结果显示:全市畜间布病阳性率为0.42%,其中羊布病阳性率为0.41%,牛布病阳性率为0.46%,牛的阳性率显著高于羊(X2=10.53,P<0.05);春夏两季牛羊布病阳性率显著高于秋冬两季(X2=1099,P<0.05);不同区县布病阳性率存在显著差异,其中伊州区羊布病阳性率最高(0.83%,4 907/592 813),与巴里坤县的(0.10%)和伊吾县的(0.28%)差异极显著(P<0.05);伊州区牛布病阳性率最高(0.69%,581/84 461),与巴里坤县的(0.27%)和伊吾县的(0.35%)差异极显著(P<0.05)。结果提示,家畜布病阳性率可能与交易模式、交易频次等因素密切相关,需继续加强布病净化工作和养殖场综合防疫管理措施,强化调运检疫力度,最大程度地降低疫情传播风险。     

连续性血液净化中阿加曲班与枸橼酸钠的抗凝效果及安全性比较

 目的 比较阿加曲班和枸橼酸钠在连续性肾脏替代治疗(continuous renal replacement therapy,CRRT)中的有效性和安全性。方法 选取2018-09至2019-05医院行CRRT治疗的患者132例,随机分为阿加曲班组60例和枸橼酸钠组72例,分别给予阿加曲班和枸橼酸钠抗凝治疗,阿加曲班组监测体内活化凝血时间(activated clotting time,ACT),枸橼酸钠监测ACT及血钙,同时记录两组患者透析前后血常规、血生化指标,尿素下降率、滤器及管路凝血情况,以及治疗后24 h内组织器官出血情况。结果 两组患者透析前ACT均在正常范围内,阿加曲班组ACT 5 min、2 h和4 h均显著升高,差异有统计学意义(P＜0.05),透析1 h后ACT显著下降至正常范围;枸橼酸钠组透析4 h和透析后ACT均无明显变化。枸橼酸钠组透析前、透析中、透析后体内游离钙均无明显变化;透析中体外游离钙均低于同时间体内游离钙水平。两组患者治疗前后血红蛋白及血小板较治疗前均无明显变化,血肌酐水平均显著下降,差异有统计学意义(P＜0.05)。两组患者治疗时间、URR值、管路滤器凝血情况及出血事件对比差异无统计学意义。结论 阿加曲班和枸橼酸钠在CRRT治疗中均为有效和安全的抗凝剂。对有高出血风险的患者选择枸橼酸钠更佳。     

光动力学疗法净化造血干细胞的研究现状

随着对光动力学疗法（photodynamic therapy，PDT）作用机制的深入研究和新型光敏剂的研发，PDT的应用已经拓展到多种肿瘤性疾病和非肿瘤性疾病的治疗，其中肿瘤性疾病包括皮肤癌、胃癌、食管癌等，而非肿瘤性疾病以鲜红癍痣、年龄相关性黄斑变性、痤疮等为代表。 近年来，PDT行体外造血干细胞净化已成为PDT应用的另一新领域。实验证明PDT能够有效地杀灭多种肿瘤细胞，如白血病细胞、淋巴瘤细胞，且没有细胞周期特异性，对耐药肿瘤细胞同样有效，而对正常造血干细胞损伤轻微。目前应用PDT净化造血干细胞的试验与临床研究正成为国内外学者所关注的热点问题。     

身份识别卡在血液净化中心的应用及体会

患者身份识别是指医务人员在医疗活动中对患者身份进行查对和核实,以确保治疗用于相应患者的全过程.患者身份识别是临床护理工作中非常重要的基础步骤,可以有效防止事故、差错发生,保障医疗护理安全[1].我科血液净化中心91％为门诊透析患者,其中42％为老年人,部分伴有听力、视力及行动障碍.由于患者透析治疗时间长、流动性大、危重病多,护士有时会用惯性思维去识别患者.而云南是少数民族地区,各民族之间言语沟通时有障碍,患者不在意随口误答或因某些原因不能回答及因方言引起误解,这些都增加了查对工作的难度[2].     

手术车舱室内空气洁净性能的试验研究

目的：观察手术车净化空调系统和紫外线对手术车舱室内空气的过滤杀菌作用,分析手术车舱室内的空气洁净性能。方法：采用激光粒子计数器测量在净化空调系统作用下手术车舱室内的颗粒浓度,采用沉降法和浮游法测量在净化空调系统过滤净化和紫外杀菌作用下手术车舱室内的细菌浓度。结果：手术区内平均净化效率在45%左右,净化效果较好。而周边区的净化效率相对较低,平均净化效率在22%左右。30min后净化空调系统和紫外线灯对手术车舱室的细菌净化效率为84%;60min后细菌净化效率为97.74%。结论：通过净化空调系统的过滤净化和除菌以及紫外线灯的照射杀菌,手术车舱室内手术区的洁净度可以达到万级,周边区的洁净度可以达到10万级,完全可以满足手术作业的要求。     

植物提取物防治放射性肺损伤的现状与展望

放射性肺损伤(RILI)是放射治疗最为常见的并发症之一, 包括放射性肺炎与放射性肺纤维化。RILI影响患者的生活质量与肿瘤治疗效率。目前临床多采用糖皮质激素、细胞因子抑制剂等治疗RILI, 虽然这些疗法具有一定的疗效, 但均存在较大的不良反应。因此, 寻找高效低毒的RILI防治药物仍是目前亟待解决的问题。近年来, 大量研究表明, 天然的植物提取物在防治RILI方面具有良好的效果, 且不良反应小, 药理作用广泛, 具有潜在的应用和开发价值。笔者综述了近年来RILI防治研究领域中的天然植物提取物及相关进展, 为植物提取物更好地开发应用提供参考。     

99Tcm-TRADOT-1显像在君复康胶囊防治毒品复吸中的应用

目的　探讨君复康胶囊修复损害的纹状体、恢复紊乱的多巴胺 (DA)系统代谢的价值。方法　正常志愿者 18例作为对照组 ;海洛因稽延性戒断综合征患者 12例 ,服用君复康胶囊前后行99Tcm 2 β [N ,N′ 双 (2 巯乙基 )乙撑二胺基 ]甲基 ,3β (4 氯苯基 )托烷 (TRODAT 1)多巴胺转运蛋白 (DAT )SPECT显像 ,剂量为 74 0MBq。使用 3个数学模型分别计算纹状体体积 (V ,cm3)、质量 (m ,g)和纹状体与全脑放射性比值 (Ra)。结果　海洛因稽延性戒断综合征患者治疗前DAT显像示 ,所有患者双侧纹状体不同程度异常 ,与对照组相比纹状体V、m和Ra差异均有显著性 (t>3 2 5 ,P <0 0 1～ 0 0 5 )。君复康胶囊治疗后 ,随稽延性戒断综合征消失 ,DAT显像示双侧纹状体恢复“熊猫眼”形 ,接近对照组的DAT影像。纹状体V、m和Ra有不同程度改善。患者操守期已达 15个月以上 (10 12例 ,83 3% ) ,同时“心瘾”消失。结论　海洛因稽延性戒断综合征患者的DAT数量、位点明显减少 ,功能低下。经君复康胶囊治疗后 ,双侧纹状体DAT功能得到明显修复 ,接近对照组水平。     

秦山核电站运行前周围环境放射性调查和居民所受剂量估算

本文调查了1983～1988年秦山核电站周围5km、20km, 80km范围内天然辐射外照射水平,20km范围内的土壤、食品和水中总β、⁹⁰Sr,¹³⁷Cs活度.估算了当地居民所受的外照射剂量和因食入⁹⁰Sr、¹³⁷Cs造成的内剂量.结果表明:5km,20km和80km的天然辐射外照射剂量相近，其人均年有效剂量当量1.0mSv,由食品所致居民⁹⁰Sr和¹³⁷Cs的年有效剂量当量分别为0.62μSv.a^-1和0.19μSv.a^-1,其结果与浙江省全省环境调查结果基本一致.     

Radioprotective effect of green tea and grape seed extracts mixture on gamma irradiation induced immune suppression in male albino rats

Purpose: Green tea extract (GTE) and grape seed extract (GSE) have antioxidant and radioprotective effects. The current study aimed to investigate the radioprotective effect of GTE and GSE mixture on radiation-induced immune suppression in rats.

Method: A total of 35 male albino rats were divided into five groups: group 1 (control rats). The 2nd and 3rd groups rats were exposed to a single dose of gamma radiation (5 and 10?Gy), respectively. The 4th and 5th groups of rats were gamma-irradiated with 5 and 10?Gy, respectively, then administrated by gavage with GTE and GSE mixture (100?mg: 200?mg/kg BW), respectively, for 14 consecutive days.

Results: Gamma irradiation induced hematological, immunological and biochemical effects in rats. Treated rats with GTE and GSE mixture (1:2) showed an increase in concentrations of immune cells including CD4 and CD8. The level of pro-inflammatory cytokines Tumor necrosis factor-α and C-reactive protein elevated after γ-irradiation and significantly decreased by mixture administration. Moreover, groups treated with antioxidant mixture showed a significant increase in all hematological parameters and a significant decrease in cholesterol and triglyceride levels.

Conclusion: GTE and GSE mixture is a good radioprotector and immune modulator compound, indicating its possible use as an adjuvant during radiotherapy.     

Formulation of a single-component kit for the preparation of technetium-99m labelled ethyl cysteinate dimer: biological and clinical evaluation

Ethyl cysteinate dimer (ECD) labelled with reduced technetium-99m has recently been proposed as a promising radiopharmaceutical for brain perfusion imaging. In the present study a single-component kit formulation has been developed, thus simplifying the radiolabelling procedure. A method of analysis by electrophoresis has also been developed, permitting identification of radiochemical impurities in the preparation. ^99mTc-ECD prepared by the single-component kit was further evaluated in primates and humans. The results demonstrated that the complex is stable in vivo, rapidly extracted and retained in the brain tissue for a sufficient time for single-photon emission tomography studies. Therefore the present single-component kit formulation can be proposed as a reliable instant freeze-dried kit for routine preparation of 99-Tc-ECD required for scintigraphic assessment of regional cerebral blood flow.     

核电站周边居民染色体畸变和淋巴细胞亚群分析

目的 探讨核电站长期运行对周边居民健康的影响,了解核电站长期运行下周边居民健康基础资料。方法 按照离核电站远近,选取0~10 km、10~20 km、20~30 km 3个调查区和对照区,采集血样,分析外周血淋巴细胞染色体畸变和淋巴细胞亚群。结果 0~10 km、10~20 km、20~30 km调查区和对照区畸变细胞率分别为0.157%、0.167%、0.070%、0.111%,差异无统计学意义。淋巴细胞亚群分析0~30 km范围3个调查区T淋巴细胞、辅助T淋巴细胞、抑制T淋巴细胞、B淋巴细胞、NK细胞均正常,各区之间差异无统计学意义。结论 该核电站在正常运行条件下,尚未对周边居民的健康产生明显影响。     

一种便携式微生物培养箱的研制及效果验证

目的：研制一种便携式微生物培养箱,解决饮用水及食品卫生学检测中微生物指标现场培养的问题。方法根据饮用水或食品中不同微生物指标对培养温度的限定要求,科学设置培养温度;对箱体温度通过单片机和组态屏实现PID控制;进行箱体设计组装;最后对培养效果开展实验验证。结果研制的便携式培养箱结构紧凑、携带方便、温度偏差≤±1℃、自带电池充满供电时间≥8h;实验表明对微生物指标的培养效果与实验室常用的电热恒温培养箱无显著差异。结论本装备适用于饮用水及食品中微生物指标的现场检测,对于野战或应急情况下及时发现和排除微生物污染隐患,保障部队官兵身体健康具有重要意义。     

The design and test of a new volume coil for high field imaging

A major problem in the development of high field (>100 MHz) large volume (>6000 cm³) MR coils is the interaction of the coil with the subject as well as the radiation loss to the environment. To reduce subject perturbation of the coil resonance modes, a volume coil that uses an array of freely rotating resonant elements radially mounted between two concentric cylinders was designed for operation at 170 MHz. Substantial electromagnetic energy is stored in the resonant elements outside the sample region without compromising the efficiency of the overall coil. This stored energy reduces the effect of the subject on the circuit and maintains a high Q, facilitating the tuning and matching of the coil. The unloaded Q of the coil is 680; when loaded with a head, it was 129. The ratio of 5.3 of the unloaded to loaded Q supports the notion that the efficiency of the coil was maintained in comparison with previous designs. The power requirement and signal-to-noise performance are significantly improved. The coil is tuned by a mechanism that imparts the same degree of rotation on all of the elements simultaneously, varying their degree of mutual coupling and preserving the overall coil symmetry. A thin radiofrequency shield is an integral part of the coil to reduce the radiation effect, which is a significant loss mechanism at high fields. MR images were collected at 4T using this coil design with high sensitivity and B₁, homogeneity.     

The first use of U in the general environment and near a shutdown nuclear power plant

We present a first effort to investigate ²³⁶U in the environment near a shutdown nuclear power plant far away from highly contaminated sites, by using accelerator mass spectrometry. The detection limit of about 1 pg ²³⁶U allowed us to identify a minimal increase of the ²³⁶U/²³⁸U isotopic ratio correlated to a peak of ¹³⁷Cs in river sediments downstream of the nuclear power plant, and to detect anthropogenic ²³⁶U also upstream, where it is probably not related to the power plant but to global fallout. The ²³⁶U content shoved variations of the ²³⁶U/²³⁸U isotopic ratio in relation to the chemical–physical characteristics of the sediments. This demonstrates the potential of ²³⁶U as an environmental tracer, and as an indicator for releases from nuclear facilities.     

Production design and evaluation of a novel breast phantom with various breast glandular fractions

The purpose of this study was to evaluate the production design of a novel breast phantom, which has adjustable breast glandular fractions and potential application in the mammography quality assurance/quality control system. The breast phantom was based on a urethane resin that was used to adjust the breast glandular fraction by varying the amount of plasticizer added. The resin was cured at constant temperature and humidity. Theoretical phantom properties, such as elemental composition, specific density, effective atomic number, electron density, and linear attenuation coefficients, at various energies were compared to those of breast tissue tabulated in the ICRU 44. These properties were also compared to polymethyl methacrylate resin and BR12. The novel breast phantom was made to represent breast glandular content calculated from breast tissue of the ICRU 44. We hypothesized that the breast phantom theoretical properties are approximately equal to those of the BR12, which is known for being an excellent substitute breast phantom. It was found that the phantom can be used to improve both mammography performance and dosimetry.