加强飞行员疗养期间的管理

目的 :观察复方丹参注射液和盐酸纳洛酮治疗急性重度酒精中毒的疗效。方法 :89例急性重度酒精中毒患者随机分为 2组。对照组 39例用传统方法治疗 ;治疗组 5 0例在对照组基础上 ,加用复方丹参注射液和盐酸纳洛酮治疗 ,观察患者意识恢复及自觉症状改善、消失的时间。结果 :在取得起效、显效和痊愈时间上 ,治疗组分别为(30 .46± 5 .6 2 )min、(5 5 .85± 8.14)min和 (140 .2 8± 12 .6 3)min ,均明显早于对照组 (72 .35± 7.83)min、(110 .86± 11.17)min和 (2 31.5 1± 16 .2 5 )min ,P <0 .0 1.结论 :复方丹参注射液与盐酸纳洛酮联合应用治疗急性重度酒精中毒患者能缩短病程 ,提高疗效。     

纳洛酮联合山茛菪碱治疗眩晕症的疗效观察及护理

目的:探讨纳洛酮联合山莨菪碱治疗眩晕症患者的方法及效果.方法:将眩晕症患者120例随机分治疗组与对照组,治疗组予纳洛酮和654-2治疗,对照组予复方丹参注射液和安定、眩晕停治疗.结果:治疗组效果显著,总有效率为91.7%;对照组效果差,总有效率为60%.结论:纳洛酮联合山莨菪碱治疗眩晕症患者安全、效果显著.     

复方丹参注射液治疗急性胰腺炎的疗效分析

目的探讨复方丹参注射液治疗急性胰腺炎的疗效。方法 73例急性胰腺炎患者按病情随机分为观察组与对照组 ,观察组在给予常规治疗同时 ,加用复方丹参注射液。观察治疗前后实验室指标及临床表现积分变化 ,评估复方丹参注射液治疗急性胰腺炎的效果。结果观察组与对照组实验室指标和临床表现均可改善 ,但观察组对临床症状体征的改善优于对照组 (P <0 .0 5 )。结论复方丹参注射液有助于改善急性重症胰腺炎患者临床症状及体征。     

复方丹参注射液治疗急性重度酒精中毒的疗效观察

目的：观察复方丹参注射液治疗急性重度酒精中毒的疗效。方法：４５例急性重度酒精中毒患者随机分为２组。对照组２２例主要用纳络酮治疗；治疗组２３例在对照组治疗基础上，加用复方丹参注射液治疗，观察患者意识恢复及自觉症状改善、消失时间。结果：在取得起效、显效和痊愈时间上，治疗组分别为（３２．６±４．２）分钟，（５７．９±７．４）分钟和（１３２．２±１１．１）分钟，均明显早于对照组〔（５８．７±７．６）分钟，（８９．６±１０．３）分钟和（２０７．１±１５．３）分钟，Ｐ均＜０．０１〕；结论：复方丹参注射液与纳络酮合用治疗急性重度酒精中毒患者可缩短病程，提高疗效。     

盐酸纳洛酮治疗75例急性酒精中毒患者的疗效分析

目的:探讨分析盐酸纳洛酮注射液在急诊内科急性酒精中毒患者治疗中的疗效分析.方法:选取2018年1月-2020年12月急诊内科收治的75例急性酒精中毒患者为研究对象,随机分为观察组(40例)和对照组(35例).对照组患者实施催吐、洗胃、吸氧、大量输液、维持水电解质平衡、胃和肝脏功能保护等对症支持治疗;观察组患者在对照组基...     

盐酸纳洛酮在急诊抢救急性乙醇中毒的临床效果分析

观察盐酸纳洛酮在急诊抢救急性乙醇中毒的临床疗效。选取153例急性乙醇中毒患者随机分成治疗组和对照组,两组均给予常规治疗,治疗组78例在此基础上给予盐酸纳洛酮治疗。观察两组的临床疗效。治疗组症状缓解时间、意识完全恢复时间明显短于对照组,差异有统计学意义(P0.05)。盐酸纳洛酮治疗急性乙醇中毒症状缓解快,催醒时间短,可作为急救急性乙醇中毒常规首选药物。     

纳洛酮联合盐酸戊乙奎醚注射液治疗急性有机磷农药中毒的效果观察

目的 探讨纳洛酮联合盐酸戊乙奎醚注射液治疗急性有机磷农药中毒的临床效果。方法 选择郑州市第九人民医院2021年至2022年3月收治的急性有机磷农药中毒患者72例,按照随机数字表法分为对照组和观察组,每组36例。对照组给予盐酸戊乙奎醚注射液治疗,观察组加用纳洛酮治疗。均于治疗7 d后比较两组治疗效果、血清相关指标、不良反应。结果 观察组治疗总有效率高于对照组,差异有统计学意义(P<0.05)。两组治疗前血清相关指标比较,差异未见统计学意义(P>0.05)。观察组治疗后胆碱酯酶(CHE)高于对照组,白细胞计数(WBC)、心肌酸激酶(CK)、乳酸脱氢酶(LDH)均低于对照组,差异有统计学意义(P<0.05)。两组不良反应比较,差异未见统计学意义(P>0.05)。结论 纳洛酮联合盐酸戊乙奎醚注射液治疗急性有机磷农药中毒效果确切,能够改善患者血清相关指标,且安全性高。     

纳洛酮复合用药治疗急性乙醇中毒疗效分析

目的探讨纳洛酮复合复方麝香注射液和维生素C治疗急性乙醇中毒的临床效果。方法60例急性乙醇中毒患者,随机分为纳洛酮复合复方麝香注射液组（A组）、纳洛酮复合维生素C组（B组）和纳洛酮组（C组）,每组20例。观察各组平均清醒时间及显效时间、症状减轻时间、症状消失时间。结果与A组比较,B、C组的清醒时间及显效时间、症状减轻时间、症状消失时间明显延长,尤以C组为甚,P〈0.05。结论纳洛酮复合复方麝香注射液治疗急性乙醇中毒临床效果最佳。     

盐酸纳洛酮和醒脑静联合治疗急性乙醇中毒24例

目的 探讨盐酸纳洛酮和醒脑静注射液治疗急性乙醇中毒的疗效.方法 对2009年2月至2010年9月急诊留院观察的24例急性乙醇中毒昏睡期患者(男21例,女3例)给予盐酸纳洛酮注射液2 mg加入5% 葡萄糖溶液250 mL和醒脑静注射液10 mL加入5%葡萄糖溶液250 mL静脉滴注,并同时予以维生素C、维生素B6静脉滴注.结果 盐酸纳洛酮和醒脑静可使乙醇中毒症状迅速缓解,明显缩短中毒后苏醒时间.结论盐酸纳洛酮和醒脑静治疗急性乙醇中毒有可靠疗效.     

洗胃在急性酒精中毒患者治疗中的应用效果观察

目的:探讨洗胃在急性酒精中毒患者治疗中的应用方法及临床效果。方法:将90例急性酒精中毒患者随机分为观察组和对照组各45例,对照组给予纳洛酮等药物治疗,观察组在药物治疗基础上给予洗胃。结果:两组轻度中毒患者苏醒时间及完全清醒时间比较差异无统计学意义(P>0.05);观察组中度、重度中毒患者苏醒时间及完全清醒时间与对照组比较差异有统计学意义(P<0.01)。结论:轻度急性酒精中毒患者可给予药物治疗,中度、重度患者应在药物治疗基础上给予洗胃。     

多色荧光原位杂交技术检测急性淋巴细胞白血病复杂核型异常

本研究建立多色荧光原位杂交（M—FISH）技术平台，探讨其在检测急性淋巴细胞白血病（ALL）复杂核型异常中的应用。联合应用常规细胞遗传学方法和M—FISH技术分析了5例伴有复杂核型异常的ALL患者。结果表明：M—FISH证实了原有的异常t（9；22）、t（1；19）和t（y；1），同时还发现了新的异常der（1）（1：：3：：7）、der（6）t（6；9）（q？；p13）、der（1）t（1；11）、der（12）t（1；12）、der（3）t（3；5）、der（2）t（2；16）、der（9）（9：：18：：7）和der（7）（9：：18：：7），并且纠正了原有的错误分析，其中der（9）（9：：18：：7）及der（7）（9：：18：：7）为世界上首例报道。结论：M—FISH在检测ALL复杂核型中的应用前景广阔，是进行精确染色体核型分析所不可缺少的先进手段。     

血管性血友病四种指标实验检测意义的比较

目的探讨血管性血友病4种检测实验诊断方法的临床应用价值。方法使用vWF抗原水平检测(vWFAg)、vWF胶原结合分析实验(vWFCBA)、瑞斯托霉素辅因子活性测定(vWFRcof)、瑞斯托霉素诱导的血小板聚集试验(RIPA)4种方法同时对正常献血员、vWD患者及其他出血性疾病患者进行检测,比较其检测方法的优越性。结果4种检测血管性血友病的实验其结果在vWD患者组与正常献血员组和其他出血性疾病组比较P<001,差异均有统计学意义;正常献血员组与其他出血性疾病组比较P>005,差异无统计学意义。1型vWD患者组中4种检测方法相关性比较显示,vWFCBA与vWF∶Ag相关性最好(r=09610),其次为vWF∶Rcof与RIPA(r=09164),而vWF∶Ag与RIPA相关性最差(r=08132)。vWF∶CBA的变异系数(39%)最小,vWF∶Ag(41%)次之,而vWF∶Rcof和RIPA较高(分别为155%和173%)。4种检测方法与诊断的总符合率分别为vWF∶Ag857%,vWF∶Rcof762%,RIPA809%,vWF∶CBA952%。结论vWF∶CBA操作简便、重复性较好,在常规vWD的诊断分型中可替代vWF∶Rcof和RIPA。     

The effect on quality of chest compressions and exhaustion of a compression--ventilation ratio of 30:2 versus 15:2 during cardiopulmonary resuscitation--a randomised trial

BACKGROUND: Recent cardio pulmonary resuscitation (CPR) guidelines changed the compression:ventilation ratio in 30:2. OBJECTIVE: To compare the quality of chest compressions and exhaustion using the ratio 30:2 versus 15:2. METHODS: A prospective, randomised crossover design was used. Subjects were recruited from the H.-Hart hospital personnel and the University College Katho for nurses and bio-engineering. Each participant performed 5min of CPR using either the ratio 30:2 or 15:2, then after a 15min rest switched to the other ratio. The data were collected using a questionnaire and an adult resuscitation manikin. The outcomes included exhaustion as measured by a visual analogue scale (VAS) score, depth of chest compressions, rates of chest compressions, total number of chest compressions, number of correct chest compressions and incomplete release. Data were compared using the Wilcoxon Signed Ranks Test. The results are presented as medians and interquartile ranges (IQR). RESULTS: One hundred and thirty subjects completed the study. The exhaustion-score using the VAS was 5.9 (IQR 2.25) for the ratio 30:2 and 4.5 (IQR 2.88) for the ratio 15:2 (P<0.001). The compression depth was 40.5mm (IQR 15.75) for 30:2 and 41mm (IQR 15.5) for 15:2 (P=0.5). The compression rate was 118beats/min (IQR 29) for 30:2 and 115beats/min (IQR 32) for 15:2 (P=0.02). The total number of compressions/5min was 347 (IQR 79) for 30:2 and 244compressions/5min (IQR 72.5) for 15:2 (P<0.001). The number of correct compression/5min was 61.5 (IQR 211.75) for 30:2 and 55.5 (IQR 142.75) for 15:2 (P=0.001). The relative risk (RR) of incomplete release in 30:2 versus 15:2 was 1.087 (95% CI=0.633-1.867). CONCLUSIONS: Although the 30:2 ratio is rated to be more exhausting, the 30:2 technique delivers more chest compressions and the quality of chest compressions remains unchanged.     

下肢深静脉血栓形成患者溶栓前后凝血、抗凝和纤溶活性改变的研究

目的观察下肢深静脉血栓（LDVT）患者溶栓前后凝血、抗凝和纤溶指标的变化，以探讨出凝血、纤溶活性改变与LDVT患者溶栓后高血栓发生率的相关性。方法测定50例LDVT患者溶栓前后抗凝血浆标本的抗凝血酶活性（AT：A）、纤维蛋白原（FIB）、纤溶酶原活性（PLG：A）、组织型纤溶酶原激活物抗原性（t—PA：Ag）、纤溶酶原活性抑制剂-1抗原性（PAI：Ag）、血浆D-二聚体（D-D）、血管性血友病因子（VWF）、Ⅷ促凝活性（Ⅷ：C）、凝血因子Ⅻ活性（Ⅻ：C）；并取32例健康体检者作对照。结果AT：A、PLG：A、t—PA：Ag、Ⅻ：C在溶栓前明显低于对照组（P〈0．01），溶栓后升高（P〈0．05或P〈0．01），其中AT：A、PIG：A、Ⅻ：C仍低于对照组（P〈0．05或P〈0．01），而t-PA：Ag无显著性差异（P〉0．05）；FIB、PAI：A、D-D、Ⅷ：C、VWF在溶栓前显著高于对照组（P〈0．01），溶栓后下降（P〈0．05或P〈0．01），其中PAI：A、D-D、Ⅷ：C、VWF下仍明显高于对照组（P〈0．05或P〈0．01），而FIB无显著性差异（P〉0．05）。结论出凝血系统机能紊乱、纤溶-抗纤溶系统失衡与LDVT患者溶栓后血栓的发生可能有密切的关系。     

Impact of an Express Admit Unit on Emergency Department Length of Stay

Background: Express admit units (EAUs) have been proposed as a way to expedite patient flow through the Emergency Department (ED). Objectives: We sought to determine the effect of opening a five-bed EAU unit for temporary placement of admitted patients on our ED length of stay (LOS) and waiting room times (WT). Method: This was a before-and-after interventional study of the 3-month period immediately before (pre-EAU) and after opening (post-EAU) of the EAU. We compared ED LOS and WT for patients admitted and discharged from the ED for both time periods, controlling for daily census and patient acuity. Results: During the post-EAU period, 386 patients (26.2% of total admits) were admitted through the EAU. Overall LOS decreased from 8:21 (interquartile range [IQR] 6:02–11:20) to 7:41 (IQR 5:22–10:16) for all admitted patients (p < 0.001), and from 3:41 (IQR 2:05–5:58) to 3:35 (IQR 2:00–5:55) for the discharged patients (p = 0.025). After controlling for census and acuity, the LOS decreased an average of 10% (95% confidence interval [CI] 6%–14%; p < 0.001) for admitted patients and 4% (95% CI 2%–7%; p = 0.001) for discharged patients. These changes represented a decreased LOS of about 50 and 9 min, respectively. There were no significant differences in WT (0:44; IQR 0:09–2:07 vs. 0:50; IQR 0:11–2:20 for admitted patients and 0:41; IQR 0:09–1:50 vs. 0:41; IQR 0:10–1:47 for discharged patients). However, after controlling for census and acuity, WT decreased 9% (95% CI 1%–16%; p = 0.022) for discharged patients, which represented a decrease of about 4 min. Conclusions: With an EAU, there was a modest improvement in ED LOS despite an overall increase in daily ED volume.     

Reliability of four methods for the diagnosis of acute infection by Epstein-Barr virus

We studied the reliability of new indirect tests in the diagnosis of acute infection by Epstein-Barr virus (EBV). Studied for all samples were: method 1, the heterophil antibodies (Abs) (Monolatex, Biokit, Germany); method 2, the IgM Abs to EBV with ELISA tests (antigen pools, Enzygnost, Behringwerke, Germany); method 3, EA (Biotest Diagnostics, Germany); and method 4, the IgG avidity test. The reliability of the four tests for the detection of primary infection by EBV was: sensitivity (method 1:89.1%; method 2: 100%; method 3: 79.7%; method 4: 99%); specificity (method 1: 98%; method 2: 100%; method 3:84%; method 4: 100%); positive predictive value (method 1: 97.6%; method 2: 100%; method 3: 73.6%; method 4: 100% method 4: 100%), and negative predictive value (method 1: 90.7%; method 2: 100%; method 3:84%; method 4: 99%). The IgG avidity test (method 4) is simple and automated in the laboratory and is very useful for ascertaining, from a single sample, the time since infection. It is criteria of recent primoinfection higher levels than 55% of IgG with low avidity for the antigen. The investigation of the Abs to antigen pools (method 2) by ELISA of virus had a high reliability, but the investigation of heterophil Abs by latex (method 1) and the Abs IgM to EA (method 2) were lacking in sensibility regarding their use in the diagnosis of the primoinfection. J. Clin. Lab. Anal. 11:78–81. © 1997 Wiley-Liss, Inc.     

Effect of ultrasound on acute inflammation of transected medial collateral ligaments

OBJECTIVE: To evaluate the effect of therapeutic ultrasound on the acute inflammation of soft-tissue injuries by measuring the levels of prostaglandin E(2) (PGE(2)) and leukotriene B(4) (LTB(4)). DESIGN: Randomized, case-control study. SETTING: Laboratory animal facility. ANIMALS: Thirty 3-month-old male Sprague-Dawley rats. INTERVENTION: Rats with medial collateral ligament transection were given 5 minutes of pulsed ultrasound therapy (1:4) daily, with different durations (1, 5, 10d) and intensities (0, 0.5, 1.5, 2.3W/cm(2)). MAIN OUTCOME MEASURES: Levels of PGE(2) and LTB(4). RESULTS: The levels of PGE(2) and LTB(4) were higher in all intensity subgroups that received 2.3W/cm(2) intensity on postinjury day 2. On postinjury day 11, LTB(4) was significantly decreased, but PGE(2) was significantly increased. CONCLUSIONS: Pulsed ultrasound therapy may stimulate inflammation of acute ligament injury.     

The effects of probiotic supplementation on mental health,biomarkers of inflammation and oxidative stress in patients with psychiatric disorders: A systematic review and meta-analysis of randomized controlled trials

Background and objectiveIn the current meta-analysis of randomized controlled trials (RCTs), the effects of probiotic supplementation on mental health, biomarkers of inflammation and oxidative stress in patients with psychiatric disorders were assessed.MethodsThe following databases were search up to February 2019: PubMed, Scopus, Web of Science, Google scholar and Cochrane Central Register of Controlled Trials.ResultsTwelve studies were included in the current meta-analysis. The findings demonstrated that probiotic supplementation resulted in a significant reduction in Hamilton Depression Rating Scale (HAMD) [Weighted Mean Difference (WMD): -9.60; 95 % CI: -10.08, -9.11]. In addition, a significant reduction in C-reactive protein (CRP) (WMD: -1.59; 95 % CI: -2.22, -0.97), interleukin 10 (IL-10) (WMD: -0.29; 95 % CI: -0.48, -0.11) and malondialdehyde (MDA) levels (WMD: -0.38; 95 % CI: -0.63, -0.13) was found after probiotics supplementation. No significant change was seen in Beck Depression Inventory (BDI) score (WMD: -11.17; 95 % CI: -24.99, 2.65), tumor necrosis factor-α (TNF-α) (WMD: -0.12; 95 % CI: -0.20, -0.05), IL-1B (WMD: -0.34; 95 % CI: -1.43, 0.74), IL-6 (WMD: 0.03; 95 % CI: -0.32, 0.38), nitric oxide (NO) (WMD: -0.54; 95 % CI: -2.16, 1.08), glutathione (GSH) (WMD: 46.79; 95 % CI: -17.25, 110.83) and total antioxidant capacity (TAC) levels (WMD: 15.21; 95 % CI: -59.96, 90.37) after probiotics supplementation.ConclusionOverall, the current meta-analysis demonstrated that taking probiotic by patients with psychiatric disorders had beneficial effects on HAMD, CRP, IL-10 and MDA levels, but it did not affect BDI score, other markers of inflammation and oxidative stress.     

糖皮质激素对晚期肿瘤患者免疫疗效影响的Meta分析

目的 探讨糖皮质激素(glucocorticoid, GC)的使用对接受免疫检查点抑制剂(immune checkpoint inhibitors, ICIs)治疗的肿瘤患者的总生存期(overall survival, OS)和无进展生存期(progression-free survival, PFS)的影响。方法 使用PubMed、Wiley、Web of Science和Cochrane Library数据库检索2020年10月以前发表的有关肿瘤患者在接受ICIs治疗期间,GC使用对患者预后影响的文献,采用Review Manager 5.3软件和Stata14.0软件进行统计分析。结果 总共有23篇文献被纳入荟萃分析,Meta分析结果显示在晚期肿瘤患者接受ICIs治疗期间,GC的使用是死亡(H R=1.54, 95% C I=1.29~1.83)和疾病进展(H R=1.82, 95% C I=1.36~2.43)的危险因素。此外,亚组分析结果显示,GC用于缓解脑水肿、癌痛等肿瘤相关并发症时会增加患者死亡(H R=2.14, 95% C I=1.62~2.81)和疾病进展(H R=2.26,95% C I=1.72~2.96)的风险。然而,GC被用于处理免疫相关不良反应(immune-related adverse events,irAEs)等非肿瘤相关性并发症,GC的使用与未使用或者小剂量(<10 mg/d)使用相比差异无统计学意义(P>0.05)。结论 当GC用于处理肿瘤相关性并发症时,GC的使用对接受免疫治疗的肿瘤患者的预后会造成负面影响。     

Formation of 8-nitroguanine in blood of patients with inflammatory gouty arthritis

BACKGROUND: NOx causes DNA damage due to an inflammatory effect of gouty arthritis. We investigated the concentration of 8-nitroguanine (8-NO(2)-G) in the blood of patients with arthritis. METHODS: Subjects were divided into 3 groups: (1) high inflammatory (HI) group (n = 21) with hyperuricemia (mean, 8.9 mg/dl) and leukocytosis, (2) low inflammatory (LI) group (n = 14) with mild hyperuricemia (mean, 7.6 mg/dl) but normal leukocyte count, (3) non-inflammatory (NI) healthy control (n = 19) with mean serum uric acid concentration 5.3 mg/dl and normal leukocyte count. Serum C-reactive protein (CRP) concentrations were measured by a visual agglutination method. The blood concentrations of 8-NO(2)-G were determined by high performance liquid chromatography-electrochemical detection and were compared between groups. RESULTS: There was significant difference in percentage of positive CRP (NI: 55.6%, LI: 64.3%, HI: 100%, p = 0.003) between the 3 groups. The leukocyte count (mean +/- S.E., NI: 7400 +/- 528, LI: 7686 +/- 433, HI: 10952 +/- 691/mm(3), p < 0.001), uric acid (NI: 5.3 +/- 0.24, LI: 7.6 +/- 0.4, HI: 8.9 +/- 0.36 mg/dl, p < 0.001), NO(2) (NI: 6.5 +/- 1.2, LI: 11.1 +/- 2.9, HI: 35.6 +/- 5.1 microg/ml, p < 0.001) and the 8-NO(2)-G (NI: 0.08 +/- 0.03; LI: 0.34 +/- 0.13; HI: 0.59 +/- 0.09 ng/microg DNA, p = 0.002) were significantly increased by inflammation. CONCLUSION: Gouty inflammation induces DNA damage by increasing 8-NO(2)-G through endogenous NO and ROS formation.