胰岛素强化治疗在2型糖尿病骨折患者围手术期的应用

Objective To investigate the best way to control the blood sugar level during the perioperation of bone fracture patients with type 2 diabetes(T2DM).Methods Bone fracture patients with T2DM were randomly divided into three groups:continuous subcutaneous insulin infusion group(insulin aspart,group CSII,n=20),glargine treatment group(insulin aspart+insulin glargine,group GA,n=20),and NPH treatment(insulin aspart+rh-insulin,group NA,n=20).The levels of fasting plasma glucose(FPG)and the 2 hours postprandial glucose(2h PG),blood glucose fluctuation(BGF),insulin dosage(ID),good effective time(GET),incidence of hypoglycemia,dawn phenomenon and infection,average time of stitches removal(ATSR),average hospitalized length(AHL)of three groups were compared.Results FPG and 2hPG,ID in group CSII[(6.32±1.18)mmol/L,(7.72±1.53)mmol/L,(35.40±1.60)IU]and group GA [(6.25±0.88)mmol/L,(7.32±1.17)mmol/L,(36.20±0.80)IU]were significantly lower than those of group NA [(7.44±1.36)mmol/L,(8.52±0.76)mmol/L,(40.50±2.40)IU,all P<0.05],simulaneously,BGF,GET incidence of complications,ATSR,AHL of group CSII and GA were significantly lower than those of group NA(all P<0.05).There were not significant difference between group CSII and group GA.Compared with group CSII,group GA had less costs in-hospital and better practicability.Conclusion Both CSII and insulin glargine combined with insulin aspart can effectively,safely,rapidly and stablely control hyperglycemia.and might be the first choice to control blood sugar for bone fracture patients with T2DM in perioperation.     

人类免疫缺陷病毒包膜糖蛋白V3区对细胞结合能力的研究

目的：研究人类免疫缺陷病毒（ＨＩＶ）不同亲嗜株包膜糖蛋白Ｖ３区结合于靶细胞的能力。方法：合成来源于不同嗜性ＨＩＶ－１Ｖ３区的生物素标记和非标记的多肽。采用流式细胞计数分析生物素化的 Ｖ３多肽对细胞的结合能力以及细胞表面的结合配体。结果：ＨＩＶ－１Ｘ４　亲嗜株ＩＩＩＢＶ３区能结合于多种细胞的表面，包括辅助受体ＣＸＣＲ４；竞争实验结果显示蛋白酶抑制剂能抑制该结合。Ｒ５亲嗜株 ＡＤＡ Ｖ３区只极微弱地结合于外周血单核细胞和表达ＣＣＲ５ 的人星形胶质细胞表面。结论：不同嗜性ＨＩＶ－１Ｖ３区结合于细胞表面的能力不同从亲嗜株Ｖ３区直接结合于细胞表面并被其自身所增强，其靶分子至少包括辅助受体 ＣＸＣＲ４和蛋白酶分子；而Ｒ５亲嗜株 ＡＤＡ Ｖ３区则不结合于 ＣＣＲ５和蛋白酶。     

丹参注射液与异甘草酸镁抗肝纤维化的临床对比研究

Objective To observe the change of liver function and liver fibrosis indexes of the chronic hepatitis B patients that were treated by Danshen injection(DI) and magnesium isnglyeyrrhizinate(MI). Methods 80 chronic hepati-tis B patients based on the conventional treatment were randomly divided into D1 group(40 patients) and MI group(40 pa-tients). The two groups were used with DI and MI injection for 30 days respaetively and then,the levels of liver function and serum hepatic fibrosis(HA, LN, Ⅳ -C) were detected and compared before and after treatment. Results Treatment by DI and MI could both improve liver function significantly, the effect of Ml group was better than DI group(P < 0.05). Moreover, in improving serum hepatic fibrosis, the effect of DI group was better than MI group (P < 0.05). Conclusions The efficacy of the improvement to hepatic fibrosis DI is better than MI, while in improvement of liver function MI is superior to DI.     

B超引导下麦默通装置在乳腺微创外科中的应用

【目的】探讨B超引导下麦默通系统在乳腺微创外科中的应用价值。【方法】在B超引导下采用麦默通装置行微创旋切对36例乳腺肿瘤患者进行诊断及治疗。【结果】10例行穿刺活检,其中恶性4例,明确诊断后均行新辅助化疗。26例乳腺肿块均完整切除。术后1月B超随访无原病灶残留和复发,3例出现术后出血并发症．1～2个月后完全吸收。超声引导成功率100％。【结论】B超引导下麦默通乳腺微创旋切术是一种治疗乳腺肿瘤安全、合理、有效、符合美学观点的诊治方法。     

介入术后健康教育处方应用效果研究

目的探讨查介入术后健康教育处方的应用效果。方法将893例住院行介入手术治疗的患者分为两组：对照组采用传统方法进行健康教育;实验组使用介入术后健康教育处方,整理两组患者发生不安全隐患的例数。依据是否应用介入术后健康教育处方为患者实施健康教育将护理人员分为两组,评估两组护士健康教育知识掌握程度,计算同期合格率。结果实验组患者术后未发生不安全隐患,护士健康教育合格率提高（P〈0．01）。结论使用介入术后健康教育处方,能降低不安全隐患的发生,提高护士健康教育的准确性和合格率。     

某部密闭舱室军事作业环境和人员健康调查评价

目的 评价特殊军事作业人工环境影响因素特征及其对人员健康的影响,为进一步开展控制措施的研究提供依据.方法 采用电磁辐射场强仪、声级计、温湿度计、风速仪、一氧化碳检测仪和二氧化碳分析仪,分别对某部军事作业密闭环境的微波辐射、噪声、温度、湿度、风速、一氧化碳和二氧化碳进行监测分析;采用自觉症状问卷,调查评价作业人员健康...     

Fracture healing following high energy tibial trauma: Ilizarov versus Taylor Spatial Frame

Introduction

The optimal treatment of high energy tibial fractures remains controversial and a challenging orthopaedic problem. The role of external fixators for all these tibial fractures has been shown to be crucial.

Methods

A five-year consecutive series was reviewed retrospectively, identifying two treatment groups: Ilizarov and Taylor Spatial Frame (TSF; Smith & Nephew, Memphis, TN, US). Fracture healing time was the primary outcome measure.

Results

A total of 112 patients (85 Ilizarov, 37 TSF) were identified for the review with a mean age of 45 years. This was higher in women (57 years) than in men (41 years). There was no significant difference between frame types (p=0.83). The median healing time was 163 days in both groups. There was no significant difference in healing time between smokers and non-smokers (180 vs 165 days respectively, p=0.07), open or closed fractures (p=0.13) or age and healing time (Spearman''s r=0.12, p=0.18). There was no incidence of non-union or re-fracture following frame removal in either group.

Conclusions

Despite the assumption of the rigid construct of the TSF, the median time to union was similar to that of the Ilizarov frame and the TSF therefore can play a significant role in complex tibial fractures.     

早孕期母体血清中Omentin-1、Betatrophin水平与妊娠期糖尿病的相关性及预测价值研究

目的 探讨早孕期母体Omentin-1、Betatrophin水平与妊娠期糖尿病(GDM)的相关性及预测价值.方法 回顾性选择2016年5月至2017年5月西安医学院附属西安市北方医院妇产科接诊的53例GDM患者(GDM组),同期50例糖耐量正常孕妇(NGT组)和50例健康未孕妇女(对照组)为研究对象.酶联免疫吸附试验...     

穴位电针影响狗血浆、胃粘膜组织中ET含量及意义

目的 :观察电针对狗胃粘膜血流量、幽门压力的调控作用及其与血浆、胃粘膜组织中内皮素含量变化的关系 ,以初步探讨电针调控胃功能的作用机制。方法 :将 2 0条狗随机分为 4组 :空白对照组、非经非穴组 ,上巨虚组、足三里组 (每组 5条 )。采用激光多普勒血流仪、胃压测量仪监测狗胃粘膜血流量、幽门压力的变化 ,同步测定血浆及胃粘膜组织中内皮素含量 ,并观察变化规律。结果 :电针足三里组胃粘膜血流量显著升高 (P <0 .0 1) ,幽门括约肌压力下降 (P <0 .0 5 ) ,血浆及胃粘膜组织中内皮素含量显著下降 (P <0 .0 1) ,上巨虚组仅血浆内皮素含量下降。但足三里组变化趋势更明显 ,其他组各监测指标无显著变化。结论 :电针可使狗胃粘膜血流量增加 ,影响幽门压力变化 ,对部分胃功能具有调控作用 ,并与影响某些脑肠肽的含量改变有关 ,具有一定的经络和穴位特异性     

原发性甲状旁腺功能亢进症的诊断和外科治疗

目的 总结原发性甲状旁腺功能亢进症的诊治经验.方法 回顾性分析1992年11月-2008年12月我院收治的91例原发性甲状旁腺功能亢进症(primary hyperparathyroidism,PHPT)的临床资料.结果 91例患者中甲状旁腺腺瘤88例(96.7%),腺癌3例(3.3%).血清钙和甲状旁腺素(PTH)均升高.主要表现为骨痛和泌尿系结石.术前B超、CT和ECT99mTc-MIBI定位准确率分别为83.5%(76/91)、60.9%(14/23)、98.6%(69/70).全部病例均行甲状旁腺腺瘤切除术,1例腺癌另行甲状腺腺叶切除加中央区淋巴结清扫.一次手术成功率97.8%(89/91).90例术后随访8个月至14年,87例腺瘤患者获得临床治愈,3例腺癌患者中2例复发,其中1例死亡.结论 原发性甲状旁腺功能亢进症的诊断并不困难,患有慢性骨病、反复发作泌尿系结石、消化性溃疡的患者应作为此病疑诊对象,血钙检查应作为常规;术前影像学检查首选B超和ECT~(99m)Tc-MIBI;定位准确的甲状旁腺瘤采用腺瘤切除术是可行的.