眼科医疗纠纷的原因及防范

眼科是医疗纠纷发生率较高的专业之一,部分纠纷会严重影响医院及卫生系统的声誉,因此有必要对眼科纠纷的特点进行分析总结,寻找规律,对易引发医疗纠纷的关键环节加以提示和防范,最大限度避免类似事件的重复发生。     

普通外科病房病原体分布及其耐药性

目的调查某院普通外科病房病原体分布及其耐药性,为临床医生合理选择抗菌药物提供依据。方法对该院普通外科2011年1月-2012年12月临床送检各类标本分离的病原体种类、分布及耐药性进行回顾性分析。结果共分离病原体859株,其中革兰阴性（G-）菌563株(占65.54%),革兰阳性（G+）菌233株(占27.12%),真菌63株(占7.33%);G-菌以大肠埃希菌(40.40%) 居多,G+菌以粪肠球菌(3.96%) 居多,真菌主要为白假丝酵母菌。病原体标本来源主要为腹腔引流/抽出液（65.43%,562株）,其次为伤口或切口分泌物（10.94%,94株）、痰液（9.90%,85株）、胆汁（6.75%,58株）等。肠杆菌科细菌对亚胺培南、美罗培南不耐药,对阿米卡星、阿莫西林/克拉维酸、哌拉西林/他唑巴坦和头孢哌酮/舒巴坦的耐药率均＜20%,对头孢菌素的耐药率较高。鲍曼不动杆菌对亚胺培南、美罗培南的耐药率高达51.85%、47.37%,对其他大部分抗菌药物的耐药率均＞60%,耐药率较低的是左氧氟沙星、阿米卡星,耐药率均＜20%。G+球菌对万古霉素的耐药率＜3.40%。结论该院普通外科住院患者医院感染主要病原体以G-菌为主,了解普通外科病房病原菌分布及加强细菌的耐药性监测,对临床医生合理选择抗菌药物,提高疗效,防止耐药菌株的产生及传播具有重要意义。     

Red-Koji Fermented Red Ginseng Ameliorates High Fat Diet-Induced Metabolic Disorders in Mice

Fermentation of medicinal herbs improves their pharmacological efficacy. In this study, we investigated the effects of red-koji fermented red ginseng (fRG) on high-fat diet (HFD)-mediated metabolic disorders, and those effects were compared to those of non-fermented red ginseng (RG). fRG (500, 250 or 125 mg/kg), RG (250 mg/kg), simvastatin (10 mg/kg), silymarin (100 mg/kg) and metformin (250 mg/kg) were orally administered from 1 week after initiation of HFD supply for 84 days. The diameter of adipocytes in periovarian and abdominal fat pads and the thickness of the abdominal fat were significantly decreased by fRG treatment, while HFD-mediated weight gain was partly alleviated by fRG in a dose-dependent manner. Moreover, biochemical and histomorphometrical analyses clearly indicated that fRG significantly inhibited HFD-induced metabolic disorders such as hyperglycemia, hyperlipidemia, hepatopathy and nephropathy in a dose-dependent manner. More favorable pharmacological effects on HFD-mediated metabolic disorders were also observed with fRG compared to an equal dose of RG. This finding provides direct evidence that the pharmacological activities of RG were enhanced by red-koji fermentation, and fRG could be a neutraceutical resource for the alleviation of obesity-mediated metabolic disorders.     

Augmented chondroprotective effect of coadministration of celecoxib and rebamipide in the monosodium iodoacetate rat model of osteoarthritis

Osteoarthritis (OA) is a degenerative joint disease characterized by the progressive loss of articular cartilage and chronic pain. Although cyclooxygenase-2 (COX-2) inhibitors such as celecoxib are recommended to patients at high risk of gastrointestinal (GI) adverse events, COX-2 inhibitors do not completely prevent GI adverse events. Rebamipide, a gastroprotective agent, has anti-inflammatory properties and acts as an oxygen radical scavenger. The aim of this study was to investigate the in vivo effects of coadministration of rebamipide and celecoxib in an OA rat model. OA was induced by intra-articular injection of monosodium iodoacetate. Oral administration of rebamipide was initiated on the day of OA induction. In this study, rebamipide showed antinociceptive properties and attenuated cartilage degeneration. Rebamipide reduced the expression of matrix metalloproteinase 13, interleukin-1β, inducible nitric oxide synthase, and nitrotyrosine in OA cartilage. OA rats treated with celecoxib in combination with rebamipide demonstrated a higher pain threshold than those treated with monotherapy. Histological examination also showed that the joints from OA animals treated with combination therapy demonstrated less cartilage damage than those of animals treated with monotherapy. We showed that the potential benefit of combination therapy with celecoxib and rebamipide on pain and cartilage degeneration in OA.     

谈勇辨治恶阻临床经验

介绍谈勇教授治疗恶阻经验。认为主证为肝胃不和,可兼脾胃虚弱、痰湿阻滞;治疗时在相应方药基础上辅以中药熏蒸,效果良好。并附验案1则。     

Performance evaluation of serum IgG subclass quantification using a SPAPLUS turbidimetric analyzer and comparison with the BNII nephelometer

Abstract

IgG consists of four subclasses: IgG1, IgG2, IgG3, and IgG4. Changes in the serum concentration of each subclass reflect different clinical situations, and quantification of each subclass is important to assess patients’ clinical states. Herein, we evaluated the analytical performance of the SPAPLUS turbidimetric analyzer (The Binding Site, Birmingham, UK) for IgG subclass. Precision, linearity, comparison with the BNII system (Siemens Healthineers, Erlangen, Germany), and reference interval were assessed according to the Clinical and Laboratory Standards Institute (CLSI) guidelines. The repeatability and within-laboratory precision were within 5% for all IgG subclasses. The coefficient of determination (R²) was higher than 0.99 for the analytical measurement range in all IgG subclasses. Comparison between SPAPLUS and BNII revealed significant differences in IgG1, IgG3, and IgG4 (p?相似文献   

禁食时间对链脲佐菌素诱导1型糖尿病小鼠模型的影响

目的:研究不同禁食时间对多次小剂量注射链脲佐菌素(streptozotocin,STZ)诱导1型糖尿病模型的影响,探讨其最佳禁食时间。方法:将40只C57BL/6J小鼠随机分为4组:对照组(C组)、禁食4 h组(F4组)、禁食10 h组(F10组)和禁食16 h组(F16组),每组10只。禁食组小鼠按多次小剂量腹腔注射STZ的方法诱导1型糖尿病模型,C组注射等量的柠檬酸盐缓冲液。测定各组小鼠注射STZ前及注射后1、2、3、4周的血糖、体质量的变化,计算小鼠糖尿病模型的成功率。结果:注射STZ2周后,各禁食组小鼠体质量明显降低,与C组比较差异有统计学意义(P<0.05或P<0.01)。注射STZ2周时,各禁食组血糖水平均>11.1 mmol/L,与C组比较差异有统计学意义(P<0.01);随着禁食时间的延长,血糖水平逐渐升高,自第3周起,F10组与F4组的血糖水平差异有统计学意义(P<0.05),但与F16组比较差异无统计学意义(P>0.05)。此外,禁食10 h后注射STZ,模型成功率为90.0%,同时不引起明显的体质量下降。结论:采用多次小剂量注射STZ的方法诱导小鼠1型糖尿病模型时,每次注射STZ前最佳禁食时间为10 h。