生半夏毒性评估及其在风湿病中的应用

因对生半夏毒性古今认识不统一,会影响其在临床中的使用。作者使用有毒中药分级衡量标准对其进行毒性分级评估,证实其含有毒性成分,通过炮制、配伍、用法等方法可对其进行减毒,并提出限制使用情况,提倡传统煎服以减少不良反应的发生。生半夏在治疗类风湿关节炎(Rheumatoid arthritis,RA)、痛风(Gout)、反应性关节炎(Reactivearthritis,ReA)、结节性红斑(Erythema nodosum,EN)、膝骨性关节炎(Osteoarthritis,OA)等疑难病时,只要符合痰证的病因病机,往往疗效显著。     

微生物发酵生产谷氨酰胺转氨酶的研究进展

谷氨酰胺转氨酶（TG）是一种催化酰基转移反应的转移酶,它可使蛋白分子间和分子内产生共价交联,从而改变蛋白的功能特性,在食品工业具有重要的潜在应用价值。为了实现工业化生产TG目的,文中综述了近年来国内外在谷氨酰胺转氨酶菌株的选育、发酵条件的优化和分离提纯等方面的进展情况。     

鼻肠管与鼻胃管喂养在预防有创通气患者中并发呼吸机相关性肺炎的临床观察

目的研究鼻肠管与鼻胃管喂养对有创通气患者中呼吸机相关肺炎（VAP）发生率的影响。方法将进行创通气的40例患者随机分成鼻肠管喂养组和鼻胃管喂养组,观察喂养期间VAP的发生情况。结果鼻肠管喂养组VAP发生率为30%,鼻胃管喂养组为75%,两组比较差异有统计学意义（P〈0.01）。结论鼻肠管喂养有利于减少有创通气患者中VAP的发生。     

先天性纠正型大动脉错位不同手术方法结果的比较

目的 比较先天性纠正型大动脉错位(ccTGA)的各种手术治疗结果方法,为临床治疗ccTGA提出更合理的手术方式.方法 1999年6月至2009年12月外科手术治疗95例ccTGA,包括传统纠治手术25例,功能性单心室纠治手术26例,双调转术(Double Switch)手术26例,姑息手术15例,另有3例接受其他手术.结果 术后死亡7例,其中传统手术组死亡2例,Double Switch手术组死亡4例,其他手术组死亡1例,单心室手术组全部存活.结论 纠正型大动脉错位的手术方法的选择取决于解剖条件和生理参数.在各类手术结果的比较中,功能性单心室纠治手术的死亡率低、并发症少、再手术率低,可适当放宽功能性单心室纠治手术指征,可能得到更好的治疗效果.但长期的手术疗效还有待于进一步随访.

Abstract：

Objective To study the clinical outcomes of various corrective surgeries for congenitally corrected transposition of the great arteries (ccTGA) in children. Methods Between June 1999 and December 2009, 95 patients with ccTGA who underwent corrective surgeries at this center were enrolled in this study. Among the 95 patients, 25 patients were performed conventional surgical repairs, 26 had functionally univentricular surgical repair, 26 had double switch operation, 15 had palliative surgeries, and 3 underwent other surgical treatments. Results Seven deaths after surgery were recorded, including 2 patients who had conventional surgical repairs, 4 with double switch operation and 1 with other surgical treatments. No death of the patients who underwent functionally univentricular surgical repair was noted. Conclusions The surgical strategy to correct ccTGA should be made according to patient's individual anatomic anomalies and pathophysiology. Short term outcome study revealed that functionally univentricular surgical repair is safe and effective.     

标准化护理程序在重症监护室心衰患者病情观察中的应用研究

目的探讨标准化护理程序在重症监护室心衰患者病情观察中的应用效果。方法选取2016年1月到2017年12月期间在我院重症监护室住院治疗的心力衰竭患者120例作为研究研究对象,以对照实验要求为依据,随机将其分为观察组和对照组,每组均设置60例研究对象。对照组患者实施常规护理程序,观察组患者实施标准化护理程序。结果两组患者护理前的舒张压、收缩压水平和心率水平均相当,组间比较差异不存在统计学意义(P0.05);两组患者护理后的舒张压、收缩压水平和心率水平,均较护理前有显著降低,但观察组患者的降低幅度显著大于对照组患者,组间比较差异存在统计学意义(P0.05)。观察组患者的致残率、致死率,均明显低于对照组患者,组间比较差异存在统计学意义(P0.05)。观察组患者的急救反应时间、院内反应时间,均明显短于对照组患者,组间比较差异存在统计学意义(P0.05)。结论标准化护理程序的实施能够有效提高重症监护室心衰患者的病情观察质量,利于保证患者生命体征平稳,从而显著降低患者的致残、致死率,提高患者的急救效果。     

平衡膳食能达到减重目的吗?

<正>近年来,我国社会经济快速发展,居民的膳食结构和生活方式发生了重要变化。我国最新的肥胖和代谢综合征(MS)调查结果显示,我国成人超重和肥胖的患病率男性分别为33.7%和13.7%,女性分别为29.2%和10.7%[1]。超重和肥胖人数的剧增,导致营养相关的慢性非传染性疾病患病率明显增加,给社会和个人及其家庭带来沉重的经济负担。正因如此,"平衡膳食"这个概念也逐渐被人们重视起来。在最新版《中国居民膳食指南(2007)》一书中对     

“糖友”必读——微量营养素

糖尿病素有“最苦富贵病”一说。为了维持血糖稳定,糖尿病患者不敢大怏朵颐,有时候甚至还不敢吃饱。美味的水果富含维生素,却因为含糖量较高而成为糖尿病患者的限制级食物。适当忌口和适量补充微量元素,究竟如何权衡。     

Protective effect of metoprolol on the development of alcoholic cardiomyopathy in rats

Background Alcoholic cardiomyopathy(ACM)is a chronic cardiomyopathy characterized by dilation and impaired contraction of one or both ventricles with normal or reduced ventricular wall thickness. For the past few years,many studies have shown that metoprolol can improve cardiac function in patients with ACM. However,the effect of metoprolol on cardiac structure and function in patients with ACM remains unclear. Methods A total of 45 Wistar rats were randomly divided into three groups:drug group(n=14),alcohol group(n=15)and control group(n=16). Rats in drug group and alcohol group were received 10% ethanol drinking and gavaged with 60% ethanol to induce ACM. Oral administration of metoprolol was applied in drug group,while the alcohol group received a placebo. The control group was received water and gavaged with normal saline. Left ventricular end-diastolic dimension(LVEDd),left ventricular ejection fraction(LVEF),fractional shortening(FS)were measured by ultrasound in the fourth month after randomization. And then,the myocardial tissues were analyzed. Results The myocardial histopathology of the alcohol group was consistent with the pathologic changes of ACM,which proved model success. Compared with control group,the LVEDd values were significantly higher in drug and alcohol groups(P0.05),while the LVEF and FS values in drug group and alcohol group were significantly lower. Furthermore,the values of LVEDd were higher in alcohol group,while LVEF and FS were significantly lower than those in drug group. Conclusions Metoprolol alleviates the pathophysiological changes of alcoholic cardiomyopathy.[S Chin J Cardiol 2019;20(2):117-120]     

卢德维氏咽峡炎的护理

卢德维氏咽峡炎的护理福建省晋江市医院蔡晶晶卢德维氏咽峡炎是口底。颌下和颈部的一种弥漫性炎症，亦是颌面部最严重的感染之一，可以是化脓性，也可以是腐败坏死性的，后者病情发展迅猛，如不及时处埋，可因舌根水肿压迫会厌或因炎症漫延至颈前而压迫气管，出现呼吸困难...     

肿瘤坏死因子-α和白介素-1β对小鼠腹主动脉炎症反应及内皮P-选择素表达的影响

目的:探讨肿瘤坏死因子-α(TNF-α)和(或)白介素-1β(IL-1β)作用后小鼠腹主动脉的炎症反应及内皮P-选择素的表达.方法:32只小鼠随机平均分为3个实验组(1L-1β组、TNF-α组、TNF-α+IL-1β组)和1个对照组,实验组在小鼠腹主动脉周围无菌注射炎性因子TNF-α和(或)IL-1β(对照组用PBS),4 h后取出腹主动脉行HE染色和内皮P-选择素免疫组化染色,定量分析动脉病理形态学的改变和半定量分析内皮P-选择素表达强度.结果:对照组动脉未见明显的病理改变及内皮P-选择素表达,3个实验组的动脉组织则发生不同程度的急性炎症改变,并以TNF-α+IL-1β组为甚,该组动脉发生的病理改变程度和内皮P-选择素表达的强度与范围明显大于IL-1β组和TNF-α组(P<0.05).结论:联合应用TNF-α和IL-1β诱导的大动脉内皮的炎性病变稳定可靠,可用于急性冠状动脉综合症和相关大动脉内皮炎性病变早期的研究.