脑卒中后吞咽障碍患者“互联网+延续护理”实施障碍的质性研究

目的 了解脑卒中后吞咽障碍患者“互联网+延续护理”实施障碍因素,为针对性干预提供参考。方法 以理论域框架为指导制定访谈提纲,对25名医护技人员进行半结构式访谈,运用主题分析法分析资料、提炼主题（障碍因素）。结果 提炼出医护技人员缺乏劳动价值获得感、缺乏自我效能感,患者吞咽障碍康复行为欠佳等14个主题（障碍因素）,分别归属为社会/职业角色和身份,能力信念,记忆、注意力与决策过程,环境与资源以及社会影响5个理论域。结论 脑卒中后吞咽障碍患者“互联网+延续护理”实施的障碍因素较多,应针对障碍因素进行干预,创造有利条件为患者提供持续的高品质康复护理。     

脊柱侧凸患者的肺功能评价

对１０５例脊柱侧凸患者的肺功能进行检测和分析。结果表明，脊柱侧凸可引起限制型的肺通气功能障碍，肺功能减退与畸形的严重程度呈显著负相关；上胸段曲度对肺功能影响最大，下胸段曲度次之，腰段曲度影响甚微；侧凸类型对肺功能影响不明显。     

Correlation of oxygen free radical items between blood and kidney of chronic renal failure rat

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Protective effect of glutamine-enriched early enteral nutrition on intestinal mucosal barrier injury after liver transplantation in rats

Background

The effect of glutamine-enriched early enteral nutrition (Gln-EEN) on intestinal mucosal barrier injury after liver transplantation (LT) remains uncertain.

Methods

The Wistar-to-Wistar rat LT model was used to explore the protective effect of Gln-EEN. Morphologic changes of intestinal mucosa, levels of intestinal malondialdehyde and secretory immunoglobulin (sIgA), plasma endotoxin, D-lactic acid, serum tumor necrosis factor-α (TNF-α), rates of bacterial translocation, and expression of intestinal nuclear factor-κB, TNF-α, and intercellular adhesion molecule-1 were determined.

Results

After LT, intestinal mucosa was damaged seriously. At 12, 24, and 48 hours posttransplantation, levels of intestinal sIgA were decreased; levels of malondialdehyde, endotoxin, D-lactic acid, and TNF-α, the ratio of bacterial translocation, and the expression of intestinal nuclear factor-κB, TNF-α, and intercellular adhesion molecule-1 all were increased. However, changes in earlier-mentioned parameters in recipients treated with Gln-EEN were attenuated remarkably at 24 to 48 hours.

Conclusions

Our data show that Gln-EEN is a potent protectant against intestinal mucosal barrier injury after LT.     

Oral uracil‐tegafur plus leucovorin vs fluorouracil bolus plus leucovorin for advanced colorectal cancer: a meta‐analysis of five randomized controlled trials

Aim The aim of this study was to evaluate systematically the efficacy and safety of oral uracil‐tegafur (UFT) plus leucovorin (LV) compared with infusional fluorouracil (5‐FU) plus LV for advanced colorectal cancer. Method Eligible studies were identified from Medline, Embase and the Cochrane Library. The end‐points included overall survival and overall tumour response rate, and toxicity including leucopenia, febrile neutropenia, stomatitis/mucositis and diarrhoea. Results Five randomized controlled trials were identified. Pooled data demonstrated no difference in overall survival between the oral UFT plus LV regimen and the 5‐FU bolus plus LV regimen [hazard ratio 1.013; 95% confidence interval (CI) 0.911–1.127].The fixed‐effect pooled estimate for overall tumour response rate showed no significant difference between the two regimens (relative risk 0.893; 0.672–1.187). Grade 3–4 leucopenia [odds ratio (OR) 0.126; 955 CI 0.048–0.326], grade 1–4 leucopenia (OR 0.089; 95% CI 0.067–0.119) and grade1–4 febrile neutropenia (OR 0.020; 95% CI 0.004–0.102) were significantly less prominent in the oral UFT regimens. For nonhaematological toxicities, grade 3–4 stomatitis/mucositis (OR 0.075; 95% CI 0.039–0.146), grade 3–4 infection (OR 0.484; 95% CI 0.310–0.758), grade 1–4 infection (OR 0.672; 95% CI 0.547–0.826, P < 0.001), grade 1–4 diarrhoea (OR 0.743; 95% CI 0.626–0.881) were also less likely to happen in patients in the oral UFT plus LV regimen, while there was no significant difference between the two treatment regimens with respect to grade 1–4 stomatitis/mucositis (OR 0.278; 95% CI 0.053–1.456) and grade 3–4 (OR 1.174; 95% CI 0.983–1.403) diarrhoea. Conclusion Oral UFT or 5‐FU bolus combined with LV results in similar overall survival and tumour response rates for advanced colorectal cancer. The former treatment regimen is greatly superior in terms of toxicity, especially haematological toxicity.     

酶处理急性分离技术用于研究果蝇成虫中枢神经细胞钾电流

目的 建立急性分离果蝇成虫中枢神经细胞技术,并记录分析其钾电流。方法 取S、R或H品系果蝇成虫3—5只,分离出果蝇脑组织。胶原酶消化处理后,加入10％的胎牛血清果蝇培养基终止酶反应。巴氏吸管吹打,细胞悬液静置1h后用于电生理实验。全细胞电压钳记录并分析其外向钾电流。结果 酶消化法成功急性分离出果蝇成虫中枢神经细胞。85％以上为Ⅱ型神经细胞,少部分为Ⅰ型和Ⅲ型神经细胞。记录到快失活与持续复合型、慢失活型、快失活和持续型四种全细胞钾电流。结论 本技术可成功急性分离三品系果蝇成虫中枢神经细胞,并记录到四种钾电流。     

骨质疏松与类风湿关节炎

类风湿关节炎和骨质疏松在我国都属于常见病和多发病,而二者之间又有着非常重要的联系。但是目前临床上还没有一个广泛应用的药物可以同时对两者都产生很好的治疗效果。为了进一步了解骨质疏松和类风湿关节炎的关系,将来能够找到更好的治疗药物,笔者从流行病学、发病机制以及治疗方法等方面分别进行了论述。     

华南地区某眼科医院的感染性角膜炎病原菌谱特征

目的 探讨华南地区某眼科医院感染性角膜炎的病原菌谱及其特点。方法 回顾性系列病例研究。选择2013年7月1日至2017年12月31日在中山大学中山眼科中心进行角膜取材和微生物检测的角膜感染患者3 914例。表面麻醉后刮取病灶边缘的病灶组织,进行细菌、真菌培养及鉴定。培养结果阳性的细菌采用生化比色或质谱进行种属鉴定;真菌依据形态学进行种属鉴定。各季节菌谱阳性率差异比较采用卡方检验。结果 感染性角膜炎患者中,男2 468例（63.1%）,女1 446例（36.9%）,年龄（49.5±16.8）岁。病原菌培养阳性的患者共1 673例（42.7%）,其中单纯细菌749例（44.8%）,单纯真菌849例（50.7%）,混合感染75例（4.5%）。最常见的细菌是葡萄球菌属（20.1%）,其次是假单胞菌属（7.5%）;最常见的真菌是镰刀菌属（25.5%）,其次是曲霉菌属（10.3%）。细菌的阳性率在5-8月明显高于1-2月和9-12月（P<0.05）,真菌的阳性率在5-6月明显低于1-2月和9-12月（P<0.05）。结论 在华南地区一所三甲眼科医院的感染性角膜炎中,真菌感染略高于细菌感染,且细菌和真菌感染存在季节性差异。