自制中药包加压理疗裤在预防和控制腹腔镜疝修补后并发症的临床研究

目的分析自制中药包加压理疗裤在腹腔镜腹股沟疝修补术后并发症的防治效果。 方法收集2019年8月至2021年8月山西省中医药研究院普外科收治的腹股沟疝患者128例,按照随机数字表法,随机分为对照组和试验组,每组患者64例。2组患者均接受腹腔镜腹股沟疝修补术。对照组术后于腹股沟区沙袋加压并穿戴传统疝气带。试验组术后穿戴我科自制中药包加压理疗裤。对比2组临床指标及并发症发生情况。 结果试验组术后疼痛视觉模拟评分较对照组低,住院时间较对照组短,PZB服务质量量表评分较对照组高（P<0.05）。术后24 h及7 d,试验组血肿及血清肿发生率、阴囊肿胀及阴囊血肿发生率低于对照组（P<0.05）。术后30 d,2组血肿及血清肿发生率、阴囊肿胀及阴囊血肿发生率差异无统计学意义（P>0.05）。 结论腹腔镜腹股沟修补术后穿戴中药包加压理疗裤可减轻疼痛程度,降低血肿、血清肿及阴囊肿胀等术后并发症发生率,缩短住院时间,提高干预满意度。     

Modified stool color card with digital images was efficient and feasible for early detection of biliary atresia—a pilot study in Beijing,China

Background

The aim of this pilot study in Beijing, China, was to validate a screening system for early detection of biliary atresia (BA) by using a modified version of the stool color card (SCC).

Methods

From 2013 to 2014, a total of 29 799 live born infants were screened. SCC was distributed in maternal facilities. Guardians were asked to check their infants’ stool colors daily using SCC up until four months after birth. The screening results among 92.5% of participants were reported. Cases deemed as high risk were referred to a surgical department immediately.

Results

Based on the results reported by the guardians, 24 infants showed pale-pigmented stools, of which two males without obvious signs of jaundice were diagnosed with BA at 52 and 55 days of age, respectively. The sensitivity was 100% and specificity was 99.9%. Four infants were confirmed as having other diseases. Two female patients failed to be screened by the SCC because they had severe jaundice and were referred to the Neonatal Intensive Care Unit after birth. They were diagnosed as BA at 14 and 17 days after birth, respectively. The overall prevalence of BA in this study was 1.3 in 10 000 live births.

Conclusion

The modified SCC was effective and feasible for early detection of BA, especially for patients with no apparent jaundice.

     

北京市城乡老年人慢性病状况及相关因素分析

目的 了解北京市城乡老年人慢性病患病状况,分析其影响因素,关注老年人躯体健康,加强慢性病防控.方法 抽样调查北京城乡60岁及以上老年人群2168例,内容包括老年人的一般情况、慢性病史、家庭、经济、职业、卫生习惯等,进行评估和分析.结果 老年人慢性病患病率高达74.2％,同时合并2种及以上慢性病者达43.5％.患病率城市高于农村,女性高于男性,随增龄有先上升再下降趋势.高血压位于慢性疾病之首,脑血管病、冠心病以及耳聋和骨关节疾病均为老年人常见慢性病.老年人躯体健康状况受性别、年龄、居住地区、文化程度、职业性质、睡眠与活动锻炼时间、收入水平等多种因素的影响.结论 北京城乡老年人慢性病患病率高,多系统疾病并存率高.需加强慢性病防控健康宣教,增强社会支持,改善社区卫生服务建设.     

老年人生活自理能力与健康自评的相关性研究

目的了解北京市老年人生活自理能力状况及其与健康自评之间的相关关系。方法采取分层整群抽样方法,抽取来自北京市城区和农村的2 411名60岁及以上的老年人进行问卷调查。问卷包括人口学资料、家庭与经济状况、卫生行为、躯体健康及生活活动能力等多个维度的内容。结果在接受健康自评调查的2 335名老年人中,分别有6.38%和40.21%的人认为自己的健康状况为"很好"或"好",17.26%和2.01%的老年人认为自己的健康状况为"差"或"很差"。农村老年人在日常活动中的非完全自理比例均明显高于城区老年人。女性老年人"洗澡"、"自己乘车"、"上街购物"、"走半里路"、"剪脚趾甲"和"上下一层楼"等项目的非完全自理比例明显高于男性老年人。Logistic回归分析结果显示老年人的生活自理能力与健康状态之间存在明显的相关关系,生活非完全自理的老年人的健康自评结果明显较自理老年人差。在各因素中,进食(OR=7.51,95%CI:3.55~15.89)和室内活动(OR=7.36,95%CI:4.29~12.64)是与健康自评有关的、主要的、独立的影响因素。结论生活自理能力是老年人的自评健康状态的重要影响因素。     

Metabolism studies on hydroxygenkwanin and genkwanin in human liver microsomes by UHPLC-Q-TOF-MS

Hydroxygenkwanin (HYGN) and genkwanin (GN) are major constituents of Genkwa Flos for the treatment of edema, ascites, cough, asthma and cancer. This is a report about the investigation of the metabolic fate of HYGN and GN in human liver microsomes and the recombinant UDP-glucuronosyltransferase (UGT) enzymes by using ultra-performance liquid chromatography quadrupole time-of-flight mass spectrometry (UHPLC-Q-TOF-MS). An on-line data acquisition method multiple mass defect filter (MMDF) combined with dynamic background subtraction (DBS) was developed to trace all probable metabolites. Based on this analytical strategy, three phase I metabolites and seven glucuronide conjugation metabolites of HYGN, seven phase I metabolites and 12 glucuronide conjugation metabolites of GN were identified in the incubation samples of human liver microsomes. The results indicated that demethylation, hydroxylation and o-glucuronidation were main metabolic pathways of HYGN and GN. The specific UGT enzymes responsible for HYGN and GN glucuronidation metabolites were identified using recombinant UGT enzymes. The results indicated that UGT1A1, UGT1A3, UGT1A9, UGT1A10 and UGT2B7 might play major roles in the glucuronidation reactions. Overall, this study may be useful for the investigation of metabolic mechanism of HYGN and GN, and it can provide reference and evidence for further experiments.     

部分脱乙酰甲壳质生物套管小间隙桥接修复周围神经损伤:免疫组织化学观察

目的:神经断端保留小间隙的静脉桥接模拟神经外膜形成神经再生室,为周围神经再生创造了良好的生理环境,从而保证神经束的良好对合。实验采用部分脱乙酰甲壳质作为套管材料,用小间隙桥接方法修复坐骨神经损伤,观察套管内的神经再生情况,并与传统外膜缝合法进行比较。方法:实验于2001-01/2002-10在北京大学人民医院创伤骨科实验室完成。①主要材料:实验所用中空圆柱形套管为北京大学人民医院与中国纺织科学院共同发明的一种部分脱乙酰甲壳质生物套管(专利号:01136314.2)。实验中所用套管尺寸为:管长4 mm,壁厚0.1 mm,内径1.5 mm。②实验动物:健康成年雄性SD大鼠20只,随机分成2大组,每组10只,每一大组全部10只动物的左腿坐骨神经为一组,右腿坐骨神经为另一组,每组10根坐骨神经。另取5只同样大鼠双侧坐骨神经未做处理作为正常对照组。③实验方法:外膜原位缝合组:切断坐骨神经,显微镜下神经外膜原位缝合;生物套管小间隙原位桥接组:切断坐骨神经,显微镜下小间隙套管桥接;断端旋转180°外膜缝合组:切断坐骨神经,显微镜下远端旋转180°后,神经外膜缝合;断端旋转180°生物套管小间隙桥接组:切断坐骨神经,显微镜下远端旋转180°后,小间隙套管桥接。④实验评估:术后第7,14,21,28,42天取坐骨神经,进行免疫组织化学染色及观察。结果:再生神经延套管中央走行,7 d时已有部分纤维通过2 mm间隙,14 d时有髓纤维数量明显多于近端。21 d后,套管组与原位外膜组新生有髓神经纤维数相近。再生纤维胞核数量较多,髓鞘纤细。套管结构完整。结论:此种部分脱乙酰甲壳质生物套管内的再生神经连续、整齐,髓鞘完整,其神经再生情况好于传统外膜缝合法。     

腹腔镜膀胱根治性切除术围手术期并发症分析

目的探讨腹腔镜下膀胱根治性切除术围手术期并发症发生情况。方法统计本院2016年12月至2018年12月104例膀胱癌患者行腹腔镜下根治性膀胱切除术(LRC)围手术期的并发症以及手术时间、术中出血量、术后住院时间等情况。围手术期并发症定义为手术30 d内发生的并发症。结果平均手术时间327 min,平均出血量478 mL,接受输血者16例(15.4%),平均输血量415 mL。术后平均住院时间17.9 d。尿流改道方式上,Bricker回肠膀胱术68例,输尿管皮肤造口术36例。围手术期并发症发生率47.1%(49例),包括肠梗阻、尿路感染、肺炎、下肢静脉血栓、肺栓塞等。结论腹腔镜下膀胱根治性切除术仍有较高的并发症发生率,常见并发症为肠梗阻,尿路感染等,术前应积极治疗基础疾病,术中严格操作,术后采取相应预防措施以防止出现严重并发症。并根据患者情况选择合适的手术方案。     

Peritoneal transport rate,systemic inflammation,and residual renal function determine peritoneal protein clearance in continuous ambulatory peritoneal dialysis patients

Background

Peritoneal protein clearance (Pcl) is related to the mortality of patients on continuous ambulatory peritoneal dialysis (CAPD) as well as technique failure. In this prospective observational study, we aimed to investigate factors associated with the level of Pcl.

Methods

We prospectively enrolled 344 prevalent CAPD patients. A standard peritoneal equilibrium test was conducted for each patient. Baseline demographics, biochemistry, and Pcl were recorded.

Results

The average Pcl of the patients was 97.40 ± 54.14 mL/day. Peritoneal transport level, serum high-sensitivity C-reactive protein (hsCRP), and residual glomerular filtration rate (rGFR) were independently related to Pcl. The standard β values were 0.53, 0.17, and ?0.10, respectively. Moreover, compared with non-diabetic patients, diabetic patients had a non-significantly higher level of Pcl (104.90 ± 48.65 vs. 96.15 ± 54.97 mL/day; P = 0.06).

Conclusion

Continuous ambulatory peritoneal dialysis patients lose a high amount of protein through the peritoneum each day. The Pcl value is positively related to the level of peritoneal transport and hsCRP and negatively related to the rGFR.