不孕症肝郁病理的生殖内分泌实质研究

目的 :探讨肝郁的病理实质及其与下丘脑—垂体—性腺系统功能紊乱———排卵障碍之间的相关性。方法 :选择原发性不孕症患者 70例 ,正常已产妇女 19例作对照 ,以肝郁病理积分、性激素检测为指标。结果 :1.不孕症患者肝郁积分及肝郁分级均显著高于对照组 (P <0 .0 1)。 2 .月经周期第 10天 ,肝郁 3级E2 较 0级、2级显著降低 (P <0 .0 5 ) ;肝郁分级与性激素间无相关性 ;而PRL与E2 、P、P/E2 呈负相关 (P <0 .0 5～P <0 .0 1) ;PRL与LH、LH/FSH呈正相关 (P <0 .0 5 )。 3.月经周期第2 0天 ,肝郁 1级、3级LH较 0级显著降低 (P <0 .0 1) ;肝郁 3级P较 0级、2级显著增高 ;肝郁 3级PRL较 0级、2级显著升高(P <0 .0 5 ) ;肝郁分级与PRL呈正相关 (P <0 .0 5 ) ,PRL与LH/FSH呈正相关 (P <0 .0 5 )。结论 :“肝为生殖之枢” ,肝郁是不孕症的重要病理环节 ,肝郁———下丘脑—垂体—性腺系统功能紊乱———排卵障碍之间可能存在轴性相关     

移动学习平台在老年专科疾病理论知识培训中的应用

目的探索移动学习平台在老年科护士专科疾病理论知识培训中的应用效果。方法整群抽取老年科护士108名,按病房分为观察组58人和对照组50人。在专科疾病理论知识培训中,对照组采用传统集中理论授课教学法,观察组采用基于即刻学堂的移动学习平台进行教学。结果观察组护士专科理论考核成绩显著高于对照组(P0.01),对培训形式设置,获取知识的及时高效性,激发学习兴趣,促进知识掌握记忆,有效调动学习主动性,提高解决问题能力,培训时间安排合理性的满意度及继续参与培训的意愿显著高于对照组(均P0.01)。结论基于即刻学堂的移动学习平台打破了传统教学的时空束缚,改进了教与学的方式,促进了在职护士理论学习的积极性和效果提高,有利于在职护士掌握理论知识。     

Risk assessment of venous thromboembolism and bleeding in COVID‐19 patients

BackgroundThe coronavirus disease 2019 (COVID‐19) is a newly recognized illness that has spread rapidly all over the world. More and more reports highlight the risk of venous thromboembolism (VTE) in COVID‐19. Our study aims to identify in‐hospital VTE risk and bleeding risk in COVID‐19 patients.MethodsWe retrospectively studied 138 consecutively enrolled patients with COVID‐19 and identified in‐hospital VTE and bleeding risk by Padua Prediction Score and Improve bleed risk assessment model. The clinical data and features were analyzed in VTE patients.ResultsOur findings identified that 23 (16.7%) patients with COVID‐19 were at high risk for VTE according to Padua prediction score and 9 (6.5%) patients were at high risk of bleeding for VTE prophylaxis according to Improve prediction score. Fifteen critically ill patients faced double high risk from thrombosis (Padua score more than 4 points in all 15 [100%] patients) and hemorrhage (Improve score more than 7 points in 9 [60.0%] patients). Thrombotic events were identified in four patients (2.9%) of all COVID‐19 patients. All of them were diagnosed with deep vein thrombosis by ultrasound 3 to 18 days after admission. Three (75.0%) were critically ill patients, which means that the incidence of VTE among critically ill patients was 20%. One major hemorrhage happened in critically ill patients during VTE treatment.ConclusionCritically ill patients with COVID‐19 suffered both a high risk of thrombosis and bleeding risks. More effective VTE prevention strategies based on an individual assessment of bleeding risks were necessary for critically ill patients with COVID‐19.     

整体护理干预在肺结核合并糖尿病患者中的应用

目的探讨对肺结核合并糖尿病患者实施整体护理干预的效果。方法 90例肺结核合并糖尿病患者按数字随机表法分为观察组和对照组,每组45例。对照组给予常规护理,观察组在此基础上实施整体护理干预。比较两组肺结核和血糖控制情况,并评价满意度。结果观察组肺结核治愈率和血糖控制良好率均显著高于对照组,差异有统计学意义（P〈0.05）。观察组满意度为95.56%（43/45）,对照组为77.78%（35/45）,差异有统计学意义（P〈0.05）。结论整体护理干预能有效提高肺结核合并糖尿病的疗效及满意度,值得临床推广应用。     

CT引导下射频联合臭氧治疗腰椎间盘突出症日间手术的疗效

探讨螺旋CT引导下射频热凝联合臭氧消融治疗腰椎间盘突出症日间手术的临床疗效。方法 回顾性收集2020年1月—2022年6月我院日间病房住院的137例腰椎间盘突出症患者的临床资料,所有患者均行螺旋CT引导下射频联合臭氧消融治疗日间手术。收集手术时间,术毕至出院时间,总住院时间,术前、术后1月、3月的疼痛数字评分(NRS),Oswestry功能障碍指数(ODI)评分,改良 Macnab评级和手术相关并发症,并进行术前与术后的对比分析。结果 所有患者在螺旋CT引导下穿刺成功率为100%,并在手术当日出院,平均手术时间为（35.55±10.44）min,平均术毕至出院时间为（58.36±25.26） min,平均总住院时间为（453.91±27.18）min。术后1、3月的NRS评分和ODI评分均低于术前;术后1、3月改良Macnab疗效评定标准有效率分别为86.13%、89.05%。所有患者均未有穿刺或治疗相关的并发症。结论 螺旋CT引导下射频联合臭氧消融治疗腰椎间盘突出症日间手术是可行的,其可降低腰椎间盘突出症患者的疼痛程度、改善日常功能障碍、安全性高,可在临床推广应用     

Retrospective analysis of lauromacrogol injection endoscopic sclerotherapy in treatment of 153 cases of esophageal varices

目的 探讨国产硬化剂聚桂醇注射液经内镜治疗食管静脉曲张的疗效及并发症.方法 回顾性分析我院内镜中心2009年5月至2010年12月行内镜下行硬化治疗的64例患者共153例次的资料,其中男性46例,女性18例,年龄21～78(48.6±14.0)岁.观察急诊止血率、静脉曲张消失和基本消失率、并发症发生率及死亡率.结果 急诊止血率94.4％,静脉曲张消失和基本消失率80.0％,并发症发生率2.0％～23.5％,死亡率1.6％.门诊及电话随访时间1～17个月.结论 国产聚桂醇注射液治疗食管静脉曲张疗效好,并发症少,临床应用安全.     

Bartter综合征1例报道

患儿,男,1 0月,以饮食差、多饮、多尿、发育障碍2月加重1月入院。患儿出生后7月余出现多饮、多尿、食欲减退、发育落后。5月龄时会抬头,1 0月出牙,会翻身。患儿系第2胎,第2产,足月顺产。家族史:无身材矮小家族史,其姐4岁,身体健康。查体:身高6 2cm ,体重7kg ,血压70 /4 5mmHg ,     

Evaluation of plasma retinol-binding protein as a surrogate measure for plasma retinol concentrations

Fasting growth hormone (GH) levels and GH responses to exercise were studied in normally menstruating women and in women taking oral contraceptives in order to find out whether the GH levels were related to the menstrual cycle or changed by oral contraceptives. The GH response to exercise was found to be higher when exercise was done in the midcycle period than when it was done at other points of time during the normal menstrual cycle. Fasting GH levels were unchanged throughout the menstrual cycle. Fasting GH levels and GH responses to exercise performed outside the midcycle period were identical in normally menstruating women and in women taking oral contraceptives. In conclusion, the GH response to exercise, but not fasting GH levels, were related to the menstrual cycle. The estrogen and progestin components of the contraceptives used in this study were balanced in such a way that the growth hormone levels and growth hormone responses to exercise were not changed by long-term therapy with these drugs.