集体心理干预在烧伤患者中的应用

目的 探讨介入术后压迫止血的有效方法。控制局部并发症发生。方法 将行介入治疗的患者452例随机分为对照组（196例）和观察组（256例），对照组介入术后用高弹性胶布压迫止血，观察组用自制鱼形沙袋压迫止血。观察两组止血效果压并发症发生率。结果 观察组无局部出血及并发症发生；对照组局部发生出血16例（8．16％）．皮肤过敏反应128例（65．31％）、水泡50例（25．51％）。两组比较，差异有显著性意义（均P〈0．01）。结论 介入术后患者采用自制鱼彤沙袋压迫止血．止血效果显著，且能有效控制局部并发症的发生。     

介入术后鱼形沙袋压迫止血的效果观察

目的探讨介入术后压迫止血的有效方法,控制局部并发症发生.方法将行介入治疗的患者452例随机分为对照组(196例)和观察组(256例),对照组介入术后用高弹性胶布压迫止血,观察组用自制鱼形沙袋压迫止血.观察两组止血效果及并发症发生率.结果观察组无局部出血及并发症发生;对照组局部发生出血16例(8.16%),皮肤过敏反应128例(65.31%)、水泡50例(25.51%).两组比较,差异有显著性意义(均P＜0.01).结论介入术后患者采用自制鱼形沙袋压迫止血,止血效果显著,且能有效控制局部并发症的发生.     

高纯度二氧化氯水溶液

二氧化氯纯水溶液,可以直接应用于杀菌消毒等多方面,有着实际应用前景.但有关它的制备工艺,目前国内尚未见报道,文章提供的方法是通过二氧化氯非水溶液来制备.     

Preparation of ionic-crosslinked chitosan-based gel beads and effect of reaction conditions on drug release behaviors

Drug-loaded chitosan (CS) beads were prepared under simple and mild condition using trisodium citrate as ionic crosslinker. The beads were further coated with poly(methacrylic acid) (PMAA) by dipping the beads in PMAA aqueous solution. The surface and cross-section morphology of these beads were observed by scanning electron microscopy and the observation showed that the coating beads had core-shell structure. In vitro release of model drug from these beads obtained under different reaction conditions was investigated in buffer medium (pH 1.8). The results showed that the rapid drug release was restrained by PMAA coating and the optimum conditions for preparing CS-based drug-loaded beads were decided through the effect of reaction conditions on the drug release behaviors. In addition, the drug release mechanism of CS-based drug-loaded beads was analyzed by Peppa's potential equation. According to this study, the ionic-crosslinked CS beads coated by PMAA could serve as suitable candidate for drug site-specific carrier in stomach.     

Wheat anaphylaxis in children

Food anaphylaxis is now the leading known cause of anaphylactic reactions treated in emergency departments, and wheat is one of the most common causes of anaphylaxis. Wheat is an important source of food worldwide. Wheat anaphylaxis is increasingly observed in our clinic. The purpose of this study was to describe the clinical features of wheat-induced anaphylaxis in 19 children for better elucidation of this disease. Children with severe reactions after ingestion of small amounts of wheat were referred to our clinic during a 4-year period. A detailed clinical history was recorded for each of the patients and a skin prick test was performed with wheat allergen extracts. The wheat-specific IgE and total IgE were measured. Grading of anaphylaxis episodes was performed according to a specific grading system. We identified 36 episodes of wheat anaphylaxis in 19 patients. All of the first attacks of wheat anaphylaxis occurred in the first-time ingestion. The most frequent manifestations of the reactions were skin and respiratory symptoms. In this study 78.9% of reactions were moderate and 21.1% of them were severe. All of our patients had positive skin prick tests to wheat. Mean total IgE level was 853.4 ± 455.27 IU/ml, and mean wheat-specific IgE was 70 ± 14.61 Ucs/ml. We conclude that wheat-induced anaphylaxis is a disease that is sufficiently severe, and. prevention of first wheat-induced anaphylaxis episodes is almost impossible. It would, however, probably be good practice to educate physicians to recognize the common clinical manifestations of this disease for early management.     

肾内小动脉和脐动脉血流量变化与高危妊娠结局

用彩超对６３例妊娠和１２例非妊娠妇女肾内小动脉（Ｉｎｒａ）和脐动脉（Ｕａ）内径、平均血流速度，分别进行检测，并计算出它们的血流量（ＢＦＶ）。结果：（１）孕妇Ｉｎｒａ内径和ＢＦＶ较非孕妇内径宽、血流量多；正常妊娠组内径和ＢＦＶ较妊高征组内径宽、血流量多；妊高征组ＢＦＶ与尿蛋白量呈负相关；（２）Ｕａ内径和ＢＦＶ，在正常妊娠组和妊高征组，分别呈正相关；在重度妊高征时，新生儿出生体重与ＢＦＶｕａ呈正相关；（３）ＢＦＶｉｎｒａ／ＢＦＶｕａ值，在重度妊高征该值上升。说明用彩超检测ＢＦＶｉｎｒａ和ＢＦＶｕａ及它们间比值变化，对高危妊娠预后及预测围产儿结局有一定价值。     

血管内皮细胞生长因子在妊高征胎盘中的变化

目的 :观察血管内皮细胞生长因子 (VEGF)及其mRNA在妊高征胎盘中的表达变化。方法 :用免疫组化和原位杂交技术检测了正常妊娠胎盘 (对照组 ) 2 0例、妊高征胎盘 2 4例及 8例早孕绒毛组织中VEGF分布。结果 :VEGF在对照组和妊高征胎盘中分布基本一致 ,分布于绒毛滋养叶细胞、绒毛血管及间质细胞。在妊高征胎盘中VEGF表达强度明显低于对照组 (P<0 .0 1) ,VEGF蛋白与mRNA在胎盘中的分布基本一致 ,VEGF在早孕绒毛中主要分布于滋养叶细胞。结论 :妊高征胎盘中VEGF水平的降低可能与胎盘滋养叶细胞侵入异常、胎盘血管形成异常有关 ,与妊高征发病有关。     

Incidence of Adenovirus Infection in Hematopoietic Stem Cell Transplantation Recipients: Findings from the AdVance Study

Adenovirus (AdV) is an increasingly recognized threat to recipients of allogeneic hematopoietic stem cell transplantation (allo-HCT), particularly when infection is prolonged and unresolved. AdVance is the first multinational, multicenter study to evaluate the incidence of AdV infection in both pediatric and adult allo-HCT recipients across European transplantation centers. Medical records for patients undergoing first allo-HCT between January 2013 and September 2015 at 50 participating centers were reviewed. The cumulative incidence of AdV infection (in any sample using any assay) during the 6 months after allo-HCT was 32% (95% confidence interval [CI], 30.9% to 33.4%) among pediatric allo-HCT recipients (n?=?1736) and 6% (95% CI, 4.7% to 6.4%) among adult allo-HCT recipients (n?=?2540). The incidence of AdV viremia ≥1000copies/mL (a common threshold for initiation of preemptive treatment) was 14% (95% CI, 13.0% to 14.8%) in pediatric recipients and 1.5% (95% CI, 1.1% to 2.0%) in adult recipients. Baseline risk factors for developing AdV viremia ≥1000copies/mL included younger age, use of T cell depletion, and donor type other than matched related. Baseline demographic factors were broadly comparable across patients of all ages and identified by multivariate analyses. Notably, the incidence of AdV infection decreased stepwise with increasing age; younger adults (age 18 to 34 years) had a similar incidence as older pediatric patients (<18 years). This study provides a contemporary multicenter understanding of the incidence and risk factors for AdV infection following allo-HCT. Our findings may help optimize infection screening and intervention criteria, particularly for younger at-risk adults.     

Methylnaltrexone bromide for the treatment of opioid-induced constipation

Introduction: The extensive and alarming use of opioids for pain management in patients with chronic pain receiving palliative care is associated with non-tolerable gastrointestinal (GI) adverse effects. Opioid-induced constipation (OIC) is the most common adverse effect impairing patient quality of life (QOL). In addition, OIC is one of the treatment limiting consequences of opioid analgesics. Management of OIC is becoming a challenge since traditional laxatives have limited efficiency. Peripherally acting mu-opioid receptor antagonists (PAMORA) have been developed for the treatment of OIC with methylnaltrexone bromide being the first approved to treat OIC in adults with advanced illness undergoing palliative care.

Areas covered: The authors systematically review the clinical evidence for methylnaltrexone bromide including a review of the pharmacokinetic and pharmacodynamic data along with clinical effectiveness and cost-effectiveness. Though there is a need for further long-term clinical investigation, there is a large body of evidence for both its efficacy and safety in the treatment of OIC.

Expert opinion: Methylnaltrexone has both subcutaneous injection and oral dosage forms available in the market. The lack of more evidence in specific populations such as pregnant women, pediatrics and elderly still remains. The global consumption of methylnaltrexone shows a projection of increased use since its approval worldwide in 2008.     

系统性出院指导对冠状动脉支架置入术后患者院外服药依从性的影响

目的探讨不同方式的出院指导对冠状动脉支架置入术后患者院外服药依从性的影响。方法将2010年5月至2011年4月在该院老年病科行冠状动脉支架置入术后患者220例分为2组,实验组113例,对照组107例。对实验组的患者进行针对性、系统性的出院指导,对照组予以传统的常规指导。分别对两组患者进行随访调查,观察两组患者在院外服药的依从性。结果实验组药物治疗依从率为73.45%,对照组为44.86%,两组比较差异有统计学意义(χ2=18.65,P<0.01)。结论针对性、系统性的出院指导可明显提高冠状动脉支架置入术后患者院外服药的依从性,减少术后并发症,从而提高药物治疗的效果,提升患者对护理服务的满意度。