膀胱灌注RTX治疗间质性膀胱炎的临床研究

目的:探讨膀胱灌注辣椒辣素类似物(resiniferatoxin,RTX)治疗间质性膀胱炎(interstitial cystitis,IC)的有效性和安全性.方法:56例间质性膀胱炎患者行RTX一次性膀胱灌注治疗.观察用药前及用药后1周、1个月、3个月时患者的临床症状情况(每日排尿次数、最大排尿容量、尿痛程度评分)和O'Leary-Sant问质性膀胱炎问卷表评分及生活质量评分(QOL)情况.并记录不良反应发生情况.结果:①患者用药后1周、1个月、3个月时每日排尿次数明显减少(用药前vs用药后1 W、1 M和3 M的每日排尿次数:28.41±10.77 vs 15.30±4.77、15.63±3.70和17.19±4.06),最大排尿容量增加[用药前vs用药后1 W、1 M和3 M的最大排尿容量为:124.26±79.31 vs 187.41±67.46、188.89±62.35和161.85±65.11(ml)],疼痛程度评分明显下降(用药前vs用药后1 W、1 M和3 M的疼痛程度评分为:6.74±1.38 vs 3.89±1.15、4.63±1.31和4.85±1.67),与用药前相比,差异具有统计学意义.②患者用药后1周、1个月、3个月时O'Leary-Sant评分和生活质量评分与用药前相比(O'Leary-Sant评分:用药前vs用药后1 W,1 M,3 M为27.93±4.03 vs 28.04±6.69,27.44±3.89,27.96±4.13;生活质量评分:用药前vs用药后1 W、1 M、3 M为5.52±0.51 vs 5.30±0.47、5.33±0.56、5.44±0.51),比较差异无统计学意义.③所有患者均坚持完成试验,无一例退出.使用RTX后患者生命体征均平稳,其中20例有轻度或中度膀胱或尿道刺激症状,可以耐受,1～3天后均自行消失,无全身不良反应.结论:用RTX膀胱灌注治疗能有效缓解间质性膀胱炎的临床症状和改善其生活质量,且耐受性及安全性好.     

血清趋化因子CXC配体13及趋化因子CXC受体5与老年进展期胃癌患者淋巴结转移的相关性

目的 观察老年进展期胃癌患者血清趋化因子CXC配体(CXCchemokine ligand,CXCL)13、趋化因子CXC受体(CXC chemokine receptor,CXCR)5水平变化,探讨CXCL13、CXCR5与老年进展期胃癌患者淋巴结转移的关系.方法 老年进展期胃癌患者89例为进展期胃癌组,其中发生淋巴...     

红细胞容积分布宽度与肾移植术后ARDS患者病死率的相关性分析

目的  探讨红细胞容积分布宽度（RDW）与肾移植术后急性呼吸窘迫综合征（ARDS）患者病死率的相关性。方法  回顾性分析106例肾移植术后ARDS患者的临床资料, 根据RDW的高低分为RDW正常组（≤15.0%, 68例）和RDW升高组（ > 15.0%, 38例）。比较两组患者的基本情况和不良事件发生情况, 绘制Kaplan-Meier曲线比较两组的50 d病死率, 采用Cox比例风险回归分析ARDS患者死亡的风险因素。结果  106例患者中, 50 d内死亡总例数为46例（43.4%）。两组在序贯器官衰竭评估（SOFA）评分、血清肌酐、血红蛋白及血小板计数的差异有统计学意义（均为P < 0.05）。RDW升高组患者的50 d病死率及感染性休克发生率明显高于RDW正常组, 差异均有统计学意义（均为P < 0.05）, Kaplan-Meier生存曲线分析表明, RDW升高组与正常组患者的50 d病死率差异有统计学意义（P < 0.01）。Cox比例风险回归法单因素分析发现, 血红蛋白 < 100 g/L、血清肌酐 > 133 μmol/L、血小板计数 < 100×10⁹/L、重度ARDS、RDW > 15.0%均为ARDS患者50 d内死亡的潜在危险因素（均为P < 0.05）。多因素分析发现, 重度ARDS[比值比（OR）=12.77, 95%可信区间（CI）11.63~15.39, P < 0.001]和RDW > 15.0%（OR=2.01, 95%CI 1.02~3.94, P < 0.043）为ARDS患者50 d内死亡的独立危险因素。结论  RDW升高与肾移植术后ARDS患者疾病严重程度和50 d病死率相关, 可以作为一项较有意义的预测肾移植术后ARDS患者预后的临床指标。     

乙型肝炎肝硬化并发食管胃底静脉曲张破裂出血患者临床特征及影响因素分析

目的 探讨乙型肝炎肝硬化并发食管胃底静脉曲张破裂出血患者的临床特征及其影响因素.方法 2015年6月～2020年6月我院收治的乙型肝炎肝硬化并发食管胃底静脉曲张破裂出血患者90例和同期乙型肝炎肝硬化未出血患者90例,收集患者临床资料,分析乙型肝炎肝硬化并发食管胃底静脉曲张破裂出血患者的临床特征,并采用多因素Logist...     

Pre and postoperative nurse-guided incentive spirometry versus physiotherapist-guided pre and postoperative breathing exercises in patients undergoing cardiac surgery: An evaluation of postoperative complications and length of hospital stay

Atelectasis is the most occurring postoperative complication after cardiac surgeries. Postoperative respiratory exercises and incentive spirometry led to decrease in postoperative complications, especially atelectasis and hospital stay. The objectives of the study were to evaluate postoperative complications and length of hospital stay of patients who received pre and postoperative nurse-guided incentive spirometry against those of patients who received pre and postoperative breathing exercises by the physiotherapist in patients who underwent cardiac surgery. Data of patients who received 2 days preoperative and 2 days postoperative nurse-guided incentive spirometry with a spirometer (PPN cohort, n = 102) or received 2 days preoperative and 2 days postoperative breathing exercises by physiotherapist without spirometer (PPP cohort, n = 105), or 2 days postoperative physiotherapist-guided breathing exercises only without spirometer (PPB cohort, n = 114) were collected and analyzed. The acute or chronic collapse of part or entire lung was defined as atelectasis. The length of stay in the hospital was from the day of admission to discharge. Patients of the PPN cohort had fewer numbers of incidences of atelectasis, dyspnea, and sweating >1 day after operations compared to those of the PPB and the PPP cohorts (P < .05 for all). The partial pressure of oxygen and oxygen saturation of arterial blood ≥6 hours after operations reported higher, the duration of ventilation was shorter, and numbers of re-intubation processes reported fewer for patients of the PPN cohort than those of the PPB and the PPP cohorts (P < .05 for all). The hospital length of the stay of patients in the PPN cohort was fewer than those of the PPB and the PPP (P < .0001 for both) cohorts. Pre and postoperative nurse-guided incentive spirometry with a spirometer following cardiac surgeries would have better postoperative pulmonary outcomes and fewer hospital stays than those of postoperative-only or pre and postoperative physiotherapist-guided breathing exercises (level of evidence: IV; technical efficacy stage: 5).     

中国10~15岁少儿抑郁情况及影响因素分析

目的 了解中国10~15岁少儿抑郁情况,为完善儿童保健政策提供基础资料。方法 采用多阶段分层抽样的方法抽取全国少儿样本2257人,采用流行病调查中心抑郁自评量表(CES-D)进行调查。结果 少儿抑郁平均得分为27.17分;单因素分析显示,年龄、母亲学历、过去一个月父母间争吵、过去一个月因病旷课及学校寄宿等因素对少儿抑郁得分有影响,差异均有统计学意义(P<0.05);二分类logistic回归分析结果显示,母亲学历较低(OR=11.761,95%CI=2.052~67.418)、不与父亲同住(OR=1.224,95%CI=1.020~1.468)、父母吵架(OR=1.017,95%CI=1.004~1.030)是少儿抑郁的危险因素(P<0.05),过去一个月没有因身体不适而旷课(OR=0.517,95%CI=0.337~0.793)是少儿抑郁的保护性因素(P<0.05)。结论 应对母亲学历较低、不与父亲同住、父母吵架及具有身体健康问题的少儿给予更多关注。     

上海市社区居民大肠癌筛查项目

2012年11月上海市重大公共卫生项目——社区居民大肠癌筛查项目正式启动实施,在全市开展大肠癌防治健康教育与免费筛查服务。该项目在对上海市大肠癌疾病负担进行研判的基础上,经过七宝社区3年试点,多方论证后纳入政府重大公共卫生服务项目。项目第一轮实施期间,超过100万居民参加了初筛检查,检出大肠癌病例1 960人,早期比例达52.8%,是筛查前本市平均水平的4.36倍,同时还检查出了各类癌前期病变7 911人,实现了筛查项目的预定目标,充分体现了\     

冰淇淋暗示法对儿童腺样体术后依从性探究

目的探讨患儿采用冰淇淋心理护理慰法对腺样体患儿术后的依从性。方法选取笔者所在科室2019年2月到2020年2月住院行小儿腺样体切除术患儿78名,随机分为实验组和对照组各39名。两组患儿在年龄无差异(P>0.05)。实验组患儿在术前宣教及术后宣教均告知家属给患儿备好冰淇淋,待全麻术后清醒食用,并让患儿自己选择冰淇淋种类,对照组则是采取一般小儿术后饮食。结果从患儿术后哭闹情况进行评估,实验组患儿术后依从性明显高于对照组(P<0.05),结果有统计学意义。结论儿童对疼痛、饥饿耐受性差,加上手术导致的术后持续平卧位及心电监护、氧气吸入。使得患儿在术后哭闹,不配合术后护理。采用冰淇淋心理护理安慰法,可以有效的对患儿起到积极的暗示作用。     

Enzymatic hydrolysis of low temperature alkali pretreated wheat straw using immobilized β-xylanase nanoparticles

A low temperature alkali (LTA) pretreatment method was used to treat wheat straw. In order to obtain good results, different factors like temperature, incubation time, NaOH concentration and solid to liquid ratio for the pretreatment process were optimized. Wheat straw is a potential biomass for the production of monomeric sugars. The objective of the current study was to observe the saccharification (%) of wheat straw with immobilized magnetic nanoparticles (MNPs). For this purpose, immobilized MNPs of purified β-xylanase enzyme was used for hydrolysis of pretreated wheat straw. Wheat straw was pretreated using the LTA method and analyzed by SEM analysis. After completion of the saccharification process, saccharification% was calculated by using a DNS method. Scanning electron micrographs revealed that the hemicellulose, cellulose and lignin were partially removed and changes in the cell wall structure of the wheat straw had caused it to become deformed, increasing the specific surface area, so more fibers of the wheat straw were exposed to the immobilized β-xylanase enzyme after alkali pretreatment. The maximum saccharification potential of wheat straw was about 20.61% obtained after pretreatment with optimized conditions of 6% NaOH, 1/10 S/L, 30 °C and 72 hours. Our results indicate the reusability of the β-xylanase enzyme immobilized magnetic nanoparticles and showed a 15% residual activity after the 11th cycle. HPLC analysis of the enzyme-hydrolyzed filtrate also revealed the presence of sugars like xylose, arabinose, xylobiose, xylotriose and xylotetrose. The time duration of the pretreatment has an important effect on thermal energy consumption for the low-temperature alkali method.

A low temperature alkali (LTA) pretreatment method was used to treat wheat straw.