重症社区获得性肺炎患者红细胞输注的危险因素及序贯器官衰竭评估联合总铁结合力对其的预测价值

目的探讨重症社区获得性肺炎(SCAP)患者红细胞输注的危险因素及序贯器官衰竭评估(SOFA)联合总铁结合力(TIBC)对红细胞输注的预测价值。方法选取2020年1月至2021年3月海南医学院第二附属医院重症监护病房(ICU)收治的116例SCAP患者作为研究对象,根据患者入住ICU 7 d内是否输注红细胞分为红细胞输注组(观察组,50例)和无红细胞输注组(对照组,66例)。比较2组患者的一般资料及实验室检查指标,采用多因素Logistic回归模型分析SCAP患者红细胞输注的危险因素,受试者工作特征(ROC)曲线评估SOFA评分、TIBC及二者联合对红细胞输注的预测价值。结果观察组SOFA评分、累计失血量、28 d病死率及铁蛋白水平均高于对照组,机械通气时间、ICU停留时间均长于对照组,白蛋白、TIBC、转铁蛋白及血红蛋白水平均低于对照组,差异均有统计学意义(均P<0.05)。多因素Logistic回归分析结果显示,SOFA评分(比值比=1.411,95%置信区间:1.109～1.796,P=0.005)、累计失血量(比值比=1.009,95%置信区间:1.004～1.015,P=...     

鼻息肉病的鼻窦根治术

本文报告一种除尽鼻、鼻窦息肉化粘膜的手术。其主要适应症是简单手术不能治愈的鼻息肉病,因此手术可获永久治愈的目的。本手术切口作于鼻背中央直达骨膜而不伤及鼻软骨,剥离骨膜暴露骨壁。凿开泪骨并逐步咬除泪骨,上颌骨额突、额骨上颌突、额窦底壁直到眶上切迹,并向后除去筛窦骨璧至筛前孔为止(骨膜剥至筛后     

中国大陆革兰阴性杆菌耐药性研究进展

近年来,国内外越来越多的细菌耐药研究资料给人们展示了目前细菌耐药的新特点,现试从国内革兰阴性杆菌的埘药现状、耐药机制、分子流行病学特征等方面来揭示国内革兰阴性杆菌耐药之规律。     

2015 - 2020年山东省烟台市发热伴血小板减少综合征空间分布特征研究

目的分析山东省烟台市发热伴血小板减少综合征(SFTS)疫情的空间分布特征及空间聚集性, 为制定有效的SFTS防控措施提供依据。方法收集"中国疾病预防控制信息系统传染病监测报告系统"中2015 - 2020年山东省烟台市各乡镇(街道)的SFTS确诊病例资料, 采用ArcGIS 10.2软件进行空间自相关分析。结果 2015 - 2020年, 烟台市共报告SFTS病例839例, 其中死亡病例124例, 年均发病率为2.14/10万, 总病死率为14.78%。全局空间自相关分析显示, 2015 - 2020年烟台市SFTS病例分布呈空间正相关性, 其中2015年病例分布的空间相关性最高(Moran′sI = 0.25, Z = 5.66, P < 0.001), 2018年最低(Moran′sI = 0.16, Z = 3.69, P < 0.001)。局部空间自相关及热点分析显示, 2015 - 2020年烟台市SFTS发病流行区主要在莱州市、蓬莱区、栖霞市、招远市、海阳市的部分山区、丘陵乡镇。结论烟台市SFTS疫情分布具有明显的地区聚集性, 应在高发地区强化宣传教育、监测等干...     

溃疡散治疗虚寒型胃脘痛20例

笔者自拟溃疡散治疗虚寒型胃脘痛20例,取得疗效,报道如下。本组男14例,女6例。年龄14～65岁。病程3个月～12年。临床症状:胃脘隐痛,痛有定时,进食、得温痛减,遇冷、饥饿则痛加,脘腹胀满,泛吐清水,大便时溏,纳差神疲,畏寒怕冷,舌淡苔白,脉濡缓。胃镜,钡餐见胃底部溃疡1例,胃体部溃疡2例,胃角溃疡12例,胃窦部溃疡5例,病理报告:慢性胃炎伴坏死组织13例,胃溃疡伴肠上皮化生5例,胃溃疡伴肠上皮轻度增生者2例。     

逍遥散加减治疗乳腺增生病182例

近年来,我们以遥逍散为基础方,加减化裁治疗乳腺增生病182例,疗效满意。现总结如下。临床资料诊断标准:一侧乳房或双侧乳房触到一个或多个大小不等、呈圆形、质韧的结节,与周围组织无粘连,可推动。除外其它乳腺肿瘤。乳房胀痛或刺痛,经前期疼痛或肿胀加剧。182例均符合诊断标准。182例中,15～20岁9例,21～30岁51例,31～40岁89例,41～50岁33例。     

乌梅对小鼠,家兔肠平滑肌运动的影响

乌梅(Fructus Mume)为蔷薇科落叶乔木梅(Prunus mume csieb(sieb)et Zucc)的未成熟果实加工熏制品,性平味酸温,具有敛肺、涩肠、生津、安蛔之功效,临床用于治疗肺虚久咳、久泻久痢、蛔厥腹痛诸证有较好的疗效,但对于其对动物肠运动的影响迄今尚未见报道,因此,我们进行了乌海对小鼠、家兔肠运动机能的影响的实验研究,初步揭示了其治疗久泻久痢的药理作用机制,现将结果报道如下。     

白血病患者造血干细胞移植前单次全身照射的预后分析

Objective To analyze the prognostic factors of patients with leukemia treated with single fraction total body irradiation (SFTBI) followed by hernatopoietic stem cell transplantation (HSCT).Methods From January 2001 to September 2008, 102 patients received HSCT. The differences of the survival rate, relapse rate and incidence of interstitial pneumonia (IP) between groups regarding different genders, ages, pathological types, transplantation methods and TBI parameters were compared and the factors related with the survival rate, relapse rate and incidence of IP were analyzed. Results The followup time ranged from 15 to 1482 days (median, 406 days). The follow-up rate was 95.1%. 86 and 55patients were followed up more than one year and three years. The 1-and 3-year survival rates were 59.0%and 44.0%. In univariate analysis, the 3-year survival rate was signifcantly different between the groups with and without relapse before transplantation (20% vs. 55%, χ2 = 6.33, P = 0. 012), allogeneictranplantation versus autologous tranplantation (39% vs. 68%, χ2 = 8.06, P = 0.005), grade 3 or more acute graft versus host disease (aGVHD) and grade 0 -2 aGVHD (0% vs. 54%, χ2 = 7.52, P = 0.006),with and without relapse after transplantation (19% vs. 58%, χ2 = 10.13, P =0.001), with and without IP (23% vs. 58%, χ2 =8.35, P=0.004). Multivariate analysis showed that grade 3 or more aGVHD was the only statistically significant prognostic factors (χ2 = 12. 74 ,P =0. 000). The l-and 3-year relapse rateswere 30. 0% and 50. 0%. The incidence of relapse was obviously higher in the group with relapse before transplantation than that without (47% vs. 16%, χ2 =7. 32, P=0. 007). Multivariate analysis showed thatrelapse before transplantation was a significant factor predicting relapse after transplantation (χ2 = 9. 39,P =0. 020). The cumulative incidence of IP was 35.0%. The incidence of IP was different between groups with dose homogeneity > 3% and ≤ 3% (27% vs. 4%, χ2 = 5. 21, P = 0. 023), with and without acute parotitis (34% vs. 3%, χ2 = 14. 15, P= 0.000), allogeneic transplantation group and autologous transplantation group (31% vs. 8%, χ2= 7.70, P= 0.006). Multivariate analysis showed that transplantation methods, acute parotitis and dose homogeneity were statistically significant factors in predictingIP (χ2 = 10. 08 , 10. 08 and 7.69 , P = 0. 002 , 0. 002 and 0. 010 , respectively) . Conclusions Patients who develop grade 3 or higher aGVHD have poor prognosis. Dose homogeneity influences the incidence of IP. Patients undergoing allogeneic transplantation are apt to have IP. Acute parotitis is related with IP and might be a predictor.     

罗布麻叶HPLC指纹图谱构建及在种属鉴别中的应用

目的 建立罗布麻叶的HPLC指纹图谱,用以控制罗布麻叶的内在质量,并对罗布麻叶药材与其混淆品进行鉴别.方法 采用HPLC梯度洗脱的方法建立指纹图谱,"计算机辅助相似度评价系统"软件进行数据处理,据此对不同种属的药材进行比较.结果 建立的罗布麻HPLC指纹图谱方法的精密度、稳定性和重现性较好.罗布麻叶(红麻叶)HPLC指纹图谱共标定12个共有指纹峰,与白麻属样品图谱之间呈显著差异,可以依此鉴别.结论 HPLC指纹图谱可以用作罗布麻叶药材的质量控制.     

小兒急性喉阻塞51例的观察

附屬二院耳鼻咽喉科自1958年10月至1959年2月共收住51例小兒喉阻塞患者,在全科医师、护士及在該科学习的60医3、9班同学細心医护下,仅对14例作了气管切开术(占27%)。今总結这項经验,供更进一步掌握对小兒喉阻塞患者的处理时作参考。