喷他佐辛对剖宫产术后静脉自控镇痛效果和母乳喂养的影响

目的：探讨喷他佐辛对剖宫产产妇术后静脉自控镇痛（ PCIA）的镇痛效果和对母乳喂养的影响。方法剖宫产产妇120例,按随机数字表法分为观察组和对照组,每组60例;观察组术后给予喷他佐辛行PCIA,对照组术后使用哌替啶行PCIA,比较两组产妇胸疼痛程度、哺乳及产后恢复情况。结果观察组各时间点视觉模拟评分均低于对照组（P＜0．05）,术后初次哺乳时间早于对照组（P＜0．05）,24 h哺乳次数多于对照组（P＜0．05）,乳汁充足率亦明显高于对照组（P＜0．05）,肛门恢复排气时间及首次下床时间均早于对照组（P＜0．05）。两组产妇产后宫底高度及阴道出血量比较,差异均无统计学意义（P＞0．05）。结论喷他佐辛在剖宫产产妇术后PCIA镇痛效果较好,能够加快产妇的恢复和促进母乳喂养。     

Murine corneal stroma cells suppress bone marrow-derived dendritic cells maturation in vitro

Background  Prostaglandin E2 (PGE₂) is a key modulator of dendritic cells (DCs) function, and cornea-derived transforming growth factor beta 2 (TGF-β₂) promotes the generation of phenotypically and functionally immature DCs. Therefore, this study was carried out to investigate whether PGE₂ is involved in the suppressive effect on DCs maturation mediated by corneal stroma cells (CSCs) and whether PGE₂ and TGF-β₂ have additive effects in this immunosuppressive mechanism.

Methods  Bone marrow-derived DCs (BM-DCs), splenic T cells and CSCs culture supernatant were obtained from mice via various protocols. After that, the level of PGE₂ in CSCs culture supernatant was analyzed by enzyme-linked immunosorbent assay. Then, immature BM-DCs pretreated by E-prostanoid 2 receptor antagonist AH6809 or dimethyl sulfoxide were induced to mature in the presence of lipopolysaccharide, with or without CSCs culture supernatant. In parallel experiments, neutralizing TGF-β₂ antibody or normal goat IgG was added into the supernatant. Next, the cellular surface markers for DCs maturation, including CD80, CD86, and major histocompatibility complex class II (MHC II), were analyzed by flow cytometry; the capability of stimulating the proliferation of T lymphocytes was evaluated by allogeneic mixed lymphocyte reactions and the function of endocytosis was assessed by fluorescein isothiocyanate-dextran uptake.

Results  Higher concentration of PGE₂ was detected in CSCs culture supernatant than in the fresh medium. In addition, compared with control group, after treated with the supernatant in the mature stage, BM-DCs displayed lower expression of CD80, CD86 and MHC II, lower T cell stimulatory capacity and higher endocytosis function. However, after the application of AH6809, BM-DCs partially regained T cell stimulatory capacity and expression of CD86 and MHC II, but partially lost endocytic activity. Moreover, after the application of AH6809 and neutralizing TGF-β₂ antibody, the result of statistical analysis indicated that there was a statistical difference of interaction in the expression of MHC II and T cell stimulatory capacity.

Conclusions  PGE₂ contributes to the suppressive effect on BM-DCs maturation mediated by CSCs in vitro, and PGE₂ and TGF-β₂ have additive effects on the immunosuppression of BM-DCs.

     

长链非编码RNA NANCI⁃NKX2.1信号通路在BPD新生小鼠肺组织中作用的研究

目的：探讨长链非编码RNA（lncRNA）NANCI?NKX2.1信号通路在新生小鼠支气管肺发育不良（bronchopulmonary dysplasia,BPD）形成过程中的作用。方法：将32只C57BL/6J新生小鼠随机分为实验组、阴性对照组、生理盐水对照组和空白对照组,每组8只。实验组于生后第2天经鼻腔吸入含lncRNA NANCI干扰序列的腺病毒 Ad?lnc NANCI shRNA的生理盐水1 μL,阴性对照组将含无关序列发卡结构病毒质粒Ad?GFP NC的生理盐水1 μL导入肺内,生理盐水对照组将生理盐水1 μL导入肺内,空白对照组除未予鼻腔吸入以外其他控制因素与上3组相同;于出生后7 d处死各组小鼠并采集肺组织。采用HE染色法察看小鼠肺组织病理变化,采用RT?qPCR检测NANCI表达量,RT?qPCR及Western blot技术分别检测NKX2.1、SPC、AQP5 mRNA和蛋白表达水平。结果：实验组肺组织病理示新隔形成减少,肺泡腔扩大、部分融合,肺泡数目较少,RAC值下降（P ＜0.05）;肺组织NANCI表达量下降（P ＜0.05）;NKX2.1、SPC及AQP5 mRNA和蛋白的表达量亦下降（P ＜0.05）。结论：NANCI?NKX2.1信号通路在BPD新生小鼠中可能起重要作用。     

无创局部麻醉在小儿静脉穿刺中应用的随机对照试验的meta分析

目的 系统评价局部麻醉(局麻)在小儿静脉穿刺中应用的有效性及安全性,为相关的护理实践提供证据参考.方法 计算机检索Web of Science、PubMed、Cochrane Library、Embase、中国知网、万方、中国生物医学文献数据库和维普网数据库,检索时限均为建库至2021年6月25日,收集所有局麻在小儿静...     

早期胃癌行内镜粘膜下剥离术应用研究

分别选取进行ESD治疗和外科手术的EGC患者分成标准组和对照组,观察术中并发症情况,并定期随访患者病灶有无残留和复发。结果经治疗和随访后,标准组中术后出现出现和穿孔2例,对照组中术后出现出现和穿孔10例,差异显著(P0.05),两组患者随访2年后,均为发现术后病灶残留或复发。内镜粘膜下剥离术是治疗早期胃癌的一种安全有效的方法,可以进行推广。     

丁苯酞注射液对脑梗死后同型半胱氨酸、超氧化物歧化酶的影响

目的分析丁苯酞注射液对脑梗死患者同型半胱氨酸(Hcy)、超氧化物歧化酶(SOD)等炎性因子的影响。方法选择本院120例急性脑梗死患者为研究对象,按美国国立卫生研究院卒中量表(NIHSS)评分分为治疗组和对照组,每组各60例。对照组患者采用阿司匹林、阿托伐他汀钙、奥扎格雷钠氯化钠注射液、丹红注射液治疗;治疗组患者在对照组基础上采用丁苯酞注射液治疗。分别于治疗前及治疗后14天检测两组患者血清Hcy、SOD水平,并比较其NIHSS评分情况。结果治疗前两组患者血清Hcy、SOD水平及NIHSS评分比较无明显差异(P>0.05);治疗后14天,治疗组患者Hcy水平和NIHSS评分均低于对照组,而SOD水平高于对照组,差异具有显著性(P<0.05)。结论丁苯酞注射液可降低脑梗死患者自身炎性反应,减少并发症发生,改善预后。     

慢性阻塞性肺病合并重度哮喘100例护理体会

慢性阻塞性肺病(慢阻肺)多见于老年人,是严重危害人们身心健康的呼吸系统疾病.特别是在冬季,由于寒冷、感染、理化等因素作用容易引起急性发作,特别是并发哮喘持续状态,病死率极高.本院内科自2005年以来共收治慢阻肺合并重度哮喘患者100例,抢救成功率为70%,现将护理体会报道如下.     

腰麻-硬膜外联合阻滞用于老年人麻醉80例临床观察

随着现代社会的发展，老龄人口的增加．临床上老年人需要做手术者越来越多。而在下肢及膀胱、前列腺手术中．以前我院多采用硬膜外麻醉，近两年来我们采用腰麻一硬膜外联合阻滞麻醉(以下简称CSEA)，效果良好，现将麻醉处理体会报告如下。     

延续护理对急性胰腺炎病人复发率及医嘱依从性的影响

[目的]探讨延续护理对急性胰腺炎病人出院后复发率及医嘱依从性的影响。[方法]将50例住院保守治疗的急性胰腺炎病人采用随机数字表法分为观察组和对照组各25例,对照组病人出院后采用常规随访,观察组病人出院后采用延续性护理。护士于病人出院后12个月时收集两组病人胰腺炎复发、医嘱依从性(戒烟戒酒、饮食控制、规范用药)、病人满意度情况。[结果]观察组病人医嘱依从性、满意度优于对照组,胰腺炎复发率低于对照组。[结论]延续护理可纠正急性胰腺炎病人不良生活习惯,提高医嘱依从性、护理工作的满意度,并降低胰腺炎复发率。     

纳洛酮联合无创呼吸机治疗老年COPD合并呼吸衰竭临床疗效分析

目的 评价纳洛酮联合无创呼吸机治疗老年慢性阻塞性肺疾病(COPD)合并Ⅱ型呼吸衰竭的临床疗效.方法 选择本院住院治疗的132例老年COPD合并Ⅱ型呼吸衰竭为研究对象,62例对照组患者给予无创呼吸机治疗,70例观察组患者接受无创呼吸机联合纳洛酮治疗.结果 观察组24 h内神志改善率为61.4％,显著高于对照组的37.1％(P＜0.05);2组住院期间死亡率差异无统计学意义;观察组患者住院时间(14.98±4.09)d,显著少于对照组的(18.46±4.28) d(P＜0.05);观察组治疗后血气分析指标Pa(CO2)、Pa(O2)及pH值显著优于对照组(P＜0.05).结论 纳洛酮联合无创呼吸机治疗老年COPD合并Ⅱ型呼吸衰竭可显著改善患者意识状态和血气分析指标.