PCT作为骨科术后切口感染指标的临床价值

目的探讨降钙素原(PCT)作为感染指标在骨科手术术后切口感染诊断中的价值。方法回顾性分析自2017-07—2018-03行内固定术与关节置换术治疗的117例骨科疾病,36例内固定术后出现切口感染(内固定术感染组),57例内固定术后无切口感染(内固定术未感染组),24例关节置换术后出现切口感染(关节置换术感染组)。常规检查PCT、C-反应蛋白(CRP)、白细胞计数(WBC)、中性粒细胞比率(NEU),比较内固定术切口感染组与未感染组、内固定术切口感染组与关节置换术感染组PCT水平并评价其在内固定术后切口感染中的诊断效能。结果内固定感染组与未感染组患者的PCT、CRP、NEU水平及抗菌药物的使用疗程差异均有统计学意义(P <0.05)。内固定术后PCT的截断点值及ROC曲线下面积分别为0.445 g/L、0.723。内固定术与关节置换术后感染患者的PCT、CRP、NEU、WBC差异比较差异无统计学意义(P>0.05)。结论 PCT可用于内固定术后切口感染诊断但需结合截断点值,其诊断效能一般且弱于CRP。PCT无法甄别内固定组与关节置换组感染的类别及严重程度,对于指导临床使用抗菌药物的价值有限。     

2-[对-(二甲氨基)苯乙烯]碘化甲基吡啶对实验性急性心肌缺血的保护作用

于摘除心脏前1 h或4 h给予DSPM 5 mg╱kg,可预防大鼠离体心脏的缺血损伤,使缺血后恢复灌流的心脏心功能有显著恢复,尤以4h前用DSPM者更明显,DSPM 1.5～6mg╱kg可显著对抗Iso引起的小鼠心肌钙含量增加,6mg╱kg 还可减少正常心肌钙含量。提示DSPM有保护缺血心肌的作用,此作用可能与其钙拮抗作用有关。     

谈“天人相应”与中医护理

“天人相应”是关于祖国医学中人与自然对立统一关系的理论。春夏秋冬四时自然气候的变化，对应着人体生长老已的生命规律；一日中四时阴阳消长变化对应着人体昼夜消长盛衰的规律。人体必须随之进行适应性的调整才能维护生存，防病治病。“天人相应”的理论在临床护理中的应用，是现代中医护理值得探索和研究的一个重要课题。     

正交实验法优选川芎白芍药对的合提工艺

目的优选川芎、白芍的乙醇合提工艺。方法采用正交实验设计,以没食子酸、芍药苷、阿魏酸含量为指标,以乙醇体积分数、加醇量、煎煮时间、煎煮次数为考察因素,筛选最佳提取条件。结果最佳提取工艺为:体积分数50%乙醇,12倍药材量,煎煮2次,每次2h,所得没食子酸、芍药苷、阿魏酸含量最高。结论该方法稳定、可行,可为该药对的进一步研究提供理论依据。     

Ponseti方法在6个月以上先天性马蹄内翻足患儿中的应用

Objective:To evaluate the effectiveness of Ponseti method in the treatment of congenital talipes equinovarus (CTE) in children older than 6 months. Methods: Ponseti method was used to treat 157 cases (227 feet) of CTE in children older than 6 months. All cases were classified by age and by the degree of deformity severity. The age group classification was: (1) Ⅰ Group (6 months to 12 months),113 feet in 81 cases; (2) ⅡGroup (1 to 3 years old), 78 feet in 52 cases; (3) Ⅲ Group (>3 years old), 36 feet in 24 cases. The degree of deformity of CTE was evaluated with Pirani scoring system. The cases were classified into three groups according to the deformity degree : (1) Mild Group (scoring 1-2. 5) , 85 feet in 56 cases; (2) Moderate Group (scoring 3-4. 5) , 104 feet in 71 cases; (3) Severe Group (scoring 5-6) , 38 feet in 30 cases. A Pirani score of 0-0. 5 is regarded as an excellent result. For each group, we evaluated the number of casts used, the percentage of excellent result according to the Pirani score, and the percentage of percutaneous achillotenotomy. The result was compared among different groups. Results: The overall percentage of excellent result among all cases was 96.92%. A-mong the age groups, the percentage of excellence was not statistically different between Ⅰ Group and Ⅱ Group (P>0. 05). The percentage of excellence was lower in the Ⅲ group than the other groups (P> 0. 01). Among the groups classified by deformity degree, the percentage of excellence was the lowest in severe group (P<0. 05), and the difference between the mild group and moderate group was not statistically different (P>0. 05). The number of casts used among different groups were different (P<0. 01). Among different groups, the percentages of percutaneous achillotenotomy were significantly different (P<0. 01). 209 feet in 148 caseswere followed up for average time duration of 3 years and 11 months. Re-lapse was observed in 40 feet in 29 cases. The percentages of relapse were not statistically different among different groups (P>0. 05). Conclusion: Using Ponseti method to treat CTE for children older than 6 months can achieve excellent results in this study.     

白细胞介素17相关生物制剂治疗银屑病过程中浅部真菌感染的发生及应对策略

本文综述白细胞介素（IL）-17与皮肤黏膜真菌感染易感性的基本机制,以及与IL-17相关的生物制剂,如司库奇尤单抗、依奇珠单抗、布罗达单抗、拜莫克珠单抗和乌司奴单抗在治疗银屑病中发生的浅部真菌感染。与IL-17相关生物制剂治疗相关的浅部真菌感染以轻度或中度为主,多呈局限性,且抗真菌治疗效果良好。此外,本文介绍了对相关浅...     

HS-GC联用法测定速效救心丸和华佗再造丸中冰片

目的 建立静态顶空-气相色谱法进行速效救心丸和华佗再造丸中冰片测定的方法.方法 HP-5毛细管色谱柱(30 m×0.32 mm ×0.25 μm);采用程序升温模式:初始温度为80℃,以每分钟5℃的速率升温至160℃.顶空进样器:温度80℃,定量环温度90℃,传输线温度100℃,瓶平衡时间为25 min,加压压力为103.4 kPa,进样时间1 min.结果 龙脑在0.05 ～1.00 mg/mL范围内具有较好的线性关系,平均回收率为89.12％,RSD为1.91％;异龙脑在0.05 ～1.00mg/mL范围内具有较好的线性关系,平均回收率为93.34％,RSD为2.67％.讨论 该方法快速、简单、可靠,因此可为速效救心丸和华佗再造丸的质量控制研究奠定基础.     

2010年自治区人民医院儿科重症监护室细菌菌谱及耐药性分析

抗感染是儿科重症监护室的一项重要治疗。由于儿科重症监护室中感染的病原种类多,严重感染、条件致病菌和耐药菌感染多,及时了解细菌的种类分布、耐药情况,对儿科重症感染病人的抗生素选择有重要意义。现将2009年自治人民医院儿科重症监护室的重症患儿感染病原菌的分布及耐药情况所作监测报道如下。