儿童重症监护室真菌肺炎11例临床分析

目的:探讨儿童真菌肺炎的临床易感因素及预防、治疗措施.方法:回顾性分析重庆医科大学附属儿童医院ICU 2007年6月～2008年4月11例确诊为真菌肺炎儿童患者的临床表现、影像学表现、实验室检查、治疗及转归.结果:真菌肺炎好发于年龄小的婴幼儿,病原菌以白色念珠菌多见.9例(占81.8%)合并有先天性心脏病,11例确诊前均有长时间静脉使用广谱抗生素及气管插管机械通气史.所有病例都有咳嗽、咯痰,其中10例有不同程度发热.该组患儿均使用两性霉素B治疗.11例患儿中死亡2例(18.2%),放弃1例(9.1%),治愈8例(72.7%).结论:念珠菌是儿童深部真菌感染的常见病原菌,其发病率和预后与宿主因素、抗生素的使用和抗真菌治疗密切相关.     

脑梗塞对大鼠膀胱功能的影响

目的探讨脑梗塞对大鼠膀胱功能的影响。方法雄性SD大鼠,用线栓法制作大脑中动脉栓塞模型。脑梗塞24小时后,测定膀胱容量、排尿潜时、膀胱内压、尿流率、尿道抵抗值。结果大鼠脑梗塞后膀胱功能发生明显变化,排尿量减少、排尿潜时缩短、尿流率降低、尿道抵抗增强。结论脑梗塞可致大鼠膀胱过度活动症。*     

经腹膜后腹腔镜肾上腺切除术治疗肾上腺偶发瘤的效果

目的 探讨腹腔镜肾上腺肿瘤切除术治疗肾上腺偶发瘤的效果。方法 选取2015年1月至2021年1月广州医科大学附属第二医院收治的60例肾上腺偶发瘤患者作为研究对象,采用随机数字表法将其分为研究1组与研究2组,每组各30例。研究1组患者采用经腹膜后腹腔镜肾上腺切除术,研究2组患者采用经腹腹腔镜肾上腺肿瘤切除术。比较两组患者的手术指标、并发症及生活质量。结果 研究1组患者的手术时间、术后进食时间、术后下床活动时间、住院时间短于研究2组,差异有统计学意义（P<0.05）;研究1组患者的术中出血量少于研究2组,差异有统计学意义（P<0.05）;研究1组患者的并发症总发生率低于研究2组,差异有统计学意义（P<0.05）。两组患者术前的生活质量（QOL）评分比较,差异无统计学意义（P>0.05）;研究1组患者术后的QOL各项评分均高于研究2组,差异有统计学意义（P<0.05）。结论 对肾上腺偶发瘤采取经腹膜后腹腔镜肾上腺切除术治疗后,可显著减少手术时间及出血量,缩短住院时间,且并发症少,安全性高,术后生活质量改善明显,值得应用与推广。     

Research on Design and Performance of Self-Compacting Cement Emulsified Bitumen Mixture (CEBM)

To meet the needs of the road industry for maintenance operations, a new cement emulsified bitumen mixture (CEBM) with early-strength, self-compacting, and room-temperature construction characteristics was designed. The strength formation mechanism of CEBM was revealed with a scanning electron microscope (SEM) and the surface free energy (SFE) theory. The mechanical properties and road performance of the CEBM were investigated extensively. The results show that before the demulsification of emulsified bitumen, the SFE of the bitumen–aggregate–water three-phase system was reduced due to the replacement of the bitumen–aggregate interface with water. The adhesion work between the emulsified bitumen and the aggregate is negative, which means the adhesion between the emulsified bitumen and the aggregate will not occur spontaneously due to the existence of water. The liquid emulsified bitumen improves the workability of the mixture and ensures that the mixture can be evenly mixed and self-compacted. After demulsification, the work of adhesion between the residual bitumen and the aggregate is positive, which means residual bitumen and aggregate can bond spontaneously. In addition, the hydration products of cement and aggregate form a skeleton, and the emulsified bitumen film wraps and bonds the cement and aggregate together, creating strength. The emulsified bitumen, cement content, and curing conditions have significant effects on the stability of CEBM. The recommended dosage of emulsified bitumen and cement is 8% and 8–10%, respectively. This material integrates the hardening effect of cement and the viscoelastic performance of bitumen and has good workability, mechanical properties, and road performance. Therefore, the CEBM is technically feasible for application to bitumen pavement.     

Comparison of six anthropometric measures in discriminating diabetes: A cross‐sectional study from the National Health and Nutrition Examination Survey

BackgroundTraditional anthropometric measures, including body mass index (BMI), are insufficient for evaluating the risk of diabetes. This study aimed to evaluate the performance of new anthropometric measures and a combination of anthropometric measures for identifying diabetes.MethodsA total of 46 979 participants in the National Health and Nutrition Examination Survey program were included in this study. Anthropometric measures, including weight, BMI, waist circumference (WC), waist‐to‐height ratio (WtHR), conicity index (CI), and A Body Shape Index (ABSI), were calculated. Logistic regression analysis and restricted cubic splines were used to evaluate the association between the anthropometric indices and diabetes. The receiver operating characteristic (ROC) curve analysis was performed to compare the discrimination of different anthropometric measures.ResultsAll anthropometric measures were positively and independently associated with the risk of diabetes. After adjusting for covariates, the per SD increment in WC, WtHR, and CI increased the risk of diabetes by 81%, 83%, and 81%, respectively. In the ROC analysis, CI showed superior discriminative ability for diabetes (area under the curve 0.714), and its optimum cutoff value was 1.31. Results of the combined use of BMI and other anthropometric measures showed that among participants with BMI <30 kg/m², an elevated level of another metric increased the risk of having diabetes (P < .001). Similarly, at low levels of weight, CI, and ABSI, an elevated BMI increased diabetes risk (P < .001).ConclusionsWtHR and CI had the best ability to identify diabetes when applied to the US noninstitutionalized population. Anthropometric measures containing WC information could improve the discrimination ability.     

成年男性中有机磷酸酯暴露与睾酮水平的相关性研究

目的 探讨有机磷酯(OPEs)代谢物磷酸二丁酯(DPHP)对成年男性睾酮水平的影响。方法 选用来自2013—2016年“美国健康和营养检查调查”数据及资料,共纳入763例作为研究对象。将DPHP水平进行连续性变量的对数变换,采用相关分析探索尿液中DPHP水平与睾酮水平的相关性。结果 通过相关分析发现,尿液DPHP水平与睾酮水平呈负相关(r=-0.748,P=0.002)。尿液DPHP水平通过四分类法将其分为4组(Q1、Q2、Q3、Q4),再次采用相关分析比较4组之间尿液DPHP水平与睾酮水平相关性。当DPHP为分类变量时,与DPHP最低暴露组相比,最高暴露组的睾酮水平更低且去趋势性检验有意义(P=0.006)。校正值水平与睾酮水平呈负相关(r=-0.810,P=0.002)。结论 高暴露于DPHP成年男性人群睾酮水平降低明显,降低OPEs类的暴露可能对促进男性生殖健康起到关键作用。     

血管腔内重建在髂动脉病变引起的难治性动脉性勃起功能障碍治疗中的应用

目的 评估血管腔内重建治疗因髂动脉病变引起的动脉性勃起功能障碍的疗效及安全性.方法 选取2017年4月至2019年1月在本院收治的经动脉造影确诊的动脉性勃起功能障碍患者8例,进行术前评估后行髂内动脉或髂总动脉腔内血运重建术,术后3个月内口服抗血小板药物,随访时间6个月.结果 8例患者手术顺利,术中未出现特殊并发症,其中...     

原发性肝癌CT灌注成像与微血管密度关系的研究

目的探讨原发性肝细胞癌(HCC)CT灌注成像与肿瘤内微血管密度(MVD)的关系。方法选择17例行肝穿刺活检病理证实为原发性肝细胞癌(HCC)的患者。在行肝穿活检前均行CT灌注成像。活检后送病理科采用LSAB免疫组化法检测其MVD。结果肿瘤强化越明显,其相应的肿瘤MVD计数越多,肿瘤强化与相应的MVD呈正相关。结论原发性肝细胞癌CT增强幅度与其MVD值有密切关系,可用于评价肿瘤的恶性程度。     

两种不同剂型的氟康唑治疗外耳道真菌病的最小成本分析

目的:比较氟康唑注射液和氟康唑滴眼液外用滴耳治疗外耳道真菌病的成本和效果。方法:回顾性分析我院采用氟康唑注射液或氟康唑滴眼液治疗的外耳道真菌病患者278例,按照不同的治疗方案进行分组,其中氟康唑注射液组88例,氟康唑滴眼液组190例,统计两组疗效及费用,并运用最小成本法进行分析。结果:氟康唑注射液组有效率为98.8%,氟康唑滴眼液组有效率为99.4%,两组比较差异无统计学意义;氟康唑注射液组治疗费用为(254.76±16.23)元,氟康唑滴眼液组治疗费用为(65.56±27.13)元,两组比较差异有统计学意义(P<0.05)。结论:两种治疗方案治疗外耳道真菌病的疗效均较好,从经济学角度看,氟康唑滴眼液治疗成本较小,为较佳治疗方案。     

辉瑞公司专利产出与经济产出的相关性研究

目的研究辉瑞公司专利产出与经济产出的相关性,分析该公司专利分布及保护情况。方法运用相关回归方法,研究2000~2010年辉瑞公司的全球专利申请数与经济产出(年销售收入/净利润)的相关性,统计分析了该公司中国专利分布情况及上市品种中4种药物阿托伐他汀钙(立普妥)、阿奇霉素(希舒美)、苯磺酸氨氯地平(络活喜)和盐酸舍曲林(左洛复)的专利保护情况。结果①辉瑞公司专利产出与经济收入成正相关,回归方程有良好的线性关系,方差分析具显著性;②辉瑞公司中国专利中以发明专利为主,专利授权率只有10%;③辉瑞公司无论是全球专利申请量还是中国专利申请量已呈逐年减少趋势;④专利对其上市药物保护作用明显,在专利保护期内销售收入呈现较大辐度增长,随着专利到期销售收入呈下滑趋势。结论专利保护战略能促进跨国公司创造重磅炸弹级药物,并为其带来巨大经济效益;研发新药费用剧增导致跨国公司新药创制减缓;科技创新及其专利保护是跨国公司在竞争中的重要武器,国内政府部门和医药企业应积极应对。