INTRABEAM实施乳腺癌术中放疗系统临床应用观察(附20例报告)

目的:评价INTRABEAM术中放射治疗系统临床应用的安全性和优势.方法:INTRABEAM对20例保乳手术患者实施术中瘤床放疗,均为单次照射每次20Gy,施用器规格为4.5cm(范围1.5-5.0cm),治疗持续时间35.5-51分钟.结果:术中照射治疗后有3例发生治疗区局部积液,经抽吸并加压包扎后愈合,乳房水肿1例.结论:INTRABEAM术中放射治疗系统近期无明显毒副作用,INTRABEAM术中放射治疗系统是一项安全良好耐受性技术,病人乐于接受.     

Inhibiting DNA methylation alleviates cisplatin-induced hearing loss by decreasing oxidative stress-induced mitochondria-dependent apoptosis via the LRP1–PI3K/AKT pathway

Cisplatin-related ototoxicity is a critical side effect of chemotherapy and can lead to irreversible hearing loss. This study aimed to assess the potential effect of the DNA methyltransferase (DNMT) inhibitor RG108 on cisplatin-induced ototoxicity. Immunohistochemistry, apoptosis assay, and auditory brainstem response (ABR) were employed to determine the impacts of RG108 on cisplatin-induced injury in murine hair cells (HCs) and spiral ganglion neurons (SGNs). Rhodamine 123 and TMRM were utilized for mitochondrial membrane potential (MMP) assessment. Reactive oxygen species (ROS) amounts were evaluated by Cellrox green and Mitosox-red probes. Mitochondrial respiratory function evaluation was performed by determining oxygen consumption rates (OCRs). The results showed that RG108 can markedly reduce cisplatin induced damage in HCs and SGNs, and alleviate apoptotic rate by protecting mitochondrial function through preventing ROS accumulation. Furthermore, RG108 upregulated BCL-2 and downregulated APAF1, BAX, and BAD in HEI-OC1 cells, and triggered the PI3K/AKT pathway. Decreased expression of low-density lipoprotein receptor-related protein 1 (LRP1) and high methylation of the LRP1 promoter were observed after cisplatin treatment. RG108 treatment can increase LRP1 expression and decrease LRP1 promoter methylation. In conclusion, RG108 might represent a new potential agent for preventing hearing loss induced by cisplatin via activating the LRP1-PI3K/AKT pathway.KEY WORDS: Cisplatin, DNMT, Apoptosis, Hair cell, Spiral ganglion neurons, RG108, Mitochondrial dysfunction, ROS     

智能代理在网络课程监控中的应用模式研究

网络课程作为终身教育学习资源的一种,越来越受到人们的重视.在网络课程中,是否具备良好的监控能力,是影响学习者学习效果的关键因素.而目前的网络监控普遍存在智能程度不高问题,无法满足网络监控的需要.该文将智能代理技术与电子学档结合起来对网络课程进行监控,以期对今后网络课程监控方面的研究提供一些帮助.     

高血压待出院患者类集体健康教育最佳方案的探讨

目的 探讨应用类集体健康教育方案对高血压待出院患者的作用效果.方法 选择高血压待出院患者90例,随机分为干预组与对照组各45例;对照组给予出院健康教育模式,干预组采用类集体健康教育方案.比较2组患者血压控制、治疗效果、教育效率及满意度.结果 术后1个月,干预组患者主诉症状(15.56%)、降压药服用依从性(46.67%)优于对照组,收缩压低于对照组,差异均有统计学意义(P<0.05);干预组教育效率、教育满意度显著高于对照组(P<0.05).结论 类集体健康教育能明显提高高血压出院宣教效率,稳定血压,提升治疗效果.     

心理干预对慢性失眠症患者睡眠质量的影响

目的 观察心理干预对慢性失眠症患者睡眠质量的改善效果.方法 对63例符合CCMD-3诊断标准的慢性失眠症患者,随机分入研究组32例(药物治疗和常规宣教+心理干预)和对照组31例(药物治疗+常规宣教),治疗药物采用小剂量米氮平,为期4周,在入组时及4周末采用多导睡眠监测(PSG)通过前后多导睡眠脑电图的变化,评价睡眠质量和效果.结果 研究组与的总睡眠时间(TST)、入睡潜伏期、觉醒次数、睡眠效率显著优于治疗组(P＜0.05).结论 心理干预能改变慢性失眠症患者对睡眠的歪曲认知,提高睡眠质量.     

嗓音病患者的遵医行为与治疗时间的相关性分析

目的探讨嗓音病患者遵医行为与疾病恢复时间的相关性。方法将需遵医行为内容细化,制定量表,对同意参加本研究的42例门诊就诊的嗓音病患者进行填表指导,要求患者自行记录治疗期间的违反遵医行为的项次,治疗结束时,统计违反项次得分与疾病治愈时间相关性。结果42例患者违反遵医行为得分与治愈时间的相关系数为r=0．762（P＜0.001）,说明不遵医行为与疾病治愈时间呈正相关。结论嗓音病患者遵医行为越差,疾病治愈越长;反之,遵医行为越好,疾病治愈时间越短,提示对门诊嗓音病患者的遵医行为应寻求有效的监督方式,促进其早日康复。     

GE多导电生理解除系统设置密码

GE多导电生理心电工作站系统是我导管室开展心脏电生理手术的必要设备,系统设置功能意外被设置密码,不能进行设置更改。协同厂家工程师,进入系统数据库,删除系统了设置密码,恢复系统设置功能。     

红外分光光度法与焦磷酸重量法测定粉尘中游离二氧化硅的比较

本文对矿山粉尘和铸造粉尘的游离二氧化硅含量进行了红外分光光度法和焦磷酸重量法的对比测定。结果表明,红外法与重量法的结果之间有很好的相关性,其测定值在统计学上无显著性差异。两法测定值的相关回归方程:(?)=1.0001×-2.0610,r=0.947997。红外法的测定不受灰化的影响,对滤膜采集的粉尘中游离二氧化硅的含量测定是一简便、快速的方法,可较好地排除粉尘中难溶或不溶物质和无定形二氧化硅等因素的干扰,克服了重量法的不足。     

Cost-effectiveness of empagliflozin as a treatment for heart failure with reduced ejection fraction: an analysis from the Chinese healthcare perspective

BackgroundThe effect of empagliflozin on the cardiovascular outcome is consistent in heart failure with reduced ejection fraction (HFrEF) patients regardless of the presence or absence of diabetes. More evidence is needed regarding the cost-effectiveness of empagliflozin in HFrEF patients. This study sought to evaluate the economic outcomes of adding empagliflozin to the standard treatment for HFrEF patients from the perspective of the Chinese healthcare system, and thus to provide information for decision makers.MethodsBased on the EMPEROR-Reduced clinical trial and other published literature data, the direct medical costs and quality-adjusted life years (QALYs) of patients with HFrEF over a 15-year study period were simulated by a Markov model, and the incremental cost-effectiveness ratio (ICER) was calculated. The price of empagliflozin referred to the data released by Menet, the hospitalization expenses and utility values were derived from published studies in China. A one-way sensitivity analysis and probabilistic sensitivity analysis were conducted to evaluate the robustness of the model.ResultsThe results of the cost-effectiveness analysis showed that the cost of the combination arm was $5,220.98, with a utility of 4.86 QALYs, and the cost of the standard arm was $4,873.96, with a utility of 4.68 QALYs, which equated to an ICER of $1,893.59 per QALY gained. The subgroup analysis showed that patients with HFrEF and diabetes in empagliflozin group had a higher QALY (4.62 vs. 4.35) and a lower cost ($5,213.28 vs. $5,958.60) than standard group. The corresponding ICER for non-diabetic patients was $2,568.15 per QALY. Deterministic sensitivity analysis showed robust results. At the willingness-to-pay threshold of 3 times gross domestic product (GDP) per capita ($31,510.57), almost all of the scattered points in three scenarios were below the threshold line.ConclusionsAt a willingness-to-pay threshold of $31,510.57, adding empagliflozin to standard treatment is a very cost-effective option for HFrEF patients with or without diabetes in China.