多维自杀问卷(MSI-28)中文版在海军官兵中的应用

背景 自杀风险评估是一个非常困难的问题,目前的量表几乎只测量自杀的风险因素,忽略了自杀的保护因素.目的 验证多维自杀问卷(Multidimensional Suicide Inventory-28,MSI-28)在我国海军官兵群体中的信效度.方法 抽取我国东部地区海军某部队1710名官兵集体施测,完成MSI-28、自杀...     

基于Crisper的新型冠状病毒核酸检测方法在临床应用中的评价

目的 建立一种快速、特异性强、灵敏度高的新型冠状病毒核酸检测方法并评价其在临床工作中的应用.方法 对2020年2月至5月经过RT-PCR及CT方法临床确诊的新冠患者标本,采用Crisper方法对50例正常标本及12例确诊标本进行检测,用本方法使12例确诊标本全部进行识别并检出,而用RT-PCR方法仅能检出10例,存在2...     

光学标测技术评价乌头碱心脏毒性的剂量关系

目的 探究不同浓度乌头碱作用于心脏时,对大鼠心脏心室电生理的影响。方法 利用光学标测(optical mapping)技术,通过体外给药乌头碱0.3、1、3 ng·ml-1,观察给药前及给药15min后不同浓度乌头碱对大鼠心室动作电位(action potential, AP)及钙信号的影响。结果 与空白组比较,在自发和6HZ刺激节律下,乌头碱都能浓度依赖性延缓动作电位的传导,特别是在浓度为3 ng·ml-1时（P＜0.05,P＜0.01）。当乌头碱浓度为1、3 ng·ml-1时,心室动作电位时程(action potential duration, APD)显著延长（P＜0.01）。还能增加动作电位传导的离散度（P＜0.05）,并且降低有效不应期(effective refractory period,ERP)与动作电位时程（APD90）的比值(ERP/APD90)（P＜0.01）。此外,乌头碱还能浓度依赖性延缓钙信号的传导（P＜0.01）,降低钙传导的速度（P＜0.05,P＜0.01）,增加钙传导及钙瞬变时程(Ca2+transient duration, CTD)的离散度（P＜0.05,P＜0.01）,降低钙信号的幅值（P＜0.01）。结论 采用光学标测技术可直观的发现,乌头碱可浓度依赖性的影响大鼠心室动作电位及钙信号的传导来诱导心律失常的发生。     

康宁克通 A 治疗支气管哮喘及喘息型慢支的疗效观察

康宁克通A(确炎舒松—A)治疗1552例支气管哮喘及喘息型慢支病人,结果表明显效率为94.7%,总有效率99.8%,用药前后的肺功能测定值均有明显或非常明显的差别,P<0.05,<0.001。     

Stapled transperineal repair for low- and mid-level rectovaginal fistulas: A 5-year experience and comparison with sutured repair

BACKGROUNDCurrently, rectovaginal fistula (RVF) continues to be a surgical challenge worldwide, with a relatively low healing rate. Unclosed intermittent suture and poor suture materials may be the main reasons for this.AIMTo evaluate the efficacy and safety of stapled transperineal repair in treating RVF.METHODSThis was a retrospective cohort study conducted in the Coloproctology Department of The Sixth Affiliated Hospital of Sun Yat-sen University (Guangzhou, China). Adult patients presenting with RVF who were surgically managed by perineal repair between May 2015 and May 2020 were included. Among the 82 total patients, 37 underwent repair with direct suturing and 45 underwent repair with stapling. Patient demographic data, Wexner faecal incontinence score, and operative data were analyzed. Recurrence rate and associated risk factors were assessed.RESULTSThe direct suture and stapled repair groups showed similar clinical characteristics for aetiology, surgical history, fistula features, and perioperative Wexner score. The stapled repair group did not show superior results over the suture repair group in regard to operative time, blood loss, and hospital stay. However, the stapled repair group showed better postoperative Wexner score (1.04 ± 1.89 vs 2.73 ± 3.75, P = 0.021), less intercourse pain (1/45 vs 17/37, P = 0.045), and lower recurrence rate (6/45 vs 17/37, P = 0.001). There was no protective effect from previous repair history, smaller diameter of fistula (< 0.5 cm), better control of defecation (Wexner < 10), or stapled repair. Direct suture repair and preoperative high Wexner score (> 10) were risk factors for fistula recurrence. Furthermore, stapled repair gave better efficacy in treating complex RVFs (i.e., multiple transperineal repair history, mid-level fistula position, and poor control of defecation).CONCLUSIONStapled transperineal repair is advantageous for management of RVF, providing a high primary healing rate and low recurrence rate.     

白莪星注射液对Hep-2细胞VEGF表达影响的实验研究

目的　探讨白莪星注射液对Hep - 2细胞VEGF表达的影响。 方法　根据抗癌药物敏感性实验的方法 ,计算出体外药物敏感性实验所用药物的一般浓度 ,分 4组 :阴性对照组、治疗组 1 (1 0 0倍稀释 )、治疗组 2 (1 0 0 0倍稀释 )、阳性对照 (顺铂 4 0 μmol/l) ,流式细胞仪检测VEGF的表达。 结果　 4组VEGF表达阳性率分别为 :5 72± 0 2 8%、3 34± 0 76 %、3 6 4± 0 2 1 %、4 6 0± 0 6 1 % ;1 0 0倍稀释组和 1 0 0 0倍稀释组VEGF表达阳性率显著低于阴性对照 (P <0 0 5 )。结论　白莪星注射液对VEGF蛋白的表达有抑制作用 ,白莪星注射液抗癌的分子机制与肿瘤血管形成有关     

Gastrointestinal immunopathology of food protein–induced enterocolitis syndrome and other non-immunoglobulin E–mediated food allergic diseases

ObjectiveTo provide a concise summary of the current literature regarding gastrointestinal immunopathology of food protein–induced enterocolitis syndrome (FPIES) and other non-immunoglobulin E (IgE)–mediated food allergic diseases.Data SourcesData were extracted from PubMed, MEDLINE, and ScienceDirect databases.Study SelectionsOriginal articles, review articles, and guidelines published in the past 5 years in peer-reviewed journals were first summarized. The original articles cited were then reviewed and relevant results were extracted.ResultsPatients with FPIES and non-IgE–mediated food allergic diseases developed vomiting, diarrhea, and food aversion expelled food allergen from their bodies. Aside from T helper type 2 (T_H2) immunity, T_H1, T_H17, innate immunity, and epithelial mucosal barrier defect were also found to be important in the pathogenesis. Eosinophils, widely identified in the biopsy samples, were key players or were late-recruited cells for tissue repairs in those diseases. Intestinal dysbiosis and their metabolites stimulated enterochromaffin cells or enteroendocrine cells to produce serotonin, interfering with intestinal motility and subsequently affecting brain function. FPIES and non-IgE–mediated food allergic diseases were likely part of the atopic march. Allergic inflammation in intestinal mucosa might result in subsequent inflammation in the airway mucosa, suggesting the theory of “one mucosa, one disease.”ConclusionThe immune responses of FPIES and non-IgE–mediated food allergic diseases were not limited to the gastrointestinal tract, but also trigger wider inflammatory responses beyond it. Further research will be required to determine the systemic effect and intestinal microbiome of those diseases.     

Combined therapy of hypertensive nephropathy with ginkgo leaf extract and dipyridamole injection and antihypertensive drugs: A systematic review and meta-analysis

Background:In recent years, the incidence rate of hypertensive nephropathy has been increasing quickly, which has been a major threat to people''s health. Renin-angiotensin-aldosterone system blockers have certain curative effects. However, there are some patients having serious adverse reactions, and the benefit population is limited, so the treatment of hypertensive renal damage is necessary to have beneficial supplement. More and more clinical studies have shown that ginkgo leaf extract and dipyridamole injection (GDI) combined with antihypertensive drugs has achieved good results in the treatment of hypertensive renal damage. It is supposed to be a supplementary treatment in hypertensive nephropathy.Objectives:To systematically assess the efficacy and safety of GDI combined with antihypertensive drugs on hypertensive renal injury.Methods:Seven databases including PubMed, Cochrane Library, Embase, Wanfang database, China biomedical literature service system (Sino Med), VIP Chinese Sci-tech journal database (VIP), and China national knowledge internet (CNKI) were retrieved to collect randomized controlled trials (RCTs) in the experimental group containing combined therapy of hypertensive nephropathy with GDI and antihypertensive drugs. The retrieval time was from the establishment of database to July 8, 2020. Two researchers independently selected literature, extracted data, and evaluated the risk of bias in the study. The methodological quality was evaluated with Cochrane handbook and meta-analysis was performed with Stata 14.0 software.Results:Eight studies were included in this study which involved 556 patients. The meta-analyses indicated that, compared with using antihypertensive drugs alone, combined treatment of GDI with antihypertensive drugs can decrease 24-hour urinary total protein (weighted mean difference [WMD] –0.61, 95% confidence interval [CI]: –0.82, –0.39; k = 6, P ≤ .001), blood urea nitrogen (WMD –1.27, 95% CI: –2.45, –0.10; k = 6, P = .033, serum creatinine (WMD –29.50, 95% CI: –56.44, –2.56; number of estimates [k] = 6, P = .032).Conclusions:Our meta-analyses showed that GDI combined with antihypertensive drugs can improve the renal function of hypertensive patients with renal injury.     

顶天立地服务需求 注重内涵创建一流——首都医科大学建校60周年教育教学与人才培养成果回顾

首都医科大学通过60年辛勤耕耘、精益求精,秉承“顶天立地”的人才培养理念,为社会培养了大批高水平的学术型与应用型医药卫生人才。回顾学校60年来本专科教育、全科医学教育、国际教育、研究生教育的人才培养成果,以总结经验并鼓舞全体首医人进一步求真务实、凝心聚力、积极进取、追求卓越,努力将学校建设成为国际一流的研究型医科大学。