手术时机对小骨窗显微手术治疗高血压脑出血患者预后的影响

目的 探究小骨窗显微手术治疗高血压脑出血的最佳手术时机.方法 连续纳入2010年6月至2014年6月来我院神经外科高血压脑出血发病24 h内接受小骨窗显微手术治疗患者.前瞻性队列研究方法进行研究设计,根据入院接受手术时间分为对照组(＞6h)27例及研究组(≤6h) 31例.两组患者均全麻下进行小骨窗开颅显微手术.术后1周内检测死亡、并发症及再出血例数.手术前后对患者进行GOS评分,手术后1周及半年对患者进行随访,并进行ADL评分及WHOQOL-BREF评分.结果 术前两组GOS评分无统计学差异(P＞0.05),术后研究组患者GOS评分显著高于对照组(P＜0.05).术后1周,两组ADL评分无统计学差异(P＞0.05);术后半年,研究组患者ADL评分显著高于对照组(P＜0.05).术后1周,两组WHOQOL-BREF评分无统计学差异(P＞0.05);术后半年,研究组患者WHOQOL-BREF评分显著高于对照组(P＜0.05).通过多重线性回归发现,在校正性别、年龄、术前GOS评分后,手术时机与术后GOS评分呈线性关系,发病到手术的时间越短,其术后GOS评分越高(P＜0.05).结论 发病到手术的时间越短,患者术后预后越好,在发病后6h内进行手术能够显著提高患者的预后,促进日常生活活动功能的恢复,提高患者的生存质量,具有重要意义.     

HPLC测定麻黄及其制剂中3种生物碱含量

目的 建立HPLC同时测定麻黄及其制剂中3种生物碱含量。方法 以乙腈-甲醇-0.1%磷酸溶液(1.5∶4∶94.5)为流动相,同时测定麻黄、金麻杏止咳片和麻杏止咳片中3种生物碱的含量。结果 盐酸麻黄碱、盐酸伪麻黄碱、盐酸甲基麻黄碱的进样量分别为0.102 9~0.686,0.025?11~0.167 4,0.022 23~0.148 2 μg,分别与峰面积呈良好的线性关系;平均回收率分别为100.56%,97.84%和98.42%,RSD分别为0.20%、0.94%和1.31%(n=6)。结论 所建立的HPLC可通过测定3种生物碱的含量综合评价麻黄及其制剂的质量。     

肝素联合低分子肝素预防动静脉内瘘术后早期血栓形成

摘 要 目的： 研究肝素联合低分子肝素对预防动静脉内瘘（AVF）术后早期血栓形成的影响。方法: 采用前瞻性研究方法,将299例行AVF术的患者随机分为两组,对照组患者术后给予低分子肝素5 000 IU皮下注射qd×7 d;观察组术中在游离动脉端与静脉端分别推注1 500 u肝素钠,术后给予低分子肝素5 000 IU皮下注射qd×7 d。观察两组患者术后1周和4周AVF血栓形成率及药品不良反应（ADR）发生情况。结果: 术后1周,对照组和观察组的AVF血栓形成率分别为3.4%和0;术后4周分别为4.8%和0.67%,观察组均明显低于对照组（P<0.05）。两组ADR发生率差异无统计学意义（P>0.05）,未发生严重不良反应。结论: 肝素联合低分子肝素可降低AVF术后早期血栓形成率,提高手术成功率,安全性较好。     

机载激光雷达多脉冲探测模式在大高差地形测绘中的应用分析

阐述了LIDAR多脉冲探测模式原理及影响因素。通过飞行实验对比了单脉冲与多脉冲探测模式在大高差地形区域的探测效率及相关问题。大高差地形测绘中,单脉冲模式只能采用低激光频率,造成点密度稀疏,难以满足高精度制图需求;多脉冲模式虽然具有作业效率高等优势,可以获取点密度更高的数据,如何规避大气边缘区的影响是必须考虑的问题。在西北某测区通过合理设计,采用多脉冲模式完成了机载激光雷达数据采集,获得了较好效果。未来采用LIDAR多脉冲探测模式可以在我国西部大高差区域地形测绘工作中发挥重要作用。     

右美托咪定混合罗哌卡因用于缓解上肢长时间手术中止血带反应的效果观察

目的 探讨右美托咪定混合罗哌卡因在肌间沟复合腋路臂丛神经阻滞应用于上肢长时间手术中的疗效观察。 方法 60例急诊断指(多指)、断腕或断臂手术患者,ASAⅠ～Ⅱ级,手术时间8～10 h,随机分配为2组 (n=30):罗哌卡因组(R组)采用1%罗哌卡因15 mL+2%利多卡因10 mL加生理盐水至40 mL;右美托咪定混合罗哌卡因组(DR组)采用1%罗哌卡因15 mL+2%利多卡因10 mL+盐酸右美托咪定1 μg/kg加生理盐水至40 mL。以神经刺激器定位肌间沟臂丛神经分支(腋神经)及腋路臂丛神经主分支(尺神经、桡神经、正中神经和肌皮神经),止血带充气压力200～250 mmHg,压迫时间90 min。观察并记录入室时(T0)、阻滞后1.5 h(T1)、3 h(T2)、4.5 h(T3)、6 h(T4)、7.5 h(T5)、9 h(T6)及术毕(T7)患者的一般生命体征(MAP、HR),同时以VAS评分法评估患者止血带反应的程度,若无法忍受止血带反应,臂丛加药后试验结束。记录患者止血带耐受情况,并以Ramsay评分评价R组及DR组的镇静程度,记录术中出现的不良反应。结果 与R组相比,DR组患者对止血带耐受率明显升高,且差异有统计学意义(P <0.05),止血带疼痛时间出现延迟(P <0.05) ;与R组比较, DR组T1～T5时HR减慢(P <0.05),DR组有7例出现窦性心动过缓,两组均未出现止血带严重并发症。 结论 1 μg/kg右美托咪定混合1%罗哌卡因对减轻上肢长时间手术带来的止血带疼痛安全、有效,并可延迟止血带疼痛出现的时间。     

The implementation of a Hazard Analysis and Critical Control Point management system in a peanut butter ice cream plant

To ensure the safety of the peanut butter ice cream manufacture, a Hazard Analysis and Critical Control Point (HACCP) plan has been designed and applied to the production process. Potential biological, chemical, and physical hazards in each manufacturing procedure were identified. Critical control points for the peanut butter ice cream were then determined as the pasteurization and freezing process. The establishment of a monitoring system, corrective actions, verification procedures, and documentation and record keeping were followed to complete the HACCP program. The results of this study indicate that implementing the HACCP system in food industries can effectively enhance food safety and quality while improving the production management.     

Anomalous functional connectivity within the default-mode network in treatment-naive patients possessing first-episode major depressive disorder

Background and Objective:Previous studies have shown that the default-mode network (DMN) has a substantial role in patients with major depressive disorder (MDD). However, there is a shortage of information regarding variations in the functional connectivity (FC) of the DMN of treatment-naive patients with first-episode MDD. The present study aims to explore the FC of the DMN in such patients.Methods:The study population consisted of 33 patients and 35 controls, paired regarding age, gender, education level, and health condition. Depression severity was assessed through the Hamilton Depression Scale (HAM-D), and subjects underwent evaluation during the resting-state through functional magnetic resonance imaging (rs-fMRI). To assess the result, we used FC and ICA. We used Spearman''s correlation test to detect potential correlations between anomalous FC and severity of HAM-D scores.Results:We have found a decreased FC in the left medial orbitofrontal gyrus (MOFG) and right marginal gyrus (SMG) in depressive patients compared to controls. There was a negative correlation between abnormal FC in the right SMG and HAM-D scores. We have not found any increase in FC of the DMN in treatment-naive, first-episode of MDD patients.Conclusions:Our study provided evidence of a negative correlation between abnormal FC in the DMN and severity of depression symptoms measured by HAM-D in treatment-naive MDD patients. This finding could shed some light on the relevance of DMN for understanding the pathophysiology of cognitive impairment in MDD.     

Effectiveness and safety of Yufeng Ningxin for the treatment of essential hypertension: A protocol for systematic review and meta-analysis

Background:Essential hypertension is the primary cause of death and disability and it has become a major public health problem globally. Yufeng Ningxin (YFNX) is a commonly used Chinese patent medicine in treating essential hypertension. The objective of this protocol is to evaluate the effectiveness and safety of YFNX for the treatment of essential hypertension.Methods:Randomized controlled trials (RCTs) in relation to the effectiveness and safety of YFNX in the treatment of essential hypertension will be systematically searched and collected from the following databases: PubMed, EMBASE, Cochrane Library, Chinese National Knowledge Infrastructure, Wanfang Database, Chinese Biomedical Literature Database, and Chinese Scientific Journal Database from the database inception to January 1, 2021. The data screening and extraction will be carried out by 2 different reviewers. The quality of randomized controlled trials will be assessed based on the version 2 of the risk-of-bias tool for randomized trials (RoB 2) in the Cochrane Handbook. The reduction of systolic blood pressure (SBP) and diastolic blood pressure (DBP) will be served as the primary outcome. The secondary outcomes will include average SBP and average DBP during the day and the night measured by 24 hours ambulatory blood pressure monitoring, the clinical effectiveness rate, scores of traditional Chinese medicine syndrome, clinical symptoms, the quality of life and adverse events. Statistical analysis will be conducted with Review Manager 5.3 and STATA 14.0 software.Conclusion:This systematic review will provide strong evidence to assess the effectiveness and safety of YFNX in the treatment of essential hypertension.Trial registration number:INPLASY202110059.