苏州科技城医院:科技与生态同步建设六部曲

苏州科技城医院坐落于苏州高新区太湖之滨,由苏州高新区政府投资新建,是一所集医疗、科研、康复、预防于一体的三级综合性公立医院。医院占地面积140亩,总建筑面积180000m~2,总投资额16亿,设计床位1200张。医院于2013年9月29日奠基,2014年12月28日主体封顶,2016年4月正式投入使用,比预定日期提前了将近1年!     

Clinical analysis of peritoneal dialysis in the treatment of rapidly progressive glomerulonephritis

Objective To observe the clinical characteristics and prognosis of patients with rapidly progressive glomerulonephritis (RPGN) caused by lupus nephritis, antineutrophil cytoplasmic antibodies (ANCA)-associated vasculitis, or primary glomerulonephritis who were treated with peritoneal dialysis (PD) and then withdrew PD because of renal recovery. Methods Data of the above patients were retrospectively analyzed. The patients were diagnosed as RPGN and received PD therapy in Kidney Disease Center, the First Affiliated Hospital, College of Medicine, Zhejiang University from February 2009 to August 2018. The patients were divided into early withdrawal group (PD time≤183 days, n=24) and late withdrawal group (PD time＞183 day, n=24). The differences of clinical characteristics between the two groups were compared. The cumulative incidence of adverse events in both groups was analyzed using Kaplan-Meier curves. Cox proportional hazards model was used to analyze the risk factors influencing the prognosis of patients. Results Forty-eight RPGN patients were included. The median time of maintaining PD was 178(76, 378) days. Compared with the late withdrawal group, the patients in early withdrawal group had lower levels of urine volume, serum albumin and parathyroid hormone, and lower rates of gross hematuria and hypertension at the beginning of PD, and received higher rates of methylprednisolone impulse, combined immunosuppressive agents, and hemodialysis or continuous renal replacement therapy (all P＜0.05). At the time of PD withdrawal, the levels of serum creatinine, serum calcium, serum albumin and parathyroid hormone in the early withdrawal group were significantly lower than those in the late withdrawal group (all P＜0.05). The Kaplan-Meier curves showed that there was no significant difference in the cumulative survival of patients in both groups (log-rank test χ2=3.485, P=0.062). Cox regression analysis revealed serum creatinine≥209 μmol/L at the time of PD withdrawal was an independent risk factor for poor prognosis (HR=5.253，95%CI 1.757-15.702, P=0.003). Conclusions PD can be used for RPGN patients caused by lupus nephritis, ANCA-associated vasculitis and primary nephritis. Serum creatinine≥209 μmol/L at the time of PD withdrawal is an independent risk factor for poor prognosis.     

常见植物药对结肠癌的防治作用及其作用机制

植物药对结肠癌具有良好的防治作用。姜黄素、多糖(苹果多糖、香菇多糖)、皂苷(重楼皂苷、人参皂苷)、白藜芦醇、槲皮素等植物药可通过不同信号通路抑制结肠癌细胞的增殖,促进细胞凋亡。此外,植物药还具有抗炎、抗氧化、抗血管生成、减轻化疗药物不良反应、逆转肿瘤细胞耐药等作用。了解植物药对结肠癌的防治作用及其可能的作用机制,能为结肠癌的临床防治提供更多的理论依据及治疗思路。     

Risk of Stroke-Associated Pneumonia With Acid-Suppressive Drugs: A Population-Based Cohort Study

Acid-suppressive drugs, including histamine-2 receptor antagonists (H2RAs) and proton pump inhibitors (PPIs), are common medications used for treating upper gastrointestinal tract disorders. However, acid-suppressive drugs have been reported to increase the risk of pneumonia in numerous disease populations. However, the relationship between acid-suppressive drugs and stroke-associated pneumonia (SAP) remains controversial.The purpose of this study was to investigate the association between acid-suppressive drug usage and pneumonia among patients with stroke by using a nationwide data set.A population-based cohort study was conducted using a data set from the Taiwanese National Health Insurance Research Database. Data on patients with new-onset stroke from 2010 to 2011 were collected. Patients with and without acid-suppressive drug usage were followed up to identify the occurrence of any type of pneumonia. We estimated the adjusted hazard ratios (HRs) by using the Cox proportional hazards model.The study cohort comprised 7965 patients with new-onset stroke. The incidence of pneumonia was 6.9% (552/7965) and more than 40% (225/552) of patients developed pneumonia within 3 months after an acute stroke. Acid-suppressive drug usage was an independent risk factor of pneumonia. The adjusted HR for the risk of pneumonia in patients with new-onset stroke using acid-suppressive drugs was 1.44 (95% confidence interval [CI] = 1.18–1.75, P < 0.01). Only PPI usage increased risk of chronic SAP (adjusted HR = 1.46, 95% CI = 1.04–2.05).Acid-suppressive drug usage was associated with a slightly increased risk of SAP. Physicians should exercise caution when prescribing acid-suppressive drugs to patients with stroke, particularly at the chronic stage.     

浙江省2007－2017年罕见病住院病例特征分析

目的 分析2007-2017年浙江省24 388例罕见病住院病例特征，为制定罕见病防控策略提供依据。方法 收集2007-2017年浙江省10家三级甲等（三甲）医院罕见病住院病例资料和各年度住院数，进行描述性统计分析。结果 罕见病病例共24 388例，占住院总例数的2.69‰（24 388/9 054 201），病例数居前3位的疾病类型依次为"血液和造血器官疾病以及某些涉及免疫机能的异常"（占32.81%，8 001/24 388）、"先天性畸形、变形和染色体异常"（占24.87%，6 065/24 388）和"神经系统疾病"（占19.01%，4 635/24 388）；2007-2017年罕见病病例数呈逐年增长趋势，年均增幅19.69%，而罕见病例数占同期住院总例数比例仅在2016-2017年明显上升，各类型罕见病时间分布呈不同特征；罕见病的病例数男女性别比为1.35：1（13 990/10 398），男女性别比最高的3类疾病依次为"消化系统疾病"（4.45：1，1 180/265）、"损伤、中毒和外因的某些其他后果"（3.51：1，281/80）和"神经系统疾病"（2.26：1，3 213/1 422）；各年龄段罕见病类型、各类型罕见病年龄分布均呈不同特征；病例数居前10位的疾病占全部罕见病例数的53.55%（13 060/24 388），其中前3位疾病分别为成人粒细胞缺乏症（14.41%，3 515/24 388）、皮质基底核退化症（7.60%，1 854/24 388）和亨诺克-舍恩莱因紫癜（6.01%，1 466/24 388）。结论 本研究分析的浙江省2007-2017年24 388例罕见病住院病例的特征资料，是推动我国罕见病的研究、监测或登记数据库构建、制定防控策略的参考依据。     

医疗器械口咽通气道产品注册的常见问题及改进建议

近年来,医疗器械口咽通气道产品的注册数量日益增加,针对该产品的相关咨询也逐渐增多。但该产品暂无相关的注册技术审查指导原则,以致该产品的注册申报资料经常出现一些共性问题。现根据医疗器械口咽通气道产品相关法规和标准,对日常工作中遇到的常见问题进行归纳,分析该产品注册申报中的技术审评要求及共性问题,并给出对策或建议。     

灾后救灾干部心理重建研究进展

灾后心理重建工作越来越受到人们的重视,目前已经被正式纳入灾后重建体系。近年来研究表明,灾后救灾干部心理健康水平低于正常人,存在不同程度的生理和心理健康问题,而且与多种影响因素有关。灾后心理重建包括物质干预和心理干预等措施。现就灾后救灾干部心理重建研究进行综述。