早产儿喂养不耐受影响因素分析及对策

目的探讨早产儿喂养不耐受的影响因素及相关对策。方法将51例喂养不耐受早产儿设为观察组,随机选择同期非喂养不耐受早产儿52例作为对照组,对上述两组的临床资料进行回顾性分析。结果两组早产儿在出生体重、胎龄大小、开奶时间、宫内窘迫、是否使用氨茶碱及胃出血等方面有差异（P〈0．05）,表明喂养不耐受与上述因素相关。结论早产儿喂养不耐受与多种因素相关,及早开奶、早期微量喂养、缓慢增加喂奶量、注意喂奶方式和途径、刺激排便、及时处理腹胀、进行相应的药物干预以及应用微生态制剂,有利于改善早产儿胃肠道喂养的耐受性。     

四川省遂宁市基层全科医师糖尿病知识培训的模式及效果

目的：探讨对基层全科医师实施有针对性的糖尿病知识教育,以期得到提高基层医师糖尿病知识的有效措施和方法。方法采用如下培训模式：编写培训讲义、教材;给基层医师集体上课与讨论,单个指导;到基层医院现场查房。培训前后分别进行2次问卷答题评分,根据评分对培训模式的效果评价。结果1）基层全科医生学历低,糖尿病诊治水平极低,尤其是村卫生室医生;2）培训前乡镇卫生院、社区卫生服务中心及村卫生室医生糖尿病相关知识考试成绩都很差,村卫生室医生明显低于前两组医生（P＜0.05）;3）经过统一模式培训后,3组医生考试成绩均较培训前提高（P＜0.05）,但村卫生室医生成绩仍然最差（P＜0.05）。结论对基层全科医生进行系统规范的糖尿病知识培训,是提高基层医生糖尿病防治能力和防治意识的一种可行措施。     

胎儿组织钙含量及其特征与未成年人钙缺乏

为探索胎儿组织钙含量特征及其状态与未成年人钙缺乏的关系 ,测定 4～ 10月龄胎儿 7种组织钙含量并进行统计分析。结果显示 ,胎儿组织钙含量是一非稳态变量 ,是时空环境的函数。组织钙含量随时间和组织重量增加而减少 ,使每克组织钙含量向降低的方向发展 ,这一特征可延续到 2 0岁左右。结果提示 ,胎儿和未成年人组织钙含量随生长发育而降低的生理特征增加了对钙缺乏的敏感性 ,是低龄人群钙缺乏的生理基础 ,为调控胎儿和未成年人及孕妇钙营养提供了生理信息     

Multi-modality imaging to determine the cellular heterogeneity of nasopharyngeal carcinoma components

Nasopharyngeal carcinoma (NPC) is an endemic public health problem in South and Southeast Asian countries. The disease components at the molecular level are unclear and need exploration for the development of future individualized molecular medicine. The purpose of this study was to test the feasibility of target-specific agents to detect different components of NPC. The binding capability of human NPC cell lines was determined by incubation with either agents that specifically target the metabolic status, host cytokines, and stroma. Mice bearing human NPC xenografts were injected with the same test agents plus a clinical molecular imaging agent (¹⁸F-fluorodeoxyglucose) and computer tomography (CT) contrast agent. In vitro cell studies have demonstrated that target-specific agents bind to NPC cells with significantly higher signal intensities. Those agents not only bound to the cell membrane but also penetrated into the cytosol and cell nuclei. In vivo imaging demonstrated that the human NPC xenografts revealed high glucose uptake and a profound vasculature in the tumor. All agents were bound to the tumor regions with a high tumor-to-muscle ratio. Finally, all imaging data were validated by histopathological results. Multiple, target-specific agents determine the dynamic and heterogeneous components of NPC at the molecular level.     

微型钢板内固定术与克氏针内固定法治疗掌指骨骨折效果比较

目的比较微型钢板内固定术与克氏针内固定法治疗掌指骨骨折的效果。方法选取2016-02至2019-02广东省汕头市中心医院收治的掌指骨骨折患者70例,按治疗方式不同分为对照组与研究组。对照组34例,给予克氏针内固定术治疗,研究组36例,给予微型钢板内固定术治疗,比较两组手术时间、住院时间、骨折愈合时间、疗效及术后并发症情况。结果研究组手术时间及住院时间均长于对照组,差异有统计学意义(P<0.05);骨折愈合时间短于对照组,差异有统计学意义(P<0.05);临床治疗优良率(97.22%)高于对照组(76.47%),差异有统计学意义(P<0.05);并发症总发生率(2.78%)低于对照组(23.59%),差异有统计学意义(P<0.05)。结论相比于克氏针内固定法,采用微型钢板内固定术治疗掌指骨骨折效果更优,且并发症相对较少。     

改良手助腹腔镜治疗脾转移瘤一例

<正>患者女性,53岁,主因腰背部胀痛1个月于2016年3月就诊于河北医科大学第二医院门诊,体格检查无阳性体征。腹部超声显示可疑脾占位性病变,CT显示脾占位性病变,考虑脾淋巴管瘤(图1)。患者既往于2009年9月因"下腹部不适2个月"于河北医科大学第二医院行CT检查,发现盆腔肿物,住院治疗;在全身麻醉下行传统开腹手术探查,发现肿物来源于卵巢,遂按卵巢肿瘤手术原则,行子宫、双附件、大网膜及阑尾切除术;术后病理回报为卵巢黏液性囊腺瘤,术     

Influence of Exercise at High Temperature on Blood Biochemical Indexes and HSP72 Expression in Adult Males

The influence of exercise at high temperature on adult males＇ routine blood indexes and biochemical indexes and the expression of HSP72 in peripheral blood lymphocytes （PBLs） was studied in order to provide theoretical ground for health supervision of adults receiving exercise at high temperature. 180 adult males were selected and divided into exercise group and control group, in which the exercise group was subdivided into subgroup 1 and subgroup 2 receiving exercise at high temperature in the afternoon and in the morning, respectively. Peripheral venous blood was phle- botomized before and after the exercise to examine routine blood indexes and blood biochemical indexes. The expression levels of HSP72 in PBLs were detected by flow cytometry. The results showed that the routine blood indexes and biochemical indexes in each group were within the range of normal values of male adults. There was no significant difference between each exercise group and control group in indexes before exercise. After exercise, the expression levels of HSP72 in PBLs in exercise groups were higher than those before exercise, and HSP72 expression levels in subgroup 1 were obviously higher than those in subgroup 2 and control group. The contents of ALT, urea, Na＋, Cl-, Ca2＋ and K＋ in subgroups 1 and 2 were lower than those in control group, but CK level was higher than in control group （P〈0.05）. The contents of Na＋ and Clin subgroup 1 were relatively lower than those in subgroup 2 （P〈0.05）. It was concluded that while receiving exercise at high temperature, adult males＇ HSP72 levels in PBLs could be increased and the biochemical indexes changed. Attention should be paid to health supervision to avoid obvious body injuries at high temperature.     

二氯二甲基海因及其复方消毒剂性能的实验室观察

经检测，二氯二甲基海因与二氯异氰尿酸钠的杀菌作用相似，而二氯二甲基海因复方的杀菌作用，明显较前两种单药为优．二氯二甲基海因及其复方的杀菌效果随有机物增加而下降，受温度影响较小．其单药与复方均属低毒、无刺激类，对金属腐蚀性较小，贮存较稳定．     

异氟醚吸入或异丙酚复合芬太尼麻醉对血糖和血脂影响的观察

目的观察异氟醚吸入或异丙酚复合芬太尼长时间麻醉(≥6h)对血糖和血脂的影响。方法 30例口腔-颌面肿瘤外科手术病人随机分为异氟醚组和异丙酚组,每组15例。异氟醚组以咪唑安定诱导,异氟醚吸入维持;异丙酚组以异丙酚靶控输注复合芬太尼连续输注。于麻醉诱导前、手术开始后第3、6h测定血糖、血脂以及术后2h测定血糖,术后24h测定血脂。结果异氟醚吸入或异丙酚复合芬太尼长时间麻醉,术中第3h和6h的血糖水平较术前均有明显升高(P<0.05),但相同时间点的血糖水平,吸入组较静脉组有显著升高(P<0.05)。异氟醚吸入6h后,术中血脂水平较诱导前无明显改变,均在正常值范围之内。异丙酚连续靶控输注3、6h,其血脂水平达到临界高值,与同时间点的异氟醚组比较,均有显著升高,其血脂水平在术后24h恢复至诱导前水平。结论对于长时间麻醉,异丙酚复合芬太尼麻醉对术中高血糖反应的抑制作用较异氟醚吸入麻醉强。两种麻醉方法,手术6h后所有病例均未见低血糖。异氟醚吸入麻醉,手术应激对血脂代谢无明显影响。异丙酚连续靶控输注6h后,可增加病人血中甘油三脂水平,并引起脂类代谢异常。