哮喘患者气道阻力变化对中枢驱动的影响

目的：了解哮喘患者气道阻力的变化对中枢驱动的影响。方法对１３例正常人和２１例哮喘患者作气道反应性测定,于激发试验前后分别测定吸气初０．１ｓ时口腔阻断压（０．０１）,其中１０例哮喘患者激发试验后吸入喘乐宁,测定ＦＥＶ１及Ｐ０．１结果：正常人９名（９／１３）、哮喘患者１９例（１９／２１例）组胺激发试验后Ｐ０．１较激发前显著升高,两组Ｐ０．１升高人数的百分比比较差异无显著性,哮喘患者激发后ＦＥＶ１％与Ｐ     

五子贴敷联合腹部推拿对腰椎骨折术后腹胀的防治效果

目的:观察五子贴敷联合腹部推拿对腰椎骨折开放术后腹胀的防治效果.方法:将腰椎骨折开放术后腹胀患者80例随机分为五子贴敷组和常规护理组各40例.常规护理组予常规护理;五子贴敷组加用五子贴敷联合腹部推拿,观察两组防治效果.结果:五子贴敷组患者肛门排气时间为(33.12±4.15)h、肠鸣音恢复时间为(19.32±2.31)...     

护士职业价值观、工作满意度、工作绩效的关系研究

目的 采用结构方程模型探讨护士工作满意度在职业价值观与工作绩效间的中介作用.方法 采用横断面现况研究于2018年9月至12月采用便利抽样的方法在陕西省6所医院抽取548名一线在职护士作为研究对象.采用护士职业价值观量表(NPVS-R)、护士工作满意度量表(NJSS)、护理行为六维度量表(6-D)进行研究,并分析其相关性...     

经皮甲状腺外缘入路介入治疗颈椎间盘突出症

日的探讨经甲状腺外侧缘与颈总动脉间入路经皮穿刺切割抽吸术治疗颈椎间盘突出症的1临床效果、不良反应及并发症。资料与方法15例确诊为颈椎间盘突出症患者,全部采用经甲状腺外侧缘与颈总动脉间入路经皮穿刺抽吸治疗。结果手术成功率为100％,11例症状、体征全部消失,3例部分缓解,1例无效。结论甲状腺外侧缘与颈总动脉间入路经皮穿刺切割抽吸术治疗颈椎间盘突出症,出血少,安全性高,值得推广应用。     

Effects of nasal irrigation after endoscopic transsphenoidal resection in patients with pituitary adenomas: A randomized controlled trial

Purpose:We aimed to explore the methods to reduce or prevent nasal complications after endoscopic transsphenoidal pituitary adenoma resection. We also examined the effects of nasal irrigation after this procedure was performed.Methods:A randomized controlled trial was performed. Sixty patients of a tertiary hospital were enrolled in this study. The subjects were randomly divided into a control group and an intervention group. The subjects of the control group were given routine guidance, and 20 mL of normal saline was atomized through inhalation. The gauze was removed 7 days after surgery. The patients of the intervention group were given 50 mL of a 2% saline solution at 37°C to 38°C for bilateral nasal irrigation for 1 week. After that, patients were given 50 mL of a 0.9% normal saline solution at 37°C to 38°C for bilateral nasal irrigations. The complications of the two groups were collected at baseline, 1 week after intervention, 1 month, and 3 months after intervention. The data were analyzed using the chi-square test.Results:A 1-month after intervention, there were significant differences in dysosmia, epistaxis, and nasal adhesion between the intervention and control groups. A 3-month after intervention, only olfactory disturbances were significantly different between the two groups.Conclusions:Nasal irrigation helps reduce the incidence of complications such as epistaxis and nasal adhesions in the early postoperative period. It can also promote the elimination or reduction of olfactory disturbances.     

Design of ZIF-based hybrid nanoparticles with hyaluronic acid-augmented ROS behavior for dual-modality PA/NIR-II FL imaging

Photoacoustic (PA) imaging has emerged as a promising bio-imaging technique due to its non-invasive visualization of lesions at great penetration depths. Fluorescence (FL) imaging in the second near-infrared window (NIR-II, 1000–1700 nm) achieves a higher imaging resolution and lower background signals compared to NIR-I. However, the single imaging method possesses its own disadvantages. Thus, we have demonstrated ZIF-8–IR820–MnPc–HA nanoparticles (ZIMH NPs) that can achieve visualization and localization of tumors in mice models with the help of a dual-modality PA/NIR-II FL imaging performance. Meanwhile, these excellent nanoparticles also induce the efficient generation of singlet oxygen (¹O₂) upon 808 nm laser illumination, and display excellent photodynamic therapy efficacy in cells, further indicating their potential application for in vivo PDT. In ZIMH NPs, hyaluronic acid (HA) impressively acts as a “sponge”, enhancing the generation of ¹O₂ and facilitating the cellular therapeutic effects. We believe that ZIF-8–IR820–MnPc–HA NPs present a brand-new strategy for the exploration of efficient PDT photosensitizers with dual-modality imaging performance for use in various biomedical applications.

We have obtained ZIF-8–IR820–MnPc–HA nanoparticles with hyaluronic acid-augmented ROS behavior for dual-modality PA/NIR-II FL imaging in vivo.     

肾静脉栓塞的彩色多普勒超声征象及其诊断价值

目的通过与增强CT对比分析,探讨彩色多普勒超声在肾静脉栓塞疾病中的诊断价值。 方法选取2014年1月至2017年9月在北京协和医院就诊的经手术病理或随访证实的40例45侧肾静脉栓塞患者,其中,15例20侧肾静脉血栓及25例25侧肾静脉癌栓,均行彩色多普勒超声及增强CT检查,总结肾静脉栓塞的超声表现,包括栓塞病灶的位置、受累静脉管腔及管壁特点、侧支形成情况及彩色多普勒表现。超声与增强CT诊断肾静脉血栓及癌栓的准确率比较采用χ²检验。 结果彩色多普勒超声对肾静脉血栓及癌栓的诊断准确性分别为85%、84%,CT增强扫描的诊断准确性依次分别为100%、96%,差异均无统计学意义（P均>0.05）。肾静脉栓塞的主要超声征象有：（1）肾静脉管腔扩张伴实性成分填充;（2）主干内血流中断或充盈缺损;（3）肾内无明显静脉血流信号或血流信号分布稀疏。 结论彩色多普勒超声与增强CT在诊断肾静脉栓塞上有较好的一致性,超声可作为评估肾静脉栓塞的重要影像学方式,结合病史能为肾静脉栓塞提供较为可靠的诊断依据。     

2种长度切口MSICS联合IOL植入术的角膜地形图分析

目的探讨2种长度切口对手法小切口白内障摘除联合人工晶状体植入术（manual small incisioncataract surgery with intra-ocular lens implantation,MSICS＋IOL）后角膜地形图的影响。方法将拟行MSICS＋IOL的患者89例89只眼（核硬度Ⅳ~Ⅴ级）分为2组,A组45只眼核硬度Ⅳ级,B组44只眼核硬度Ⅴ级,分别行5.5 mm、6.5 mm巩膜隧道切口的MSICS＋IOL,用角膜地形图仪观察手术前、手术后1周及1个月时的角膜形态变化。结果术后1周及1个月时,B组角膜表面散光值（cylinder,CYL）、平均角膜曲率（average cornealpower,ACP）值均大于A组,差异有统计学意义（P〈0.05）;术后1周,B组角膜表面非对称指数（surface asym-metry index,SAI）较A组增加,差异有统计学意义（P〈0.05）,术后1个月时则与A组大致相同（P〉0.05）;2组术后1周、1个月的角膜表面规则指数（surface regularity index,SRI）差异无统计学意义（P〉0.05）。结论切口长度为5.5 mm的MSICS＋IOL手术较6.5 mm对术后早期角膜散光影响小;切口长度为5.5 mm的MSICS＋IOL手术和6.5 mm长度切口者对术后早期角膜的规则性影响相似。     

A retrospective study of breast cancer subtypes: the risk of relapse and the relations with treatments

Immunohistochemical markers are often used to classify breast cancer into subtypes that are biologically distinct and behave differently. The aim of this study was to estimate relapse for patients with the major subtypes of breast cancer as classified using immunohistochemical assay and to investigate the patterns of benefit from the therapies over the past years. The study population included primary, operable 2,118 breast cancer patients, all non-specific infiltrative ductal carcinoma, with the median age of 53.2 years. All patients underwent local and/or systemic treatments. The clinicopathological characteristics and clinical outcomes were retrospectively reviewed. The expression of estrogen receptor (ER), progesterone receptor, human epidermal growth factor receptor 2 (HER2), epidermal growth factor receptor (EGFR), and cytokeratin 5/6 were analyzed by immunohistochemistry. All patients were classified into the following categories: luminal A, luminal B, HER2 overexpressing, basal-like, and unclassified subtypes. Ki-67 was detected in luminal A subtype. The median follow-up time was 67.9 months. Luminal A tumors had the lowest rate of relapse (12.7%, P < 0.001), while luminal B, HER2 overexpression, and basal-like subtypes were associated with an increased risk of relapse (15.7, 19.1, 20.9%). Molecular subtypes retained independent prognostic significance (P < 0.001). In luminal A subtype, adjunctive radiotherapy could decrease the risk of relapse (P = 0.005), Ki67 positive was a high-risk factor for relapse (P < 0.001), and adjuvant chemotherapies could reduce the relapse for the patients with risk factors (P < 0.001). Adjuvant hormone therapy was an effective treatment for ER-positive tumors (P < 0.001). Molecular subtypes of breast cancer could robustly identify the risk of recurrence and were significant in therapeutic decision making. The model combined subtype and clinical pathology was a significant improvement. Luminal A tumors might represent two distinct subsets which demonstrated distinct prognosis and therapy response.     

早期先兆流产保胎治疗后妊娠结局观察

目的 探讨早期先兆流产保胎治疗继续妊娠的结局.方法 对早期先兆流产保胎治疗后继续妊娠的孕妇144例与同期内无早期先兆流产征象的孕妇150例进行观察,比较两组的妊娠结局.结果 两组在子痫前期、产后出血、早产、新生儿不良结局方面无显著差异(P>0.05),而胎盘粘连、前置胎盘的发生两组有显著差异(P<0.05).结论 早期先兆流产经保胎治疗后继续妊娠,对妊娠结局无严重不良影响.但是出血时间长及有多次自然流产史的患者胚胎缺陷可能性大,需慎重.