黄芪总苷对小鼠日本血吸虫病肝纤维化的影响

目的:研究黄芪总苷(AST)对小鼠日本血吸虫病肝纤维化和虫卵肉芽肿的影响.方法:以日本血吸虫尾蚴感染ICR小鼠制作肝纤维化动物模型,5 wk末随机分为:AST高剂量组20 mg/(kg·d)、AST低剂量组10 mg/(kg·d)、阳性药护肝片组540 mg/(kg·d)和模型对照组,各组均于感染40 d后,吡喹酮杀虫2 d 500mg/(kg·d).同时设置正常对照组30只.感染后6、10和14 wk每组随机处死10只,观察肝脏指数,应用HE和天狼猩红染色观察小鼠虫卵结节大小及纤维化程度;构建组织芯片,应用免疫组织化学方法检测虫卵结节中Ⅰ、Ⅲ型胶原蛋白的表达.结果:感染后10、14 wk, AST高、低剂量组与模型组相比较,肝组织中血吸虫虫卵结节显著缩小,纤维化程度明显减轻,Ⅰ、Ⅲ型胶原蛋白含量(MOD)明显减低(10 wk: 0.093±0.002、0.084±0.003 vs 0.134±0.004,P＜0.01;0.074±0.002、0.104±0.005 vs 0.146±0.008,P＜0.05;14 wk: 0.099±0.004、0.095±0.004 vs 0.141±0.007,P＜0.01;0.070±0.003、0.077±0.003 vs 0.101±0.004,P＜0.05).感染10 wk,AST高、低剂量组Ⅲ型胶原蛋白含量有统计学差异(P＜0.01).结论:AST通过抑制虫卵结节、减少Ⅰ、Ⅲ型胶原的合成发挥抗小鼠日本血吸虫病肝纤维化的作用.     

异丙酚和七氟烷对全麻病人短时间吸入纯氧诱发氧化应激反应的影响

Objective To investigate the effects of propofol and sevoflurane on oxidative stess response induced by short period pure oxygen inhalation during general anesthesia.Methods Sixty ASA Ⅰ or Ⅱ patients aged 20-60 yr weighing 50-85 kg undergoing elective abdominal surgery under general anesthesia were randomly divided into 2 groups (n=30 each):group propofol (group P) and group sevoflurane (group S).Each group was further divided into 2 subgroups inhaling 40% O2 (P0.4,S0.4) and 100%O2(P1.0,S1.0) respectively during operation.Anesthesia was induced with propofol 1-2 mg/kg,midazolan 0.02 mg/kg and sufentanil 0.1-0.2 mg/kg.Tracheal intobation was facilitated with rocuronium 0.6-0.8 mg/kg.The patients were mechanically ventilated(VT 8 ml/kg,RR 12 bpm).PET CO2 was maintained at 35-40 mmHg.Anesthesia was maintained with in both groups.BIS was maintained at 40-60.Arterial blood samples were collected immediately before induction of anesthesia (baseline),at 2,4,6h after tracheal intubation(T1-3) and 24h after operation(T4) for determination of PaO2,serum 8-iso-PGF2α and MDA concentrations and SOD activity.PaO2/FiO2 was calculated.Results In subgroup S1.0 the serum 8-iso-PGF2α and MDA concentrations were significantly increased while serum SOD activity was significanfly decreased at T1-3 as compared with the baseline.Serum 8-iso-PGF2α and MDA concentrations were significantly higher while serum SOD activity and PaO2/FiO2 were significantly lower at T1-3 in subgroup S1.0 than in stress response induced by≤6h pure O2 inhalation but inhalation of 1.5%-3.0% sevoflurane can not.     

异丙酚和七氟烷对全麻病人短时间吸入纯氧诱发氧化应激反应的影响

Objective To investigate the effects of propofol and sevoflurane on oxidative stess response induced by short period pure oxygen inhalation during general anesthesia.Methods Sixty ASA Ⅰ or Ⅱ patients aged 20-60 yr weighing 50-85 kg undergoing elective abdominal surgery under general anesthesia were randomly divided into 2 groups (n=30 each):group propofol (group P) and group sevoflurane (group S).Each group was further divided into 2 subgroups inhaling 40% O2 (P0.4,S0.4) and 100%O2(P1.0,S1.0) respectively during operation.Anesthesia was induced with propofol 1-2 mg/kg,midazolan 0.02 mg/kg and sufentanil 0.1-0.2 mg/kg.Tracheal intobation was facilitated with rocuronium 0.6-0.8 mg/kg.The patients were mechanically ventilated(VT 8 ml/kg,RR 12 bpm).PET CO2 was maintained at 35-40 mmHg.Anesthesia was maintained with in both groups.BIS was maintained at 40-60.Arterial blood samples were collected immediately before induction of anesthesia (baseline),at 2,4,6h after tracheal intubation(T1-3) and 24h after operation(T4) for determination of PaO2,serum 8-iso-PGF2α and MDA concentrations and SOD activity.PaO2/FiO2 was calculated.Results In subgroup S1.0 the serum 8-iso-PGF2α and MDA concentrations were significantly increased while serum SOD activity was significanfly decreased at T1-3 as compared with the baseline.Serum 8-iso-PGF2α and MDA concentrations were significantly higher while serum SOD activity and PaO2/FiO2 were significantly lower at T1-3 in subgroup S1.0 than in stress response induced by≤6h pure O2 inhalation but inhalation of 1.5%-3.0% sevoflurane can not.     

溶血性贫血患者的护理

溶血性贫血是指红细胞破坏加速,超过骨髓造血功能的代偿能力而发生的贫血。因为红细胞膜先天性异常所致的溶血性贫血,包括遗传性球形红细胞增多症、遗传性椭圆形红细胞增多症等;因为红细胞酶异常所致溶血性贫血,     

循坐骨神经穴位针刺联合分阶段康复训练法对老年股骨颈骨折髋关节置换术后患者的疗效

目的：探讨循坐骨神经穴位针刺联合分阶段康复训练法对老年股骨颈骨折（FNF）髋关节置换术后患者的疗效。方法：选取2019年6月—2021年6月来上海市第五康复医院就诊并符合纳入标准的老年FNF患者86例,参照随机数字表法分入观察组与对照组,每组43例。两组均进行常规全髋关节置换术及术后常规干预措施;对照组采取分阶段康复训练法干预;观察组在对照组的基础上行循坐骨神经穴位针刺干预。两组连续观察3个月。比较两组髋关节Harris评分、骨折愈合时间、骨密度、临床疗效及并发症。结果：术后3个月,观察组患者的Harris评分明显高于对照组,而骨折愈合时间显著短于对照组（P <0.01）;术后3个月,两组腰椎正位（L2-4）、右跟骨、股骨颈的骨密度明显升高,且观察组明显高于对照组（P <0.01）;末次随访当日,观察组的髋关节功能优良率较对照组提升更加显著（90.70%vs 69.77%,P <0.05）;观察组患者中下肢深静脉血栓与假体松动发生率显著低于对照组（4.66%vs 23.26%,P <0.05）。结论：于西医常规干预基础上,循坐骨神经穴位针刺联合分阶段康复训练法对...     

蜈蚣败毒饮对银屑病不同血分证型患者皮损指数、中医证候评分及血液学检验指标的影响

目的：探讨蜈蚣败毒饮对银屑病血热证、血瘀证、血燥证型患者皮损指数、血液学检验指标的影响,并探讨其相关机制。方法：将符合纳入标准的300例寻常型银屑病患者采用随机数字表法分为治疗组和对照组,每组再分为血热证、血燥证、血瘀证组,除脱落病例外,最终治疗组141例,对照组146例。治疗组给予蜈蚣败毒饮水煎剂,每日1剂,每日2次;对照组给予复方甘草酸苷片,每次2片,每日3次,各组患者均连续给药4周。观察两组不同证型患者临床疗效,比较治疗前后两组银屑病皮损面积和严重程度指数(PASI)、中医证候评分、8项血液学检测指标[C反应蛋白(CRP)、前白蛋白(PA)、降钙素原(PCT)、白细胞计数(WBC)、红细胞沉降率(ESR)、载脂蛋白A(APOA)、载脂蛋白B(APOB)、纤维蛋白原(FIB)]水平。结果：治疗组各证型患者临床疗效均高于对照组同证型患者(P<0.01)。治疗前各组患者的PASI评分、各项血液学指标差异无统计学意义(P>0.05);与本组治疗前比较,治疗后的治疗组的PASI评分、中医证候评分均显著降低(P<0.01),CRP、PCT、WBC、ESR、APOB、FIB水...     

原发免疫性血小板减少症患儿慢性化现状及其相关危险因素探讨

目的 探讨原发免疫性血小板减少症(primary immune thrombocytopenia,ITP)患儿慢性化现状及其相关危险因素。方法 回顾性收集2019年6月至2022年6月河北省唐山市妇幼保健院收治的241例ITP患儿临床资料,所有患儿均接受静脉注射用免疫球蛋白、激素单独或联合治疗,出院后随访2年,根据随访期间ITP患儿疾病是否发生慢性化分为慢性化组(39例)和非慢性化组(202例)。统计两组随访期间ITP患儿慢性化发生情况及单因素,采用多因素logistic回归分析ITP患儿慢性化的危险因素。结果 241例ITP患儿随访期间发生慢性化共39例,慢性化率为16.18%。单因素分析结果显示,慢性化组和非慢性化组年龄、确诊时血小板计数、发病情况、确诊时外周血淋巴细胞绝对值水平、发病前病毒感染史情况、确诊时外周血骨髓巨核细胞数、初始治疗方法比较,差异有显著性(P<0.05)。多因素logistic回归分析结果显示,年龄≥10岁、发病隐匿为ITP患儿慢性化的独立危险因素(OR分别为2.782、3.378,P<0.05),确诊时外周血淋巴细胞绝对值水平较高、初始治疗方法静脉注射用免疫球蛋白联合激素均为ITP患儿慢性化的保护因素(OR分别为0.517、0.263,P<0.05)。结论 ITP患儿慢性化发生率较高,其保护因素包括初始治疗方法静脉注射用免疫球蛋白联合激素、确诊时外周血淋巴细胞绝对值水平较高,危险因素包括年龄≥10岁、发病隐匿,因此,临床可对年龄≥10岁、发病隐匿、确诊时外周血淋巴细胞绝对值水平较低的患儿进行针对性治疗或干预,降低患儿疾病发生慢性化的风险。     

多维教学法在《临床检验基础》课程中的应用探讨

《临床检验基础》作为一门医学检验专业的必修课和主干课,其教学内容包含了临床检验实践中最基础、最常用的检测项目.本研究是针对《临床检验基础》课程的培养目标和课程特点,将教学内容根据各个检测项目进行模块化,再通过基于问题为导向的教学模式、基于案例的教学法等多种教学方法的灵活应用,设计针对不同项目模块的教学活动,以改变传统课...     

肠道益生菌联合纳洛酮对重症手足口病患儿免疫球蛋白水平及肠黏膜屏障功能的影响

目的 探讨肠道益生菌联合纳洛酮治疗重症手足口病的疗效,以及对患儿免疫球蛋白水平及肠黏膜屏障功能的影响.方法 选取医院2018年3月至2020年3月收治的重症手足口病患儿112例,按随机数字表法分为观察组和对照组,各56例.两组患儿均予常规治疗,观察组患儿加用肠道益生菌联合纳洛酮治疗,均连续治疗1周.结果 观察组患儿的总...