Selective cyclo-oxygenase 2 inhibition affects ileal but not colonic anastomotic healing in the early postoperative period

BACKGROUND: Selective cyclo-oxygenase 2 (COX-2) inhibitors are increasingly prescribed in the perioperative period. Recent recognition of a possible role for COX-2 in wound healing has raised concerns about the safety of their use in surgical practice. Therefore, the influence of celecoxib, a selective COX-2 inhibitor, on early anastomotic healing was investigated. METHODS: Celecoxib, in doses of 15, 50 or 200 mg per kg per day, was given daily from the day before operation onwards to male Wistar rats that received both ileal and colonic anastomoses. Anastomotic strength was assessed by measuring the breaking strength and bursting pressure on the third day after operation. A second group received a dose of 50 mg per kg per day and a colonic anastomosis only, and healing was assessed on the third and fifth day after surgery. RESULTS: Expression of COX-2 protein was upregulated in the anastomotic area. Administration of celecoxib, at all doses tested, resulted in a significantly higher ileal dehiscence rate than in control rats (P = 0.002). In contrast, colonic anastomoses healed normally within the same animals. The latter was confirmed in rats with colonic anastomoses only. CONCLUSION: In this model, administration of the COX-2 inhibitor celecoxib affected ileal but not colonic anastomotic healing in the early postoperative period.     

非典型肾结核45例诊治分析

目的：提高对非典型肾结核临床特点的认知及诊治水平。方法：回顾性分析1979年1月～2009年12月收治的45例非典型肾结核患者的临床资料：男24例,女21例,年龄19～61岁,平均38岁,其中20～50岁者38例,占84．4％。临床表现为尿频31例（68．9％）,肉眼或镜下血尿9例（20．0％）,尿常规不正常36例（80．0%）。15例（62．5％）男性患者曾诊为慢性前列腺炎,治疗1～3年无效,后诊为肾结核;7例伴有附睾结核,其中3例已在外院行附睾切除术。治疗前行尿路造影、CT和B超检查。9例采用异烟肼加利福平加乙胺丁醇药物治疗,疗程9～12个月;36例于抗结核治疗2、3周后行患肾切除术,4例加行附睾切除。结果：尿路造影、CT和B超诊断准确性分别为21．2％、100％和88．9％。36例手术治疗者全部治愈,9例药物治疗者中,5例在6～24个月复查时,患肾损坏严重,遂行肾切除。结论：非典型肾结核的膀胱刺激症状不明显,尿常规、B超、静脉肾盂造影是主要的检查方法,CT具有较大的诊断价值;外科手术仍是肾结核无功能肾的主要治疗手段。     

临床护士工作应激及焦虑抑郁对血清总皮质醇的影响

目的 探讨临床护士工作应激及焦虑抑郁情绪对其血清总皮质醇的影响.方法 对104名临床护士采用护士工作应激源量表及Zung焦虑、抑郁自评量表进行调查,同时检测其血清总皮质醇.结果 临床护士工作应激源总评分为(529.85±176.87)分,SAS评分(36.84±7.20)分,SDS评分(41.21±7.22)分;血清总...     

基于社会生态系统理论的阴茎癌患者患病体验的质性研究

目的 了解阴茎癌患者的患病体验,为制定针对性的护理干预提供借鉴。方法 以社会生态系统理论为理论框架,采用目的抽样法选取11例阴茎癌患者为访谈对象,基于现象学研究对其进行面对面半结构式访谈并收集资料,采用定向内容分析法对资料进行处理与分析。结果 共归纳出3个主题,10个亚主题,即微观系统（舒适改变、实际需求未得到满足、持续的负性情绪、就医延迟）,中观系统（经济负担沉重、角色缺失、家庭关系紧张）,宏观系统（缺乏信息支持、就医体验及诊疗水平待改善、社会压力）。结论 阴茎癌患者的社会生态系统状况存在诸多问题,医护人员应重视疾病给患者身心健康带来的改变,采取有效措施以满足患者身心健康需求,维持其社会生态系统的稳定。     

掌上无线超声引导桡动脉穿刺置管的护理配合

目的 总结掌上无线超声引导桡动脉穿刺置管的护理配合要点。 方法 对51例患者采用掌上超声定位桡动脉穿刺置管,护理配合包括患者准备、仪器及耗材等准备,Allen试验评估,穿刺中配合医生摆放穿刺体位、进行桡动脉穿刺配合,穿刺后护理及常见并发症处理等。 结果 51例均完成置管,其中一次穿刺成功44例（86.28%）,1例5次穿刺成功患者出现穿刺处血肿,其余患者未发生感染、血管痉挛、动脉血栓、神经损伤等并发症。 结论 高效、规范的护理配合可提高掌上无线超声引导桡动脉穿刺置管成功率,减少并发症。     

跌倒恐惧对老年糖尿病患者生活空间移动的影响及阈值效应研究

目的 探讨跌倒恐惧对老年糖尿病患者生活空间移动性的影响及阈值效应。方法 对435例老年糖尿病患者采用一般资料问卷、修订版跌倒效能量表(测评跌倒恐惧)、生活空间评估表进行调查,行单因素分析、分层logistic回归分析、建立平滑拟合曲线分析阈值效应,探索影响因素与影响程度。结果 患者生活空间移动得分59.13±14.14,45.7%存在生活空间移动受限。跌倒效能得分7.55±1.44。分层logistic回归分析显示,跌倒恐惧、户外环境感知、糖尿病并发症是生活空间移动受限的主要影响因素(均P<0.05)。拟合曲线及阈值效应分析显示,跌倒效能得分≤6.50时生活空间移动水平不受影响(P>0.05),跌倒效能得分>6.50分时生活空间移动水平随跌倒效能得分的增加而增加(P<0.05)。结论 老年糖尿病患者生活空间移动受限比例较高,跌倒效能处于中等水平,跌倒效能得分>6.50可作为患者具有活动自信心的节点,制定安全活动干预措施还应综合考虑环境与糖尿病并发症的影响。     

Adolescent idiopathic scoliosis - to operate or not? A debate article

Adolescent idiopathic scoliosis (AIS) represents a rare condition with a potentially detrimental impact on young patients. Despite vast clinical research and published treatment guidelines and algorithms, the optimal therapeutic choice for these patients remains highly controversial. While advocates of early surgery emphasize the benefits of surgical deformity correction with regard to physical and psychological outcome, the opponents base their arguments on the high risk of complications and a lack of documented subjective long-term outcome. In the present paper, the authors were invited to debate the opposite positions of "pro" versus "contra" surgical treatment of AIS, based on the currently available evidence and published guidelines.     

Microstructural brain abnormalities of children of idiopathic generalized epilepsy with generalized tonic‐clonic seizure: A voxel‐based diffusional kurtosis imaging study

The above article, published online on 3 May 2014 in Wiley Online Library ( wileyonlinelibrary.com ), has been retracted by agreement between the authors, the journal Editor in Chief, and Wiley Periodicals, Inc. The retraction has been agreed due to errors in the results of the published article. The authors stated in the Methods section that ‘. . . only clusters with a false discovery rate (FDR)‐corrected P‐value less than 0.05 were included.’ However, it was subsequently discovered that the FDG‐correction had not been performed correctly. Had this been carried out in the right way, the difference between the case group and the control group in most of the presented regions would have been insignificant. REFERENCE 1. Gao J, Feng S‐T, Wu B, Gong N, Lu M, Wu P‐M, Wang H, He X, and Huang B. Microstructural Brain Abnormalities of Children of Idiopathic Generalized Epilepsy With Generalized Tonic‐Clonic Seizure: A Voxel‐Based Diffusional Kurtosis Imaging Study J mag res. 2014 May 3. doi: 10.1002/jmri.24647 [epub ahead of print]     

γ刀照射三叉神经的剂量-效应关系研究

目的 探讨伽玛刀不同剂量照射大鼠三叉神经(感觉根)后对照射范围内三叉神经组织的损伤以及对周围临近脑干组织和脑桥的影响,为优化伽玛刀照射剂量提供理论依据。方法 选用成年雄性SD大鼠65只,分别以不同照射剂量(20、40、80、160 Gy)照射三叉神经,观察照射后1周、2周、4周大鼠行为学变化,取全脑组织进行HE、Nissl、MAPLC3B、53BP1、XRCC1染色观察细胞形态学和自噬以及DNA损伤和修复等变化。结果 所有剂量组照射大鼠均存活。20和40 Gy组均无行为学和病理学改变;80和160 Gy组均出现了照射部位毛发脱落;HE、Nissle、LC3B、53BP1及XRCC1染色发现,受照部位组织在80和160 Gy照射后,可见神经元细胞固缩、膨胀,神经元细胞发生自噬以及DNA损伤明显,160 Gy组DNA损伤明显加重。40 Gy照射后,神经元发生DNA损伤修复的程度较其他剂量增高。结论 伽玛刀照射三叉神经根对神经元有明显的剂量-效应关系。