实验性肝硬化大鼠肝组织中CSE和Ki-67的表达及其意义

目的应用正常及制备的肝硬化大鼠模型的肝脏组织观察H2S过载及不足状态下肝细胞的增殖变化。方法雌性SD大鼠48只,随机分为6组(每组8只):NF组(正常对照组)、SF组(正常H2S增加组)、PF组(正常H2S减少组)、HF组(肝硬化对照组)、SHF组(肝硬化H2S增加组),PHF组(肝硬化H2S减少组)。分组比较门静脉压力及门静脉血浆H2S含量,免疫组化法观察CSE及Ki-67的表达,免疫荧光双重染色观察CSE及Ki-67是否在同一细胞表达。结果随着给予H2 S供体及H2 S的抑制剂,HF组H2S含量明显低于NF组(P<0.01),SHF组和SF组中,给予H2S供体均能使H2S含量升高(P<0.01),给予H2S供体使H2S含量进一步升高(P<0.01);HF组CSE表达明显低于NF组(P<0.01),SF组H2S表达较SHF组均减少(P<0.01)。H2S对正常大鼠无明显作用;HF组Ki-67表达明显高于NF组(P<0.01),SF组H2S表达较SHF组增加(P<0.01),Ki-67表达在正常大鼠无明显作用。结论 NaHS作为H2S供体可能具有抑制实验性肝硬化大鼠肝组织内细胞增殖的作用,H2S可能通过抑制星状细胞和肝血管平滑肌细胞从而对肝硬化起到保护作用。     

Asymptotic Structure of Cosmological Burgers Flows in One and Two Space Dimensions: A Numerical Study

We study the cosmological Burgers model, as we call it, which is a nonlinear hyperbolic balance law (in one and two spatial variables) posed on an expanding or contracting background. We design a finite volume scheme that is fourth-order in time and second-order in space, and allows us to compute weak solutions containing shock waves. Our main contribution is the study of the asymptotic structure of the solutions as the time variable approaches infinity (in the expanding case) or zero (in the contracting case). We discover that a saddle competition is taking place which involves, on one hand, the geometrical effects of expanding or contracting nature and, on the other hand, the nonlinear interactions between shock waves.     

磁共振成像在无髁突骨折的颞颌关节即刻损伤中的诊断价值

  目的   探讨磁共振成像（magnetic resonance imaging,MRI）在无髁突骨折的颞颌关节即刻损伤后的潜在诊断价值。  方法   选取云南大学附属医院口腔颌面外科2018年6月至2021年3月收治的无髁突骨折的颞下颌关节损伤患者36例，共72侧关节纳入研究。所有的患者锥形束CT结果均显示髁突及关节窝无骨折且伤后髁突表面骨质“完整”。患者伤前均无关节疾患，伤后均出现不同程度的关节区疼痛和张口受限及弹响，其中24例合并有面部及其他部位的骨折。通过MRI对纳入患者进行影像检查，并对结果进行分析。  结果   MRI检查显示有关节48侧关节发生不同程度损伤，发生率为66.7%。损伤类型为骨髓水肿12侧（25%），关节盘后区损伤撕裂27侧（56.25%），关节盘移位33侧（68.75%）以及关节腔积血、积液36侧（75%）。关节盘后区损伤撕裂，关节盘移位，关节腔积血（积液）与骨髓水肿的发生率相比较，前3者发病率明显高于骨髓水肿，差异有统计学意义（ P < 0.05）。  结论   MRI在无髁突骨折的颞颌关节即刻损伤后，能清楚的显示出关节软组织的损伤部位和类型。此外，在这些损伤中关节盘后区损伤撕裂，关节盘移位，关节腔积血（积液）与骨髓水肿的发生率相比较，前三者发生率明显高于骨髓水肿。MRI是无髁突骨折的颞颌关节即刻损伤后重要检查和评价手段。     

舒适护理在急性脑梗死临床护理中的应用

目的：探讨舒适护理对急性脑梗死患者的影响。方法：将140例急性脑梗死患者按照随机数字表法分为舒适护理组和对照组各70例，对照组采用传统护理方法，舒适护理组在对照组传统护理的基础上采取舒适护理。结果：舒适护理组症状缓解率明显高于对照组，并发症发生率明显低于对照组，住院天数短于对照组，比较差异均有统计学意义（P〈0.05）。舒适护理组的护理满意度明显高于对照组，差异有统计学意义（P〈0.01），且心理满意度明显高于对照组，差异有统计学意义（P〈0.05）。结论：舒适护理可减少急性脑梗死患者的并发症的发生，提高抢救成功率及护理满意度。     

邢台山区65岁以上老年人骨质疏松症患病情况及其影响因素分析

目的探讨邢台山区65岁以上老年人骨质疏松症（OP）患病情况及其影响因素。 方法调查选取2016年3月至2018年12月邢台山区65岁以上老年人1 207例，采用自制《老年人OP问卷》调查OP患病情况及其影响因素。 结果本次调查的1 207例老年人中，有OP者129例、患病率为10.69%；单因素分析结果显示，有无OP老年人的年龄、体质量指数、运动量、吸烟、奶品摄入、OP家族史比较，差异有统计学意义（P<0.05）；Logistic回归分析结果显示，75~80岁、体质量指数>28 kg/m²、吸烟、OP家族史是老年人OP患病的独立危险因素，经常运动、奶品摄入是老年人OP患病的独立保护因素（P<0.05）。 结论邢台山区65岁以上老年人OP的患病率高，其与多种因素有关，提示应重点关注75~80岁、体质量指数>28 kg/m²、吸烟、OP家族史等老年人群，并应指导老年人进行合理的运动、奶品摄入。     

创新载体 形式多样 努力做到思想政治工作全覆盖——河北省木兰林管局思想政治工作的经验

地处京津地区生态重地的木兰围场国有林场管理局是河北省面积最大的国有林场管理局。近年来,木兰林管局以多角度、多形式,不断创新载体,通过创新"抓、促、汇、送"的管理举措,真抓实干,以业务工作提升思想水平,以思想建设促进业务工作开展,有效保证了林场思想政治工作的"六个到位",使林场职工精神面貌焕然一新,森林经营技术水平普遍提高。     

重症监护病房导管相关性尿路感染的影响因素及对院内感染的影响

目的探究重症监护病房导管相关性尿路感染的影响因素及对院内感染的影响。方法选取2018年6月至2019年10月本院收治的1128例重症患者,根据其是否发生导管相关性尿路感染分为观察组(65例)和对照组(1063例)。应用单因素分析及logistic回归分析重症患者导管相关性尿路感染的相关危险因素。结果1128例重症患者出现导管相关性尿路感染65例,发生率为5.76%(65/1128)。65例导管相关性尿路感染患者共分离病原菌79株。病原菌以革兰阴性菌为主,占43.04%(34/79);其次为真菌和革兰阳性菌,分别占25.32%(20/79)和24.05%(19/79)。两组合并糖尿病、住院时间、侵入性操作、留置导尿管时间及24 h尿量比较,差异均有统计学意义(P<0.05)。两组性别、年龄、体重指数(BMI)及合并高血压比较,差异均无统计学意义(P>0.05)。Logistic回归分析显示,合并糖尿病(OR=0.443,95%CI:0.228~0.860)、侵入性操作(OR=1.613,95%CI:1.163~2.104)、留置导尿管时间(OR=2.719,95%CI:2.314~4.106)、24 h尿量(OR=4.362,95%CI:1.974~10.915)是重症监护室患者发生导管相关性尿路感染的危险因素(P<0.05)。结论导管相关性尿路感染的危险因素包括合并糖尿病、侵入性操作、留置导尿管时间等。医务人员应采取相关措施以避免导管相关性尿路感染的发生,从而进一步减少医院感染。     

Subcutaneous tunneling technique to improve outcomes for patients undergoing chemotherapy with peripherally inserted central catheters: a randomized controlled trial

ObjectiveTo compare the value of the subcutaneous tunneling technique versus the normal technique in improving the outcomes of patients undergoing chemotherapy with peripherally inserted central catheters (PICCs).MethodsOne hundred thirty patients were randomly divided into an experimental group (subcutaneous tunneling technique) and control group (normal technique) according to the PICC placement technique, and clinical data were compared between the groups.ResultsIn total, 129 PICCs were successfully inserted. Compared with the control group, the experimental group had a lower occurrence of complications after placement (especially catheter dislodgement: 3.1% vs. 15.4%, venous thrombosis: 3.1% vs. 15.4%, and wound oozing: 14.1% vs. 27.7%), lower occurrence of unscheduled PICC removal (3.1% vs. 13.8%), greater comfort during placement (14.16 ± 2.21 vs. 15.09 ± 2.49 on a scale ranging from 6 to 30 points, with higher scores indicating lower degrees of comfort), and lower costs of PICC maintenance (median (interquartile range) per-day maintenance cost: 13.90 (10.99–32.83) vs. 15.69 (10.51–57.46) Yuan). The occurrence of complications and amount of bleeding during placement were not significantly different between the two groups.ConclusionsThe subcutaneous tunneling technique can improve PICC placement by reducing complications and costs of maintenance with better patient comfort during placement.     

Establishment of Multiple Locus Variable-number Tandem Repeat Analysis Assay for Genotyping of Borrelia burgdorferi sensu lato Detected in China

Objective Human Lyme Borreliosis （LB）, which is caused by Borrefia burgdorferi sensu lato （B. burgdorferi）, has been identified as a major arthropod-borne infectious disease in China. We aimed to develop a multiple locus variable-number tandem repeat （VNTR） analysis （MLVA） assay for the genotyping of Borrelia burgdorJ：eri strains detected in China. Methods B. garinii PBi complete 904.246 kb chromosome and two plasmids （cp26 and Ip54） were screened by using Tandem Repeats Finder program for getting potential VNTR loci, the potential VNTR loci were analyzed and identified with PCR and the VNTR loci data were analyzed and MLVA clustering tree were constrcted by using the categorical coefficient and the unweighted pair-group method with arithmetic means （UPGMA）. Results We identified 5 new VNTR loci through analyzing 47 potential VNTR loci. We used the MLVA protocol to analyse 101 B. burgdorferi strains detected in China and finally identified 51 unique genotypes in 4 major clusters including B. burgdorferi sensu stricto （B.b.s.s）, B. garinii, B. a[zelii, and B. valaisiana, consistent with the current MLSA phylogeny studies. The allele numbers of VNTR-1, VNTR-2, VNTR-3, VNTR-4, and VNTR-5 were 7, 3, 9, 7, and 6. The Hunter-Gaston index （HGI） of five VNTR loci were 0.79, 0.22, 0.77, 0.71, and 0.67, respectively. The combined HGI of five VNTR loci was 0.96. Clustering of the strains of Xinjiang, Inner Mongolia and Heilongjiang was confirmed, and this situation was consistent with the close geographical distribution of those provinces. Conclusion The MLVA protocol esytablished in this study is easy and can show strains＇ phylogenetic relationships to distinguish the strains of Borrelia species. It is useful for further phylogenetic and epidemiological analyses of Borrelia strains.