喉癌患者不同手术方式临床疗效及预后影响因素的探究

目的 探讨喉癌患者不同手术方式的临床疗效及预后影响因素.方法 以本院2008年1月～2011年1月收治的60例喉癌手术治疗患者为研究对象,根据手术方式的不同分为全切除组及部分切除组,比较两组患者的3年生存率及术后早期生活质量,分析影响喉癌患者预后水平的危险因素.结果 两组患者3年生存率差异无统计学意义（P＞0.05）,部分切除组患者术后早期生活质量高于全切除组,差异有统计学意义（P＜0.05）.单因素分析结果显示,年龄、术前是否存在淋巴结转移、TNM分期情况及患者术后早期生活质量是影响患者预后水平的主要因素.结论 部分喉癌切除术在治疗喉癌中,与全切除术生存率相近,但术后早期生活质量较高;年龄、术前是否存在淋巴结转移、TNM分期情况及患者术后早期生活质量是影响预后的主要因素.     

SV40T抗原真核表达载体的构建及表达

目的:构建SV40T抗原的特异性真核表达载体,并导入胃癌细胞株SGC7901进行表达鉴定.方法:扩增小鼠H /K ATPase β亚基启动子,与pMT18-T载体相连,并将其亚克隆至真核表达载体 pcDNA3.1(-),构建pcDNA3.1(-)/HK; 从含有SV40T基因的pLITAg质粒酶切回收SV40T基因,与pcDNA3.1(-)/HK相连,构建胃壁细胞特异性表达载体pcDNA3.1(-)/HKSV,同时构建非特异性表达载体pcDNA3.1(-)/SV,进行酶切及测序鉴定.用脂质体转染的方法将构建的载体导入胃癌细胞株SGC7901,PCR扩增基因组DNA,RT-PCR检测SV40T mRNA的表达.结果:限制性内切酶分析与测序结果显示,真核表达载体pcDNA3.1/HKSK构建成功;转染该载体的SGC7901细胞可检测到SV40T基因DNA的存在,且有SV40T mRNA的表达.结论:特异性表达SV40T基因的真核表达载体pcDNA3.1(-)/HKSV构建成功.     

A multi-centre,randomised, double-blind,placebo-controlled clinical trial of methylphenidate in the initial treatment of acute mania (MEMAP study)

Based on many clinical and preclinical findings the ‘vigilance regulation model of mania’ postulates that an unstable regulation of wakefulness is a pathogenetic factor in both mania and Attention Deficit Hyperactivity Disorder (ADHD) and induces hyperactivity and sensation seeking as an autoregulatory attempt to stabilize wakefulness. Accordingly, stimulant medications with their vigilance stabilizing properties could have rapid antimanic effects similar to their beneficial effects in ADHD. The MEMAP study – a multi-center, double-blind, placebo-controlled and randomized clinical trial (RCT) – assessed the antimanic efficacy and safety of a 2.5-day treatment with methylphenidate (20–40 mg/day). Of 157 screened patients with acute mania, 42 were randomly assigned to receive 20–40 mg per day of methylphenidate in one or two applications, or placebo. The primary outcome was the change in Young Mania Rating Scale (YMRS) sum scores from baseline to day 2.5 in the methylphenidate group compared to the placebo group. A group sequential design was chosen to justify early RCT termination based on efficacy or futility at an interim analysis after inclusion of 40 patients. In the interim analysis, the change from baseline in the YMRS total score at day 2.5 was not significantly different between both groups (F(1,37)=0.23; p=0.64). Thus, futility was declared for methylphenidate and the RCT was stopped. In summary, although methylphenidate was well tolerated and safe in the full analysis set, it failed to show efficacy in the treatment of acute mania. Trial registration: clinicaltrials.gov (URL: http://www.clinicaltrials.gov; registration number: NCT01541605).     

十全大补汤加减对高龄骨质疏松性股骨粗隆间骨折气血两虚型患者炎症及骨代谢指标的影响

目的:探讨十全大补汤在气血两虚型高龄骨质疏松性股骨粗隆间骨折患者治疗中的应用价值,观察其对炎性指标及骨代谢指标的影响.方法:所有病例均来自2018年4月至2020年4月于南昌市洪都中医院就诊的气血两虚型高龄骨质疏松性股骨粗隆间骨折患者,共98例,随机分为观察组(49例)和对照组(49例).所有患者均行股骨近端防旋髓内钉...     

Comparison of breath-guards and face-masks on droplet spread in eye clinics

IntroductionCOVID-19 has impacted ophthalmic care delivery, with many units closed and several ophthalmologists catching COVID-19. Understanding droplet spread in clinical and training settings is paramount in maintaining productivity, while keeping patients and practitioners safe.ObjectivesWe aimed to assess the effectiveness of a breath-guard and a face mask in reducing droplet spread within an eye clinic.MethodsWe performed a randomised trial of droplet spread using a fluorescein-based cough model to assess the efficacy of a ‘breath-guard’ and ‘face-mask’ to prevent the spread of droplets. The ‘cough’ spray was collected on calibrated paper targets. The sheets were photographed under blue light, with an orange filter on the camera; the position and size of the spots was measured with software originally developed for astronomy.We performed 44 randomised coughs; 22 controls with no breath-guard or face-mask, 11 using breath-guard only and 11 with combined breath-guard and face-mask. We compared both the number of droplets detected and the area of drops on paper targets.ResultsThe average number of droplets in the controls was 19,430 (SE 2691), the breath-guard group 80 (SE 19) droplets (P < 0.001); in the combined In the group the count was 5 (SE 2), a significant drop from shield only (P = 0.008). The mean areas of each target covered by spots for each group were 5.7 ± 0.857% (95% CI), 0.004 ± 0.000104% (95% CI) and 0.001 ± 0.0000627% (95% CI) respectively.ConclusionThese results show that the breath-guard alone reduced the droplet count by 99.93%. Combining the breath-guard with a face-mask reduced the droplet count by over 99.98%. Breath-guards are widely used in clinics and this trial demonstrates that breath-guards with face-masks effectively block droplet spray.Subject terms: Risk factors, Microbiology     

卡介菌多糖核酸辅助治疗对结核病患者血清可溶性白细胞介素2受体的影响

目的 观察结核病治疗的强化期联用卡介菌多糖核酸(BCG-PSN)(商品名:斯奇康)对患者血清可溶性白细胞介素2受体(sIL-2R)的影响.方法 将53例初治结核病患者随机分为观察组和对照组,在采用标准短程化疗方案(2HRZE/4HRE)的基础上,观察组在强化期加用臀部肌肉注射BCG-PSN,两组分别在治疗前后检查血清sIL-2R浓度.结果 两组治疗后血清sIL-2R均有明显降低,其中观察组已降至正常水平,与对照组相比有显著差异.结论 结核病治疗的强化期联用BCG-PSN能显著降低血清sIL-2R,提高结核病患者细胞免疫功能.     

阿奇霉素序贯疗法治疗小儿支原体肺炎的临床疗效及其安全性

目的 探讨阿奇霉素序贯疗法治疗小儿支原体肺炎的临床疗效及其安全性.方法 选取抚州市东乡区人民医院2017—2019年收治的支原体肺炎患儿60例,按照就诊序号单双号分成对照组和研究组,每组30例.对照组给予布地奈德、奥司他韦进行常规治疗,研究组在对照组基础上给予阿奇霉素序贯治疗.比较2组临床疗效,咳嗽、发热及肺啰音消失时...     

肝癌TACE中化疗和栓塞与肿瘤抑制和肝损伤关系的临床研究

目的 研究肝癌TACE中化疗与栓塞的并用与否对肿瘤抑制和肝损伤的影响.方法 回顾性分析152例HCC患者接受化疗灌注(A组30例)、栓塞(B组29例)或化疗栓塞(C组93例)后1天和4天,AFP下降及肝功能各指标变化.结果 (1)AFP下降人数,B组(56.5%,78.3%)和C组(67%,80.7%)显著大于A组(25%,25%)(P＜0.001).(2)肝功能异常人数增幅表现为:TBil,A、C组明显高于B组(P＜0.001).ALT及ALB,B、C组明显大于A组(P＜0.005).PA,C组明显高于A、B组(P＜0.005).结论 TACE对肿瘤的抑制主要归功于肿瘤供血血管的栓塞作用;加用肝动脉化疗灌注后,肝损伤的增加明显大于对肿瘤的抑制.     

不同诊断标准对上海市浦东新区40岁以上社区人群糖代谢类型分布的影响

目的比较不同诊断标准对社区自然人群糖代谢类型分布的影响。方法抽取2002年上海市浦东新区社区自然人群糖尿病调查数据库中40岁以上人群1716例,分别按照1999年世界卫生组织(WHO)和 2003年美国糖尿病学会(ADA)糖尿病诊断标准划分人群糖代谢类型。结果 40岁以上人群中,糖尿病患病率为 10．4％。与WHO标准相比,ADA标准所诊断的糖调节受损患病率升高8．9％(从21.3％至30．2％),而正常葡萄糖耐量下降8．9％(从68．3％至59．4％)。ADA标准新确定的空腹葡萄糖受损与正常葡萄糖耐量比较,其体重指数(40～49岁)和腰臀比(50～59岁)明显增加,而与WHO标准确定的空腹葡萄糖受损的差异无显著性。结论上海市浦东新区40岁以上社区自然人群糖代谢异常患病率较高,不同诊断标准对糖代谢类型比例有明显的影响,ADA新的诊断标准比WHO标准更有利于早期发现高危糖尿病人群。