桂林市育龄人群地中海贫血筛查与产前诊断研究

地中海贫血（简称地贫）是珠蛋白基因缺失或突变导致血红蛋白的珠蛋白肽链缺如或合成减少引起的溶血性遗传病。广西是地贫发生区,居出生缺陷首位。笔者对育龄人群进行地贫筛查及基因诊断,并对高风险夫妇产前诊断情况进行跟踪。     

静脉炎54例治疗及护理体会

静脉炎是由于静脉中输入浓度高、刺激性强药物或静脉内长期放置刺激性较大的塑料管（留置针）引起的局部静脉化学炎性反应,以及在输液过程中护理人员操作不规范引起的局部静脉损伤感染,临床上静脉炎发生率正逐渐上升,让患者在原发病基础上增加新的痛苦,同时更给临床继续用药和再次穿刺以及护理工作带来很多困难.     

脑电双频指数监测对指导心脏手术麻醉中丙泊酚用量的作用

目的:评价脑电双频指数(BIS)监测麻醉深度以指导麻醉用药在心脏手术麻醉中的应用.方法:30例择期风心瓣膜病行瓣膜置换术手术患者,随机分为两组,每组15例.对照组根据经验以微量泵连续泵注丙泊酚维持麻醉镇静深度;BIS组以微量泵连续注射丙泊酚维持麻醉镇静深度,并且根据监护仪监测的BIS值调整注射丙泊酚的速度来维持麻醉深度,保持BIS值为50～60.结果:与对照组相比,BIS组手术中血流动力学等监测指标更为平稳,BIS波动较小,镇静麻醉药丙泊酚总用量减少,两组相比有显著性差异(P＜0.05).结论:以BIS反馈调控能指导麻醉用药量,获得更为平稳的血流动力学,维持适当的麻醉深度,并减少麻醉维持中麻醉药物用量.     

流式细胞术在急性双表型白血病诊断中的应用

流式细胞术针对细胞内外的特异性抗原，用免疫荧光标志物进行急性双表型白血病的免疫分型，检测和分析其来源及分化情况，提高了急性双表型白血病诊断的准确性，并在其治疗和预后判断方面有着广阔的应用前景。     

骨软骨瘤继发肉瘤变临床病理分析

Objective To investigate the clinicopathologic,radiological and immunohistochemical characteristics of osteochondroma with malignant transformation.Methods The clinical data,radiological imagings and hematoxylineosin stained histologic sections were reviewed in 463 cases of osteochondroma diagnosed in Shanghai 6th Hospital from 1991 to 2008,including 11 cases with malignant transformation.Immunohistochemical two-step staining was used to detect CK,vimentin,S-100 protein,p53 and c-myc expression in seven cases of osteochondroma with malignant transformation and 10 cases without malignant transformation.The relevant literature was reviewed.Results Among the 11 cases with malignant transformation,five were single osteochondroma(5/408,1.2%),and six were multiple osteochondromas (6/55,10.9%).The male to female ratio was 10:1.These 11 cases were derived from femur(4 cases),tibia(3 cases),ilium(3 cases),shoulder bone(1 case)and pubis(1 case).There was one case that showed malignant transformation in both the femur and ilium.The mean ages for the malignant and nonmalignant cases were 39.8 years and 20.4 years respectively.All the malignant cases showed large sized lesions with prominent calcification in the thick cartilage caps.The malignant component was low grade,peripheral chondrosarcoma(grade Ⅰ-Ⅱ).In some areas the tumor cells infiltrated the peripheral soft tissue and bone marrow.Of the seven cases with malignant transformation that had immunohistochemical staining,all were positive for vimentin and S-100 protein;p53 protein was positive in 2 of 7 cases.Conclusions Malignant transformation of osteochondroma was usually encountered in multiple lesions.Most patients were more than 30 years old with a long clinical history and with a male predominance.These tumors showed thick cartilage caps with prominent calcification.The lobulated nature of the tumors was evident and they infiltrated the surrounding soft tissue.The sarcomatoid component was peripheral type,well differentiated chondrosarcoma.p53 mutation may explain part of the molecular mechanism in the malignant transformation.     

基于Kano模型下的护理干预对特发性矮小症患儿生长发育、骨代谢水平的影响

目的：探究基于Kano模型下的护理干预对特发性矮小症(idiopathic short stature,ISS)患儿生长发育、骨代谢水平的影响。方法：选取于2022年1—7月九江市妇幼保健院收治的90例ISS患儿作为研究对象,并根据随机数字表法将其分为对照组与干预组,各45例。给予对照组患儿常规干预,给予干预组患儿常规干预+基于Kano模型下的护理干预。分别于干预前、干预6个月后,对比两组血清生长因子、骨代谢水平及体格发育情况。结果：干预后,两组胰岛素样生长因子结合蛋白-3(insulin-like growth factor binding protein-3,IGFBP-3)、胰岛素样生长因子Ⅰ(insulin-like growth factor-Ⅰ,IGF-Ⅰ)、25-羟维生素D₃水平均升高,且干预组上述指标水平均显著高于对照组(P<0.05)。干预后,两组身高、体重、骨龄(bone age,BA)及身高标准差积分(height standard deviation score,HtSDS)均升高,其中干预组身高、HtSDS均显著高于对照组(P<...     

辛芍组方效应成分在正常和脑缺血再灌注损伤大鼠肝微粒体中的酶促反应动力学分析

目的:研究辛芍组方中效应成分灯盏乙素、灯盏甲素和芍药苷在正常大鼠和大脑中动脉闭塞(MCAO)局灶性脑缺血再灌注损伤大鼠肝微粒体中的酶促反应动力学,比较上述成分在不同状态大鼠肝微粒体中的体外酶代谢动力学差异。方法:制备不同状态大鼠的肝微粒体,将辛芍组方与大鼠肝微粒体进行孵育,选择UPLC-MS为分析手段,采用底物消除法,计算各成分在正常大鼠和MCAO大鼠肝微粒体中的酶反应动力学米氏常数(Km),最大反应速率(Vmax)及体外肝微粒体对药物的固有清除率(CLint),将各参数进行组间统计学分析。结果:灯盏乙素、灯盏甲素和芍药苷在正常大鼠体外肝微粒体中的Km[(0. 597±0. 065),(0. 166±0. 012),(0. 640±0. 046)μmol·L~(-1)]与MCAO大鼠中的Km[(0. 798±0. 031),(0. 213±0. 017),(0. 499±0. 029)μmol·L-1]均明显不同;与正常组相比,MCAO大鼠体内的灯盏乙素和芍药苷的Vmax和CLint均明显减少(P 0. 05,P 0. 01),灯盏甲素的Vmax也显著降低(P 0. 05)。结论:辛芍组方的效应成分在脑缺血再灌注损伤大鼠肝微粒体中的代谢速率降低、消除减慢。     

人文关怀对慢性心力衰竭患者焦虑抑郁情绪的影响研究

目的探讨人文关怀对慢性心力衰竭患者焦虑抑郁情绪的影响。方法以2014年3月～2015年10月在我院接受治疗的慢性心力衰竭患者为观察对象,并将其随机分为对照组和观察组,每组各50例患者。对照组给予常规护理,观察组在常规护理的基础上给予人文关怀。比较两组患者干预前后焦虑、抑郁情绪和睡眠质量的差异,观察两组患者满意度的差异。结果两组患者干预前焦虑、抑郁得分无明显差别(P0.05);干预后,两组患者的焦虑、抑郁评分均较治疗前降低,且观察组降低更明显(P0.05);两组患者干预前睡眠质量无明显差别(P0.05);干预后,两组患者睡眠质量较干预前改善,且观察组改善更明显(P0.05);观察组的满意率为98.00%,明显高于对照组,差异具有统计学意义(P0.05)。结论人文关怀可明显改善慢性心力衰竭患者焦虑抑郁情绪,提高其睡眠质量和住院满意度。     

尿巨细胞病毒定量检测在婴儿巨细胞病毒感染诊治中的意义

目的探讨荧光定量聚合酶链反应法（FQ—PCR）检测尿巨细胞病毒（CMV）在婴儿CMV感染的诊断与治疗动态监测中的应用价值。方法采用FQ—PCR法检测怀疑CMV感染婴儿血、尿CMV,分析阳性检出率、病毒含餐及治疗后的病毒含量变化。同时与ELISA法检测CMV—IgM结果进行比较。结果396例婴儿中,FQ—PCR法血、尿阳性检出率分别为10．61％、61．87％,尿阳性高于血（P〈0．01）;ELISA法阳性检出率为31．06％,FQ—PCR法尿阳性检出率明显高于ELISA法。治疗前后尿CMV拷贝数均高于血（P〈0．01）,治疗后血、尿CMV拷贝数较治疗前明显下降（P〈0．01）。结论FQ—PCR法检测尿CMV在婴儿CMV感染的诊断与治疗动态监测中有良好的应用价值：