SHOX2和RASSF1A基因甲基化检测在早期肺癌的诊断研究

目的：探讨SHOX2和RASSF1A基因甲基化检测在早期肺癌的诊断价值。方法：选择2020年8月-2021年3月期间我院收治肺部小结节患者107例为研究对象,其中经病理活检确认早期肺癌患者72例（肺癌组）,肺部良性病变患者35例（对照组）。采集患者肺泡灌洗液（BALF）样本,进行细胞学检查且荧光PCR法测定样本中SHOX2和RASSF1A基因甲基化阳性率,分析甲基化情况及其病理诊断关系。结果：肺癌组和对照组SHOX2基因甲基化阳性率分别为51.4%和2.9%,RASSF1A基因甲基化阳性率分别为61.1%和5.7%,均差异显著（P<0.05）,且SHOX2和RASSF1A基因甲基化任意阳性率显著高于细胞学检查阳性率（P<0.05）;并联SHOX2和RASSF1A基因甲基化检测早期肺癌的灵敏度和特异性分别为76.4%(55/72)、91.4%(32/35),且在不同病理分型中存在差异,灵敏度在小细胞癌中最高（95.7%,22/23）,鳞癌次之（76.5%,13/17）,腺癌最低（68.8%,22/32）。结论：SHOX2和RASSF1A基因甲基化任意阳性率在患者BALF中诊断...     

桑菊饮合止咳散加减联合阿奇霉素治疗小儿肺炎支原体感染疗效研究

目的：探讨桑菊饮合止咳散加减联合阿奇霉素治疗小儿肺炎支原体感染的疗效。方法：将2020年1月-2020年12月在滕州市中心人民医院中医儿科治疗的70例小儿肺炎支原体感染患儿随机分为两组,对照组使用阿奇霉素治疗,在此基础上,观察组使用桑菊饮合止咳散加减治疗,对比两组的临床疗效、中医证候积分变化、炎性因子水平变化。结果：观察组治疗有效率明显高于对照组（P <0.05）;观察组治疗后咳嗽、咳痰、气喘等中医证候积分明显低于对照组（P <0.05）;观察组治疗后C-反应蛋白（C-reactive Protein,CRP）、肿瘤坏死因子-α(Tumor Necrosis Factor-α,TNF-α)、干扰素-γ(Interferon-γ,IFN-γ)水平明显低于对照组（P <0.05）。结论：桑菊饮合止咳散加减联合阿奇霉素治疗小儿肺炎支原体感染疗效显著,能有效缓解证候,抑制机体炎症反应,提升整体治疗效果。     

急性冠脉综合征合并左主干病变急诊手术的早期结果分析

目的 评估急性冠脉综合征合并左主干病变急诊冠脉搭桥患者的预后。 方法 对40例急性冠脉综合征合并左主干病变患者行急诊冠脉搭桥术的临床资料进行分析总结。 结果 全组死亡4例,病死率10%。4例死亡者术前均有急性心肌梗死。住院期间并发症主要为低心排综合征、严重心律紊乱及肾功能衰竭。 结论 不稳定心绞痛合并左主干病变患者应尽早行急诊冠脉搭桥术。左主干病变合并心源性休克患者应首先考虑在机械辅助循环的支持下,尽快采用内科介入方法行血管重建;如内科介入治疗失败,应尽早施行急诊冠脉搭桥术。     

暴力攻击行为候选基因研究进展

暴力攻击行为是近30年来精神卫生相关基础和临床研究中的一个重要领域.至今其病因机制并不十分明确,较多研究发现遗传学因素可能起到重要的作用,主要探讨的基因涉及单胺氧化酶A(MAOA)、5-羟色胺转运体(SLC6A4)、儿茶酚胺甲氧基转移酶(COMT)、脑源性神经营养因子(BDNF)等.近年来相关侯选基因的探索有了重大进展,本文聚焦于近期国内外研究中关注的与暴力攻击行为相关的一些新的候选基因,期望对今后的深入研究提供参考信息.     

等离子体空气消毒器用于非洁净手术室空气消毒效果的观察

摘要 目的 观察等离子体空气消毒器用于非洁净手术室空气的消毒效果。方法将该等离子体空气消毒器分别安装于6间非洁净手术间,采用平板自然沉降法和激光颗粒计算器,观察6间非洁净手术间空气消毒效果。结果启动该等离子体空气消毒器运行不同时间后,均可使6间非洁净手术间空气中0.5 μm颗粒洁净度达到10 000级。6间非洁净手术间在该等离子体空气消毒器运行不同时间后空气中的沉降菌均可达到医院Ⅱ类环境卫生标准。结论应用该等离子体空气消毒器对非洁净手术室消毒效果显著。     

中国精神卫生立法进程回顾

本文围绕中国新出台的精神卫生法究竟是有所创新还是因循守旧的问题,通过分三阶段回顾立法的曲折历史,概括分析了这部法律立法思想和有关制度设计的形成过程,并对其中一些规定背后的观点交锋以及法律实施后可能带来的影响作了简要介绍,旨在为精神卫生相关立法研究和法律在实施中的进一步完善提供参考.     

Surgical incision in complete video-assisted mitral valve replacement

Background Prosthetic mitral valve replacement is a common surgical treatment of mitral valve disease.Complete video-assisted mitral valve replacement represents the contemporary minimally invasive cardiac surgery in valve disease surgical therapy. In the field of minimally invasive cardiac surgery, the success of the operation is largely depending on surgical incision, it also reflects the surgeon's technique level. Method From February 2010 to February 2013, 80 cases of cardiac patients with mitral valve pathological changes in our department who had received surgical treatment of complete video-assisted mitral valve replacement were recruited, they were divided into two groups according to the surgical incision: midclavicular group(M group,n = 50) and parasternal group(P group, n = 30). The clinical data were recorded including: cardiopulmonary bypass time, aortic clamping time, volume of thoracic drainage after operation, ICU tracheal intubation time,postoperative days of hospital stay and time for observing the postoperative complications. The comparison between two groups was performed using t-test analysis. Result Both M Group and P Group had favorable surgical view, there were no emergency situation of redo median sternotomy during initial operative period or intraoperative death, no pericardial tamponade, no infection, and no other serious postoperative complications.Whereas, there were 2 cases of redo operation for stanch bleeding in M Group and 1 case of perivalvular leakage in P Group. Nevertheless, 3 months later, the result of reexamine showed that the perivalvular leakage had vanished. The clinical data was shown as follow(M Group vs. P Group): cardiopulmonary bypass time(90.2 ± 28.7 vs. 87.3 ± 24.5 min, P 0.05), aortic clamping time(65.2 ± 17.4 vs. 68.6 ± 21.9 min, P 0.05),1st day volume of thoracic drainage after operation 1(75.8 ± 35.6 vs. 53.2 ± 25.6 mL, P 0.05), ICU tracheal intubation time(9.6 ± 3.4 vs. 8.4 ± 4.5 hours, P 0.05), postoperative days of hospital stay(7.3 ± 2.2 vs. 6.9± 3.2 days, P 0.05). T-test analysis of the data of each groups showed that there were no significant statistically difference. Conclusions Appropriate surgical incisions guarantee a favorable surgical view and the success of the whole process during intraoperative period. In both midclavicular and parasternal approaches, the complete video-assisted mitral valve replacement is able to be accomplished safely and successfully. Due to the current development level of thoracoscopic instruments and equipment, the surgical incision and approach for video-assisted mitral valve replacement are diversified. As a result, diversified surgical incisions can be customized according to the variegated pathological changes of cardiac patients.     

中医药在脊髓损伤神经源性肠道功能障碍的研究进展

脊髓损伤(spinal cordin jury,SCI)后神经源性肠功能障碍对患者身心健康和生活质量的严重影响,目前越来越受到国际关注.但国内对此尚未普遍开展.中医理论在SCI及SCI后出现的排便异常尚未作相关总结.现有研究中医药对肠道自主神经系统已经成熟,其有效性获得国内外普遍承认,并较药物更易接受.为SCI肠功能障碍的研究打下基础.但目前国内对SCI后排便异常缺乏专业认识、项目资助和人员管理,临床研究欠规范,中医理论有待完善.现主要针对SCI神经源性肠功能障碍出现的排便异常,在中医病名、病机、主要方法、有效性、优势及存在问题作一综述.     

Bleeding from thermistor connector indicates entrapment of pulmonary artery catheter

Several complications of insertion and use of pulmonary artery catheter (PAC), including catheter entrapment, are recognized during or after cardiac surgery. Early detection is very important. We report a case of PAC entrapment because the the catheter was accidentally sutured to the superior vena cava. Bleeding from the thermistor connector was initially detected after surgery because the needle punctured the lumen of thermistor connector. The PAC was removed through re-exploration. Therefore, bleeding from the thermistor connector could early indicate the PAC entrapment. We suggest that abnormal bleeding from the non-injectate lumen ports of PAC should be checked before sternal closure.     

下肢关节康复器在膝关节僵直术后功能锻炼中的应用

回顾性总结38例利用下肢关节康复器（CPM）辅助膝关节僵直患者术后功能锻炼的治疗观察，发现其较传统方法可提高膝关节活动度，且痛苦小，患者易于接受。同时加强术前、术后护理，均可取得满意疗效。