Magnet induced perforated appendicitis and ileo-caecal fistula formation

Foreign body ingestion is a common paediatric problem. In the majority of cases spontaneous passage occurs. Magnet ingestion is rare and solitary magnet ingestion usually does not cause any complications. A number of gastrointestinal complications have been reported, such as fistula formation, perforation and volvulus following multiple magnet ingestion. We review magnet ingestion and describe the first case in the literature of magnet induced perforated appendicitis with an associated ileo-caecal fistula.     

乳杆菌肽聚糖调节小鼠免疫细胞基因表达的通路分析

目的:探索乳杆菌肽聚糖免疫调节作用的机制.方法:BALB/c小鼠腹腔注射乳杆菌肽聚糖,从腹腔巨噬细胞和脾淋巴细胞提取RNA,基因芯片分析基因表达情况,基于已知的基因网络数据库利用PathwayExplorer和GeneMAPP分析乳杆菌肽聚糖刺激特异性的基因网络.结果:PathwayEx-plorer分析得到的最显著变化的基因网络是"细胞因子-细胞因子受体相互作用"和"辅助性T细胞表面分子".GeneMAPP分析得到最显著基因网络是核糖体蛋白、炎性反应基因网络和血红素合成基因网络.结论:乳杆菌肽聚糖刺激引起大量蛋白表达,引起保护性炎性反应,激活Th细胞,可能引起Th1免疫反应.     

护士主导全科团队服务对高龄独居老人心理干预的效果评价

目的 评价以社区护士为主导的全科团队服务对社区高龄独居老人抑郁、孤独等心理状况的影响.方法 将81例80岁以上的高龄独居老人随机分为干预组41例和对照组40例,干预组接受为期3个月、每月3次、每次30min,由社区护士为主导的高龄独居老人全科团队家访服务.对照组实施常规的社区卫生服务.两组在干预前后分别进行抑郁、孤独等观察指标评价.结果 干预前两组高龄老人抑郁、孤独显著低于我国常模水平(p＜0.05),两组间差异无统计学意义.干预后干预组抑郁、孤独得分均低于干预前水平和对照组同期水平(P＜0.01),对照组前后变化不明显(P＝0.858和0.785).结论 以社区护士为主导的全科团队家访服务可明显改善高龄独居老人的抑郁、孤独等不良心理状况.     

再次鼻中隔矫正术

目的 探讨鼻中隔矫正术失败而再次手术的技术方法。方法 对1992-2004年鼻中隔矫正术失败的32例患者进行鼻科检查,根据患者鼻中隔偏曲的部位、程度,原有软骨及骨质的残留状况和患者年龄,我们采用3种不同的手术切口（径路）进行矫正：①对5例鼻中隔前端偏曲,1例低位偏曲和14例高位偏曲的患者采用鼻中隔前端“U”形切口;②对8例鼻中隔后端偏曲和2例高位偏曲患者,在偏曲部位的前方作纵向切口,并辅助鼻内镜进行矫正;③对2例鼻中隔前端低位偏曲的青少年患者采用唇龈沟正中横切口,向上揭翻,辅助耳科电钻进行手术。结果 32例患者均获满意矫正,鼻中隔偏曲引起的临床症状消失或明显改善。随访6～36个月,无一例出现鼻中隔穿孔、鞍鼻、鼻腔粘连等并发症。结论 鼻中隔偏曲再次矫正术需针对不同的临床特点选择正确的手术方法,可获满意效果。     

孕妇营养状况与胎儿发育迟缓及新生儿视力发育障碍的关系

目的 了解孕妇营养状况与胎儿发育迟缓（IUGR）及新生儿出生后视力发育障碍的关系。方法 将60例住院产妇分为两组：即IUGR组与对照组,各30例。分析孕妇8种营养食品的摄取情况,用荧光法检测母血及脐血中维生素A含量,用吸收光谱法测定母血与脐血中铁、铜、锌含量,检测新生儿出生后3－7d及出生后10个月时的闪光视觉诱发电位。结果 与对照组相比,IUCR组孕妇的鸡蛋、猪肝与瘦肉的摄取量均明显减少（P＜0．05）,母血及脐血中维生素A、铁含量显著降低（P＜0．01）,脐血中锌含量降低（P＜0．05）,新生儿闪光视觉诱发电位检测提示,三相波中波峰向上主波（P100）的潜伏期延长,幅值降低。结论 孕期富含维生素A、铁与锌等营养成分的食物摄取减少与IUGR的发生密切相关,并可导致胎儿视觉发育障碍。     

鼻咽癌治疗前后TSGF的测定及其意义

目的 :检测鼻咽癌患者治疗前后血恶性肿瘤相关物质群 (TSGF)的水平 ,探讨 TSGF在鼻咽癌的早期诊断及预后判断的意义。方法 :动态观察 35例鼻咽癌患者在治疗前、后 TSGF水平与 EBV滴度的变化 ,并分析两者之间的关系。结果 :TSGF与 EBV- Ig A的诊断阳性率分别为 91% ,97%。两者之间无相关性。治疗无效者TSGF保持在较高水平 ,有效者则显著下降。结论 :TSGF可作为鼻咽癌早期诊断的血清肿瘤标志物之一 ,动态监测对于了解病情变化有重要临床意义。     

c-myc反义寡核苷酸对HL-60细胞增殖及c-myc基因表达的影响

目的：观察c-myc基因反义寡核苷酸(ASODN)对HL-60细胞增殖及c-myc基因表达的抑制作用．探讨ASODN作为药物进行白血病基因治疗的可行性、方法：应用c-myc反义寡核苷酸封闭HL-60细胞c-myc基因、RTPCR方法检测该基因表达抑制情况．流式细胞仪进行细胞周期分析,倒置显微镜观察细胞形态变化．绘制细胞生长曲线,MTT法检测细胞增殖状态。结果：c-myc基因反义寡核苷酸转染HL-60细胞后,c-myc基因表达明显受抑;S期细胞比值由55.6％降至16．7％;细胞生长受抑,增殖能力减弱,其抑制作用具有序列特异性及剂量依赖性。结论c-myc基因反义寡核苷酸对HKL-60细胞增殖及c-myc基因的表达具有明显的抑制作用,有望成为抑制白血病细胞增殖的核酸药物。     

中医院患者下呼吸道感染卡他莫拉菌耐药性分析

目的了解中医院患者下呼吸道感染卡他莫拉菌的分布与耐药性,为该疾病提供有效的治疗措施。方法对2009年1月-2013年12月1 304例下呼吸道感染患者的痰标本进行检测,观察下呼吸道卡他莫拉菌感染的分布,并对检出的卡他莫拉菌进行药敏试验和β-内酰胺酶检测。结果从痰标本中培养出1 932株病原菌,卡他莫拉菌居第3位,共检出216株,占11.2%;均来自216例下呼吸道患者的痰培养标本,卡他莫拉菌在第一、四季度分离最高,分别占31.0%、33.8%;191株β-内酰胺酶检测结果阳性,产β-内酰胺酶率88.4%;卡他莫拉菌对头孢唑肟、头孢吡肟、左氧氟沙星、头孢呋辛、加替沙星和阿莫西林/舒巴坦的耐药率均<10.0%;对氨苄西林、头孢克洛与磺胺甲噁唑/甲氧苄啶的耐药率较高,分别为75.9%、62.0%和58.3%。结论卡他莫拉菌是下呼吸道感染患者的主要病原菌;第一季度和第四季度的是卡他莫拉菌感染的高发季节;在下呼吸道卡他莫拉菌抗感染治疗中应充分考虑其耐药性,合理应用抗菌药物。     

Rates of venous thromboembolism in multiple myeloma patients undergoing immunomodulatory therapy with thalidomide or lenalidomide: a systematic review and meta‐analysis

Summary. Introduction: The incidence of venous thromboembolism (VTE) in patients with multiple myeloma (MM) treated with thalidomide‐ and lenalidomide‐based regimens is high. Recent observational studies have suggested that thromboprophylaxis might be efficacious in decreasing the risk of VTE in this population. Purpose: To determine the absolute rates of VTE with and without different thromboprophylactic agents in patients with newly diagnosed or previously treated MM receiving thalidomide‐ or lenalidomide‐based regimens. Results: Patients with newly diagnosed MM treated with thalidomide in combination with dexamethasone have a VTE risk of 4.1 (95% CI, 2.8–5.9) per 100 patient‐cycles. Therapeutic doses of anticoagulants seem to provide the largest absolute risk reduction of VTE. The rate of VTE in patients with previously treated MM receiving thalidomide in combination with dexamethasone is 0.8 (95% CI, 0.1–2.1) per 100 patient‐months. A combination of lenalidomide and dexamethasone is associated with of risk of VTE of 0.8 (95% CI, 0.07–2.0) per 100 patient‐cycles and 0.7 (95% CI, 0.4–0.9) per 100 patient‐cycles in patients with newly diagnosed and previously treated MM, respectively. Similarly, the rates of VTE in patients also receiving thromboprophylaxis with aspirin were 0.9 (95% CI, 0.5–1.5) and 0.6 (95% CI, 0.01–2.1), respectively. Conclusion: Patients with newly diagnosed or previously treated MM receiving thalidomide‐ or lenalidomide‐based regimens in combination with dexamethasone are at high risk of VTE. The benefit of various types of thromboprophylaxis is difficult to quantify in patients with MM receiving immunomodulatory therapy, especially in those receiving lenalidomide‐based therapy or who have previously treated MM. Randomized controlled trials are needed to address this important clinical need.