老年人工髋关节置换围术期应激性溃疡的预防性护理

目的：探讨我院老年人工髋关节置换围术期应激性溃疡预防性护理的临床疗效。方法选取2010年4月～2013年4月在我院骨科住院髋部骨折且接受手术的老年患者106例，随机分为对照组和观察组，每组53例。对照组采用常规护理，观察组采用预防性护理。比较两组患者应激性溃疡发生率，术后1d、5d、10d、14d消化性溃疡症状分级量化积分。结果观察组应激性溃疡发生率明显低于对照组（P＜0．01）；观察组术后1d、5d、10d、14 d消化性溃疡症状评分明显优于对照组，差异有显著意义（ P＜0．01）。结论中西医结合预防性护理干预对预防老年人工髋关节置换围术期应激性溃疡效果显著，促进了疾病的康复，提高了患者的生活质量。     

国内首例内镜下袖状胃成形术

正肥胖症已成为跨越年龄、种族和社会经济界限的全球性问题,其与代谢疾病、心血管疾病、消化系统疾病、呼吸系统疾病等疾病有关。我国体重指数(body mass index,BMI)≥27.5的肥胖症患病率为7.1%~([1,2])。生活方式干预和内科治疗易反复,无法达到稳定的减重效果;外科减肥手术如Roux-en-Y胃旁路术、垂直袖状胃切除术等是目前临床可靠有     

Is prevention of atopic eczema with hydrolyzed formulas cost-effective? A health economic evaluation from Germany

To cite this article: Mertens J, Stock S, Lüngen M, Berg AV, Kr?mer U, Filipiak-Pittroff B, Heinrich J, Koletzko S, Grübl A, Wichmann H-E, Bauer C-P, Reinhardt D, Berdel D, Gerber A. Is Prevention of Atopic Eczema with Hydrolyzed Formulas Cost-Effective? A Health Economic Evaluation from Germany. Pediatr Allergy Immunol 2012: 23: 597-604. ABSTRACT: Objective: The German Infant Nutritional Intervention (GINI) trial, a prospective, randomized, double-blind intervention, enrolled children with a hereditary risk for atopy. When fed with certain hydrolyzed formulas for the first 4?months of life, the risk was reduced by 26-45% in PP and 8-29% in intention-to-treat (ITT) analyses compared with children fed with regular cow's milk at age 6. The objective was to assess the cost-effectiveness of feeding hydrolyzed formulas. Patients and Methods: Cost-effectiveness was assessed with a decision tree model programmed in TreeAge. Costs and effects over a 6-yr period were analyzed from the perspective of the German statutory health insurance (SHI) and a societal perspective at a 3% effective discount rate followed by sensitivity analyses. Results: The extensively hydrolyzed casein formula would be the most cost-saving strategy with savings of 478?€ per child treated in the ITT analysis (CI95%: 12?€; 852?€) and 979?€ in the PP analysis (95%CI: 355?€; 1455?€) from a societal perspective. If prevented cases are considered, the partially whey hydrolyzed formula is cost-saving (ITT -5404?€, PP -6358?€). From an SHI perspective, the partially whey hydrolyzed formula is cost-effective, but may also be cost-saving depending on the scenario. An extensively hydrolyzed whey formula also included into the analysis was dominated in all analyses. Conclusions: For the prevention of AE, two formulas can be cost-effective or even cost-saving. We recommend that SHI should reimburse formula feeding or at least the difference between costs for cow's milk formula and the most cost-effective formula.     

Bone marrow-derived mesenchymal stem cells versus adipose-derived mesenchymal stem cells for peripheral nerve regeneration

Studies have confirmed that bone marrow-derived mesenchymal stem cells(MSCs) can be used for treatment of several nervous system diseases. However, isolation of bone marrow-derived MSCs(BMSCs) is an invasive and painful process and the yield is very low. Therefore, there is a need to search for other alterative stem cell sources. Adipose-derived MSCs(ADSCs) have phenotypic and gene expression profiles similar to those of BMSCs. The production of ADSCs is greater than that of BMSCs, and ADSCs proliferate faster than BMSCs. To compare the effects of venous grafts containing BMSCs or ADSCs on sciatic nerve injury, in this study, rats were randomly divided into four groups: sham(only sciatic nerve exposed), Matrigel(MG; sciatic nerve injury + intravenous transplantation of MG vehicle), ADSCs(sciatic nerve injury + intravenous MG containing ADSCs), and BMSCs(sciatic nerve injury + intravenous MG containing BMSCs) groups. Sciatic functional index was calculated to evaluate the function of injured sciatic nerve. Morphologic characteristics of nerves distal to the lesion were observed by toluidine blue staining. Spinal motor neurons labeled with Fluoro-Gold were quantitatively assessed. Compared with sham-operated rats, sciatic functional index was lower, the density of small-diameter fibers was significantly increased, and the number of motor neurons significantly decreased in rats with sciatic nerve injury. Neither ADSCs nor BMSCs significantly improved the sciatic nerve function of rats with sciatic nerve injury, increased fiber density, fiber diameters, axonal diameters, myelin sheath thickness, and G ratios(axonal diameter/fiber diameter ratios) in the sciatic nerve distal to the lesion site. There was no significant difference in the number of spinal motor neurons among ADSCs, BMSCs and MG groups. These results suggest that neither BMSCs nor ADSCs provide satisfactory results for peripheral nerve repair when using MG as the conductor for engraftment.     

维吾尔文版MMSE量表的信度、效度分析

目的分析维吾尔文版简易智能状态检查量表(MMSE-U)在维吾尔族人群中应用的信度、效度,以满足科研课题的需求。方法对86例55~75岁以上、不同文化程度的维吾尔族患者进行MMSE-U问卷调查后,进行统计分析。结果 MMSE-U的克朗巴赫(Cronbach's)α系数=0.906,提示MMSE-U具有良好的内部一致性;随机抽取30人,用MMSE-U问卷进行重测,结果两次重测总分的相关系数r=0.720(P0.05);应用多元逐步回归法对维吾尔文版MMSE-U各个亚项贡献因子对痴呆筛查效度进行评价,结果有统计学意义(P0.05)。结论 MMSE-U具有良好的信度、效度及可行性,适合应用于维吾尔族人群认知功能的评估。     

新疆汉、维、哈族帕金森病患者必需氨基酸相关性研究

目的本研究旨在探讨新疆汉、维、哈不同民族帕金森病与人体血清必需氨基酸相关性。方法自2012年1月~2016年12月就诊于新疆维吾尔自治区中医院,伊犁州地区、和田地区、阿克苏地区、库尔勒地区、哈密地区、阿勒泰地区等各地州医院的门诊及住院帕金森病患者,同时各医院选取年龄(±3岁)、性别、族别与其匹配的健康患者作为对照组,经前期处理后利用高效气象色谱法测定血清中8种人体必需氨基酸相对含量,分析汉族、维、哈3个民族病例组与对照组及3组间8种氨基酸含量的差异。结果 (1)对照组与病例组相比,3个民族血清甲硫氨酸含量存在差异且有统计学意义(P 0.05);(2)汉、哈族色氨酸存含量存在差异且有统计学意义(P 0.05);(3) 3个民族病例组比较可得出两两比较色氨酸含量均有差异(P 0.05)。结论血清必须氨基酸中的甲硫氨酸、色氨酸是帕金森病发病的重要影响因素。     

导师治疗原发性痛经经验浅析

刘静君教授认为血瘀是原发性痛经主要的发病机理。治疗以活血调经、祛瘀止痛为主,自拟止痛调经方,获得较好治疗效果。     

1例口服10％氯化钾溶液致过敏反应患者的护理

患者男，42岁，3d前于工作时出现心前区酸痛，呈压迫感，疼痛向左肩背部放射，持续20—30min，休息及饮水后可缓解。于2011年4月9日开车时再次出现上述症状，故来我院就诊。入院诊断：冠心病。入科后患者神志清，精神可，否认有药物、食物过敏史。于4月10日查血生化示血钾为3．32mmol／L，