精神分裂症患者奥氮平剂量校正血浆浓度的非遗传影响因素分析

目的 考察精神分裂症患者奥氮平剂量校正血浆浓度的影响因素.方法 选取2020年2—9月就诊于北京回龙观医院且服用奥氮平治疗的544例精神分裂症住院患者,采用高效液相色谱-串联质谱联用方法检测奥氮平血浆浓度,从病历系统中提取患者的一般资料,统计分析年龄、性别、体重、合并用药和肝肾功能对奥氮平剂量校正血浆浓度的影响.结果 ...     

Effectiveness of calamine lotion as an adjunctive therapy to mometasone furoate ointment in the treatment of infant eczema: A retrospective study

This retrospective study investigated the effectiveness of calamine lotion (CL) as an adjunctive therapy to mometasone furoate ointment (MFO) in the treatment of infant eczema (IE).This retrospective study analyzed the electronic medical records of 50 IE infants. They were allocated to a treatment group or a control group, with 25 subjects in each group. All infants in both groups received MFO. In addition, infants in the treatment group underwent CL. The outcomes were effectiveness based on the eczema area and severity index, lesion area, and pruritus severity. We analyzed the outcomes before and after treatment.The results of this study showed that infants in the treatment group had more effective in effectiveness based on eczema area and severity index (P < .01), lesion area (P < .01), and pruritus severity (P = .01) than those in the control group. However, no medical records reported any adverse events in either group.The results of this study showed that CL added to MFO was more effective than MFO alone in the treatment of infants with IE.     

Distinguishing pancreatic solid serous cystadenomas from nonfunctional pancreatic neuroendocrine tumors by computed tomography: A propensity score analysis

This study aims to evaluate the utility of calculated computed tomography (CT) attenuation value ratio (AVR) and enhancement pattern in distinguishing pancreatic solid serous cystadenomas (SCAs) from nonfunctional pancreatic neuroendocrine tumors (NF-pNETs). A total of 142 consecutive patients with 22 solid SCAs and 120 NF-pNETs confirmed by pathology were included in this retrospective study. All patients underwent preoperative contrast-enhanced CT and were categorized into 2 groups, solid SCA and NF-pNET groups. Patients with NF-pNETs were matched to patients with solid SCAs via propensity scores. AVR was measured and defined as: attenuation value of tumor/attenuation value of normal pancreas. AVR and enhancement pattern performance were assessed according to the discriminative abilities of patients. After matching, 29 patients were allocated to the NF-pNET group. Before matching, sex, age, and the peak enhanced value phase were significantly different between solid SCA and NF-pNET patients (P < .05). After matching, no significant difference was observed between both groups (P > .05). Solid SCAs AVRs were significantly smaller than NF-pNETs AVRs in all unenhanced, arterial, portal venous, and delayed phases (P < .05). Solid SCAs showed significantly more wash-in and wash-out enhancement patterns than NF-pNETs (P < .05). For unenhanced, arterial, portal venous, and delayed phases, and enhancement pattern, the area under the curve (AUC) values were 0.96, 0.72, 0.80, 0.85, and 0.86, respectively. Low AVR on unenhanced CT and wash-in and wash-out enhancement patterns were useful for differentiating solid SCAs from NF-pNETs and may be useful for clinical decisions, a clearer opinion will be formed with further studies to be conducted with larger patient numbers.     

A randomized controlled trial of positive end-expiratory pressure on pulmonary oxygenation and biventricular function in esophageal cancer patients receiving one-lung ventilation under a lower FiO2

BackgroundArterial oxygenation is often impaired during one-lung ventilation (OLV), due to both pulmonary shunt and atelectasis. Lower fraction of inspiration O₂ (FiO₂) may reduce inflammation and complications, but may increase the risk of hypoxemia. The aim of this randomized controlled parallel trial was to analyze whether higher positive end-expiratory pressure (PEEP) could improve oxygenation and maintain lower levels of inflammation during OLV under a lower FiO₂.MethodsOne hundred and twenty patients with selective thoracotomy for esophageal cancer (EC) were classified randomly into four groups on a ratio of 1:1:1:1 using a computer-generated list, including Group A (FiO₂ =0.6, PEEP =0), Group B (FiO₂ =0.6, PEEP =5 cmH₂O), Group C (FiO₂ =1.0, PEEP =8 cmH₂O), and Group D (FiO₂ =1.0, PEEP =10 cmH₂O). The oxygenation and pulmonary shunt were primary outcomes. Haemodynamics, respiratory mechanics, serum IL-6 and IL-10 levels, and complications were taken as secondary outcomes. Follow-up was terminated until discharge.ResultsTwo patients in Group A and two in Group D were excluded due to hypoxemia and hypotension, respectively. Then the data of 116 patients (Group A =28, Group B =30 Group C =30, and Group D =28) were assessed for final analysis. Compared with Group B, the partial pressure of oxygen (PaO₂) and dynamic compliance during OLV in Group D were significantly increased from 15 minutes to 60 minutes, while pulmonary shunt was significantly decreased (P>0.05). Patients in Group D had higher levels of central venous pressure (CVP) and airway pressure (Paw) during OLV and higher levels of IL-6 and IL-10 after OLV compared with Group B (P>0.05). No statistical differences were found in oxygen saturation (SaO₂), PvO₂ (partial pressure of oxygen in venous blood), partial pressure of end-tidal carbon dioxide (ETCO₂), partial pressure of carbon dioxide in artery (PaCO₂), heart rate (HR), mean arterial pressure (MAP), and complications among the four groups (P>0.05).ConclusionsHigher PEEP increased the oxygenation under 60% O₂ during OLV. However, the haemodynamics and respiratory mechanics changed, and the levels of inflammation increased. A higher PEEP under 60% O₂ during OLV is not recommended.Trial RegistrationChinese Clinical Trial Registry ChiCTR1900024726.     

Intervention efficacy of MARSI nursing management on skin injury at peripherally inserted central catheter insertion site on oncological patients

To evaluate the intervention efficacy of medical adhesive‐related skin injury (MARSI) nursing management at peripherally inserted central catheter (PICC) insertion site on oncological patients. This study used the case‐control research method. We randomly divided 156 patients with PICCs implanted in our hospital''s surgery department from January 2019 to December 2020 into a control group (85 patients) and an intervention group (71 patients). The control group was the conventional nursing care group, and the intervention group was the MARSI nursing management group. Through implementing a series of interventions (ie, risk assessment, risk prevention, and risk management) for the MARSI nursing care management group, the incidence rate of MARSI, and its types (including mechanical injury, dermatitis, maceration, and folliculitis) were compared between the two groups. The total incidence rate of MARSI was 30.59% in the control group and 7.04% in the intervention group (P < .05), and the difference was statistically significant. The incidence rate of mechanical injury in the control group was 12.94%, which decreased to 2.82% after intervention (P < .05), and the difference was statistically significant. The incidence rate of dermatitis in the intervention group was 11.76%, which decreased to 2.82% after intervention (P < .05), and the difference was statistically significant. By implementing MARSI nursing care management, the incidence rate of MARSI at PICC insertion site can be effectively reduced.     

临床病理科住院医师规范化培训中标本取材教学的探索

病理标本取材是做好病理诊断的前提,也是临床病理科住院医师规范化培训学员入科必须掌握的首要技能。本文针对当前标本取材教学中遇到的问题和困难,通过5年的摸索和尝试,逐步建立起一套以理论教学、实践教学、以考促教、以老带新、回顾教学为基本要素的新模式。对学员的考评分析及问卷调查结果表明,该教学能快速、高效地让住培学员掌握标本取材方法,在实践中学习和提升临床技能,为后续的组织病理诊断规范化培训打下坚实的基础。     

症状自评量表(SCL-90)在心理健康研究中应用的争议

目的分析SCL-90量表在心理健康研究中的应用争议。方法搜集相关文献,采用内容分析法对相关研究的对象、方法和结果进行综述。结果SCL-90量表在适用对象、信效度及常模3个方面存在争议。结论在目前尚无更好的可供选择的心理健康评定量表的情况下,SCL-90有其存在和应用的价值;同时,要注重更加科学、有效的量表的引进或研制。     

高中生的学习投入及其与应激的关系

目的探讨高中生的学习投入水平及其与应激事件的关系。方法380名高中生接受中文版Utrecht工作投入量表和青少年生活事件量表的调查。结果高中生的学习投入水平一般,高二的活力水平要显著高于高一,女生的专注程度要显著高于男生,应激事件是学习投入重要的预测变量。结论高中生的学习投入水平良好,应激事件对学习投入有重要影响。     

红白血病MIC特征分析

回顾分析了７例红白血病（急性髓系白血病Ｍ６）的形态学、免疫学、细胞遗传学特征。血象示二系或是三系减少，可见数量不等的有核红细胞。骨髓主要累及红系和粒系，但大部分患者有三系病态造血，有核红细胞ＰＡＳ染色呈阳性。白血病细胞主要表达血型糖蛋白、ＣＤ１３和ＣＤ３８。大部分患者有染色体核型异常，但均为随机非特异性改变。