锂对染铅大鼠海马胆囊收缩素和神经元型一氧化氮合酶神经元的保护作用

目的 探讨锂对染铅大鼠海马胆囊收缩素（CCK）和神经元型一氧化氮合酶（nNOS）神经元的保护作用及其与动物学习记忆功能变化的关系.方法 通过测量体重,利用反映学习记忆功能的Y迷宫法和ABC免疫组化法,研究饮用含0.2 g/L醋酸铅（PbAc）水和含不同剂量（3、30、300、3 000mg/kg）氯化锂（LiCl）饲料喂养的大鼠体格发育情况、学习记忆能力以及海马不同亚区CCK和nNOS阳性神经元数目的变化.结果铅染毒组大鼠体重增加少于对照组大鼠,差异有统计学意义（P＜0.05）,Y-迷宫学会次数多于对照组大鼠,差异有统计学意义（P＜0.05）;其海马各区CCK和nNOS阳性神经元数明显减少,差异有统计学意义（P＜0.05）.铅＋LiCl（3、30、300mg/kg）组体重增加多于对照组大鼠,差异有统计学意义（P＜0.05）;Y-迷宫学会次数少于对照组大鼠,差异有统计学意义（P＜0.05）,海马各区CCK阳性神经元数明显增加,差异有统计学意义（P＜0.05）.铅＋3 000mg/kg LiCl组大鼠Y-迷宫学会次数多于对照组大鼠,差异有统计学意义（P＜0.05）;海马各区CCK阳性神经元数明显少于对照组,差异有统计学意义（P＜0.01）;与铅染毒组比较,差异无统计学意义（P＞0.05）.结论 铅可损伤大鼠学习记忆能力,影响大脑海马CCK和nNOS阳性神经元的数目.较低剂量的锂对铅引起的学习记忆损伤和海马CCK阳性神经元的变化有一定保护作用.     

建立行风建设有效机制提升医疗服务质量

介绍贵阳医学院附属医院抓行风建设,提升医疗服务质量的经验。医德医风建设实行一岗双责,量化落实;以制度规章强化制约;以服务为本,提供合理便捷的人性化服务;形成医德医风管理体系,进行有效监督;进行医德医风教育,营造和谐温馨的医院环境。     

ESE-3小鼠同源基因在哮喘小鼠的表达及意义

目的:研究ESE-3小鼠同源基因Ehf在支气管哮喘(简称哮喘)小鼠肺组织的表达,探索ESE-3在哮喘发病机制中的作用。方法:将20只雌性BALB/c小鼠随机分成2组,即哮喘模型组和对照组,用逆转录PCR、荧光定量PCR检测EhfmRNA的表达,用免疫印迹法检测其蛋白质的表达。结果:EhfmRNA和蛋白质在哮喘模型组和对照组中均有表达,逆转录PCR显示哮喘组EhfmRNA的表达为0.5800±0.2081,明显高于对照组的表达0.2300±0.2336(P=0.001)。荧光定量PCR显示哮喘组EhfCt/β-actinCt值为25.28±1.05/18.71±0.39,与对照组小鼠EhfCt/β-actinCt值(29.68±0.45/18.82±0.47)的差异有显著性(P=0.000)。哮喘组Ehf的蛋白质表达为1.0717±0.2088,明显高于对照组的表达0.7300±0.2336(P=0.001)。结论:哮喘组Ehf明显较对照组表达高,ESE-3可能是人类哮喘发病过程中一个重要的因子。     

利用ACL与NAT完成内部HIS与外部医保网的对接

结合实际工作中出现的问题,在保证内部网络安全和满足医院医疗服务的前提下,作者提出了利用ACL与NAT技术,实现医院内部信息网与外部医保网络对接的解决方案,并给出了具体的实现方法.     

欧姆龙 HEM-770A型电子血压计的检测方法

本文介绍了欧姆龙 HEM-770A型电子血压计的实用检测方法及专用插头.     

芪丹颗粒剂治疗肺间质纤维化105例临床研究

目的:观察芪丹颗粒剂对肺间质纤维化患者的临床疗效.方法:选择105例肺间质纤维化患者作为治疗组,给予芪丹颗粒剂,对照组60例,给予强的松0.5mg/kg,两组疗程均为3～6个月,每1～3个月随诊1次.观察两组患者治疗后的症状、体征、肺部高分辨率CT(HRCT)及肺功能变化.结果:治疗6个月后,治疗组症状、体征改善率优于对照组(P＜0.05或P＜0.01);治疗组治疗3个月和6个月后,肺HRCT和肺功能改善率优于对照组(P＜0.05或P＜0.01).结论:芪丹颗粒剂可以不同程度地改善肺间质纤维化患者症状和体征,使患者肺功能停止恶化,且用药期间未见任何副作用,耐受性良好.     

高效液相色谱法测定益肾健骨片中齐墩果酸的含量

目的：建立HPLC测定益肾健骨片中齐墩果酸含量的方法。方法：色谱条件为：C18柱，流动相为乙腈-0．1％磷酸(67：33)，UV检测波长为210am。结果：此方法线性关系良好，平均加样回收率为97．25％(n=6)。结论：该方法分离良好，结果准确可靠。     

Different classes of antibiotics exhibit disparate negative impacts on the therapeutic efficacy of immune checkpoint inhibitors in advanced non-small cell lung cancer patients

It has been reported that antibiotics (ATBs) have adverse effect on the efficacy of treatment with immune checkpoint inhibitors (ICIs) in cancer patients. Since different classes of ATBs have different antibacterial spectrum, we aimed to study whether all ATBs had similar or different negative effects on the clinical outcomes of ICIs in patients with advanced non-small cell lung cancer (NSCLC). Patients with advanced NSCLC who received ICIs were included in this retrospective study and grouped by the class of ATBs they had used around the ICIs treatment time. The overall survival (OS) and the progression free survival (PFS) of patients among these groups were compared using Kaplan-Meier method and Cox proportional hazards model. A total of 148 eligible patients were enrolled, and 80 patients used ATBs. The results indicated that quinolones had no significant negative consequence on the clinical outcomes, while β-lactams significantly shortened the OS and PFS of patients. Furthermore, patients exposed to the combination of β-lactams and quinolones suffered the worst OS and PFS. Moreover, the subgroup analysis of β-lactams revealed that only penicillins, but not carbapenems and cephalosporins, markedly reduced both OS and PFS. In addition to the class of ATBs used, the time frame of ATBs used also affected the clinical outcomes of ICIs therapy. Patients receiving ATBs within 60 days prior to and 30 days after the initiation of ICI treatment had significantly shorter OS and PFS compared with those who did not use ATBs. This study demonstrated that different classes of ATBs had disparate negative impacts on the clinical outcomes, and the use of β-lactams, especially penicillins, should be avoided in advanced NSCLC patients who are receiving or scheduled to receive ICIs within 60 days.     

"术前体质辨证、术后快速整体康复" 模式在剖宫产的临床应用

[目的] 观察并验证在"术前体质辨证、术后快速整体康复"理念模式的指导下,运用中医活血祛瘀、健旺脾胃、固本培元等方法,促进剖宫产术后伤口愈合和整体康复,从而提高术后生活质量,达到快速整体康复为目的的临床疗效.[方法] 以2000 年1月至2005年12月符合入选标准的产妇 5500 例作为对照组,以2006年1月至2007年8月符合入选标准的产妇2 300例作为治疗组.治疗组根据产前体质辨证,产后以中药体质调理并配合耳针、穴位贴敷、穴位注射等综合疗法治疗.对照组围手术期使用抗生素预防感染,并配合能量合剂、维生素等支持疗法.观察两组产妇术后伤口感染和伤口疼痛评分、胃肠道反应、术后胃肠道排气排便时间、泌乳情况、宫底下降高度、产后24 h出血量以及血常规中白细胞计数等指标.[结果] 治疗组术后在伤口疼痛评分、伤口感染及胃肠道反应方面均较对照组明显减轻,排气排便时间提早,泌乳增加,与对照组比较,差异均有显著性意义(P<0.05).[结论]"术前体质辨证、术后快速整体康复"模式在剖宫产中的应用,可使产妇顺利、快速地度过产后康复全过程.     

Use of Ilizarov Device to Gain Early Range of Motion in the Treatment of Pediatric Talus Body Fractures: A Series of Four Cases and Literature Review

BackgroundTalus fractures are rare in children but can lead to severe outcomes if untreated. The Ilizarov external fixator has been used in the treatment of a variety of lower extremity pathologies. The purpose of this study was to investigate the clinical outcomes of talus body fractures treated with the Ilizarov external fixator.Case PresentationFour male pediatric patients (age range, 5–11 years) with talus body fractures who were treated by open reduction and internal fixation combined with Ilizarov external fixator between November 2015 and April 2016 were reviewed. Mean follow‐up period was 4 years (range, 4–5). Clinical outcome was evaluated using the clinical rating scale of the American Orthopaedic Foot and Ankle Society (AOFAS). All four patients achieved good to excellent results at the last follow‐up. None of the patients developed avascular necrosis. One patient developed automatic fusion of tibiotalar joint.ConclusionUse of the Ilizarov external fixator to gain early range of motion is a valuable option for treatment of talus body fractures in children.