新生儿舒适护理研究进展

阐述了体位对早产儿呼吸系统、胃肠道功能及心理的影响，沐浴、体温测量对新生儿皮肤有影响。提出保护性措施可减轻对患儿的伤害，提高其舒适度。     

特异性磷酸二酯酶抑制剂对老年供体肺保存的干预

目的:利用大鼠离体肺再灌注模型,应用特异性磷酸二酯酶抑制剂米力农在器官摘取及保存期处理老年大鼠供体肺,观察其对老年供体肺保存效果的影响。方法:实验于2006-10/12在阜外心血管病研究所实验外科完成。①实验分组及方法:选用20周龄SD大鼠24只及SD老年大鼠12只,将大鼠按随机数字表法分为3组:对照组(6只年轻大鼠→6只年轻大鼠),建立大鼠离体肺再灌注模型,低钾右旋糖酐液灌洗后摘取心肺器官,4℃恒温冰箱中保存12h后取出,以5mL/min流量再灌注60min。老年大鼠供体常规保存组(6只老年大鼠→6只年轻大鼠),按其体质量配相应灌洗液量,余同对照组。米力农处理老年大鼠供体组(6只老年大鼠→6只年轻大鼠),供体肺灌洗液及保存液中含有666μg/L米力农,余同老年大鼠供体常规保存组。②实验评估:观察各组大鼠供体肺流出血氧分压、平均肺动脉压、肺气道压力动态变化及再灌注后供体肺湿干比、肺组织丙二醛含量及髓过氧化物酶活性。结果:36只大鼠全部进入结果分析。①随着灌注时间的延长,老年大鼠供体常规保存组大鼠各时间段供体肺的流出血氧分压均低于对照组(P<0.05),平均肺动脉压均高于对照组(P<0.05),再灌注40min和60min时的肺气道压力高于对照组(P<0.05)。而米力农处理老年大鼠供体组与对照组差异均无显著性意义(P>0.05)。②老年大鼠供体常规保存组再灌注后供体肺湿干比、肺组织丙二醛含量及髓过氧化物酶活性均显著高于对照组(P<0.05),米力农处理老年大鼠供体组与对照组差异无显著性意义(P>0.05)。结论:特异性磷酸二酯酶抑制剂米力农药物处理老年供体肺能够减轻缺血再灌注损伤,明显改善移植后早期老年供体肺功能。     

Increased release of gentamicin from acrylic bone cements under influence of low-frequency ultrasound.

The release profile of antibiotics from antibiotic-loaded bone cement, used to prevent infections in total joint arthroplasty, is neither ideal nor complete. Ultrasound has been used to allow drugs to cross otherwise impermeable barriers. The aim of this study was to establish a possible effect of ultrasound on antibiotic release from bone cements. Samples were made of three commercially available gentamicin-loaded bone cements. Part of the samples was allowed to release gentamicin for 3 weeks before insonation. An insonation device produced an ultrasound field with a time average acoustic intensity of 167 mW/cm2 at a frequency of 46.5 kHz. The samples were exposed to the ultrasound field or not exposed to it as a control. The amount of gentamicin released was measured by fluorescence polarization immunoassay. There was a limited increase of gentamicin release with application of ultrasound in fresh samples but not in the samples that had been allowed to release gentamicin. For fresh samples, a linear regression model showed that this ultrasound effect was statistically significant. The mechanism behind these observations is not clear, but it is suggested that microstreaming or localized temperature rises may be involved.     

Patterns of physical activity and obesity indices among white-collar men in Taiwan

The purposes of this study were to identify patterns of physical activity among white-collar men in Taiwan and to analyze the relationships between physical activity patterns and obesity indices. This cross-sectional survey included 350 subjects (between 21 and 75 years old). The Monitoring Trends and Determinants of Cardiovascular Disease Optional Study of Physical Activity Questionnaire (MOSPA-Q), developed and published by the World Health Organization (WHO) was used to measure subjects' daily energy expenditures attributed to physical activity. Obesity indices included body weight, body mass index (BMI), waist/hip ratio (WHR), body fat percentage, total cholesterol, triglycerides, high-density lipoprotein (HDL), and low-density lipoprotein (LDL). Three patterns of physical activity, namely work-oriented, active, and light-active lifestyles, were identified through cluster analysis. The work-oriented group reported spending the most amount of time on work-related activities (10.5 hours/week). The active group spent the most time (1 hour/day) of the three groups on leisure activities. The light-active group spent the most time (7 hours/day) of the three groups on light activities. Referencing the 150 minutes/week of moderate- intensity physical activity recommended by the US Centers for Disease Control and prevention (CDC) for health gain as a cut-off point, 1.1%, 15.2%, and 29.1% of subjects in the active, light-active and work-oriented groups, respectively, failed to achieve this minimal level. Those in the work-oriented group categorized in high work-overload and prevalent inactivity situations returned the worst obesity indices (Body weight, BMI, WHR, and body fat percentages) adjusted by age.     

11例急性早幼粒细胞性白血病全反式维甲酸治疗疗效观察

目的观察11例急性早幼粒细胞性白血病患者经全反式维甲酸治疗后的临床效果。方法予全反式维甲酸40～60mg/d,持续服药至缓解,缓解后与化疗药物序贯治疗,用药前后检察患者血象及骨髓象。结果用全反式维甲酸诱导缓解率达91%,达缓解天数平均44d,所需维甲酸总剂量2648mg。结论全反式维甲酸对急性早幼粒细胞性白血病患者的预后有很大改善。     

地黄杜仲汤联合羟基脲对老年慢性粒细胞白血病患者的临床疗效及对预后的影响

目的:探讨地黄杜仲汤联合羟基脲对老年慢性粒细胞白血病患者的临床疗效以及对预后产生的影响。方法:选取2012年3月至2015年7月在沈阳军区总医院接受治疗的老年慢性粒细胞白血病患者70例作为本次研究对象,采用随机数表法将他们分为治疗组和对照组各35例,对照组患者给予地黄杜仲汤治疗,治疗组患者给予地黄杜仲汤联合羟基脲治疗,比较2组患者治疗后的临床疗效、生存率以及不良反应发生情况。结果:治疗后,治疗组患者的总缓解率为94.28%高于对照组68.57%,2组比较差异有统计学意义(P0.05);治疗组患者治疗后的≥6年生存率为80.00%,对照组为34.28%,治疗组高于对照组,2组比较差异有统计学意义(P0.05);治疗组患者治疗后出现恶心呕吐、白细胞低、肾功能异常以及肝功能异常等不良反应的发生率明显低于对照组患者,2组患者进行比较,差异有统计学意义(P0.05)。结论:地黄杜仲汤联合羟基脲治疗老年慢性粒细胞白血病临床效果显著,降低不良反应,延长患者的生存期。     

Fresh Osteochondral Allograft Transplantation for Treatment of Large Cartilage Defects of the Femoral Head: A Minimum Two-Year Follow-Up Study of Twenty-Two Patients

Background

Controversy remains over the surgical management of large osteochondral lesions of the femoral head in young, active patients. The purpose of this study is to assess midterm clinical and radiographic outcomes after fresh osteochondral allograft transplantation (OAT) for large femoral head lesions at minimum 2-year follow-up.

The effect of intradialytic combined exercise on hemodialysis efficiency in end-stage renal disease patients: a randomized-controlled trial

Purpose

Insufficient dialysis is a difficult problem for patients undergoing hemodialysis, and causes cardiovascular complications and increases mortality. Increasing aerobic exercise and resistance exercise have been shown to be beneficial to physical fitness of patients undergoing hemodialysis, but a few studies have focused on combined exercise (combination of aerobic and resistance exercise training) and the interaction effect of combined exercise and intervention duration on hemodialysis efficiency. This study aimed to investigate the effects of 24-week combined exercise on hemodialysis efficiency, blood pressure, exercise capacity, and quality of life in patients undergoing hemodialysis.

Methods

In total, 47 eligible subjects were randomly allocated to exercise group and control group. The intervention group performed a 24-week, three times weekly, and moderate-intensity intradialytic combined exercise. Patients in the control group received usual care. The primary outcome was hemodialysis efficiency, which recorded every 4 weeks. Secondary outcomes included blood pressure, exercise capacity, and quality of life, measured at baseline and after 24 weeks of intervention.

Results

In intervention group, sp Kt/V significantly improved by 13.2%, and systolic blood pressure and diastolic blood pressure significantly decreased by 8.5 mmHg and 6.5 mmHg, respectively. The 6-min walking distance increased significantly by 43 m (9.8%), but there was no significant change in quality of life.

Conclusion

Combined exercise and intervention duration had an interaction effect on hemodialysis efficiency. Combined exercise improved blood pressure and physical fitness for patients undergoing hemodialysis, but did not affect quality of life. The extensive benefits of combined exercise provide evidence for the exercise development for patients undergoing hemodialysis.