直肠癌新辅助放化疗后预防回肠造口与吻合口漏相关性研究

目的探讨研究保护性回肠造口是否可以降低直肠癌新辅助治疗患者术后吻合口漏的发病率及相关性。方法选取首都医科大学附属北京友谊医院2011年5月-2020年8月直肠癌新辅助放化疗行直肠癌前切除术的患者108例实施保护性回肠造口(试验组)63例,未实施保护性回肠造口(对照组)45例。主要比较两组患者吻合口漏发病率,同时分析吻合口漏相关因素,统计永久造口率。采用SPSS 19.0软件进行统计分析、结果试验组和对照组术后吻合口漏的总发病率分别为9.52%(6/63)和6.66%(3/45)(P=0.59),其中试验组发生A级吻合口漏2例,对照组无A级吻合口漏,两组差异无统计学意义(33.33%比0,P=0.77);试验组发生B级吻合口漏4例,对照组2例,两组差异无统计学意义(66.67%比66.67%,P=0.45);试验组无C级吻合口漏.对照组发生C级吻合口漏1例,两组差异无统计学意义(0比33.33%,P=0.70)。Logistic回归分析显示实施保护性造口与否同吻合口漏的发生无关(P=0.26),肿瘤距肛缘距离关系吻合口漏的发生(P=0.01)。试验组术后永久造口率为9/63(16.67%)。结论保护性回肠造口在降低直肠癌新辅助放化疗患者术后吻合口漏发病率方面并无显著优势,并有可能导致永久造口。     

分级式急诊护理在急性胰腺炎患者中的应用现状

急性胰腺炎是常见的消化系统疾病,也是急诊科的常见急腹症之一。急性胰腺炎的发病原因较为多样,且经常伴随多种并发症,导致患者的病情危急程度各不相同,轻症大部分呈自限性病程,而重症则有着较高的死亡率,需要及时给予有效治疗。急诊科作为重症患者的第一抢救场所,根据患者病情给予恰当的治疗是提高患者生存率的关键。本文对近年分级式急诊护理在急性胰腺炎患者中的应用进行综述,旨在为提高急诊护理工作的效率提供一定参考。     

Intratumoral and Peritumoral Analysis of Mammography,Tomosynthesis, and Multiparametric MRI for Predicting Ki-67 Level in Breast Cancer: a Radiomics-Based Study

Molecular Imaging and Biology - To noninvasively evaluate the use of intratumoral and peritumoral regions from full-field digital mammography (DM), digital breast tomosynthesis (DBT), dynamic...     

TRPM7抑制剂对压力超负荷大鼠心肌肥厚的影响

目的研究瞬时受体电位通道M7(Transient receptor potential melastatin 7 channels,TRPM7)抑制剂对压力超负荷所致心肌肥厚及炎症反应的影响。方法雄性SD大鼠20只,随机分为三组:假手术组(n=6)、主动脉缩窄组(TAC组)(n=7)、TAC+2-Aminoethoxydiphenyl Borate(2-APB)组(TRPM7抑制剂组)(n=7)。通过在右侧无名动脉和左侧颈总动脉之间缩窄胸主动脉而诱导大鼠心肌肥厚模型。抑制剂组造模前一天开始给药,腹腔注射,每3天一次,2.5mg/kg。造模2周后取各组大鼠左心室,将心肌样本切片,苏木素-伊红染色观察心肌形态学改变;Masson染色检测心肌组织胶原沉积,免疫荧光检测TRPM7、巨噬细胞标记分子CD68和单核细胞趋化蛋白-1(MCP-1)的表达。结果 TAC组与假手术组相比,心肌细胞直径增大,胶原沉积增多,TRPM7、CD68、MCP-1表达均增加;TRPM7抑制剂处理后,上述情况均有改善。结论 TRPM7的表达在压力超负荷诱导的心肌肥厚模型中显著增加,抑制TRPM7改善心肌肥厚,减少心肌组织胶原沉积及巨噬细胞浸润。     

诺维本化疗性渗漏原因分析及处理

[目的]明确诺维本化疗渗漏的发生原因,提出有效可行的处理措施。[方法]对2011年1月—2012年1月在西安交通大学医学院第一附属医院肿瘤放疗科住院并使用诺维本静脉用药的病人146例进行观察,统计分析其渗漏发生率及渗漏原因。[结果]146例病人中发生诺维本化疗性渗漏12例,占8.2%。渗漏原因:护士对药物毒副反应了解不足,血管选择错误,使用穿刺针种类不当,固定不妥,观察不细。[结论]在使用诺维本化疗时要采取积极有效的处理措施,严防诺维本化疗性渗漏的发生。     

Coupling the valley degree of freedom to antiferromagnetic order

Conventional electronics are based invariably on the intrinsic degrees of freedom of an electron, namely its charge and spin. The exploration of novel electronic degrees of freedom has important implications in both basic quantum physics and advanced information technology. Valley, as a new electronic degree of freedom, has received considerable attention in recent years. In this paper, we develop the theory of spin and valley physics of an antiferromagnetic honeycomb lattice. We show that by coupling the valley degree of freedom to antiferromagnetic order, there is an emergent electronic degree of freedom characterized by the product of spin and valley indices, which leads to spin–valley-dependent optical selection rule and Berry curvature–induced topological quantum transport. These properties will enable optical polarization in the spin–valley space, and electrical detection/manipulation through the induced spin, valley, and charge fluxes. The domain walls of an antiferromagnetic honeycomb lattice harbors valley-protected edge states that support spin-dependent transport. Finally, we use first-principles calculations to show that the proposed optoelectronic properties may be realized in antiferromagnetic manganese chalcogenophosphates (MnPX₃, X = S, Se) in monolayer form.     

Do radiographic disease and pain account for why people with or at high risk of knee osteoarthritis do not meet physical activity guidelines?

Objective

Knee osteoarthritis (OA) and pain are assumed to be barriers to meeting physical activity guidelines, but this has not been formally evaluated. The purpose of this study was to determine the proportions of people with and those without knee OA and knee pain who meet recommended physical activity levels through walking.

Methods

We performed a cross‐sectional analysis of community‐dwelling adults from the Multicenter Osteoarthritis Study who had or who were at high risk of knee OA. Participants wore a StepWatch activity monitor to record steps per day for 7 days. The proportion of participants who met the recommended physical activity levels was defined as those accumulating ≥150 minutes per week at ≥100 steps per minute in bouts lasting ≥10 minutes. These proportions were also determined for those with and those without knee OA, as classified by radiography and by severity of knee pain.

Results

Of the 1,788 study participants (mean ± SD age 67.2 ± 7.7 years, mean ± SD body mass index 30.7 ± 6.0 kg/m², 60% women), lower overall percentages of participants with radiographic knee OA and knee pain met recommended physical activity levels. However, these differences were not statistically significant between those with and those without knee OA; 7.3% and 10.1% of men (P = 0.34) and 6.3% and 7.8% of women (P = 0.51), respectively, met recommended physical activity levels. Similarly, for those with moderate/severe knee pain and those with no knee pain, 12.9% and 10.9% of men (P = 0.74) and 6.7% and 11.0% of women (P = 0.40), respectively, met recommended physical activity levels.

Conclusion

Disease and pain have little impact on achieving recommended physical activity levels among people with or at high risk of knee OA.

     

Bronchogenic cysts in retroperitoneal region

Bronchogenic cyst is a relatively rare abnormality that develop from the accessory lung buds of the foregut. The cyst is regarded as a congenital developmental abnormality. Occurence in the retroperitoneal presentation is rare. Here, we present two patients who had an incidentally discovered retroperitoneal mass which were revealed to be bronchogenic cysts after surgical extirpation.     

不同人群对男护士需求的调查

[目的]了解病人、医护人员对男护士的认知、需求情况以及男性从事护理职业影响因素，为培养和使用男护士提供参考依据。[方法]采用问卷调查法对北京市3所医院医护人员及病人进行调查。[结果]147名调查对象中对男护士的知晓率为85，7％；认为男性适合从事护理工作者占84.4%；认为需要或者非常需要男护士占83．7%；认为最需要男护士的科室分别是急诊、精神科、外科、手术室；影响男护士职业因素主要是传统观念（30．8％）、工作性质（30．0％）、就业待遇低（21．5％）、无职业成就感（20．8％）。[结论]护理工作需要男性加入，只要合理规定男护士的工作内容以及转变社会从业人员的观念，培养和使用男护士是可行的。     

呼气末正压呼吸和同步间歇指令通气对肺心病患者血气和血流动力学影响的比较研究

对比研究了呼气末正压呼吸（ＰＥＥＰ）和同步间歇指令通气（ＳＩＭＶ）对肺心病患者血气、血流动力学和氧运输的影响。８例患者应用７ｃｍＨ＿２ＯＰＥＥＰ３０分钟后，生理分流明显减少（Ｐ＜０．０５），动脉血氧分压平均升高０．４ｌｋＰａ，但伴混合静脉血氧分压降低（Ｐ＜０．０５）。９例患者应用ＳＩＭＶ３０分钟后，肺血管阻力下降（Ｐ＜０．０５），心脏指数和混合静脉血氧分压明显升高（Ｐ＜０．０５和Ｐ＜０．０１）。提示肺心病患者应慎用ＰＥＥＰ，不可避免时，应与ＳＩＭＶ合用。