短纯音诱发的听性脑干反应测试中声诱发短潜伏期负反应研究

目的 总结在有听力损失儿童中行短纯音诱发的听性脑干反应(tbABR)测试时记录到的声诱发短潜伏期负反应(acoustically short latency negative response,ASNR)的特点.方法 在有听力损失的0～6岁儿童中应用SmartEP听觉诱发电位仪记录短声和短纯音ABR的反应阈,在记录到ASNR的受试者中分析其反应阈和潜伏期.结果 在所有80受试耳中共7耳(8.75%)在cABR测试中引出ASNR,40耳(50%)在tbABR测试中引出ASNR,其中1 kHz引出率最高(37耳,46.25%),2 kHz次之(25耳,31.25%).引出ASNR者ABR波V反应阈最低65 dB nHL,ASNR反应阈最低80 dB nHL.0.5、1、2和4 kHz短纯音诱发的ASNR潜伏期分别为6～8、5～7、3～5、3～4 ms.随刺激强度的增加,其潜伏期缩短.结论 有听力损失的儿童tbABR测试中可以记录到AS-NR,但不影响以波V反应阈评估听力.     

美多丽-P诊断性散瞳前后眼压差异的研究

目的:观察用美多丽-P诊断性散瞳后眼压的变化情况。方法:选取2006-12/2007-02间在本院眼科门诊就诊患者56例(87眼),进行诊断性散瞳,散瞳前后用非接触式眼压计(NCT,Topcon CT-80A)分别进行眼压测量,比较散瞳前后眼压的差异。结果:活动性散瞳后双眼眼压均比散瞳前升高,两者差值分别为:右眼2.00±1.70mmHg,左眼1.77±1.94mmHg(P<0.001)差异具有统计学意义。对于同时进行双眼活动性散瞳的31例患者的左右眼间差异进行比较,差值为0.39±1.28mmHg,P>0.05无统计学意义。相同眼别,活动性散瞳前后进行相关性比较,右眼r=0.853,左眼r=0.806,P<0.01,具有统计学意义。结论:散瞳后可引起眼压的升高,甚至有诱发急性青光眼的可能,因此诊断性散瞳前对基础眼压的测量尤为重要,有利于保证医疗护理工作的安全。     

复方丹参方抗大鼠心肌缺血作用研究

[目的]复方丹参方不同工艺提取物心肌缺血差异。[方法]采用冠脉结扎的大鼠模型 ,以心肌缺血面积、心肌酶、自由基作为药效指标 ,观察复方丹参片和复方丹参滴丸抗心肌缺血作用。[结果]大鼠结扎冠脉前降支21h后坏死面积高达60 35 % ,LDH含量为 (2552 7±268 3)U/L ,明显高于对照组和假手术组 ,P<0.01 ;用药后不同剂量复方丹参片 (剂量分别为1 04、2 08、4 13g/kg 生药量 )均可使坏死面积缩小 ,LDH含量下降 ,P<0.01 ,滴丸组优于同等生药量的片剂组 ;冠脉结扎21h后ST段下降 ,下降的波幅以用药组明显 ,显著高于模型组 ,P<0.05。冠脉结扎后血浆SOD含量也下降 ,使用复方丹参片、复方丹参滴丸、消心痛后其含量均升高 ,与模型组相比有显著差异 ,但其中以片剂2.08g/kg组为优。[结论]复方丹参方两种工艺提取物均具有抗心肌缺血作用。     

胸段食管癌IGRT分次内误差对靶区剂量的影响

目的 使用CBCT测量食管癌IGRT分次内误差,评价其对靶区和周围OAR剂量的影响。方法 应用CBCT采集 23例胸段食管癌放疗前后摆位图像,获取分次内误差。将分次内误差模拟治疗计划2和计划3,与原始计划1比较,分析其对靶区和OAR剂量学影响,并用单因素方差分析和配对t检验。结果 胸上段、胸中段、胸下段食管癌IGRT分次内平均误差在左右方向分别为(1.2±1.5)、(1.0±1.0)、(1.0±1.0) mm (P=0.138),在上下方向分别为(1.2±1.0)、(1.1±1.0)、(1.2±1.0) mm (P=0.656),在前后方向分别为(1.3±1.1)、(1.2±1.0)、(0.8±0.7) mm (P=0.003)。全部患者3 mm内误差发生频率在左右、上下、前后方向分别占95.2%、94.5%、93.9%。计划3与计划1相比,GTV V_100%下降5.55%,有 3例患者PTV D_95%下降超过原始计划处方的5%。计划3中全肺 V₃₀为(15.24±2.24)%,低于计划1的(15.67±2.28)%(P=0.033)。计划2中 4例脊髓>4500 cGy (D_max为4517.2 cGy),计划3中 19例脊髓>4500 cGy (D_max为5045.2 cGy)。结论 IGRT分次内误差对患者靶区剂量分布有一定影响。脊髓为串行器官,对分次内误差相对敏感,可能会导致部分患者脊髓超过最大耐受量。     

通窍活血汤对犬急性心肌缺血、心脏血流动力学及心肌耗氧量的影响

观察了通窍活血汤对犬急性心肌缺血、心脏血流动力学及心肌耗氧量的影响。结果表明：通窍活血汤可明显减轻心肌缺血程度（∑－ＳＴ），缩小经Ｎ－ＢＴ染色所显示的梗塞区；增加冠脉血流量，扩张冠脉血管；增加动脉血压、左室内压、ｄｐ／ｄｔ＿（ｍａｘ）、心输出量及左室作功，提高心肌收缩力；降低心肌耗氧量，改善氧的供需平衡。提示该方剂对心肌缺血有明显的保护作用。     

概述美国的药学服务实践流程变迁

摘 要 目的： 概述美国的药学服务实践流程变迁,为我国开展药学服务工作提供借鉴。方法: 查阅文献,对美国医院药学相关学会组织提出的药学服务实践流程进行总结、分析。结果与结论:美国药学从业者联合委员会提出的以患者为中心的药学服务完整总结了其实践流程,包括采集-评估-计划-实施-随访等步骤,强调与团队的沟通、合作、资源共享,适合任何工作环境对患者提供的药学服务。     

Distribution of complete blood count constituents in gestational diabetes mellitus

Background (Trial Design):The incidence rate of gestational diabetes is high. In the long run, it harms the health of both the mother and child. In order to understand the distribution of hematological cells with gestational diabetes mellitus (GDM), a longitudinal cohort study was conducted from 2012 to 2018.Methods:A longitudinal case control study of 1860 pregnant women was conducted between 2012 and 2018. Data of hematological parameters at 11 time points of gestational stage were obtained from a laboratory database. Repeated measures analysis and independent t-test were used to analyze the effect of the hematological parameters on GDM.Results:The trend of blood cells fluctuated with gestational age in normal controls but was more remarkable in GDM. Compared with the controls, blood neutrophils, lymphocytes, and monocytes augmented in the second trimester but decreased in the third trimester; platelet (PLT) and thrombocytocrit increased throughout the three trimesters, and red blood cell (RBC) was abundant in the last 2 trimesters in GDM.Conclusions:Peripheral blood leukocytes, platelets, and erythrocytes were significantly different during gestation between GDM and normal controls. Inflammation may also be involved in GMD.     

An In‐House Prevocational Training Program for Newly Discharged Psychiatric Inpatients: Exploring Its Employment Outcomes and the Predictive Factors

Individuals with severe mental disorders continue to experience low employment rates. Occupational therapists play an important role in helping these individuals develop the skills and obtain the supports necessary for productive living. This retrospective cohort study aimed to explore employment outcomes and identify factors predictive of the outcomes of an in‐house prevocational training program designed for newly discharged psychiatric inpatients. Data retrieved from the files of 58 participants including demographics, diagnostic history, physical fitness, functional assessment results, the use of vocational counselling service and employment status were analyzed. The overall employment rates among the participants were high (67.2–79.3%) within the 6 months following the prevocational training program. No significant differences were found in the employment rates across the 1, 3 and 6‐month time periods post‐training. Vocational counselling service post‐training and hand function were two factors predictive of participants' employment outcomes. Occupational therapists should attend to the clients' need for continuous vocational support and carefully identify the personal, functional and environmental factors contributing to successful employment. Caution in interpreting the results is warranted because of the lack of control and randomization in this retrospective study. Additional longitudinal cohort or experimental studies would add further certainty to the current findings. Copyright © 2015 John Wiley & Sons, Ltd.