丙戊酸钠联合左乙拉西坦治疗癫痫疗效的Meta分析

目的 系统评价丙戊酸钠(VPA)联合左乙拉西坦(LEV)治疗癫痫的疗效和安全性。方法 检索万方数据资源系统、中国知网(CNKI)系列数据库、维普期刊资源中文数据库、Embase、PubMed、Cochrane英文数据库,获取VPA联合LEV治疗癫痫的随机对照试验(RCTs)有关文献,检索时限为各数据库建库至2021年8月;采用Cochrane风险偏倚评估工具对文献质量进行评价,使用Review Manager5.4.1软件进行数据的统计分析。结果 共纳入15篇文献,包括13篇中文文献和2篇英文文献,共计1770例患者。分析结果表明,VPA联合LEV较单用VPA[OR=4.66,95%Cl(3.40～6.38),P<0.00001]或LEV[OR=4.33,95%Cl(2.14～8.80),P<0.0001]总有效率更高[OR=4.60,95%Cl(3.45～6.41),P<0.00001];VPA联合LEV较单用VPA治疗癫痫,脑电图痫样改善较好[OR=3.84,95%Cl(2.50～5.90),P<0.00001]且癫痫发作次数[SMD=-5.91,95%Cl...     

快速康复外科理念在经脐单孔腹腔镜胆囊切除术中的应用

目的 探讨快速康复外科理念在经脐单孔腹腔镜胆囊切除术中的应用价值.方法 选择60 例择期经脐单孔腹腔镜胆囊切除的患者,随机分为快速康复外科组(n=30)及对照组(n=30),比较两组手术时间、术后下床活动时间、进食时间、排气、排便时间、住院天数及住院费用、并发症的差异.结果 快速康复外科组术后下床活动时间、进食时间、排气、排便时间、住院天数明显缩短,住院费用显著降低(P<0.05),两组手术时间比较差异无统计学意义(P>0.05).结论 快速康复外科理念应用在经脐单孔腹腔镜胆囊切除术中是可行的,可加速患者的康复,明显缩短住院时间,降低住院费用.     

颅内动脉瘤90例围手术期失眠原因分析及护理对策

目的对颅内动脉瘤围手术期失眠的影响因素进行了调查与分析。方法采用自行设计的问卷对90例颅内动脉瘤患者围手术期睡眠情况进行调查。结果 90例患者均出现不同程度的失眠,其中手术前1 d、手术当日、手术后1 d失眠率分别为80%、94%、90%。心理因素是术前失眠的主要原因,疼痛是导致术后失眠的最主要原因。结论颅内动脉瘤患者围手术期存在严重的睡眠障碍,护理人员应给予相应的护理措施,促进睡眠及疾病的恢复。     

桑枝颗粒提取物对α-葡萄糖苷酶的抑制作用研究

目的初步分离桑枝颗粒提取物中对α-葡萄糖苷酶的抑制活性成分。方法利用超滤工艺对桑枝颗粒提取物进行纯化。结果在同样的样品浓度下,桑枝颗粒提取物中相对分子量在5×105D～10×105D的组分的抑制活性最高,抑制率达68.0%。结论相对分子量在5×105D～10×105D的组分对α-葡萄糖苷酶的抑制活性最高。     

PERINATAL FETAL WELL-BEING MONITORING: A COMPARISON BETWEEN RANDOMIZED URINARY ESTRIOL/CREATININE AND SERUM FREE ESTRIOL DETERMINATION

Randomized urinary and blood samples were obtained from three hundred and ninety-two cases of late pregnancies simultaneously for comparison of the validity in perinatal fetal monitoring. The results of randomized urinary estriol/creatinine (RUE_3/C) and serum free estriol (SFE_3) tests revealed that Ⅰ. The coefficient of correlation between RUE_3/C and SFE_3 level were close in either normal or high-risk pregnancies (y=0.1477X+14.2368, r=0.4586, n=170; y=0.1724X+8.6698, r=0.5868, n=222, respectively, P<0.001); 2.92%cases of the false positive rate of RUE_3/C were corrected by SFE_3 test. In cases of pregnancy-induced hypertension (PIH) the false positive rate of RUE_3/C were highest in comparison with those in cuses of other high-risk pregnancies (53.6%); 3. The correct rate of SFE_3 test in prenatal predication of fetal well-being was significantly higher (95.6%) than that of RUE_3/C (87.3%) (X~2=17.77, P<0.001). This paper suggests that RUE_3/C can be used as a first line test for perinatal monitoring. When RUE_3/C value is lower than normal, SFE_3 test should be added to ensure the reliability of perinatal diagnosis, especially in PIH cases. Obviously, to use these two tests for perinatal fetal monitoring simultaneously is better than to use any one test alone.     

左炔诺孕酮硅胶棒应用者子代细胞遗传学研究

目的 :通过对左炔诺孕酮硅胶棒 ( 6根型 )埋植剂应用者子代细胞遗传学指标的检测 ,以期对避孕埋植剂的长期安全性提供依据。方法 :在同一地区随机选择 50名埋植 4年、取药 1年后妊娠夫妇的子代为实验组 ,选择 49名正常夫妇的子代为对照组。静脉采血检测染色体畸变、姊妹染色单体交换 ( SCE)、细胞微核的发生率。结果 :实验组染色体畸变率、SCE频率、细胞微核率平均值与对照组比较 ,均无显著差异 ( P>0 .0 5)。结论 :长期使用左炔诺孕酮硅胶棒 ( 6根型 )对子代不产生潜在的细胞遗传学损伤效应。     

A NEW TEST IN ANTENATAL MONITORING-THE EVALUATION OF SALIVARY UNCONJUGATED ESTRIOL MEASUREMENT

A new unconjugated saliva estriol (SE_3) determination by radioimmunoassay(~3H-E_3) was used to monitor 497 fetuses of late pregnancies, including 280 high-risk and217 normal pregnant women. The normal pregnant SE_3 values had been established by themeasurement of 1378 cases from 20 to 41 weeks of gestation. The results of SE_3 assaysrevealed that 1. In prenatal prediction of fetal well-being, the total false negative andfalse positive rates were 2.0% and 0.6%, respectively, the correct rate which was similarto that of serum free E_3 (SFE_3) values was 97.4%, and was significantly higher thanthat of overnight 12-hour urine E_3/C analyses as formerly reported. 2. There were 8 fetaldeathe in 11 cases with low SE_3 levels. No perinatal death occurred in the 486 cases withnormal SE_3 values, except one fetus who died of nuchal cord strangulation. It is highlyimportant that the saliva specimen be correctly collected and the technique ofmeasurement of SE_3 be carefully carried out. Our observations suggest that the clinicaluse of SE_3 assays are scientific, reliable, and it is more practicable than that of SFE3 as-says. The determination of SFE_3 can be replaced by SE_3 test for assessing fetal-placentalwell-being.     

临床药师运用PDCA循环法对内分泌科患者抗菌药物的合理性使用与管理的实践研究

目的：探究PDCA循环管理的运用对降低住院患者抗菌药物使用率、使用强度及联合用药的影响,为临床合理使用抗菌药物提供参考。方法：运用PDCA循环法对内分泌科住院患者抗菌药物的使用进行干预,利用医院HIS信息系统回顾性抽取邵阳学院附属第二医院内分泌科（2019-2021年）住院患者的抗菌药物使用率、抗菌药物使用强度、联合使用抗菌药物人数占比、住院患者平均使用抗菌药物疗程等,在临床药师干预跟踪后,对抗菌药物的使用数据进行对比。结果：经过PDCA循环管理后,内分泌科室住院患者的抗菌药物使用率从实施前（2019年）的41.17%,经干预后下降至（2021年）39.17%;使用强度从实施前的43.76 DDDs,经干预后下降至32.07 DDDs;抗菌药物联合使用人数占比从干预前的41.97%,下降至干预后的24.73%;人均使用抗菌药物天数从实施前的21.17天,经干预后下降至17.17天;以上数据干预前后差异均具有统计学意义（P<0.05）。结论：应用PDCA循环法对患者的用药进行管控可降低患者抗菌药物使用率、使用强度,减少抗菌药物的联用,缩短使用疗程,PDCA循环法的干预有利于抗菌药物...     

高职高专药学专业基于工作过程的药剂学实训师资培训探讨

从高职高专实训教师培训的现状、内容、方法及培训保障系统建设等方面探索高职基于工作过程药剂学实训教师培训工作改革。