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91.
Jian-Hua Li Tuo Chen Hao Xing Rui-Dong Li Cong-Huan Shen Quan-Bao Zhang Yi-Feng Tao Zheng-Xin Wang 《Hepatobiliary & pancreatic diseases international : HBPD INT》2023,22(3):245-252
Background: Liver transplantation(LT) is the “cure” therapy for patients with hepatocellular carcinoma(HCC). However, some patients encounter HCC recurrence after LT. Unfortunately, there is no effective methods to identify the LT patients who have high risk of HCC recurrence and would benefit from adjuvant targeted therapy. The present study aimed to establish a scoring system to predict HCC recurrence of HCC patients after LT among the Chinese population, and to evaluate whether these patients... 相似文献
92.
Kydd A 《Journal of nursing management》2008,16(2):121-126
AIM: To explore what life was like for frail older people, classed as 'delayed discharges'. BACKGROUND: Delayed discharge or 'bed blocking' is when a patient is inappropriately occupying a hospital bed. Most delayed discharges are frail older people who are waiting until a care home bed is available for them to move to. This paper explores what life was like for some people who were living in such a state of transition. METHODS: An ethnographic approach was employed, using a variety of methods. This paper discusses one of the methods used; participant observation on a ward for older people classed as delayed discharge. The researcher visited the ward for over a year, field notes and interviews were transcribed and the data analysed using thematic analysis. RESULTS: The frail older people were anxious about their futures. Not one voiced their anxieties to staff and the findings showed they felt unsupported during this critical and final stage in their lives. CONCLUSIONS: In order to support frail older people undergoing a major life event, staff need to be aware of the effect of the stress involved for those who know they have to move on and yet have no control over their destiny. IMPLICATIONS FOR NURSING MANAGEMENT: Qualified and unqualified staff need to understand that patients in transition have many anxieties about their futures. The stress of moving on should be sensitively addressed in everyday care. 相似文献
93.
R E Brolin MD JH Gorman MD RC Gorman MD AJ Petschenik M D LJ Bradley MS RD HA Kenler PhD RP Cody Pb D 《Journal of gastrointestinal surgery》1998,2(5):436-442
Although iron, vltamm B12, and folate deficiency have been well documented after gastric bypass operations performed for morbid obesity, there is surprisingly
little information on either the natural course or the treatment of these deficiencies in Roux-en-Y gastric bypass (RYGB)
patients Durmg a l0-year period, a complete blood count and serum levels of iron, total iron-binding capacity, vltamin B12, and folate were obtained in 348 patients preoperatively and postoperatively at 6-month intervals for the first 2 years,
then annually thereafter The principal objectives of this study were to determine how readily patients who developed metabolic
deficiencies after Roux-en-Y gastric bypass responded to postoperative supplements of the deficient micronutrient and to learn
whether the risk of developmg these deficiencies decreases over time Hemoglobin and hematocrit levels were slgnificantly decreased
at all postoperative intervals in comparison to preoperative values Moreover, at each successive interval through 5 years,
hemoglobin and hematocrit were decreased signifiantly compared to the preceding interval Folate levels were significantly
increased compared to preoperative levels at all time intervals Iron and vltamin B12 levels were lower than preoperative measurements and remained relatively stable postoperatively Half of the low hemoglobin
levels were not associated with iron deficiency Taking multivltamin supplements resulted in a lower incidence of folate deficiency
but did not prevent iron or vitamin B12 deficiency Oral supplementation of iron and vitamin B12 corrected defiaencies in 43% and 81% of cases, respectively Folate deficiency was almost always corrected with multivitamins
alone No patient had symptoms that could be attributed to either vitamin B12 or folate deficiency Conversely, many patients had symptoms of iron deficiency and anenua Lack of symptoms of vitamin B12 and folate deficiency suggests that these deficiencies are not clinically important after RYGB Conversely, iron deficiency
and anemia are potentially serious problems after RYGB, particularly in younger women Hence we recommend prophylactic oral
iron supplements to premenopausal women who undergo RYGB 相似文献
94.
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96.
目的:观察糖尿病大鼠心肌缺血再灌注时血管紧张素Ⅱ、胰岛素样生长因子1、醛固酮、细胞间黏附分子1和自由基代谢的变化及L-精氨酸对其的影响。方法:实验于2005-02/2006-06在江苏大学医学院机能学实验室完成。①实验分组:腹腔注射链脲佐菌素制作糖尿病大鼠模型,30只大鼠造模成功。按随机数字表法分为3组(n=10):心肌缺血再灌注组:开胸结扎冠脉,造成心肌缺血,60min后放松再灌注60min;L-精氨酸治疗组:于手术前4周灌胃L-精氨酸250mg/(kg·d),然后重复心肌缺血再灌注组操作;假手术组:完成操作后只穿线不结扎,观察2h作为对照。实验结束时心室取血6mL,摘取心脏,留取左心室心肌组织。②实验评估:检测大鼠血浆血管紧张素Ⅱ、醛固酮和血清胰岛素样生长因子1含量及心肌细胞间黏附分子1蛋白表达。检测大鼠血清、心肌组织超氧化物歧化酶、谷胱甘肽-过氧化物酶活性、丙二醛含量及心肌线粒体Na ,K -ATP酶、Mg2 -ATP酶、Ca2 -ATP酶活性。结果:30只大鼠全部进入结果分析。①与假手术组相比,心肌缺血再灌注组血浆血管紧张素Ⅱ、醛固酮含量明显升高(P<0.05~0.01),血清胰岛素样生长因子1含量降低(P<0.05);L-精氨酸治疗4周后血浆血管紧张素Ⅱ、醛固酮含量低于心肌缺血再灌注组(P<0.05~0.01),血清胰岛素样生长因子1含量高于心肌缺血再灌注组(P<0.05)。②与假手术组相比,心肌缺血再灌注组血清、心肌丙二醛含量明显升高(P<0.05),血清、心肌超氧化物歧化酶和谷胱甘肽-过氧化物酶活性明显降低(P<0.05 ̄0.01);用L-精氨酸治疗4周后血清、心肌丙二醛含量低于心肌缺血再灌注组(P<0.05 ̄0.01),血清、心肌超氧化物歧化酶和谷胱甘肽-过氧化物酶活性高于心肌缺血再灌注组(P<0.05~0.01)。③与假手术组相比,心肌缺血再灌注组心肌线粒体Na ,K -ATP酶、Mg2 -ATP酶、Ca2 -ATP酶活性明显降低(P<0.05),心肌细胞间黏附分子1蛋白表达明显升高(P<0.01);用L-精氨酸治疗4周后心肌线粒体Na ,K -ATP酶、Mg2 -ATP酶、Ca2 -ATP酶活性明显高于心肌缺血再灌注组(P<0.05),心肌细胞间黏附分子1蛋白表达低于心肌缺血再灌注组(P<0.05)。结论:血管紧张素Ⅱ、醛固酮和胰岛素样生长因子1可能共同参与了糖尿病心肌缺血再灌注的发生,细胞间黏附分子1蛋白表达与糖尿病心肌损伤关系密切。L-精氨酸通过减少细胞间黏附分子1蛋白表达,起心肌保护作用。糖尿病心肌缺血再灌注时存在自由基代谢异常,补充L-精氨酸后,可通过提高超氧化物歧化酶、谷胱甘肽-过氧化物酶和ATP酶活性,降低丙二醛水平,减轻自由基损伤,改善心肌组织功能。 相似文献
97.
白细胞介素1及白细胞介素8在心肌缺血再灌注损伤中的动态演变及药物干预效果 总被引:3,自引:3,他引:3
目的:在心肌缺血再灌注损伤中,炎症细胞因子参与其过程的多个环节。实验拟验证白细胞介素1、白细胞介素8因子在此过程中的动态变化,并分析其与药物干预的关系。方法:实验于2005-10/2006-11在新乡医学院形态学实验室完成。①实验分组:选择健康Wistar成年大鼠70只,按随机数字表法分为3组:对照组(n=10)、模型组(n=30)和药物组(n=30)。后两组又分为缺血0.5h,再灌注2,4,8,12,24h6个时相点,每个时相点5只。对照组只设12h一个时相点作为总体对照。②实验方法:大鼠麻醉后,药物组在右股静脉注入甲泼尼龙(30mg/kg),对照组及模型组注入生理盐水(0.75mg/kg)。采用夹闭左冠状动脉前降支建立大鼠心肌缺血再灌注损伤模型。对照组只开胸不夹闭。③实验评估:在各时相点观察各组大鼠缺血再灌注后的心肌细胞改变;血清学检测白细胞介素1、白细胞介素8因子的动态表达。结果:①模型组缺血再灌注12h炎细胞浸润最显著,药物组炎细胞呈散在浸润。②模型组和药物组白细胞介素1、白细胞介素8因子质量浓度明显高于对照组[缺血再灌注8h为例,白细胞介素1分别为(99.21±14.37),(85.77±11.31),(21.87±10.32)ng/L;白细胞介素8分别为(794.85±24.07),(536.95±19.72),(103.94±11.59)ng/L,P<0.05],峰值分别在缺血再灌注4,8h;同时相点药物组白细胞介素1、白细胞介素8因子质量浓度明显低于模型组(P<0.05)。结论:白细胞介素1和白细胞介素8因子在心肌缺血再灌注损伤的炎症反应中发挥着重要作用;甲泼尼龙对缺血再灌注损伤心肌有保护作用。 相似文献
98.
Muscle necrosis in the extremities: evaluation with Tc-99m pyrophosphate scanning--a retrospective review 总被引:1,自引:0,他引:1
A retrospective review was done of 34 extremities studied between 1981 and 1985 with technetium-99m pyrophosphate scanning; 22 were subsequently amputated. Results of detailed pathologic examination or immediate postoperative examination of the resected extremity were available in 16 cases. In these cases, scanning had allowed correct prediction of the level of amputation and of the specific areas of muscle infarction in 13 cases. In the one case in which amputation was performed for infection rather than muscle necrosis, the lack of necrosis was correctly predicted with the scan. The limited results of this study indicate that the Tc-99m pyrophosphate scan allows the location of necrotic muscle to be predicted accurately and may therefore be a useful adjunct in determining the best level for ultimate amputation. Special caution is required in those cases in which muscle necrosis is due to acute causes (e.g., traumatic thrombosis) rather than chronic vascular disease. 相似文献
99.
100.
KH Neppelenbroek RS Seó VM Urban S Silva LN Dovigo JH Jorge NH Campanha 《Oral diseases》2014,20(4):329-344
In healthy individuals, Candida species are considered commensal yeasts of the oral cavity. However, these microorganisms can also act as opportunist pathogens, particularly the so‐called non‐albicans Candida species that are increasingly recognized as important agents of human infection. Several surveys have documented increased rates of C. glabrata, C. tropicalis, C. guilliermondii, C. dubliniensis, C. parapsilosis, and C. krusei in local and systemic fungal infections. Some of these species are resistant to antifungal agents. Consequently, rapid and correct identification of species can play an important role in the management of candidiasis. Conventional methods for identification of Candida species are based on morphological and physiological attributes. However, accurate identification of all isolates from clinical samples is often complex and time‐consuming. Hence, several manual and automated rapid commercial systems for identifying these organisms have been developed, some of which may have significant sensitivity issues. To overcome these limitations, newer molecular typing techniques have been developed that allow accurate and rapid identification of Candida species. This study reviewed the current state of identification methods for yeasts, particularly Candida species. 相似文献