小儿心脏手术麻醉期间空气混合氧(Fi020.5)改善气体交换

目的:100%O2常规用于麻醉前预先吸氧和麻醉诱导.吸高氧浓度更快地发生肺不张,一个重要的原因是全麻期间损害肺气体交换.我们用气管插管后0.5 FiO2混合空气和100%O2的通气效果,评价损害气体交换的发展过程.方法:102名年龄1月～15岁,先天性心脏病(非紫绀型)手术病人,均100%O2麻醉前预先吸氧3min和(麻醉诱导时)面罩通气2min,接下来气管插管.这些病人随机分为两组:Ⅰ组49例0.5FIO2和空气混合通气,Ⅱ组53例100%O2通气.分别于预先吸氧前和气管插管后30min、入ICU、拔管后30min、术后前三天做动脉血气分析,做记录接着计算PaO2/FiO2比值.结果用t检验和单相方差分析.P值＜或=0.05结果相差显著.结果:PCO2值入ICU(C)时CO2交换Ⅰ组明显优于Ⅱ组,PaO2术后在入ICU(C)60%FiO2、拔管后30min(D)1.5L/min FIO2面罩吸氧两个时间点动脉血氧Ⅰ组明显高于Ⅱ组,PaO2/FiO2值在插管后30min(B)、入ICU(C)60%FiO2、拔管后30min(D)Ⅰ组明显高于Ⅱ组(P值＜0.03).结论:先天性心脏病(非紫绀型)手术患儿全麻时,0.5 FiO2混合空气通气较100%O2通气能够显著的改善肺的气体交换功能.     

基于智慧药学服务的药品供应质量管理信息平台构建与应用

本院在文献研究和运用信息技术挖掘现有药品质量数据基础上,提出基于智慧药学服务的药品质量管理策略并搭建质量管理信息平台。该平台运用数字可视化技术实现了药品供应质量全程、实时监管,有助于提高药品供应质量监管的准确性、真实性、实时性,为进一步探索信息化药品供应质量评价体系的建立奠定基础。     

槐耳菌冲剂对慢性乙型肝炎e系统影响的初步观察

试用民间药用真菌槐耳冲剂治疗慢性乙型肝炎病毒感染患者20例,旨在观察其对血清HBV复制标志中e系统的影响。结果显示,治疗组20例HBeAg阴转6例,占30%,其中有3例HBeAb转为阳牲,有1例在HBeAg转为HBeAb时HBsAg阴转。对照组10例(IL-2)中HBeAg有4例阴转,占40%。两组比较阴转率相似。初步证明槐耳菌冲剂的活性成分可能对HBV复制有一定的抑制作用。     

BAG-1蛋白及其在多种肿瘤中表达的临床意义研究进展

BAG-1基因（Bcl-2-associated athanogene 1）系抗凋亡基因，其蛋白为一种多功能结合蛋白，可与Bcl-2蛋白、热休克蛋白Hsp70和Hsc70、类固醇激素受体等多种信号因子相互作用，发挥调节细胞增殖、抑制细胞凋亡等重要功能。BAG-1在多种肿瘤（如乳腺癌、结直肠癌、肺癌等）中均有不同程度表达，且表达意义不尽相同，可作为肿瘤早期诊断、预后判断及指导治疗的生物学指标之一。本文综述了BAG-1蛋白及其在多种肿瘤中表达的研究进展。     

闭合性喉气管断裂的诊治体会

探讨闭合性喉气管断裂的发病机理、临床特点及急救原则。方法：诊治了８例严重闭合性损伤致喉气管断裂的患者，男６例，女２例，年龄１３－３６例，平均２４岁。     

MICRODISSECTION OF MINIATURE PIG EAR

Objective To investigate the suitability of miniature pigs as an animal model for otological research. Methods Microdissection of the temporal bone was performed on 10 miniature pigs and recorded on photo-graphs. Results The morphology and measurement of the external, middle and inner ear and the lateral re-cess of the miniature pigs were obtained by microdissection. Conclusion Compared to traditional animal models, the miniature pig may be a better model for biomedical research because of its many similarities in physiological functions with humans. Similarities of the temporal bone structures, including the external, middle and inner ear and the lateral recess, between the miniature pig and human make the animal a poten-tially useful model for otological research.     

Tumor-Infiltrating Immune Cells Are Associated With Prognosis of Gastric Cancer

Immune cells contribute to determining the prognosis of gastric cancer. However, their exact role is less clear.We determined the prognostic significance of different immune cells in intratumoral tissue (_T), stromal tissue (_S), and adjacent normal tissue (_N) of 166 gastric cancer cases and their interactions, including CD3⁺, CD4⁺, CD8⁺, CD57⁺, CD68⁺, CD66b⁺, and Foxp3⁺ cells, and established an effective prognostic nomogram based on the immune reactions.We found high densities of _TCD3⁺, _TCD4⁺, _TCD8⁺, _SCD3⁺, _SCD4⁺, _SCD57⁺, _SCD66b⁺, and _NFoxp3⁺ cells, as well as high _TCD8⁺/_SCD8⁺ ratio, _TCD68⁺/_SCD68⁺ ratio, _TCD3⁺/_TFoxp3⁺ ratio, _TCD4⁺/_TFoxp3⁺ ratio, _TCD8⁺/_TFoxp3⁺ ratio, _SCD3⁺/_SFoxp3⁺ ratio, and _SCD4⁺/_SCD8⁺ ratio were associated with better survival, whereas high densities of _TCD66b⁺, _TFoxp3⁺, _SFoxp3⁺ and _NCD66b⁺ cells as well as high _TCD57⁺/_SCD57⁺ ratio, _TCD66b⁺/_SCD66b⁺ ratio, _SCD8⁺/_SFoxp3⁺ ratio, and _TFoxp3⁺/_NFoxp3⁺ ratio were associated with significantly worse outcome. Multivariate analysis indicated that tumor size, longitudinal tumor location, N stage, _TCD68⁺/_SCD68⁺ ratio, _TCD8⁺/_TFoxp3⁺ ratio, density of _TFoxp3⁺ cells, and _TCD66b⁺/_SCD66b⁺ ratio were independent prognostic factors, which were all selected into the nomogram. The calibration curve for likelihood of survival demonstrated favorable consistency between predictive value of the nomogram and actual observation. The C-index (0.83, 95% CI: 0.78 to 0.87) of our nomogram for predicting prognosis was significantly higher than that of TNM staging system (0.70).Collectively, high _TCD68⁺/_SCD68⁺ ratio and _TCD8⁺/_TFoxp3⁺ ratio were associated with improved overall survival, whereas high density of _TFoxp3⁺ cells and _TCD66b⁺/_SCD66b⁺ ratio demonstrated poor overall survival, which are promising independent predictors for overall survival in gastric cancer.     

间接检眼镜、眼B超、OCT及全视网膜镜对视网膜裂孔的早期诊断

目的 探究视网膜裂孔早期诊断的最佳检查方法。方法 纳入2019年6月至2020年6月期间经A/B超、验光检查诊断为玻璃体混浊伴后脱离（posterior vitreous detachment ,PVD）及高度近视的974例患者,分别采用间接检眼镜、眼B超,光学相干断层扫描技术（optical coherence tomography, OCT）及全视网膜镜（125°或165°）行眼底检查,对比各种方法对早期视网膜裂孔的检出率及不同检查方法对于早期检出视网膜裂孔的灵敏性和特异性。结果 974例（1 008眼）玻璃体混浊或PVD患者视网膜裂孔检出眼分别为：眼B超160眼、OCT42眼、间接检眼镜71眼、全视网膜镜65眼,检出率分别为15.9%、4.2%、7.0%及6.4%。统计学分析显示间接检眼镜与全视网膜镜早期视网膜裂的检出率大致相同（P>0.05）;检测灵敏度,间接检眼镜高于眼B超（P<0.001）和OCT（P<0.001）,眼B超高于OCT（P<0.001）。特异度OCT高于眼B超（P<0.001）和间接检眼镜（P>0.05）,间接检眼镜高于眼B超（P>0.05）。结论 在检出视网膜裂孔方面,间接检眼镜具有最高的灵敏度,OCT具有最高的特异度;眼B超的误诊率最高,特异性较低。全视网膜镜（或间接检眼镜）是早期查找视网膜裂孔的有力工具,应得到广大医生的重视及广泛应用。     

高血压及心脑血管疾病与颈动脉粥样硬化

经超声检测１３６例高血压及心脑血管并发症病人的颈动脉，与３２例非高血压心脑血管疾病患者和３８例正常人作对照。结果表明，各疾病组颈动脉内中膜厚度和斑块指数明显高于对照组，以心脑血管并发症组增加最为明显。高血压各组颈动脉管径与血压比值降低，心脑血管并发症组搏动指数和阻力指数高于无并发症组和对照组。经逐步回归分析表明：年龄、体重指数、吸烟、血压、高血压病程和严重程度、高密度脂蛋白胆固醇，低密度脂蛋白胆固醇／高密度脂蛋白胆固醇比值，以及冠心病和脑血管病的存在均与颈动脉粥样硬化密切相关。提示，颈动脉粥样硬化程度可作为预测心脑血管病存在的参考指标。