影响分化型甲状腺癌术后促甲状腺激素抑制治疗疗效因素的研究进展

分化型甲状腺癌（DTC）在全部甲状腺癌类型中最为常见,占94%以上。目前主要采取根治性手术切除、选择性放射（¹³¹I）治疗和促甲状腺激素（TSH）抑制治疗的综合治疗,总体预后较好。TSH能够与DTC细胞表达的TSH受体结合,刺激DTC细胞生长,因此TSH抑制治疗是减少DTC患者术后肿瘤复发风险的重要环节,已得到国内外多项指南的明确推荐。但在临床实践中,仍存在部分患者难以实现TSH抑制治疗目标,需要反复调整治疗剂量以达到预期目标,治疗过程中可能伴随乏力、嗜睡或心悸等不适。本文主要总结DTC术后TSH抑制治疗疗效的影响因素,以期帮助临床医生为DTC患者提供更好的术后TSH抑制治疗和随访管理,以提高患者生活质量,延长远期生存时间,降低DTC术后复发率。     

Preparation of rigid polyurethane foam from lignopolyol obtained through mild oxypropylation

Lignin, one of the main components of lignocellulose, can be used as an alternative to chemical polyols in the production of polyurethane because of its abundant phenolic and alcohol hydroxyls. Traditionally, lignin is directly applied in the preparation of polyurethane; however, modified lignin has been proved to be superior, especially that obtained by the oxypropylation reaction. Therefore, lignopolyol obtained by mild and efficient oxypropylation was utilized in the production of rigid polyurethane foam in this study. Specifically, the effects of the content of lignopolyol on the chemical structure, morphological structure, mechanical properties and thermal stability of the lignin-based rigid polyurethane foam were investigated. It was found that the compressive strength of the rigid polyurethane foam was significantly improved with the addition of lignopolyol compared with that of the pure polyurethane foam, which was attributed to the fact that oxypropylation made lignin into highly branched and functionalized polyols by transforming all phenolic hydroxyls into aliphatic hydroxyls. Moreover, when the molal weight of lignopolyol accounted for 40% of the added polyols, the generated foam showed optimal uniformity and regularity, and the compressive strength reached 0.18 MPa, meeting the requirements of industrial application, below which, the amount of undesired reactions is bound to increase. As a consequence, the added amount of lignopolyol was increased as much as possible on the basis of guaranteeing the desired properties, which was more conducive to realizing the green degradation and economic synthesis of rigid polyurethane foam.

Lignin-based polyurethane foam with excellent performance could be produced with the lignopolyol prepared by mild and efficient oxypropylation.     

12例急性四乙基铅中毒的心理分析和干预

为探讨急性四乙基铅中毒病人的心理状态和心理干预的作用,我们对12例急性四乙基铅中毒病人进行了心理干预.结果 显示,急性四乙基铅中毒病人在应激情况下存在明显的心理问题,通过有效的心理干预可缓解病人的心理压力,改善不良心理状态.     

A hybrid composite of H2V3O8 and graphene for aqueous lithium-ion batteries with enhanced electrochemical performance

Aqueous rechargeable lithium-ion batteries (ARLBs) are regarded as a competitive challenger for large-scale energy storage systems because of their high safety, modest cost, and green nature. A kind of modified composite material composed of H₂V₃O₈ nanorods and graphene sheets (HVO/G) has been effectively made by a one-step hydrothermal method and following calcination at 523 K. XRD, SEM, TEM, and TG are used to determine the phase structures and morphologies of the composite materials. Owing to the advantage of the layered structure of H₂V₃O₈ nanorods, the excellent conductivity of the graphene sheets, and the 3D network structure of the modified composite, the ARLBs with HVO/G can deliver an adequate specific capacity of 271 mA h g⁻¹ at 200 mA g⁻¹ and have a retention rate of 73.4% after 50 cycles. The average discharge capacity of ARLB with HVO/G as anode has a considerable improvement over that of HVO/CNTs and HVO, whatever the current rate used. Moreover, we find that the diffusion coefficient of lithium-ion increases by an order of magnitude through the theoretical calculation for HVO/G ARLB. The new ARLB with HVO/G electrode is a potential energy storage system with great advantages, such as simple preparation, easy assembly process, excellent safety and low-cost environmental protection.

Aqueous rechargeable lithium-ion batteries (ARLBs) are regarded as a competitive challenger for large-scale energy storage systems because of their high safety, modest cost, and green nature.     

医疗器械生物学评价——实验动物保护要求

2006版“医疗器械生物学评价-动物保护要求“国际标准规定了在用于评价医疗器械的材料或医疗器械本身的生物相容性的动物试验中,爱护动物和使用动物的最基本要求.目的在于:为进行医疗器械生物学评价的委托者,设计者以及进行试验或从动物试验进行推测、评价的科研人员,提供尊重生命的通用性要求;也推荐并提供以下指南:促进今后进一步“减少(reduction)“应用动物全部的数量;“精致(refinement)“在动物中减少或除去痛苦或苦恼的试验方法;以及其他的合乎科学、有效的不需要动物的方法来“代替(replacement)“动物试验.该标准适用于在除人类之外的脊椎动物体上进行医疗器械或材料的生物相容性试验.     

ESWL与输尿管镜下气压弹道碎石术联合治疗输尿管结石

目的探讨输尿管结石的治疗方法。方法采用体外震波碎石(ESWL)与输尿管镜下气压弹道碎石联合治疗917例输尿管结石,其中单侧结石733例,双侧结石184例,一般先行ESWL,ESWL无法完成或治疗无效时需要用输尿管镜下气压弹道碎石术。结果结石总排净率为99.2%(910/917)。其中ESWL组结石总排净率为93.5%(858/917);气压弹道碎石组结石总排净率为88.1%(52/59)。结论ESWL与输尿管镜下气压弹道碎石术联合治疗输尿管结石安全有效,是理想的治疗方法。     

基底动脉狭窄程度与孤立性脑桥梗死短期转归的相关性

目的:探讨基底动脉狭窄程度与急性孤立性脑桥梗死短期转归的相关关系。方法:连续纳入2016年4月至2018年4月在开封市中心医院神经内科入住的急性孤立性脑桥梗死患者共137例。根据1月改良Rankin量表(mRS)评分将患者分为转归良好组(mRS≤2分)和转归不良组(mRS评分>2分),入院当天或第2天采集空腹静脉血进行...     

超声检查在前列腺癌诊断中的应用进展

超声检查在早期诊断前列腺癌中具有重要的意义。近年来,超声技术发展很快,尤其在与临床检验和其他新技术结合方面使超声显像更具优势,其在前列腺癌的治疗及预后评估方面也发挥着非常大的作用。现对超声在前列腺癌中应用的进展情况作一综述。     

血管内皮生长因子在子宫内膜异位症中的表达及临床意义

目的 测定血管内皮生长因子(vascular endothelial growth factor,VEGF)在子宫内膜异位症组织中的表达,探讨VEGF在子宫内膜异位症发生发展中的作用.方法 采用逆转录聚合酶链反应(RT-PCR)技术,检测21例手术后病理确诊的子宫内膜异位症患者的异位内膜及其诊断性刮的子宫内膜组织中 VEGF mRNA表达,同时以20例非因子宫内膜异位症而行诊断性刮宫的患者,经病理证实为正常子宫内膜组织中VEGF mRNA表达水平为对照.采用免疫组化(SP法)检测这些病例中VEGF的表达.结果 子宫内膜异位症患者异位子宫内膜与自体子宫内膜及对照子宫内膜均有VEGF表达,VEGF主要表达于子宫内膜腺上皮细胞的细胞浆,而前者与后两者比较差异有显著性(P＜0.05),后两者比较差异无统计学意义(P＞0.05).结论 VEGF通过影响新生血管生成而导致子宫内膜异位症的发生发展,有可能为子宫内膜异位症发病机制和有效治疗的研究提供新的思路.     

氢吗啡酮自控镇痛应用于子宫肌瘤动脉栓塞术的有效性和安全性

目的 评价氢吗啡酮经静脉患者自控镇痛泵应用于子宫肌瘤动脉栓塞术（UAE）围手术期镇痛的有效性和安全性。方法 选取2021年6月至12月在郑州大学第一附属医院接受UAE术治疗的27例子宫肌瘤患者。将氢吗啡酮10 mg+0.9%氯化钠溶液配至100 mL镇痛泵中,术前15 min开始挂泵给药,术中根据患者疼痛情况调整用药剂量。采用疼痛数字评价量表（NRS）评估患者栓塞即刻、栓塞后5 min、手术结束时及术后6、12、24、48、72 h疼痛情况,并观察不良反应发生情况。结果 栓塞即刻、栓塞后5 min、手术结束时,术后6、12、24、48、72 h疼痛控制良好,中位住院时间为5 d,患者对镇痛治疗结果满意。术后简明疼痛评估量表（BPI）评分除“对行走能力的影响”与术前比较差异无统计学意义（P=0.861）外,其他生活质量评价项差异有统计学意义（均P<0.05）。5例（18.52%）发生不良反应,未发生呼吸抑制等严重不良反应。结论 子宫肌瘤动脉栓塞术中氢吗啡酮自控镇痛泵应用安全有效,可显著减轻患者疼痛并缩短住院时间。自控泵操作简便,不良反应发生率低,有一定的推广价值。