褥疮三级监控制度的实施体会

目的预防褥疮的发生和加强院前褥疮的护理,提高护理质量。方法采用历史对照法分为两组,2003年实施褥疮三级监控制度的院前褥疮40例病人为观察组,2002年未实施褥疮三级监控的院前褥疮28例病人为对照组。并对两组病人院前褥疮治愈数据进行统计。结果杜绝了院内褥疮的发生;2003年院前褥疮治愈率较2002年有明显的提高,经字2检验,有显著性差异,P<0.05。结论褥疮的三级监控制度是控制院内褥疮发生和促进院前褥疮愈合的有效手段,切实提高基础护理质量。     

急性缺血性脑卒中患者血浆胰岛素、瘦素、内脂素水平的改变及其临床意义

目的 对急性缺血性脑卒中患者中内脂素、瘦素、胰岛素的改变和临床意义进行探究.方法 将2016年6-12月来陕西省汉中市中心医院就诊的216例急性缺血性脑卒中患者设为A组,并根据是否合并2型糖尿病(T2DM)分成A1组(合并T2DM,100例)和A2组(不合并T2DM,116例),同时选择同期来该院体检的136例健康人员设为B组.收集不同人群临床资料,对比不同时间A、B两组血清瘦素水平、内脂素水平、空腹胰岛素水平.结果 A、B两组的年龄、性别、体重指数、高密度脂蛋白比较差异无统计学意义(P>0.05).A组的舒张压、收缩压、体脂含量、腰臀比、总胆固醇、三酰甘油、低密度脂蛋白都高于B组(P<0.05).在入院第1、3、7、14天,A组的低密度脂蛋白、总胆固醇、空腹血糖、胰岛素抵抗指数、胰岛素、内脂素、瘦素均大于B组(P<0.05).A1组、A2组的胰岛素抵抗指数在入院第3天均达到峰值,瘦素水平、胰岛素水平在入院第7天均达到峰值.A1组入院第7天,内脂素水大于A2组,入院第3、7、14天瘦素水平大于A2组(P<0.05).A1组入院第1、3、7、14天的胰岛素水平、胰岛素抵抗指数均大于A2组(P<0.05).结论 内脂素、胰岛素、瘦素水平同急性缺血性脑卒中的发生可能存在一定相关性,在急性缺血性脑卒患者中,合并T2DM的瘦素、胰岛素水平显著高于未合并T2DM者.     

2010～2011年乌鲁木齐地区住院呼吸道感染患儿人博卡病毒检测与分析

目的 了解新疆乌鲁木齐地区住院呼吸道感染患儿中人博卡病毒(human bocavirus,HBoV)的检出情况.方法 收集新疆维吾尔自治区人民医院2010年1月至2011年12月住院呼吸道感染患儿鼻咽抽吸物标本525例,用巢氏PCR扩增人HBoV NS1片段检测HBoV 1 ～4型.结果 在525份标本中,HBoV总阳性检出率为8.38％ (44/525),其中HBoV 1型6例,HBoV 2型38例,未检出HBoV 3、4型.各民族患儿之间HBoV阳性检出率统计分析发现,维族、回族患几分别高于汉族患儿,差异有统计学意义(P＜0.05).HBoV 1型与参考株核苷酸序列相似度为97.7％ ～ 99.4％,HBoV2型与参考株核苷酸序列相似度为93.6～ 100％.HBoV的检出时间主要以冬春季为主,HBoV感染在年龄及性别方面差异均无统计学意义.结论 2010～ 2011年乌鲁木齐地区呼吸道感染的住院患儿存在HBoV 1、2型的流行,以HBoV 2型为主,维族、回族患儿HBoV的检出率分别高于汉族患儿.     

云南省人和家畜立克次体病血清流行病学调查

目的了解云南省正常人及主要家畜立克次体血清流行病学特点。方法按地理位置,选择云南省东北寻甸回族彝族自治县、西北玉龙纳西族自治县及南部的思茅地区3个调查点,以间接免疫荧光法检测莫氏立克次体、黑龙江立克次体、恙虫病东方体、贝氏柯克斯体、横赛巴尔通体、查菲埃立克体及人粒细胞无形体等8种常见立克次体血清IgG或IgM抗体。结果3个调查点237份成人,莫氏立克次体、巴尔通体及贝氏苛克斯体IgG抗体阳性率分别为16．46％、6．33％、9．28％。50岁人群最高（21．74％、9．57％及14．78％）,而4-6岁儿童调查结果显示,英氏立克次体IgG抗体阳性率最高,达12．35％（10／31）,动物8种病原体抗体IgG及IgM抗体均检出,其中莫氏立克次体阳性率最高（61．48％）,且地区间差异无显著意义。结论云南省正常农业人群及家畜存在多种立克次体感染,以莫氏立克次体、巴尔通体及贝氏柯克斯体为多。     

AUTOLOGOUS TRANSFUSION AFMC EXPERIENCE (1992–1996)

In this era of Acquired Immune Deficiency Syndrome (AIDS) and other infectious diseases – complications of homologous blood transfusion, autologous transfusion is the safest possible blood for transfusion. The present study was conducted from January 1992 to August 1996 to analyse the programme of autologous transfusion. A total of 471 pre-operative autologous collections were undertaken out of a total of 27,542 blood collections during this period. The present study shows a significant increase in autologous collections from 0.44 per cent in 1992 to 3.94 per cent till August 1996. 37.1 per cent autologous donors were from the urosurgery ward. Of the total 471 autologous blood units collected, 171 were transfused to the autologous donors (27.5%).KEYWORDS: Autologous transfusion, Pre-operative, Safe blood     

MILITANCY TRAUMA : PENETRATING AND NONPENETRATING CARDIAC INJURY

Two hundred and eighty patients with serious chest injuries were treated at a service hospital during a period of 41 months. Out of 9 patients who suffered cardiac trauma S had penetrating cardiac injuries, 2 had penetrating pericardial injury and 2 patients had myocardial contusions. Myocardial contusions simulated myocardial infarction. All patients except one had polytrauma, associated injury to the lung or intra-abdominal organs. Early evacuation, resuscitation, high index of suspicion for cardiac injury and prompt surgical intervention were the keys to successful management in these patients. Thoracotomy was performed to repair the myocardial perforation and lacerated lung injuries. Associated infra-abdominal injuries were managed with laparotomy. Two patients died due to lack of cardiopulmonary bypass facilities and resistant cardiac arrhythmias. Seven patients had uneventful recovery.KEY WORDS: Heart injuries, Thoracic injuries, Traumatology, Wounds, gunshot, Wounds, nonpenetrating, Wounds, penetrating     

氨甲蝶呤对脑梗塞患者红细胞与内皮细胞粘附的影响

目的:探讨氨甲蝶呤对脑梗塞患者红细胞与内皮细胞粘附的影响及其机制。方法:采用流室系统,定量研究氨甲蝶呤对脑梗塞患者红细胞与内皮细胞粘附影响。结果:用氨甲蝶呤处理红细胞、内皮细胞或血浆,红细胞与内皮细胞粘附明显减少,随切应力增加,红细胞与内皮细胞粘附数目趋近于零。结论:氨甲蝶呤能明显降低脑梗塞患者红细胞与内皮细胞粘附的作用。     

99Tc-MDP联合钙剂、活性维生素D3治疗甲亢继发骨质疏松症的疗效评价

目的 评价99Tc-MDP治疗甲亢继发骨质疏松症的疗效。方法 将89例甲亢继发骨质疏松患者按治疗方法分为联合治疗组（A组 42例）和对照组（B组 47例）,两组均采用131I治疗甲亢,联合治疗组采用常规口服钙剂加活性维生素D3治疗,同时加用99Tc-MDP注射治疗,10d为1个疗程,连续3个疗程,每疗程之间间隔3~4w; 对照组常规口服钙剂加维生素D3治疗。分别观察 2 组治疗前及治疗后 3、6、12 个月骨密度( BMD) 、血清骨钙素( BGP) 、骨碱性磷酸酶( B-ALP) 以及甲状腺功能各项指标( FT3、FT4、TSH) 的变化。结果 （1）131I治疗6个月后联合治疗组BGP、B-ALP开始下降,治疗前后比较差异有统计学意义（P＜0.05）;（2）联合治疗组BMD值在治疗后 12 个月较治疗前增加,与对照组比较差异有统计学意义( P＜0. 05);(3)治疗3、6、12个月后两组间甲状腺功能指标变化无差异（P>0.05）;（4）联合治疗组与对照组总有效率分别为92.8%,76.6%,联合治疗组优于对照组,差异有统计学意义（P<0.05）。结论 99Tc-MDP与钙剂及活性维生素D3联用,对甲亢继发骨质疏松症有较好疗效,具有一定临床推广价值。     

Antidepressant-like effects of a novel 5-HT3 receptor antagonist 6z in acute and chronic murine models of depression

Aim:

To investigate the antidepressant-like effects of a novel 5-HT₃ receptor antagonist N-(benzo[d]thiazol-2-yl)-3-methoxyquinoxalin-2-carboxamide (6z) in acute and chronic murine models of depression.

Methods:

5-HT₃ receptor antagonism was examined in guinea pig ileum in vitro. A tail suspension test (TST) was used as acute depression model to evaluate the antidepressant-like behavior in mice treated with 6z (0.5–2 mg/kg, ip). In chronic depression model, mice were exposed to a 4-week chronic unpredictable stress (CUS) protocol, and treated with 6z (0.5–2 mg·kg⁻¹·d⁻¹, po) or a positive drug fluoxetine (10 mg·kg⁻¹·d⁻¹, po) in the last 2 weeks, followed by behavioral and biochemical assessments.

Results:

The 5-HT₃ receptor antagonism of 6z (pA₂=7.4) in guinea pig ileum was more potent than that of a standard 5-HT₃ receptor antagonist ondansetron (pA₂=6.9). In acute depression model, 6z administration significantly decreased the immobility duration. In chronic depression model, 6z administration reversed CUS-induced depressive-like behavior, as evidenced by increased immobility duration in the forced swim test and sucrose preference in the sucrose preference test. Furthermore, chronic administration of 6z prevented CUS-induced brain oxidative stress, with significant reduction of pro-oxidant markers and elevation of antioxidant enzyme activity. Moreover, chronic administration of 6z attenuated CUS-induced hypothalamic-pituitary-adrenal axis hyperactivity, as shown by reduced plasma corticosterone levels. Similar results were observed in the fluoxetine-treated group.

Conclusion:

6z is a novel 5-HT₃ receptor antagonist with potential antidepressant-like activities, which may be related to modulating hypothalamic-pituitary-adrenal axis and attenuating brain oxidative damage.     

PD-1/PD-L1免疫检查点抑制剂对右心室功能的影响

目的:采用二维斑点追踪技术评估PD-1/PD-L1免疫检查点抑制剂(immune checkpoint inhibitors,ICIs)对肿瘤患者右心室功能的影响.方法:选择2018年6月至2020年11月在天津医科大学第二医院泌尿外科和肿瘤科住院的肿瘤患者46例,患者均未使用过ICIs,且进一步需要ICIs治疗.患者...