改革护理夜查房模式对提高护理质量的效果观察

目的：探讨改革护理夜查房模式对提高护理质量的效果。方法在护理部的领导下,让护士长和护理骨干参与夜查房,将夜查房中发现的护理缺陷进行反馈并追踪管理。结果改革护理查房模式半年以来,病房护理质量得到明显改善,保证了护理工作的持续性和延续性,强化了护理人员参与护理管理的意识,保证了夜间护理安全,提高了护理质量,同时为医院护理人才储备了后备力量。结论改革护理夜查房的工作模式,可有效提高护理质量,减少护理缺陷。     

胸腔积液糖类抗原125和腺苷脱氨酶含量检测对渗出性胸膜炎的诊断价值

目的探讨胸腔积液糖类抗原125(CA125)含量检测对渗出性胸膜炎的诊断价值。方法采用电化学发光法及速率法分别检测我院114例渗出性胸膜炎(82例结核性、32例肿瘤性)患者的胸腔积液CA125水平和ADA水平并进行分析。结果在82例结核性胸膜炎组中胸腔积液CA125含量水平升高,其阳性率为96%(79/82),高于胸腔积液ADA阳性率71%(58/82)。在32例肿瘤组胸腔积液中CA125含量水平亦升高,与结核性胸膜炎CA125含量水平差异无统计学意义。结论胸腔积液CA125水平对结核性胸膜炎诊断缺乏特异性,但敏感性高,与胸腔积液ADA联合检测对提高结核性胸膜炎的确诊率有帮助,故有一定的诊断价值。     

Quantitative measurement of cartilage volume with automatic cartilage segmentation in knee osteoarthritis

Clinical Rheumatology - To determine the reproducibility of the automatic cartilage segmentation method using a prototype KneeCaP software (version 1.3; Siemens Healthcare, Erlangen, Germany) and...     

Excretion and detection of SARS coronavirus and its nucleic acid from digestive system

AIM: To study whether severe acute respiratory syndrome coronavirus (SARS-CoV) could be excreted from digestive system. METHODS: Cell culture and semi-nested RT-PCR were used to detect SARS-CoV and its RNA from 21 stool and urine samples, and a kind of electropositive filter media particles was used to concentrate the virus in 10 sewage samples from two hospitals receiving SARS patients in Beijing in China. RESULTS: It was demonstrated that there was no live SARS-CoV in all samples collected, but the RNA of SARS-CoV could be detected in seven stool samples from SARS patients with any one of the symptoms of fever, malaise, cough, or dyspnea, in 10 sewage samples before disinfection and 3 samples after disinfection from the two hospitals. The RNA could not be detected in urine and stool samples from patients recovered from SARS. CONCLUSION: Nucleic acid of SARS-CoV can be excreted through the stool of patients into sewage system, and the possibility of SARS-CoV transmitting through digestive system cannot be excluded.     

Clinical analysis of the risk factors for recurrence of HCC and its relationship with HBV

AIM: To comprehend the risk factors of recurrence of hepatocellular carcinoma (HCC) and its relationship with the infection patterns of hepatitis B virus (HBV).METHODS: All materials of 270 cases of postoperative HCC were statistically analyzed by SPSS software.Recurrence and metastasis were classified into early( ≤2 years) and late phase (>2 years). Risk factors for recurrence and metastasis after surgery in each group were analyzed.RESULTS: Out of 270 cases of HCC, 162 cases were followed up in which recurrence and metastasis occurred in 136 cases. There were a lot of risk factors related to recurrence and metastasis of HCC; risk factors contributing to early phase recurrence were serum AFP level, vascular invasion, incisal margin and operative transfusion, gross tumor classification and number of intrahepatic node to late phase recurrence. The HBV infective rate of recurrent HCC was 94.1%, in which ““HBsAg, HBeAb, HBcAb““ positive pattern reached 45.6%. The proportion of HBV infection in solitary large hepatocellular carcinoma (SLHCC)evidently decreased compared to nodular hepatocellular carcinoma (NHCC) (P<0.05).CONCLUSION: The early and late recurrence and metastasis after hepatectomy of HCC were associated with different risk factors. The early recurrence may be mediated by vascular invasion and remnant lesion, the late recurrence by tumor‘s clinical pathology propert, as multicentric carcinogenesis or intrahepatic carcinoma de novo. HBV replication takes a great role in this process.From this study, we found that SLHCC has more satisfactory neoplasm biological behavior than NHCC.     

Interleukin-10 promoter polymorphisms in rheumatoid arthritis and Felty's syndrome

OBJECTIVE: To examine whether promoter polymorphisms associated with variation in interleukin-10 (IL-10) production are relevant to the development of rheumatoid arthritis (RA) or Felty's syndrome (FS). METHODS: DNA was obtained from 44 FS patients, 117 RA patients and 295 controls. The promoter region between -533 and - 1120 was amplified by polymerase chain reaction, and polymorphisms detected by restriction enzyme digest or sequence-specific oligonucleotide probing. RESULTS: We found no significant difference in allele or haplotype frequencies between the groups. CONCLUSION: There is no association between FS or RA and these recently identified IL-10 promoter polymorphisms. Other genetic or environmental factors could explain the alterations in IL-10 levels seen in these conditions.      

儿童完全植入式静脉输液港日间手术策略的选择和体会

目的比较同期儿童完全植入式静脉输液港(totally implantable venous access port,TIVAP)日间手术和住院手术情况,探讨开展儿童TIVAP植入日间手术的可行性。方法收集2015年4月至2020年4月在重庆医科大学附属儿童医院肿瘤外科接受TIVAP植入术的516例患儿的相关资料。其中,男311例,女205例;将321例接受日间手术的患儿作为日间手术组;将195例接受住院手术的患儿作为住院手术组。通过电子病历(electronic medical record,EMR)和医院信息系统(hospital information system,HIS)收集两组患儿的病史资料和手术情况,通过互联网医院、微信或者电话定期随访患儿TIVAP使用情况和主要并发症的发生情况。比较两组患儿住院天数、总费用和术后并发症情况。结果13例日间手术组和8例住院手术组患儿锁骨下静脉穿刺置管失败改为颈内静脉入路,两组之间的差异无统计学意义(P<0.05)。本研究所有TIVAP植入术成功。日间手术组住院时间为(1.00±0)d,住院手术组为(5.40±1.69)d,两组之间的差异具有统计学意义(P<0.01)。日间手术组总费用为(13125±568)元,住院手术组为(16125±1035)元,均除外其他疾病的治疗费用,两组之间的差异具有统计学意义(P<0.001)。术后主要并发症包括导管相关性血行感染、导管堵塞、港体周围皮肤感染和非计划取港,并发症的发生率在两组之间的差异无统计学意义。结论儿童TIVAP植入日间手术是高质量、低成本的治疗模式,具有推广使用价值。     

Central nervous system infections in patients with systemic lupus erythematosus

OBJECTIVE: To evaluate the clinical profiles of patients with systemic lupus erythematosus (SLE) with central nervous system (CNS) infections. METHOD: We retrospectively reviewed patients with SLE with CNS infections from January 1983 to June 2003. The clinical features, laboratory data, and prognoses of these patients were recorded. RESULTS: During the 20-year review period, 17 SLE patients with CNS infections were identified. The mean age at CNS infection was 29.6 +/- 15.3 years. Cryptococcal infection was identified in 10 patients and bacterial meningitis in 7. Most patients (94%) had active SLE at the time of CNS infection. Fifteen patients received corticosteroid therapy and of these, 7 received it in conjunction with immunosuppressive agents. The most common presentation was headache, fever, and vomiting. The mortality rate among the 17 patients was high (41.2%). CONCLUSION: Cryptococcal meningitis played the major role in CNS infection of patients with SLE, and it cannot be ruled out even when the cerebrospinal fluid (CSF) white blood cell count is within normal range. CSF India ink and latex agglutination testing for cryptococcal antigen should be performed and are effective screening tools to establish an early diagnosis.