预防维持性血液透析患者发生动静脉内瘘失功的护理对策

目的 探讨预防维持性血液透析患者发生动静脉内瘘失功的护理对策.方法 选取河南省某医院于2017年1月—2021年1月收治的60例维持性血液透析患者为研究对象.采用随机数字表法将患者分为对照组和观察组,每组30例.对照组患者给予常规护理干预.观察组患者给予针对性护理干预.比较2组患者干预前及干预6个月时焦虑自评量表(SAS)、抑郁自评量表(SDS)评分、健康知识掌握情况及生活质量;比较2组患者干预6个月时并发症发生情况.结果 干预前,2组患者SAS及SDS评分比较,差异无统计学意义(P＞0.05).干预6个月时,2组患者SAS及SDS评分均低于干预前,且观察组低于对照组,差异均有统计学意义(P＜0.05).干预前,2组患者健康知识掌握评分比较,差异无统计学意义(P＞0.05).干预6个月时,2组患者健康知识评分均高于干预前,且观察组高于对照组,差异均有统计学意义(P＜0.05).干预前,2组患者生活质量量表中躯体功能、认知功能及社会功能评分比较,差异无统计学意义(P＞0.05).干预6个月时,2组患者生活质量量表中躯体功能、认知功能及社会功能评分均高于干预前,且观察组高于对照组,差异均有统计学意义(P＜0.05).观察组患者并发症发生率低于对照组,差异有统计学意义(P＜0.05).观察组患者动静脉内瘘失功发生率低于对照组,差异有统计学意义(P＜0.05).结论 对维持性血液透析患者采用针对性护理措施可有效改善患者不良的心理状态,提高健康知识水平和生活质量,降低并发症发生率及动静脉内瘘失功发生率,进而提高患者透析质量.     

进展期胃癌行腹腔镜辅助小切口根治手术的临床分析

目的：探讨对进展期胃癌患者行腹腔镜辅助小切口根治手术的临床效果。方法整群选取2012年6月-2014年12月该院收治的48例进展期胃癌患者为研究对象,随机将其分为治疗组和对照组,每组24例患者。治疗组采用腹腔镜下辅助小切口胃癌根治术进行治疗,对照组采用传统的开腹手术进行治疗。比较两组患者术后出血量、住院时间、清除淋巴结数量、并发症等情况。结果通过手术治疗,两组患者所用手术时间和清扫淋巴结数量差异无统计学意义(P>0.05)。但治疗组术中出血两明显比对照组少,且住院时间和术毕至首次排气时间都比对照组短,治疗组术后并发症发生率也明显低于对照组,差异有统计学意义(P<0.05)。结论使用腹腔镜辅助小切口根治术治疗进展期胃癌病症,具有临床效果好、并发症少、术后恢复快等优点,值得在临床上大力推广应用。     

富氧水耐缺氧和抗疲劳作用

目的研究富氧水对小鼠的耐缺氧和抗疲劳作用。方法采用灌胃法给予小鼠不同剂量的富氧水,分别测定小鼠的常压耐缺氧时间、急性脑缺血性缺氧存活时间、亚硝酸钠中毒存活时间、负重游泳时间及小鼠游泳后血清尿素氮、血乳酸、肝糖原的含量。结果富氧水低剂量组(2.4mg/kg)小鼠常压耐缺氧生存时间较对照组显著延长(P<0.05);肝糖原储备量增加(P<0.05);血乳酸上升速度减慢(P<0.05);血乳酸曲线下面积降低(P<0.05)。与对照组比较,富氧水低剂量组急性脑缺血性缺氧生存时间、亚硝酸钠中毒存活时间和负重游泳时间差异无统计学意义,但有延长的趋势;小鼠运动后血清尿素氮含量也有降低的趋势。结论富氧水具有一定耐缺氧和抗疲劳作用。     

Validation of a method for localised microinjection of drugs into thalamic subregions in rats for epilepsy pharmacological studies

OBJECTIVES: To validate a method for the chronic implantation of micro-cannulae to examine the effect of drug administration to two small brain regions critical to the control of generalised seizures, the reticular nucleus of the thalamus (Rt) and the ventrobasal thalamus (VB), in a genetically epileptic rat model. METHOD: Micro-cannulae guides (length 9 mm, 26G, i.d. 0.24 mm, o.d. 0.46 mm) were implanted bilaterally into either the Rt or the VB of 11- to 13-week-old Genetic Absence Epilepsy Rats from Strasbourg (GAERS) using a stereotaxic head frame. After a seven-day recovery period the animals were injected with 0.2 microl of methylene blue. The animals were allowed to move freely in their cages for a further 90 min while a post-drug EEG recording was acquired and then brains were perfused with 4% paraformaldehyde and extracted. Twenty-micrometer slices were cut on a cryostat and the site and extent of the methylene blue staining in the brain determined. The implantation co-ordinates were adjusted accordingly, and then a validation study was performed on a further cohort of rats (n=8 Rt, n=7 VB). RESULTS: The co-ordinates that were found to most accurately localise the Rt were: AP -3mm, ML 3.6mm, DV -5.8mm (relative to Bregma). Those that accurately localised the VB were: AP -3mm, ML 2.6mm, DV -5.5mm. In the validation study, the dye staining was measured to diffuse an average radius of 520+/-120 microm from the centre of the injection site for the 0.2 microl injection in both brain hemispheres. For the VB injections the dye remained confined within the structure, however, for the smaller Rt there was spread to surrounding structures in the axial plane. The radial diffusion for the 0.5 microl injection was similar, but more of the dye was found to spread back up the cannula tract away from the target zone. CONCLUSION: These studies have validated a method for accurate and localised injection of drugs into the VB and Rt for neuropharmacological studies in a rat model of generalised epilepsy. This method allows the measurement of localised drug effects on EEG and generalised seizure activity at these sites.     

2004年～2013年某医院糖尿病出院病例统计分析

目的 了解糖尿病患者的发病情况,为制定预防控制措施提供科学依据.方法 对某医院2004年至2013年间确诊为糖尿病的出院病例进行回顾性调查分析,根据ICD-10进行分类,利用EXCEL、SAS9.2为统计分析工具,对出院病例首页进行检索、汇总分析.结果 糖尿患者数量有明显增加,出院病例数量年平均增长速度是10.99％;男性糖尿病患者人数多于女性;从2007年开始,构成比最高的年龄组从65～岁转变为55～年龄组.结论 糖尿病的疾病负担日益增加,针对病因的初始预防和一级预防应该是糖尿病人群的防治重点,中青年人群可能是防治的重点人群.     

缺血修饰白蛋白在慢性阻塞性肺疾病及阻塞性睡眠呼吸暂停综合征患者中的变化及意义

<正>缺血修饰白蛋白(ischemic modified albumin,IMA)是唯一经过美国食品和药品管理局(FDA)批准的检测组织缺血的生物标记物~([1]),其水平不受年龄、性别及种族的影响,可用于检测心肌不可逆损伤前的缺血阶段~([2-3]),在缺血性心肌损伤早期诊断中具有较高的应用价值~([4-5])。呼吸系统疾病是临床常见病,在城市死亡率中占第3位~([6])。有研究指出,部     

踝关节损伤中下胫腓联合分离的诊疗分析

目的分析并探讨在临床上用于治疗踝关节损伤伴下胫腓联合分离的手术方法。方法回顾性分析该院骨科于2010年5月—2011年12月期间进行踝关节损伤伴有下胫腓联合分离手术治疗的56例患者的临床资料,对56例患者全部进行内固定手术治疗。结果 56例患者均顺利完成手术治疗,在术后均进行12个月的随访,未发生深部感染和断针情况,骨折均愈合,骨折愈合时间为10~21周,优良率为83.93%。结论踝关节损伤伴有下胫腓联合分离应该积极进行手术内固定处理,使下胫腓联合稳定。术后功能恢复与术中固定方法、踝关节的复位效果及术后锻炼等有密切联系。     

581首优选古方基本特征考查

目的 分析《（百）一选方治验实录》一书所载的581首方剂的剂型、出处、组成、用药范围等基本特征.方法 根据权威文献逐一规范这些方剂中的药物名称,录入Excel2003并进行统计.结果 其剂型共涉及7种,最常见的是汤剂;其出处共涉及131部著作,排在第一位的是《伤寒杂病论》;共涉及360种中药,平均每个方剂约6.92味药.结论 可以直观的看到这些优选古方的基本特征,及中药方剂的知识分布的不均衡性,为今后的学习和研究提供了基础数据.     

Estrogen-mimicking isoflavone genistein prevents bone loss in a rat model of obstructive sleep apnea-hypopnea syndrome

Objective: Intermittent hypoxia was introduced to mimic obstructive sleep apnea-hypopnea syndrome (OSAHS) in rats. Then, bone mass, bone strength and bone turnover were evaluated, and the influence of genistein on bone mass reduction was investigated in these rats. Methods: OSAHS animal model was established via chronic intermittent hypoxia, and genistein (2.5 mg/kg/day) was used to treat OSAHS rats. The bone mineral density (BMD), bone Histomorphometric indicators, bone biomechanics and expressions of genes related to bone formation and resorption (Runx2, Col I, ALP, Osteocalcin, OPG, RANKL and TRAP-5b) were measured after treatment. Results: The BMD in OSAHS+OVX group was significantly lower than that in OVX group (P<0.05). The BMD in OSAHS+OVX+Genistein group was markedly increased when compared with OSAHS+OVX group (P<0.05), accompanied by partial improvement of the OSAHS induced damage to the lumbar biomechanics. In OSAHS+OVX group, the expressions of Runx2, Col I, ALP and Osteocalcin were significantly reduced when compared with OVX group, and rats in OSAHS+OVX+Genistein group had significantly higher expressions of Runx2, Col I, ALP and Osteocalcin and reduced TRAP-5b expression as compared to OSAHS+OVX group (P<0.05). Conclusions: Genistein can improve the reduction in bone mass and bone strength due to OSAHS in OVX rats, which may be attributed to the increase in bone formation and inhibition of bone resorption. Our findings suggest that genistein may be used to treat and prevent osteoporosis in postmenopausal women with OSAHS.