2-巯基丙酸协同试验检测细菌金属β内酰胺酶

我们采用 2 巯基丙酸 (2 mercaptopropionicacid ,2 MPA)和头孢他啶 (CAZ)双纸片琼脂扩散协同试验检测细菌金属β内酰胺酶 ,并与EDTA协同试验进行比较。一、材料与方法1.菌株来源 :185株菌株均为临床分离的革兰阴性菌 ,质控菌包括大肠埃希菌ATCC2 5 92 2 ,产IMP 1绿脓假单胞菌 ,产超广谱 β内酰胺酶肺炎克雷伯菌及高产AmpC酶阴沟肠杆菌。2 .主要试剂 :2 MPA购自Sigma公司 ,培养基及CAZ纸片(30 μg/片 )系梅里埃公司产品 ,EDTA纸片含 2 0mmol/L的EDTA溶液 2 0 μl,2 MPA纸片含 2 MPA 3μl。3.金属 β内酰胺酶检测 :将…     

急性脑梗死患者动脉介入性溶栓治疗术后的观察与护理

脑梗死又称缺血性脑卒中,是指由于脑部血液供应障碍,缺血、缺氧引起的局限性脑组织的缺血性坏死或脑软化.脑梗死约占全部脑卒中的80%[1].随着医学影像学的发展及神经介入治疗技术的进行,动脉内接触性溶栓作为急性脑梗死的紧急处理方法之一[2],成为近年来出现的一种治疗脑梗死的新方法.     

对合同制聘用护士性观念的现状调查

目的为配合某部医院开设婚恋教育系列讲座而进行课前调查,了解合同制聘用护士性观念以及对性知识的认知情况,对于聘用护士整体心理状况的探究和应对具有现实意义。方法自制结构式调查表,对某部医院260名合同制聘用护士的性观念进行问卷调查。结果聘用护士的性观念呈现持理智、谨慎观念与持矛盾、轻率观念并存的现状。结论健康理智的性观念是心理健康的重要组成部分,作为护理管理者应对聘用护士的性观念认清情况,正视现实,将引导健康的性观念纳入到经常性的思想性的继续教育范畴里来。     

剪切波弹性成像定量评估糖尿病肾病患者肾损害程度

目的探讨剪切波弹性成像（SWE）技术评价糖尿病肾病（DN）患者肾损害程度的临床应用价值。 方法选取2018年1月至2020年1月在青岛大学附属医院就诊的DN患者155例,根据尿蛋白/肌酐（ACR）水平不同将其分为正常白蛋白尿组55例（ACR＜30 mg/g）、微量白蛋白尿组50例（30 mg/g≤ACR≤300 mg/g）、临床白蛋白尿组50例（ACR＞300 mg/g）。另选取健康体检者46例为对照组。应用SWE检测4组的肾实质弹性模量最大值（Emax）、平均值（Emean）、最小值（Emin）,并测定各组血清胱抑素C（CysC）,比较各组间弹性模量值及CysC的变化,并对DN各组的弹性模量值与CysC之间的相关性进行分析。 结果DN各组的Emax、Emean、Emin测值均大于健康对照组,且随着ACR水平增高,Emax、Emean、Emin呈逐渐增大趋势,即临床白蛋白尿组＞微量白蛋白尿组＞正常白蛋白尿组＞对照组,组间差异均有统计学意义（P均＜0.05）。正常白蛋白尿组与对照组的CysC水平比较,差异无统计学意义（P=0.124）,DN各组CysC水平比较,临床白蛋白尿组＞微量白蛋白尿组＞正常白蛋白尿组,组间差异均有统计学意义（P均＜0.05）。DN患者肾实质弹性模量值Emax、Emean、Emin与CysC均呈正相关（r=0.808、0.829、0.807,P均＜0.05）。 结论SWE可无创定量评价DN患者肾损害程度,为动态监测疾病进展、评估临床干预效果及调整治疗方案提供依据。     

禤国维运用中医药治疗斑秃经验介绍

正斑秃是一种突然发生的良性、复发性、非瘢痕性的脱发,起病急骤,病程缠绵,是临床较为常见的损容性皮肤病,属中医学的油风范畴,俗称鬼剃头,《诸病源候论》称:"人有风邪在于头,在偏虚处,则发失落、肌肉枯死,或如钱大,或如指大,发不生,亦不痒,故谓之鬼舔头。"现代医学认为,其发病原因尚不完全清楚,可能与人的过度紧张和机体劳累有关,也可能与患者的自身免疫功能有关。随着现代生活节奏加快,斑秃患者的数量日益增多。广东省     

中介素及其受体系统在油酸致大鼠急性肺损伤中的变化和意义

目的:观察油酸(OA)致大鼠急性肺损伤(ALI)模型中,血管活性肽中介素(Intermedin,IMD)及其受体系统--降钙素受体样受体(CL)与受体活性修饰蛋白(RAMPs) 在肺组织中含量的变化及其病理意义.方法:尾静脉注射OA(0.2 mL/kg)制备大鼠ALI模型为OA组,测定大鼠动脉血氧分压(PaO2)、支气管肺泡灌洗液(BALF)中白细胞计数及中性粒细胞百分比(%PMN);放射免疫法测定血浆和肺组织匀浆IMD1-53含量; 半定量RT-PCR方法测定肺组织IMD,CL 和RAMP1,-2,-3 mRNA水平; 受体放射配体结合实验检测肺浆膜125I-IMD1-53受体结合力.结果:与正常对照组比较,油酸组大鼠血浆及肺组织匀浆中IMD1-53含量分别下降20.8%和74.5%(均P＜0.05);肺组织IMD,CL,RAMP1,RAMP2的mRNA表达水平分别下降30%,38%,26%和37.9%(均P＜0.01),肺组织中IMD与其受体系统mRNA变化水平有一定的相关性.125I- IMD1-53受体最大结合位点增加.肺组织、血浆中IMD浓度与PaO2呈正相关,与BALF中%PMN呈负相关(P＜0.01或0.05).结论:油酸致急性肺损伤大鼠肺组织IMD1-53含量降低,IMD,CL 和RAMP1,-2,-3基因表达有不同程度的降低,提示IMD及其受体系统参与了OA致急性肺损伤的发病过程.     

开颅和腹部手术患者苏醒期脑过度灌注现象的比较

 目的 使用颈静脉球部血氧饱和度和经 颅多普勒监测,研究手术苏醒期患者脑血流动力学的变化。方法 随机选择择期在全麻下行开颅脑肿瘤切除术和腹部手术的患者,分为开颅手术组（Ⅰ组）（n＝50）和腹部手术组（Ⅱ组）（n＝50）。Ⅰ组患者术前行颈静脉球部置管,分别测术前,术后拔管即刻,拔管后30,60,90和120min时大脑中动脉平均血流速度（mean velocity of middle cerebral artery, MCA Vm）,平均动脉压（mean arterial pressure, MAP）及颈静脉球部血氧饱和度（blood oxygen saturation of jugular vein bulb,SjvO2 ）。Ⅱ组分别测量术前,术后拔管即刻,拔管后30,60,90和120min时的MCA Vm和MAP。 结果 Ⅰ组患者MCA Vm从术后拔管即刻到拔管后2h间均较术前明显升高（P<0.05）,Ⅱ组患者术后MCA Vm无明显升高,两组MCA Vm在各时点差异有统计学意义（P<0.05）。Ⅰ组患者术后SjvO2较术前显著升高,并维持至拔管后2h（P<0.05）。Ⅰ组MCA Vm和同时点MAP值均不存在线性相关,和同时点SjvO2值在术后各点均存在正相关关系（P<0.05）。结论 仅Ⅰ组术后发生脑过度灌注,脑过度灌注程度与血压无线性相关关系。     

右美托咪定在腹腔镜下嗜铬细胞瘤切除术麻醉中的观察

Objective: To investigate the feasibility of dexmedetomidine anesthesia in laparoscopic pheochromocytoma resection. Methods: Thirty ASA Ⅰ-Ⅱ patients undergoing elective laparoscopic pheochromocytoma resection and general anesthesia combined with epidural anesthesia were randomly assigned into the dexmedetomidine group (n=15;pump load before anesthesia, maintenance dose after anesthesia induction) and the control group (n=15;pump equal volume of normal saline). FloTrac/Vigileo cardiac output monitoring system and bispectral index (BIS) were used to monitor hemodynamics and anesthesia depth in both groups before anesthesia. The anesthesia induction and maintenance methods of the two groups were the same, the depth of intravenous anesthesia was adjusted according to BIS, and the same vasoactive drugs were used. Heart rate (HR), mean arterial pressure (MAP), cardiac index (CI), central venous pressure (CVP), cardiac output (CO), stroke volume (SV), and stroke volume variability (SVV) were recorded before operation (T₀), at tracheal intubation (T₁), at CO₂ pneumoperitoneum (T₂), at tumor resection (T₃), at 3 min after tumor resection (T₄), 10 min after tumor resection (T₅) and at the end of operation (T₆). Normetanephrine (NMN) and metanephrine (MN) were compared between the two groups before operation (T₀'), before induction (T₁'), at intubation (T₂'), at tumor dissection (T₃') and after surgery (T₄');The dosage of vasoactive drugs and general anesthetics were recorded when BIS value was 40-60. Results: The hemodynamic parameters at T₁ to T₃ were significantly higher than those at T₄ and T₅ (all P<0.05). The HR, MAP, CVP, CO, CI, and SV of the dexmedetomidine group were lower than those of the control group at T₁ to T₃ (all P<0.05);the HR was lower than that of the control group at T₄ and T₅;but the MAP, CVP, CO, CI, and SV were higher than those of the control group (all P<0.05). In both groups, SVV was significantly higher at T₁ to T₃ than at T₄ to T₆, but the SVV of the dexmedetomidine group at T₁ to T₅ was lower than that of the control group (all P<0.05). The HR and MAP of the dexmedetomidine group at T₆ were lower than those of the control group (both P<0.05), whereas the hemodynamic parameters of CO, CI, and SV between the two groups at T₆ showed no significant difference (all P>0.05). The content of NMN in the dexmedetomidine group was lower than that in the control group at T₁' to T₃' (all P<0.01). There was no significant difference in NMN between the two groups at T₀' and T₄' (both P>0.05). There was no significant difference in MN between the two groups at T₁', T₂' and T₃'(all P>0.05).The dosage of vasoactive drugs and propofol used in the dexmedetomidine group was less than that in the control group (all P<0.05). Conclusion: The hemodynamics of dexmedetomidine used in the perioperative period of laparoscopic pheochromocytoma are stable, which can reduce the dosage of vasoactive drugs and general anesthetics. © 2021, The Second Affiliated Hospital, College of Medicine, Zhejiang University.. All right reserved.     

运动性心肌肥大大鼠心肌肌肉生长抑制素表达的变化

目的:观察运动性心肌肥大大鼠心肌组织肌肉生长抑制素(myostatin,MSTN)表达的变化。方法:16周龄雄性SD大鼠随机分为对照组和运动组,每组10只。运动组进行持续8周跑台训练,每周5次,每次60分钟,跑速26米/分钟。测定两组大鼠心重并计算心系数,HE染色观察心肌细胞横截面积,分别采用real-time PCR技术和western blot方法测定心肌MSTN mRNA和蛋白表达,放免法测定血浆MSTN水平。结果:运动组大鼠心脏重量和心系数显著高于对照组(P<0.05),心肌细胞横截面积增大。运动组大鼠血浆MSTN水平、心肌MSTN mRNA和蛋白表达显著低于对照组(P<0.05)。结论:运动性心肌肥大时,大鼠心肌MSTN mRNA和蛋白表达被抑制,可能通过解除其对心肌生长的负调控作用,促进心肌细胞对运动产生适应性肥大。     

润肠通便汤治疗便秘57例疗效观察

目的探讨中医中药治疗便秘的临床治疗效果。方法我科2010年~2013年1月用润肠通便汤治疗57例便秘患者。结果57例中,治愈45例,好转10例,效果满意。结论便秘患者中气不足、气不布津,兼之结肠传导无力,故排便困难临厕努挣乏力、虚汗淋漓、辩证论治则与本方主治合拍,取得了较为显著的效果。