疗养院体检服务质量评价系统的实践

本文详细介绍了疗养院体检服务质量评价系统的设计目的 、设计方法和主要实现功能.该系统的应用,使体检人员的意见得到及时反馈,有助于管理者对各科室及员工的服务水准和存在问题进行判断总结,从而促进了疗养院体检服务质量水平的进一步提高.     

胰腺损伤并发症的治疗进展

胰腺损伤发生率较低,但是病死率很高。并发症是其致死的主要原因,对于并发症的正确处理是提高胰腺损伤抢救成功率的关键。胰腺损伤的常见并发症包括胰瘘、大出血、感染、腹腔间隙综合征、胰腺假性囊肿。应该根据胰腺损伤的程度,针对不同的并发症采取不同的治疗措施。治疗应遵循损害控制的原则,抢救生命是第一位。胰周充分引流,抑制胰液分泌,控制腹腔感染,综合运用介入和内镜等技术,酌情应用腹腔开放减压术。     

超高效液相色谱-三重四级杆质谱法检测阿归养血糖浆中阿胶及牛皮源成分

目的：建立阿归养血糖浆中阿胶及掺杂牛皮源成分的专属性检测方法。方法：用胰蛋白酶对阿归养血糖浆处方中胶类成分进行酶解，采用超高效液相色谱-三重四极杆质谱（UPLC-QQQ/MS），选择阿胶特征分子离子峰m/z 540.0（双电荷）→612.2、m/z 540.0（双电荷）→924.4及牛皮源特征离子对m/z 641.3（双电荷）→726.2、m/z 641.3（双电荷）→783.3作为检测离子对，离子化模式为ESI⁺，进行多反应监测。结果：26批阿归养血糖浆中未检出阿胶的有13批，其中3批检出牛皮源成分，1批检出牛皮源成分但未超出限度，9批均未检出阿胶及牛皮源成分；26批样品检出阿胶的有13批，其中同时检出牛皮源成分的有1批，未检出牛皮源成分的为12批。结论：该检测方法专属性强，可用于阿归养血糖浆中阿胶及牛皮源的检测。     

不明原因发热患者肺泡灌洗液病毒群落解析

目的: 分析不明原因发热患者肺泡灌洗液中的病毒谱。方法: 将58例肺泡灌洗液样本随机分为5组分别构建5个文库，利用病毒宏基因组学技术进行病毒群落分析，并对获得的细环病毒及鼻病毒进行阳性样本筛选。结果： 肺泡灌洗液病毒群落组成中，指环病毒科占主体地位（19.4%），其次为圆环病毒科（11.0%），藻去氧核糖核酸病毒科（11.0%），人类内源性递转录病毒科（10.2%），痘病毒科（4.9%），逆转录病毒科（3.2%），帚状病毒科（2.3%），小RNA病毒科（0.6%）；并发现了4株序列较长的细环病毒，根据细环病毒开放阅读框1进行系统进化分析，显示其与已知的细环病毒在核酸水平上有一定的差异。通过对细环病毒及鼻病毒阳性样本的筛选，发现细环病毒阳性率为11.3%，鼻病毒阳性率为10.0%。结论： 应用病毒宏基因组学技术成功解析出不明原因发热患者肺泡灌洗液中的病毒群落组成，病毒群落中指环病毒科占比最高，其中细环病毒因发热导致的炎性环境以及患者免疫力低下而大量增殖。     

Contrast-Enhanced Ultrasound for Monitoring Non-surgical Treatments of Uterine Fibroids: A Systematic Review

Non-surgical treatment options for uterine fibroids are uterine artery embolization (UAE), high-intensity focused ultrasound ablation (HIFUA), and percutaneous microwave ablation (PMWA). Magnetic resonance imaging (MRI) is the reference standard imaging method before and after these procedures. Contrast-enhanced ultrasound (CEUS) has been studied as an alternative to MRI for evaluating the fibroids’ characteristics and responses to non-surgical treatments. PubMed, Ovid MEDLINE and Scopus databases were searched for literature published from January 2000 through June 7, 2020, that investigated the application of CEUS as an adjunct to monitor UAE, HIFUA or PMWA in human uterine fibroid treatments. Two independent reviewers analyzed 128 publications, out of which 17 were included. Based on this systematic review, CEUS provides detailed data about fibroid volume and vascularization prior, during and post UAE, and it helps determine the endpoint of the procedure. HIFUA with intra-procedural CEUS has faster volume shrinkage over a shorter time period with less needed energy and provides early detection of residual tissue after HIFUA. CEUS and contrast-enhanced MRI have sufficient agreement to be used interchangeably in the clinic to evaluate the therapeutic effect of PMWA and HIFUA on fibroids.     

Targeted Tissue and Cell-Free Tumor DNA Sequencing of Advanced Lung Squamous-Cell Carcinoma Reveals Clinically Significant Prevalence of Actionable Alterations

Background

Major guidelines do not recommend routine molecular profiling of lung squamous-cell carcinoma (LUSC) because the prevalence of actionable alterations is thought to be low. Increased utilization of next-generation sequencing (NGS), particularly with cell-free circulating tumor DNA, facilitates reevaluation of this premise.