某三甲医院普外科围手术期预防用抗菌药物临床应用干预效果分析

目的了解该院对比干预前、后普外科围手术期预防用抗菌药物合理性,评估干预措施的实施效果。方法选取实施干预前后2011年1—6月和2013年1—6月该院普外科甲状腺手术、乳腺手术、腹股沟疝手术三类清洁手术出院病例,对其围手术期抗菌药物使用情况进行回顾性调查,评价干预前后各项数据以验证干预效果。结果干预后抗菌药物使用率由100%下降为19.3%,抗菌药物合理使用率由0.0%上升为78.0%。结论该院采取的干预措施有效、可行,可明显提高围手术期的抗菌药物用药水平,但也存在着选择抗菌药物不重视经济性,有待进一步加强监管。     

Rapid fabrication of porous silicon/carbon microtube composites as anode materials for lithium-ion batteries

Herein, we present a simple and rapid method to synthesize porous silicon/carbon microtube composites (PoSi/CMTs) by adopting a unique configuration of acid etching solution. The CMTs can act as both conductive agent and buffer for Si volume change during the charge and discharge process. The highly reversible capacity and excellent rate capability can be ascribed to the structure, where porous silicon powders are wrapped by a network of interwoven carbon microtubes. The composites show specific capacities of more than 1712 mA h g⁻¹ at a current density of 100 mA g⁻¹, 1566 mA h g⁻¹ at 200 mA g⁻¹, 1407 mA h g⁻¹ at 400 mA g⁻¹, 1177 mA h g⁻¹ at 800 mA g⁻¹, 1107 mA h g⁻¹ at 1000 mA g⁻¹, 798 mA hg⁻¹ at 2000 mA g⁻¹, and 581 mA h g⁻¹ at 3000 mA g⁻¹ and maintain a value of 1127 mA h g⁻¹ after 100 cycles at a current density of 200 mA g⁻¹. Electrochemical impedance spectroscopy (EIS) measurements prove that charge transfer resistance of PoSi/CMT composites is smaller than that of pure PoSi. In this study, we propose a quick, economical and feasible method to prepare silicon-based anode materials for lithium-ion batteries.

We added additives to the acid etching solution and prepared the silicon/carbon microtubes composites using a simple and fast method.     

蚌埠市部分青少年健康危险行为现况调查

目的了解蚌埠市青少年危险行为现状及其影响因素,为针对性地进行干预和教育提供科学依据。方法针对青少年打架、吸烟、喝酒、性行为和网吧上网等5种危险行为,抽取蚌埠市初三至高三学生9 275人,采取问卷调查并分析结果。结果青少年危险行为的比例在2.6%（性行为）至40.8%（上网）之间。男生与女生之间打架行为的比例分别为22.9%和3.5%,吸烟14.7%和1.8%,喝酒41.0%和21.2%,性行为4.1%和1.0%,网吧上网53.7%和27.2%,其差异均有统计学意义（P〈0.01）。初中与高中年级的学生打架分别为22.9%和12.4%,喝酒22.7%和32.3%,性行为1.2%和2.7%,网吧上网29.0%和42.2%,经卡方检验存在统计学意义（P〈0.05）。重点中学与非重点中学的学生打架比例分别为12.5%和14.5%,吸烟5.9%和11.1%,喝酒29.7%和33.1%,网吧上网38.0%和43.8%,它们之间的差异也具有统计学意义（P〈0.01）。家长一年内体罚频次增加,子女发生危险行为的比例亦增高。结论男性学生的家长要加强孩子的思想教育,非重点中学应加大学生管理水平。     

A contemporary review of “realistic” success rates after surgical closure of nasal septal perforations

ObjectiveThe surgical closure of septal perforations is a challenging procedure. Various techniques exist. Each perforation proves that there is not the one precise procedure for all perforations. Nevertheless, success rates of about 90% are reported, although the procedure for closing the defect is challenging. Our goal was to evaluate the existing data.MethodsWe performed a contemporary review of published closure rates of septal perforations on order to compare the present results in the literature. The limitations of the respective studies were analyzed.ResultsWe found closure rates from 30 to 100%. Numerous procedures were described and combined. Prospective studies comparing different techniques are missing. The follow-up time in studies was quite short or not even specified. Studies on long-term success rates are rare.ConclusionThe closure of septal defects is one of the most challenging rhinosurgical interventions. Closure rates ≥90% as described in literature seem relatively high. One reason might be short follow-ups and retrospective study designs. Frequently, precise information on the follow-up and the method of follow up is missing. Thoroughly designed prospective studies are absent. Longer follow-up times are associated with lower complete closure rates. A long-term success rate between 70 and 80% seems realistic.     

Analysis of patient factors associated with hospital visits for allergic rhinitis in Japanese adult patients: A cross-sectional study

ObjectiveAllergic rhinitis (AR) is one of the most common diseases in Japan. However, several AR patients do not seek optimal treatments at clinics/hospitals. This may affect the patient's quality of life and labor productivity. In this study, we assessed the characteristics of the outpatients’ AR and factors associated with their hospital visit, using the dataset obtained from a nation-wide survey in Japan.MethodsIn this cross-sectional study, we used data from the nation-wide 2013 and 2016 Comprehensive Survey of Living Conditions (CSLC) in Japan. We analyzed the data of AR outpatients through logistic regression, using the outcome as the dependent variable, and age groups, sex, household size, educational status, smoking history, alcohol use, household expenditure, psychological distress, quality of sleep, asthma and atopic dermatitis outpatients as explanatory variables.ResultsAmong the data of 317,984 outpatients aged between 20 and 79 years in 2016 CSLC survey, the proportion of AR outpatients was significantly less among current smokers (odds ratio (OR); 0.47, 95% confidence interval (CI); 0.43–0.51, P < 0.001) and those with large household sizes (OR; 0.80, 95% CI; 0.72–0.89, P < 0.001). Conversely, the proportion of AR outpatients was significantly more among subjects with a past smoking habit (OR; 1.19, 95% CI; 1.08–1.31, P < 0.001), insufficient sleep (OR; 2.93, 95% CI; 2.52–3.42, P < 0.001), psychological distress (OR; 1.71, 95% CI; 1.62–1.80, P < 0.001), high household expenditures (OR; 1.68, 95% CI; 1.56–1.80, P < 0.001), and asthma and atopic dermatitis outpatients (OR; 8.97, 95% CI; 8.13–9.89 P < 0.001 for asthma and OR; 7.61, 95% CI; 6.76–8.58 P < 0.001 for atopic dermatitis). We observed the same trend using the dataset of 2013 CLSC survey.ConclusionThis study revealed that smoking habit, psychological distress, insufficient sleep, high household expenditures and outpatients with other allergic diseases are the factors associated with AR outpatient visit.     

改良痔上黏膜环形切除钉合术治疗Ⅳ度痔200例临床分析

目的 对改良的痔上黏膜环形切除钉合术(PPH)手术方式治疗Ⅳ度痔的临床效果进行观察。方法 回顾性分析2011年1月至2015年12月蚌埠医学院第一附属医院200例行PPH术Ⅳ度痔病人的临床资料,根据手术方式不同分为常规PPH组100例,改良PPH组100例,将两组的手术耗时、住院周期、术中活动性出血发生情况、术后并发症(术后肛缘水肿、术后尿潴留、术后便血)发生率以及术后痔的复发率进行比较分析。结果 两组在手术耗时、住院周期、术中活动性出血发生情况、术后尿潴留及便血发生率之间差异无统计学意义(P>0.05)。改良PPH组术后肛缘水肿的发生率1.00%低于常规PPH组的11.00%,且术后改良PPH组痔复发0例,亦明显低于常规PPH组的13例,差异有统计学意义(χ²=8.865、13.900,P=0.003、0.000)。结论 改良PPH术能显著降低病人术后肛缘水肿发生率及术后复发率,值得临床采用。     

术前血浆磷脂转运蛋白水平与冠状动脉旁路移植术后 新发心房颤动的相关性

目的 探讨术前血浆磷脂转运蛋白(PLTP)水平与冠状动脉旁路移植术(CABG)后新发房颤(POAF)的相关性及其诊断价值。方法 自2015年1月至2016年6月,在中国医学科学院北京协和医学院泰达国际心血管病医院就诊并接受单独CABG手术的所有病人中,选取40例发生POAF的病人为AF组,未发生POAF的病人40例,为SR组。测量两组病人术前血浆中PLTP水平,评价其与POAF的相关性与其对POAF的诊断价值。结果 AF组PLTP水平(1.5±1.5) mg/mL显著低于SR组 (2.6±1.6) mg/mL(P=0.004);在矫正POAF发生的相关变量后,PLTP仍与POAF独立相关;ROC分析显示PLTP诊断POAF的曲线下面积(AUC)为0.74(P<0.001),其临界值为0.43 mg/mL。结论 发生CABG术后POAF的病人血浆中PLTP水平较未发生病人为低;术前血浆中PLTP水平与CABG术后POAF的发生独立相关,且可能为POAF发生的可靠预测指标。     

重组牛碱性成纤维细胞生长因子凝胶超适应证用药分析及干预

目的：分析重组牛碱性成纤维细胞生长因子凝胶临床超适应证用药情况并干预,促进合理用药。方法：分析重组牛碱性成纤维细胞生长因子凝胶适应证使用现状,对其超适应证用药的临床研究进行系统检索并对文献进行质量评价;利用合理用药软件管理系统制定重组牛碱性成纤维细胞生长因子凝胶适应证用药规则。随机抽取重组牛碱性成纤维细胞生长因子凝胶2017年1-4月（干预前）和2017年5-8月（干预后）处方400张,评价超适应证用药干预效果。结果：重组牛碱性成纤维细胞生长因子凝胶超适应证用药严重,仅有1篇高质量研究文献,干预后超适应证用药现象显著下降,由干预前的43.75%下降至8.25%。结论：重组牛碱性成纤维细胞生长因子凝胶超适应证用药现象严重,利用合理用药软件信息化实时监测,能显著减少超适应证用药。     

Inhibition of glycolysis ameliorate arthritis in adjuvant arthritis rats by inhibiting synoviocyte activation through AMPK/NF-кB pathway

Objective

This study aimed to evaluate glycolysis inhibitor which can effectively ameliorate arthritis by inhibiting synoviocyte activation through AMPK/NF-кB pathway in AA rats.

Methods

Adjuvant arthritis (AA) rats were treated with 2-deoxyglucose (2-DG), glycolysis inhibitor. HE staining and radiological Examination were used for histopathology analysis and evaluation of joint destruction. HKII expression was quantified by immunostaining. Proliferation and migration of synoviocytes were assessed by synovicyte scores of joint, CCK8 and transwell assay. Inflammatory factors and levels of AMPK, p65 and IκBα were quantified by ELISA analysis and WB.

Results

We observed that HKII expression was positively correlated with synovial hyperplasia, inflammatory cell infiltration, and cartilage destruction, and glycolysis inhibitor reduces the joint swelling degree, alleviates bone destruction, inhibits the proliferation and migration of synoviocyte, and reduces secretory function of synoviocytes in AA rats. In addition, we investigated that glycolysis inhibitor may inhibit activation of the NF-κB signaling pathway by activating the AMPK pathway.

Conclusion

This study suggests the involvement of energy metabolism in the pathological inflammation process in RA joints. Glycolysis inhibitors might, therefore, provide an opportunity for therapeutic intervention.

     

Prognostic value of CD117 in cancer: a meta-analysis

Background: The prognostic value of CD117 expression in cancers has been evaluated for several years while the results remain controversial. We thus performed a systematic review and meta-analysis of studies assessing the impact of CD117 expression on overall survival (OS) and disease-free survival (DFS) to clarify this issue. Methods: We searched Pubmed, Embase and Web of Science to identify studies on the prognostic impact of CD117 expression in cancers. A total of 4,458 patients from 39 eligible studies were included in the analysis. Pooled risk ratios (RRs) with 95% confidence interval (95% CI) were calculated to estimate the effect using random-effects model. Results: The analysis indicated that CD117 had significant association with poor OS of osteosarcoma (OR=1.36, 95% CI=1.03-1.79, I2=0%, fixed model) and renal carcinoma (OR=4.86, 95% CI=2.72-8.67, I2=0%, fixed model).However, no significant association between CD117 and DFS was found in overall studies. Conclusions: CD117 expression might be a predictive factor of poor prognosis in some surgically treated cancers, particularly in renal carcinoma.