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??OBJECTIVE To investigate the clinical effect of pharmacist-nurse co-managed program on health education on the management of coronary heart disease. METHODS Consult literature related to pharmacists and nurses cooperation on health education for coronary heart disease patients, and combine actual clinical needs and work experience, pharmacist-nurse co-managed program on medication education of coronary heart disease was been preliminary established in cardiology department in our hospital. RESULTS The pharmacist-nurse co-managed program can improve the patients concern for pharmacological actions, dosage and precautions for drugs. Compared with the traditional nurses health education, pharmacist-nurse co-managed program significantly improved the drug compliance of patients from 31% to 92.5%. The 90% of the patients hope to accept long-term follow-up.The role of pharmacists improved in the health team. The clinical outcomes was improved. CONCLUSION Clinical pharmacists certainly play a role in the medical teams.Pharmacist-nurse co-managed program is effective in improving the clinical outcome and reduce the adverse drug reactions. A long-term follow-up system is needed in the future.     

Effect of inclination and anteversion angles on kinematics and contact mechanics of dual mobility hip implants

BackgroundSteep inclination and excessive anteversion angles of acetabular cups could result in adverse edge-loading. This, in turn, increases contact pressure and impingement risk for traditional artificial hip joints. However, the influence of high inclination and anteversion angles on both the kinematics and contact mechanics of dual mobility hip implants has rarely been examined.MethodsThis study focuses on investigating both the kinematics and contact mechanics of a dual mobility hip implant under different inclination and anteversion angles using a dynamic explicit finite element method developed in a previous study.FindingsThe results showed that an inclination angle of both the back shell and liner ranging from 30° to 70° had little influence on the maximum contact pressure and the accumulated sliding distance of inner and outer surfaces of the liner under normal walking gait. The same results were obtained for an anteversion angle of the liner varying between −20° and +20°. However, when the anteversion angle of the liner was beyond this range, the contact between the femoral neck and the inner rim of the liner occurred. Consequently, this caused a relative rotation at the outer articulation.InterpretationsThis suggests that both inclination and modest anteversion angles have little influence on the kinematics and contact mechanics of dual mobility hip implants. However, too excessive anteversion angle could result in a rotation for this kind of hip implant at both articulations.     

结直肠癌流行病学特征及其危险因素

近几十年内,随着经济的发展,生活方式的改变以及医疗科技水平的提高,尤其是我国,结直肠癌发病率和死亡率迅速的增长,使其防治工作面临着巨大的考验。结直肠癌的发生是一个多因素、多步骤的过程,是机体的内因和环境的外因相互作用的结果。因此,了解结直肠癌流行病学特征及其危险因素,对于结直肠癌的预防、筛查和治疗都是十分重要的。文中对结直肠癌流行特征及其危险因素进行综述。     

Pentobarbital overdose: A case of contract killing

Suicides by pentobarbital overdose have increased since about 2012, which appear to be influenced by technical information on active euthanasia that has spread over the Internet. We encountered a pentobarbital poisoning case of a patient with amyotrophic lateral sclerosis. A caregiver found the patient unconscious immediately after two visitors left the room. The patient was immediately transferred to the emergency hospital but eventually declared dead. A fatal concentration of pentobarbital was detected in peripheral blood samples collected in the emergency hospital and during autopsy (53.8 μg/mL and 29.4 μg/mL, respectively). Because the ratios of pentobarbital concentrations between the gastric contents and peripheral blood were 35 and 29 in the hospital and autopsy samples, respectively, it is likely that pentobarbital was administered via the gastrostomy tube. The patient had contacted the visitors through social media. Although the patient had requested the doctor perform active euthanasia and expressed a desire to end their life on social media, nobody had noticed the plan to commit suicide.     

癌源exosomes的制备及其对胃癌细胞生长的作用

目的:分离癌细胞源exosomes,对其超微结构进行鉴定,探讨exosomes对胃癌细胞增值活性的影响。方法:采用超速梯度离心法从MGC 803胃癌细胞培养上清液中提取exosomes,通过透射电镜技术对其超微结构进行鉴定,并利用MTT法探讨exosomes对胃癌细胞增殖活性的作用。结果:胃癌MGC 803细胞来源的exosomess具有特征性的盘状结构,由双层膜构成,直径约50~130 nm。Exosomes以剂量依赖性的方式促进MGC 803细胞的增殖。结论:癌细胞来源的exosomes能促进胃癌细胞增殖,其表面所负载肿瘤抗原可能在肿瘤细胞增殖过程中起重要的信息传递作用。     

临床信息多媒体导航系统构建

介绍内蒙古医科大学临床信息多媒体导航系统的设计方法及主要功能,总结其应用效果。该系统可以有效防止护理疏忽和差错的出现,简化工作程序,提高工作效率,降低沟通成本。     

神经外科术后感染脑脊液病原菌分布及耐药变化特点

目的:调查近3年北京天坛医院神经外科术后颅内感染的脑脊液细菌分布特点和耐药变化,为神经外科合理选用抗菌药物治疗颅内感染提供依据。方法:利用医院信息系统查询2010~2012年神经外科术后颅内感染患者的脑脊液培养病原菌的种类、数量、抗菌药物药敏结果等数据,并分类分析近3年内病原菌的流行特点和药敏情况。结果:近3年脑脊液共分离培养出病原菌844株,其中革兰阳性菌639株(75.7%),主要为耐甲氧西林的葡萄球菌,对青霉素类抗生素基本耐药,只对万古霉素和利奈唑胺敏感。万古霉素耐药肠球菌由2010年的0株增长到2012年的5株;革兰阴性菌205株(24.3%),主要包括肺炎克雷伯菌,鲍曼不动杆菌,铜绿假单胞菌等。其中鲍曼不动杆菌泛耐药现象十分严重。结论:引起神经外科术后颅内感染细菌耐药越来越严重,必须严密监测细菌耐药和控制预防用药疗程和抗感染药物的滥用。     

药用植物蓝刺头的研究进展

摘 要 蓝刺头（Echinops latifolius Tausch）为菊科蓝刺头属植物,其干燥根作为中药禹州漏芦用,其干燥花絮作为蒙药蓝刺头用。本文对近几年来中药禹州漏芦和蒙药蓝刺头的研究成果进行了整理,并从化学成分、工艺研究、质量控制和药理作用四个方面对两种药材进行了比较和综述,以期为药用植物蓝刺头的进一步开发和利用提供科学依据。     

正交试验优选蒽酮 硫酸法测定蒙药“那仁满都拉”水溶性糖含量条件

摘 要 目的： 优选蒽酮 硫酸法测定蒙药“那仁满都拉”水溶性糖含量试验条件,并对蒙药“那仁满都拉”水溶性糖进行含量测定。方法: 在单因素试验基础上,对影响水溶性糖含量测定的四个因素：反应温度、反应时间、硫酸浓度,蒽酮浓度进行正交试验设计,优选最佳测定条件。结果: 蒽酮 硫酸法测定蒙药“那仁满都拉”水溶性糖含量的最佳条件为：反应温度80℃、反应时间45 min、硫酸浓度75%、蒽酮浓度0.2%。在此条件下,葡萄糖在2.040 0～32.580 0 mg·mL^-1范围内线性关系良好,r=0.999 6,平均回收率为101.88%,RSD为0.69%。三批样品含量测定的RSD均小于0.95%。结论: 用蒽酮 硫酸法测定“那仁满都拉”中的水溶性糖含量时,显色条件对定量有不容忽视的影响。     

Analysis of clinical prognosis in patients with non-hepatic hyperammonemia

The aim of this study was to evaluate the association of non-hepatic hyperammonemia (NHH) with the prognosis of critically ill patients with NHH.According to the serum ammonia level, the patients with NHH (n = 498) were retrieved by us. The risk factors of the mortality with NHH patients were investigated by conducting univariate and multivariate logistic regression analyses. A nomogram to predict the risk of hospital mortality was constructed. Receiver operating characteristic curve (ROC) analysis was conducted to compare nomogram (ammonia into a prognostic model, P1) with the simplified acute physiology II (SAPSII) and quick sequential organ failure assessment (qSOFA).Five independent factors for the mortality in patients with NHH were identified, including age, platelets, bun, hemoglobin, and ammonia. Models P1 using ammonia showed good prediction power. The AUROC of P1 (AUROC, 0.755 [95% CI, 0.713–0.796]) was higher than that of qSOFA (AUROC, 0.500 [95% CI, 0.449–0.551]), and SAPS II (AUROC, 0.703[95% CI, 0.658–0.748]).Ammonia was an independent prognostic predictor of mortality for NHH patients. We developed a nomogram that can predict hospital mortality with patients. Nomogram had superior discriminative power to qSOFA and SAPS II, indicating that the nomogram may have clinical utility.