用阿德福韦酯联合聚乙二醇干扰素α-2a治疗HBeAg阳性慢性乙肝患者的疗效评价

目的：评价阿德福韦酯（ADV）联合聚乙二醇干扰素α-2a（PEG α-2a）治疗HBeAg阳性慢性乙肝患者（CUB）的疗效。方法：将2010年4月2012年2月间收治的60例HBeAg阳性CHB分为观察组（n=30）和对照组（n=30）；观察组采用ADV联合PEG α-2a治疗，对照组采用PEG α-2a治疗，观察其疗效。结果：经治疗后观察组ALT、TBII、AST和ALB水平值以及ALT复常率、HBV-DNA转阴率、HBeAg转阴率和HBeAg血清转换率值均显著高于对照组，其差异有统计学意义（P〈0．05）；但两组患者并发症的发生率，经统计学分析，其差异无统计学意义（P〈0．05）。结论：此治疗法对HBeAg阳性CHB疗效确切，值得临床推广应用。     

PCT联合血培养在诊断脓毒症中的应用

目的研究降钙素原(procalcitonin,PCT)联合血培养在脓毒症诊断中的临床应用价值。方法选取2018年1月至2019年12月于本院重症监护室接受治疗的60例疑似脓毒症患者作为研究对象,按照随机数字表法分为对照组和观察组,各30例。对照组仅采用血培养检查方法进行脓毒症诊断,观察组采取降钙素原联合血培养检查方法进行脓毒症诊断。比较两组检查方法结果,并分析诊断价值。结果观察组脓毒症检出率明显高于对照组,差异有统计学意义(P<0.05);观察组灵敏度、特异度、阳性预测值及阴性预测值均明显高于对照组,差异有统计学意义(P<0.05)。结论降钙素原联合血培养对脓毒症进行诊断具有较高的诊断价值,能为脓毒症的诊断提供重要参考依据。     

Post-marketing Surveillance for Combined Oral Contraceptive Containing Desogestrel （Marvelon） in Chinese Rural Areas

To assess the side effects and the continuation rate of combined oral contraceptive （COC） containing desogestrel （Marvelon） during 12 months. Methods This was a post-marketing surveillance study on Marvelon COC among 870 healthy rural women in 5 different counties of Jiangsu Province during 12 months. Results About 24.02% of the women who used Marvelon COC experienced side effects during 12 months. Gastrointestinal disorder, bleeding/spotting and chloasma were ranked the first three in the side effects. The rate of side effects of Marvelon COC users during the first 3 months in southern area of Jiangsu was significantly higher than that of users in northern area of Jiangsu. Most of the users did not experience obvious weight changes i.e., loss or increase in weight of more than 5 kg during 12 months. Blood pressure and biochemical indicators of almost 99% among users were within the normal range. The gross cumulative continuation rate for 12 months was 83.14%; the most common medical reason for discontinuation was gastrointestinal disorder. There was an increased risk of discontinuation use among women with lower educational level. Conclusion Marvelon COC brought fewer side effects and was well accepted when applied in Chinese rural women.     

Decolorization of dark-colored waste cotton fabric using redox decoloring agents

A huge quantity of dark-colored waste cotton fabrics with a high content of dye powder is dumped in landfills and incinerated, which is a waste of resources and pollutes the land and atmosphere. Also, it is meaningful to effectively strip the color from these dark-colored waste cotton fabrics with minimal damage to the strength of the textiles. In this study, a dark-colored waste cotton fabric dyed with reactive dyes was subjected to chemical treatment with redox decoloring agents. The effects of various treatments on the coloration and mechanical properties of the fabric were compared. This work developed an effective Na₂S₂O₄–H₂O₂ system for decolorizing waste cotton fabric, with numerous advantages over conventional physicochemical approaches including achieving a CIE whiteness index of 74.1, tensile strength loss of 24.0%, weight loss of 1.2%, decoloration rate of 97.8%, and a degree of polymerization of 735.3. Furthermore, a mechanism was proposed to explain the two-step synergistic decolorization process.

Decolorization of dark-colored waste cotton fabric using redox decoloring agents.     

基层医院病案管理的现状与发展

基层医院病案管理工作相对滞后,未能充分认识到病案信息在医院发展规划中的价值所在,由于病案质量不高导致病案信息缺乏真实性和科学性。同时病案管理人员专业素质较低,缺少先进的服务理念。在今后发展过程中要充分发挥病案信息在医院经营活动中的科学指导作用,加强医务人员关于病案知识和相关法律法规的培训教育,保证病案的完整、准确和优质。同时强化病案管理人员的“人性化”服务理念,适应当代病案管理需要,最终使基层医院的病案管理走向规范化和科学化。     

凋亡抑制因子5在卵巢癌中的表达及临床意义

目的检测凋亡抑制因子5(API5)在卵巢癌中的表达,分析其与临床病理特征的关系。方法Western blotting方法检测2例正常卵巢组织及6例不同级别的卵巢癌组织的表达,组织化学方法检测10例正常卵巢、119例卵巢癌(浆液性腺癌61例、黏液性癌5例、内膜样癌10例、透明细胞癌10例及未分化癌33例)组织中API5的表达,分析其表达与临床病理参数及5年生存率之间的相关性,细胞转染及凋亡流式细胞分析检测API5及顺铂对卵巢癌细胞的作用。结果 API5在卵巢癌组织中的表达高于正常卵巢组织,API5的表达与临床病例特征之间密切相关,Kaplan-Meier生存曲线揭示API5表达高的卵巢癌患者较低表达患者生存率低,流式细胞术分析显示,抑制API5的表达能增加顺铂对卵巢癌细胞的敏感性。结论 API5的异常表达与卵巢癌的发生密切相关,提示API5在预后评价中具有潜在的临床应用价值,有可能成为卵巢癌治疗的潜在靶点。     

腰骶丛三角工作区的应用解剖及临床意义

BACKGROUND: Conception of three-dimensional reconstruction of the lumbosacal plexus is confused, and actual physical anatomy is needed to confirm its range and area thus providing guidence for clinical pratice.     

Impact of different contraceptive methods on quality of life in rural women of the Jiangsu province in China

Background

The combined oral contraceptives (COCs) and intrauterine devices (IUDs) are the most common contraceptive methods used by women. Women's choices of contraceptive method are largely affected by the safety and efficacy of contraceptive methods as well as by change in women's quality of life. However, there are still scanty data focusing on the impact of COC or IUD on quality of life in women, especially in China. The aim of this study was to evaluate the impact of desogestrel and ethinyl estradiol tablets (Marvelon) and Yuangong-Cu220 IUD (YCu220 IUD) on quality of life in rural women of the Jiangsu province in China.

Study Design

In this prospective cohort study, 784 COC users and 910 YCu220 IUD users were included. The women filled up quality-of-life questionnaires (Quality of Life Enjoyment and Satisfaction Questionnaire) before and after use of contraceptive methods.

Results

Significant score changes in physical health, mood, work/school/labor, living situation, vision, general well-being and overall satisfaction were noted as significant improvements after COC use in women (p<.05), and the largest improvements were in physical health and living situation; all item scores except for work/school/labor, household activities and leisure time activities had improved statistically from baseline in YCu220 IUD users (p<.05). For COC users, the proportions of women with total quality-of-life scores ≥57 before and after COC use were 11.50% and 11.79%, respectively; but the proportion of YCu220 IUD users with total quality-of-life scores ≥57 increased from 4.40% to 12.04%. Compared to women without contraceptive use history, women with past OC and/or IUD use had a significantly higher difference in the total quality-of-life scores.

Conclusions

COC and YCu220 IUD could significantly improve overall quality of life in rural women of the Jiangsu province.     

针灸通督法联合药物治疗缺血性卒中的疗效及对预后的影响

目的观察针灸通督法联合常规药物治疗急性缺血性卒中患者的疗效及对预后的影响及其与CD40/CD40L 系统的关系。方法收治缺血性卒中患者100 例,采用随机数字表法分为药物组和针药组,每组50例,药物组采用常规药物治疗,针药组采用针灸通督法联合常规药物治疗。治疗前后抽提患者外周血单个核细胞(PBMCs)并应用Real-time PCR 及Western blot 检测其中CD40 mRNA 及蛋白的表达水平;ELISA 法检测所收集血浆中sCD40L、IL-1?、IL-6 的水平;通过NIHSS 评分评价两组患者的疗效,同时比较两组患者治疗后3 个月不良事件发生情况。结果与药物组相比,针药组PBMCs 中CD40 mRNA 及蛋白表达水平下降更为显著(P<0.05);两组患者治疗后血浆sCD40L、IL-1?、IL-6 水平均明显降低(P<0.05),但针药组降低更为显著(P<0.05);针药组神经功能恢复情况显著优于药物组(P<0.05),治疗后3 个月不良事件发生率也明显低于对照组(P<0.05)。结论针灸通督法联合常规药物治疗能够明显提升缺血性卒中患者治疗疗效并降低治疗后不良事件的发生率,其机制与针灸通督法联合治疗能更有效地抑制CD40/CD40L 系统的活性有关。     

HPLC法测定塞来昔布中对磺酰胺基苯肼盐酸盐的含量

摘 要 目的：建立塞来昔布中基因毒性杂质对磺酰胺基苯肼盐酸盐的含量测定方法。方法: 采用HPLC法,色谱柱：以100%多孔渗水石墨为填料的Hypercarb系列C18柱（150 mm×4.6 mm,3 μm）;流动相：10 mmol·L^-1乙酸铵水溶液-甲醇（50∶50）和甲醇,梯度洗脱;流速：0.8ml·min^-1;检测波长：220 nm;柱温：35 ℃;进样量：20 μl。结果: 对磺酰胺基苯肼盐酸盐在99.897～599.382 ng·ml^-1（r=0.998 2）浓度范围内与峰面积呈良好的线性关系。平均回收率为97.4%（RSD=3.0%,n=9）。结论: 该方法简便、准确,可用于塞来昔布中对磺酰胺基苯肼盐酸盐的含量测定。