苯妥英在兔骨折愈合中的作用

为了观察苯妥英在骨折愈合中的作用，选用健康家兔７２只，手术造成双侧桡骨骨折模型。随机分为三组：全身用药组，局部用药组及对照组。分别于骨折后第９，１６及３０ｄ处死动物，采用Ｘ线摄片、骨痂重量测定及组织学检查等方法观察苯妥英局部应用和全身应用在促进骨折愈合中的作用。结果表明：苯妥英局部应用和全身应用均有促进骨折愈合的作用。     

Oral and fecal polio vaccine excretion following bOPV vaccination among Israeli infants

IntroductionInactivated polio virus (IPV) vaccinations are a mainstay of immunization schedules in developed countries, while oral polio vaccine (OPV) is administered in developing countries and is the main vaccine in outbreaks. Due to circulating wild poliovirus (WPV1) detection in Israel (2013), oral bivalent polio vaccination (bOPV) was administered to IPV primed children and incorporated into the vaccination regimen.ObjectivesWe aimed to determine the extent and timeframe of fecal and salivary polio vaccine virus (Sabin strains) shedding following bOPV vaccination among IPV primed children.MethodsFecal samples were collected from a convenience sample of infants and toddlers attending 11 Israeli daycare centers. Salivary samples were collected from infants and toddlers following bOPV vaccination.Results398 fecal samples were collected from 251 children (ages: 6–32 months), 168 received bOPV vaccination 4–55 days prior to sample collection. Fecal excretion continued among 80 %, 50 %, and 20 %, 2, 3, and 7 weeks following vaccination. There were no significant differences in the rate and duration of positive samples among children immunized with 3 or 4 IPV doses. Boys were 2.3-fold more likely to excrete the virus (p = 0.006). Salivary shedding of Sabin strains occurred in 1/47 (2 %) and 1/49 (2 %) samples 4, and 6 days following vaccination respectively.ConclusionsFecal detection of Sabin strains among IPV-primed children continues for 7 weeks; additional doses of IPV do not augment intestinal immunity; limited salivary shedding occurs for up to a week. This data can enhance understanding of intestinal immunity achieved by different vaccination schedules and guide recommendations for contact precautions of children following bOPV vaccination.     

肝功能不全的不常见表现与治疗：附16例报告

作者报告了肝胆胰外科中不常见的胆总管引流白胆汁１４例和术后不寻常大出血２例，指出这些不常见表现实际上为肝功能不全的反映，当引起临床医师重视。同时还就肝功能不全的表现方式和治疗进行了讨论，强调保肝和营养支持治疗是其根本治疗措施     

髋臼骨折合并坐骨神经损伤的治疗(附20例报告)

目的　探讨髋臼骨折合并坐骨神经损伤的创伤机制及治疗。方法　分析本组髋臼骨折合并坐骨神经损伤共 2 0例 ,均行肌电图检查。 4例采用患肢持续股骨髁上牵引非手术治疗 ;16例采用髋臼骨折切开复位内固定手术治疗 ,术中视坐骨神经损伤程度作神经外膜松解或束间松解。结果　坐骨神经恢复情况 :优 7例 ,良 6例 ,可 4例 ,差 3例。结论　应根据临床检查 ,X线及CT所示骨折移位情况和有无髋关节后脱位 ,作电生理检查 ,结合临床有无造成神经严重损伤的因素而决定是否探查坐骨神经 ;术中肉眼观察坐骨神经损伤程度对指导手术和判断预后有一定意义 ,神经的恢复情况与术中所见损伤程度有关     

应用膳食平衡指数评价成都某农村地区老年居民膳食质量

目的 应用中国膳食平衡指数(DBI-16)评价成都市某农村地区老年居民膳食质量。方法 随机抽取成都市某农村地区参与2021年度社区体检的老年人,对其进行膳食调查并运用DBI-16对其膳食质量进行评价。采用SPSS 22.0软件进行数据分析。根据数据类型,组间比较分别采用t检验、χ²检验及方差分析。结果 共纳入1 275例老年人。被调查老年人中,1 214例(95.22%)存在推荐“常吃”、“多吃”或“适量”进食食物的摄入不足,中、高度摄入不足有465例(36.47%);1 049例(82.27%)存在推荐“少吃”、“不吃”或“适量”进食食物的摄入过量,中、高度摄入过量有202例(15.84%);处于膳食失衡状态的老年人数高达1 272例(99.69%),中、高度失衡老年人有725例(56.86%)。对各个食物组摄入情况进行分析,发现该地区老年人存在主食摄入不均衡、蔬菜水果、奶类豆类食物摄入量较少,动物性食物摄入量过多,食物多样性程度低,同时纯能量食物(酒和糖)摄入超过推荐量等问题。结论 该地区老年人群中膳食失衡比例高,建议增加新鲜蔬菜水果、奶类豆类等食物的摄入量,...     

公民逝世后器官捐献肝移植78例临床经验分析

目的总结公民逝世后器官捐献肝移植的临床经验及疗效分析。方法回顾性分析2012年3月至2015年11月四川大学华西医院肝脏移植中心完成的公民逝世后器官捐献供体肝移植的76例供体和78例受体的临床资料。观察肝移植受体早期移植物功能恢复情况并分析引起早期移植物功能障碍(EAD)的危险因素,观察远期的移植物生存及受体生存情况、并发症发生情况。结果 78例受体术后EAD的发生率为36%(28/78),其中供体总胆红素(TB)高和冷缺血时间长是EAD发生的危险因素。受者围手术期存活率为92%(72/78),死亡6例,分别死于原发性移植物失功4例、上消化道大出血1例、肺部感染1例。术后发生腹腔感染5例,胆道狭窄3例,血管血栓形成2例,除1例死亡外,其余经相应治疗后好转。受体术后1年的存活率为84.2%,2年存活率为80.0%。结论公民逝世后器官捐献供肝是较好的供肝来源,其近远期效果良好。控制术前供肝质量,缩短冷缺血时间等均是提高临床效果的重要措施。     

髋臼骨折手术治疗的疗效分析

目的 为了提高髋臼骨折的治疗效果,对影响髋臼骨折手术治疗效果的一些因素进行分析,找出以治疗效果有直接影响的一些相关因素。方法 对７８例手术治疗的髋臼骨折患者１～８年,平均３年的随访,髋臼骨折按ＡＯ方法进行分类并评价其术后髋关节功能和Ｘ线表现。结果 按Ｍａｔｔａ复位标准,解剖复位３７例,满意复位２１例,不满意复位２０例。患髋功能评价,优２１例,良２３例,可１８例,差１６例。优良率５６．４％。结论 髋     

Application of the theoretical domains framework to identify factors influencing catch-up HPV vaccinations among male college students in the United States: A review of evidence and recommendations

BackgroundGenital human papillomavirus (HPV) infection is the most prevalent sexually transmitted infection among young adults ages 15–25 years in the United States (US). Although HPV vaccines are recommended for individuals ages through 26 years, vaccine completion rates remain substantially low.MethodsAccordingly, our study utilized a comprehensive – Theoretical Domains Framework (TDF) of behavior change to systematically identify facilitators and barriers to catch-up HPV vaccinations. Five databases - Medline, Embase, CINAHL, ERIC, and PsycINFO were searched from January 2009 to July 2019 for empirical studies using quantitative and qualitative methods to assess HPV vaccine uptake among males ages 18–26 years within US college and university settings. The TDF analytic process included a content analysis using the mixed deductive-inductive approach to extract, analyze and categorize data into TDF domains/themes and sub-themes.ResultsOverall, 17 studies were selected for data extraction. We identified eleven key TDF domains that influenced HPV vaccination behavior among college male students: ‘knowledge’ (82% of included studies), ‘environmental context and resources’ (53%), ‘beliefs about consequences’ (53%), ‘unrealistic optimism’ (50%) and ‘pessimism’ (6%), ‘emotion’ (50%), ‘social influences’ (50%), ‘beliefs about capabilities’ (41%), ‘intention’ (24%), ‘reinforcement’ (18%), ‘social professional role and identity’(12%), and ‘behavioral regulation’ (12%). Barriers influencing HPV vaccine uptake included lack of knowledge and awareness regarding HPV infections, HPV vaccine safety, effectiveness, side effects, and costs; absence of health providers’ recommendations; lack of healthcare and health insurance; low levels of perceived susceptibility and severity for HPV infections; HPV vaccine misinformation; as well as social stigma and peer influences regarding HPV vaccinations. Enablers for HPV vaccine uptake included high levels of perceived benefits for HPV vaccines.DiscussionOur study theoretically identified factors influencing HPV vaccinations. This could inform the efficient planning, support, and implementation of interventions that facilitate catch-up HPV vaccination practices among high-risk males within college/university settings.