反油酸对人脐静脉平滑肌细胞活力的影响

<正>平滑肌细胞是血管壁中膜的主要细胞成分,是动脉粥样硬化(atherosclerosis,As)和血管成形术后再狭窄(restenosis after angioplasty,RAA)等病理过程形成和发展的重要部位,对血管壁的完整性和紧张性的调节也起重要作用,其异常增殖及形态学转变将导致动脉粥样硬化过程     

高频超声与喉镜诊断声带麻痹的对照研究

目的探讨超声诊断声带麻痹的价值及局限性。方法分析33例声带麻痹的超声表现,并与喉镜对照。结果超声诊断为单侧和双侧声带麻痹者各为30和3例。单侧者声像图表现为单侧声带变形18例,运动和振动减弱或固定27例,声门裂扩大19例,杓状软骨运动减弱或固定30例,伴前移12例,梨状窝扩大25例,环杓后肌变薄、回声增强10例。双侧者声像图均表现为双声带变形、声门裂扩大、杓状软骨运动减弱。喉镜诊断单侧声带麻痹28例,双侧5例。超声诊断声带麻痹的符合率达93.9%。结论超声是诊断声带麻痹的一种无创、便捷、有效的方法,尤其可借助观察杓状软骨的运动来判断声带麻痹。     

Issues in cardiopulmonary transition at birth

The transition from fetal to newborn life involves a complex series of physiological events that commences with lung aeration, which is thought to involve 3 mechanisms. Two mechanisms occur during labour, Na⁺ reabsorption and fetal postural changes, and one occurs after birth due to pressure gradients generated by inspiration. However, only one of these mechanisms, fetal postural changes, involves the loss of liquid from the respiratory system. Both other mechanisms involve liquid being reabsorbed from the airways into lung tissue. While this stimulates an increase in pulmonary blood flow (PBF), in large quantities this liquid can adversely affect postnatal respiratory function. The increase in PBF (i) facilitates the onset of pulmonary gas exchange and (ii) allows pulmonary venous return to take over the role of providing preload for the left ventricle, a role played by umbilical venous return during fetal life. Thus, aerating the lung and increasing PBF before umbilical cord clamping (known as physiological based cord clamping), can avoid the loss of preload and reduction in cardiac output that normally accompanies immediate cord clamping.     

暴露法在新生儿脐部护理中的应用

目的 探讨风险预测评估暴露法在新生儿脐部应用的效果.方法 采用随机分组方法将2012年7月1日至2014年1月31日在本院出生的1000例足月新生儿按双盲随机分为实验组和对照组,实验组采用风险评估暴露法对新生儿脐部的影响,评估：①新生儿营养状态和生产过程对新生儿的影响及脐部的情况;②断脐后,暴露其部位可能带来不良的影响;③家属与产妇对暴露脐部的方法接受程度等.脐部暴露方法的处理：用脐带夹结扎脐带包扎24 h后暴露脐带至脐带脱落,这期间每天用75％酒精消毒脐部一次.对照组采用传统的脐部包扎法.观察两组新生儿脐带脱落天数、脐部愈合时间、脐部红肿、出血、分泌物、新生儿呼吸改变等情况.结果 实验组脐部红肿1例（0.20％）、脐部出血2例（0.40％）、脐炎12例（2.42％）、脐带脱落时间（6.59±1.85）d、脐部愈合时间（2.14±0.59）d,对照组脐部红肿12例（2.41％）、脐部出血11例（2.21％）、脐炎80例（16.06％）、脐带脱落时间（7.52±2.21）d、脐部愈合时间（2.35±0.65）d、呼吸改变5例（1.00％）,两组比较差异有统计学意义（P＜0.05）.结论 脐部暴露法应用于新生儿可促进脐带脱落及脐部愈合,减少脐部感染的发生,是安全、有效的新生儿脐部护理方法,值得临床推广应用.     

Japanese orthopaedic association cervical myelopathy evaluation questionnaire (JOACMEQ): Part 5. Determination of responsiveness

Background

In 1999, the Japanese Orthopaedic Association decided to develop a new Cervical Myelopathy Evaluation Questionnaire (JOACMEQ). The final version of the JOACMEQ, comprising 24 questions and five domains (cervical spine function (CF); upper extremity function (UF); lower extremity function (LF); bladder function (BF); and quality of life (QOL)), was established after three nationwide investigations. The fourth investigation, reported in this paper, was performed to confirm the responsiveness of the questionnaire.

Intramedullary Sarcoidosis Presenting as Incomplete Paraplegia: Case Report and Literature Review

Abstract

Sarcoidosis is a chronic, multisystem noncaseating granulomatous disease of unknown etiology. Sarcoidosis typically presents clinically in individuals between the ages of 20 and 40 years. Although sarcoidosis most commonly affects the respiratory system, nearly any organ system can be involved. Spinal cord involvement by sarcoidosis is a rare event, occurring in less than 1% of patients with systemic disease. The case presented is that of a 29-year-old black male with benign past medical history who presented with a 6-week history of progressive incomplete paraplegia arid bowel dysfunction. Magnetic resonance imaging revealed an intramedullary mass at the T-4-T-5 levels. The patient underwent thoracic laminectomy and debulking of the mass. The pathology was consistent with granulomatous disease. Postoperatively, the patient was placed on prednisone. He subsequently received comprehensive inpatient and outpatient rehabilitation and at present is bowel and bladder continent and ambulating at community levels with a rolling walker. The diagnosis of sarcoidosis; potential treatment options, including debulking and long-term steroid use; and prognosis will be discussed.     

Patient Preference for ln-Exsufflation for Secretion Management with Spinal Cord Injury

Abstract

An important aspect of respiratory management in patients with acute spinal cord injury (SCI) is the elimination of secretions. Methods utilized for secretion management in patients with SCI includes endotracheal suctioning and mechanical in-exsufflation (MI-E). Surveyed here is a group of patients with SCI who have had experience with both endotracheal suctioning and MI-E via tracheostomy, to determine patient opinions and experiences regarding the 2 techniques. The survey was administered to 18 patients with traumatic SCI, with an average age of 34. 72% were ASIA A, 22% percent were ASIA B, and 6% were ASIA C, with neurological level of injury ranging from C-1-T-3. Results indicate that patients found MI-E significantly less irritating (p < 0.001 ), less painful (p < 0.001 ), less tiring (p = 0.01 ), and less uncomfortable (p < 0.001) than endotracheal suctioning. In a direct comparison, 89% of patients preferred mechanical in-exsufflation to suctioning. In addition, 89% of patients found MI-E faster, 78% found MI-E more convenient, and 72% found MI-E more effective than suctioning. This study demonstrates that all measured aspects of patient experience are more positive for MI-E than for endotracheal suctioning.     

Treatment of Umbilical Granuloma in Infants With Topical Application of Common Salt: A Scoping Review

BackgroundCommon salt is a safe, effective and cheap home-made remedy for umbilical granuloma. The aim of this scoping review is to identify and summarize the available evidence and examine the research conducted on salt treatment for umbilical granuloma.MethodsA literature search was performed in the second week of September, 2022 using Google scholar, PubMed, MEDLINE and EMBASE databases using the keywords ‘umbilical granuloma’ and ‘salt treatment’ to identify all English articles pertaining to salt treatment for umbilical granuloma. Tables were made to summarize the methodological characteristics, results and the dosage regimens of salt used by different authors. The Cochrane Collaboration's tool was used for assessing risk of bias in RCTs. The indexing statuses of the journals publishing these studies were also noted. The overall efficacy with the use of common salt was calculated by adding the success rates mentioned in each study.ResultsTwenty-four articles (2 systematic reviews, 6 Randomized Controlled Trials, 11 prospective cohort studies, 1 case control study, 3 retrospective case series and 1 case report) were included. An overall 93.91% success rate (1033/1100) was seen with common salt application, without any reports of complications/recurrences.ConclusionTopical application of common salt for umbilical granulomas is simple, effective and inexpensive. This scoping review provides a broader outlook at the existing level of evidence and may help in planning interventional comparative studies, so that recommendations can be formulated. It also highlights a lack of properly designed randomized controlled trials on this topic.Level of EvidenceI.