斜仰半截石位顺行与逆行微创治疗输尿管结石

目的:探讨斜仰半截石位顺行微创经皮肾镜取石术(mPCNL)与逆行输尿管镜共同治疗输尿管多发结石的可行性、疗效与安全性。方法:分析2010年8月～2011年7月采用B超引导行mPCNL与输尿管镜结合同时治疗输尿管多发结石患者10例的临床资料。结果:10例均获得良好疗效,B超引导穿刺全部成功,mPCNL与输尿管镜同时处理输尿管多发结石,无严重并发症发生。结论:斜仰半截石位顺行微创经皮肾镜取石术与逆行输尿管镜共同治疗输尿管多发结石手术创伤小,疗效满意,值得在临床推广应用。     

Socioeconomic position and cardiovascular risk factors among people with screen-detected Type 2 DM: Six-year follow-up of the ADDITION-Denmark trial

AimsTo examine whether socioeconomic position (SEP) was associated with change in cardiovascular risk factors and meeting treatment targets for cardiovascular risk factors among individuals with screen-detected Type 2 DM at six-year follow-up.MethodsThe study population was 1533 people with Type 2 DM identified from at stepwise diabetes screening programme in general practice during 2001–2006 in the ADDITION-Denmark study. The ADDITION-study was performed as a randomised trial but the two randomisation groups were analysed as one cohort in this study. Cardiovascular risk factors were measured at baseline and repeated at follow-up (mean: 5.9 [1.4] years). Information on SEP, redeemed antihypertensive and lipid-lowering treatment were obtained from Danish registers. Multivariate analyses were performed to estimate change in cardiovascular risk factors and difference in meeting treatment targets.ResultsThe change in HbA_1c, cholesterol, blood pressure and BMI were virtually the same across educational level, income level, occupational status or cohabiting status. Overall, the ability to meet treatment targets for HbA_1c, cholesterol and blood pressure was not modified by SEP-group. A higher proportion of people with lower educational level or lower income level in the intensive care redeemed anti-hypertensive treatment compared to people with higher educational or income levels.ConclusionScreen-detection and early treatment onset did not introduce socioeconomic inequality in metabolic control in people with screen-detected Type 2 DM at six-year follow-up.     

采用穿刺侧肢体外展120°体位对气切患者PICC置管的研究

目的探讨穿刺侧肢体外展120°体位对气管切开患者PICC置管的影响。方法将120例需行PICC穿刺的气管切开患者，随机分为试验组和对照组，各60例。对照组采用传统穿刺体位。试验组采用穿刺侧肢体外展120°体位。比较两组置管成功率、置管时间、患者舒适度、置管后并发症的差异。结果试验组置管成功率100％，平均置管时间28min，置管后并发症发生率3．3％。对照组置管成功率88．3％，平均置管时间40min，置管后并发症发生率26．4％，两组比较有显著性差异（P〈0．05）。术后舒适度评分，试验组为2．5分，对照组为2．8分，两组比较无显著性差异（P〉0．05）。结论对于气管切开患者行PICC置管，穿刺侧肢体外展120°较传统穿刺体位更加安全高效，减少了患者痛苦及因反复盲目调节导管而导致的感染发生，也简化了护士的操作流程，更重要的是增加了气管切开患者PICC置管的成功率，保证患者得到及时有效的治疗。     

天茄子不同提取部位止血作用研究

目的研究天茄子不同提取部位的止血药理作用。方法依次以环己烷（T1）、水（T2）和乙醇（T3）为溶剂进行提取并对乙醇提取物依次用石油醚（T4）、乙酸乙酯（T5）、正丁醇（T6）进行萃取得到相应的部位以及水部位（T7）,采用毛细玻管法、玻片法、剪尾法和测定血浆复钙时间检测其止血作用。结果 T3、T6、T7可缩短小鼠玻片法凝血时间,T3、T5、T6、T7可显著缩短小鼠毛细管法凝血时间,T3、T4、T5、T6、T7可显著缩短小鼠断尾法出血时间,T3、T6、T7可显著缩短小鼠血浆复钙时间。结论天茄子95%醇总提物、乙酸乙酯部位、正丁醇部位、水部位凝血效果显著,其中95%醇总提物、正丁醇部位、水部位凝血效果极其显著。     

基于2D电阻抗成像的位置误差和相对数量指数的后处理方法

本文提出了一种基于2D电阻抗成像的位置误差和相对数量指数的后处理方法,用于多种电导率分布的确定、组织成分的识别以及位置信息的确定。此外,还介绍了一种基于现有两种重建算法的混合正则化算法,并将三种重建算法重建的结果进行了比较。结果证明,这种后处理方法可以提高2D电阻抗成像的位置精度和空间分辨率,使得电阻抗成像适用于临床检查和过程监测。     

Evaluation of the Impact of Body Position on Primary Central Sleep Apnea Syndrome

ObjectiveTo evaluate the impact of the body position on primary central sleep apnea syndrome.MethodsFifty-five subjects diagnosed with central sleep apnea (CSA) through polysomnographic examinations were prospectively enrolled in the study. All patients underwent cardiologic and neurologic examinations. Primary positional central sleep apnea (PCSA) was determined when the supine Apnea–Hypopnea Index (AHI) was greater than two times the non-supine AHI. The primary PCSA and non-PCSA groups were compared in terms of demographic characteristics, sleep parameters, and treatment approaches.ResultsOverall, 39 subjects diagnosed with primary CSA were included in the study; 61.5% of the subjects had primary PCSA. There were no differences between the primary PCSA and non-PCSA groups regarding age, sex, body mass index (BMI), co-morbidities, and history of septoplasty. In terms of polysomnography parameters, AHI (P = .001), oxygen desaturation index (P = .002), the time spent under 88% saturation during sleep (P = .003), number of obstructive apnea (P = .011), mixed apnea (P = .009), and central apnea (P = .007) was lower in the primary PCSA group than in the non-PCSA group. Twenty-nine percent of the patients in the primary PCSA group were recommended position treatment and 71% were recommended positive airway pressure (PAP) therapy; all patients in the non-PCSA group were recommended PAP therapy.ConclusionsOur results demonstrated that the rate of primary PCSA was high (61.5%) and primary PCSA was associated with milder disease severity compared with non-PCSA. The classification of patients with primary CSA regarding positional dependency may be helpful in terms of developing clinical approaches and treatment recommendations.