呼出气温度对儿童哮喘气道炎症变化的预测意义

目的 探讨呼出气温度（EBT）对哮喘患儿气道炎症变化的预测意义。方法 选择门诊初诊时符合纳入标准的哮喘患儿60例作为哮喘组,另选60例健康儿童作为对照组,应用最新的三代产品（X-halo）检测EBT水平,记录儿童哮喘控制测试（C-ACT）评分,比较哮喘组和对照组EBT水平和C-ACT评分差异。1个月后复诊根据患儿C-ACT评分,将其分为良好控制组、部分控制组和未控制组,检测三组EBT和FeNO水平,比较三组EBT水平和C-ACT评分差异,分析EBT和FeNO相关性。追溯其初诊资料,比较初诊时三组EBT水平和C-ACT评分差异,最后比较复诊和初诊时三组EBT水平和C-ACT评分的差异。结果 初诊时,哮喘组EBT水平显著高于对照组（P < 0.05）,C-ACT评分显著低于对照组（P < 0.05）。复诊时,不同控制水平的三组EBT比较差异有统计学意义,即未控制组 > 部分控制组 > 良好控制组（P < 0.05）;三组C-ACT评分比较差异亦有统计学意义,即良好控制组 > 部分控制组 > 未控制组（P < 0.05）。三组初诊EBT水平和C-ACT评分的组间比较差异均无统计学意义（P > 0.05）。与初诊时比较,复诊时良好控制组EBT明显降低（P < 0.05）,部分控制组和未控制组均明显升高（P < 0.05）;良好控制组和部分控制组C-ACT评分均明显升高（P < 0.05）,未控制组明显降低（P < 0.05）。复诊时未控制组EBT和FeNO水平呈正相关（P < 0.05）。结论 EBT对儿童哮喘气道炎症的变化具有预测意义。     

梗阻性大肠癌的急诊处理(附138例分析)

目的　探讨结肠癌急性梗阻的诊断和手术方式选择。方法　回顾分析我院 1986— 2 0 0 0年 13 8例梗阻性结直肠癌病人的临床特点及治疗方法。对梗阻性左半结肠癌 ,术中行顺行结肠灌洗或次全结肠切除 ,Ⅰ期切除吻合术 98例 ( 70 %) ,分期手术 2 2例( 16%) ,Miles及Hartmann术 12例。其他手术 10例。结果　手术死亡率为 8.7%( 12 / 13 8) ,吻合口漏发生率 4.5 %,切口感染率 16.2 %,其余病人恢复顺利。结论　对于梗阻性左半结肠癌 ,术中灌洗Ⅰ期吻合和结肠次全切除都是可供选择的方法 ,但应依据病人全身情况和肿瘤局部条件实施     

中药对肠梗阻术后胃肠屏障保护及细胞免疫功能的调节

目的:观察肠梗阻术后中药对胃肠屏障保护及改善细胞免疫功能的作用。方法:20例分为手术加中药组和手术组,两组均用手术治疗,手术加中药组手术后给予健脾承气汤。均于术前、术后第1、4、7天测定血浆内毒素,术前及术后第1、7天测定血浆D-乳酸和T淋巴细胞亚群CD3、CD4、CD8、CD4/CD8水平。结果:术前及术后第1天两组之间各项检测指标均无明显差异(P0.05),术后第4、7天手术加中药组内毒素水平明显低于手术组(P0.05),术后第7天手术加中药组D-乳酸水平与手术组比较明显降低(P0.05),而CD3、CD4、CD4/CD8水平明显升高(P0.05)。两组术前、术后CD8比较无明显差异(P0.05)。结论:健脾承气汤可促进胃肠道平滑肌的蠕动,减少胃肠道内毒素吸收,保护胃肠黏膜的机械性和化学性屏障,提高机体的细胞免疫功能。     

Hepatic sinusoidal obstruction syndrome after allogeneic hematopoietic stem cell transplantation in adult patients with idiopathic aplastic anemia

We retrospectively investigated the incidence, risk factors, and outcomes of SOS (sinusoidal obstruction syndrome; previously veno-occlusive disease [VOD]) after allogeneic hematopoietic stem cell transplantation (alloHSCT) in aplastic anemia. Two hundred and sixty patients were included in the analysis. SOS developed in 7.3% (n = 19/260) of patients. Classical Cy (200 mg/m²)-ATG was the most common conditioning regimen (84.2%) in the SOS group. The SOS mortality rate was 4/19 (21.1%). Univariate analyses revealed that Cy 200 mg/m² conditioning (p = 0.035), classical Cy-ATG conditioning (p = 0.007), and horse ATG conditioning (p < 0.001) were significant risk factors for developing SOS. Multivariate analysis revealed that only horse ATG conditioning was a poor prognostic factor (HR = 3.484; 95% CI 1.226–9.904; p = 0.002). Rabbit ATG (HR 12.719; 95% CI 2.332–69.373; p = 0.003) and weight gain > 10% (HR 35.655; 95% CI 2.208–575.805; p = 0.012) were risk factors in the overall SOS group. Both rabbit ATG conditioning and weight gain of more than 10% were associated with poor overall survival with a median of 1.2 months (5Y survival rate, any risk factor vs. none: 74.6% vs. 0.0%; p < 0.001; Fig. 2) in the SOS group.     

排尿过程能量消耗曲线对女性膀胱出口梗阻的诊断价值

[目的]了解排尿过程能量消耗曲线对女性膀胱出口梗阻(BOO)的诊断价值.[方法]对171例女性下尿路症状患者,通过女性下尿路症状评分量表(FLUTSSS)评估病情,并对其排尿过程能量消耗曲线进行研究.经尿道镜检查其中54例证实有膀胱颈抬高后,行经尿道膀胱颈电切手术.于手术后3个月和1年复测女性下尿路症状评分量表和尿动力学检查及排尿过程能量消耗曲线.21例术后选择膀胱镜复查.[结果]术后3个月与1年复查结果显示女性下尿路症状评分明显下降,排尿期消耗曲线恢复到正常范围.最小能量损耗比下降.[结论]女性BOO用普通的尿动力学方法不能作出一个准确的诊断标准,排尿过程能量消耗曲线可为女性BOO的诊断提供一个较精确的参数.     

腹部针刺治疗术后早期炎性肠梗阻65例

目的:对术后早期炎性肠梗阻的病因、诊断、进行分析和探讨。方法:回顾分析65例术后早期炎性肠梗阻的临床资料及治疗效果。结果:65例均经禁食、静脉营养、腹部针刺等方法治愈。平均6.3天,无复发者。结论:应用针刺等非手术方法治疗术后早期炎性肠梗阻效果满意。     

Active Crack Obstruction Mechanisms in Crofer® 22H at 650 °C

Increased cyclic loading of components and materials in future thermal energy conversion systems necessitates novel materials of increased fatigue resistance. The widely used 9–12% Cr steels were developed for high creep strength and thus base load application at temperatures below 620 °C. At higher temperature, these materials present unstable grain structure, prone to polygonization under thermomechanical fatigue loading and limited resistance to steam oxidation. This seminal study compares thermomechanical fatigue resistance and long crack propagation of the advanced ferritic-martensitic steel grade 92 and Crofer^® 22H, a fully ferritic, high chromium (22 wt. %) stainless steel, strengthened by Laves phase precipitation. Crofer^® 22H features increased resistance to fatigue and steam oxidation resistance up to 650 °C. Both thermomechanical fatigue (crack initiation) and residual (crack propagation) lifetime of Crofer^® 22H exceeded that of grade 92. The main mechanisms for improved performance of Crofer^® 22H were increased stability of grain structure and “dynamic precipitation strengthening” (DPS). DPS, i.e., thermomechanically triggered precipitation of Laves phase particles and crack deflection at Laves phase-covered sub-grain boundaries, formed in front of crack tips, actively obstructed crack propagation in Crofer^® 22H. In addition, it is hypothesized that local strengthening may occur near the crack tip because of grain refinement, which in turn may be impacted by testing frequency.     

Ancillary treatment of patients with lung disease due to non-tuberculous mycobacteria: a narrative review

Background and ObjectiveNon-tuberculous mycobacterial lung disease (NTM-LD) manifests with bronchiectasis, inflammatory bronchiolitis, nodules, and/or cavitation. Bronchiectasis is characterized by permanently dilated airways wherein mucus accumulates, creating a vicious cycle of chronic injurious inflammation and recurrent infections. While antibiotics are an important part of the treatment of NTM-LD, airway clearance techniques to mitigate this pathogenic mechanism of bronchiectasis as well as other ancillary measures are also important components of NTM-LD treatment. The objective of this contemporaneous Narrative Review is to emphasize the importance of such ancillary measures.MethodsWe searched PubMed for the key words of “airway clearance”, “pulmonary rehabilitation”, “nutrition”, “swallowing dysfunction”, “gastroesophageal reflux”, “vestibular dysfunction”, or “cochlear dysfunction” with that of “non-tuberculous mycobacterial lung disease”, “bronchiectasis”, or “respiratory disease”. The bibliographies of identified articles were further searched for relevant articles not previously identified. Each relevant article was reviewed by one or more of the authors and a narrative review was composed.Key Content and FindingsHerein, we discuss five ancillary treatment measures that are pertinent to patients with bronchiectasis and NTM-LD: (I) airway clearance; (II) physical and pulmonary rehabilitation; (III) nutrition; (IV) diagnosis and mitigation of swallowing dysfunction and of gastroesophageal reflux disease (GERD); and (V) minimization of vestibular and cochlear dysfunction associated with some anti-NTM drugs.ConclusionsWhile antibiotics is often the central focus of treatment of NTM-LD, given its propensity for recurrent and recalcitrant infection, other ancillary measures to break the vicious cycle of injurious inflammation and infection should also be emphasized to optimize treatment success.     

Network-based pharmacological study of the mechanism of kaiyuzhongyutang in the treatment of tubal fimbria obstruction

To apply a network pharmacological approach to explore the targets and possible mechanisms of Kai Yu Zhong Yu Tang (KYZYT) in the treatment of tubal fimbria obstruction. The target information of KYZYT was extracted from TCMSP and HERB database. Genes related to tubal fimbria obstruction were searched using the GENECARD database. Target protein network maps (PPI) were drawn using string database analysis and Cytoscape 3.7.1 software. Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway enrichment analysis and gene function analysis (GO) enrichment analysis were performed with the help of Perl language and biological program package in R language. To explore the multiple pharmacological mechanisms of action of KYZYT in the interventional treatment of tubal fimbria obstruction and to lay the foundation for further experimental validation. Through the collection and analysis of multiple databases, 355 biological targets of KYZYT were identified. 168 targets of tubal fimbria obstruction were obtained from disease database. The “drug-component” and “drug-target” networks of KYZYT were constructed, and the protein interaction network (PPI) of overlapping targets was analyzed to identify the key targets of the drug affecting the disease. In addition, KEGG pathway analysis and GO enrichment analysis were performed on the overlapping targets to explore the mechanism of KYZYT in the treatment of tubal fimbria obstruction. KYZYT has the characteristics of multi-component, multi-target and multi-pathway in the treatment of tubal fimbria obstruction, which provides new ideas and scientific basis for further clarification of the molecular mechanism.