箱内给氧治疗早产儿低氧血症的疗效观察

目的探讨早产儿箱内吸氧的疗效,为早产儿低氧血症寻求较好的给氧方式。方法将低氧血症的早产儿入NICU治疗后,呼吸功能改善,但仍需低流量（1L/min）吸氧的100例早产儿,按入院先后序号,单号为观察组,双号为对照组。观察组50例采用温箱内吸氧,对照组50例采用间歇鼻导管吸氧（1L/min）,每天2h。观察两组经皮血氧饱和度（TcSO2）的变化。结果两组早产儿治疗效果比较,差异有统计学意义（χ2=55.479,P〈0.01）。根据早产儿管理指南的要求,箱内吸氧更符合早产儿的生长发育需求。结论箱内吸氧无创伤性、舒适、安全,避免了血氧饱和度忽高忽低等现象,对纠正早产儿低氧血症起到积极的作用,有效地降低了并发症的发生,提高了早产儿生存质量。     

Comparison of two inside‐out transobturator suburethral sling techniques for stress incontinence: Early postoperative thigh pain and 3‐year outcomes

Objectives: Inside‐out tension‐free vaginal tape obturators for the cure of female stress incontinence can cause postoperative thigh pain. The aim of the present study was to analyze and compare the mid‐term outcomes of two tension‐free vaginal tape obturator procedures. Methods: Patients diagnosed with urinary stress incontinence were enrolled to undergo a tension‐free vaginal tape obturator sub‐mid urethral tape operation either by de‐Leval's method or by Flam's modification. Peri‐ and postoperative data were collected by uninvolved researchers and analyzed. Follow up was 36 months. Results: Overall, 161 patients were included in the study. Cure and complication rates were similar between the two treatment groups. Postoperative thigh pain was significantly more frequent and lasted longer in the de‐Leval group compared with the Flam group (31.9% vs 10.0%, respectively). Urinary urgency was more frequent in the de‐Leval patients (20.3% vs 2.8%). Conclusion: Our findings suggest that both tension‐free vaginal tape obturator procedures are effective with few adverse effects. The Flam method provides shorter and decreased levels of postoperative thigh pain, as well as reduced long‐term postoperative urinary urgency.     

Quality of care and education provided by Greek day-care centres: an approach from researcher's and early childhood educators' perspective

The present study is aimed at examining the level of quality and care provided by Greek preschool programmes, from the researcher's and early childhood educators' perspectives and verify whether they evaluate with the same way. Research results indicate that according to the researcher's assessment both preschool and infant/toddler classrooms provide care and education of adequate quality, whereas according to early childhood educators their classrooms (both preschool and infant/toddler) provide care and education of good quality. Correlation analysis indicated that early childhood educators rated higher the quality of care and education provided by them compared with researcher. Years of experience and level of education have been found to correlate with early childhood educators' ratings. Thus, the type of setting has been found to correlate both with the researcher's and the early childhood educators' ratings. Research results suggest that the quality of care and education is a relative concept and substantiating previous research results highlight the need to take into account the perspectives of all those involved (parents, children and educators) when we attempt to define and evaluate the quality.     

慢性糜烂性胃炎胃镜像及病理分型与中医证型相关性研究

目的:探讨慢性糜烂性胃炎(CEG)胃镜表现及病理组织学改变与中医证型的关系。方法 :收集河北省中医院经电子胃镜诊断为慢性糜烂性胃炎患者133例,病变部位做病理检查,中医辨证分为浊毒内蕴组和肝胃不和组,对胃镜表现及其病理组织学改变与两组证型的相关性进行统计学分析,并比较两组证型胃镜像及病理表现的差异性。结果:CEG患者以中年男性为主;浊毒内蕴组胃镜像出现隆起型较肝胃不和组多,差异有统计学意义(P0.05);两组病理表现为肠上皮化生率无统计学意义(P0.05);浊毒内蕴组中胃镜像中隆起型病理表现为肠化较平坦型多,差异有统计学意义(P0.05)。结论:慢性糜烂性胃炎患者以中年男性居多,中医证型属浊毒内蕴患者中胃镜像为隆起糜烂型,患者病理表现大多伴有肠上皮化生。     

Intrameningioma metastasis: A case-based literature review

A tumor-to-tumor metastasis inside a meningioma is a rare phenomenon. Malignant neoplasms of the breast and lung are the most common primary tumors. Other sites of origin include prostate, renal and gastric neoplasms. The included case files were retrieved from the medical records of the University Hospital of Crete, Greece. A review of the literature was conducted in March 2020 via PubMed. Relevant search results were few. We report a case of a 66-year-old female, with known Small Cell Lung Cancer, who presented with left-sided hemiparesis. The Magnetic Resonance Imaging scan revealed a right frontal extra-axial mass. The patient underwent a craniotomy and a gross total removal of the tumor. Histological examination of the excised mass revealed metastatic adenocarcinoma deposits inside a meningioma: tumor-to-tumor metastasis. Reviewing the available literature, it has been hypothesized that the following factors play a role in the pathophysiology of this phenomenon: progesterone and estrogen receptors, cell-to-cell adhesion molecules, rich vascularization, favorable metabolic, micro-and immunological environment. Meningiomas seem to be the most common type of intracranial neoplasm to host a metastasis. There is a difference between tumor-to-tumor metastasis and collision tumors. The former implies a recipient role of the host tumor, and the latter refers to a co-localization of two different tumors that grow into one another, both being in the same organ. Tumor-to-tumor brain metastasis is a well-described phenomenon but with unclear pathophysiology. Deeper knowledge could be beneficial for its management.     

浅议“和法”治疗慢性心力衰竭

"和法"作为中医八法之一,常用于治疗各种内科杂病。慢性心力衰竭患者多虚实夹杂,气血不和。立足"和法"治疗本病,应从调和气血、调和表里、调和补泻、调和肝脾、调和阴阳、以求平和等出发。和法的应用虽然广泛,但应和而有据,勿使之过泛,以免贻误病机。同时也应做到与时俱进,不可认为墨守原方才为循法而治。     

不同方法治疗老年性股骨粗隆间骨折的临床分析

目的 探讨不同方法治疗老年性股骨粗隆问骨折安全有效的内固定方法、临床效果及其临床适应证.方法 对58例老年性股骨粗隆间骨折分别采用股骨近端解剖型锁定钢板固定14例,动力髋螺钉(DHS)固定24例,股骨近端解剖型钢板固定20例,比较3组术中失血量、手术时间、骨质劈裂情况及骨折愈合时间,随访Sanders评分结果和并发症发生情况,并进行临床和统计学分析.结果 术后全部得到随访,随访8个月～3年,平均1.5年,3组术式的优良率分别为92.9%、92%和90%.结论 不同方法治疗老年性股骨粗隆间骨折的临床效果都很满意,但各有其适应证,手术方式应根据骨折类型、年龄、体质因素及患者骨质疏松程度,结合各内固定特点选择最佳治疗方案,对伴有严重骨质疏松的高龄患者适合选用应用解剖型锁定钩板(ALHP)固定,对Evans Ⅰ、Ⅱ型和部分EvansⅢ型适合选用DHS固定,对Ⅳ、Ⅴ型适合选用股骨近端解剖型钢板固定.     

“Inside‐Out” PEGylation of Bovine β‐Cross‐Linked Hemoglobin

The development of a blood substitute is urgent due to blood shortages and potential communicable diseases. A novel method, inside‐out PEGylation, has been used here to conjugate a multiarm maleimide‐PEG (Mal‐PEG) to β‐cross‐linked (βXL‐Hb) hemoglobin (Hb) tetramers through the Cys β93 residues. This method produces a polymer with a single PEG backbone that is surrounded by multiple proteins, rather than coating a single protein with multiple PEG chains. Electrophoresis under denaturing conditions showed a large molecular weight species. Gel filtration chromatography and analytical ultracentrifugation determined the most prevalent species had three βXL‐Hb to one Mal‐PEG. Thermal denaturation studies showed that the cross‐linked and PEGylated species were more stable than native Hb. Cross‐linking under oxy‐conditions produced a high oxygen affinity Hb species (P₅₀ = 9.18 Torr), but the oxygen affinity was not significantly altered by PEGylation (P₅₀ = 9.67 Torr). Inside‐out PEGylation can be used to produce a hemoglobin‐based oxygen carrier and potentially for other multiprotein complexes.     

多发性创伤病人院前院内急救的护理

[目的]总结多发性创伤病人院前院内的急救和护理以提高医疗护理质量.[方法]对我院急诊的80例多发性创伤病人进行现场救护、转运途中救护、急诊室救治及心理护理.[结果]80例病人中有2例在送往我院途中死亡,2例入院后因并发急性肾衰竭抢救无效死亡,2例入院后因创伤性休克抢救无效死亡,69例治愈或住院进一步治疗,5例因其他原因转院治疗.[结论]多发性创伤病人病情复杂、凶险、病死率高,早期、准确、主动采取救护措施是抢救成功的关键.急诊医护人员在抢救过程中应分秒必争,及时有效地进行院前(现场)救护,快速、安全地转运病人,为挽回病人生命赢得宝贵的抢救时机.