笑气联合利多卡因用于无痛人工流产的临床研究

目的:探讨笑气吸入联合利多卡因宫颈注射用于早孕人工流产镇痛的临床效果。方法:将150例自愿行人工流产的早孕者随机分为A组(笑气吸入)、B组(笑气吸入联合利多卡因)及C组(常规人工流产术),每组50例。对3 组镇痛效果、扩宫情况、术中出血量、子宫收缩幅度及呼吸、循环系统情况进行比较。结果:3组镇痛及扩宫效果有显著性差异(P<0．05),B组镇痛和宫颈扩张效果最佳。子宫出血量及子宫收缩幅度3组无显著性差异(P>0．05)。结论:笑气联合利多卡因宫颈注射用于无痛人工流产, 镇痛效果及宫颈松弛良好,副反应少且操作简单安全, 值得临床推广使用。     

复方吲哚美辛栓与卡孕栓在人工流产术中镇痛及扩宫疗效的临床对照研究

目的:比较复方吲哚美辛栓与卡孕栓在人工流产术中止痛和扩张宫颈作用。方法:将322例早孕要求终止妊娠妇女,分为复方吲哚美辛栓组(n=140),卡孕栓组(n=182),观察两组对象术中疼痛程度、扩宫效果及副反应发生情况。结果:复方吲哚美辛栓组术中镇痛、扩张宫颈效果优于卡孕栓组(P<0·01,P<0·05),血卡孕栓组较复方吲哚美辛栓组术中、术后出血量少(P<0·05),卡孕栓组术后恶心、呕吐及腹泻例数明显多于复方吲哚美辛栓组(P<0·01),其他副反应则无明显差异(P>0·05)。结论:复方吲哚美辛栓较卡孕栓在人工流产术中具有明显的扩张宫颈、减轻疼痛的作用,且术后副反应少。     

718周期夫精宫腔内人工授精临床因素分析

目的:探讨影响夫精宫腔内人工授精(intrauterine inseminatio,IUI)成功率的各种临床因素.方法:回顾性分析526例患者进行718周期的IUI.对患者年龄、自然周期或超排卵周期、IUI次数、IUI活性精子数量、输卵管条件、子宫内膜厚度与妊娠率的关系进行分析.结果:718周期的IUI中妊娠109周期,其中双胎妊娠率9.2%,三胎妊娠率为2.8%,流产率为22.2%,每周期临床妊娠率为15.2%.自然周期或超排卵周期、单侧或双侧输卵管通畅病人间,妊娠率无显著性差异(P＞0.05).就女方年龄,＜30岁、30～40岁和＞40岁妊娠率分别为17.24%、14.40%和3.22%,年龄越大受孕率越低,＞40岁组妊娠率明显低于前两组(P＜0.05)).第3次IUI的妊娠率明显高于第2次IUI(妊娠率分别为25.00%、10.39%,P＜0.05).当IUI活性精子数量低于1×106时,妊娠率为3.33%,明显低于活性精子数为1～10×106,10～50×106,和＞50×106组(妊娠率分别为15.82%、16.67%和27.27%,P＜0.05).LH峰或注射HCG时,子宫内膜厚度＜7 mm和＞16 mm时,妊娠率分别为7.14%和3.23%,明显低于7～12 mm和13～16 mm组(妊娠率为16.86%和14.18%,P＜0.05).结论:IUI中女方的年龄、IUI活性精子数量和子宫内膜厚度是影响IUI妊娠率的直接因素.     

口服米索前列醇用于早期妊娠人工流产术前扩张宫颈的有效性和安全性评价

目的:系统评价口服米索前列醇与安慰剂比较用于孕早期人工流产术前扩张宫颈的有效性和安全性。方法:检索相关文献并行Meta分析。据异质性检验结果采用固定效应模型、敏感性分析或随机效应模型等处理。结果:纳入文献5篇688例,国外文献质量高于国内。口服米索前列醇较之安慰剂宫颈扩张度好的比例较高,可降低术中出血量及疼痛发生率;在人工流产综合征(PAAS)、胃肠道副反应和用药后腹痛发生率及手术时间上两者差异无统计学意义。结论:国内原始研究质量有待提高,结局指标需更加规范。口服米索前列醇对于扩张宫颈有较好临床效果,而在其他有效性指标方面效果不明显,其安全性有待更多证据加以评价。     

MycroMesh网片无张力腹股沟疝修补术30例报告

目的研究MycroMesh网片无张力疝修补术治疗腹股沟疝的临床效果。方法对我院收治的29例斜疝(1例双侧斜疝)、1例直疝选用MycroMesh生物性植入网片行无张力疝修利、术。结果30例患者经MycroMesh网片无张力疝修利-术后恢复快．无疼痛及异物感，随访至今，未见复发病例。结论MycroMesh网片无张力疝修补术治疗腹股沟疝效果满意，恢复快，患者痛苦少，为腹股沟疝较理想的治疗方法。     

复方甘草酸苷联合人工肝治疗重型肝炎疗效观察

目的:观察复方甘草酸苷联合人工肝治疗重型肝炎的疗效。方法:将58例重型肝炎患者随机分为治疗组和对照组,对照组除给予基础治疗外,根据患者情况每隔3d～5d行血浆置换或血液灌流,每位患者一般做5次～10次;治疗组在对照组治疗的基础上给予复方甘草酸苷治疗。结果:治疗组与对照组总有效率分别为64.52%、40.74%,二者间有显著性差异(P<0.05);治疗8wk时治疗组肝功能改善情况优于对照组(P<0.05)。结论:复方甘草酸苷联合人工肝治疗重型肝炎有效、安全。     

美金刚与多奈哌齐合用对帕金森痴呆患者MoCA、ADL与血清CRP、PARK7的影响

【摘要】 目的 研究分析美金刚与多奈哌齐合用对帕金森痴呆患者MoCA、ADL与血清CRP、PARK7的影响。方法 选取本院收治的89例行帕金森痴呆患者进行研究,将所选患者按照治疗方法的不同随机分为研究组49例与对照组40例。对照组患者给予多奈哌齐进行治疗,研究组在对照组基础上联合美金刚进行治疗。回顾性分析两组患者的临床资料,对比分析两组患者临床疗效、认知功能以及日常生活能力的具体情况,并记录治疗期间不良反应发生情况。结果 对照组总有效率为7750%,研究组总有效率为9592%,研究组总有效率高于对照组（P＜005）;治疗12周后,两组患者UPDRS总评分、MMSE评分、MoCA评分、ADL评分均较前明显改善。研究组UPDRS总评分低于对照组,MMSE评分、MoCA评分、ADL评分高于对照组,两组对比存在明显差异（P＜005）;治疗12周后,两组患者血清CRP、PARK7、NT 3水平均较前明显改善。研究组血清CRP、PARK7水平低于对照组,NT 3水平高于对照组,两组对比存在明显差异（P＜005）;对照组患者治疗后的不良反应发生率（1250%）高于研究组患者（1224%）,但两组比较无明显差异（P＞005）。结论 美金刚与多奈哌齐合用对帕金森痴呆患者具有良好的临床疗效,可以有效改善帕金森痴呆患者行为功能以及认知功能,并明显降低患者血清CRP、PARK7水平,提高了NT 3水平,且安全性较高,可作为帕金森痴呆患者首选的治疗方案。     

Artificial neural network for modeling the elastic modulus of electrospun polycaprolactone/gelatin scaffolds

Scaffolds for tissue engineering (TE) require the consideration of multiple aspects, including polymeric composition and the structure and mechanical properties of the scaffolds, in order to mimic the native extracellular matrix of the tissue. Electrospun fibers are frequently utilized in TE due to their tunable physical, chemical, and mechanical properties and porosity. The mechanical properties of electrospun scaffolds made from specific polymers are highly dependent on the processing parameters, which can therefore be tuned for particular applications. Fiber diameter and orientation along with polymeric composition are the major factors that determine the elastic modulus of electrospun nano- and microfibers. Here we have developed a neural network model to investigate the simultaneous effects of composition, fiber diameter and fiber orientation of electrospun polycaprolactone/gelatin mats on the elastic modulus of the scaffolds under ambient and simulated physiological conditions. The model generated might assist bioengineers to fabricate electrospun scaffolds with defined fiber diameters, orientations and constituents, thereby replicating the mechanical properties of the native target tissue.     

Risk stratification for mortality in cardiovascular disease survivors: A survival conditional inference tree analysis

Background and aimsEfficient analysis strategies for complex network with cardiovascular disease (CVD) risk stratification remain lacking. We sought to identify an optimized model to study CVD prognosis using survival conditional inference tree (SCTREE), a machine-learning method.Methods and resultsWe identified 5379 new onset CVD from 2006 (baseline) to May, 2017 in the Kailuan I study including 101,510 participants (the training dataset). The second cohort composing 1,287 CVD survivors was used to validate the algorithm (the Kailuan II study, n = 57,511). All variables (e.g., age, sex, family history of CVD, metabolic risk factors, renal function indexes, heart rate, atrial fibrillation, and high sensitivity C-reactive protein) were measured at baseline and biennially during the follow-up period. Up to December 2017, we documented 1,104 deaths after CVD in the Kailuan I study and 170 deaths in the Kailuan II study. Older age, hyperglycemia and proteinuria were identified by the SCTREE as main predictors of post-CVD mortality. CVD survivors in the high risk group (presence of 2–3 of these top risk factors), had higher mortality risk in the training dataset (hazard ratio (HR): 5.41; 95% confidence Interval (CI): 4.49–6.52) and in the validation dataset (HR: 6.04; 95%CI: 3.59–10.2), than those in the lowest risk group (presence of 0–1 of these factors).ConclusionOlder age, hyperglycemia and proteinuria were the main predictors of post-CVD mortality.Trial registrationChiCTR-TNRC-11001489.     

老年人工髋关节置换围术期应激性溃疡的预防性护理

目的：探讨我院老年人工髋关节置换围术期应激性溃疡预防性护理的临床疗效。方法选取2010年4月～2013年4月在我院骨科住院髋部骨折且接受手术的老年患者106例，随机分为对照组和观察组，每组53例。对照组采用常规护理，观察组采用预防性护理。比较两组患者应激性溃疡发生率，术后1d、5d、10d、14d消化性溃疡症状分级量化积分。结果观察组应激性溃疡发生率明显低于对照组（P＜0．01）；观察组术后1d、5d、10d、14 d消化性溃疡症状评分明显优于对照组，差异有显著意义（ P＜0．01）。结论中西医结合预防性护理干预对预防老年人工髋关节置换围术期应激性溃疡效果显著，促进了疾病的康复，提高了患者的生活质量。