妊娠期高甘油三酯血症性急性胰腺炎的临床特征及重症进展的预测因素分析

背景与目的：妊娠合并急性胰腺炎（APIP）是妊娠期中少见且严重的并发症,APIP的严重进展可导致母体和胎儿死亡。近年来高甘油三酯血症（HTG）逐渐成为APIP的主要病因。目前关于HTG引起的APIP的临床特征和病情预后因素研究的报道较少。因此,本研究探讨妊娠期高甘油三酯血症性急性胰腺炎（HTG-APIP）的临床特征以及重症进展的预测因素。方法：回顾性分析2018年1月—2020年12月湖北省妇幼保健院成人重症医学科和华中科技大学同济医学院附属同济医院胆胰外科39例APIP患者临床资料。根据甘油三酯的浓度将患者分为HTG-APIP组（17例）和非HTG-APIP组（22例）,比较两组患者的一般资料、病情严重程度等以及各种实验室指标;比较HTG-APIP患者中轻症（MAP）与重症（SAP）患者相关实验室指标的差异,分析HTG-APIP重症进展的危险因素,并用ROC曲线评价其预测效能。结果：HTG-APIP组与非HTG-APIP组比较,前者除了血甘油三酯高和血钙偏低之外（均P<0.05）,其余指标均无明显差异（均P>0.05）。在HTG-APIP患者中,MAP 8例,SAP 9例...     

Investigation of rosemary herbal extracts (Rosmarinus officinalis) and their potential effects on immunity

The discovery of new curative drugs and the consumption of natural dietary ingredients with the ability to exhibit immunomodulatory activity is urgently needed to decrease the risk of chronic diseases among the population. Rosmarinus officinalis (Lamiaceae) is an aromatic plant that has been traditionally and medicinally used as a carminative, antispasmodic, painkiller, circulatory tonic, to stimulate hair growth and to improve memory dysfunction. This study aimed to assess the potential effects of rosemary solvent extracts on human immune function. Science Direct, Web of Science, Wiley, Elsevier, PubMed, Scopus, and the Google scholar search engines were used to retrieve relevant information included combinations of “rosemary” or “R. officinalis” with “immune function,” “immunity,” “immune system,” “anti‐inflammatory,” “inflammation,” or “health benefit.” A number of studies have been found a stimulatory effect of rosemary and its active compounds on the immune system in vitro and animal study, but there is a lack of evidence in humans for supporting this. The results demonstrated the potential of rosemary and its main active components as dietary ingredients with immunomodulatory functionality. Human studies should be performed and a double‐blind randomized controlled trial would be ideal.     

危重病人GH与TF变化的临床意义

目的：探讨生长激素（GH）和血清转铁蛋白（TF）对危重病人营养代谢的影响。方法：根据APACHE-Ⅱ评分标准,对不同病情（普通A组、危重B组、极危重C组）患者测定血清转铁蛋白及生长激素值,并对B组和C组的患者在疾病恢复期进行复查。结果：C组患者血清转铁蛋白水平低于B组,B组患者低于A组。B组病人的生长激素水平明显高于A组,C组病人与另两组差异均无显著性。进入恢复期后,患者血清转铁蛋白水平明显上升,而生长激素水平无明显下降。结论：急性危重症患者大多存在急性能量-蛋白质营养不良,并引起内分泌紊乱。血清转铁蛋白水平可反映患者营养状况及患者病情危重程度。     

妊娠合并心脏病的监护体会

目的 探讨妊娠合并心脏病孕产妇有效的监护方法.方法 对我院重症孕产妇救治中心自2002年7月～2005年7月间51例妊娠合并心脏病患者的临床资料进行回顾性分析.结果 妊娠合并心脏病孕产妇经及时合理的监护,治愈率为76.4%(39/51),好转率为21.5%(11/51),死亡率为1.96%(1/51).结论 妊娠合并心脏病仍然是产科一种严重合并症,应为患者提供舒适安静的环境,保证充足的睡眠,预防感染,严密观察,及早发现和认真处理先兆心力衰竭,并加强心力衰竭的监护.     

Human breast milk-based nutritherapy: A blueprint for pediatric healthcare

Human Breast Milk (HBM) is a storehouse of micronutrients, macronutrients, immune factors, microbiota and numerous other bioactive macromolecules. Fulfilment of optimum nutritional requirements of more than 240 million malnourished infants worldwide is possible via adequate amount (570–900 mL/d) of breast milk administration to infants in first few years of life. Technological advancements enable study of multiple components of HBM like stem cells, bioactive proteins, micro RNAs, immunoglobulins and epithelial cells to understand their role in enhancement of nutritional value of HBM. Furthermore, immunological and protective functions of HBM against various illnesses like diabetes, anemia, respiratory and cardiovascular abnormalities, otitis media and gastrointestinal diseases prove superiority of HBM over artificial milk. Presence of major macronutrients like fatty acids, sphingomyelins, proteins, peptides, lactoferrin, lactalbumins, lysozymes, mucins, growth factors, oligosaccharides and cytokines increase nutritive value of HBM. In the future, HBM can serve as a carrier for delivery of drugs, vaccines and genes to infants and offer novel therapeutic applications to stimulate effective health, growth and development of infants. The review article highlights multimodal nutritional benefits of HBM, provides insight into preclinical and clinical studies of HBM-based therapeutics and encourages further research on HBM therapy to suffice nutritional needs of infants.     

孕前尿路结石预处理的临床价值

目的探讨对孕前尿路结石进行预处理的适应证与临床价值。方法76例孕前获诊尿路结石患者按随机与自愿原则分为预处理组35例和待处理组41例。其中预处理组肾结石16例18侧、输尿管结石19例23侧,属孤立肾1例,根据结石类型、部位在孕前采用体外震波碎石(ESWL)、经皮肾镜或输尿管镜取石(PCNL);待处理组肾结石18例21侧、输尿管结石23例27侧,孕前定期复查。监测两组受孕及孕后继发尿路积水、肾绞痛和肾功能情况。结果预处理组孕前均排尽结石。33例(94%)受孕后6~9个月发生尿路积水7例(21%)、肾绞痛9例(27%)和肾功能不全1例(3%),无新增结石及妊娠期高血压病例。3例(9%)行双J管引流,其余保守治疗缓解,均顺利足月分娩;待处理组34例(82%)受孕后3~6个月继发尿路积水21例(61%)、肾绞痛25例(73%)、肾功能损害8例(22%)及肾性高血压5例(14%)。22例(64%)保守治疗无效需配合双J管置入、肾造痿或腔内碎石等处理,2例术后出现异常宫缩。1例因持续尿路感染及肾功能不良终止妊娠,其余病例安全渡过围产期。两组孕期与尿路梗阻有关的并发症发生率比较差异有显著性意义(p<0.01)。结论对孕前尿路结石尤多发性、孤立肾或双侧肾输尿管结石进行预处理可大大降低孕期尿路积水、肾绞痛及肾功能损害的发生机率和处理风险,提高妊娠期母婴的安全性。     

长效长方案促排卵前采取高纯度人尿促性素预处理的临床分析

目的 探讨在长效长方案促排卵前,采取高纯度人尿促性素(HP-hMG)预处理,对接受体外受精/卵胞浆内单精子注射(IVF/ICSI)-胚胎移植(ET)助孕的不孕女性临床妊娠结局的影响.方法 选择2018年1月至2019年8月,于中国人民解放军联勤保障部队第九八零医院生殖医学中心进行IVF/ICSI-ET助孕,并采用长效长...     

子宫肌瘤栓塞治疗的中长期临床观察

目的评价子宫肌瘤栓塞治疗的中长期疗效。方法对110例子宫肌瘤患者栓塞治疗,并追踪观察,追踪时间48～72个月,采用经阴道彩色超声复查,栓塞剂采用超液化碘油和平阳霉素混合液(51例)和聚乙烯醇微粒(直径350～700μm,59例),观察其中长期临床疗效,并发症,性激素变化,怀孕妊娠分娩和肌瘤的再发情况等。结果110例均进行了双侧子宫动脉栓塞,月经量过多症状改善有效93/94(98.93%),压迫症状改善26/26(100%)。子宫体积减少51.5%±3.1%(t值2.861,P<0.01)。肌瘤体积减少64.2±6.6%(t值2.664,P<0.01)。栓塞前后黄体生成素、促卵泡素和雌二醇水平差异无显著性。栓塞后腹痛6/110(5.5%);发热90/110(81.8%);阴道出血95/110(86.4%);血尿11/110(10.0%);膀胱误栓1/110(0.9%);短暂性闭经3/110(2.7%)和卵巢衰竭永久性闭经3/110(2.7%)。手术失败率1/110(0.9%),肌瘤栓塞后2年再发率为4/110(3.6%)。栓塞后5例子宫肌瘤患者7次怀孕,其中4例患者分娩4次,同一患者先后人工流产3次,怀孕期间和分娩后,B超复查没有发现子宫肌瘤增大或出现新发子宫肌瘤。结论子宫肌瘤栓塞的中长期疗效肯定。子宫肌瘤栓塞后有一定的再发率。子宫肌瘤栓塞对卵巢功能的影响较轻。子宫肌瘤栓塞后妊娠和分娩仍较安全。     

The Effect of Nutrition on Aging—A Systematic Review Focusing on Aging-Related Biomarkers

Despite the increasing life expectancy, an individual’s later years tends to be accompanied by a decrease in the quality of life. Though biological changes that occur through the natural process of aging cannot be controlled, the risk factors associated with lifestyle can. Thus, the main goal of this systematic review was to evaluate how nutrition can modulate aging. For this purpose, thirty-six studies were selected on (i) the efficiency of nutrition’s effect on aging, (ii) the evaluation of biomarkers that promote healthy aging, and (iii) how to increase longevity through nutrition, and their quality was assessed. The results showed that choosing low carbohydrate diets or diets rich in vegetables, fruits, nuts, cereals, fish, and unsaturated fats, containing antioxidants, potassium, and omega-3 decreased cardiovascular diseases and obesity risk, protected the brain from aging, reduced the risk of telomere shortening, and promoted an overall healthier life. With this study, the conclusion is that since the biological processes of aging cannot be controlled, changing one’s nutritional patterns is crucial to prevent the emergence and development of diseases, boost longevity, and, mostly, to enhance one’s quality of life and promote healthy aging.