海口市550名医学生膳食营养状况

目的了解海口市医学生膳食营养状况,为改善学生膳食质量提供指导意见。方法采用24h膳食回顾法,记录550名医学生连续5d的膳食情况,利用营养计算器V6.0版及Excel软件对结果进行分析。结果大多数学生能量、维生素A、维生素C、钙等营养素摄入量不足,男生膳食维生素A、维生素C、钙的摄入量分别为推荐摄入量的63.63%,50.00%及44.63%,女生分别为61.00%,50.00%和44.13%,女生能量摄入量为推荐摄入量的81.60%。膳食钙磷比男、女生分别为0.31和0.40。早、中、晚三餐能量分配分别为18%,43%和39%。结论海口市医学生膳食结构不够合理,应增加能量、维生素A、维生素C、钙的摄入量。     

ADJUSTABLE SUTURES IN STRABISMUS SURGERY: A PERSONAL SERIES OF CASES

A personal series of 77 separate primary adjustable suture procedures performed on 69 patients is analysed. Adjustable suture surgery was performed on patients over ten years of age undergoing rectus muscle surgery, and a few selected younger patients. The ages ranged from 7 to 74 years. A 24-month-old infant who had a two-stage-anaesthesia is included in the series.
Thirty-eight of the 69 patients were reoperations. Of the 77 primary procedures, 48 (62.3%) required postoperative adjustment; 29 (37.7%) were tied down without adjustment.
Sixty-two of the 69 patients (89.8%) achieved a "cure". A further four patients (5.8%) were initially in desired alignment, but deteriorated within the follow-up period. Three of these were successfully reoperated. Of the three primary failures (4.4 %) two were reoperated with one achieving orthophoria.
Apart from alignment failure in the primary procedure, complications were minimal. Current follow-up periods range from one to 24 months.     

蒙古族验方北沙参四味汤研究进展及药效物质基础预测

蒙成药经典验方北沙参四味汤历史悠久,有清肺解热、止咳祛痰的功效,临床多用来治疗肺炎、支气管炎等疾病,疗效确切,具有潜在的开发价值。本文基于化学成分、药理作用、质量控制和临床研究,综述了北沙参四味汤的研究现状并预测分析其潜在的药效物质基础,为其后续相关研究提供参考。     

Bcl-2和Caspase-9对儿童癫痫持续状态近期预后的预测价值

目的探讨血清B细胞淋巴瘤相关蛋白-2(Bcl-2)和半胱氨酸天冬氨酸蛋白酶-9(Caspase-9)对儿童癫痫持续状态(SE)近期预后的预测价值。 方法选择SE患儿62例为SE组,选择同期体检健康儿童62例为对照组;按照预后将SE患儿分为预后不良组和预后良好组。癫痫持续状态严重程度量表(STESS)评估SE患儿SE严重程度。ELISA检测各组血清Bcl-2和Caspase-9水平。结果SE组Bcl-2和Caspase-9水平高于对照组(P＜0.05)。预后不良组和预后良好组STESS评分、Bcl-2和Caspase-9水平比较,差异有显著性(P＜0.05)。STESS评分、Bcl-2和Caspase-9是影响SE患儿近期预后的独立影响因素(P＜0.05);入院血清Bcl-2和Caspase-9联合检测对SE患者近期预后具有较好的预测效能(P＜0.05)。 结论血清Bcl-2和Caspase-9是SE患儿近期预后的有效预测指标。     

脓毒症患者外周血单核细胞miR-147b的表达及其与病情严重程度和预后的关系

目的 探讨脓毒症患者外周血单核细胞miR-147b的表达水平及其与病情严重程度及预后的相关性。方法 选择2019年1月至2021年6月于安徽医科大学第一附属医院就诊的46例脓毒症患者(脓毒症组)和50例普通感染患者(普通感染组)作为研究对象。查阅患者病历,记录年龄、性别、感染部位等一般资料。采用酶联免疫吸附试验试剂盒检测研究对象血清中肿瘤坏死因子-α(tumor necrosis factor-α,TNF-α)和C反应蛋白(C-reactive protein, CRP)的浓度。计算序贯性器官衰竭评分(sequential organ failure score, SOFA)和急性生理学与慢性健康状况评分Ⅱ(acute physiology and chronic health scoreⅡ,APACHEⅡ)。观察或随访脓毒症患者的28 d预后情况,分为生存组和死亡组。应用逆转录聚合酶链反应测定外周血单核细胞中miR-147b的表达水平。结果 脓毒症组和普通感染组的年龄、性别、感染部位分布比较差异无统计学意义(P>0.05)。脓毒症组患者的TNF-α、CRP水平、SOFA评分和A...     

不同机械通气方式联合猪肺磷脂注射液治疗新生儿呼吸衰竭疗效比较

目的 比较常频机械通气(CMV)、猪肺磷脂注射液联合CMV、猪肺磷脂注射液联合高频振荡通气(HFOV)治疗新生儿呼吸衰竭的疗效。方法 选择2019年1月至2020年12月南阳市中心医院收治的133例呼吸衰竭新生儿为研究对象,根据治疗方式将患儿分为对照组(n=41)、观察组A(n=45)和观察组B(n=47)。对照组患儿给予单纯CMV治疗,观察组A患儿给予猪肺磷脂注射液联合HFOV治疗,观察组B患儿给予猪肺磷脂注射液联合CMV治疗。比较3组患儿机械通气时间、用氧时间、治疗前后的呼吸力学指标[动脉血氧分压(PaO₂)、动脉血二氧化碳分压(PaCO₂)、氧合指数(OI)、呼吸指数(RI)]和血清内皮素-1(ET-1)、肌酸激酶同工酶(CK-MB)、Ⅱ型肺泡表面抗原-6(KL-6)、Clara细胞蛋白16(CC16)水平及不良反应发生情况。结果 3组患儿的机械通气时间和用氧时间比较差异有统计学意义(F=12.658、26.196,P<0.05);观察组A和观察组B患儿的机械通气时间和用氧时间显著短于对照组(P<0.05),观察组A患儿的机...     

急性加重期慢性阻塞性肺疾病患者有创机械通气期间营养风险及影响因素分析

目的 探究慢性阻塞性肺疾病急性加重期(AECOPD)有创机械通气患者营养风险及影响因素分析。方法 选取2020年2月—2022年2月入住中国医科大学附属盛京医院重症监护病房(ICU)需要有创机械通气支持的AECOPD患者126例,根据营养风险筛查量表(NRS)2002将患者分为有营养风险组(86例)和无营养风险组(40例)。收集患者动脉血氧分压(PaO₂)、动脉血二氧化碳分压(PaCO₂)、第1秒用力呼气容积占用力肺活量百分比(FEV₁/FVC)、残气量(RV)、白蛋白(ALB)、前白蛋白(PA)等临床资料。采用多因素一般Logistic回归分析有创机械通气AECOPD患者发生营养风险的危险因素,绘制受试者工作特性(ROC)曲线评价上述指标对有创机械通气AECOPD患者营养风险的诊断价值。结果 有营养风险组PaO₂<60 mmHg、PaCO₂≥50 mmHg、FEV₁/FVC<50%、ALB<30.00 g/L、PA<145.00 ...     

神经重症患者非惊厥性癫痫持续状态的早期预防及分步治疗研究进展

神经重症监护病房的患者通常具有非惊厥性癫痫持续状态发作的高风险,但其症状通常不典型,常导致诊断和治疗延迟,使发生非惊厥性癫痫持续状态患者的残疾率、病死率增加。目前连续脑电图的使用推动了非惊厥性癫痫持续状态的早期识别,并提出了治疗的分步方法。笔者总结了神经重症监护病房中非惊厥性癫痫持续状态早期预防及当前的治疗进展,并概述了进一步研究的领域。     

Immunoglobulins, cognitive status and duration of illness in alzheimer''s disease

Immunologic changes have been reported in the dementing illnesses of mid and late life. The results of two studies of drug-free males meeting research diagnostic criteria for primary neuronal degeneration of the Alzheimer's type suggest that serum IgG levels decrease with the progression of dementia. Serum IgG levels were inversely correlated with duration of illness and the levels of psychiatric symptomatology. Performance on the mini-mental status examination was positively associated with serum IgG concentrations.     

Measurement of functional ability and health status in the arthritic patient

Chronic arthritis may have great impact on the patient but also on his or her family, relatives and friends. The assessment of the consequences of chronic arthritis and the effect of therapy not only in terms of physical, but also psychological and social dimensions deserves more attention. Functional ability and health status can be measured using a questionnaire or ‘instrument’, high-lighting important aspects not quantified with more traditional measurements. In this paper, arguments to apply such instruments more frequently are given. Health status instruments can be used not only to assess beneficial but also deleterious (side-)effects of therapeutic interventions. The properties are summarized of the most frequently used instruments assessing functional ability and health status. Many of these instruments have been evaluated sufficiently for validity and reliability; their sensitivity to detect change seems to be satisfactory. Therefore it is advisable to choose an internationally accepted, frequently used instrument, reflecting the area of interest.