双球囊导管用于瘢痕子宫足月引产的临床观察

目的 探讨瘢痕子宫使用双球囊导管促宫颈成熟及引产后阴道分娩的安全性和有效性.方法 以2016年1月—2018年7月本院收治有阴道分娩条件和意愿的59例宫颈未成熟的足月瘢痕子宫作为研究组,以同期分娩的67例足月非瘢痕子宫宫颈未成熟的为对照组,两组均使用双球囊导管促宫颈成熟及引产,比较两组的母婴结局.结果 研究组孕产妇的年...     

双波长HPLC同时测定羚羊清肺散中4种有效成分的含量

目的:建立以高效液相色谱法同时测定羚羊清肺散中绿原酸、栀子苷、芍药苷和甘草苷的含量的方法。方法:采用双波长HPLC法,Kromasil C18色谱柱(4.6 mm×250 mm,5μm),流动相乙腈-0.1%磷酸水梯度洗脱,流速1.0 m L·min-1,检测波长327 nm(绿原酸),237 nm(栀子苷、芍药苷、甘草苷)。结果:绿原酸、栀子苷、芍药苷和甘草苷4种成分进样量分别在1.579~78.96μg(r=0.999 8),1.261~63.04μg(r=1),0.364~18.2μg(r=0.999 9),0.329 6~16.48μg(r=0.999 9)与峰面积线性关系良好;平均回收率分别为97.6%,97.6%,97.1%和99.8%,RSD分别为1.0%,0.7%,1.2%和1.3%。结论:该方法简便、快速、准确,可用于羚羊清肺散的质量控制。     

Effectiveness of a new triple-row circular stapler in reducing the risk of colorectal anastomotic leakage: A historical control and propensity score–matched study

Anastomotic leakage (AL) after colorectal surgery is a serious complication. This study aimed to evaluate the effectiveness of the EEA™ circular stapler, a new triple-row circular stapler (TCS), relative to a conventional, double-row circular stapler (DCS).A total of 285 patients who underwent anastomosis with the double stapling technique at the Tokyo Medical University Hospital between 2017 and 2021 were included in this nonrandomized clinical trial with historical controls using a propensity score (PS) analysis. The primary endpoint was the risk of AL.We performed a 1:2 PS matching analysis. Before case matching, AL occurred in 15 (7.4%) and 2 (2.4%) patients in the DCS and TCS groups, respectively, with no significant difference (P = .17). After case matching, AL occurred in 13 patients (11.6%) and 1 patient (1.8%) in the DCS and TCS groups, respectively, revealing a significant difference (P = .04). Cox models were created by applying PS to adjust for group differences via regression adjustment. Odds ratios for AL in the DCS group versus the TCS group were 0.31 (95% confidence interval [CI]: 0.07–1.38) in the entire cohort, 0.15 (95% CI: 0.02–0.64) in the regression adjustment cohort, and 0.14 (95% CI: 0.02–1.09) in the 1:2 PS-matched cohort.PS analysis of clinical data suggested that the use of TCS contributes to a reduced risk of AL after colorectal anastomosis CTwith the double stapling technique.     

Optimization of the Growth Process of Double Perovskite Pr2−δNi1−xMn1+xO6−y Epitaxial Thin Films by RF Sputtering

Epitaxial thin films of Pr_2−δNi_1−xMn_1+xO_6−y (PNMO) double perovskite were grown on (001)-oriented SrTiO₃ substrates by RF magnetron sputtering. The influence of the growth parameters (oxygen pressure, substrate temperature, and annealing treatments) on the structural, magnetic and transport properties, and stoichiometry of the films was thoroughly investigated. It is found that high-quality epitaxial, insulating, and ferromagnetic PNMO thin films can only be obtained in a narrow deposition parameter window. It is shown that a careful selection of the growth conditions allows for obtaining a high degree of Ni/Mn cation ordering, which is reflected in the values of the Curie temperature, T_C, and saturation magnetization, M_S, which are very close to those of bulk material.     

1例重症Goodpasture病的诊治

作者报道了１例重症Ｇｏｏｄｐａｓｔｕｒｅ病患者。患者入院时血肌酐近１３００μｍｏｌ／Ｌ，肾活检发现新月体占肾小球总数的９１．７％。经过双重血浆滤过、甲基强的松龙和环磷酚胺冲击等强化、综合治疗，患者肺出血停止，血清抗肾小球基底膜抗体转阴，但肾功能及重复肾活检病理均无改善。     

药学类本科毕业实践环节推行校企双导师制模式探讨

文章通过分析传统药学毕业实践环节存在的各种弊端，提出在毕业环节中实行校企双导师制模式。文中还阐述了该模式的几个优点。通过对校企双导师制的探讨，文章认为在药学类毕业环节中实行校企双导师制是非常有必要的和非常可行的。     

Percutaneous stenting for malignant biliary stenosis

Summary Percutaneous stenting for malignant biliary stenosis is quite beneficial to patients with unresectable or recurrent disease, tremendously improving the quality of their lives. Percutaneous transhepatic biliary drainage (PTBD) was attempted in 92 patients with obstructive jaundice during the period between January 1986 and July 1989. Implantation of an endoprosthesis was performed in 14 cases (15.2%) and succeeded in 12 (85.7%). When a guide wire could not be passed distally across the stricture site, percutaneous transhepatic cholangioscopy (PTCS) through the dilated PTBD fistula was carried out to enable its passage. PTCS is also valuable in the preoperative diagnosis of obstructive jaundice. The patients who are not candidates for surgery are suitable for this procedure. A Miller double-mushroom stent is used as the endoprosthesis in the majority of cases. One patient with recurrent hepatoma has lived at home with this stent for >3 years due to repeated transarterial embolization and chemotherapy and does not need to wash or change the stent.     

双重血浆滤过治疗脂蛋白肾病的护理

目的探讨双重血浆滤过(DFPP)治疗脂蛋白肾病(LPG)的临床护理要点。方法选择LPG患者12例行DFPP治疗,共治疗53例次,并对患者实施以保证治疗安全、提高治疗效果为目的整体护理。结果所有患者均顺利完成治疗,经治疗后免疫学指标均明显下降,无1例发生低血压、导管感染、溶血、过敏等并发症。结论 DFPP治疗LPG效果显著,优质的专科护理技术是保证治疗安全有效完成的关键。     

Antisynthetase syndrome with refractory lung involvement and myositis successfully treated with double filtration plasmapheresis

Antisynthetase syndrome (ASS) is characterized by inflammatory muscle disease, pulmonary and joint involvement, and antisynthetase autoantibodies, with anti‐Jo‐1 antibody being the most common. Despite the use of immunosuppressive drugs, the prognosis of lung involvement seems poor. Herein, we report a case of refractory ASS, which maintained long‐term remission by double filtration plasmapheresis (DFPP) combined with immunosuppressive therapy. For a 65‐year‐old woman, who was diagnosed with ASS, immunosuppressive therapy was initiated and plasmapheresis (PP) was performed five times due to acute interstitial pulmonary disease and inflammatory myopathy. She remained in remission for eight months following PP. Increase in interstitial involvement was identified by lung tomography when the patient presented again with complaint of progressive increase in dyspnea and muscle pain. Although the immunosuppressive therapy was increased for the patient with elevated creatine phosphokinase (CPK) (2776 IU/mL), a rapid decrease in diffusion capacity of the lung for carbon monoxide (DLCO) was observed and the patient underwent PP. After four sessions of therapy, insufficient clinical and laboratory response was obtained (control CPK 1797 IU/mL) and because of that issue DFPP using a 2A filter was performed to the patient. There was a marked improvement in complaints of the patient, DLCO, and laboratory findings (control CPK 508 IU/mL) after three sessions of DFPP. The patient, who continued the immunosuppressive therapy after DFPP procedure, is being followed for 12 months in remission. Although our experience is limited with only one patient, DFPP seems promising as a treatment option for ASS with severe lung involvement. J. Clin. Apheresis, 28:422–425, 2013. © 2013 Wiley Periodicals, Inc.