利妥昔单抗治疗难治性激素耐药型肾病综合征的疗效和安全性

目的:探讨利妥昔单抗(RTX)治疗儿童难治性激素耐药型肾病综合征(SRNS)的疗效和安全性。方法:回顾性分析2013年9月至2018年3月东部战区总医院儿科收治并接受RTX治疗的10例难治性SRNS患儿的临床资料。结果:10例患儿发病年龄(4.47±2.75)岁,男女各5例;5例(50%)肾活检为局灶节段性肾小球肾炎,...     

Experiment and Theoretical Investigation on Fatigue Life Prediction of Fracturing Pumpheads Based on a Novel Stress-Field Intensity Approach

Fracturing pumpheads are typical pressure vessels that experience frequent fatigue failure under the effect of notches in their cross-bore. To enhance the fatigue life of fracturing pumpheads, the study of the notch effect is indispensable and important to establish a reliable mathematical model to predict their fatigue life. In the present paper, two novel fatigue life prediction models are proposed for notched specimens. In these models, two new geometric fatigue failure regions are defined to improve the weight function. Finally, the elaborated novel stress-field intensity approach was applied to three different types of notched specimens. Experiment results indicate that the new SFI approach achieves 47.82%, 39.48%, and 31.85% higher prediction accuracy than the traditional SFI approach, respectively. It was found that the modified SFI approach provided better predictions than the traditional SFI approach and the TCD method. The II-th novel SFI approach had the highest accuracy, and the I-th novel SFI approach was more suitable for sharply notched specimens.     

Two-dimensional aluminum phosphide semiconductor with tunable direct band gap for nanoelectric applications

More and more attractive applications of two-dimensional (2D) materials in nanoelectronic devices are being achieved successfully, which promotes the rapid and extensive development of new 2D materials. In this work, the structural and electronic properties of the V structure aluminum phosphide (V-AlP) monolayer are examined by density functional calculations, and its electronic properties under strain and an electric field are also explored in detail. The computation results indicate that it has good stability. Interestingly, it possesses a wide direct gap (2.6 eV), and its band gap exhibits a rich behavior depending on the strain, E-field and layer stacking. Under biaxial strain, its band gap can be tuned from 1 eV to 2.6 eV. And a direct-indirect band gap transition is found when external tension is applied. The V-AlP monolayer also exhibits anisotropic behavior as its band structure variation trends under strains along different directions are obviously different. When the external E-field is changed from 0.5 V Å⁻¹ to 1 V Å⁻¹, the band gap of the V-AlP monolayer can be tuned linearly from 0 eV to 2.6 eV. Layer stacking narrows the band gap of the 2D V-AlP material. It is concluded that strain, E-field and layer stacking can all be used effectively to modify the electronic property of the V-AlP monolayer. Thus, these results indicate that the V-AlP monolayer will have promising applications in nanoelectric devices.

More and more attractive applications of two-dimensional (2D) materials in nanoelectronic devices are being achieved successfully, which promotes the rapid and extensive development of new 2D materials.     

Henoch-Schönlein Purpura Nephritis and Cerebral Venous Sinus Thrombosis Due to Hereditary Deficiency of Antithrombin III

Indian Journal of Pediatrics -     

米索前列醇不同给药方式在无痛人工流产中的应用

目的探讨米索前列醇不同给药途径在无痛人工流产中的效果。方法将150例无阴道分娩史要求无痛人工流产的患者随机分为A、B、C3组,A组50例予米索前列醇600μg口服,B组50例给米索前列醇200μg阴道后穹窿内置入,C组50例术前未用任何药物,手术时采用丙泊酚和芬太尼静脉麻醉。结果用药后A、B两组宫颈扩张,有效分别是96.0%、88.0%明显高于C组4.0%,A、B两组手术时间较C组短。结论无痛人工流产术前应用米索前列醇可获得有效的宫颈扩张效果,缩短手术时间,减少出血量,提高手术安全性。     

健康教育结合随访对骨质疏松症腰背疼痛患者自我管理行为的影响

目的探讨健康教育结合随访对骨质疏松症腰背疼痛患者自我管理行为的影响。方法将原发性骨质疏松症腰背疼痛患者96例,按入院序号随机分为试验组和对照组各48例,两组患者常规治疗,护理相同。对照组患者出院后电话随访1次。试验组在此基础上实施系统、规范的健康教育,出院后每周电话随访1次。比较两组患者出院时知识掌握情况、出院后1个月、2个月自我管理行为及治疗效果。结果试验组患者骨质疏松症知识掌握优良率为93.75%,出院后1个月、2个月遵医行为明显优于对照组,治疗后1个月、2个月VAS评分均低于与对照组,三者比较,差异均有统计学意义（均P〈0.05）。结论实施系统、规范的健康教育及电话随访,不仅提高质疏松症腰背疼痛患者对疾病相关知识的认知程度,遵医行为及治疗效果也明显到提高,从而改善腰背疼痛,减少并发症的发生,促进疾病康复,提高骨质疏松症患者的生活质量。     

会阴侧切术不使用抗生素的临床效果观察

目的探讨正常分娩行会阴侧切术助产的产妇围术期不使用抗生素的可行性。方法抽取2011年10月～2013年1月288例正常分娩行会阴侧切术助产的产妇资料,随机分为两组,对照组使用抗生素治疗,实验组不用抗生素治疗,比较两组患者切口愈合率、切口感染率、产褥病率、切口疼痛程度、术后总住院费用。结果两组患者的切口愈合率、切口感染率、产褥病率、切口疼痛程度几项指标的差异均无统计学意义,而术后总住院费用实验组明显低于对照组,差异有统计学意义。结论自然分娩会阴侧切是否使用抗生素对伤口的愈合并未起到明显影响,除个别特殊情况外,均无需使用抗生素。     

流动采血车消毒灭菌效果监测分析及对策

目的 通过对流动采血车消毒灭菌效果监测和检查,能及时发现问题、分析原因并提出改进措施,以加强对流动采血车消毒灭菌的管理.方法 对流动采血车的消毒灭菌进行定期微生物监测和不定期现场抽查.结果 实施定期微生物监测与不定期现场抽查,使消毒灭菌效果明显提高.结论 流动采血车消毒灭菌管理意识存在薄弱环节,只有加强对流动采血车消毒灭菌管理才能有效地预防院内感染的发生,对提高血液质量,确保患者输血安全具有重要的意义.     

如何降低社会因素的剖宫产率

目的 探讨如何降低社会因素的剖宫产率。方法 对本院3年来的剖宫率变化及其主要并发症新生儿窒息和产后出血进行了回顾性分析。结果 剖宫产率逐年上升,社会因素剖宫产率占有较高的比例,上升速度迅速,年间比较差异有统计学意义（P〈0．01）,所发生的新生儿窒息率无明显下降,产后出血却相应增加,2003年和2001年比较差异有统计学意义（P〈0．05）,给许多孕产妇造成了一定程度的医源性痛苦。结论 控制社会因素的剖宫产率迫在眉睫,呼吁全社会关注,医患双方共同努力,将剖宫产率控制在一个合理的范围内。     

孕康口服液对化学损伤联合米非司酮致气血两虚型流产模型大鼠的保胎作用研究

目的 探究孕康口服液对限饲联合乙酰苯肼、环磷酰胺及米非司酮致气血两虚型流产模型大鼠的保胎作用。方法 将妊娠大鼠随机分为正常对照组、模型对照组、黄体酮组及孕康口服液低、中、高剂量组(4,6,9 mL·kg^–1),每组12只。前9 d,一边造模一边给药。第10,11天,除正常对照组外,其余各组均灌胃米非司酮。给药期间检测自主活动、肛温、体质量,血液分析仪检测红细胞数(red blood cells,RBC)、血红蛋白数(hemoglobin,HGB)、白细胞数(white blood cells,WBC)。第12天处死大鼠后解剖计算胚胎丢失率、子宫、卵巢、胸腺和肝脏系数,酶联免疫法检测血清中激素β-人绒毛膜促性腺激素(β-human chorionic gonadotropin,β-HCG)、孕酮(progesterone,P)、雌二醇(estradiol,E₂)水平及肿瘤坏死因子(tumor necrosis factor,TNF-α)、γ干扰素(γ levels of interferon,IFN-γ)、白细胞介素4(interleukin 4,IL-4)、白细胞介素10(interleukin 10,IL-10)的水平,免疫组化法检测子宫组织中孕激素受体(progesterone receptor,PR)及血管内皮生长因子(vascular endothelial growth factor,VEGF)表达。结果 与模型对照组比较,不同剂量孕康口服液组大鼠体质量、肛温、自主活动次数显著增加,血液中RBC、HGB和WBC数目增多,子宫、卵巢、胸腺和肝脏系数显著升高,血清中P、E₂、IL-4、IL-10水平显著增加(P<0.05或P<0.01),胚胎丢失率明显下降,血清中TNF-α、IFN-γ水平降低(P <0.05或P<0.01),子宫内膜的病变程度减轻,子宫组织PR和VEGF蛋白表达明显上调。结论 孕康口服液对乙酰苯肼+环磷酰胺+限饲联合米非司酮造成气血两虚型流产模型大鼠具有明显的保胎作用。