对代谢综合征病人疾病的认知程度及治疗依从性的调查

代谢综合征(metabolic syndrome,MS)是包括多种代谢紊乱的一组病理综合征。这些代谢紊乱之间具有密切而复杂的相互关系,是造成包括高血压病、糖尿病、心脑血管疾病在内的一组疾病的基础。MS患病率在世界范围内正以极快的速度增长,预防和治疗MS相关疾病的发生和发展,是目前备受关注的重大社会卫生问题[1]。笔者对119例MS病人进行MS认知程度的调查,分析影响MS病人治疗依从性的因素。1对象和方法1.1对象2003年6月—2005年6月我院内分泌科住院和门诊MS病人119例,均符合中华糖尿病学分会CDS(2004)MS诊断标准[2]。所有病人思维清晰,语言表…     

医院感染现患率调查结果与分析

目的:了解医院感染的现状,评价日常监测资料的准确性,为制定防控措施提供科学依据。方法:采用床旁调查和在架病历调查相结合的方法,填写统一个案调查表,对2005年4月28日的住院病人进行医院感染现患率调查。结果:医院感染现患率为6.9%,例次现患率为7.5%;现患率以综合ICU最高,占为44.4%;感染部位以呼吸道感染居首位,占48.6%;抗菌药物使用率为61.2%;医院感染的高危因素是动静脉插管、使用呼吸机、气管切开和基础诊断≥3种;分离的病原体以G-菌占优势,占52.2%。结论:进行医院感染现患率调查便于及时发现医院感染管理中存在的问题,应加强防范措施。     

县级医院护士伦理道德素质调查

近年来，对护理伦理学的研究已日渐增多，护理伦理学已列入护理的正规教程，但时于基层医院护理队伍伦理道德素质状况的研究甚少，县级医院面对的是占中国80％的农村和城镇居民，其服务对象不同于大医院，也不同于村、镇卫生院。基于上述原因，本问卷调查目的在于丁解县级医院护理队伍伦理道德素质教育的状况。以及护士所面对的冲突和困难，以加强和改善护理队伍的素质建设，提高护理工作质量。     

膀胱癌变过程中PCNA表达的研究

为了解膀胱癌变过程中细胞增殖状态及其与肿瘤生物学行为、复发的关系，作者采用免疫组化方法检测了正常上皮、增生上皮、乳头状瘤和癌组织中的增殖细胞核抗原表达。增殖细胞核抗原指数在四种组织中呈增高趋势，并且与肿瘤病理分级、分期密切相关，但与肿瘤大小、数目无相关。复发者的增殖细胞核抗原指数显著高于无复发者。结果提示，膀胱癌变过程中细胞增殖能力不断增强，增殖细胞核抗原指数可以作为肿瘤生物学行为、判断肿瘤复发的一项有价值的标记物。     

腹腔镜手术在老年女性妇科疾病中的应用价值

目的探讨腹腔镜手术在老年女性妇科手术中的安全性和应用价值。方法1998年5月-2003年5月，回顾性分析124例妇科疾病患者的临床资料(老年腹腔镜手术一组41例，非老年腹腔镜手术治疗组48例，老年经腹手术治疗组35例)。结果老年患者恶性肿瘤发病率明显高于非老年组(x^2=4．750，P=0．029)，经腹手术组的卵巢，输卵管恶性肿瘤患者多于腹腔镜手术组(x^2=14．302，P=0．01)，老年组待手术日明显长于非老年组(t=49．791，P=0．001)，附件手术腹腔镜组术中出血明显少于经腹手术组(t=11．430，P=0．006)，腹腔镜组肠功能恢复短于经腹手术组(t=8．79，P=0．001)。结论腹腔镜手术治疗老年妇科疾病的患者是安全、有效的。     

门诊患者医疗投诉原因与分析及防范措施

本文收集了2003～2004年在北京大学深圳医院门诊办公室214例投诉,分析了投诉产生的原因,并提出现阶段医院的防范措施:转变观念,变被动服务为主动服务;加强医德医风教育,树立“以病人为中心”的医院文化;门诊就诊流程再造,简化就诊程序;增加便民服务措施,方便患者就诊;建立“门诊质量监控体系”;成立“门诊疑难病会诊中心”;提高门诊工作地位,完善门诊管理模式。     

Inhibited interleukin 35 expression and interleukin 35–induced regulatory T cells promote type II innate lymphoid cell response in allergic rhinitis

BackgroundInterleukin (IL)-35 and IL-35–producing regulatory T cells (iTr35) have been reported to inhibit T_H2 response in allergic rhinitis (AR). However, its effects on type II innate lymphoid cells (ILC2) are not well characterized.ObjectiveTo investigate the effect of IL-35 on ILC2 in AR.MethodsA total of 25 patients with AR and 20 controls were recruited. The expression and regulation of IL-35 receptor in ILC2 were analyzed by real-time polymerase chain reaction. The effect of IL-35 on ILC2 differentiation and cytokine production was analyzed by real-time polymerase chain reaction and enzyme-linked immunosorbent assay. In addition, iTr35 were cocultured with ILC2 to explore the effect of iTr35 on ILC2. The AR mice models were also established to confirm the role of IL-35 in vivo.ResultsThe patients with AR had decreased IL-35 expression and iTr35 proportion and increased ILC2 and type II cytokines compared with the controls. Notably, IL-35 inhibited ILC2 differentiation and type II cytokine production by regulating IL-12Rβ2 and gp130. IL-35 promoted the inducible costimulatory molecule expression by iTr35 and the inducible costimulatory molecule ligand expression by ILC2. IL-35–treated mice with AR presented decreased frequency and function of nasal ILC2.ConclusionIL-35 inhibited ILC2 responses directly or through mutual contact between iTr35 and ILC2 in AR, suggesting that IL-35 may be used as a potential treatment target in AR.     

甲状腺腺叶切除术精细化操作技术临床结果初步报告

目的 回顾总结集程序化、精细化操作与质控为一体的甲状腺腺叶切除术外科模式在甲状腺全切除术中临床应用结果.方法 2013年5月至2014年8月应用该外科模式实施甲状腺全切除72例,按程序化的设计和步骤进行精细化操作完成手术,对手术切口、手术时间、术中出血量、术中重要结构保护、切口愈合、术后并发症、患者满意度情况进行总结.结果 颈部第二皮纹切口更符合患者立位的社会属性;一侧腺叶手术时间30 ～ 50 min;出血约2～5 ml;无喉上神经损伤,出现暂时性喉返神经麻痹4侧,术后3～4周均自行恢复;暂时性甲状旁腺功能减退10例,术后4～6周自行恢复;切口均一期愈合;手术切口非常满意66例,满意4例,可接受2例.结论 集程序化、精细化操作与质控为一体的甲状腺腺叶切除外科模式对甲状腺手术的实施是一种良好的外科模式,对标准化流程的建立、质控和临床教学均有积极的推动作用.     

Functional giant parathyroid cyst with high concentration of CA19-9 in cystic fluid

A 63-year-old man was admitted to our hospital for the evaluation of hypercalcemia and anterior neck mass. Laboratory findings revealed hypercalcemia, hypophosphatemia, and hypercalciuria, as well as elevated serum levels of parathyroid hormone (PTH) and alkaline phosphatase. Computerized tomography and magnetic resonance images showed that the mass contained a cystic area. Parathyroid scintigraphy using either 99mTc-sestamibi alone or 201Tl-chloride in conjunction with 99mTc-pertechnetate for thyroid image subtraction showed uptake of the radioactivity into the cyst wall, suggesting that the mass originated from the parathyroid. Fine needle aspiration biopsy revealed that the cyst fluid was serous and bloody with extremely high concentrations of both PTH and CA19-9. The patient was diagnosed as primary hyperparathyroidism caused by parathyroid cyst and cervical exploration was performed. The cyst was dissected away along with the right lobe of the thyroid gland. After tumor removal, serum calcium and PTH levels were normalized. Histological study showed that the tumor possessed malignant potential with capsular invasion as well as moderate cellular atypia with trabecular pattern in arrangement. Parathyroid cells in the wall of the cystic tumor were immunostained positively for CA19-9, suggesting that CA19-9 in the cyst fluid was produced from the cells.     

Extracts from rabbit skin inflamed by the vaccinia virus attenuate bupivacaine-induced spinal neurotoxicity in pregnant rats

Extracts from rabbit skin inflamed by the vaccinia virus can relieve pain and promote repair of nerve injury. The present study intraperitoneally injected extracts from rabbit skin inflamed by the vaccinia virus for 3 and 4 days prior to and following intrathecal injection of bupivacaine into pregnant rats. The pain threshold test after bupivacaine injection showed that the maximum possible effect of tail-flick latency peaked 1 day after intrathecal injection of bupivacaine in the extract-pretreatment group, and gradually decreased, while the maximum possible effect in the bupivacaine group continued to increase after intrathecal injection of bupivacaine. Histological observation showed that after 4 days of intrathecal injection of bupivacaine, the number of shrunken, vacuolated, apoptotic and caspase-9-positive cells in the dorsal root ganglion in the extract-pretreatment group was significantly reduced compared with the bupivacaine group. These findings indicate that extracts from rabbit skin inflamed by the vaccinia virus can attenuate neurotoxicity induced by intrathecal injection of bupivacaine in pregnant rats, possibly by inhibiting caspase-9 protein expression and suppressing nerve cell apoptosis.