品管圈活动在喜疗妥联合新鲜马铃薯外敷治疗小儿输液外渗中的应用效果分析

目的探讨品管圈活动在喜疗妥联合新鲜马铃薯外敷治疗小儿输液外渗中的应用效果。方法选取我院2016年8月至2018年12月收治的输液外渗患儿100例,随机分为两组各50例。对照组给予50%硫酸镁湿敷治疗与常规护理,干预组采用喜疗妥联合新鲜马铃薯外敷,进行品管圈活动。对比两组的临床疗效、损伤痊愈时间和完全消肿时间。结果干预组的总有效率为90.00%,高于对照组的74.00%(P <0.05)。干预组的损伤痊愈时间和完全消肿时间短于对照组(P <0.05)。结论品管圈活动在喜疗妥联合新鲜马铃薯外敷治疗小儿输液外渗中的效果较好,可缩短临床症状消失时间,加快康复进程。     

Investigation of the mechanisms of Genkwa Flos hepatotoxicity by a cell metabolomics strategy combined with serum pharmacology in HL-7702 liver cells

1. To investigate Genkwa Flos hepatotoxicity, a cell metabolomics strategy combined with serum pharmacology was performed on human HL-7702 liver cells in this study.

2. Firstly, cell viability and biochemical indicators were determined and the cell morphology was observed to confirm the cell injury and develop a cell hepatotoxicity model. Then, with the help of cell metabolomics based on UPLC-MS, the Genkwa Flos group samples were completely separated from the blank group samples in the score plots and seven upregulated as well as two down-regulated putative biomarkers in the loading plot were identified and confirmed. Besides, two signal molecules and four enzymes involved in biosynthesis pathway of lysophosphatidylcholine and the sphingosine kinase/sphingosine-1-phosphate pathway were determined to investigate the relationship between Genkwa Flos hepatotoxicity and these two classic pathways. Finally, the metabolic pathways related to specific biomarkers and two classic metabolic pathways were analyzed to explain the possible mechanism of Genkwa Flos hepatotoxicity.

3. Based on the results, lipid peroxidation and oxidative stress, phospholipase A₂/lysophosphatidylcholine pathway, the disturbance of sphingosine-1-phosphate metabolic profile centered on sphingosine kinase/sphingosine-1-phosphate pathway and fatty acid metabolism might be critical participators in the progression of liver injury induced by Genkwa Flos.     

2019年重庆市30岁及以上人群归因于被动吸烟的肺癌疾病负担研究

目的 分析重庆市肺癌发病死亡和疾病负担归因于被动吸烟的情况,为开展肺癌防治提供建议。 方法 肺癌死亡个案数据来源于2019年重庆市肿瘤登记报告系统,被动吸烟率来自2013年重庆市慢性病及危险因素监测。计算人群归因危险度百分比(population attributable risk percent, PAR%)、被动吸烟导致的肺癌发病、死亡和疾病负担。采用Excel 2010与SPSS 25.0进行统计分析,率的比较采用χ²检验。 结果 2013年30岁及以上成年人被动吸烟率为52.37%。2019年重庆市30岁及以上人群肺癌发病率与标化发病率分别为118.44/10万与80.83/10万,死亡率与标化死亡率分别为96.51/10万、63.58/10万。肺癌发病率和死亡率归因于被动吸烟的PAR%分别为19.76和19.04,归因发病率与归因标化发病率分别为23.41/10万和16.34/10万,归因死亡率与归因标化死亡率分别为18.38/10万和12.40/10万。2019年重庆市30岁及以上肺癌早死所致寿命损失年率(years of life lost,YLL)、残疾所致寿命损失年率(years lived with disability,YLD)、调整伤残寿命损失年率(disability adjusted life year,DALY)分别为21.16‰、0.31‰、21.47‰,YLL率、YLD率、DALY率归因于被动吸烟的PAR%分别为21.16、19.76和20.49,归因YLL率为4.34‰,归因YLD率为0.06‰,归因DALY率为4.40‰。 结论 2019年重庆市30岁及以上人群肺癌发病率、死亡率、YLL率、DALY率高,被动吸烟率高,肺癌归因于被动吸烟的疾病负担重,应加强落实控烟工作。     

完全型雄激素不敏感综合征2例临床特点及处理

雄激素不敏感综合征(androgen insensitivity syndrome,AIS)又称为睾丸女性化综合征(testicular feminization syndrome,TFS),是一种X连锁遗传病,是男性假两性畸形中较常见的类型,可分为完全型AIS和不完全型AIS,其原因主要是雄激素受体(androgen receptor,AR)基因的突变导致其对雄激素产生抵抗和不应答。本文回顾南京医科大学附属妇产医院2例CAIS患者的临床资料及诊疗过程,以期能进一步提高对该病的认知及诊治水平。     

Delivery during extracorporeal membrane oxygenation (ECMO) support of pregnant woman with severe respiratory distress syndrome caused by influenza: a case report and review of the literature

Objective: To report a case of labour induction during extracorporeal membrane oxygenation (ECMO) support in a patient with acute respiratory distress syndrome (ARDS) caused by influenza and review of the literature.

Methods: Case report and the literature search of all English articles on delivery while on ECMO in patients with ARDS caused by influenza.

Results: A 25-year-old pregnant woman was initiated with ECMO due to severe ARDS caused by influenza A (H1N1) virus. When the patient had symptoms of colporrhagia and uterine contractions, the medical team decided to start labour induction while on ECMO. There were in total five case reports identified. Maternal oxygenation was improved after delivery and ECMO was successfully discontinued.

Conclusions: Maternal oxygenation was improved after delivery, which may be beneficial to reduce the duration of ECMO. Caesarean section (CS) may be the most used mode and labour induction could be another option. The procedure should be performed by an experienced ECMO team, cooperating with the obstetrician, anaesthesiologist, and ICU doctors.     

不同强度运动对大鼠心脏降钙素基因相关肽的影响

目的:探讨不同强度运动训练对降钙素基因相关肽(CGRP)在心脏组织中表达的影响及其作用机制。方法:将60只SD大鼠随机分为对照组(C组)、小强度运动组(LE组)、中等强度运动组(ME组)和大强度运动组(HE组),每组15只。建立8周不同强度运动训练动物模型,采用免疫组织化学法和计算机图像分析技术,对大鼠心脏形态结构进行观察,并进行心脏CGRP免疫组化分析。结果:8周小强度运动后,大鼠心脏CGRP表达较对照组变化不明显;8周中等强度运动后,大鼠心脏CGRP表达较对照组显著增加(P<0.05),HE染色、HBFP染色和变色酸2R亮绿染色显示心肌组织形态结构无明显改变,仅心肌纤维有轻度缺血缺氧改变;8周大强度运动后,大鼠心脏CGRP表达较对照组显著减少(P<0.05),HE染色、HBFP染色和变色酸2R亮绿染色显示心肌形态结构发生改变并存在明显的缺血缺氧损伤。结果表明,长期中等强度运动使心脏CGRP表达增加,改善了冠状循环和心肌血液供应,对心肌细胞具有保护作用;长期大强度运动使心脏CGRP对心肌细胞的保护作用减弱,可能是导致心肌发生缺血缺氧性损伤的重要原因之一。     

微板紫外速率法漏检高值ALT标本一例

谷丙氨基转移酶（Alanine asninotrasferase，ALT）检测是采供血机构血液必检项目之一，ALT检测作为早期肝病诊断的一项非特异性指标，有助于鉴别与输血相关肝炎病毒携带者，同时可以在一定程度上弥补某些肝炎病毒标志物未被检测及“窗口期”的缺陷，有助于预防输血相关肝炎的传播。我血站实验室采用微板为载体的方法进行血清ALT检测：微板紫外速率法为初检方法；微板丙酮酸氧化酶法为复检方法。在检测过程中一例高值ALT血样，微板紫外速率法检测结果为6．6U／L，出现假阴性结果造成漏检，现报告如下：     

一种防脱出易制作义眼台的研制

目的探讨一种新型简易防脱出的义眼台的制作方法与效果。方法根据眼球摘除后的解剖特点设计义眼台大小,选择聚甲基丙烯酸甲酯和涤纶布为材料制作复合材料义眼台,并对6只家兔行眼球摘除后置入义眼台,经HE染色观察及肉眼观察术后不同时间置入物与眼周围组织的解剖关系。结果聚甲基丙烯酸甲酯部分与组织无黏连,涤纶布形成牢固黏连,周围有纤维组织长入并包绕,义眼台无脱出、移位。结论以聚甲基丙烯酸甲酯和涤纶布为材料制作复合义眼台,方法简易,效果可靠,组织相容性好,术后反应轻,值得在临床上推广使用。     

内镜辅助方型脸改型术

目的探讨内镜在方型脸改型术中的临床应用效果。方法采用口内入路，在内镜辅助下，用高速涡轮气钻截除肥大下颌角、切除部分咬肌和颊脂垫，进行方型脸的面部改型。结果本组共38例，其中男3例，女35例，年龄21～40岁。内镜完全可以清楚显示下颌升支、下颌角、下颌体下缘，视野清晰。使用高速涡轮气钻截除肥大下颌角可以更加精确和容易，且创伤小，出血少，手术时间短，感染风险低。下面部轮廓改善满意。结论内镜辅助方型脸改型术，有助于获得良好的手术效果。