胰岛素强化治疗在2型糖尿病骨折患者围手术期的应用

Objective To investigate the best way to control the blood sugar level during the perioperation of bone fracture patients with type 2 diabetes(T2DM).Methods Bone fracture patients with T2DM were randomly divided into three groups:continuous subcutaneous insulin infusion group(insulin aspart,group CSII,n=20),glargine treatment group(insulin aspart+insulin glargine,group GA,n=20),and NPH treatment(insulin aspart+rh-insulin,group NA,n=20).The levels of fasting plasma glucose(FPG)and the 2 hours postprandial glucose(2h PG),blood glucose fluctuation(BGF),insulin dosage(ID),good effective time(GET),incidence of hypoglycemia,dawn phenomenon and infection,average time of stitches removal(ATSR),average hospitalized length(AHL)of three groups were compared.Results FPG and 2hPG,ID in group CSII[(6.32±1.18)mmol/L,(7.72±1.53)mmol/L,(35.40±1.60)IU]and group GA [(6.25±0.88)mmol/L,(7.32±1.17)mmol/L,(36.20±0.80)IU]were significantly lower than those of group NA [(7.44±1.36)mmol/L,(8.52±0.76)mmol/L,(40.50±2.40)IU,all P<0.05],simulaneously,BGF,GET incidence of complications,ATSR,AHL of group CSII and GA were significantly lower than those of group NA(all P<0.05).There were not significant difference between group CSII and group GA.Compared with group CSII,group GA had less costs in-hospital and better practicability.Conclusion Both CSII and insulin glargine combined with insulin aspart can effectively,safely,rapidly and stablely control hyperglycemia.and might be the first choice to control blood sugar for bone fracture patients with T2DM in perioperation.     

人类免疫缺陷病毒包膜糖蛋白V3区对细胞结合能力的研究

目的：研究人类免疫缺陷病毒（ＨＩＶ）不同亲嗜株包膜糖蛋白Ｖ３区结合于靶细胞的能力。方法：合成来源于不同嗜性ＨＩＶ－１Ｖ３区的生物素标记和非标记的多肽。采用流式细胞计数分析生物素化的 Ｖ３多肽对细胞的结合能力以及细胞表面的结合配体。结果：ＨＩＶ－１Ｘ４　亲嗜株ＩＩＩＢＶ３区能结合于多种细胞的表面，包括辅助受体ＣＸＣＲ４；竞争实验结果显示蛋白酶抑制剂能抑制该结合。Ｒ５亲嗜株 ＡＤＡ Ｖ３区只极微弱地结合于外周血单核细胞和表达ＣＣＲ５ 的人星形胶质细胞表面。结论：不同嗜性ＨＩＶ－１Ｖ３区结合于细胞表面的能力不同从亲嗜株Ｖ３区直接结合于细胞表面并被其自身所增强，其靶分子至少包括辅助受体 ＣＸＣＲ４和蛋白酶分子；而Ｒ５亲嗜株 ＡＤＡ Ｖ３区则不结合于 ＣＣＲ５和蛋白酶。     

丹参注射液与异甘草酸镁抗肝纤维化的临床对比研究

Objective To observe the change of liver function and liver fibrosis indexes of the chronic hepatitis B patients that were treated by Danshen injection(DI) and magnesium isnglyeyrrhizinate(MI). Methods 80 chronic hepati-tis B patients based on the conventional treatment were randomly divided into D1 group(40 patients) and MI group(40 pa-tients). The two groups were used with DI and MI injection for 30 days respaetively and then,the levels of liver function and serum hepatic fibrosis(HA, LN, Ⅳ -C) were detected and compared before and after treatment. Results Treatment by DI and MI could both improve liver function significantly, the effect of Ml group was better than DI group(P < 0.05). Moreover, in improving serum hepatic fibrosis, the effect of DI group was better than MI group (P < 0.05). Conclusions The efficacy of the improvement to hepatic fibrosis DI is better than MI, while in improvement of liver function MI is superior to DI.     

B超引导下麦默通装置在乳腺微创外科中的应用

【目的】探讨B超引导下麦默通系统在乳腺微创外科中的应用价值。【方法】在B超引导下采用麦默通装置行微创旋切对36例乳腺肿瘤患者进行诊断及治疗。【结果】10例行穿刺活检,其中恶性4例,明确诊断后均行新辅助化疗。26例乳腺肿块均完整切除。术后1月B超随访无原病灶残留和复发,3例出现术后出血并发症．1～2个月后完全吸收。超声引导成功率100％。【结论】B超引导下麦默通乳腺微创旋切术是一种治疗乳腺肿瘤安全、合理、有效、符合美学观点的诊治方法。     

介入术后健康教育处方应用效果研究

目的探讨查介入术后健康教育处方的应用效果。方法将893例住院行介入手术治疗的患者分为两组：对照组采用传统方法进行健康教育;实验组使用介入术后健康教育处方,整理两组患者发生不安全隐患的例数。依据是否应用介入术后健康教育处方为患者实施健康教育将护理人员分为两组,评估两组护士健康教育知识掌握程度,计算同期合格率。结果实验组患者术后未发生不安全隐患,护士健康教育合格率提高（P〈0．01）。结论使用介入术后健康教育处方,能降低不安全隐患的发生,提高护士健康教育的准确性和合格率。     

某部密闭舱室军事作业环境和人员健康调查评价

目的 评价特殊军事作业人工环境影响因素特征及其对人员健康的影响,为进一步开展控制措施的研究提供依据.方法 采用电磁辐射场强仪、声级计、温湿度计、风速仪、一氧化碳检测仪和二氧化碳分析仪,分别对某部军事作业密闭环境的微波辐射、噪声、温度、湿度、风速、一氧化碳和二氧化碳进行监测分析;采用自觉症状问卷,调查评价作业人员健康...     

广防己致大鼠慢性肾小管-间质损伤的实验研究Ⅰ

目的:　观察广防己醇提取物(RAFE)急性以及不同剂量的RAFE对肾脏慢性毒性。方法:采用常规的急性毒性实验方法和用不同剂量的RAFE(2 5 . 0 ,12 .0 0 ,2 0 0. 0mg·kg^-1·d^-1)以及马兜铃总酸(10. 0mg·kg^-1·d^-1)给大鼠间断灌胃13周,分别于给药第4 ,8,13周留取血、尿和肾组织标本,检测相关肾功能和组织学变化。结果:RAFE的LD50 为36. 8g·kg^-1,LD50 95 %可信限为38 .8～2 .8 .9g·kg^-1;不同剂量的RAFE作用早期,大鼠肾功能改变为氮质血症、大量蛋白尿以及尿NAG酶升高。肾脏组织形态学:中、大剂量和总酸组给药早期主要表现以皮髓质交界为主的急性肾小管坏死,而后可见部分动物肾间质纤维化。结论:NAG可作为大鼠早期肾功能损伤的观测指标之一;RAFE中、大剂量间断灌胃13周均可导致大鼠肾小管功能损害。     

肠出血性大肠埃希菌O157∶H7环介导恒温扩增快速检测方法的建立与应用

目的肠出血性大肠埃希菌(Enterohemorrhagic Escherichia coli,EHEC)O157∶H7是一种重要的人畜共患病致病菌,主要通过被污染的食物传播,引起出血性结肠炎,建立其快速检测方法具有重要意义。方法基于EHEC O157∶H7保守的rfbE基因序列,设计4条引物,利用环介导等温扩增技术(loop-mediatedisothermal amplification,LAMP),成功建立了EHEC O157∶H7LAMP快速检测方法 ,60min内即可完成致病菌检测。结果利用该LAMP方法对30种共38株细菌进行检测,所试EHEC O157∶H7均为阳性结果 ,说明该方法具有高度特异性。本方法对纯培养的EHEC O157∶H7检测限为12CFU/mL,污染食品中EHEC O157∶H7的检测限为18CFU/g。实践应用表明,对1121份进出口肉类、奶类制品及人工污染样品等进行检测,检出57份LAMP阳性,与采用AOAC标准检测结果的符合率为100%。结论该LAMP方法操作简便、特异性强、灵敏度高,具有良好的实用性。     

胰岛素强化治疗在2型糖尿病骨折患者围手术期的应用

Objective To investigate the best way to control the blood sugar level during the perioperation of bone fracture patients with type 2 diabetes(T2DM).Methods Bone fracture patients with T2DM were randomly divided into three groups:continuous subcutaneous insulin infusion group(insulin aspart,group CSII,n=20),glargine treatment group(insulin aspart+insulin glargine,group GA,n=20),and NPH treatment(insulin aspart+rh-insulin,group NA,n=20).The levels of fasting plasma glucose(FPG)and the 2 hours postprandial glucose(2h PG),blood glucose fluctuation(BGF),insulin dosage(ID),good effective time(GET),incidence of hypoglycemia,dawn phenomenon and infection,average time of stitches removal(ATSR),average hospitalized length(AHL)of three groups were compared.Results FPG and 2hPG,ID in group CSII[(6.32±1.18)mmol/L,(7.72±1.53)mmol/L,(35.40±1.60)IU]and group GA [(6.25±0.88)mmol/L,(7.32±1.17)mmol/L,(36.20±0.80)IU]were significantly lower than those of group NA [(7.44±1.36)mmol/L,(8.52±0.76)mmol/L,(40.50±2.40)IU,all P<0.05],simulaneously,BGF,GET incidence of complications,ATSR,AHL of group CSII and GA were significantly lower than those of group NA(all P<0.05).There were not significant difference between group CSII and group GA.Compared with group CSII,group GA had less costs in-hospital and better practicability.Conclusion Both CSII and insulin glargine combined with insulin aspart can effectively,safely,rapidly and stablely control hyperglycemia.and might be the first choice to control blood sugar for bone fracture patients with T2DM in perioperation.     

A method to score radiographic change in psoriatic arthritis

INTRODUCTION: Radiographic features of psoriatic arthritis (PsA) are very characteristic and differ from those observed in rheumatoid arthritis, especially in two aspects: 1) the distribution of affected joints (i.e. DIP joints), 2) the presence of destructive changes and bone proliferation at the same time. A scoring method for PsA, therefore, has to account for these characteristics of PsA. OBJECTIVE: To develop, describe and validate a method for scoring radiographic changes in patients with PsA. DESCRIPTION OF THE METHOD: Forty joints of the hands and feet are scored for destruction and proliferation. In the destruction score (DS) grading on a 0-5 scale is based on the amount of joint surface destruction: 0 = normal, 1 = one or more erosions with an interruption of the cortical plate of > 1 mm with destruction of the total joint surface up to 10%, 2 = 11-25%, 3 = 26-50%, 4 = 51-75%, 5 = > 75% joint surface destruction. The proliferation score (PS) sums up any kind of bony proliferation typical for PsA; graded 0-4: 0 = normal, 1 = bony proliferation of 1-2 mm or bone growth < 25% of the original size (diameter), 2 = bony proliferation 2-3 mm or bone growth 25-50%, 3 = bony proliferation > 3 mm or bone growth > 50%, 4 = bony ankylosis. The DS (0-200) and the PS (0-160) can be summed up to the total score (0-360). VALIDATION OF THE METHOD: To validate the method x-rays of 20 patients with active PsA taken 3 years apart were read twice in pairs, knowing the chronological order but not knowing demographic, clinical or laboratory data of the patients. The data were analyzed with a hierarchical analysis of variance model. RESULTS: There was good agreement between the first and the second reading of the same rater and between the two raters regarding the destruction score. The agreement regarding the proliferation score was lower but still acceptable. The reliability of the method to describe change over time--relation of progression (intra-patient variance) to the measurement error (inter-rater variance)--was 3.9 for the DS, 2.8 for the PS and 4.1 for the total score. The minimal detectable change when the readings of two raters were compared (inter-rater MDC) was 5.8, 5.0 and 4.6%, respectively of the maximum possible score for the destruction, the proliferation and the total score. These data compare very well with the results of standard scoring methods in rheumatoid arthritis. CONCLUSION: We propose a method for scoring radiographic change in psoriatic arthritis which reliably quantifies the progression of the disease seen on radiographs.