四种手术方式治疗痔病的网状Meta分析

目的利用网状Meta分析系统评价传统外剥内扎术（MMH）、吻合器痔上黏膜环切术（PPH）、选择性痔上黏膜切除术（TST）和多普勒超声引导下痔动脉结扎术（DG-HAL）治疗痔病的手术方式的疗效和安全性,为临床提供参考。 方法检索中国知网、万方数据、中国生物医学网,Pubmed、Cochrane Library、Embase数据库,收集建库至2020年12月关于MMH、PPH、TST和DG-HAL治疗痔病的随机对照试验,提取的资料采用GeMTC 0.14.3软件进行网状Meta分析。 结果最终纳入45项研究,包括43篇两臂实验,2篇三臂实验;共5 847例患者,其中MMH组1 777例,PPH组1 971例,TST组1 205例,DG-HAL组894例。与MMH相比,DG-HAL（MD=-4.16,95% CI：-6.49~ -1.82,P<0.05）和PPH（MD=2.28,95% CI：0.64~3.89,P<0.05）可以显著降低术后疼痛程度,差异均有统计学意义;TST术后尿潴留发生率明显低于MMH（OR=2.08,95% CI：1.23~4.09,P<0.05）;相比于MMH（OR=0.01,95% CI：0~0.15,P<0.05）和PPH（OR=0.08,95% CI：0~0.78,P<0.05）,DG-HAL术后肛门狭窄发生率低;而PPH（OR=6.56,95% CI：1.20~57.74,P<0.05）和TST（OR=58.25,95% CI：4.37~2 605.94,P<0.05）的术后肛门狭窄发生率均比MMH低,TST优于PPH（OR=8.50,95% CI：1.23~150.91,P<0.05）,差异均有统计学意义。术后24 h疼痛评分排序为MMH>PPH>TST>DG-HAL;术后出血发生率排序为MMH>PPH>TST>DA-HAL;尿潴留发生率排序为MMH>PPH>DA-HAL>TST;肛门狭窄发生率排序为MMH>PPH>TST>DG-HAL;复发率排序为DA-HAL>PPH>MMH>TST。 结论四种手术方式治疗痔病的作用机制各有优势,DG-HAL和TST术后疼痛、出血、尿潴留、肛门狭窄等并发症发生率低,术后舒适度和安全性方面有明显优势。术后复发率方面TST最优,DG-HAL最差。     

角膜接触镜经营企业质量管理现况及监管对策思考

目的通过系统调查,了解角膜接触镜经营企业质量管理现况,探索进一步有效监管的方向。方法对上海市徐汇区62家角膜接触镜经营企业质量管理指标进行系统调查,并对不同经营模式企业进行数据对比与统计分析。结果角膜接触镜批发企业、零售连锁企业各项质量管理指标明显好于非连锁角膜接触镜零售企业。结论提高许可门槛,鼓励角膜接触镜零售连锁经营模式,加强对角膜接触镜经营企业的监管,重点是加强对单体零售企业的监管。     

Homeostatic adaptations in brain energy metabolism in mouse models of Huntington disease

Impairment of energy metabolism is a key feature of Huntington disease (HD). Recently, we reported longitudinal neurochemical changes in R6/2 mice measured by in-vivo proton magnetic resonance spectroscopy (¹H MRS; Zacharoff et al, 2012). Here, we present similar ¹H MRS measurements at an early stage in the milder Q111 mouse model. In addition, we measured the concentration of ATP and inorganic phosphate (P_i), key energy metabolites not accessible with ¹H MRS, using ³¹P MRS both in Q111 and in R6/2 mice. Significant changes in striatal creatine and phosphocreatine were observed in Q111 mice at 6 weeks relative to control, and these changes were largely reversed at 13 weeks. No significant change was detected in ATP concentration, in either HD mouse, compared with control. Calculated values of [ADP], phosphorylation potential, relative rate of ATP synthase (v/V_max(ATP)), and relative rate of creatine kinase (v/V_max(CK)) were calculated from the measured data. ADP concentration and v/V_max(ATP) were increased in Q111 mice at 6 weeks, and returned close to normal at 13 weeks. In contrast, these parameters were normal in R6/2 mice. These results suggest that early changes in brain energy metabolism are followed by compensatory shifts to maintain energetic homeostasis from early ages through manifest disease.     

血清尿酸水平评估慢性阻塞性肺疾病急性加重者病情的临床价值

目的探讨血清尿酸水平评估慢性阻塞性肺疾病急性加重（AECOPD）者病情的临床价值。方法收集2014年4月至2015年4月在呼吸科住院治疗的111例经肺功能检测确诊的AECOPD患者的临床资料。以血清尿酸值416μg/L为临界点，分成血清尿酸＞416μg/L组，血清尿酸＜416μg/L组，进行临床资料分析。结果血清尿酸＞416μg/L组以男性为主，年龄更大，吸烟率更高，肺功能更差，D级患者构成比更多，在首次住院床日、1年内机械通气发生率、1年内病死率、1年内住院次数均显著高于血清尿酸＜416μg/L组（P＜0.05或0.01）。血清尿酸＞416μg/L组呼吸衰竭更严重，更多合并有冠心病、充血性心力衰竭、心律失常、糖尿病、恶性肿瘤、意外骨折和褥疮（P＜0.05或0.01）。结论测定AECOPD患者血清尿酸水平有助于对其病情及预后作出评估。     

High acetone sensing properties of In2O3–NiO one-dimensional heterogeneous nanofibers based on electrospinning

Pure NiO nanofibers and the In₂O₃–NiO one-dimensional heterogeneous nanofibers were prepared by electrospinning, and the gas sensing properties to acetone were also investigated. Material characterization proved that the heterogeneous nanofibers were composed of In₂O₃ and NiO, and the nanofibers exhibited an enhanced sensitivity to acetone. At the optimal working temperature, the response of In₂O₃–NiO nanofibers to 50 ppm acetone was more than 10 times higher than that of pure NiO nanofibers. The minimum detection limit of the heterogeneous nanofibers reached 10 ppb, while the pure NiO nanofibers only reached 100 ppb. Among acetone and the comparison gases (methanol, ethanol, triethylamine, ethyl acetate, and benzene), the heterogeneous nanofibers achieved the highest response to acetone. In addition, the heterogeneous nanofibers exhibited an improved response–recovery rate and good long-term stability. These results indicated that the In₂O₃–NiO one-dimensional heterogeneous nanofibers have great potential in low-concentration acetone detection. Combined with the material properties, the mechanism of the enhanced sensing properties was discussed in detail for the In₂O₃–NiO heterogeneous nanofibers.

The In₂O₃–NiO nanofiber with p–n heterojunctions exhibited an enhanced acetone sensing performance, and the detection limit reached 10 ppb.     

血灵侧脑室注射对大鼠动脉血压和心率的影响

目的：血灵是降血压中药制剂。本实验探讨血灵对心血管中枢的作用及其机理。方法：将药物微量地注射入麻醉大鼠侧脑室,观察注药后６０ｍｉｎ内血压和心率的变化。结果：（１）侧脑室注射血灵（１０ｍｇ／２０ｕｌ）引起动脉血压明显升高,２５ｍｉｎ时达到峰值,增幅为２６．５９％;心率增加,增幅为１５．７６％,侧脑室注射相同窖的ＮＳ。血压和心率无明显影响。（２）血压升高与侧脑室注射血灵的剂量呈明显的剂量－效应关系。（     

氨基质子饱和转移效应MRI技术研究进展

近年来,氨基质子饱和转移MRI（APT-MRI）技术在动物实验与临床研究中均取得突破性成果,促进了APT-MRI序列的改进和成像设备的更新。APT-MRI可探测内源性游离蛋白质和缩氨酸含量,临床用于诊断脑肿瘤、脑卒中等疾病。本文针对APT-MRI技术的关键点,对其成像基本原理、序列发展和序列改进特点、数据采集方法和临床运用以及未来发展和研究趋势进行综述。     

双侧股骨干骨折七例治验

双侧股骨干骨折临床少见,文献论述也较少。近年来,双侧股骨干骨折发生率有上升趋势。此种创伤骨折比较严重,且常合并其他损伤和休克,若抢救不力、治疗不当,不仅造成伤残,甚至危及生命。１９８１年以来,我所收治此类患者１１例。除４例病情特别严重送上级医院外,我所治疗７例,现报道如下。１　临床资料　　１１例中男９例,女２例;年龄１７～５８岁之间,平均２９岁,全部为车祸造成。受伤至就诊时间：３０ｍｉｎ～４例,１天～有２例,２天～５例。受伤部位：上１／３骨折８个肢体,中１／３骨折６个肢体,下１／３骨折８个肢体。…     

休克饮抗肠菌转位的实验研究

目的：观察休克饮的抗肠菌转位作用，为临床病患者多脏器竭（ＭＯＦ）的中医治疗提供依据。方法：根据具备 如休克等引起肠菌转位及肠源性脓毒症继而导致ＭＯＦ的病理生理学基础，建立出血性休克诱发肠菌转位的大和以确定温脾汤加减组成的休克饮对肠菌转位的影响。结果：以休克饮灌胃的休克经且大鼠肠道细菌转位至肠系膜淋巴、肝、脾的发生率（３／１５）比未灌胃休克组大鼠的发生率（１１／１３）明显低（Ｐ〈０．０１）；但两组大     

关于抗风湿类中药制剂中非法添加化学药品的检测方法研究

目的:研究抗风湿类中药制剂中非法添加化学药品的检测方法。方法:采用薄层色谱法进行初步定性研究,再采用高效液相色谱法进行进一步的定性分析。色谱柱为Diamonsil C18,以流动相为乙腈—水(40:60),流速为1.0mL/min,检测波长240nm。结果与结论:本方法准确度高,分离度好。