本科护生实习期戴圆筒帽的三方观点调查

目的调查本科护生、带教教师和患者三方对护生实习期戴圆筒帽的看法,为更有利于护生的工作和学习以及营造祥和协调的医疗生活环境提供参考。方法采用问卷调查法及访谈法对112名本科护生及50名科室带教教师和100例患者就其对本科护生实习期戴圆筒帽的看法和建议进行调查。结果96.42%本科护生认为戴圆筒帽弊大于利,88.39%不乐意戴圆筒帽。94.00%带教教师对护生戴燕尾帽无异议。58.00%患者认为实习护生戴圆筒帽使科室护理群体看起来不协调,62.00%认为给他们一种不安全和不可信任感。结论带教实习期戴圆筒帽给护生实习带来负面影响。     

Association between atherosclerotic cardiovascular diseases risk and renal outcome in patients with type 2 diabetes mellitus

AimsChronic kidney disease (CKD) and diabetes mellitus increase atherosclerotic cardiovascular diseases (ASCVD) risk. However, the association between renal outcome of diabetic kidney disease (DKD) and ASCVD risk is unclear.MethodsThis retrospective study enrolled 218 type 2 diabetic patients with biopsy-proven DKD, and without known cardiovascular diseases. Baseline characteristics were obtained and the 10-year ASCVD risk score was calculated using the Pooled Cohort Equation (PCE). Renal outcome was defined as progression to end-stage renal disease (ESRD). The association between ASCVD risk and renal function and outcome was analyzed with logistic regression and Cox analysis.ResultsAmong all patients, the median 10-year ASCVD risk score was 14.1%. The median of ASCVD risk score in CKD stage 1, 2, 3, and 4 was 10.9%, 12.3%, 16.5%, and 14.8%, respectively (p = 0.268). Compared with patients with lower ASCVD risk (＜14.1%), those with higher ASCVD risk had lower eGFR, higher systolic blood pressure, and more severe renal interstitial inflammation. High ASCVD risk (>14.1%) was an independent indicator of renal dysfunction in multivariable-adjusted logistic analysis (OR, 3.997; 95%CI, 1.385–11.530; p = 0.010), though failed to be an independent risk factor for ESRD in patients with DKD in univariate and multivariate Cox analysis.ConclusionsDKD patients even in CKD stage 1 had comparable ASCVD risk score to patients in CKD stage 2, 3, and 4. Higher ASCVD risk indicated severe renal insufficiency, while no prognostic value of ASVCD risk for renal outcome was observed, which implied macroangiopathy and microangiopathy in patients with DKD were related, but relatively independent.     

Vitamin D receptor gene polymorphism in postmenopausal women of the Han and Uygur nationalities in China

Ｔｈｅｒｉｓｋｏｆｏｓｔｅｏｐｏｒｏｓｉｓｉｓｃｌｏｓｅｌｙｒｅｌａｔｅｄｔｏｂｏｎｅｍｉｎｅｒａｌｄｅｎｓｉｔｙ (ＢＭＤ ) ,ｗｈｉｃｈｉｓｕｎｄｅｒｓｔｒｏｎｇｇｅｎｅｔｉｃｃｏｎｔｒｏｌ Ｍｏｒｒｉｓｏｎｅｔａｌ1　ｈａｖｅｓｈｏｗｎａｓｔｒｏｎｇｒｅｌａｔｉｏｎｓｈｉｐｂｅｔｗｅｅｎｐｏｌｙｍｏｒｐｈｉｓｍａｔｔｈｅｖｉｔａｍｉｎＤｒｅｃｅｐｔｏｒ (ＶＤＲ)ｇｅｎｅａｎｄＢＭＤ ＩｎａｄｄｉｔｉｏｎｔｏＢｓｍⅠ ,ｒｅｓｔｒｉｃｔｉｏｎｆｒａｇｍｅｎｔｌｅｎｇｔｈｐｏｌｙｍｏｒｐｈｉｓｍａｔｔｈ…     

中药新药试行标准转正的稳定性试验问题探讨

本文从企业申请中药新药试行标准转为正式标准的材料中整理出一些具有代表性的、对药品稳定性考察不规范的实例进行了分析,指出了企业在稳定性试验中主要存在的问题;通过与规范实例的对照,强调了规范稳定性试验考察的重要性;最后,就企业进行药品有效期的预测试验提出了一些建议.     

Identification of a clinical web-based nomogram to predict overall survival in elderly retroperitoneal sarcoma patients: A population-based study

The purpose of this study was to develop a web-based nomogram and risk stratification system to predict overall survival (OS) in elderly patients with retroperitoneal sarcoma (RPS). Elderly patients diagnosed with RPS between 2004 and 2015 were identified in the Surveillance, Epidemiology, and End Results (SEER) database. We used univariate and multivariate Cox analysis to identify independent prognostic factors. We plotted the nomogram for predicting the OS of elderly RPS patients at 1, 3, and 5 years by integrating independent prognostic factors. The nomograms were subsequently validated by receiver operating characteristic (ROC) curves, calibration curves, and decision curve analysis (DCA). By calculating the Nomogram score for each patient, we build a risk stratification model to evaluate the survival benefit of elderly RPS patients. A total of 722 elderly RPS patients were included in our study. The nomogram includes 5 clinicopathological variables as independent prognostic factors: age, histological subtype, grade, metastasis status, and surgery. Through the validation, we found that the nomogram has excellent prediction performance. Then web-based nomograms were established. We performed a web-based nomogram and a risk stratification model to assess the prognosis of elderly RPS patients, which are essential for prognostic clustering and decision-making about treatment.     

免疫亲和柱净化光化学衍生高效液相色谱-荧光检测法测定动物类药材中黄曲霉毒素

目的建立动物类药材中黄曲霉毒素B1,B2,G1,G2的免疫亲和柱净化光化学衍生高效液相色谱-荧光检测(HPLC-FLD)法。方法样品经甲醇-水(80∶20)提取后,通过免疫亲和柱净化、柱后光化学衍生、高效液相色谱-荧光检测器测定。结果在优化条件下,黄曲霉毒素G2,G1,B2,B1的检出限分别为0.15,0.25,0.1,0.2μg/kg,回收率为78.8%～106.7%,RSD均低于7.1%。结论所用方法简便快速、灵敏度高、重现性好,可满足动物类药材中黄曲霉毒素检测的需要。     

白虎加桂枝汤加减改善尿酸性肾病大鼠肾小管损伤的机制

目的：观察白虎加桂枝汤对尿酸性肾病（HN）大鼠的治疗效果,并从肾小管损伤角度探讨其作用机制。方法：将60只无特定病原体（SPF）级SD雄性大鼠随机分为正常对照组、模型组、白虎加桂枝汤高剂量组（BHJGZ高组）、白虎加桂枝汤中剂量组（BHJGZ中组）、白虎加桂枝汤低剂量组（BHJGZ低组）、别嘌醇组,每组10只。采用腺嘌呤灌胃联合腹部皮下注射氧嗪酸钾构建大鼠尿酸性肾病模型,连续造模18 d。造模成功后,正常对照组及模型组给予等体积蒸馏水灌胃,其余各组给予对应药物灌胃,连续干预8周。观察大鼠体质量、活动能力、精神状态及毛色,检测大鼠血清尿酸（UA）、血清尿素氮（BUN）、血清肌酐（Scr）、24 h尿蛋白定量（24 h UTP）,通过HE染色、过碘酸希夫（PAS）染色和Masson染色,观察高尿酸血症（HUA）大鼠肾脏组织形态学、肾小球系膜增生以及肾间质纤维化情况。结果：与模型组比较,治疗6周后,白虎加桂枝汤各剂量组大鼠体质量增加,活动能力、精神状态及毛色好转（P<0.05）。BHJGZ中组可显著降低大鼠血清Scr水平（P<0.01）,BHJGZ中组、BHJGZ高组可明显降低大鼠血清BUN水平（P<0.01）;白虎加桂枝汤各剂量组均可明显降低HUA大鼠血清UA、24 h UTP水平并改善肾组织形态学、肾小球系膜增生及肾间质纤维。结论：白虎加桂枝汤可能通过抑制肾小球系膜基质增生、减少肾小管损伤及肾间质纤维化,延缓HN进展。     

阎小萍老师治疗强直性脊柱炎“治未病”学术思想的临床应用

阎小萍老师认为,强直性脊柱炎（AS）的核心病机为肾督阳气不足,风寒湿热诸邪深侵肾督;在防治方面重视“治未病”思想的应用,主要体现在：1）未病先防,倡导扶助正气、精神恬淡,重视健康宣教;2）既病防变、防残,中药治疗以补肾强骨通络为主,根据脏腑辨证、循经辨证,随证加减用药,防止AS患者发生目疾改变、骨量减少、骨质疏松以及髋关节病变,防止关节畸形、致残,同时重视体育锻炼及非药物治疗;3）瘥后防复,恢复期患者注意调畅情志,饮食宜清淡,禁烟酒,定期门诊复诊,遵医嘱坚持服药,防止复发。