全营养素混合液(TNA)在肠外营养的应用

脂肪乳剂、葡萄糖、氨基酸、电解质、维生素及微量元素按一定程序混合配成10种全营养素混合液。在4℃14天贮存期内,10种混合液的pH和渗透压变化不大,不同混合液在不同时期的脂粒平均直径变化为0.3135±0.1012μm～0.4813±0.1893μm,94.93％脂粒的直径<0.6μm,无直径>6μm的脂粒,细菌培养阴性。74例共输全营养素混合液1,796次,无不良临床反应和异常实验室检查结果;用1周以上者大都显示氮平衡改善,用2周以上者血清转铁蛋白和白蛋白浓度可有不同程度升高。     

Detection of linkage under heterogeneity: comparison of the two-locus vs. admixture models.

Linkage analysis under the two-locus model and the admixture model was compared on pedigree data for a common disease stimulated under a model of genetic heterogeneity. The ascertainment of families was designed so that the samples had a large proportion of families segregating for both disease loci. The two-locus linkage analysis model did not demonstrate increased power of detecting linkage or more accurate estimates of the recombination fraction, theta than did the admixture model linkage analysis. When a sample was purposely chosen so that all of the families were segregating for both loci, then the two-locus lod score analysis was better. However, the increased power depended on assuming the correct gene frequency for the linked locus. It can be concluded that under the conditions of genetic heterogeneity examined here, testing for linkage under the admixture model is the preferred method of analysis. However, this is not a general conclusion that can apply to all two-locus disease models.     

Searching for archaic contribution in Africa

Abstract

Context: Africa’s role in the narrative of human evolution is indisputably emphasised in the emergence of Homo sapiens. However, once humans dispersed beyond Africa, the history of those who stayed remains vastly under-studied, lacking the proper attention the birthplace of both modern and archaic humans deserves. The sequencing of Neanderthal and Denisovan genomes has elucidated evidence of admixture between archaic and modern humans outside of Africa, but has not aided efforts in answering whether archaic admixture happened within Africa.

Objectives: This article reviews the state of research for archaic introgression in African populations and discusses recent insights into this topic.

Methods: Gathering published sources and recently released preprints, this review reports on the different methods developed for detecting archaic introgression. Particularly it discusses how relevant these are when implemented on African populations and what findings these studies have shown so far.

Results: Methods for detecting archaic introgression have been predominantly developed and implemented on non-African populations. Recent preprints present new methods considering African populations. While a number of studies using these methods suggest archaic introgression in Africa, without an African archaic genome to validate these results, such findings remain as putative archaic introgression.

Conclusion: In light of the caveats with implementing current archaic introgression detection methods in Africa, we recommend future studies to concentrate on unravelling the complicated demographic history of Africa through means of ancient DNA where possible and through more focused efforts to sequence modern DNA from more representative populations across the African continent.     

Symptom patterns and causes of somatization in men: I. Differentiation of two discrete disorders

Two distinct patterns of somatization were identified in 807 Swedish adopted men, using comprehensive lifetime psychiatric and sick-leave records. "Diversiform" somatizers had a high frequency of brief sickness occasions for a wide diversity of complaints, particularly pain in the head, joints, and abdomen. "Asthenic" somatizers had a lower frequency and diversity of complaints. They recuperate more slowly, however, and were more often disabled by fatigue, weakness, and minor illnesses such as upper respiratory infections. Both types of somatizers had associated psychosocial maladjustment, but they had discrete clinical patterns, with infrequent overlap. Diversiform somatizers had a higher risk of alcohol abuse, psychiatric hospitalization, and substandard income than either asthenic somatizers or non-somatizers. Asthenic somatizers had a higher risk of divorce than either diversiform somatizers or non-somatizers. Men with prominent somatization had an excess of psychiatric treatment for alcoholism or anxiety disorders, but, unlike female somatizers, no excess of criminality. These clinical differences suggest that the psychiatric processes associated with somatization may be qualitatively different in men and women. The method used here is generally applicable in genetic epidemiology to identify natural clinical subtypes within a heterogeneous phenotype.     

静脉用药调配中心干预不合理医嘱的效益分析

目的对静脉用药调配中心(pharmacy intravenous admixture services,PIVAS)干预临床不合理用药产生的经济效益、社会效益、人力资源效益进行分析,促进临床合理、安全、经济用药。方法采用回顾性分析方法,调取2018年10月1-31日山东大学齐鲁医院PIVAS接收的全部静脉用药医嘱及对不合理用药医嘱的干预结果,分析PIVAS干预不合理用药医嘱产生的药品资源、人力资源节约情况。结果2018年10月1-31日PIVAS药师共审核用药医嘱412782组,其中不合理医嘱1967组,占0.417%,包括不规范、不适宜及超常医嘱等类型。通过PIVAS药师干预不合理用药医嘱,及时纠正医师用药医嘱错误,节约了药品资源及护理工时。结论PIVAS进行用药医嘱审核对于保障患者临床合理用药具有积极意义,有利于节约医疗资源。     

全静脉营养液的合理应用

目的：探讨全静脉营养液的合理应用,以避免或减少并发症的发生;方法：查文献,从适应证、营养状况评定、组方、配制、药物的加入、输入、监测及及时过渡到肠内营养几个方面综述全静脉营养液的合理应用;结果：营养状况的准确评定、科学组方、合理配制、规范输入、准确监测、以及及早过渡到肠内营养,是全静脉营养液合理应用的重要环节;结论：全静脉营养液的合理应用,对避免或减少并发症的发生,成功地进行完全胃肠外营养有重要意义。     

全静脉营养液质量控制的研究进展

全静脉营养液(total nutrient admixture，TNA)应用于临床多个领域，其成分复杂且富含营养物质．质量受多种因素影响，由于TNA导致的并发症逐渐增多，TNA质量控制问题应受到更多的关注。本文着重讨论了影响TNA质量的主要因素及质量控制方法。     

二维码技术在我院PIVAS管理信息系统中的应用

目的:提高我院静脉药物配置中心(PIVAS)信息管理水平,并为PIVAS中的条形码设计与发展提供参考。方法:在我院原有的医院资源管理平台上,以二维码技术代替原来的一维码用于PIVAS的信息管理系统,并介绍其功能作用及应用效果。结果与结论:二维码技术可用于PIVAS信息管理系统中的输液标签生成、输液记费、输液出仓核对、输液数量统计等功能中,不但信息存储量大,而且运行稳定、操作简易,在提高PIVAS工作效率、减少人为因素导致的差错的同时,也为PIVAS今后的电子信息扩充提供了有力保障,值得推广。     

鸦胆子油乳注射液及配置后静脉输液的室温稳定性研究

目的 考察说明书中贮存条件要求冷藏,且须临用前即配即用的鸦胆子油乳注射液的原液和稀释后的静脉输液在室温(25 ℃)下的稳定性,为该药品的临床管理与使用提供依据。方法 模拟临床给药剂量和给药时间,考察性状、pH、渗透压、颗粒细度和油酸含量在室温下放置不同时间点的变化。结果 在室温下,鸦胆子油乳注射液原液放置72 h质量稳定,配置后静脉输液(30 mL∶250 mL 0.9%生理盐水)在24 h内各项理化指标均无明显变化。结论 鸦胆子油乳注射液在医院内部的短时间药物配送无需严格实施冷链管理;配置后静脉输液室温放置24 h稳定,无需“即配即用”。     

静脉用药调配中心24小时全医嘱下临时医嘱的运行模式

目的：探讨24 h工作模式下我院静脉用药调配中心（PIVAS）临时医嘱的运行模式,为临床安全合理用药提供参考。方法：分析PIVAS临时医嘱的审核、提取、批次安排、摆药、贴签、配置及扫描交接的运行模式。结果：临时医嘱PIVAS集中调配后,日均调配人数减少66.67%,调配时间减少77.78%,调配耗材减少13.64%。结论：我院PIVAS 24 h接收并配制临时医嘱,提高了工作效率,满足了临床配置临时医嘱的需求,保证了静脉用药的安全性及合理性。