MANAGEMENT TO PREVENT BLEEDING DURING ENDOSCOPIC SUBMUCOSAL DISSECTION USING THE FLUSH KNIFE FOR GASTRIC TUMORS

The gastric vasculature responsible for intraoperative bleeding in endosocpic submucosal dissection (ESD) is the ramified vascular network occupying the middle of the submucosal layer and large vessels penetrating the muscle layer. Appropriate management for these vessels must be addressed. The trimming of the ramified vascular network can be safely performed with coagulation mode following shallow mucosal cutting. A large penetrating vessel usually requires precoagulation prior to dissection. These procedures are effectively performed with the water jet short needle knife (Flush knife).     

Self-compassion weakens the association between hot flushes and night sweats and daily life functioning and depression

Objectives

Some women find hot flushes and night sweats (HFNS) to interfere more in daily life and mood than others. Psychological resources may help to explain these individual differences. The aim of this study was to investigate the role of self-compassion, defined as healthy way of relating toward the self when dealing with difficult experiences, as a potential moderator of the relationship between HFNS and daily life activities, which in turn influences symptoms of depression.

Study design

This was a cross-sectional study using questionnaire data from 206 women aged 40–60 who were currently experiencing hot flushes and/or night sweats. Path analysis was used to model relationships among menopausal factors (HFNS frequency and daily interference ratings), self-compassion and mood.

Main outcome measure

Hot flush interference in daily activities and depressive symptoms.

Results

On average, women experienced 4.02 HFNS per day, and HFNS frequency was moderately correlated with interference ratings (r = 0.38). In the path analytic model, self-compassion made significant direct contribution to hot flush interference ratings (β = −0.37) and symptoms of depression (β = −0.42), and higher self-compassion was associated with lower interference and depressive symptoms. Self-compassion also moderated the relationship between HFNS frequency and hot flush interference. Higher self-compassion was associated with weaker effects of HFNS frequency on daily interference.

Conclusions

Self-compassion may weaken the association between HFNS and daily life functioning, which in turn, could lead to less HFNS-related mood problems. These findings imply that self-compassion may be a resilience factor to help women manage hot flushes and night sweats.     

三种封管液对小儿留置针的影响比较

目的探讨三种封管液对小儿留置针留置效果的影响。方法选择需静脉留置套管针输液的患儿100例,随机分为1、2、3三组,分别采用50 U/ml的肝素钠盐水、10 U/ml的肝素钠盐水和生理盐水作为封管液,对三组留置针的留置时间、静脉炎和堵管发生率进行比较。结果 1组的留置时间明显优于2、3组(P0.05),三组之间静脉炎和堵管发生率的比较无统计学意义(P0.05)。结论 50 U/ml肝素盐水封管效果优于10 U/ml肝素盐水和生理盐水。     

Flushing in rosacea: An experimental approach

Summary A simple method is described which causes rosacea patients to flush. This flush is experienced similarly to the flush which occurs spontaneously and its intensity can be measured and monitored wuantitatively. Therefore, it can be used as a suitable experimental tool to measure and compare the inhibitory effects of some drugs, as well as the fluctuations of the blood level of certain chemical vasoactive mediators.     

国产冲洗液与IL1300系列血气酸碱分析仪冲洗液的对比研究

在IL1300系列血气酸碱分析仪上,对国产冲洗液和IL公司冲洗液,从两点标定、pH标准液测定、血气标准物ABC测量,以及临床应用等方面,进行了性能对比研究。其结果证明国产冲洗液,已达到IL公司冲洗液的标准,完全可以替代IL公司冲洗液,用于IL1300系列血气酸碱分析仪。     

Effective and clinically meaningful non-hormonal hot flash therapies

Although many non-hormonal compounds have shown statistically significant benefit over placebo in hot flash randomized controlled trials (RCTs), these studies have varied considerably in basic methodology making it challenging to deduce which compounds have the greatest potential to provide clinically meaningful benefit. This review used evidence-based methodology closely mirroring the FDA and EMEA guidelines as a template to identify "well-designed" RCTs from which effective and clinically meaningful non-hormonal hot flash therapies could be identified. In addition, pertinent safety information was reviewed. Out of 3548 MEDLINE citations and abstracts, 51 well-designed hot flash RCTs were identified. From these trials, gabapentin, oxybutynin ER, desvenlafaxine, soy-derived isoflavones and black cohosh each showed a clinically meaningful treatment effect in at least 1 RCT. Among these 5 compounds, only gabapentin demonstrated consistent and statistically significant benefit over placebo in all of its well-designed RCTs. Desvenlafaxine, soy-derived isoflavones, and black cohosh demonstrated statistically significant benefit over placebo in 75%, 21%, and 17% of the well-designed RCTs for each compound, respectively. There was only 1 well-designed RCT using oxybutynin ER, which showed it to have a robust and clinically meaningful benefit. In terms of safety, there have been cardiovascular risks associated with desvenlafaxine use in postmenopausal women with hot flashes. The use of anticonvulsants, in general, has been associated with an absolute 0.21% increase in suicidal thoughts and behavior. Further research is needed with several of these nonhormonal compounds to replicate these findings and to also directly compare their efficacy and tolerability with those of hormone replacement therapy.     

声门下积液清除方法对呼吸机相关性肺炎的影响研究

目的探讨不同声门下积液清除方法对下呼吸道细菌数和呼吸机相关性肺炎(VAP)发生率、机械通气(MV)时间、ICU入住时间、病死率的影响,为临床预防VAP提供参考。方法对2011年1-12月入住综合ICU行机械通气>48h的57例患者进行研究,按随机数字表法分为A组30例、B组27例,A组在常规气道护理的基础上进行声门下冲洗;B组在常规气道护理的基础上进行声门下联合口咽部冲洗,分别于MV<48h、4、7d收集气囊滞留物和下呼吸道分泌物进行细菌培养,观察MV患者VAP发生率、MV时间、ICU入住时间、病死率,采用SPSS17.0软件进行统计分析。结果 MV<5dVAP发生率A组为46.67%、B为14.82%,差异有统计学意义(P<0.05),MV≥5dVAP发生率A组为70.00%、B为51.85%,差异无统计学意义;两组患者MV时间、ICU入住时间、病死率比较差异无统计学意义,但发生与未发生VAP患者的MV时间、ICU入住时间比较,差异有统计学意义(P<0.05);发生与未发生VAP患者的病死率比较,差异无统计学意义。结论声门下联合口咽部冲洗比单纯声门下冲洗能更有效地降低早发性VAP的发生率;VAP的发生可使重症患者的MV时间、ICU入住时间明显延长。     

Reflex heating of the skin and telethermography

Summary Thermography is a very instructive method of showing the interaction between direct changes in heat radiation of the surface of the skin and its relation to reflex processes. Short reflex arcs, such as the axon reflex, and long reflex arcs, such as the flush phenomenon provoked by visceral cutaneous reflexes, can be illustrated by thermography. Reflex changes in skin temperature by cooling the skin of patients with cold contact urticaria with the short-term development of large areas of warmed skin and also reflex changes in cholinergic urticaria after prior heating of such skin areas where the urticarial eruption follows are reflected in the picture of telethermography. Reflex arcs between extremities affect the arterial blood flow and show individual variation, as in the case of the cessation of permanent local vasoconstriction by indirect cooling. The thermographic illustration of convective heat transport to the skin surface can be obstructed by the cooling effect of sweat secretion, e.g., water vapor exudation and by changes in conductive heat transport in abnormal skin.