血细胞分离机采集SARS康复者血浆安全性的探讨

目的　探讨SARS康复者采集血浆的安全性。方法　采用连续流动式血细胞分离机采集SARS康复者的血浆 ,对比观察其采集前后血压、心率、呼吸和血液学的变化。结果　单采前后SARS康复者血压、呼吸、WBC、RBC、Hb、Hct、Plt、Ca2 + 和血清总蛋白无显著变化 (P >0 .0 5 ) ;单采后心率较单采前明显增加 (P <0 .0 1) ,但仍稳定在正常范围内。结论　使用连续流动式血细胞分离机采集SARS康复者的血浆安全可靠 ,整个采集过程不会对其心血管系统和血液学产生影响     

康复者血浆治疗新型冠状病毒肺炎疗效分析1例

新型冠状病毒肺炎在全球范围内爆发,对人类健康构成极大威胁,目前仍无特异性的治疗方法。本研究通过对1例康复者血浆治疗新型冠状病毒肺炎重症患者进行疗效评估,比较输注前后临床症状、实验室指标、肺部影像学改变及病毒核酸检测结果的变化,探讨康复者恢复期血浆在治疗新型冠状病毒肺炎中是否有效。患者输注康复者恢复期血浆后72 h内,临床症状明显改善,氧饱和度、氧合指数趋于好转,炎症指标明显改善;输注康复者恢复期血浆后72 h肺部影像学无改善,病毒核酸检测仍然阳性,但基因ORFlab、N的靶标Ct值较前增大。本例新型冠状病毒肺炎患者输注康复者血浆治疗后临床症状及炎性指标得以改善,但更好的疗效依赖于把握康复者血浆的抗体效价以及输注时机等。     

陕西省汉中疗养院住院麻风康复者综合健康状况调查评价

目的:探讨并评价住院麻风康复者的综合健康状况。方法:调查2016年5月至2017年7月在本院进行治疗的麻风患者100例,让患者填写自测问卷,记录多菌型麻风康复者与少菌型麻风康复者的例数及畸残等级状况,并统计两种菌型麻风康复者的主要畸残部位及各个部位形成的表现。结果:多菌型麻风康复者比少菌型麻风康复者多,且两种菌型康复者的二级畸残率最高(P<0.05)。两种菌型麻风康复者的主要畸残部位为手部、足部与眼部,并且会形成爪型手、足底溃疡、兔眼等表现(P<0.05)。结论:住院的麻风病患者在康复过程中,畸残状况不容乐观,二级畸残率较高,要合理有效地对麻风康复者的综合健康状况进行及时的调查,完善康复的手段,加强对康复者的护理。     

康复者恢复期血浆在病毒性疾病治疗中的研究进展

康复者恢复期血浆可治疗多种病毒性感染疾病。本文通过总结既往康复者恢复期血浆在治疗病毒性传播疾病中的研究进展,分析其在新型冠状病毒肺炎治疗中的潜在价值。总结了康复者恢复期血浆在募集、血浆处理、抗体效价检测中的技术进展及其在禽流感病毒、MERS-CoV、SARS-CoV、EBOV、SARS-CoV-2等病毒性感染的临床治疗效果以及血浆输注相关不良反应等。康复者恢复期血浆在多数病例报道及回顾性分析结果提示其可以降低疾病死亡率,可作为新型冠状病毒肺炎感染潜在的治疗方法。     

影响麻风康复者高血压患者服药依从性的影响因素及护理干预

目的 探讨麻风康复者高血压患者服药依从性的影响因素及护理干预的影响. 方法 纳入我院2013年1月至2014年11月确诊为麻风康复者高血压患者200例,进行问卷调查,对调查的结果进行分析汇总,采用单因素及多因素的Logistic回归进行服药依从性的影响因素的分析;并将纳入调查研究的200例患者随机平均分为两组,其中对照组100例,给予常规的基础治疗;护理干预组100例,在对照组的基础上给予个体化对策的护理干预,分别比较两组患者的服药依从性及血压控制情况. 结果 根据Logistic回归分析依从性危险因素为年龄大、医患关系一般、高血压知识知晓度差、经济收入低;护理干预组在服药依从性及血压控制情况均优于对照组( P<0. 05 ). 结论 麻风康复者高血压患者药物治疗依从性较差与年龄、高血压知识知晓程度、医患关系不良、经济收入低有关,实施相应的护理干预以可以明显提高患者服药依从性并改善血压控制情况.     

肿瘤康复者对恶性肿瘤患者心理支持干预及效果

目的探讨肿瘤康复者对恶性肿瘤患者的心理支持干预及效果。方法 2008年10月起,我们招募与培训肿瘤康复志愿者,通过他们对在我院住院的恶性肿瘤患者进行心理支持干预,在干预前后采用生活质量综合评定问卷（GQOLI-74）进行调查。结果在肿瘤康复者支持干预前后,恶性肿瘤患者的生活质量总体评价前后比较差异有统计学意义（P〈0.05）;躯体功能、心理功能、物质生活状态维度前后比较差异有统计学意义（P〈0.05）。结论肿瘤康复者根据自身康复的经验与体会对恶性肿瘤患者的各方面进行针对性的干预,能有效改善患者的心理状态,从而明显提高了患者的生活质量。     

输血相关治疗应用于新冠病毒肺炎救治中的思考

本文简要探讨了新冠病毒肺炎的可能致病机制,对可能应用于新冠病毒肺炎治疗的输血相关技术及这些治疗技术在应用中存在的一些问题提出思考和建议。希望对参与新冠病毒肺炎治疗的输血同道有所参考、有所帮助。     

康复者恢复期血浆治疗新型冠状病毒疾病临床疗效的系统评价

目的系统评价新型冠状病毒疾病(COVID-19)康复者恢复期血浆(CP)治疗COVID-19的临床疗效。方法计算机检索PubMed、EMbase、The Cochrane Library、VIP、WanFang Data和CNKI数据库,搜集有关CP治疗COVID-19疗效的随机对照试验(RCT),检索时限均从建库至2021年9月15日。由2名研究者独立筛选文献、提取资料并评价纳入研究的偏倚风险后,采用RevMan 5.4.1软件进行Meta分析。结果共纳入16个RCT,包括15301例患者。Meta分析结果显示:CP治疗组与空白对照组[RR=0.99,95%CI(0.93,1.05),P=0.63]或生理盐水组[RR=1.06,95%CI(0.60,1.86),P=0.84]相比,病死率差异无统计学意义。但与标准血浆相比,CP组病死率更低[RR=0.59,95%CI(0.37,0.95),P=0.03]。此外,与空白对照或生理盐水相比,CP治疗不能改善28~30天临床病情;疾病早期和随机化分组时不需有创机械通气的患者给予CP治疗不能降低病死率。结论当前证据显示,与空白对照或生理盐水相比,CP治疗COVID-19患者不能降低病死率。但当病情发展到需要使用标准血浆时,CP治疗可能会降低患者的病死率。另外,疾病早期或非危重COVID-19患者使用CP不能降低病死率及改善临床症状。受纳入研究数量和质量的限制,上述结论尚待更多高质量研究予以验证。     

新冠康复者恢复期血浆抗SARS-CoV-2中和抗体检测分析

目的 了解新冠康复者恢复期血浆中抗SARS-CoV-2中和抗体水平,评价其是否具有特异的抗SARS-CoV-2 S抗原作用,为临床使用提供实验室支持数据.方法 以9名已从COVID-19中恢复的新冠康复者恢复期血浆捐献者为研究对象,以4名完成疫苗接种的志愿者和3名新冠抗体筛查阳性的无偿献血者做对比,采用化学发光免疫分析...     

埃博拉感染患者恢复期血清可能用于治疗该病患者北大核心CSCD

科学家将在几内亚开展一项临床试验,研究埃博拉感染幸存者血液中的抗体能否帮助该病毒感染者抵御这致命性疾病。如果证实有效,在继续进行药物和疫苗研发工作的同时,恢复期血清可以作为短期干预措施,迅速扩大生产,用于临床。一项由安特卫普热带医学研究所领衔的国际研究正在开展这项工作。     

不同ELISA试剂与1种假病毒中和试验检测COVID-19康复者恢复期血浆抗体结果分析

目的 了解不同的严重急性呼吸系统综合征冠状病毒2(SARS-CoV-2) ELISA抗体试剂应用于核酸检测确诊新型冠状病毒肺炎(COVID-19)康复者恢复期血浆抗体检测的结果差异性.方法 应用3种SARS-CoV-2 ELISA抗体试剂(代以ELISA试剂1、2、3)和1种假病毒中和试验(ppNAT),于2020年9...     

小型节能头灯的制做与应用

医院(特别是儿童医院)在日常的诊断和治疗护理工作中,需要在小局部范围、短时间光源照明.目前市场上各种医用头灯存在着价格昂贵,使用不方便;我院医护人员在加05年10月至2007年3月使用我院自行研制的节能头灯,采用现代电子技术,在夜间给病人注射、换药和其他治疗以及查房巡视等小范围用光场合,取得了良好的效果.     

Cervicogenic exophthalmos: Possible etiology and pathogenesis

BACKGROUND Unilateral exophthalmos is often caused by inflammation, neoplasm, infection,metabolic disease, vascular disorder and several other less common conditions.Reflex sympathetic dystrophy related to unilateral exophthalmos has not been reported in the past literature.CASE SUMMARY We describe a 45-year-old female with unilateral exophthalmos caused by reflex sympathetic dystrophy and its unexpected spontaneous disappearance after a standard anterior cervical discectomy and fixation operation with two PEEK interbody cages and a plate. To our surprise, the patient’s left unilateral exophthalmos improved spontaneously in the morning on postoperative day 2-with no relapse, without any further medication, as of seven years. We have named this condition "cervicogenic exophthalmos."CONCLUSION We would inform other clinicians that unilateral exophthalmos was caused not only by inflammation, vascular disorder, infection, neoplasm, or metabolic disease, but also by reflex sympathetic dystrophy related with cervicogenic spondylosis. To the best of our knowledge, ours is the first related case report and use of the term "cervicogenic exophthalmos" after reviewing previous literature.     

Photodynamic therapy as salvage therapy for residual microscopic cancer after ultra-low anterior resection: A case report

BACKGROUND The rate of positive resection margins(R1) in patients with low rectal cancer is substantial. Recommended remedies such as extended resection or chemoradiotherapy have their own serious drawbacks. It has been reported that photodynamic therapy(PDT) as a remedial treatment for esophageal cancer.Colorectal cancer and esophageal cancer has many similarities,however,PDT as a salvage therapy for rectal cancer is rare.CASE SUMMARY Here,we describe a 56-year-old man who was admitted to the hospital due to a 6-mo history of hemafecia,which had been aggravated for 1 mo. Colonoscopy revealed a 3 × 4 cm ulcerated mass in the rectum 4 cm from the anus.Preoperative pathological examination showed villous adenoma,moderate-tohigh-grade dysplasia,good differentiation,and invasion of the mucosal muscle.The patient had R1 after ultra-low anterior resection,but he refused extended resection and experienced severe liver function impairment after 3 cycles of chemotherapy. Ultimately,the patient underwent PDT to remove R1. After five years of follow-up,there was no liver function impairment,recurrence,metastasis,sexual dysfunction,or abnormal defecation function.CONCLUSION This is the first case worldwide in which R1 of rectal cancer were successfully treated by PDT.     

Endodontic management of the maxillary first molars with two root canals: A case report and review of the literature

BACKGROUND The complex anatomy of the maxillary first molars has always been a major challenge for complete root canal treatment in endodontic therapy. Here, we present two cases of maxillary first molars, each with only two root canals, which have been rarely reported. We also perform a literature review of maxillary first molar anatomy.CASE SUMMARY The two patients were referred to the hospital after 1) finding a cavity in their tooth with a color change and, 2) a toothache during mastication, respectively.Both of these cases were diagnosed as apical periodontitis by X-ray imaging and cone beam computed tomography(CBCT). Non-surgical endodontic therapy was performed with the assistance of a dental operating microscope(DOM). CBCT showed rare but accurate images of both patients, each with two root canals and two roots in their maxillary first molars. Both roots were located in the buccal in the palatal direction, and each root had only one clear root canal. In addition,each maxillary first molar in both patients was symmetrical to that on the opposing side with only two separate root canals. Non-surgical endodontic therapy was performed with the assistance of a DOM. Finally, the teeth were restored using composite resin and the patients were satisfied with the results.CONCLUSION Making full use of CBCT and DOM would contribute to helping dentists make correct diagnoses and successfully treat teeth with rare root canal morphologies.     

世界疼痛日——中国镇痛周暨建立疼痛科新闻发布会隆重召开中华医学会疼痛学分会第七届年会胜利闭幕

世界疼痛日中国镇痛周暨建立疼痛科新闻发布会、中华医学会疼痛学分会第七届年会于2007年10月12～16日在北京九华山庄隆重举行.全国人大副委员长中科院韩启德院士、原全国人大副委员长中科院吴阶平院士、卫生部陈啸宏副部长、卫生部医政司王羽司长、卫生部科教司刘雁飞司长、中华医学会吴明江常务副会长、原卫生部副部长中国医师协会殷大奎会长及有关方面的领导、专家及参加大会的疼痛医学专家代表约五百人参加了新闻发布会.     

读片窗及答案

病例 男,62岁.以"发现尿黄5天"为主诉入院.无发热、恶心及厌食等伴随症状.查体:血压150/100mmHg,巩膜轻度黄染,腹软无压痛,肝区无叩击痛,肝肋下未触及.实验室检查:血WBC 13.1×109/L,EO 5.2×109/L,占39.7%.TBIL 36.6μmol/L,DBIL 21.5μmol/L,UDBIL 15.1μmol/L.ALT 88U/L,GGT 201U/L.AFP及CEA阴性.HBsAb阳性,其余4项均阴性.     

结合中医理论对上呼吸道感染的护理

上呼吸道感染一年四季均可发病,但以冬春季节为多.此类病人病程一般在10 d以上,易反复,有的甚至迁延不愈达1个月以上,造成门诊输液量增加、交叉感染机会增多,在医治过程中医护人员也易感染.此病虽然不像癌症使人恐惧,但它的发病率高,有的1年内可发病3次～5次,给身体和生活造成很大的不便.此类病人的症状为鼻塞、流涕、喷嚏、咳嗽、咽干、咽痛、头痛、发热、乏力、全身不适等,护理一般采取对症施护:休息、保持室内空气清新、多饮水、清淡饮食等,而应用中医理论施护则更具体、更有效,对于疾病的痊愈会有极大的促进作用.     

伸缩式垂直升降护理机的适用性探讨

昏迷病人、截瘫病人、慢性消耗性疾病及脑卒中后遗症病人常伴有肢体瘫痪而长期卧床,生活不能自理,大小便失禁,易发生压疮,给病人带来极大痛苦,给家属带来繁重的负担[1].为解决这一难题,人们研究了一些护理器械,如"升降护理装置",这种护理装置由铁床、软布带、支架杆、绑绳钢筋、软网布、定滑轮组件、动滑轮组件、万向节连接件和钢丝绳组成.     

Seroconversion of HBsAG coincides with hepatitis A superinfection: A case report

BACKGROUND Hepatitis B virus(HBV)is a hepatotropic virus that can cause acute and chronic liver damage.According to the world health organization 257 million people are infected with chronic HBV infection worldwide.Super-infection with other hepadnaviruses,including hepatitis A virus(HAV),hepatitis C virus,hepatitis D virus,and hepatitis E virus is associated with increased risk of acute liver failure in patients with chronic HBV.CASE SUMMARY Here,we report a case of a 47-year old male patient with HBV-related compensated Child A cirrhosis,who presented with general fatigue,malaise and laboratory signs of acute hepatitis.Although the patient was regularly seen at a specialized university liver unit,the HAV vaccination status was unclear.Acute HAV super-infection was diagnosed by positive serological and polymerase chain reaction analysis.Following acute HAV super-infection,spontaneous HBsAg elimination and development of an anti-HBs titer were observed.CONCLUSION This case illustrates the importance of carefully checking the vaccination status.In our patient,unspecific immunological responses to HAV led to functional cure of HBV.