淫羊藿总黄酮的提取工艺研究

目的:研究研究淫羊藿总黄酮的提取工艺.方法 以淫羊藿总黄酮含量为指标,采用正交设计,结合工业生产的实际情况优选淫羊藿总黄酮的最佳提取工艺.结果 淫羊藿总黄酮的最佳提取工艺是采用10倍量70%的乙醇提取2次,每次2小时,总黄酮提取率为92.89%.结论 所优选工艺符合生产需要,工艺稳定.     

紫杉醇联合诺维本治疗22例乳腺癌术后转移的疗效观察

目的评价紫杉醇联合诺维本治疗乳腺癌术后转移的临床疗效和毒副反应。方法对22例经病理学和细胞学证实或影像学证实的转移性乳腺癌患者应用紫杉醇与诺维本联合治疗,28 d为1个周期,完成2~4个周期后评价疗效。结果总有效率(RR)为54.5%(12/22);中位缓解期5个月(4~26个月)。主要毒副反应为骨髓抑制、脱发和周围静脉炎。结论紫杉醇联合诺维本治疗乳腺癌术后转移有很好的疗效,且毒副反应患者可耐受。     

沙棘油的致畸和致突变研究

本文研究了沙棘油的致畸和致突变性。结果表明:(1)沙棘油对大鼠无胚胎毒性和致畸效应;(2)小鼠微核率和精子畸形率分别为1.30-1.50‰和1.50-2.02‰之间,与正常对照组比无显著性差异(P>0.05);(3)     

肝愈胶囊对小鼠免疫功能的影响

目的：观察肝愈胶囊对小鼠免疫功能的影响。方法：分别灌胃给予小鼠肝愈胶囊0.125，0.25及0.5g／kg，连续7d,测定肝愈胶囊对小鼠免疫器官脾、胸腺指数、单核巨噬细胞吞噬功能、溶血素抗体生成、迟发型超敏反应功能的影响。结果：肝愈胶囊对小鼠免疫器官重量、小鼠单核巨噬细胞吞噬功能无明显影响；可抑制溶血素抗体生成、有促进小鼠迟发型超敏反应的作用。结论：肝愈胶囊对小鼠免疫功能有明显的调节作用。     

小儿扁桃体挤切术的护理体会

扁桃体摘除术在我院多为门诊手术 ,术后留院观察 1ｄ ,现将我院 1995年至 1999年实施扁桃体挤切术 5 12例的护理体会总结如下。1　临床资料1.1　一般资料　本组 5 2 1例中男 2 5 9例 ,女 2 6 2例 ,4～ 13岁 ,均有慢性扁桃体炎史 ,反复发作 2年以上 ,其中扁桃体肥大 ,吞咽及呼吸障碍 2 13例 ,病灶性扁桃体炎 12 4例 ,反复化脓感染 184例。1.2　方法　以 3%利多卡因喷雾咽部2次 ,量不宜过多 ,患者取仰卧头低位 ,用无菌盖布包裹躯干及四肢 ,由助手双手固定患儿头部 ,术者右手持挤切刀 ,左手用拇指挤压扁桃体 ,嘱患儿张口 ,先挤右侧扁桃体 ,然后…     

雌、孕激素受体和Her-2阴性乳腺癌的临床病理特征

Objective To study the clinicopathologic characteristics of triple-negative breast cancer (TNBC) and its value in the prediction of prognosis. Method In this study,500 cases of female breast cancers were examined immunohistochcmically for the TNBC. The clinicopathologic characteristics of the 243 TNBC cases were inspected. Results TNBC accounted for 17.6% (88/500) of the 500 breast cancers. The histological types of the TNBC included mainly infihrative ductal carcinoma, metaplastic carcinoma and medullar carcinoma. Among those, histological grade Ⅲ accounted for 72.7% (64/88) of all the TNBC and was more common than that in hormone receptor positive breast cancers (HR+ group ) and Her-2 overexpression breast cancers (Her-2 group)(P=0.000). The positive rates of CK5/6 and EGFR in the TNBC were 30.7% (27/88) and 34.1% (30/88), respectively. The positive rates of ERCC1 and KIT in the TNBC were 28.4% (25/88) and 34.1% (30/88), respectively, Both of which were higher than those in the HR + group and Her-2 group, respectively (P=0.032 and P=0.026). 3-year survival rate of the TNBC was 71.5% and it was lower than that of HR group (P=0.021) and not significantly different from that of Her-2 group (P=0.474). Conclusions TNBC is the breast cancer with high aggressive pathologic futures and poor prognosis. EGFR and ERCC1 expression were positive in a portion of TNBC cases.     

肠内营养对质子泵抑制剂导致的胃肠道不良反应的保护作用

目的：观察肠内营养对危重患者质子泵抑制剂（proton pump inhibitors，PPIs）相关的消化道不良反应的作用。方法：采用横断面研究，对全国100家医院ICU内2017年4月25日住院的所有患者（不包括当天新入院患者）进行问卷调查。所用问卷包括自行设计问卷和标准化问卷，了解患者一般情况、使用的药物和治疗、营养实施情况、喂养耐受性评估、实验室检查结果、体重指数（body mass index，BMI）、急性胃肠损伤（acute gastrointestinal injury，AGI）分级、SOFA（sepsis?related organ failure）评分、急性生理功能和慢性健康状况评分系统Ⅱ（acute physiology and chronic health evaluation Ⅱ，APACHE?Ⅱ）评分等。采用单因素分析使用PPIs是否对胃肠功能有所影响，多因素Logistic回归模型考察肠内营养是否为患者发生AGI的影响因素。结果：①未给予肠内营养的508例患者中，使用PPIs的401例（78.9%），未使用PPIs的107例（21.1%）。使用PPIs组的AGI 2~3级和AGI 4级的患者比例（17.0%和3.8%）明显高于非PPIs组（9.3%和1.9%），差异有统计学意义（P=0.027）；②1 138例使用过PPIs的患者中，已开始肠内营养的724例（63.6%）患者AGI分级评分（AGI 2~3级为10.5%，AGI 4级为0.7%）优于未开始肠内营养的401例（35.2%）患者（AGI 2~3级为17.0%，4级为3.8%），差异有统计学意义（P＜0.001）。但两组在28 d转归方面差异无统计学意义。多因素Logistic回归结果显示，肠内营养为AGI评分的独立保护因素（OR=0.353，95%CI：0.242~0.513，P＜0.001）。结论：肠内营养与保护PPIs所导致的ICU患者胃肠功能损伤存在关联性，但未发现其与患者死亡率降低有关。     

信息动态

重症急性胰腺炎(SAP)往往涉及多系统器官功能,病情危重,并发症多,病死率高,是临床常见危重症,治疗和护理难度很大[1].有文献报道,SAP并发结肠瘘发生率约为3.2％ ～11.4％.一旦发生往往是致命性的,病死率高达24.0％ [2-3].临床处理结肠瘘常见方法为末端回肠造口,回肠消化液腐蚀性很大,一旦在造口处外漏,会导致造口周围皮肤红肿、疼痛、糜烂、坏死,甚至导致造口塌陷,伤口疼痛,病人体位受限,降低病人的舒适度,影响疾病预后.为此,我们胰腺炎治疗中心对SAP回肠造口伴有造口周围炎的病人使用可塑型二件式造口袋进行造口管理,现报道如下.     

雌、孕激素受体和Her-2阴性乳腺癌的临床病理特征

Objective To study the clinicopathologic characteristics of triple-negative breast cancer (TNBC) and its value in the prediction of prognosis. Method In this study,500 cases of female breast cancers were examined immunohistochcmically for the TNBC. The clinicopathologic characteristics of the 243 TNBC cases were inspected. Results TNBC accounted for 17.6% (88/500) of the 500 breast cancers. The histological types of the TNBC included mainly infihrative ductal carcinoma, metaplastic carcinoma and medullar carcinoma. Among those, histological grade Ⅲ accounted for 72.7% (64/88) of all the TNBC and was more common than that in hormone receptor positive breast cancers (HR+ group ) and Her-2 overexpression breast cancers (Her-2 group)(P=0.000). The positive rates of CK5/6 and EGFR in the TNBC were 30.7% (27/88) and 34.1% (30/88), respectively. The positive rates of ERCC1 and KIT in the TNBC were 28.4% (25/88) and 34.1% (30/88), respectively, Both of which were higher than those in the HR + group and Her-2 group, respectively (P=0.032 and P=0.026). 3-year survival rate of the TNBC was 71.5% and it was lower than that of HR group (P=0.021) and not significantly different from that of Her-2 group (P=0.474). Conclusions TNBC is the breast cancer with high aggressive pathologic futures and poor prognosis. EGFR and ERCC1 expression were positive in a portion of TNBC cases.     

门诊护士的语言形象对护理工作的影响

门诊是接待病人,完成一般治疗护理的前沿阵地,护士稳重的举止,恰当的语言,得体的着装,大方的仪表,加上和蔼的态度,会给病人带来良好的感觉,使病人产生安全感、信赖感、亲切感.反之,衣冠不整、态度生硬、操作时动作粗暴,会使病人没有安全感甚至产生惧怕心理,从而影响了护士的形象,同时也影响了医院的整体形象,因此,门诊护士的语言形象对护理工作的影响至关重要.