门诊分诊叫号系统构建

以江苏省人民医院为例，介绍医院门诊分诊叫号系统设计。从软硬件实现两方面阐述系统整体架构、具体功能和应用实践，指出该系统有助于改善门诊就医环境、减轻医护人员工作压力、提升患者满意度。     

幕下肿瘤切除术后局部积液的预防和治疗

我院近3年间手术治疗幕下肿瘤71例，其中17例术后出现不同程度的发热、头痛、强迫头位、手术区皮瓣隆起，经CT检查可见后颅窝局部积液，占总病例数的24％。部分积液病例在处理上非常棘手，给患者带来了身心痛苦和经济负担。我们对这些病例进行分析总结，并提出预防和治疗措施。     

女性腹部脂肪抽吸手术前后焦虑抑郁状态调查

目的探讨女性腹部脂肪抽吸手术前后焦虑、抑郁情绪反应的发生率及变化情况。方法采用焦虑自评量表、抑郁自评量表对行腹部脂肪抽吸女性病人76例及随机抽取正常青年女性104人为调查对象。结果术前焦虑状态、抑郁状态发生率分别为28.96%、23.67%,术后焦虑状态、抑郁状态发生率分别为23.69%、18.40%,分别与对照组比较均存在显著性差异（P〈0.05）,手术前后焦虑自评量表、抑郁自评量表评分比较,术后焦虑量表评分明显低于术前（P〈0.05）,高于对照组（P〈0.05）,而术后抑郁自评量表与术前比较无显著性差异（P〉0.05）。结论女性腹部脂肪抽吸手术前普遍存在焦虑、抑郁情绪障碍,在病人术前和术后应加强心理干预。     

Evaluation of Percutaneous Transforaminal Endoscopic Discectomy in the Treatment of Lumbar Disc Herniation: A Retrospective Study

ObjectiveThe objective of the present study was to evaluate the safety and efficacy of percutaneous transforaminal endoscopic discectomy (PTED) and open fenestration discectomy (OFD) in the treatment of lumbar disc herniation (LDH).MethodsPatients in our hospital with LDH who received PTED (n = 71) and OFD (n = 39) from 2013 to 2014 were retrospectively studied. Patient information, including age, gender, visual analogue scale (VAS) score for low back pain and leg pain, body weight, height, Oswestry disability index (ODI), Japanese Orthopedic Association (JOA), and recurrence, was collected. The patients in the two groups were followed up for an average of 63 months after surgery.ResultsA total of 136 patients completed the operation and 110 patients were followed up completely. There was no significant difference in baseline data between the two groups (P > 0.05). The postoperative low back pain, leg pain, ODI, and JOA of the two groups were better than those preoperatively (P < 0.05). One week after surgery, the recovery of PTED patients was better than that of OFD. The ODI score of the PTED group was lower than that of the OFD group (10 [8, 12] vs 14 [11, 16]; P < 0.05), the waist VAS score of the PTED group was lower than that of the OFD group (2 [2, 3] vs 3 [2, 4]; P < 0.05), the leg VAS score of the PTED group was lower than that of the OFD group (1 [0,1] vs 1 [1, 2]; P < 0.05), while the JOA score of the PTED group was higher than that of OFD group [19(16, 20) vs 12(10, 17); P < 0.05]. There were no significant differences in ODI, JOA, waist and leg VAS scores between the two groups at 1 month after surgery and at subsequent follow‐up (P > 0.05). At the end of the follow up, 89.7% (35/39) of patients in the OFD group had excellent improvement in the JOA score, and 88.7% (63/71) of patients in the PTED group had an excellent improvement. There was no significant difference between the two (P > 0.05). There was also no significant difference in the recurrence rate between the two groups [(5/71) vs (3/39); P > 0.05]. [Correction added on 05 March 2021, after first online publication: “3/29” was amended to “3/39” in the preceding sentence.]ConclusionBoth PTED and OFD can achieve good mid‐term efficacy in the treatment of LDH but PTED has certain advantages, including the small incision, a shorter hospital stay, and quicker, earlier recovery. However, prospective randomized controlled studies with a larger sample size are needed.     

青年与老年急性心肌梗塞临床差异性探讨

目的 :探讨青年与老年急性心肌梗塞 (AMI)的临床特点。方法 :对 1 5例青年组 (年龄≤ 40岁 )与 1 4 3例老年组 (年龄≥ 6 5岁 ) AMI的临床资料进行了对比分析。结果 :青年组 AMI吸烟者占 73.3% ,明显高于老年组 (P<0 .0 1 )。老年组 AMI发病率 38.9% ,无心绞痛者占 37.8% ,合并心力衰竭、心源性休克及病死率分别为 2 9.4%、2 2 .4%及 2 7.3% ,均明显高于青年组 (P<0 .0 5 )。结论 :青年组 AMI吸烟者明显高于老年组 ,老年组 AMI发病率、无心绞痛者、合并心力衰竭、心源性休克及死亡率均明显高于青年组     

应用PCR—SSCP非同位素技术检测人宫颈癌nm23—H1基因突变

恶怀肿瘤病人死亡的主要原因非原发灶本身,而是肿瘤细胞发生转移、浸润全身各器官引起器官功能衰竭所致。宫颈癌是妇科凶的恶性肿瘤,其发病率高居妇科各种肿瘤之首。本研究利用ＰＣＲ－ＳＳＣＰ非同位素技术检测人宫颈癌组织中是否存在转移抑制基因ｎｍ２３－Ｈ１基因突变。其中正常组织２０例。慢性宫颈炎组织３０例的未发现ｎｍ２３－Ｈ１基因突变。２４例宫颈癌组织中Ⅰ例Ⅲ期低分宫颈腺癌组织中发生ｎｍ２３－Ｈ１基因突变。结     

奈达铂（Nedaplatin）在大鼠体内的肾毒性和骨髓抑制的时辰毒理学研究

目的:以大鼠为实验对象,通过测定给药时间与奈达铂(Nedaplatin)诱发的肾毒性和骨髓抑制的关系,研究铂(Pt)衍生物奈达铂的时辰毒理.方法:于8:00或20:00通过尾静脉给S-D大鼠(n=8)注射奈达铂(5 mg/kg体重)或空白溶媒,给药间隔为7天.定期采血、采尿测定血清肌苷清除率和周边血中的中性粒细胞.最后一次给药后24小时,处死动物,采集肾脏和大腿骨用于Pt浓度测定和组织学检查.共给药6次.结果:20:00给药组的体重抑制明显高于8:00给药组,实验结束时,两实验组均有2只动物死亡.奈达铂诱发的骨髓抑制没有明显的给药时间相关性,但20:00给药组的肾毒性明显大于8:00给药组.肌苷清除率和肾组织损伤积分均与肾皮质中n的含量有很好的相关性.结论:奈达铂诱发的肾毒性和药物在组织中的蓄积与给药时间有很好的相关性,提示该类药物在临床使用过程中应注意给药时间的选择.     

Spectral characterization of squeaking in ceramic‐on‐ceramic total hip arthroplasty: Comparison of in vitro and in vivo values

Squeaking is a cause for concern in total hip arthroplasty (THA). However, the definition of this sound remains vague. Our goals were to characterize spectrally the squeaking in vitro under lubricated conditions and to compare the in vitro frequencies to in vivo frequencies. Four patients, who presented with a squeaking after ceramic‐on‐ceramic THA were investigated. In addition, 3 alumina ceramic 32 mm diameter components were tested in vitro under edge loading conditions using a friction simulator. Tests were conducted under lubricated conditions without and with the addition of a third body alumina particle. In vitro, no squeaking occurred under edge loading conditions. However, with the addition of a third body particle in the contact region, squeaking was obtained; the dominant frequency was 2.6 kHz. In vivo, the main recorded sound frequencies were: 2.3, 2.24, and 2.46 kHz for squeakers during walking and 1.45 kHz for a squeaker rising from a bent position. The in vivo recordings had a dominant frequency similar to, but slightly lower than, the in vitro values. Two types of squeaking were found in vivo and characterized spectrally. The rising squeaker had intermittent squeaking corresponding to a lower fundamental frequency compared to the walking squeakers. This finding suggests two different mechanism of squeaking. © 2011 Orthopaedic Research Society Published by Wiley Periodicals, Inc. J Orthop Res 30:185–189, 2012     

Stage-specific regulation of oligodendrocyte development by Hedgehog signaling in the spinal cord

Elucidation of signaling pathways that control oligodendrocyte (OL) development is a prerequisite for developing novel strategies for myelin repair in neurological diseases. Despite the extensive work outlining the importance of Hedgehog (Hh) signaling in the commitment and generation of OL progenitor cells (OPCs), there are conflicting reports on the role of Hh signaling in regulating OL differentiation and maturation. In the present study, we systematically investigated OPC specification and differentiation in genetically modified mouse models of Smoothened (Smo), an essential component of the Hh signaling pathway in vertebrates. Through conditional gain-of-function strategy, we demonstrated that hyperactivation of Smo in neural progenitors induced transient ectopic OPC generation and precocious OL differentiation accompanied by the co-induction of Olig2 and Nkx2.2. After the commitment of OL lineage, Smo activity is not required for OL differentiation, and sustained expression of Smo in OPCs stimulated cell proliferation but inhibited terminal differentiation. These findings have uncovered the stage-specific regulation of OL development by Smo-mediated Hh signaling, providing novel insights into the molecular regulation of OL differentiation and myelin repair.     

A short review of recent advances in CO2 hydrogenation to hydrocarbons over heterogeneous catalysts

CO₂ hydrogenation to hydrocarbons is a promising way of making waste to wealth and energy storage, which also solves the environmental and energy issues caused by CO₂ emissions. Much efforts and research are aimed at the conversion of CO₂via hydrogenation to various value-added hydrocarbons, such as CH₄, lower olefins, gasoline, or long-chain hydrocarbons catalyzed by different catalysts with various mechanisms. This review provides an overview of advances in CO₂ hydrogenation to hydrocarbons that have been achieved recently in terms of catalyst design, catalytic performance and reaction mechanism from both experiments and density functional theory calculations. In addition, the factors influencing the performance of catalysts and the first C–C coupling mechanism through different routes are also revealed. The fundamental factor for product selectivity is the surface H/C ratio adjusted by active metals, supports and promoters. Furthermore, the technical and application challenges of CO₂ conversion into useful fuels/chemicals are also summarized. To meet these challenges, future research directions are proposed in this review.

CO₂ hydrogenation to hydrocarbons over heterogeneous catalysts.