Flow-through arterialized venous free thenar flaps for palmar soft tissue defects in fingers

ObjectiveTo evaluate the efficacy of venous free thenar flaps for reconstructing palmar soft tissue defects in fingers.MethodsFrom December 2018 to October 2019, 11 patients with palmar soft tissue defects in fingers were treated using venous free thenar flaps. At the final follow-up, the range of thumb radial and palmar abduction on the injured side and opposite side was calculated. The total active movement (TAM) of the injured and opposite fingers and flap sensibility recovery were also recorded.ResultsThe mean follow-up time was 13.4 months, all flaps survived, and all wounds at the donor sites healed with no skin necrosis. At the last follow-up, the average range of thumb radial abduction and thumb palmar abduction on the injured side was 96.6% and 95.9% of the value on the opposite side, respectively. The average TAM of the injured fingers was 98.2% of the value of the opposite fingers. Sensation in the flaps was restored to grade S2 to S3.ConclusionVenous free thenar flaps can be alternatives for reconstructing palmar soft tissue defects in fingers.     

臭茉莉叶总黄酮提取工艺优化及月周期变化研究

目的:采用超声辅助正交试验法优化臭茉莉叶总黄酮的提取工艺,并进一步研究臭茉莉叶中总黄酮1年内每月含量变化趋势,探讨臭茉莉叶最佳采收时间。方法:以提取液中总黄酮含量为指标,选择乙醇浓度(%)、超声时间(min)、料液比、提取温度(℃)等为考察因素,采用正交试验法L9(34)确定臭茉莉叶提取液中总黄酮的最优工艺。结果:臭茉莉叶所含总黄酮最优提取工艺条件:乙醇浓度70%、超声时间60min、料液比1∶25、提取温度50℃。3月份总黄酮/药材量是0.0235mg·g-1为最高。结论:该提取工艺快捷以及操作简便,适用于臭茉莉叶总黄酮的提取。结合总黄酮月周期变化规律,可以确定1年中5月份和7月份为最佳采摘期。     

基于CiteSpace的中医药治疗肺癌知识图谱可视化分析＊

目的 基于CiteSpace工具，对中医药治疗肺癌的文献进行知识图谱可视化分析，探索中医药治疗肺癌的发展状况。方法 在中国知网中检索2009年-2018年中医药治疗肺癌的相关文献，应用CiteSpace3.9.R6软件对作者、机构、关键词绘制知识图谱并进行分析。结果 共纳入文献1050篇，近10年发文量较为稳定。研究学者440位，以徐振晔等为代表；研究机构为352家，以上海中医药大学附属龙华医院为代表；关键词为140个，频次最高的为非小细胞肺癌，聚类显示研究主要包括中医药治疗肺癌临床疗效观察、名老中医诊治肺癌规律分析、生物学机制研究及中西医结合治疗肺癌等方向。应用数据挖掘技术于该领域是目前研究主流，且持续性可观。结论 近10年我国中医药治疗肺癌领域正处于蓬勃发展时期，中医药治疗肺癌具有独特优势，通过图谱初步直观展现了该领域发展脉络、研究热点及前沿趋势，为科研人员提供研究方向。     

升髓合剂防治化疗后骨髓抑制的临床研究

目的:观察患者临床症状、客观检测指标及用药期间是否出现不良反应等,评价升髓合剂对多西他赛联合顺铂方案(Docetaxel Combined with Cis-platinum,DP)化疗所致骨髓抑制的有效性及安全性。方法:将50例符合标准的恶性肿瘤患者随机分为两组,治疗组和对照组各25例。对照组:DP方案化疗同时加服地榆升白片,治疗组:在DP方案化疗基础上加用升髓合剂。2个周期后观察患者化疗后第3、7、14 d外周血细胞变化及骨髓抑制情况,化疗后中医临床症状评分及疗效以及体力状况评分(Karnofsky,KPS)、体质量变化及其不良反应。结果:①两组化疗完成率观察组明显高于对照组(P<0.05);②观察组血常规中白细胞、中性粒细胞、血小板计数治疗后1周与治疗前比较无统计学意义,(P>0.05),而对照组白细胞、中性粒细胞、血小板计数下降显著,与治疗前差异有统计学意义,(P<0.05);两组相比,化疗后1周观察组血常规白细胞、中性粒细胞、血小板水平明显高于对照组,差距有统计学意义(P<0.05);③化疗后2周观察组白细胞计数升高明显高于对照组,两组差异有显著性(P<0.05);④化疗后中医证候改善方面,观察组症状改善显著(P<0.05)。对照组症状上改善不明显(P>0.05),两组在总体症状改善率方面相比较有显著性差异,治疗组明显优于对照组(P<0.05);⑤治疗组KPS评分明显优于对照组(P<0.05);⑥治疗组不良反应的发生率明显低于对照组(P<0.05)。结论:升髓合剂对于多西他赛联合顺铂化疗方案引起的骨髓抑制等不良反应具有防治作用。     

新城镇居民自杀意念相关因素分析

目的 了解新城镇居民自杀意念的现状并分析其相关因素.方法 采用自编社会人口学问卷、PHQ-9健康问卷、广泛性焦虑量表(GAO-7)、自编自杀意念等,用便利抽样的方法对516名山东新城镇居民进行问卷调查.结果 新城镇居民过去一年内自杀意念检出率为7.33％,焦虑(OR=11.781,95％CI:4.531～30.633)是过去一年内自杀意念的危险因素,与父母关系一般(OR=0.179,95％CI:0.036～0.900)、与父母关系融洽(OR=0.084,95％CI:0.019～0.368)为保护因素.新城镇居民终生自杀意念检出率为13.88％,亲人有自杀意念(OR=8.653,95％CI:3.323～22.533)、偶尔饮酒(OR=2.579,95％CI:1,180～5.637)、睡眠异常(OR=2.602,95％CI:1.333～5.078)、焦虑(OR=3.680,95％CI:1.412～9.590)是终生自杀意念的危险因素,60岁及以上(OR=0.232,95％CI:0.100～0.537)、偶尔吸烟(OR=0.099,95％CI:0.014～0.687)为保护因素.结论 亲人有自杀意念、偶尔饮酒、睡眠异常、焦虑的新城镇居民易产生自杀意念,与父母关系融洽或一般、60岁及以上、偶尔吸烟的新城镇居民不易产生自杀意念.     

The association of metabolic health obesity with incidence of carotid artery plaque in Chinese adults

Background and aimsWe aimed to evaluate the association between different obese phenotypes with carotid artery plaque (CAP) event.Method and resultsThe current retrospective cohort study was performed in 32,778 Chinese adults (19,221 men and 13,557 women, aged 41.9 ± 11.0 years). Obese phenotypes were assessed based on baseline body mass index (<24.0 vs. ≥24.0 kg/m²) and metabolic characteristics (health vs. unhealth). All the participants were further classified into four groups: metabolic health and normal weight (MHNW), metabolic unhealth and normal weight (MUHNW), metabolic health and overweight (MHO), and metabolic unhealth and overweight (MUHO). Ultrasound B-mode imaging was annually performed to evaluate CAP throughout the study. We have identified 2142 CAP cases during 5-year follow-up. Comparing with the MHNW group, the hazard ratios for the risk of incident CAP was 2.44 (95% CI:1.92 and 3.09) for the MUHNW group, 1.52 (95% CI:1.06 and 2.18) for the MHO group, and 1.8 (95% CI:1.4 and 2.33) for the MUHO group. The association was more pronounced in young adults (<65 y) than that in aged adults (≥65 y). Sensitivity analysis generated similar results with the main analysis.ConclusionMUHNW, MHO, and MUHO were associated with the risk of CAP.     

临床护士共享治理在给药安全管理中的实践

目的 将共享治理的管理理念运用到给药安全管理中,提高护士给药安全的风险管理意识和参与度,降低给药错误隐患事件和给药错误发生率.方法 2019年7～12月将共享治理应用于病房给药安全管理中,并与2019年1～6月未实施共享治理时的给药隐患事件、给药错误发生率、护理人员决策参与程度等进行对比.结果 实施共享治理后给药隐患事件、给药错误发生率显著低于实施前(P＜0.05,P＜0.01);实施共享治理后护理人员决策参与度和给药安全理念得分显著高于实施前(均P＜0.01).结论 共享治理能有效提高护士给药安全的风险管理意识,降低给药错误及隐患事件的发生.