简介：摘要目的探讨心理护理在患儿静脉穿刺中的作用。方法运用沟通技巧，分散患儿的注意力，作好解释工作，处理好与家属的关系，提高护理人员的水平。结果观察组的患儿家长满意度96%明显高于对照组患儿家长满意度80%。经比较,差异具有明显的统计学意义(P<0.05)。结论能使患儿提高对静脉输液的依从性，提高穿刺成功率，改善护患关系，提高了医务人员的工作效率和患者满意度。

简介：无

简介：AbstractThe first practice of pre-implantation genetic testing (PGT) was reported more than 30 years ago. PGT, originally named preimplantation genetic screening (PGS) and pre-implantation genetic diagnosis (PGD), is now categorized as PGT for aneuploidies (PGT-A), PGT for monogenic/single-gene defects (PGT-M), and PGT for chromosomal structural rearrangements (PGT-SR). Patients with fertility issues caused by advanced maternal age, carrier status of chromosomal abnormalities, or harboring pathogenic variant(s) are recommended to undergo PGT to increase the possibility of successful live birth and avoid potentially affected newborns. High-throughput techniques, such as DNA microarrays and next-generation sequencing (NGS), have enabled comprehensive screening of all 24 chromosomes, instead of few loci at a time. Furthermore, as a comprehensive PGT, PGT-Plus was enabled by the rapid development of a genome-wide single-cell haplotyping technique to detect embryo aneuploidy, single-gene disorders, and chromosomal aberrations simultaneously using a single universal protocol. In addition, non-invasive approaches enable a more intact embryo during the biopsy procedure, which may avoid potential mosaicism issues at a certain scale by testing spent culture media (SCM). As a novel PGT application, PGT-P detects genome-wide variations in polygenic diseases, which account for a large proportion of premature human deaths and affect a markedly larger population than monogenic diseases, using polygenic risk score calculation to decrease the potential of affecting complex conditions. Owing to the emergence of new technologies recruited to PGTs, more couples with infertility issues have a promising chance of conceiving a healthy baby, ultimately facilitating the human species to live more prosper.

简介：无

简介：目的探讨乙型肝炎病毒pre—S1Ag、pre—S2Ag、HBV—DNA、HBV—M的相关性及其临床意义。方法HBV—DNA采用荧光定量PCR法；HBV—M及pre—S1Ag、pre—S2Ag采用ELISA法，检测96例HBV—DNA阳性感染者血清中pre-S1Ag、pre—S2Ag、HBV—M，同时以30例HBV—M全阴性的健康体检者血清作为对照，并对结果进行统计学分析。结果96例HBV—DNA阳性患者中HBsAg、HBeAg、HBcAb阳性检出率为64．6％；HBsAg、HBeAb、HBcAb阳性检出率为20．8％；HBsAg、HBcAb阳性栓出率为14．6％；pre—S1Ag在96例HBV—DNA阳性标本中检出率为70．8％；pre—S2Ag检出率为79．2％；均明显高于HBeAg的阳性率64．6％，30例对照中未检测出pre—S1Ag、pre—S2Ag及HBV—DNA。结论HBeAg、HBV—DNA、pre—S1Ag、pre—S2Ag之间具有一定的关联性。pre—S1Ag和pre—S2Ag均较HBeAg敏感。pre—S1Ag与pre—S2Ag的栓出率差异无显著性，ELISA检测HBV—M、pre—S2Ag及pre—S1Ag只是表型指标，只能提供HBV感染的间接证据。而HBV—DNA的检测是HBV感染与否的直接证据。HBV—M、pre—S1Ag、pre—S2Ag、HBV—DNA的检测各自有其独特的临床意义。应用pre—S1Ag、pre—S2Ag、HBV—DNA及HBV—M进行联合检测，对HBV感染的早期诊断，了解HBV复制、转归及监测疗效和预后有重要的意义。

简介：Pre-mRNAsplicingisafundamentalprocessrequiredfortheexpressionofmostmetazoangenes.Itiscarriedoutbythespliceosomethatcatalyzestheremovalofnon-codingintronsequencestoligateexonsintomaturemRNApriortotransportandtranslation.Thepurposeofourstudyistoexplorewhethertheinvitrounlabeledpre-mRNAsplicingassaycouldbeperformedasanalternativemethodofsplicingreactionotherthantheradiolabeledone.Twodifferentsplicingmethodsinvitro,Plabeledandunlabeledpre-mRNAasthesubstratesinthereaction,wereinvestigated.TheradiolabeledproductswerevisualizedbyautoradiographywhiletheunlabeledproductswereobservedbyEthidiumBromide(EB)staining.Asaresult,althoughtherearemoreunspecificbandsintheEBstainingassaythan32Plabeledone,theRNAproductsofinvitrosplicingcouldbeobservedclearly.Thissuggeststhattheunlabeledpre-mRNAsplicingassaycanbeanoptionalsubstitutionfortheisotope-labeledassay.

简介：Gapinducedpie-pulseinhibition(Gap-PPI)ofacousticstartlereflexhasbeenusedasameasurementoftinnitusinanimalmodels.However,whetherthistestissensitivetodetecttinnitusinhumansisstillunclear.Basedonthetestingprocedureusedinanimalstudies,ahumansubjecttestingmethodwasformulatedandconductedtoinvestigateifasimilarresultcouldbefoundintinnituspatients.Audiologicandtinnitusassessmentsandacousticstartlereflexmeasurementswereperformedonseventinnitussubjectsandnineagematchedsubjectswithouttinnitus.TherewasnosignificantdifferencefoundbetweenthecontrolandtinnitusgroupontheGap-PPlacrossthefrequenciesevaluated.Theamplitudeofthestartleresponseinthetinnitusgroupwithnormalhearingthresholdswassignificantlyhigherthanthecontrolgroupandthosewithtinnitusandhearingloss.Thispreliminaryresultsuggeststhathyperexcitabilityinthecentralauditorysystemmaybeinvolvedintinnitus.Therewasnocorrelationbetweenhearingthresholdsandtheincreasedamplitudeofstartleresponse.

简介：Objective:Toreportasurgicalmethodforthetreatmentofpre-auricularfistulatolowerpost-operativerecurrencerate.Methods:Clinicaldataof187patientswithpre-auricularfistulawhounderwentenblocresectionattheAffiliatedHospitalofLuzhouMedicalCollegefromAugust2006toNovember2012wereretrospectivelyreviewed.FactorsthatmightaffecttheprognosisfollowingEnblocfistularesectionborderedbythesuperficialtemporalisfascia,helixperichondriumandauriculocephalicsulcuswereinvestigated.Results:Ofthe187patients,181achievedprimaryhealingand6endedupwithdelayedhealing.Duringthefollow-upperiod(onetosevenyears),therewere4casesofrecurrence(2.1%).Conclusions:Cleardemarcationofsurgicalresectioncanfacilitateeasyandthoroughresectionofpreauricularfistulaandleadtolowrecurrencerate.Propertimingandcarefulsearchforpotentialfistulabranchesarethetwocrucialfactorsaffectingprognosis.

简介：摘要：目的：探讨腹部B超检查在职业健康体检中的应用。方法：选取2021年10月8日到2021年12月20号之间，在我体检中心进行腹部B超健康检查的120例职业人士作为本次试验的受试者，以上所有受试者的检查项目包括血常规、尿常规、心电图以及腹部B超检查，回顾性分析以上所有患者的检查结果，探讨在常规职业检查中腹部B超的应用效果。结果：在此次检查中，共有28例患者被检出患有腹部疾病，腹部B超的总检出率为45%，其中有9例患者患有脂肪肝，4例患者患有肾结石，5例患者患有子宫肌瘤，5例患者患有肾囊肿，5例患者患有胆囊结石。且以上检查结果均经后续临床病理学检查确定。结论：针对职业健康体检，应用腹部B超进行检查，疾病的检出率更高，检出时间快，为患者后续治疗提供时间，适合在临床推广应用。

简介：无

简介：万献尧，男，大连医科大学附属一院重症医学科（中心ICU）主任，教授，主任医师，硕士研究生导师。中华医学会重症医学分会第一和第二届全国委员、中华医学会创伤学分会创伤与感染学组委员、第9届中国病理生理学会理事、中国病理生理学会危重症专业委员会常委、中国医师协会重症医学医师分会委员、中国医师协会急救复苏专业委员会委员、中华医学会辽宁省重症医学分会副主任委员、大连市医学会理事、大连市医学会重症医学分会主任委员。

简介：无

简介：AbstractCurrently, the diagnosis of tuberculosis (TB) is mainly based on the comprehensive consideration of the patient's symptoms and signs, laboratory examinations and chest radiography (CXR). CXR plays a pivotal role to support the early diagnosis of TB, especially when used for TB screening and differential diagnosis. However, high cost of CXR hardware and shortage of certified radiologists poses a major challenge for CXR application in TB screening in resource limited settings. The latest development of artificial intelligence (AI) combined with the accumulation of a large number of medical images provides new opportunities for the establishment of computer-aided detection (CAD) systems in the medical applications, especially in the era of deep learning (DL) technology. Several CAD solutions are now commercially available and there is growing evidence demonstrate their value in imaging diagnosis. Recently, WHO published a rapid communication which stated that CAD may be used as an alternative to human reader interpretation of plain digital CXRs for screening and triage of TB.

简介：AbstractBackground:We aimed to describe and analyze the pre-hospital emergency medical service (EMS) in Beijing and provide information for the government and medical institutions to optimize EMS.Methods:We collected all pre-hospital emergency data in Beijing from 2008 to 2017. The chief complaint in each case was classified according to the Medical Priority Dispatch System (MPDS). The sites’ administrative districts were determined through geo-encoding of addresses and then classified into four functional regions. We analyzed the demand for EMS, emergency response times (ERT), and disease spectrum for Beijing as a whole, and for each functional region.Results:A total of 4,192,870 pre-hospital EMS cases met the inclusion criteria, with a significant increase (P < 0.001) of 51.60% from 2008 to 2017. EMS demand was positively associated with population (r= 0.946, P < 0.001). The pre-hospital EMS demand rate was 1907.05 in 2008 and 2172.23 in 2017 per 100,000, with no significant change (P = 0.57). ERT increased significantly (P = 0.001), from 19.18 min in 2008 to 24.51 min in 2016. According to MPDS classifications, the demand for pre-hospital care increased for 14 diseases, remained stable for 19, and decreased for only 1 disease. Cases of injury-related disease increased significantly from approximately 90,000 in 2017, accounting for 20% of all pre-hospital EMS cases, and the demand rate decreased in the core region but increased in the sub-urban regions. Cases of heart problems and stroke/transient ischemic attack also increased significantly in the four functional regions, with the highest demand rate in the Core Functional Region.Conclusions:More resources and effort should be devoted to pre-hospital EMS according to the increased pre-hospital EMS demand and prolonged ERT in Beijing over our 10-year study period. Changes in disease spectrum and differences between functional regions should also be considered.

简介：Atotalof30studentsscoringbetween12and20ontheTestAnxietyScalewhohadbeenexhibitingananxiousstate>24hours,and30normalcontrolstudentswererecruited.IndicesofheartratevariabilitywererecordedusinganActiheartelectrocardiogramrecorderat10minutesbeforeauricularpressing,inthefirsthalfofstimulationandinthesecondhalfofstimulation.Theresultsrevealedthatthestandarddeviationofallnormaltonormalintervalsandtherootmeansquareofstandarddeviationofnormaltonormalintervalsweresignificantlyincreasedafterstimulation.Theheartratevariabilitytriangularindex,very-low-frequencypower,low-frequencypower,andtheratiooflow-frequencytohigh-frequencypowerwereincreasedtodifferentdegreesafterstimulation.Comparedwithnormalcontrols,therootmeansquareofstandarddeviationofnormaltonormalintervalswassignificantlyincreasedinanxiousstudentsfollowingauricularpressing.Theseresultsindicatedthatauricularpressingcanelevateheartratevariability,especiallytherootmeansquareofstandarddeviationofnormaltonormalintervalsinstudentswithpre-examanxiety.

简介：无

简介：目的探讨构建携带人pre—mir181a基因的重组腺病毒载体，为基因治疗研究提供一种新的方法，并观察其在神经胶质瘤细胞U251细胞中的表达。方法以从Genesil公司购买的含有mir181a的质粒为模板扩增pre—mir181a基因，将回收的PCR产物片段克隆入pGenesil载体，获得重组质粒pGenesil—pre—mir181a。从pGenesil—pre—mir181a上通过LR体外同源重组将mir181amicroRNA表达框转移至pGSadeno腺病毒表达载体上。在体外用不同感染复数（M·O·I）值rAd5-mir181ab分别转染神经胶质瘤细胞U251细胞。采用流式细胞仪、RT—PCR方法检测目的基因的转染效率和表达。结果PCR、酶切鉴定以及序列测定与比对分析表明，重组腺病毒rAd5-mir181a构建正确。神经胶质瘤细胞U251细胞转染rAd5-mir181a的最高效率可达99％，转染后的神经胶质瘤细胞U251细胞表达相应的mir181a。结论本实验成功构建了含mir181a基因的重组腺病毒rAd5-mir181a载体，在体外能高效转染神经胶质瘤细胞U251细胞。

简介：摘要目的探讨乙肝病毒前S1抗原（Pre-S1Ag）与HBV血清标志物（HBVM）同步检测的临床价值。方法对确诊的380例乙肝病例空腹抽血，采用ELISA法及HAMILTN全自动酶联免疫分析仪同步检测Pre-S1Ag与HBVM（HBsAg、抗-HBs、HBeAg、抗-HBe、抗-HBc），并对结果进行比较分析。统计学处理采用χ2检验。结果统计显示PreS1Ag的检出率HBsAg、HBeAg、HBcAb阳性组（78.8%）明显高于HBsAg、HBeAb、HBcAb阳性组（41.6%），差异有显著性（χ2=21.04，P＜0.01）；HBsAg、HBeAg阳性组PreS1Ag阳性率（79.3%）明显高于HBsAg、HBcAb阳性组（25.3%），提示HBeAg阳性组中PreS1Ag阳性率明显高于HBeAg阴组，差异有显著性(χ2=21.49，P＜0.01)；提示PreS1Ag是一个与HBeAg同时存在的较好指标。结论前S1抗原与病毒复制有关，与HBeAg具有一致性；与HBVM同步检测，可减少和避免HBeAg系统发生变异所致的假阴性对临床的误导。

简介：AbstractTotal pancreatectomy with islet autotransplantation (TPIAT) is an effective treatment option for non-diabetic patients with intractable chronic pancreatitis. The outcome and potential benefits for pre-diabetic and diabetic patients are less well established. Thirty-four patients underwent TPIAT were retrospectively divided into 3 groups according to pre-operative glycemic control: diabetes mellitus (DM) (n=5, 15%), pre-DM (n=11, 32%) and non-DM (n=18, 54%). Pre-operative fasting c-peptide was detectable and similar in all 3 groups. Islet yield in the DM group was comparable to pre-DM and non-DM groups (median islet equivalents [IEQ] was 191,800, 111,800, and 232,000 IEQ, respectively). Patients received islet mass of over the target level of 2000 IEQ/kg in pre-DM and DM at lower but clinically meaningful rates compared to the non-DM group: 45% (5/11) and 60% (3/5) for a combined 50% (8/16) rate, respectively, compared to 83% (15/18) for the non-DM group. At 1 year, fasting c-peptide and HbA1c did not differ between DM and pre-DM groups but c-peptide was significantly higher in non-DM. Islet transplantation failed (negative c-peptide) only in 1 patient. Preoperatively, all patients experienced pancreatic pain with daily opioid dependence in 60% to 70%. Pancreatic-type pain gradually subsided completely in all groups with no differences in other painful somatic symptoms. Diabetic patients with measurable pre-operative c-peptide can achieve similar benefit from TPIAT, with comparable outcomes to pre-diabetic and non-diabetic patients including pain relief and the metabolic benefit of transplanted islets. Not surprisingly, endocrine outcomes for diabetic and prediabetics patients are substantially worse than in those with normal pre-operative glucose control.

简介：摘要黄尧洲教授认为，银屑病的根本病因为素有血热，主要发病诱因为感受外邪。银屑病的治疗应兼顾血热和外邪两方面，治疗过程中顾护正气，灵活选择清轻升散的药物，散表不伤正，标本兼顾；清热凉血药物的选择兼顾凉血、化瘀、收敛等方面，一药数用，随证加减，取得了较好的临床疗效。