目的:研究替米沙坦對合并高血壓的陣發性房顫患者轉復為竇性心律后復發的影響。方法: 選擇84例合并高血壓的陣發性房顫患者,隨機分成觀察組及對照組,觀察組降壓藥使用替米沙坦,對照組使用氨氯地平,兩組均使用胺碘酮復律,隨訪2年,觀察兩組患者的療效及超聲心動圖(左房內徑)變化。結果:觀察組治療合并高血壓的陣發性房顫復發率顯著低于對照組。結論:替米沙坦聯合抗心律失常藥物,能有效防止房顫復發,維持竇性心律。
目的 調查安置永久性人工心臟起搏器的老年患者術前焦慮狀況，為制訂護理對策提供依據。 方法 2004年7月-2008年7月收治需安置永久性人工心臟起搏器的心臟病患者78例，術前采用焦慮自評量表（SAS）對其進行問卷調查，并采用自制一般情況問卷調查了解情況。 結果 植入永久性心臟起搏器的老年患者術前SAS得分高于國內常模（Plt;0.05）。根據自制調查問卷結果，差異有統計學意義（Plt;0.05）的項目:老年患者隨年齡增長焦慮量表評分降低；喪偶者焦慮評分高于有配偶者；完全公費、部分公費、自費的焦慮量表評分依次增高；老年患者對起搏器知識了解程度越少，焦慮評分越高；無家人陪伴者比有家人陪伴者焦慮評分高。而性別、文化水平差異無統計學意義。 結論 植入永久性起搏器的老年患者術前多數存在焦慮情緒，且焦慮與年齡、婚姻、費用支付方式、有無家人陪伴、相關知識等有一定關系，醫護人員應針對性地做好患者術前護理，幫助患者面對現實，以積極的心態接受手術治療。
Objective To study effect of carcinoembryonic antigen (CEA) positive targeted lymphocytes on gastric cancer cells in vitro and in vivo. Methods The peripheral blood mononuclear cells (PBMCs) were isolated from the peripheral blood of healthy volunteers. The recombinant vector anti-CEA-scFv-CD3ζ-pcDNA3.0 was transfected into the PBMCs by lipofectamine 2000, by this means, the CEA special lymphocytes were obtained. Meanwhile, the PBMCs transfected with empty plasmid pcDNA3.0 were used as control (empty vector lymphocytes). The different lymphocytes and gastric cancer cells (CEA positive KATOⅢ gastric cancer cells and CEA negative BGC-823 gastric cancer cells) were co-cultured, then the ability to identify the gastric cancer cells and it’s effect on apoptosis of gastric cancer cells were observed at 24 h or 36 h later respectively. The CEA special lymphocytes and empty vector lymphocytes were injected by the tail vein of nude mice bearing gastric cancer cells, then it’s effect on the tumor was observed. Results ① The CEA special lymphocytes could strongly identify the KATOⅢ gastric cancer cells (identification rate was 72.3%), which could weakly identify the BGC-823 gastric cancer cells (identification rate was 7.8%). ② The apoptosis rate of the co-culture of CEA special lymphocytes and KATOⅢ gastric cancer cells was significantly higher than that of the co-culture of empty vector lymphocytes and KATOⅢ gastric cancer cells (P=0.032), which had no significant difference between the co-culture of CEA special lymphocytes and BGC-823 gastric cancer cells and the co-culture of empty vector lymphocytes and BGC-823 gastric cancer cells (P=0.118). ③ The tumor volume of the co-culture of CEA special lymphocytes and KATOⅢ gastric cancer cells was significantly smaller than that of the co-culture of empty vector lymphocytes and KATOⅢ gastric cancer cells (F=5.010, P<0.01) or the co-culture of CEA special lymphocytes and BGC-823 gastric cancer cells (F=4.982, P<0.01), which had no significant difference between the co-culture of CEA special lymphocytes and BGC-823 gastric cancer cells and the co-culture of empty vector lymphocytes and BGC-823 gastric cancer cells (F=1.210, P>0.05). Conclusion CEA special lymphocytes can promote cell apoptosis and inhabit tumor reproduction of CEA positive gastric cancer cells in vitro and in vivo.
目的:觀察等效劑量瑞芬太尼和芬太尼誘導氣管插管對小兒血流動力學的影響。方法:40例擇期行全麻患兒隨機分為瑞芬太尼組和芬太尼組,麻醉誘導使用咪唑安定0.15mg/kg、丙泊酚2.5mg/kg、芬太尼2.5μg/kg或瑞芬太尼2μg/kg和維庫溴銨0.1mg/kg。分別于麻醉誘導前(T0)、誘導后2min(T1)、插管后1、2min(T2、T3)記錄心率、收縮壓和舒張壓。結果:兩組誘導前血流動力學指標相似。與T0時比較,兩組患兒T1時收縮壓、舒張壓均降低(Plt;0.05或Plt;0.01),心率均減慢(Plt;0.05或Plt;0.01);瑞芬太尼組T2.T3時收縮壓、舒張壓降低(Plt;0.05或Plt;0.01),心率減慢(Plt;0.05);芬太尼組T2、T3時收縮壓、舒張壓升高(Plt;0.05),心率增快(Plt;0.05)。與芬太尼組比較,瑞芬太尼組T1、T2和T3時收縮壓、舒張壓均降低(Plt;0.05),心率減慢(Plt;0.05)。結論:瑞芬太尼比等效劑量芬太尼能更好地抑制小兒全麻誘導氣管插管時的心血管反應。
ObjectiveTo investigate the method for generating anchor chemric T lymphocytes that can target tumor associated glycoprotein-72 (TAG72) antigen and analyze their repressive effects on proliferation of TAG72 positive hepatocarcinoma cells. MethodsFirstly, peripheral blood mononuclear cells (PBMCs) from healthy volunteers were isolated. And then, CD8+ T cells were isolated from PBMCs via magnetic activated cell sorting (MACS). These lymphocytes were transfected with recombinant vector, anti-TAG72-scFv-CD28-pcDNA3, through Lipofectamine2000 to gernerate anchor chimeric TAG72-specific CD8+ T cells. SMMC7721 (TAG72 positive) hepatocarcinoma cells were co-cultured with chimeric T lymphocytes and their cell cycles were analyzed by flow cytometry (FCM). ResultsAnchor chmeric T lymphcytes targetting TAG72 recognized TAG72 positive SMM7721 cells and repressive effects on their proliferation were observed by flow cytometry. ConclusionAnchor chmeric T lymphcytes targetting TAG72 on tumor surface can specifically recognize TAG72 positive hepatocarcinoma cells and may exert repressive effect on their proliferation.
Methods To explore the level of delirium knowledge of geriatric nurses in Sichuan province and analyze the factors, so as to provide the basis for systematic and targeted knowledge training on delirium and clinical management. Methods Using the self-designed “the Questionnaire of Elderly Delirium Knowledge”, geriatric nurses from 22 hospitals in Sichuan province were investigated through a convenient sampling method from September 2018 to February 2019. Results A total of 475 geriatric nurses were investigated. The average delirium knowledge score of the 475 geriatric nurses was 69.51±12.42. Multiple linear regression analysis showed that the main factors affecting the score of delirium-related knowledge were the education of nurses (P=0.037), technical title (P<0.001), years of working in the geriatric department (P=0.001), and the level of working hospital (P=0.001). Conclusions The level of delirium knowledge of geriatric nurses is low and can not meet the needs of clinical work. Nursing managers should carry out delirium knowledge training according to the different characteristics of nurses.
目的 總結神經外科復雜腦脊髓血管病雜交手術的護理配合經驗。 方法 回顧分析2011 年4 月－2012 年5月華西醫院手術室完成的 56例神經外科雜交手術的臨床資料，總結神經外科雜交手術的護理配合經驗。 結果 所有手術均順利進行，未出現明顯危及患者安全的情況。 結論 神經外科Hybrid手術治療復雜腦脊髓血管病較普通手術更為安全有效。但手術護理準備及配合更為復雜，在手術室布局、手術流程方面需要醫護協調專門進行優化。有神經外科專業經驗的護士經過一段時間專門培訓后擔任手術巡回及器械護士更有利于手術的順利、安全進行。
Objective To evaluate the effect of day surgery with diagnosis-related groups (DRG) evaluation indicators. Methods The inpatients undergoing surgery in Beijing Tongren Hospital of Capital Medical University between March and September 2022 were enrolled in this study. The medical quality, medical efficiency, hospitalization cost, DRG insurance payment and other DRD-related indicators were retrospectively collected and compared between day surgery patients and non-day surgery patients, and the average length of hospital stay and hospitalization costs were compared between the two surgery modes within DRGs. Chi-square test was used for enumeration data, and t-test and Mann-Whitney U test were used for measurement data. Results A total of 29339 day surgery patients and 19019 non-day surgery patients were enrolled. In the day surgery group, the proportions of local patients (71.71% vs. 68.62%), routine discharge (99.93% vs. 99.78%), and class A incisions (99.92% vs. 99.55%) were better than those in the non-day surgery group (P<0.05), and the average length of hospital stay [(1.00±0.00) vs. (6.98±5.00) d] and the average hospitalization costs [(7306.62±4605.73) vs. (24913.97±24623.54) yuan] were lower than those in the non-day surgery group (P<0.05). The top 2 reduction of average length of hospital stay were in the CB49 group and CB39 group, decreasing by 87.45% and 86.24%, respectively. The top 2 reduction of hospitalization costs were in the DC19 group and CC15 group, decreasing by 84.15% and 73.61%, respectively. DRG payment balance of medical insurance in the day surgery group was higher than that in the non-day surgery group (22.95% vs. 5.98%). Conclusions Day surgery not only ensure the medical quality, but also shorten the length of hospital stay and reduce the burden of medical expenses. Day surgery can effectively improve the utilization efficiency of hospital bed resources, it is an effective measure to promote the high quality development of hospital and comply with DRG payment reform.
目的 了解糖尿病患者院外自行注射胰島素存在的風險。 方法 2010年1月－12月，通過隨訪調查老年組83例，中青年組69例糖尿病患者院外自行注射胰島素的實施情況，對存在的問題進行歸類、統計。調查的內容主要包括3個方面：胰島素裝置的正確使用、胰島素的規范注射、血糖監測及低血糖處理。分析兩組患者院外注射胰島素的風險，并對存在的問題進行原因分析、提出解決方法。 結果 發放調查表152份，有效回收131份，其中老年組73份，中青年組58份。在胰島素裝置使用方面，老年組存在問題48項，中青年組27項，兩者間差異無統計學意義（χ2=2.432，P＞0.05）。在胰島素的規范注射方面，老年組存在問題176項，中青年組77項，老年組在胰島素注射方面存在的問題明顯高于中青年組（χ2=25.009，P＜0.001）。在低血糖的認識及正確處理上，老年組存在問題115項，中青年組33項，兩組差異具有統計學意義（χ2=40.383，P＜0.001）。 結論 糖尿病患者院外自行注射胰島素存在諸多風險。老年糖尿病患者院外胰島素注射需在他人協助、監督下進行。
Objective To study the prokaryotic expression of the anti-tumor associated glycoprotein-72 (TAG-72) singlechain fragment variable (scFv) antibody and its specific affinity to hepatocellular carcinoma cell lines and tissues. Methods The cDNA of anti-TAG-72 scFv antibody was inserted into pCANTAB5E to obtain phage vector anti-TAG-72 -scFv-pCANTAB5E. Isopropyl-β-D-thiogalactoside (IPTG) was used to induce the expression of anti-TAG-72 scFv antibody. SDS-PAGE and Western blot were used to identify the anti-TAG-72 scFv antibody. Human hepatocellular carcinoma cells were cultured, and TAG-72 was determined with the obtained scFv by immunohistochemistry in the cells and paraffin-embedded hepatocellular carcinoma tissues. Results SDS-PAGE and Western blot showed that the anti-TAG-72-scFv antibody was successfully expressed. Anti-TAG-72 scFv could bind to hepatocellular carcinoma cell lines SMMC7721, HepG2, and HHCC, but not to BEL7402, suggesting that SMMC7721, HepG2, and HHCC cells expressed TAG-72. For the 40 cases of hepatocellular carcinoma tissues, the positive rate of TAG-72 in stage Ⅰ and Ⅱ-Ⅲ was 23.08% (3/13) and 62.96%(17/27), respectively. While no TAG-72 expression was found in the 10 normal cases. TAG-72 expression was significantly different between hepatocellular carcinomas and normal tissues (Plt;0.05). Conclusions The prokaryotic expression of anti-TAG-72 scFv antibody is successfully achieved, and can be used to identify TAG-72 antigen. TAG-72 is highly expressed in hepatocellular carcinoma, but not in normal liver tissue, which may be suggested as cancer marker of hepatocellular carcinoma.