【摘要】 目的 优选出紫冰栓中紫草油的最佳提取工艺。 方法 以左旋紫草素的含量为工艺考察指标，使用高效液相色谱建立左旋紫草素含量测定方法，采用L9（34）正交试验法优化紫草油的提取条件。 结果 选用紫草，加8倍菜籽油，温度140 ℃，加热0.5 h为最优提取工艺。 结论 优选的提取工艺合理、可行，质量可控。【Abstract】 Objective To optimize the preparation process of extracting arnebiae oil from Zibing suppository. Methods The optimum preparation process of extracting arnebiae oil was investigated by L9(34) orthogonal design as the shikonin content index. Results The optimum technical condition: added eight times rape oil and cooked for half an hour with the temperature of 140 ℃. Conclusion The optimized preparation procedure is feasible and the quality of the product can be controled.
目的 提高对先天性腹主动脉瘤（AAA）的认识。 方法 报道2012年11月1日先天性AAA 1 例，回顾国内外报道的24 例先天性AAA的临床资料。 结果 患儿男，2岁，以肉眼血尿起病，伴高血压、蛋白尿和反复血小板降低；多层螺旋CT血管成像（MSCTA）见AAA伴左肾动脉狭窄；彩色多普勒超声见AAA累及双侧髂总动脉伴动脉壁间血栓及钙化，左肾萎缩；保守治疗7个月后猝死，临终前头颅CT见脑梗死。回顾分析24例先天性AAA，包括肾下型AAA 15 例，肾上型AAA 5例，胸腹部AAA 2例，未具体指明类型2例；产前诊断6例，出生后诊断18例（其中包括新生儿5例和1个月～3岁婴幼儿8例）；以腹部搏动性包块起病8 例，呕吐4 例，呼吸困难2例，腰部疼痛1例，因其他疾病就诊3例；采用血管超声21例，MSCTA 16例，磁共振血管造影9例；13例肾下型AAA接受手术治疗；死于AAA破裂5例，死于心力衰竭2例。 结论 先天性AAA以肾下型为主，多为婴幼儿，常表现为腹部肿块，确诊该病首选MSCTA，主张行早期个体化手术。
目的 探讨婴儿急性白血病（IAL）的临床与实验室检查特征。 方法 对1999年12月－2011年6月收治的15例婴儿急性白血病的临床资料进行总结与分析。 结果 其中急性淋巴细胞白血病（ALL）6例，急性髓系白血病（AML）8例，分类不明1例，其中以M4（4例）、M5（3例）为主。临床表现多样，髓外浸润明显。1例细胞形态学与免疫分型有差异，1例合并染色体异常。放弃治疗者11例，死亡2例，正规治疗的2例于诱导缓解后获完全缓解。 结论 IAL预后差，需完善相关检查并不断总结临床资料以提高IAL治愈率。
Objective To explore the risk factors of premature infants death. Methods The medical records of hospitalized premature infants admitted to West China Second University Hospital of Sichuan University between January 2015 and December 2022 were collected. Premature infants were divided into the death group and the non-death group (control group) based on discharge diagnosis of death. Parturient and premature infants related information were collected, and the disease classification and diagnosis of premature infants were analyzed. Results A total of 13 739 premature infants were included, with 53 deaths and a mortality rate of 3.85‰ (53/13 739). The ages of death were 1-49 days, and the median age of death was (9.68±9.35) days. According to the matching method, 212 premature infants were ultimately included. Among them, there were 53 premature infants in the death group and 159 premature infants in the control group. Compared with the control group, premature infants in the death group had lower gestational age, birth weight, lower 1-minute Apgar scores, lower 5-minute Apgar scores and shorter hospital stay (P<0.05), and received more delivery interventions (P<0.05). There was no statistically significant difference in other indicators between the two groups of premature infants (P>0.05). A total of 212 parturient were included. Among them, there were 53 parturients in the death group and 159 parturients in the control group. The use rate of prenatal corticosteroids in the control group was higher than that in the death group (55.35% vs. 54.72%). There was no statistically significant difference in other related factors between the two groups of parturient (P>0.05). The results of logistic regression analysis showed that longer hospital stay [odds ratio (OR)=0.891, 95% confidence interval (CI) (0.842, 0.943), P<0.001], prenatal use of corticosteroids [OR=0.255, 95%CI (0.104, 0.628), P=0.003] reduced the risk of premature infant death. However, tracheal intubation [OR=10.738, 95%CI (2.893, 39.833), P<0.001] increased the risk of premature infant death. Conclusions Clinicians should pay attention to prenatal examination of newborns and pay attention to evaluation of newborn status. Obstetricians and neonatologists should make joint plans for women with high risk factors for preterm delivery. During the hospitalization, after the diagnosis is clear, standardized treatment should be carried out in strict accordance with the guidelines for systemic diseases and expert consensus.
Objective To explore the characteristics of cognitive impairment in patients with alcohol dependence, and analyze the related influencing factors. Methods The Montreal Cognitive Assessment Scale (MoCA) was used to evaluate the cognitive function of 65 alcohol dependent patients hospitalized between January 1st and December 31st, 2014. The features of cognitive impairment and related influencing factors were analyzed. Results The differences of MoCA attention and delayed recall between different drinking year groups had statistical significance (P<0.05). The correlations of drinking year with MoCA attention (r=–0.250,P=0.044), and with delayed recall (r=–0.326,P=0.008) were both negative. MoCA scores, naming, attention and delayed recall were different statistically among different age groups (P<0.05). The correlations of ages with MoCA scores (r=–0.429,P<0.001), naming (r=–0.261,P=0.035), attention (r=–0.391,P=0.001) and delayed recall (r=–0.461,P<0.001) were all negative. MoCA scores, the visuoconstructional skills, language, abstraction and delayed recall were significantly different among different education level groups (P<0.05). The correlations of education level with MoCA scores (rs=0.650,P<0.001), the visuoconstructional skills (rs=0.540,P<0.001), language (rs=0.486,P<0.001), abstraction (r=0.602,P<0.001) and delayed recall (rs=0.593,P<0.001) were all positive. Ages had an effect on MoCA scores by multiple linear regression analysis (P<0.01). Conclusions For alcohol dependent patients with cognitive impairment, cognitive function is correlated with drinking year, age and education level. The cognitive function is much serious in patients with older age and longer drinking years. This kind of patients should be focused on and intervened early.
ObjectiveTo study the diagnosis and treatment of multiple neuroendocrine carcinoma.MethodClinical data of a case of multiple neuroendocrine carcinoma was retrospective analyzed.ResultsAfter discussion by a multidisciplinary team (MDT), the patient was diagnosed as multiple neuroendocrine carcinoma with late clinical stage and inoperable. Chemotherapy and radiotherapy were given, which showed significant effects, and the patient died after 1 year of follow-up.ConclusionIn the clinical diagnosis and treatment of patients with multiple neuroendocrine carcinoma, MDT cooperative treatment model should be adopted to provide a better treatment program.
Objective To explor the influence of the hospital-community-family mental rehabilitation mode on the quality of life of patients with schizophrenia. Methods We selected 101 patients diagnosed as schizophrenia according to ICD-10, who were hospitalized in mental health center of the West China Hospital and took part in rehabilitation voluntarily after discharge. Those patients were randomly assigned to two groups. Hospital-community-family mental rehabilitation mode intervention was applied to the patients based on inpatient rehabilitation in the trial group (n=52), while inpatient rehabilitation alone was applied in the control group (n=49). The total score of quality of life, psycho-social dimension, motivation and energy dimension, score of mental disability and social function, and family social care index were recorded. Then, statistical analysis was performed using SPSS 17.0 software. Results After 3 months and 6 months, the trial group had lower scores of the total score of quality of life, psycho-social domain, and motive and energy dimension than those of the control group (Plt;0.05). After 6 months, the trial group had lower scores of mental disability and social function (Plt;0.05) but a higher score of family social care index (Plt;0.05). The scores of WHO-DSA II and SQLS were positively correlated, while the scores of APGAR and SQLS were negatively correlated. Conclusion The integral mode of hospital-community-family mental rehabilitation effectively improves the quality of life of patients with schizophrenia, which also positively improves patients’ rehabilitation.
ObjectiveTo investige the effects of multidisciplinary perioperative nutrition management on nutrition and postoperative complications of patients with esophageal cancer.MethodsA total of 239 patients with esophageal cancer who received elective surgical treatment were included in the study. They were divided into a trial group (120 patients) and a control group (119 patients) according to the random number table method. There were 97 males and 23 females in the trial group with an average age of 63.78±9.13 years, and 94 males and 25 females in the control group with an average age of 64.12±7.91 years. The control group received routine diet management, and the trial group received multidisciplinary perioperative nutrition management. The differences of nutrition and postoperative complications between the two groups were compared.ResultsThe total protein and albumin levels on postoperative days 3 and 7 in the trial group were higher than those in the control group (P<0.05), patients' postoperative anal exhaust time was shorter than that in the control group (P<0.05), the incidence of postoperative gastrointestinal adverse reactions, lung infection, postoperative anastomotic fistula, hypoproteinemia on postoperative days 3 and 7 was lower than that in the control group (P<0.05), and hospitalization cost was lower than that in the control group (P<0.05).ConclusionMultidisciplinary nutrition management can effectively improve the nutrition of patients, promote the rapid recovery of postoperative gastrointestinal function, reduce postoperative complications, and reduce hospitalization costs. It has high clinical reference and promotion value.
The incidence of acute kidney injury (AKI) has increased rapidly in recent years. The causes of AKI are complex and diverse, and there is no effective treatment strategy. Reliable and stable animal models and in vitro models play an important role in the development and prevention of AKI. Focusing on rodent models and in vitro models, this review summarizes AKI models induced by ischemia, nephrotoxic drugs and urinary tract obstruction from three levels of prerenal, intrinsic renal and postrenal AKI.
Objective To explore the application of multi-disciplinary team (MDT) clinics in fetal developmental abnormalities. Methods A retrospective analysis method was used to collect case data of fetal developmental abnormalities and completion of prenatal MDT clinics diagnosis and treatment in pregnant women who were registered in the Department of Obstetrics of West China Second Hospital, Sichuan University between December 2021 and November 2022. The situation of pregnant women and fetuses was summarized and analyzed. Results There were 19362 registered pregnant women, of which 1125 (5.8%) had abnormal fetal development. Among them, 272 (24.2%) received prenatal MDT clinics diagnosis and treatment. Fetal developmental abnormalities were mainly characterized by structural abnormalities (208 cases, 76.5%), with the top three being central nervous system abnormalities, circulatory system abnormalities, and multiple malformations. There were 202 pregnant women who continue to conceive, and 70 cases had undergone induced labor, with an induced labor rate of 25.7%. The top three main causes of induced abortion were multiple malformations, central nervous system abnormalities, and circulatory system abnormalities. After prenatal MDT clinics diagnosis and treatment, the diagnosis of fetal developmental abnormalities in 46 pregnant women were corrected. Conclusion Prenatal MDT clinics are helpful for the early comprehensive evaluation of fetal developmental abnormalities and the determination of diagnosis and treatment plans.