【摘要】 目的 探讨小儿白血病合并回盲肠综合征的临床特点、诊断及治疗。方法 对2005年2月—2009年10月间4例小儿白血病合并回盲肠综合征的临床症状、体征及辅助检查进行回顾性分析。结果 在小儿白血病的治疗过程中,可出现回盲肠综合征。临床表现为腹痛、腹胀及腹泻等;查体可见腹肌紧张,右下腹压痛,或有反跳痛等;血常规中白细胞减少,尤其中性粒白细胞显著下降;给予抗感染,静脉营养,丙种球蛋白增强机体抵抗力,输浓缩红细胞及血小板支持治疗,可以收到较好的治疗效果。若保守治疗症状得不到缓解,或病情加重,可行手术治疗。结论 回盲肠综合征是小儿白血病治疗过程的合并症,其临床表现复杂,体征缺乏特异性,根据不同的病情采用相应的治疗方法可收到良好的临床效果。
医学人文教育是突显医学人文价值和实现医学宗旨的根本。本文针对目前医学人文教育的现状，提出应从提高教师队伍人文素养、用人文精神培育学生、培养医学生职业意识三方面着手，加强医学生人文精神的培养，为社会输送符合时代要求的复合型医学人才。
Objective To investigate the effects of applied electric fields on the migration of human retinal pigment epithelial (hRPE) cells, and probe the physiological effects and clinic significance of electric fields on the RPE cells during the wound healing process. Methods hRPE cells were clutured with Dubbeccolsquo;s modified Eagle medium (DMEM) (DMEM group ) or DMEM+10% fetal bovine serum (FBS) (DMEM+10% FBS group), and the cells unexposed to the electric fields were used as the control. After hRPE cells were exposed to direct current electric fields with the tension of 0,4, 6 and 8 V/cm, serial images were taken at 15 minuets intervals within 2 hours by photomicroscope to observe the migration of the cells, and then the migrating distances and angle between the cellular translocation direction and the field vector were measured. The results were analyzed by an image analyzer. Resutls The response of the hRPE cells cultured in DMEM group to the electric fields was not as obvious as that in DMEM+10% FBS group. The cells showed a tendency of cath odal migration when the field tension was added to 6 V/cm (the average cosine Phi; was compared with the normal control, P＜0.05.The effect of electric fields on cells clutured in DMEM+10%FBS group was ber than those in DMEM group. The long axes of the cells were perpendicular to the field line with the tension of 4 V/cm, and the cells continued migrating to the cathode, which was more obvious when the field tension increased (the average cosine Phi; was comparedwith the normal control, P＜0.05). After the polarity of the electric field reversed , the cells migrated to the opposite direction in accord with the direction of the cathode. Conclusion Applied electric fields can induce the cathode-directed migration of hRPE cells, which is positively correlated with the field tension and can be influenced by the serum. Physiological electric fields may be one of the inducing factors of cell migration at the early phase of healing process of wounded retina. (Chin J Ocul Fundus Dis, 2006, 22: 404-407)
Objective To analyze the measles epidemic characteristic, so as to provide scientific evidence for the strategy of controlling and eliminating measles. Methods The data of measles cases was collected from the national epidemiological investigation and surveillance report system, and the measles epidemiological characteristic as well as the efficacy of measles control strategy were analyzed through descriptive studies. Results The total number of the reported measles cases reached 309 in 2009, the incidence rate was 5.1 per 100 000 population and declined by 71.26% compared with the year of 2008. Seasonal peak in 2009 appeared from January to April. The infants less than eight months old as well as the patients more than 15 years old were the main suffering population, which accounted for 33.98% (105/309) and 49.51% (153/309) of the total, respectively. The patients having no or having unclear measles vaccination history accounted for 93.2% (288/309). The cases of floating population accounted for 9.71% (30/309). Conclusion It has been demonstrated that vaccine immunization activities are important measures to eliminate measles. To achieve the goal of measles elimination, not only does the children routine immunization have to be performed, but also the strengthened immunization has to be carried out for the key crowd in key areas.
Objective To investigate the value of sentinel lymph node biopsy (SLNB) in predicting the metastasis of central cervical lymph nodes (CCLN) in differentiated thyroid carcinoma, and to explore reasonable program for CCLN dissection. Methods This retrospective analysis was performed basing on the clinical data of 407 patients with differentiated thyroid carcinoma who were admitted to the Department of General Surgery of Xuanwu Hospital from June 2013 to December 2016, including 237 patients with microcarcinoma. Results ① The results of the lymph nodes detection. All patients had detected 7 766 lymph nodes (1 238 metastatic lymph nodes were detected from 219 patients), and 2 085 sentinel lymph nodes were detected (448 metastatic sentinel lymph nodes were detected from 189 patients). In the patients with microcarcinoma, there were 3 614 lymph nodes were detected (390 metastatic lymph nodes were detected from 97 patients), and 1 202 sentinel lymph nodes were detected (149 metastatic sentinel lymph nodes were detected from 82 patients). ② The value of SLNB to predict CCLN metastasis. The sensitivity, specificity, false positive rate, false negative rate, positive predictive value, and negative predictive value of SLNB to predict CCLN metastasis for all patients was 86.30% (189/219), 100% (188/188), 0 (0/189), 13.70% (30/219), 100% (189/189), and 86.24% (188/218) respectively; for patients with microcarcinoma was 84.54% (82/97), 100% (140/140), 0 (0/82), 15.46% (15/97), 100% (82/82), and 90.32% (140/155), respectively. ③ The value of SLNB to predict the presence of additional positive lymph nodes (APLN). The sensitivity, specificity, false positive rate, false negative rate, positive predictive value, and negative predictive value of SLNB to predict the APLN for all patients was 81.48% (132/162), 76.73% (188/245), 23.27% (57/245), 18.52% (30/162), 69.84% (132/189) and 86.24% (188/218), respectively; for patients with microcarcinoma was 73.68% (42/57), 77.78% (140/180), 22.22% (40/180), 26.32% (15/57), 51.22% (42/82) and 90.32% (140/155) respectively. ④ The value of positive sentinel lymph node ratio (PSLNR) to predict the presence of the APLN. The sensitivity, specificity, false positive rate, false negative rate, positive predictive value, and negative predictive value of PSLNR to predict the APLN for all patients was 71.97%, 78.95%, 21.05%, 28.03%, 88.79%, and 54.88% respectively, and the cutoff for PSLNR was 0.345 2. For patients with microcarcinoma, the sensitivity, specificity, false positive rate, false negative rate, positive predictive value, and negative predictive value of PSLNR to predict the APLN was 83.33%, 67.50%, 32.50%, 16.67%, 72.92%, and 79.41% respectively, and the cutoff for PSLNR was 0.291 7. Conclusion There is an important predicted value of SLNB for CCLN dissection in the patients suffered from differentiated thyroid carcinoma, and the PSLNR is a reliable basis for CCLN dissection.
In the realm of data mining based on modern acupuncture clinical research, the impact of literature features such as literature quality, evidence level, sample size, and clinical efficacy on the quality of data mining outcomes remains uncertain. These issues are significant factors restricting the translational application of data mining research results. We suggest employing both entropy weight and linear weighting techniques to assess the specified indicators. This assessment results in a comprehensive weighted score for acupuncture prescriptions, serving as the foundation for our ensuing data mining endeavors. In this study, migraine research serves as an example to contrast the efficacy of weighted algorithms against that of classical algorithms. The findings demonstrate that the algorithm introduced in this research significantly contributes to studies focusing on the dispersed selection of acupuncture points. Its superiority lies in cluster analysis, where it adeptly discerns potential patterns in the amalgamation of acupoints. This algorithm amalgamates evidence-based acupuncture with data mining processes, providing innovative perspectives that augment the caliber of research in acupuncture data mining. Nonetheless, additional research is essential to corroborate these results.
Objective To understand the effect of World Health Organization(WHO) multimodal hand hygiene improvement strategy on hand hygiene compliance among acupuncturists. Methods All the acupuncturists in departments (Department of Acupuncture, Department of Encephalopathy, Department of Orthopedics and Traumatology) with acupuncture programs in Xi’an Hospital of TCM were chosen in this study between September 2015 and August 2016. Based on the WHO multimodal hand hygiene improvement strategy, comprehensive measures were regulated among acupuncturists. Hand hygiene compliance and accuracy, and hand hygiene knowledge score were compared before and after the strategy intervention. Then, the effects of key strategies were evaluated. Results Overall hand hygiene compliance rate, accuracy and knowledge scores increased from 51.07%, 19.86% and 81.90±2.86 before intervention to 72.34%, 51.70%, and 98.62±2.92 after intervention (P<0.05). Hand hygiene compliance rates also increased in various occasions such as before contacting the patient, after contacting the patient, before acupuncture treatment, and before acupuncture needle manipulation (P<0.05). Conclusion Hand hygiene compliance in acupuncturists can be significantly improved by the implementation of WHO multimodal hand hygiene improvement strategy.
ObjectivesTo systematically review the prevalence of methicillin-resistant staphylococcus aureus (MRSA) in healthy Chinese population.MethodsPubMed, EMbase, WanFang Data and CNKI databases were electronically searched to collect cross-sectional studies of the prevalence of MRSA in China from inception to December 16th, 2018. Two reviewers independently screened literature, extracted data and assessed the risk of bias of included studies, and then, meta-analysis was performed by using Stata 12.0 software.ResultsA total of 25 cross-sectional studies were included. The results of meta-analysis showed that: the pooled prevalence of MRSA in healthy population was 13.9% (95%CI 9.6% to 18.2%). The results of subgroup analysis showed that: the prevalence of MRSA in children was 16% (95%CI 8% to 24%), and that in adults (non-children) was 13% (95%CI 9% to 16%). The prevalence of MRSA in individuals with occupational livestock exposure was 28% (95%CI 5% to 51%), in medical staff it was 16% (95%CI 8% to 25%), in medical students it was 12% (95%CI 3% to 20%) and in community residents it was 5% (95%CI 2% to 8%).ConclusionsThe overall prevalence of MRSA in healthy Chinese population is approximately 13.9%. Effective prevention and control measures are required to reduce the spread of MRSA.