目的 分析miR-142-3p、miR-216a、miR-107-5p在ICU血液净化急性肾损伤(acute kidney injury,AKI)患者中的表达及对疗效的评估价值.方法 选取我院ICU收治的行血液净化治疗的AKI患者132例作为AKI组,同期选取于我院行健康体检的健康志愿者80例作为健康组.检测miR-142-3p、miR-216a、miR-107-5p表达量,分析其在ICU血液净化AKI患者中的表达,所有患者均行血液净化治疗,对比患者治疗前后及不同疗效下上述指标表达量,分析三者对疗效的评估价值.结果 与健康组相比,AKI组miR-142-3p、miR-107-5p表达升高,miR-216a表达降低(P<0.05).与治疗前相比,治疗后AKI组患者miR-142-3p、miR-107-5p表达升高,miR-216a表达降低(P<0.05).根据治疗是否有效分为治疗有效组110例,治疗无效组22例.与治疗有效组相比,miR-142-3p、miR-107-5p在治疗无效组表达升高,miR-216a在治疗无效组中表达降低(P<0.05).与存活患者相比,miR-142-3p、miR-107-5p在死亡患者中表达升高,miR-216a在死亡患者中表达降低,差异有统计学意义(P<0.05).ROC曲线分析显示,miR-142-3p、miR-216a、miR-107-5p对ICU血液净化AKI患者疗效的评估价值均较高(P<0.05).结论 ICU血液净化AKI患者miR-142-3p、miR-107-5p高表达,miR-216a低表达,且与临床疗效密切相关,可用于患者疗效的评估.

Objective To investigate the protective effect and mechanism of dl-3-n-butylphthalide (NBP) on hydrogen peroxide (H2O2) - induced oxidative damage of vascular endothelial cells (VECs). Methods Human umbilical vein endothelial cells (HUVECs) and human umbilical artery endothelial cells (HUAECs) were cultured and MTT assay was used to find the appropriate dosage of H2O2 for establishment of oxidative stress injury model. Then the cells were pre-incubated with two different dosages of NBP (5 and 10 μmol/L) 2 h before exposure to H2O2. The cell viability was detected by MTT assay, mitochondrial membrane potential was measured by rhodamine 123, cell apoptosis was detected by Annexin-V/PI double staining, and intracellular free Ca2+ was measured by Fura-4/AM. Results H2O2-induced oxidative injury reduced the cell viability of HUVECs and HUAECs, increased the intracellular free Ca2+ concentration thus leading to mitochondrial membrane potential decline and cell apoptosis(P＜0.05). However, NBP treatment improved the above changes induced by H2O2. Conclusions NBP protects vascular endothelial cells by alleviating the oxidative damage induced by H2O2.

目的 探讨肌内注射(肌注)百草枯中毒的临床特点及治疗措施.方法 回顾分析我院肌注百草枯中毒致死1例的临床资料.结果 本例因自服200％百草枯20 ml约18h急诊入院.18 h 前外院行清水洗胃后离院,因病情加重来我院,毒物检测尿液百草枯5.6 μg/ml,行血液灌流等治疗好转后出院.3d后再次因自行肌注50％百草枯5 ml入院,查血常规、肝肾功能均出现异常,毒物检测血液百草枯8.2 μg/ml,尿液百草枯265.0 μg/ml,经积极治疗,最终抢救无效于入院28 h后死亡.结论 肌注百草枯中毒病情不易控制,需共同探讨合理高效的治疗方案及措施.

目的:探讨经皮双侧子宫动脉栓塞术救治产后大出血患者的临床护理及观察。方法:对本组35例难治性产后大出血患者,经导管注入明胶海绵颗粒栓塞,并进行术前的心理护理,加强术后护理。结果:35例产后大出血患者经皮双侧子宫动脉栓塞治疗后阴道出血停止,无1例发生严重并发症。结论:经皮双侧子宫动脉栓塞术具有操作简单、创伤小、止血迅速彻底、安全性高、保留子宫、并发症少等优点,可作为治疗产后大出血的首选方法,严密、精心的术后护理是保证患者早期康复的关键。

快速、准确、高效的护理服务是急诊医疗体系中的重要组成部分.本文在阐述急诊科护士长的自身素质要求、护理人员技术的培训、严格的急诊科护理管理制度及岗位责任制度的基础上,探讨较大城市三甲医院建立以护士长领导下护理组长负责制及岗位责任制为核心的各项管理制度对急诊科整体医疗水平提高的效应.