目的 探讨红细胞指数用于鉴别缺铁性贫血(iron deficiency anemia,IDA)与地中海贫血特质(thalassemia trait,TT)患者的应用价值和最佳界值.方法 选取2017年10月1日至2021年3月31日北京和睦家医院确诊为IDA或TT的中国患者40例.根据血常规结果,计算8种红细胞指数,分析其对于鉴别IDA或TT的灵敏度与特异度、约登指数,根据ROC探讨其在我国患者中的适合界值.结果 40例患者中有22例IDA和18例TT.Jayabose、Green and King和Ricerca 3种红细胞指数用于鉴别IDA和TT的约登指数分别为0.667、0.667和0.682,ROC的AUC分别为0.990、0.995和0.992,均为十分可靠的指标.同时,Jayabose、Green and King和Ricerca 3种红细胞指数的最适合界值分别为251.69、79.56和3.91.调整界值后,Jayabose、Green and King和Ricerca 3种红细胞指数鉴别IDA和TT的准确率均提高至97.5％.结论 含有红细胞分布宽度指标的红细胞指数对于鉴别我国小细胞低色素性贫血患者的病因具有很高的应用价值,值得临床推广.

代谢综合征(MS)由一组与心脑血管疾病极为相关的多种代谢异常组成的症候群.目前随着人民生活水平改善,高脂肪、高热量类食品摄人显著增加,使MS的患病率不断上升,造成严重的心脑血管事件,给家庭及社会带来沉重负担.而MS的发生是可防可治的,其中定期体检具有重要意义.

Objective To deepen the understandirg of the clinical and etiological features of postopera-tive nosocomial infections (NI) in the surgery department. Methods Eighty-four cases of postoperative NI in the surgery department of our hospital during 2007-2008 were analyzed. Results Of the 84 cases investiga-ted,in our hospital, the department of general surgery and urinary surgery and neurosurgery showed a high in-cidence of NI ;the respiratory infection accounted for the majority of all the NI cases. Invasive work and intra-operative general anesthesia and the admission time more than one month were the most common reasons for NI;infection rate of G~- bacilli was 49. 58%, G~+ coccobacteria was 35.77%, fungus was 14. 63%. Con-clusion To upgrade the medical staffs' understanding on how to prevent and control postoperative NI in the surgery department, and to reduce the rate of postoperative NI in the surgery department by taking all-around methods are necessary.

目的 探讨肠道益生菌制剂对老年住院患者抗生素相关性腹泻的预防作用.方法 135例≥60岁的感染患者随机分为预防组(68例)和对照组(67例),预防组在使用广谱抗生素抗感染的同时加用双歧杆菌/嗜酸乳杆菌/肠球菌组成的益生菌复合制剂,对照组仅在患者使用广谱抗生素发生腹泻后再加用上述肠道益生菌制剂.观察两组抗生素相关性腹泻发生情况及肠道菌群紊乱恢复情况.结果 预防组腹泻发生率为9/68例(13.2%),对照组为21/67例(31.3%),发生率绝对值下降18.1%,两组相比差异有显著性.结论 肠道益生菌制剂可以预防和减少老年住院患者抗生素相关性腹泻发病率,并缩短腹泻病程.

Objective To discuss the correlation between procalcitonin (PCT) , C -reactive protein (CRP) , white blood cell count (WBC) and community - acquired pneumonia (CAP) severity. Methods Thirty - eight CAP patients without complications of COPD, bronchiectasia or other chronic lung diseases, and sixteen healthy controls were enrolled to the study. Serum PCT, CRP and WBC were measured and Pneumonia Severity Index (PSI) were calculated on the first day and the seventh day after their admission. Results The increase of PCT concentrations were obvious in CAP group ( P < 0. 01). On the first day, the correlation coefficient between PCT and PSI was significantly correlated (r = 0. 539, P<0.01 ) , but there were no correlation between CRP and PSI( r =0. 044,P >0. 05,between WBC and PSI(r= -0.007 ,P>0.05 ) respectively. On the seventh day, the correlation coefficient between CRP and PSI was non - correlated (r = 0. 183, P > 0.05) , but between PCT and PSI (r = 0.472, P < 0.05) , WBC and PSI( r = 0. 381 ,P < 0. 05 ) were correlated respectively. Conclusion Serum PCT levels in CAP group were markedly elevated than that in control group. As a marker of pneumonia severity, PCT was superior to CRP and WBC.

建立适合老年医学特点的临床医学教育模式、方法是一门不断完善的实践科学.采用的教学模式和经验有:强化教学意识,树立健康管理的理念,病历书写培训和教学查房,病历讨论与病历回顾性总结,结合视听教育,进行模拟训练等.

脂肪乳是普遍应用于危重症患者救治的肠外营养液,由磷脂包含的甘油三酯组成,并含有卵磷脂、甘油、维生素E等成分.根据甘油三酯中脂肪酸碳链上碳原子的数目分为长链和中链脂肪酸(MCT);按照脂肪酸碳链上含有共价双键碳原子的数目分为饱和(不含双键)、单价不饱和(含1个双键)、多价不饱和脂肪酸(含1个以上双键);如果第1个共价双键分别出现在脂肪酸碳链第3、6、9位碳原子位置上,则可以相应命名为n-3、n-6、n-9脂肪酸.