Objective: To explore the nursing difficulties and Countermeasures of central venous catheterization in the prevention of infection in 129 patients with AIDS. Methods: using retrospective case data, 129 AIDS patients treated in Beijing You''an Hospital from January 2011 to December 2020 were collected and indwelling central venous catheter. Standard prevention was implemented in strict accordance with the requirements of nosocomial infection, and nursing intervention was taken in the aspects of infection source management, transmission route management and susceptible patient management. Adopt protective isolation for all AIDS patients.; Results: none of 129 AIDS patients had nosocomial cross infection during indwelling central venous catheter. Conclusion: it is effective to take intervention measures in the prevention of infection for AIDS patients with indwelling central venous catheter. In view of the four nursing difficulties existing in AIDS patients with indwelling central venous catheter, the implementation of timely, correct and effective nursing intervention measures for nursing difficulties can effectively cut off the path of cross infection in AIDS patients with indwelling central venous catheter, so that AIDS patients do not have cross infection during indwelling central venous catheter, Finally, reduce the hospitalization expenses and hospitalization days of patients.

目的 探讨与妊娠相关子宫动静脉瘘患者的治疗方案.方法 回顾性分析2013年1月至2018年12月首都医科大学附属北京妇产医院妇科收治的16例与妊娠相关子宫动静脉瘘患者病例资料,探讨其病因、术中失血和并发症情况.结果 16例患者平均孕次3.19次,其中12例(75.00％)既往有2次以上妊娠史;13例(81.25％)曾有宫腔操作史(包括剖宫产史、人工流产史、手剥胎盘史等).所有患者均因阴道出血就诊,彩色多普勒提示增强的子宫肌层血管分布区域的范围为(2.0cm×1.7cm×1.3cm)～(6.7cm×4.7cm×4.2cm).15例(93.75％)最终采用了超声监测下的宫腔镜下病损组织切除,1例(6.25％)最终行腹腔镜下病损组织切除术,术中出血为5～20ml,无术中及术后并发症,术后阴道异常出血症状缓解.结论 对与妊娠相关子宫动静脉瘘患者的治疗方案,应个体化评估,子宫动脉栓塞不一定是最优治疗方案,超声监测下的腔镜手术可能也是一种选择.

目的 探讨右美托咪定对急性脑损伤(ACI)患者脑组织损伤及预后的影响.方法 选取自2014年3月至2017年3月在首都医科大学密云医院接受治疗的73例ACI患者为研究对象.按随机数字表法将患者分成A组(n=35)和B组(n=38).检测两组麻醉诱导前(T0)、术毕(T1)、术后24 h(T2)的白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)等炎症反应有关指标,神经元特异性烯醇化酶(NSE)及S-100β等脑损伤指标,以及格拉斯哥预后量表(GOS)评分.结果 两组T1、T2时的IL-6、TNF-α水平均高于T0时,T2时的IL-6、TNF-α水平均高于T1时,差异均有统计学意义(P<0.05).B组T1、T2时的IL-6、TNF-α水平均分别低于A组,组间比较,差异均有统计学意义(P<0.05).两组T1、T2时的NSE、S-100β水平均高于T0时,T2时的NSE、S-100β水平均高于T1时,差异均有统计学意义(P<0.05).B组T1、T2时的NSE、S-100β水平均低于A组,组间比较,差异均有统计学意义(P<0.05).A组和B组GOS评分5分的患者分别为12例(34.3％)和23例(60.5％),组间比较,差异有统计学意义(P<0.05).结论 ACI患者术中给予右美托咪定能有效缓解其炎症反应,改善预后,值得临床推广应用.

Objective To analyze the efficacy and safety of oseltamivir in children with influenza H1N1.Methods The medical records of patients who were hospitalized and treated with oseltamivir in Beijing Ditan Hospital, Capital Medical University from Mar.2009 to Mar.2016 were analyzed retrospectively.They were divided into two groups according to the age: children group (≤14 years) and adults group (18-60 years).The duration of fever, length of stay, efficacy and adverse drug reactions were analyzed.Results A total of 349 patients were enrolled into the analysis.There were 159 cases in the children group which comprised 87 male and 72 female, aged from 10 months to 14 years with average age of (7±4) years, including 18 severe cases (11.3%).There were 190 cases in the adults group which comprised 117 male and 73 female, aged from 18 to 60 years with average age of (32±12) years, including 19 severe cases (10.0%).The differences in duration of fever and the length of stay between mild patients of the two groups were not statistically significant (P>0.05).The duration of fever and the length of stay were shorter in severe patients of children group than in severe patients of adults group [(2.3±1.3)d vs.(5.2±5.3)d, (6.8±4.4)d vs.(12.7±8.1)d, both P<0.05].The rate of efficacy of the children group and the adults group were 100.0% (159/159) and 99.5% (189/190).There was no significant difference between the two groups (χ2=0.839, P>0.05).There was no significant difference in incidence of adverse events between the two groups [5.0% (8/159) vs.3.7% (7/190), χ2=0.382, P>0.05].Conclusion Oseltamivir is effective in the children with influenza H1N1 and it is safe with a low incidence of adverse reactions.

Objective To Study the cinical efficacy and safety of oseltamivir in the treatment of Pandemic(H1N1).Methods The clinical data of 527 patients who were admitted into Beijing DiTan Hospital from 2009 to 2013 were analyzed retrospective.Results The 527 cases were dicided into 3 groups according to the severity of the clinical symptoms:common type,severe type and extremely severe type. Compared with patients therapied after 48 hours,duration of clinical symptoms,duration of fever and duration of viral nucleic acid positive were significant decrease in common type and severe type patients with oseltamivir within 48 hours.Duration of fever and duration of viral nucleic acid positive were also significant decrease in extremely severe type patients,but duration of clinical symptoms was not significant difference.Hospitalization time in the three groups were not statistically significant.There were no dead cases in common type and severe type patients.The difference of mortality rate in extremely severe type patients with oseltamivir in different time was not significant.Adverse drug reactions of 20 cases mainly occurred in digestive system. Conclusion Osehamivir was effective and safety in the treatment of Pandemic(H1N1 ).Therapiy with oseltamivir in 48 hours would effectively ameliorate the symptomsand shorten the course of the disease.

注射用丁二磺酸腺苷蛋氨酸(思美泰),是治疗胆汁淤积的常用药物之一,因药物使用安全,可用于妊娠期妇女.但在临床工作中发现连续静脉滴注思美泰与复方甘草酸苷(苏来乐)时,出现输液管阻塞,更换输液器后,液路通畅.进行相关实验后发现思美泰与注射用苏来乐之间存在配伍禁忌,现报道如下.

目的综述拉米夫定在妊娠合并慢性乙型肝炎患者中的应用及安全性研究。方法检索近年来国内外相关文献资料并进行总结,对妊娠合并慢性乙型肝炎的患者使用拉米夫定的临床疗效、安全性,进行分析和讨论。结果研究显示,拉米夫定可以显著降低孕产妇慢性乙型肝炎病毒DNA含量,改善其肝功能,减少母婴传播风险,且不良反应较少,应用较为安全。结论拉米夫定是目前妊娠合并慢性乙型肝炎患者的主要治疗药物,可以达到抑制病毒复制,降低婴儿宫内感染,提高母婴传播阻断率的目的,为了尽量减少胎儿发育成熟前对可能危害药物的接触,拉米夫定不能盲目应用,应权衡利弊,选择恰当用药时机。

目的简述治疗慢性乙型肝炎新药替诺福韦酯(tenofovir disoproxil fumarate,TDF)的研究进展。方法查阅国内外有关文献,对替诺福韦酯的在治疗慢性乙型肝炎方面的药理作用、药代动力学、临床研究和药物不良反应等进行综述。结果与结论替诺福韦酯是一种有效抗乙型肝炎病毒(hepatitis B virus,HBV)的核苷类似物,临床研究显示,其对HIV/HBV合并感染、HBV单一感染均有良好的疗效和病毒抑制作用。虽然在肾功能不全患者、肝功能不全患者以及肝移植患者中的疗效及安全性尚需进一步的大规模临床研究,但TDF仍是一个有治疗前景的新药物。