总结我中心发热门诊在新型冠状病毒肺炎疫情期间的运行情况,分析评估其发挥的作用和暴露出的问题,探讨改进策略及发热门诊的信息化建设.

目的:紧急实施一系列建设与保障举措,应对新冠肺炎疫情防控对医院信息化的新挑战、新要求.方法:通过通信链路、信息系统、硬件设备、安全防护的改造与升级,以及5G远程医疗新技术应用,探索形成应急综合信息保障能力.结果:综合技术手段多措并举实现了疫情防控所需的快速、高效、安全的信息保障,为临床有效救治赢得时间与效率.结论:疫情防控推动信息保障模式转变,信息化能够快速响应疫情防控变化需求,信息系统、技术与人员是医院疫情防控的重要支撑要素.

Objective To study the protective effects of oral sodium pyruvate on microstructural changes of L5 dorsal root ganglion in rats subjected to simulated weightlessness.Methods Forty male Sprague-Dawley rats were randomly divided into groups of normal control drinking regular water (group CON),tail-suspension drinking regular water (group SUS),tail-suspension drinking normal saline (group SAL) and tail-suspension drinking pyruvate saline (group PYR).After the microgravity for 8 weeks,both sides of L5 dorsal root ganglion were taken out.Cell morphology with hematoxylin eosin staining and Nissl body shape with toluidine blue staining examined by light microscopy and mitochondria observed by electron microscopy were carried out with dorsal root ganglion.Glial cell line-derived neurotrophic factor and glial fibrillary acidic protein protein expressions were measured by Western-blot.ATP contents and ATPase activities were also detected.Four groups of samples were compared using analysis of variance.Results Compared with groups SUS and SAL,dorsal root ganglion cells showed no obvious swelling and gap widened.Their Nissl bodies were staining darker and mitochondrial structure was integral in group PYR.Western-blot determinations revealed that the glial cell line-derived neurotrophic factor expression in group PYR was increased with 223％ and 212％,compared with group SUS and group SAL,respectively;the glial fibrillary acidic protein level was decreased in both group SUS and group SAL by 28％ and 24％ in comparison with group PYR,respectively,the differences were statistically significant (with P values below 0.05).In metabolic parameters,ATP contents in group PYR were enhanced by 35％ and 38％,relative to groups SUS and SAL,respectively.ATPase activities in group PYR were improved with 42％ and 51％,relative to groups SUS and SAL,respectively,the differences were statistically significant (with P values below 0.05).ATP contents and ATPase activities in group PYR were all preserved.All the parameters in group PYR were not statistically significant different from those in group CON (with P values above 0.05).Conclusions The dorsal root ganglion and its organelles in both structure and function were injured in rats subjected with 8-week simulated weightlessness;oral pyruvate could alleviate damage of dorsal root ganglion in the early stage of microgravity.

Objective To evaluate the efficacy and safety of SURGIFLO,a hemostatic material,when used to stop active bleeding in anterior cervical operations.Methods Eighty-six patients who had received one-level anterior cervical operation between October 2015 and May 2016 were divided into two groups using the randomized method.SURGIFLO was used for hemostasis in the study group,while the traditional method was used in the control group.Operation time,intraoperative blood loss,postoperative drainage were recorded and compared between the two groups to evaluate the hemostatic effect.Results In anterior cervical operations,the intraoperative blood loss was (39.4 ± 16.9) ml and operation time was (73.8 ± 13.9) mins in the study group,compared with (46.7 ± 15.9) ml and (86.3 ± 18.5) mins in the control group.There was significant difference between the two groups (P ＜ 0.05),butthere was no significant difference between the study group (6.1 ± 4.2) ml and the control group (9.3 ± 8.9) ml in postoperative drainage (P ＞ 0.05).Conclusions In one-level anterior cervical operations,the use of SURGIFLO can shorten the operation time and reduce the intraoperative blood loss and surgical complications.SURGIFLO is a safe and effective hemostatic material in spine surgery.

目的 作为阶梯式治疗方法之一,评价选择性神经根阻滞术(selective nerve root block,SNRB)对腰椎椎间孔狭窄症(1umbar foraminal stenosis,LFS)的疗效.方法 选取我科收治的LFS患者56例,Wildermuth分级:1级30例,2级26例,根据症状、体征及影像学表现,明确责任间隙,局麻下行SNRB术,术前术后随访患者VAS和JOA评分,Nakai分级标准评价术后疗效.结果 随访3-15个月,平均12.8个月,5例后期行椎间孔微创手术,4例行开放融合手术,SNRB手术短期优良率达80％,VAS评分术前腰痛、腿痛评分分别为(6.5±1.9)、(7.2±1.3),术后1d分别为(3.1±1.2)、(2.5±0.8),末次随访分别为(3.5±0.8)、(2.8±1.2)分,JOA评分术前、术后、末次随访分别为(13.8±4.2)、(24.5±3.8)、(23.1±2.6)分.VAS、JOA术后和末次随访较术前差异均有明显统计学意义,术后1d和末次随访评分无统计学差异.结论 SNRB作为阶梯治疗方式在腰椎椎间孔狭窄症中疗效确切,SNRB不仅是一种诊断方式,也是一种行之有效的治疗方式.

Objective To compare the clinical effect of minimally invasive surgery transforaminal lumbar inter-body fusion (MIS-TLIF) and posterior lumbar interbody fusion (PLIF) in treatment of L5~S1 degenerative lumbar spine disease. Methods A total of 84 patients with L5~S1 degenerative lumbar spine disease (38 patients for MIS-TLIF, 46 pa-tients for PLIF), who admitted to Department of Spinal Surgery in our hospital from December 2012 to August 2014, were selected as the subjects. The average follow-up time for these patients was 15.8 months (range, 12~20 months). The time of surgery, blood loss, time of standing recovery, hospital time, X-ray exposure, postoperative drainage volume, vi-sual analogue score (VAS) and Japanese Orthopedic Association (JOA) scores of MIS-TLIF group and PLIF group were compared. Results There were no differences between the MIS-TLIF group and PLIF group in age, gender and clinical diagnosis (P>0.05). Compared with PLIF group, MIS-TLIF group had significantly shorter operative time (122 h vs 136 h), less blood loss (115 mL vs 151 mL), less postoperative drainage volume (0 mL vs 140 mL), shorter postoperative bed time (3.6 d vs 5.2 d) and longer X-ray exposure time (15 s vs 11.6 s), all with P<0.05. After discharged from hospital, the VAS scores of low back pain in MIS-TLIF group [(3.8 ± 2.3) points] was significantly shorter than that in PLIF group [(4.9±4.2) points] (P<0.05). After 3 months of surgery and final follow-up, there were no significant differences between MIS-TLIF group and PLIF group in VAS scores [3 months post operation:2.1 points vs 2.5 points;Final follow-up:1.3 points vs 1.5 points) (P>0.05) and JOA scores (3 months post operation:19.2 points vs 18.9 points;Final follow-up:24.6 points vs 25.1 points) (P>0.05), while which were significantly better than preoperative scores in two groups (P<0.05). There was no significant difference between MIS-TLIF group (92.1%) and PLIF group (91.3%) in the clinical curative effects of final follow-up. Conclusion MIS-TLIF has the advantages of surgery in L5~S1 lumbar degenerative disease, so we can choose the reasonable surgical procedure according to individual skill levels and instruments.

目前虽有多种方法可诊断幽门螺杆菌(Helicobacter pylori,Hp)的感染,但其结果易受试剂、标本、环境、用药情况、主观经验等因素的影响,而且样本采集常有侵入性和创伤性，给患者带来一定的痛苦和心理负担,限制了在临床的普及.

目的探讨幽门螺杆菌(Hp)感染与冠心病相关因素的关系。方法应用海立克碳-13呼气试剂检测208例冠心病患者(观察组)和197名健康者(对照组)的 Hp 感染情况及 Hp 抗体组分 UreB66、Ure-3.30,观察与冠心病及其相关因素总胆固醇、甘油三酯、高密度脂蛋白胆固醇、低密度脂蛋白胆固醇等的关系。结果观察组 Hp 抗体的阳性率72.32%,明显高于对照组(59.26%)(P<0.05),观察组 Hp 抗体组分 UreB66的阳性率(46.31%)与对照组(28.21%)相比,差异有统计学意义(P<0.01;观察组中 Hp 阳性患者的总胆固醇(5.63±1.61)mmol/L、低密度脂蛋白胆固醇(3.21±0.99)mmol/L,明显高于 Hp 阴性者[(4.35±0.98)mmol/L、(2.68±0.88)mmol/L,均 P<0.05];而两组的甘油三酯及高密度脂蛋白胆固醇水平差异无统计学意义(P>0.05)。结论 Hp 感染与冠心病发病和脂代谢紊乱存在一定的关系。