Objective:To investigate the application of perioperative comprehensive management in patients with choledocholithiasis combined with acute cholangitis by endoscopic retrograde cholangiopancreatography (ERCP) and laparoscopic cholecystectomy (LC).Methods:Eighty patients with choledocholithiasis complicated with acute cholangitis who received ERCP+LC were randomly divided into two groups. The control group was given perioperative routine management, and the observation group was given perioperative comprehensive management. SPSS 25.0 software was used to analyze the data. Perioperative indexes, hemodynamic indexes, inflammatory emergency indexes and myocardial injury markers were presented with (), independent t test was used for comparison between groups; The statistical data such as complication rate were compared by χ2 test. P<0.05 was considered statistically significant.Results:The length of hospital stay in the observation group was better than that in the control group (P<0.05). After induction of anesthesia (T1), immediately after intubation (T2), 5?min after pneumoperitoneum (T3), and at the end of operation (T4), the fluctuation of heart rate (HR) and mean arterial pressure (MAP) in the observation group was smaller than that in the control group (P<0.05). One day after operation, the inflammatory stress indexes in the observation group were lower than those in the control group(P<0.05). 3 days after operation, the myocardial injury indexes in the observation group were lower than those in the control group(P<0.05). There was no significant difference in the total complication rate between the two groups (P>0.05).Conclusion:Perioperative comprehensive management intervention for choledocholithiasis patients with acute cholangitis treated with ERCP+LC can effectively maintain the hemodynamic stability of patients, reduce postoperative inflammatory stress response and myocardial damage, which is conducive to postoperative rehabilitation of patients, and is safe and feasible.

野战医疗队是军队医院遂行应急支援卫勤保障任务的拳头力量,新形势下其人员结构的调整对有效履行卫勤保障任务提出了新的挑战.笔者剖析了联勤保障部队第九○四医院野战医疗队跨区基地化训练中人员管理存在的问题,并提出了相应的对策.

目的 探讨认知行为疗法在原发性急性闭角型青光眼(APACG)手术患者中的应用效果.方法 选择2018年1月至2019年6月收治的APACG手术患者78例,按治疗方法分为观察组42例、对照组36例.对照组给予常规护理干预,观察组联合应用认知行为疗法,比较2组疾病认知水平、自我管理能力、生活质量等指标.结果 出院时,观察组患者发病原因、用药管理、睡眠管理、心理调护、复查时间与项目、疾病认知知晓率高于对照组(P＜0.05);随访6个月,健康知识水平、自我概念、自我责任感、自我护理技能、自我管理能力总分高于对照组(P＜0.05),远视力/移动和光感、调节能力、读与精细工作、生活质量总分高于对照组(P＜0.05).结论 认知行为疗法有助于增强原发性急性闭角型青光眼手术患者疾病认知水平,促进自我管理能力的养成,改善患者生活质量.

军队医院的首要职能使命是战时保打赢、平时保健康.野战医疗队作为军队医院编组的应急机动卫勤保障力量,其建设水平直接关系到医院的战斗力、保障力.野战医疗队组训的目标是提高队员的综合素质,从而实现卫勤保障能力的有效提升.该文报告了某军队医院按照PDCA循环理论的要求不断改进野战医疗队组训的做法.通过把握好四关——计划、执行、检查、改进,并不断循环往复,可显著提升野战医疗队的组训效果,提高遂行实战化卫勤保障任务的能力.

野战医疗队作为我军后方医院一种主要的应急机动卫勤保障力量,其建设水平直接关系到部队医院的战斗力、保障力,历来为各级首长机关所重视.通过带领医疗队参加跨区基地化训练考核实践,文章着重分析思想铸魂、实战引领和创新驱动三个方面抓组训的体会,期望能为类似基层卫勤分队组训提供参考.

近年来,部队赴沙漠艰苦地区驻训逐渐成为我军提升实战化水平的重要途径之一,但演训过程中部队消化系统疾病高发,而卫生防病方面的研究较少,文章通过对某部连续2次赴甘肃沙漠地区跨区演训卫生防病跟踪观察,通过对沙漠地区气候及部队宿营方式、消化系统疾病发病特点和原因分析以及针对性处置措施进行分析研究,为赴沙漠地区演训部队消化系统疾病防治提供参考及经验.

目的 探讨智能计步设备在军队医院长跑组训中的应用价值.方法 分析以往长跑组训中存在的问题,通过问卷调查和小分队试训方式探索智能计步设备应用于长跑组训的可行性和优缺点.结果 智能计步设备应用于军队医院长跑组训有灵活性、科学性、公平性等特点,可明显提高长跑组训的参训率和训练效果.结论 智能计步设备应用于军队医院长跑组训设备易于获得,依从性高,值得应用推广并深入研究.

糖皮质激素受体(glucocorticoid receptor,GR)被激活后,通过与核内靶基因上的一段特定DNA序列结合,从而调控基因转录,发挥各种生物效应.GR广泛参与了生物体内多种生物学行为,在肿瘤发生发展调控方面,发挥了非常复杂的作用,表现出明显的组织特异性,在不同来源组织及细胞中的作用差异巨大.本文分析了GR与肿瘤迁移、侵袭、增殖等方面的关系.此外,本文还针对GR与其他核受体及microRNA之间的相互作用,对肿瘤的影响进行了综述,进一步阐述GR介导的生物学效应对肿瘤治疗及预后的影响.