目的 探讨烟酸注射液联合硝酸甘油注射液治疗不稳定型心绞痛的临床疗效.方法 回顾性分析 2019 年 2 月—2023 年 2 月在西安交通大学附属红会医院治疗的 118 例不稳定型心绞痛患者的临床资料.根据用药种类的不同分为对照组和治疗组,每组各 59 例.对照组静脉输入硝酸甘油注射液,20 mL加入 5%葡萄糖注射液 50 mL,初始剂量 5 μg/min,根据病情调整剂量,1 次/d;在此基础上,治疗组肌肉注射烟酸注射液,100 mg/次,5 次/d.两组患者均进行 7 d治疗.观察两组患者临床疗效,比较治疗前后两组患者心绞痛发作次数及持续时间,血凝素样氧化低密度脂蛋白受体 1(Lox-1)、I 型胶原吡啶交联终肽(ICTP)、心肌营养素-1(CT-1)、血栓烷素B2(TXB2)、B淋巴细胞瘤/白血病-2(Bcl-2)、脂联素(APN)、总胆固醇(TC)、三酰甘油(TG)、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)、肌酸激酶(CK)、α-羟基丁酸脱氢酶(HBDH)、肌酸激酶同功酶(CK-MB)和乳酸脱氢酶(LDH)水平.结果 治疗后,治疗组临床有效率(98.31%)明显高于对照组(81.36%,P＜0.05).治疗后,两组心绞痛发作次数、每次持续时间均减少(P＜0.05),且治疗组减少最显著(P＜0.05).治疗后,两组患者血清Lox-1、ICTP、CT-1、TXB2、TC、TG、LDL-C、CK、HBDH、CK-MB和LDH水平均明显下降,而Bcl-2、APN、HDL-C水平明显增高(P＜0.05),且治疗组这些指标比对照组改善更明显(P＜0.05).结论 烟酸注射液联合硝酸甘油注射液治疗不稳定型心绞痛可有效缓解临床症状,促进心功能、血脂、血清细胞因子水平改善.

目的:研究分析创伤合并急性呼吸窘迫综合征(ARDS)死亡病例的临床特点,筛选发现相关高危因素.方法:选取94例创伤合并ARDS患者作为研究对象,将患者分为非死亡组和死亡组,对两组患者的临床资料、病例特点、受伤部位、受伤机制、基础疾病、实验室检查结果等进行统计分析,总结临床特点和相关危险因素.结果:患者的年龄、创伤的部位、基础疾病、休克、大量输血、氧合指数、乳酸、降钙素原均是创伤合并ARDS患者病情恶化致死的相关危险因素.结论:创伤合并ARDS的患者,应尽早采取相应的治疗策略,以减轻具有可识别危险因素的创伤患者群体中ARDS的发展,降低患者病死率.

目的:通过心肌缺血再灌注损伤(I/R)的不同时间点急性给药达格列净,探讨钠-葡萄糖共转运蛋白2(SGLT-2)抑制剂对心功能的影响.方法:对40只大鼠进行同等程度的心脏I/R刺激.将大鼠分为四个干预组:对照组、预处理组、缺血组、再灌注开始时组,快速给予SGLT-2抑制剂(达格列净,1 mg/kg).监测各组大鼠心肌梗死面积大小、左室功能和心律失常情况.结果:缺血前给予达格列净可降低心律失常发生的频率、减小心肌梗死面积,使心肌I/R损伤后左室功能得到改善,从而达到最大程度的心脏保护作用.缺血期间给予达格列净也显示出心脏保护作用,但效果较缺血前给药降低.结论:心脏I/R损伤时急性给药达格列净可通过减少心肌梗死面积、改善左室功能和减少心律失常而发挥心脏保护作用.

Objective:To investigate the effect of edaravone, a free radical scavenger, on the regulation of retinal autophagy and the protection of photoreceptor cells at the early stage of experimental retinal detachment (RD) in rats.Methods:Fifty-one adult male Sprague-Dawley rats were used for RD model establishment, and another 24 rats were served as PBS injection group.The RD model was established via subretinal injection of 0.5% sodium hyaluronate into the right eye of the rats and the rats with successful modeling were randomly divided into RD model group and edaravone treatment group.The rats in the edaravone treatment group were given edaravone of 3 mg/kg intraperitoneally, twice a day after modeling, and the rats in the PBS injection group and RD model group were given equal volume of normal saline.Rats were sacrificed on the 1st day, 3rd day and 7th day following modeling.The T-superoxide dismutase (T-SOD) activity and malondialdehyde (MDA) content in the intraocular fluid was detected.The expression levels of superoxide dismutase 2 (SOD2), nuclear factor E2-related factor 2 (Nrf2), autophagy related gene 4 (Atg4), microtubule-associated protein 1 light chain 3B (LC3B) and other proteins in retinal tissue were identified by Western blot analysis.TUNEL staining was performed on paraffin sections of the whole eyeball to analyze the apoptosis of photoreceptor cells.The study protocol was approved by an Ethics Committee of Xi'an Fourth Hospital (No. 2016016). The use and care of animals complied with the Regulations on the Administration of Experimental Animals.Results:The RD area was more than 60% in rat eyes of RD model.There were significant differences in MDA content and T-SOD activity among different groups at various time points (MDA: Fgroup=385.513, P<0.01; Ftime=13.021, P<0.01.T-SOD: Fgroup=48.865, P<0.01; Ftime=7.700, P=0.003). Compared with the PBS injection group, the MDA concentration was significantly increased and the T-SOD activity was significantly decreased in the RD group and edaravone treatment group on the 1st, 3rd and 7th day after modeling (all at P<0.05). The MDA concentration was significantly reduced and the T-SOD activity was significantly elevated in the edaravone treatment group on the 1st, 3rd and 7th day after modeling in comparison with those of the RD group (all at P<0.05). Compared with the PBS injection group, the relative expression levels of SOD2 and Nrf2 proteins were significantly increased in the RD group and edaravone treatment group on the 1st, 3rd and 7th day after modeling (all at P<0.05), and Atg4 and LC3B-Ⅱ/LC3B-Ⅰ were significantly increased on the 1st, 3rd and 7th day after modeling (all at P<0.05). The expression level of SOD2 in the edaravone treatment group was significantly higher than that in the RD group on the 1st, 3rd and 7th day after modeling (all at P<0.05), and the expression level of Nrf2 was significantly increased in the edaravone treatment group on the 1st and 3rd day after modeling compared with that of the RD group (both at P<0.05), and the expression levels of Atg4 and LC3B-Ⅱ/LC3B-Ⅰ were significantly increased in the edaravone treatment group on the 3rd day after modeling in comparison with those of the RD group (both at P<0.05). No significant TUNEL positive cells were observed in PBS injection group at all time points, and TUNEL positive cells were observed on the 1st, 3rd and 7th day after modeling in the RD group, and the expression level of caspase-3 in the RD group was significantly increased in comparison with that of the PBS injection group ( P<0.05). The apoptosis of photoreceptor cells and the expression level of caspase-3 in edaravone treatment group were significantly decreased in comparison with those of the RD group on the 1st, 3rd and 7th day after modeling (all at P<0.05). Conclusions:The intraperitoneal injection of edaravone, twice a day, can significantly improve the antioxidant capacity of the retina after experimental RD in rats, regulate retinal autophagy and reduce the apoptosis of photoreceptor cells in early-stage RD.

[目的]探讨品管圈活动在降低老年外科围术期病人高血糖发生率的实践效果.[方法]根据老年外科特点,成立品管圈小组,按照品管圈的理论逐项进行主题选定、活动计划、现况把握、要因分析、对策拟订与实施等共10个步骤的活动.于2018年6月—2018年7月对老年外科围术期200例病人的血糖监测数据进行分析,并与2017年12月—2018年1月未实施品管圈活动时所监测的相关指标进行对比评价.[结果]围术期病人高血糖发生率由品管圈活动实施前的50.3％ 降至实施后的31.3％.全体圈员在品管圈手法运用、团队凝聚力、专业知识、沟通协调能力、活动积极性、自信心和责任荣誉7个方面的能力均有所提高.[结论]开展品管圈活动可有效降低围术期老年病人高血糖的发生率.品管圈活动有助于提高护理人员的综合能力和学习积极性,规范了临床护理工作,使护理质量得到持续改进.

<span id="ChDivSummary" name="ChDivSummary" class="abstract-text">文章基于2008-2017年的季度数据,运用协整检验、误差修正模型和脉冲响应分析,从长期弹性和短期弹性的视角,对我国电子商务和快递业之间的关系进行实证分析。研究结果表明我国电子商务和快递业之间具有长期均衡的关系,电子商务对快递业有正向推动作用,当短期波动偏离长期均衡时,通过负反馈机制调整至均衡状态;电子商务对快递业的推动作用表现为长期效应大于短期效应;在长期和短期内,电子商务对快递业务量的推动作用均比对快递业务收入的推动作用更显著。</span>

Objective To investigate the expression status of immune related cytokines IFN-γ, IL-10 and TGF-βmRNA in breast cancerous microenvironment and make comparison with clinicopathologic features to explore its significance.Methods Forty-eight samples of breast cancer with excised axillary lymph nodes were included.The samples were divided into two groups according to lymph node metastatic status.Digoxin-labeled oligonucleotide probes and in situ hybridization technique were used to detect the expressions of IFN-γ, IL-10 and TGF-βmRNA in breast cancer cells and the tumor infiltrating mononuclear cells.Results The expressions of TGF-βand IL-10 mRNA in breast cancerous cells were significantly higher in node metastatic group compared to those of non-metastatic group ( TGF-β[%/accumulative index]:46.25 ±12.88/0.49 ±0.27 vs 19.33 ±7.69/0.28 ±0.18; IL-10[%/accumulative index]: 39.08 ±17.49/0.42 ±0.19 vs 22.58 ±7.87/0.33 ±0.17, t=4.330, P<0.01;t=2.962, P<0.05).The difference in expression of TGF-βmRNA in breast cancer cells was more significant.IFN-γmRNA positive cancer cell was not detected.In tumor infiltrating mononuclear cells, the IFN-γmRNA positive cells in node metastatic group were significantly less than TGF-βand IL-10 mRNA positive cell (TGF-β:35.58 ± 13.62/0.40 ±0.25, IL-10:40.83 ±15.49/0.47 ±0.22, IFN-γ:18.17 ±8.41/0.18 ±0.08, t=3.005, P<0.05;t=4.390, P<0.01;t=3.563, P<0.01).Conclusion Treg and Th2 related cytokines are predominated in local microenvironment of breast cancer and the microenvironments of breast cancer demonstrate an immunoinhibitory status in terms of anticancer immune response.

Objective To investigate the plasma level and clinical significance of microRNA-181b (miR-181b)in patients with colon cancer.Methods The plasma level of miR-181b in 42 patients with colon cancer and 42 healthy controls were detected by stem-loop RT-PCR.The relationship between clinicopathological characteristics of colon cancer and miR-181b was analyzed.Results Compared with healthy controls,the plasma miR-181b in patients with colon cancer was significantly higher (0.38±0.13 vs 0.64±0.22,respectively,P <0.01).There was no significant difference between plasma miR-181b and gender,age and tumor size in patients with colon cancer (P >0.05).There were significant differences between plasma miR-181b and lymph node metastasis,distant metastasis and tumor stage (P <0.05).Conclusion The plasma miR-181b in patients with colon cancer increased and miR-181b may contribute to the development of colon cancer.

目的:检测microRNA-100(miR-100)在胰腺癌患者血浆中的表达水平,初步探讨其临床意义.方法:收集33例胰腺癌患者和40例正常对照者的血浆,采用定量茎-环逆转录聚合酶链反应(RT-PCR)方法检测血浆中miR-100的表达水平,统计分析正常对照组与胰腺癌组血浆中miR-100表达差异及其表达水平与胰腺癌病理参数之间的关系.结果:胰腺癌患者血浆中miR-100水平(0.61 +0.24)显著高于正常对照组(0.38 +0.13),差异具有统计学意义(P＜0.01);胰腺癌患者血浆中miR-100水平在不同性别、年龄、吸烟、临床分期、局部淋巴结转移、远处转移、CA199浓度之间差异无统计学意义(P＞0.05).结论:胰腺癌患者血浆中miR-100水平增高,miR-100可能参与了胰腺癌的发生过程.

目的 探讨结肠癌患者血浆中microRNA-100(miR-100)的水平变化及其临床意义. 方法采用茎环逆转录聚合酶链反应(reverse transcription polymerase chain reaction,RT-PCR)方法 检测40例结肠癌患者和40例正常对照血浆中miR-100的表达水平,统计分析miR-100表达水平与结肠癌病理参数之间的关系. 结果 结肠癌患者血浆中miR-100水平显著低于正常对照组,差异具有统计学意义(0.39 ±0.14 vs 0.65 ±0.21,P＜0.01);结肠癌患者血浆中miR-100水平在不同性别、年龄及肿瘤大小之间差异无统计学意义(P＞0.05),而与肿瘤的淋巴转移、远处转移及临床分期明显相关(P＜0.05). 结论 结肠癌患者血浆中miR-100水平降低,miR-100可能参与了结肠癌的病理过程.