目的 提高医务人员对药物相关性低钠血症的认识,并为低钠血症的处理提供借鉴和帮助.方法 收集1例使用特利加压素导致儿童严重低钠血症的病例资料,分析该不良反应与特利加压素的相关性,并讨论特利加压素致低钠血症的机制、风险因素及处理方式等.结果 该低钠血症的发生与特利加压素的使用存在时间相关性,符合严重低钠血症的临床特征,且排除疾病和其他药物因素,并经停药后好转,可考虑该低钠血症为特利加压素引起.结论 特利加压素致低钠血症在临床治疗中日益常见,医师和药师需加强对药物相关性低钠血症的认识,避免不合理用药.在发现低钠血症时,临床药师应发挥所长,积极排查相关药物并做好药学监护,提高患者用药的安全性.

目的:比较两种方法在全麻颌面部日间手术眼睛保护中应用效果.方法:选取全麻下颌面部日间手术患者102例,按住院号尾数奇偶分为眼膏联合透明敷料组(对照组)和伤口敷料组(实验组).对照组患者全麻后涂金霉素眼膏后闭合双眼外贴3M透明敷料,实验组患者全麻后直接闭合双眼外贴侧边折叠的3M伤口敷料.比较敷料沾染睫毛和眉毛的发生率、眼部症状及并发症的发生率及护士操作用时.结果:两组患者术后眼部不适及并发症的发生率差异无统计学意义(P>0.05).实验组患者术后敷料上沾有眉毛和睫毛的发生率、眼周皮疹及视物模糊发生率、操作所需用时均低于对照组(P<0.05).结论:对全麻颌面部日间手术患者,3M伤口敷料法是一种简便、有效的眼睛保护方法,患者感受较好.

目的 探讨日间手术室护理风险因素及管理策略.方法 随机分组,对照组实施常规护理,观察组实施PDCA循环管理.结果 观察组术前、术中及术后风险发生率分别2.4％、0及2.4％、术前、术中及术后满意度分别(96.0±3.1)分、(94.7±5.5)分及(95.1±2.6)分.对照组术前、术中及术后风险发生率分别9.8％、7.3％及12.2％、术前、术中及术后满意度分别(76.1±4.2)分、(80.2±3.8)分及(74.5±8.9)分.两组数据对比,差异显著(P＜0.05).结论 实施PDCA循环管理,可减少日间手术室护理风险,确保护理安全.

OBJECTIVE:To investigate the significance of detecting serum complement C3 and C4 in patients with multiple myeloma (MM) and to explore its correlation with myeloma bone disease (MBD).METHODS:The levels of serum complement C3 and C4 in 69 MM patients and 30 healthy people were examined by scatter nephelometry. The bone density of L1-4 vertebral body, bilateral femoral neck and bilateral hip joints were measured by dual energy bone density meter (DXA).RESULTS:The levels of serum complement C3 and C4 in MM patients significantly increased in comparison with that in healthy people (P＜0.01). The patients in advanced clinical stage exhibited a higher levels of C3 and C4 than those in stable stage (P＜0.01). In addition, the patients with grade C of MBD had a higher levels of serum complement C3 and C4 than those in patients with grade A and B of MBD (P＜0.01). The levels of serum complement C3 and C4 in MM patients negatively correlated with bone density in L1-4 vertebral body, bilateral femoral necks and hip joints. The correlation coefficients were r=-0.938, r=-0.659, r=-0.745, r=-0.748, r=-0.596 in complement C3 and r=-0.908, r=-0.623, r=-0.710, r=-0.714, r=-0.595 in complement C4, respectively.CONCLUSION:The levels of complement C3 and C4 positively correlate with the severity of bone disease and bone density in MM patients, which suggests that complement C3 and C4 plays important roles in the development of MBD. The levels of serum C3 and C4 may be the sensitive biomarkers of MBD.

Objective To investigate the effects of dipeptidyl peptidase-Ⅳ (DPP-Ⅳ) inhibitor sitagliptin on the proliferation,apoptosis and content of 3-nitrotyrosine (3-NT) in rat Schwann cells(RSC96) in high glucose.Methods Schwann cell model was established by culturing RSC96 under high glucose(100 mmol/L D-glucose).The model were treated with peroxynitrite anion (ONOO-) inhibitor uric acid (UA) (1 μmol/L) and sitagliptin (1 μmol/L) for 48 hours,the effects of UA and sitagliptin on the proliferation and apoptosis of RSC96 under high glucose were observed by CCK-8 and flow cytometry.The effects of UA and sitagliptin on the expression of 3-NT protein in RSC96 were detected by ELISA.Results Compared with normal control group,the hyperglycemia group inhibited cell proliferation,promoted cell apoptosis and expression of intracellular 3-NT protein (P ＜ 0.05);UA and sitagliptin could promote the proliferation of RSC96 under high glucose,inhibited apoptosis and intracellular 3-NT protein expression (P ＜ 0.05).Conclusion Sitagliptin can increase the proliferation activity of RSC96 under high glucose,inhibit apoptosis and reduce the damage of RSC96 cells induced by high concentration of glucose by inhibiting the nitrosylation stress of cells.