目的:探讨普外科腹部手术患者留置尿管拔管前夹闭尿管训练膀胱功能必要性的研究,为开展循证实践提供证据.方法:收集我院2019年3月—9月普通外科腹部手术患者118例,将其随机分为实验组与对照组,实验组为开放引流直接拔除尿管,对照组为拔除尿管前夹闭尿管数次后拔除.对比两组尿管留置平均时间,尿潴留、尿路刺激征及尿路感染的发生情况.结果:实验组与对照组平均留置时间分别为(47.05±33.14)h,(67.00±50.60)h,实验组与对照组发生尿潴留的情况分别为1例(1.6％),0例,差异无统计学意义(P=1.000>0.05),实验组与对照组发生尿路刺激征的情况分别为2例(3.3％),0例,差异无统计学意义(P=0.496>0.05),实验组与对照组自行排尿后尿白细胞数分别为(40.28±80.57),(91.63±434.84),差异无统计学意义(P=0.063>0.05).结论:普通外科腹部手术患者留置尿管拔管前不夹闭训练对发生尿潴留、尿路刺激征及尿路感染的发生无影响,提示腹部术后患者拔除尿管前不必夹闭练习.

Objective:To evaluate the reliability, validity and sensitivity of the Chinese version of pruritus-specific quality of life instrument (ItchyQoL) .Methods:Based on the English version of ItchyQoL, items of the Chinese version of ItchyQoL were determined after forward-backward translation and cultural adaption. Totally, 218 patients with pruritus caused by skin diseases were enrolled from Department of Dermatology, Peking University First Hospital from January to December 2019, and a questionnaire survey was conducted. At the time of enrollment and 2 weeks after enrollment, the Chinese version of ItchyQoL, dermatology life quality index (DLQI) and numerical rating scale (NRS) were used to evaluate the effect of pruritus on the quality of life of patients. Confirmatory factor was used to assess the structural validity of the Chinese version of ItchyQoL, and Cronbach′s α coefficient was used to estimate its internal consistency reliability. Spearman correlation coefficient was used to analyze correlations (convergent validity) of the Chinese version of ItchyQoL score with DLQI and NRS scores, and correlations (sensitivity) of changes in the Chinese version of ItchyQoL score with changes in DLQI and NRS scores.Results:The Chinese version of ItchyQoL contained a total of 22 items, including 3 dimensions, i.e., "symptoms", "functions" and "emotions", with the Cronbach′s α coefficients being 0.946, 0.883 and 0.953 respectively, suggesting excellent internal consistency. At 2 weeks after enrollment, the NRS score was strongly correlated with the total ItchyQoL score ( rs = 0.700, P < 0.01) , and moderately correlated with the subscores of "emotions", "functions" and "symptoms" ( rs = 0.452, 0.673, 0.692 respectively, all P < 0.01) ; the DLQI score was also strongly correlated with the total ItchyQoL score ( rs = 0.887, P < 0.01) and the subscores of "functions" and "symptoms" ( rs = 0.886, 0.750 respectively, both P < 0.01) , and moderately correlated with the "emotions" subscore ( rs = 0.674, P < 0.01) . Compared with the scores at the time of enrollment, the change in the total ItchyQoL score after 2 weeks was moderately correlated with the change in the NRS score ( rs = 0.642, P < 0.01) , and strongly correlated with the change in the DLQI score ( rs = 0.757, P < 0.01) ; the changes in "symptoms" and "functions" subscores were moderately correlated with the change in the NRS score ( rs = 0.648, 0.549 respectively, both P < 0.01) , while there was a weak correlation between the changes in "emotions" subscore and NRS score ( rs = 0.225, P < 0.01) ; the changes in "symptoms" and "functions" subscores were strongly correlated with the change in the DLQI score ( rs = 0.755, 0.703 respectively, both P < 0.01) , while the change in "emotions" subscore was moderately correlated with the change in the DLQI score ( rs = 0.401, P < 0.01) . Moreover, the total score of the Chinese version of ItchyQoL and subscores of "symptoms", "functions" and "emotions" all significantly differed among different NRS and DLQI score groups at 2 weeks after enrollment (all P < 0.05) . Conclusion:The Chinese version of ItchyQoL has good reliability and validity, and can be used to evaluate the quality of life of patients with pruritus caused by skin diseases in China.

心血管疾病占全国疾病致死因素之首.动脉粥样硬化症(atherosclerosis,AS)是中老年群体心血管疾病中最为常见[1]的病症,也是诱发心梗和卒中的罪魁祸首之一.利用小鼠建立动脉斑块模型是研究A S的一个重要手段,模型的成功建立是新药筛选的关键也是研究疾病机理的基础,对AS疾病的诊断与治疗都具有重要作用.目前,造模领域评价斑块的位置及具体性质的金标准主要是通过解剖病理检查及血清指标,都需要在建模期间对小鼠进行处死,且以上方法并不能观察斑块转移等的动态变化,消耗动物成本偏高.影像技术不仅可以实时动态地观察病变动脉的情况,而且可以极大地降低动物成本.近年来,已经应用于小动物动脉粥样硬化斑块影像学评价方法主要有:电子计算机X射线断层扫描技术(computed tomography,CT)、磁共振成像(magnetic resonance imaging,MRI)、正电子发射计算机断层扫描(positron emission tomography,PET)、超声成像(ultrasound)等.本文综述了成像技术在小鼠动脉粥样斑块模型中的诊断评价的最新进展.

目的：对50例寻常型天疱疮患者密切观察，探讨寻常型天疱疮的护理措施，改善天疱疮患者的预后。方法：在50例寻常型天疱疮患者治疗期间密切观察，对患者进行有针对性的、个体化的护理，如心理护理、饮食护理、皮肤黏膜护理等，及时发现激素及免疫抑制剂的副作用并予治疗，积极给予出院指导及健康教育。结果：积极有效的护理和治疗措施促进了创面的愈合，减少了继发感染，50例寻常型天疱疮患者病情均得到基本控制。结论：加强对寻常型天疱疮的综合护理，对病情的控制及改善疾病的预后具有重要意义。

Objective To report five cases of nasal sinus mycoses caused by filamentous fungi and related laboratory inves-tigation.Methods Analyze five clinical cases of nasal sinusitis.Direct smear examination,fungal culture,PCR and sequence a-nalysis were performed for diagnosis.Results Morphological study could not identify fungi to species level but sequences a-nalysis can identify the 5 isolates as Fusarium solani ,Aspergillus fumigatus ,Aspergillus flavus ,Pseudallescheria boydii , Fusariam napiforme .Endoscopic surgeries were applied to 4 patients;1 patient received voriconazole and amphotericin B therapy;treatments were effective to all patients.Conclusions Nasal sinus mycoses could be cause by various fungi.Molecular Biology can identify pathogens to species level,and endoscopic surgery is a reliable treatment for nasal sinus mycoses.