Antibiotic abuse can lead to gut microbiota disturbance and intestinal inflammation, which in turn may lead to serious inflammatory bowel disease and metabolic syndromes. To investigate the effect of fucoidan on alleviation of the side effects of antibiotics and its structure-activity relationship, we compared the effects of two fucoidan fractions with medium and low molecular weights (MF and LF) from Laminaria japonica on microbiota dysbiosis, colonic inflammation and intestinal mucosal damage in a cefoperazone-induced intestinal injury mouse model. Our results showed that oral administration of 200 mg kg-1 LF (Mw = 1.13 kDa) and MF (Mw = 26.7 kDa) together with 100 mg kg-1 cefoperazone for 10 days could significantly alleviate weight loss, colon shortening and enlargement, mucosal structural damage in the small intestine, cecum and colon induced by cefoperazone in mice. Meanwhile, LF and MF also significantly suppressed the overproduction of TNF-α, IFN-γ, and IL-6 in the colon; however, LF can restore the decrease in the levels of TNF-α and IL-6 in the small intestine and the decrease in the levels of TNF-α, IFN-γ, and IL-6 in the cecum induced by cefoperazone in mice. We found that the molecular weight of fucoidan plays an important role in the regulation of the gut microbiota in antibiotic-treated mice. Interestingly, fucoidans with different molecular weights resulted in quite different caecal microbiota communities. MF exhibited a much better effect on the restoration of the gut microbiota community richness and diversity and the beneficial bacterium Muribaculaceae. However, LF resulted in the dominance of bacteria including Staphylococcus in cefoperazone treated mice, without an increase in the community richness and diversity of caecal microbiota. In the LF and MF treated mice, an increase in the abundance of beneficial bacteria, Muribaculaceae, Acinetobacter_lwoffii and Alloprevotella, and a decrease in the abundance of harmful bacteria, e.g., Parasutterella, Helicobacter and Enterococcus were also observed. Considering the negative effect of LF on the gut microbiota, MF with a molecular weight of 26.7 kDa seemed to be a more suitable choice of prebiotics for patients receiving cefoperazone treatment.

目的 研究了不同相对分子质量的海带岩藻聚糖硫酸酯对抗生素诱导肠道损伤和菌群破坏的预防作用及其作用机制.方法 利用热降解和超滤技术,从海带中制备低分子质量(LF)和中分子质量岩藻聚糖硫酸酯(MF).采用头孢哌酮诱导小鼠肠道损伤模型,观察不同相对分子质量岩藻聚糖硫酸酯对小鼠体质量、肠道黏膜组织病理学、肠道炎症因子(TNF-α、IFN-γ、IL-6)水平和盲肠的肠道菌群结构的影响.结果 口服LF和MF 200 mg·kg-1能够显著提高头孢哌酮诱导肠道损伤模型小鼠的体质量,减轻小肠、盲肠和结肠黏膜组织的损伤,显著提高小肠和盲肠中TNF-α、IFN-y和IL-6免疫因子的表达,但是能够抑制结肠中TNF-α、IFN-γ和IL-6因子的过度表达.口服海带岩藻聚糖硫酸酯能够大大提高头孢哌酮小鼠盲肠中葡萄球菌、鼠杆菌和鲍曼不动杆菌等细菌的比例,而环状芽孢杆菌、梭菌等有害菌的比例显著下降.不同分子质量岩藻聚糖硫酸酯对肠道损伤小鼠的肠道菌群结构有不同的影响.结论 海带岩藻聚糖硫酸酯对抗生素诱导的肠道损伤和微生物破坏有很好的保护作用.

目的 从小有刺参中制备纯化硫酸软骨素和岩藻聚糖硫酸酯及各自的低分子量组分,并比较不同结构硫酸多糖的抗血小板聚集活性,揭示海参硫酸多糖抗血小板聚集活性的构效关系.方法 利用离子交换色谱和自由基降解技术,从小有刺参中制备硫酸软骨素和岩藻聚糖硫酸酯及各自的低分子量组分.采用体外凝血酶诱导血小板聚集模型,比较不同结构的硫酸软骨素和岩藻聚糖硫酸酯对血小板聚集率的影响.结果 4～60 μg/mL硫酸软骨素和低分子量硫酸软骨素具有显著的抑制血小板聚集的活性,在浓度为20 μg/mL时对血小板聚集的抑制率高达94.6％和95.3％,且分子量的降低对其活性无影响.比较不同来源的岩藻聚糖硫酸酯的活性发现,在4～60 μg/mL浓度范围内,海参与海带来源的岩藻聚糖硫酸酯都显著抑制血小板聚集,且活性没有显著差异,但经过自由基降解后,海参和海带来源的岩藻聚糖硫酸酯的抗血小板聚集活性都显著降低.结论 海参硫酸软骨素的抗血小板聚集活性显著高于岩藻聚糖硫酸酯,海参硫酸多糖可以应用于新型抗血小板聚集药物的研究开发.

甲醇(CH3OH)属低碳醇,为无色透明、易燃、高挥发的液体,略有乙醇气味,比重0.79 ,沸点64.7℃,可用于制造甲酸甲酯、醋酸、甲胺等,常被用作有机溶剂或添加剂,清洗去油剂等.甲醇可经呼吸道、皮肤黏膜和消化道等途径进入人体,导致中毒.文献报道甲醇中毒以生活性较多,职业性中毒少见[1-6].现将2例职业活动中吸入甲醇导致中毒失明病例报告如下,以供参考借鉴.

Objective To study the protective activity of the high molecular weight (HMW) fucoidan and low molecular weight (LMW) fucoidan from Laminaria japonica on the thromboembolic cerebral ischemia injury and possible action mechanism.Methods With the HMW fucoidan and LMW fucoidan from Laminaria japonica as the research objectives,the thromboembolic cerebral ischemia injury model was induced by the electricity-stimulated carotid thrombosis in rats,and intravenous administration method was adopted.After injection,the neurological grade evaluation,volume of cerebral infraction,morphology of brain cortex and the content of TXB2,6-keto-PGF1α,t-PA,u-PA,PA and LPA in the blood were measured.Results HMW fucoidan and LMW fucoidan from Laminaria japonica were effective in preventing the thromboembolic cerebral ischemia injury.Intravenous administration of HMW fucoidan and LMW fucoidan significantly decreased the scores of neurological grade,volume of cerebral infraction and the damage of cerebral cortex neurons,accompanied with alleviates of cerebral edema injury induced by thromboembolic cerebral ischemia in rats.Our results showed that the protective activity of LMW fucoidan was only 10％ of HMW fucoidan.Under the effective protection concentration,the protective mechanism on the thromboembolic cerebral ischemia injury of HMW fucoidan and LMW fucoidan might be ascribe to the inhibition of TXB2 and LPA levels and promotion of 6-keto-PGF1α,t-PA and u-PA levels.Conclusion Fucoidan had excellent protective activity on the thromboembolic cerebral ischemia injury in vivo.

老年人由于生理机能衰退,往往伴有认知和思维的改变.在养老机构的老年群体中,老人的心理活动变化尤为复杂,由于身体健康状况、文化素质、生活经历的不同,其生活方式、性格特征等方面存在很大差异,在心理活动方面,既有个案性,又存在普遍性.因此,护理人员应熟知老年人的心理特征,认真观察其心理变化,根据老年人不同的心理特征和护理需求,提供全方位整体护理,让入住老人能够安享晚年.

Objective: To investigate the effects of tumor necrosis factor-α (TNF-α) monoclonal anti-body on nuclear factor-κB (NF-κB) activation and inducible nitric oxide synthase (iNOS) expression in rats with pulmonary fibrosis induced by silica dust. Methods: A total of 48 male Wistar rats were randomly divided into intervention group, silica dust exposure group, and control group, with 16 rats in each group. The rats in the intervention group were given intratracheal injection of 50 mg silicon dioxide dust once to establish a rat model and then treated with subcutaneously injected TNF-α monoclonal antibody 15 mg/kg for 5 consecutive days at 2-6 days after the establishment of the model. The rats in the silica dust exposure group were treated with the same method to establish the model and then given subcutaneous injection of the same volume of normal saline. The rats in the control group were given intratracheal and subcutaneous injection of normal saline. In both groups, 8 rats each were sacrificed at 7 and 14 days after the establishment of the model. Hematoxylin-eosin staining or Masson staining was used to observe morphological changes in lung tissue, ELISA was used to measure the serum level of TNF-α, IHC was used to measure the expression of NF-κBp65 in lung tissue, Western blot was used to measure the protein expression of I-κB in lung tissue, and RT-qPCR was used to measure the transcriptional level of iNOS mRNA in lung tissue. Results: Compared with the control group, the silica dust exposure group had significant increases in the lung inflammation score (3.375±1.061 and 2.500±0.535) , serum TNF-α level (86.405±20.494 and 77.064±11.829) , absorbance of cells with positive NF-κBp65 in lung tissue (0.297±0.05 and 0.287±0.039) , and mRNA expression of iNOS (12.906±0.590 and 12.600±0.517) at 7 and 14 days after dust exposure, a significant increase in pulmonary fibrosis score at 14 days (3.250±0.707) , and significant reductions in the protein expression of I-κB at 7 and 14 days (0.579±0.141 and 0.748±0.081) (P<0.05) . Compared with the silica dust exposure group, the intervention group had significant reductions in the lung inflammation score at 7 days (2.375±1.061) , pulmonary fibrosis score at 14 days (2.375±1.061) , serum level of TNF-α at 7 and 14 days (66.565±19.850 and 58.734±16.335) , absorbance of cells with positive NF-κBp65 in lung tissue at 7 and 14 days (0.248±0.028 and 0.238±0.027) , and mRNA expression of iNOS at 7 and 14 days (11.656±0.405 and 12.025±0.618) , as well as significant increases in the protein expression of I-κB at 7 and 14 days (0.802±0.165 and 0.888±0.144) (P<0.05) . Conclusion: TNF-α monoclonal antibody can inhibit the activation of the NF-κB signaling pathway and down-regulate the expression of iNOS, and thus exerts a certain protective effect on lung tissue in rats with pulmonary fibrosis induced by silica dust.

Objective To investigate the changes of iron metabolism index in patients with occupational pulmonary thesaurosis induced by dust of iron or iron compounds after ending iron dust exposure for 10 years.Methods A total of 22 patients with occupational pulmonary thesaurosis induced by dust of iron or iron compounds were selected as study subjects . They were misdiagnosed as electric welder ' s pneumoconiosis in 2004-2006.After ending exposure to iron dust for 10 years, high kV X-ray photography and computed tomography of chest were conducted .Indicators of serum iron metabolism , blood routine and blood biochemical were examined .Six patients were randomly selected to detect genes of hereditary hemochromatosis .The study subjects were divided into observation group ( 13 patients ) and control group ( 9 patients ) according to the lung examination .Results The median of serum ferritin ( SF) was 858.2 μg/L.The over standard rate of SF was 77.3%(17/22), and the iron overload was seen in 40.9% (9/22) of patients.The over standard rate of serum total iron binding capacity (TIBC) was 22.7%(5/22).The over standard rate of serum iron was 4.5%(1/22). The SF level of observation group was higher than that of the control group ( P<0.05 ) .The SF was positively correlated with alanine aminotransferase ( ALT ) ( P <0.05 ) .The serum TIBC was positively correlated with prealbumin ( P <0.05).The serum iron were positively correlated with ALT and aspartate aminotansferase respectively (P<0.05).But the above 3 iron metabolism indices were not correlated with the blood routine indices , blood glucose and C-reactive protein (P>0.05).The six patients tested for genes of hereditary hemochromatosis were excluded from disease .Conclusion There were iron metabolism abnormalities in patients with occupational pulmonary thesaurosis induced by dust of iron and iron compounds , which is related to the iron deposition in lung .

目的 探讨中性粒细胞弹性蛋白酶抑制剂(NEI)对急性百草枯中毒大鼠的治疗作用.方法 96只健康SPF级Wistar大鼠,随机分为对照组、模型组、治疗组,每组32只.以50 mg/kg 20％百草枯水剂溶液一次性灌胃大鼠建立急性百草枯中毒动物模型,治疗组给予西维来司钠8 mg/kg iv bid×3d.密切观察各组大鼠行为学改变,于染毒后第1、3、7、21天处死大鼠,采用ELISA法检测大鼠血清中血清白细胞介素-8(IL-8)、肿瘤坏死因子-α(TNF-α)、转化生长因子-β1(TGF-β1)和中性粒细胞弹性蛋白酶(NE)浓度水平.结果 与对照组相比,模型组各时间点血清IL-8、TNF-α、TGF-β1、NE水平较对照组均明显升高(P＜0.05).与模型组相比,治疗组在染毒后各时间点血清IL-8及TNF-α水平明显降低(P＜0.05),血清TGF-β1水平第1、3天明显降低(P＜0.05),血清NE第1、3、7天浓度水平较模型组明显下降(P＜0.05).结论 NEI对急性百草枯中毒大鼠有一定治疗作用,其机制可能与该药的抗炎作用有关.

[目的]观察布地奈德雾化吸入治疗对尘肺病合并感染患者的临床效果.[方法]选取2015年1月—2016年1月期间入院治疗的尘肺病合并感染患者60例,将其随机分为对照组(n=30)和观察组(n=30).对照组患者采用常规治疗,如吸氧、解痉、平喘及对症治疗.观察组患者除上述常规治疗外,加用布地奈德雾化吸入,每日两次,每次2 mg,连续用10 d,并对两组患者治疗后的临床效果进行比较.[结果]治疗后第10天,观察组患者疗效优于对照组,差异有统计学意义(P<0.05);观察组总有效率为96.7%,高于对照组的73.3%.两组患者治疗后的肺功能较治疗前均有所改善,且观察组FEV1、FEV1/FVC均高于对照组,差异有统计学意义(P<0.05).[结论]布地奈德雾化吸入治疗尘肺病合并感染的临床效果较好,值得在临床上进一步推广和应用.

目的提高患者化疗时的安全性。方法在开展优质护理服务中将前健康教育应用到临床化疗护理中。结果自2011年1月至5月共计300例化疗患者,均顺利完成化疗,无1例出现化疗意外,患者满意度提高。结论前健康教育提高了患者化疗的顺应性,减少了化疗意外。

目的:探讨医务人员与家属参与陪伴分娩的初产妇在分娩过程中的体会,为优质护理服务提供依据。方法:选择我院280例待产初孕妇,对其中140例进行产前健康教育及产时人性化护理陪伴分娩比较观察。结果:陪伴分娩的初产妇自然分娩率明显提高,而剖宫产率明显降低。

目的研究食管癌术后十二指肠营养管的护理,寻求好的护理方法。方法选取我院自2008年3月至2012年2月手术治疗食管癌256例,术后所有病例的营养支持治疗均由十二指肠营养管供给。结果患者痛苦小,恢复快,平均住院日减少,收到良好效果。结论对食管癌术后置十二指肠营养管的患者实施精心的护理,可以使得患者加速术后的恢复,减少患者术后并发症的发生。

目的:研究护理干预对子宫内膜异位症患者实施腹腔镜手术后的影响,寻求好的护理方法.方法:选取2009年1月～2011年6月经过腹腔镜手术治疗的76例子宫内膜异位症患者,术后对患者进行精心的护理干预,总结护理干预对于患者康复的影响.结果:所有子宫内膜异位症患者实施腹腔镜手术患者术后均顺利的康复出院,无1例患者发生严重并发症.结论:对子宫内膜异位症患者实施腹腔镜手术后护理人员再对其进行精心的护理干预,可以使得患者加速术后的恢复,减少患者术后并发症的发生,因此,护理干预对子宫内膜异位症患者实施腹腔镜手术后的影响非常重大.

目的:比较米索前列醇联合缩宫素与单纯应用缩宫素减少产后出血,预防产后大出血的临床效果。方法:回顾性配对分析2007年1月～2008年12月正常分娩初产妇各200例的临床资料。结果:联合用药组产后2 h失血量、血红蛋白下降、红细胞压积下降及产后出血发生率均低于单纯应用缩宫素组。结论:应用缩宫素的同时联合应用米索前列醇对于减少产后出血,防止产后大出血效果更佳,值得临床广泛应用。

目的:观察手法按摩乳房对发生乳汁淤积的剖宫产产妇的治疗效果。方法:选取208例发生乳汁淤积的剖宫产术后初产妇作为研究对象,随机分为实验组和对照组,实验组用热敷后手法按摩乳房,对照组用热敷加吸奶器吸奶。结果:实验组一次治愈率接近90%,而对照组一次治愈率仅为70%(P<0.05),差异有统计学意义。结论:手法按摩乳房治疗剖宫产术后乳汁淤积疗效好,具有一定的推广价值。

随着医学科学的不断发展,传统的单纯生物医学模式受到了巨大的冲击,新的医学模式即生物-心理-社会医学模式便应运而生,成为医学教育、研究和临床服务的指导思想,心理社会因素与人的心身健康的关系越来越引起人们的广泛关注.

目的探讨剖宫产术后早期进食对产妇乳汁分泌的影响。方法选择120例剖宫产产妇按手术时间先后顺序随机分为观察组肛门排气前进食,对照组肛门排气后进食,观察两组产妇乳汁分泌量的变化。结果观察组和对照组术后第1d乳汁的分泌量进行比较,两组之间无显著性差异(P>0.05),无统计学意义,从术后第2d开始,观察组和对照组比较,差异有极其显著性,(P<0.05)。结论剖宫产术后,早期进食的产妇可以促进乳汁的提前分泌,对产妇胃肠功能的恢复,无不良影响。

自2005年2月,我们在贵重药品皮下注射方面,将胰岛素注射器与普通1ml注射器进行比较,取得满意效果.现报告如下.

2004年1月～2006年1月,我们共收治溃疡性结肠炎患者86例,经积极治疗与精心护理,效果满意.现将护理体会报告如下.