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Abdominal paracentesis drainage ameliorates myocardial injury in severe experimental pancreatitis rats through suppressing oxidative stress 预览
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作者 Yi Wen Hong-Yu Sun +5 位作者 Zhen Tan Ruo-Hong Liu Shang-Qing Huang Guang-Yu Chen Hao Qi Li-Jun Tang 《世界胃肠病学杂志:英文版》 SCIE CAS 2020年第1期35-54,共20页
BACKGROUND Abdominal paracentesis drainage(APD)is a safe and effective strategy for severe acute pancreatitis(SAP)patients.However,the effects of APD treatment on SAPassociated cardiac injury remain unknown.AIM To inv... BACKGROUND Abdominal paracentesis drainage(APD)is a safe and effective strategy for severe acute pancreatitis(SAP)patients.However,the effects of APD treatment on SAPassociated cardiac injury remain unknown.AIM To investigate the protective effects of APD on SAP-associated cardiac injury and the underlying mechanisms.METHODS SAP was induced by 5%sodium taurocholate retrograde injection in Sprague-Dawley rats.APD was performed by inserting a drainage tube with a vacuum ball into the lower right abdomen of the rats immediately after SAP induction.Morphological staining,serum amylase and inflammatory mediators,serum and ascites high mobility group box(HMGB)1,cardiac-related enzymes indexes and cardiac function,oxidative stress markers and apoptosis and associated proteins were assessed in the myocardium in SAP rats.Nicotinamide adenine dinucleotide phosphate oxidase activity and mRNA and protein expression were also examined.RESULTS APD treatment improved cardiac morphological changes,inhibited cardiac dysfunction,decreased cardiac enzymes and reduced cardiomyocyte apoptosis,proapoptotic Bax and cleaved caspase-3 protein levels.APD significantly decreased serum levels of HMGB1,inhibited nicotinamide adenine dinucleotide phosphate oxidase expression and ultimately alleviated cardiac oxidative injury.Furthermore,the activation of cardiac nicotinamide adenine dinucleotide phosphate oxidase by pancreatitis-associated ascitic fluid intraperitoneal injection was effectively inhibited by adding anti-HMGB1 neutralizing antibody in rats with mild acute pancreatitis.CONCLUSION APD treatment could exert cardioprotective effects on SAP-associated cardiac injury through suppressing HMGB1-mediated oxidative stress,which may be a novel mechanism behind the effectiveness of APD on SAP. 展开更多
关键词 Abdominal paracentesis drainage Severe acute pancreatitis Myocardial injury High mobility group box 1 Nicotinamide adenine dinucleotide phosphate oxidase Oxidative stress
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乌司他丁对重度烧伤患者SIRS发生率和氧化应激因子水平的影响 预览
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作者 陈思思 邹同荣 +3 位作者 吴琛 岑瑛 王冰玲 林虹丽 《中国美容医学》 CAS 2020年第1期131-134,共4页
目的:研究乌司他丁对重度烧伤患者全身炎症反应综合征(Systemic inflammatory response syndrome,SIRS)发生率和氧化应激因子水平的影响。方法:选取笔者医院2016年4月-2018年7月收治的重度烧伤患者82例,根据治疗方法不同分为两组。对照... 目的:研究乌司他丁对重度烧伤患者全身炎症反应综合征(Systemic inflammatory response syndrome,SIRS)发生率和氧化应激因子水平的影响。方法:选取笔者医院2016年4月-2018年7月收治的重度烧伤患者82例,根据治疗方法不同分为两组。对照组给予清洗、补液、抗感染、抗休克及加强营养支持等基本治疗,观察组在对照组基础上给予乌司他丁治疗。分析两组患者治疗后的SIRS发生率及丙二醛(Malonaldehyde,MDA)、脂质过氧化物(Lipid peroxide,LPO)、髓过氧化物酶(Myeloperoxidase,MPO)、白细胞介素-2(Interleukin-2,IL-2)、白细胞介素-10(Interleukin-10,IL-10)表达水平。结果:观察组患者住院时间为(16.98±4.27)d短于对照组的(23.25±5.11)d,差异具有统计学意义(t=6.029,P=0.000)。两组治疗前MDA、LPO、MPO、IL-2、IL-10水平比较,差异不具有统计学意义(P>0.05)。观察组治疗3d、5d、7d后MDA、LPO、MPO水平低于对照组,IL-2、IL-10水平高于对照组,差异有统计学意义(P<0.05)。观察组入院3d、7d时SIRS发生率低于对照组,差异有统计学意义(P<0.05)。结论:乌司他丁应用于重度烧伤患者可调节IL-2、IL-10的表达水平,抑制氧化应激反应,减少SIRS发生率,缩短住院时间,加速患者康复。 展开更多
关键词 烧伤 重度 乌司他丁 氧化应激 全身炎症反应综合征 白细胞介素-2 脂质过氧化物
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重症急性胰腺炎腹腔感染的临床治疗探讨 预览
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作者 洪东煌 杨火保 +1 位作者 沈阳辉 刘进生 《中国卫生标准管理》 2020年第1期40-42,共3页
目的探讨重症急性胰腺炎腹腔感染的临床治疗方案及其效果。方法选择本院在2017年1月—2019年3月收治的重症急性胰腺炎患者腹腔感染54例为对象,用单盲法将研究对象分成两组,各27例:用常规方案治疗对照组患者,而观察组患者在接受常规方案... 目的探讨重症急性胰腺炎腹腔感染的临床治疗方案及其效果。方法选择本院在2017年1月—2019年3月收治的重症急性胰腺炎患者腹腔感染54例为对象,用单盲法将研究对象分成两组,各27例:用常规方案治疗对照组患者,而观察组患者在接受常规方案治疗的同时,给予腹腔清创和持续灌洗、肠内营养等方法治疗。分析两组患者的临床症状改善情况,监测其血清淀粉酶水平变化,根据其病情改善程度判断临床治疗效果,将两组的治疗总有效率进行比较。结果观察组的总有效率92.6%相较于对照组的70.4%高,P<0.05,差异有统计学意义。结论重症急性胰腺炎腹腔感染患者接受具有针对性的综合方案治疗效果显著。 展开更多
关键词 急性胰腺炎 重症 腹腔感染 腹腔清创 持续灌洗 肠内营养
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肺康复治疗对重度和极重度慢性阻塞性肺疾病患者的疗效 预览
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作者 刘映霞 陈培锦 《中山大学学报(医学版)》 CAS CSCD 北大核心 2019年第3期453-458,共6页
【目的】探讨肺康复治疗对重度、极重度慢性阻塞性肺疾病患者的疗效。【方法】选择2014年1月至2016年1月潮州市人民医院收治的慢性阻塞性肺疾病患者68例,其中男性51例,女性17例,平均年龄(64±8)岁。将所有患者随机分为治疗组(34例)... 【目的】探讨肺康复治疗对重度、极重度慢性阻塞性肺疾病患者的疗效。【方法】选择2014年1月至2016年1月潮州市人民医院收治的慢性阻塞性肺疾病患者68例,其中男性51例,女性17例,平均年龄(64±8)岁。将所有患者随机分为治疗组(34例)和对照组(34例)。所有患者给予常规药物治疗及生活方式指导,治疗组在此基础上给予康复锻炼。随访12个月,定时收集患者肺功能指标、6 min步行试验、CAT评分、HADs评分等数据。【结果】随访6个月时两组FEV_1/预计值、FEV_1/FVC、6 min步行试验及HADs评分对比差异均无统计学意义(P> 0.05),治疗组CAT评分优于对照组,差异有统计学意义(P <0.05);随访12个月时两组FEV_1/预计值和HADs评分对比差异无统计学意义(P> 0.05),治疗组FEV_1/FVC、6 min步行试验、CAT评分优于对照组,差异均有统计学意义(P <0.05,P <0.05,P <0.05);治疗组随访6个月时6 min步行试验、CAT评分较治疗前改善,差异有统计学意义(P <0.01,P <0.001),随访12个月时6 min步行试验、CAT评分较治疗前改善,差异有统计学意义(P <0.001,P <0.001)。【结论】康复治疗可改善重度、极重度慢性阻塞性肺疾病患者的症状、肺功能,提高生活质量和运动耐力。 展开更多
关键词 慢性阻塞性肺疾病 肺康复 重度 极重度
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Risk factors for progression to acute-on-chronic liver failure during severe acute exacerbation of chronic hepatitis B virus infection 预览
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作者 Ling Yuan Bai-Mei Zeng +7 位作者 Lu-Lu Liu Yi Ren Yan-Qing Yang Jun Chu Ying Li Fang-Wan Yang Yi-Huai He Shi-De Lin 《世界胃肠病学杂志:英文版》 SCIE CAS 2019年第19期2327-2337,共11页
BACKGROUND Acute exacerbation in patients with chronic hepatitis B virus (HBV) infection results in different severities of liver injury. The risk factors related to progression to hepatic decompensation (HD) and acut... BACKGROUND Acute exacerbation in patients with chronic hepatitis B virus (HBV) infection results in different severities of liver injury. The risk factors related to progression to hepatic decompensation (HD) and acute-on-chronic liver failure (ACLF) in patients with severe acute exacerbation (SAE) of chronic HBV infection remain unknown. AIM To identify risk factors related to progression to HD and ACLF in compensated patients with SAE of chronic HBV infection. METHODS The baseline characteristics of 164 patients with SAE of chronic HBV infection were retrospectively reviewed. Independent risk factors associated with progression to HD and ACLF were identified. The predictive values of our previously established prediction model in patients with acute exacerbation (AE model) and the model for end-stage liver disease (MELD) score in predicting the development of ACLF were evaluated. RESULTS Among 164 patients with SAE, 83 (50.6%) had compensated liver cirrhosis (LC), 43 had progression to HD without ACLF, and 29 had progression to ACLF within 28 d after admission. Independent risk factors associated with progression to HD were LC and low alanine aminotransferase. Independent risk factors for progression to ACLF were LC, high MELD score, high aspartate aminotransferase (AST) levels, and low prothrombin activity (PTA). The area under the receiver operating characteristic of the AE model [0.844, 95% confidence interval (CI): 0.779-0.896] was significantly higher than that of MELD score (0.690, 95%CI: 0.613-0.760, P < 0.05) in predicting the development of ACLF. CONCLUSION In patients with SAE of chronic HBV infection, LC is an independent risk factor for progression to both HD and ACLF. High MELD score, high AST, and low PTA are associated with progression to ACLF. The AE model is a better predictor of ACLF development in patients with SAE than MELD score. 展开更多
关键词 Acute-on-chronic LIVER failure Chronic hepatitis B Hepatic DECOMPENSATION LIVER CIRRHOSIS Risk factors Severe ACUTE EXACERBATION
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SOD抗自由基喷剂在减轻光动力治疗痤疮不良反应中的应用
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作者 李欣 胡玲玲 +1 位作者 刘子重 宋为民 《中国皮肤性病学杂志》 CAS CSCD 北大核心 2019年第7期783-787,共5页
目的探讨SOD抗自由基喷剂在减轻光动力治疗痤疮不良反应的疗效及安全性。方法 41例中、重度痤疮患者随机分为试验组和对照组,分别给予ALA-PDT治疗,每2周1次,共4次。试验组治疗后均使用SOD抗自由基喷剂,对照组常规生理盐水冷敷,两组治疗... 目的探讨SOD抗自由基喷剂在减轻光动力治疗痤疮不良反应的疗效及安全性。方法 41例中、重度痤疮患者随机分为试验组和对照组,分别给予ALA-PDT治疗,每2周1次,共4次。试验组治疗后均使用SOD抗自由基喷剂,对照组常规生理盐水冷敷,两组治疗后常规避光24~48 h。每次治疗后记录两组患者的不良反和临床疗效。结果试验组红斑水肿、灼热刺痛、干燥脱屑、面部瘙痒、色素沉着及反应性痤疮发生率均低于对照组,上述不良反应持续时间均短于对照组,两组比较差异有统计学意义(P<0.05)。第2、3、4次治疗后试验组有效率分别为78.95%、89.47%和94.74%,明显高于对照组的42.86%、71.43%和85.71%,差异均有统计学意义(P<0.05),4次治疗后试验组有效率优于对照组。结论 SOD抗自由基喷剂能有效减少光动力治疗痤疮的不良反应,缩短皮损持续时间,提高光动力疗效。 展开更多
关键词 中重度痤疮 光动力疗法 SOD 不良反应
重症急性胰腺炎患者出院准备度及其影响因素分析 预览
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作者 宋洪涛 《现代临床护理》 2019年第8期9-13,共5页
目的了解重症急性胰腺炎患者的出院准备度情况,并探讨其影响因素。方法使用一般资料调查表、出院准备度量表、出院指导质量量表对2017年3月—2019年3月期间在本院ICU住院后转至胰胆病区的重症急性胰腺炎患者进行横断面调查。结果77.4%... 目的了解重症急性胰腺炎患者的出院准备度情况,并探讨其影响因素。方法使用一般资料调查表、出院准备度量表、出院指导质量量表对2017年3月—2019年3月期间在本院ICU住院后转至胰胆病区的重症急性胰腺炎患者进行横断面调查。结果77.4%重症急性胰腺炎患者主观表示已做好了出院前的准备,115例患者的出院准备度总均分为(153.95±31.73)分。多元线性回归分析显示,出院指导质量、是否首发、有无并发症、肠内营养耐受情况是重症急性胰腺炎患者出院准备度的主要影响因素(均P<0.05)。结论重症急性胰腺炎患者出院准备度较为不足,应引起相关护理人员的重视。针对出院准备度不足应采取强化出院前管理和指导等措施,促进出院前身心恢复和出院后应对能力的提升。对出院准备度偏低的高危患者给予有针对性的护理干预,并加大帮扶力度,从而全面提升重症急性胰腺炎患者的出院准备度水平。 展开更多
关键词 重症 急性胰腺炎 出院准备度 影响因素
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纤支镜肺泡灌洗联合注射用亚胺培南西司他丁钠治疗医院获得性重症肺炎的临床研究
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作者 欧阳惠利 赵亮 陈远平 《广州医科大学学报》 2019年第1期103-106,共4页
目的:探讨纤支镜肺泡灌洗联合注射用亚胺培南西司他丁钠治疗医院获得性重症肺炎的临床效果。方法:选择2016年3月至2018年9月河源市源城区人民医院收治的80例医院获得性重症肺炎患者作为研究对象,随机数字表法分为试验组和对照组,每组各4... 目的:探讨纤支镜肺泡灌洗联合注射用亚胺培南西司他丁钠治疗医院获得性重症肺炎的临床效果。方法:选择2016年3月至2018年9月河源市源城区人民医院收治的80例医院获得性重症肺炎患者作为研究对象,随机数字表法分为试验组和对照组,每组各40例。两组均予以常规治疗,于此基础上对照组予以注射用亚胺培南西司他丁钠治疗,试验组予以纤支镜肺泡灌洗联合注射用亚胺培南西司他丁钠治疗,均治疗10 d。比较两组临床效果,治疗前后急性生理学与慢性健康状况评分系统Ⅱ(APACHE-Ⅱ)评分、血气指标[血氧分压(PaO2)、氧合指数(PaO2/Fi O2)]、血清炎性因子[C反应蛋白(CRP)、降钙素原(PCT)]水平。结果:治疗10 d后,试验组总有效率为90.00%高于对照组的67.50%(P<0.05);治疗10 d后两组APACHE-Ⅱ评分较治疗前降低,且试验组低于对照组(P<0.05);治疗10 d后试验组PaO2及PaO2/Fi O2水平较治疗前增高,且试验组高于对照组(P<0.05);治疗10 d后试验组血清CRP及PCT水平较治疗前降低,且试验组低于对照组(P<0.05)。结论:纤支镜肺泡灌洗联合注射用亚胺培南西司他丁钠可减轻医院获得性重症肺炎患者病情,改善血气情况,缓解炎症反应,疗效显著。 展开更多
关键词 肺炎 医院获得性 重症 纤支镜肺泡灌洗 注射用亚胺培南西司他丁钠 急性生理学与慢性健康状况评分系统Ⅱ评分 炎症反应
Effects of adjuvant raw rhubarb enema therapy on systemic inflammatory stress response and intestinal mucosal barrier function in patients with severe pancreatitis
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作者 Ping Fang Xian-Hua Xiao 《海南医科大学学报(英文版)》 2019年第9期50-53,共4页
Objective: To investigate the effects of adjuvant raw rhubarb enema therapy on systemic inflammatory stress response and intestinal mucosal barrier function in patients with severe pancreatitis. Methods: A total of 78... Objective: To investigate the effects of adjuvant raw rhubarb enema therapy on systemic inflammatory stress response and intestinal mucosal barrier function in patients with severe pancreatitis. Methods: A total of 78 patients with severe pancreatitis treated in the Second People's Hospital of Neijiang, Sichuan, China between December 2016 and September 2018 were included in the study. The patients were divided into control group (n=39) and raw rhubarb group (n=39) by simple randomization. The control group of patients received conventional treatment of severe pancreatitis with western medicine, while the raw rhubarb group of patients received raw rhubarb enema on the basis of the treatment of control group, and the efficacy was evaluated after continuous treatment for 1 week. The differences in serum levels of inflammatory mediators (high mobility group protein B1, C-reactive protein, prostaglandin E2 and tumor necrosis factor α), stress hormones (cortisol and epinephrine) as well as intestinal mucosal barrier function indicators (D-lactate, endotoxin and diamine oxidase) were compared between the two groups of patients before and after treatment. Results: Before treatment, there was no statistically significant difference in serum levels of inflammatory mediators, stress hormones and intestinal mucosal barrier function indicators between the two groups (P>0.05). After treatment, serum high mobility group protein B1, C-reactive protein, prostaglandin E2 and tumor necrosis factor levels of the observation group were significantly lower than those of the control group;cortisol and epinephrine levels were significantly lower than those of the control group;D-lactate, endotoxin and diamine oxidase levels were significantly lower than those of the control group (P<0.05). Conclusions:Adjuvant raw rhubarb enema therapy on the basis of western medicine can help alleviate the inflammatory stress response and optimize the intestinal mucosal barrier function in patients with severe pancreatitis. 展开更多
关键词 SEVERE PANCREATITIS RAW RHUBARB enema SYSTEMIC INFLAMMATORY response Stress response Intestinal mucosal barrier function
临床路径健康管家新模式用于呼吸科重症耐药菌感染防控 预览
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作者 黄勤凤 任国琴 《国际医药卫生导报》 2019年第13期2073-2075,共3页
目的观察基于临床路径的健康管家新模式对呼吸科重症患者发生耐药菌感染的预防效果。方法选取2016年2月至2018年10月入住本院的呼吸科重症患者90例作为主要观察对象,采用随机数字表法将患者分为观察组(45例)、对照组(45例),观察组采用... 目的观察基于临床路径的健康管家新模式对呼吸科重症患者发生耐药菌感染的预防效果。方法选取2016年2月至2018年10月入住本院的呼吸科重症患者90例作为主要观察对象,采用随机数字表法将患者分为观察组(45例)、对照组(45例),观察组采用基于临床路径的健康管家新模式,对照组采用常规护理,对比两组患者对用药的依从性、耐药菌感染发生率及生活质量变化情况。结果观察组患者服药依从性得分7(6,8)分,对照组患者得分为6(5,6)分(Z=-4.235,P<0.05);观察组耐药菌发生率为4.44%(2/45),对照组耐药菌发生率为26.67%(12/45),P<0.05;观察组患者护理后急性生理学、慢性健康症状评分均显著高于对照组(均P<0.05)。结论基于临床路径的健康管家新模式用于呼吸科重症患者,能够改善患者的用药依从性及生活质量,并有助于降低患者发生耐药菌感染的风险,具有护理借鉴价值。 展开更多
关键词 临床路径 健康管理新模式 呼吸科 重症 耐药菌感染
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间充质干细胞治疗急性移植物抗宿主病的现状和未来 预览
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作者 冯丹 姜尔烈 《中国医学前沿杂志(电子版)》 2019年第9期20-24,共5页
急性移植物抗宿主病(acute graft versus host disease,aGVHD)是异基因造血干细胞移植后特有的并发症,也是导致患者死亡的主要原因之一。间充质干细胞(mesenchymal stem cell,MSC)已被广泛研究用于aGVHD的治疗,尤其是用于经一线(类固醇... 急性移植物抗宿主病(acute graft versus host disease,aGVHD)是异基因造血干细胞移植后特有的并发症,也是导致患者死亡的主要原因之一。间充质干细胞(mesenchymal stem cell,MSC)已被广泛研究用于aGVHD的治疗,尤其是用于经一线(类固醇)治疗后无反应的重度激素耐药aGVHD。本文通过探讨MSC治疗aGVHD是否有效、aGVHD受累器官或严重程度是否影响MSC治疗反应率、MSC体外扩增的技术问题与治疗效果之间的关系、MSC的供体来源、MSC治疗时机、输注后转归等问题研究MSC治疗的现状与未来。 展开更多
关键词 间充质干细胞 急性移植物抗宿主病 重度激素耐药
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重症脑梗死优化诊治方案及流程建议草案
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作者 吴思缈 吴波 +11 位作者 郭富强 张世洪 郝子龙 杨东东 李小刚 吴碧华 王淳 段劲峰 凌天金 张浩 刘鸣 《华西医学》 2019年第10期1096-1108,共13页
重症/大面积脑梗死治疗难、预后差,定义不统一且针对性研究相对滞后。该草案推荐了相关定义标准和诊断流程,特别强调对重症/大面积脑梗死需重点关注恶性脑水肿预防和早期预测;加强监测意识和生命体征,及预防管理肺部感染等并发症;提出... 重症/大面积脑梗死治疗难、预后差,定义不统一且针对性研究相对滞后。该草案推荐了相关定义标准和诊断流程,特别强调对重症/大面积脑梗死需重点关注恶性脑水肿预防和早期预测;加强监测意识和生命体征,及预防管理肺部感染等并发症;提出了在重症患者中使用脑梗死特异性疗法(如静脉溶栓、血管内介入、抗血小板和抗凝治疗)的特殊建议;指出脑水肿和颅高压内外科治疗和早期康复在重症/大面积脑梗死患者的个体化应用需要更多研究。 展开更多
关键词 脑梗死 重症 大面积 诊治 流程
Long-term safety follow-up of children from a randomized-controlled phase Ⅱb proof-of-concept efficacy study of the live,attenuated,tetravalent dengue vaccine (CYD-TDV) in Thailand
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作者 Kriengsak Limkittikul Weerawan Hattasingh +7 位作者 Danaya Chansinghakul Arunee Sabchareon Wut Dulyachai Carina Frago T Anh Wartel Edith Langevin Sophia Gailhardou Alain Bouckenooghe 《亚太热带医药杂志:英文版》 SCIE CAS 2019年第9期396-403,共8页
Objective:To investigate the long-term safety of a tetravalent dengue vaccine(CYD-TDV)in children in a phase Ⅱ b follow-up study in Thailand.Methods:In the phase Ⅱb study,children aged 4-11 years were randomized(2:1... Objective:To investigate the long-term safety of a tetravalent dengue vaccine(CYD-TDV)in children in a phase Ⅱ b follow-up study in Thailand.Methods:In the phase Ⅱb study,children aged 4-11 years were randomized(2:1)to receive three injections of CYD-TDV or serve as control at 6-month intervals,with 25 months’ active follow-up(active phase).This study was an additional four-year passive surveillance for hospitalized virologically-confirmed dengue(VCD;hospital phase).Cases of hospitalized VCD,severe hospitalized VCD,vaccine-related serious adverse events,and deaths were reported for the total population,with post-hoc analyses by enrollment age(<9 and≥9 years).Results:Of 3 997 participants receiving≥1 injection,80.1% were recruited to the hospital phase[2 131(CYD-TDV);1 072(control)].Eighty-five hospitalized VCD cases were reported in the CYD-TDV group and 46 in the control group during the four-year hospital phase[relative risk(RR):0.93,95% confidence interval(Cl):0.64-1.36].The RR over six years of follow-up was 0.77(95% CI:0.57-1.05).In those aged≥9 years,the cumulative RRs in the active phase,hospital phase,and entire six years were 0.28(95% CI:0.08-0.81),0.51(95% CI:0.25-1.05),and 0.42(95% CI:0.24-0.75),respectively.In the overall population,there were ten severe hospitalized VCD cases in the CYD-TDV group and five in the control group over six years(RR:1.00,95% CI:0.31-3.75).Conclusions:Over six years of follow-up,in children aged ≥9 years,CYD-TDV administration is associated with a reduced risk of hospitalized VCD. 展开更多
关键词 CYD-TDV DENGUE vaccine HOSPITALIZED DENGUE Severe DENGUE Virologtically confirmed DENGUE
Liver involvement in the drug reaction, eosinophilia, and systemic symptoms syndrome 预览
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作者 Sylvia A Martinez-Cabriales Neil H Shear Emmanuel I Gonzalez-Moreno 《世界临床病例杂志》 2019年第6期705-716,共12页
First described in 1996, the drug reaction, eosinophilia, and systemic symptoms syndrome (DReSS) is considered, along with Stevens-Johnson syndrome and toxic epidermal necrolysis, a severe cutaneous drug reaction. It ... First described in 1996, the drug reaction, eosinophilia, and systemic symptoms syndrome (DReSS) is considered, along with Stevens-Johnson syndrome and toxic epidermal necrolysis, a severe cutaneous drug reaction. It is characterized by the presence of a maculopapular erythematous skin eruption, fever, lymphadenopathy, influenza-like symptoms, eosinophilia, and visceral involvement such as hepatitis, pneumonitis, myocarditis, pericarditis, nephritis, and colitis. The prognosis of patients with DReSS is related to the severity of visceral involvement. The mortality ranges from approximately 5% to 10%, and death is mainly due to liver failure, which is also the organ most commonly involved in this syndrome. Although it was previously hypothesized in 1994, DReSS syndrome can lead to reactivation of one or more human herpesvirus family members. Now being included as diagnostic criteria in a proposed diagnostic score system, this reactivation can be detected up to 2-3 wk after DReSS syndrome onset. Other causes of mortality in DReSS syndrome include myocardial or pulmonary lesions and hemophagocytosis. We reviewed the literature of previously reported case-series of DReSS and liver involvement, highlighting the pattern of liver damage, the treatment used, and the outcome. 展开更多
关键词 DRUG reaction eosinophilia and SYSTEMIC SYMPTOMS SYNDROME SEVERE
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Simulation of hydrogen distribution and effect of Engineering Safety Features (ESFs) on its mitigation in a WWER-1000 containment 预览
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作者 Omid Noori-kalkhoran Najmeh Jafari-ouregani +1 位作者 Massimiliano Gei Rohollah Ahangari 《核技术:英文版》 SCIE CAS CSCD 2019年第6期88-103,共16页
In this study, thermal–hydraulic parameters inside the containment of aWWER-1000/v446 nuclear power plant are simulated in a double-ended cold leg accident for short and long times (by using CONTAIN 2.0 and MELCOR 1.... In this study, thermal–hydraulic parameters inside the containment of aWWER-1000/v446 nuclear power plant are simulated in a double-ended cold leg accident for short and long times (by using CONTAIN 2.0 and MELCOR 1.8.6 codes), and the effect of the spray system as an engineering safety feature on parameters mitigation is analyzed with the former code. Along with the development of the accident from design basis accident to beyond design basis accident, the Zircaloy–steam reaction becomes the source of in-vessel hydrogen generation. Hydrogen distribution inside the containment is simulated for a long time (using CONTAIN and MELCOR), and the effect of recombiners on its mitigation is analyzed (using MELCOR). Thermal–hydraulic parameters and hydrogen distribution profiles are presented as the outcome of the investigation. By activating the spray system, the peak points of pressure and temperature occur in the short time and remain belowthe maximumdesign values along the accident time. It is also shown that recombiners have a reliable effect on reducing the hydrogen concentration below flame propagation limit in the accident localization area. The parameters predicted by CONTAIN and MELCOR are in good agreement with the final safety analysis report. The noted discrepancies are discussed and explained. 展开更多
关键词 CONTAINMENT HYDROGEN DISTRIBUTION Invessel SEVERE accident Recombiners CONTAIN MELCOR
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肺康复应用于慢性阻塞性肺疾病合并重度呼吸衰竭的效果 预览
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作者 李静 《中国继续医学教育》 2019年第20期162-164,共3页
目的探讨肺康复对慢性阻塞性肺疾病合并重度呼吸衰竭治疗的促进作用。方法抽选136例慢性阻塞性肺疾病合并重度呼吸衰竭患者作为研究对象。根据不同的治疗方案,将其分为两组,对照组(68例)选择常规治疗方案;观察组(68例)选择肺康复治疗,... 目的探讨肺康复对慢性阻塞性肺疾病合并重度呼吸衰竭治疗的促进作用。方法抽选136例慢性阻塞性肺疾病合并重度呼吸衰竭患者作为研究对象。根据不同的治疗方案,将其分为两组,对照组(68例)选择常规治疗方案;观察组(68例)选择肺康复治疗,比较两组患者的治疗效果。结果在治疗有效率方面实施比较,观察组有效率高于对照组,差异具有统计学意义(P<0.05)。治疗后,观察组患者血气相关临床指标均优于对照组,两组比较,差异具有统计学意义(P<0.05)。结论针对慢性阻塞性肺疾病合并呼吸衰竭治疗过程中选择肺康复临床价值高,促进呼吸功能康复,满足临床需求。 展开更多
关键词 肺康复 慢性阻塞性肺疾病 重度 呼吸衰竭 治疗 促进作用
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Differences in pathological changes between two rat models of severe traumatic brain injury 预览
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作者 Yi-Ming Song Yu Qian +6 位作者 Wan-Qiang Su Xuan-Hui Liu Jin-Hao Huang Zhi-Tao Gong Hong-Liang Luo Chuang Gao Rong-Cai Jiang 《中国神经再生研究:英文版》 SCIE CAS CSCD 2019年第10期1796-1804,共9页
The rat high-impact free weight drop model mimics the diffuse axonal injury caused by severe traumatic brain injury in humans,while severe controlled cortical impact can produce a severe traumatic brain injury model u... The rat high-impact free weight drop model mimics the diffuse axonal injury caused by severe traumatic brain injury in humans,while severe controlled cortical impact can produce a severe traumatic brain injury model using precise strike parameters.In this study,we compare the pathological mechanisms and pathological changes between two rat severe brain injury models to identify the similarities and differences.The severe controlled cortical impact model was produced by an electronic controlled cortical impact device,while the severe free weight drop model was produced by dropping a 500 g free weight from a height of 1.8 m through a plastic tube.Body temperature and mortality were recorded,and neurological deficits were assessed with the modified neurological severity score.Brain edema and bloodbrain barrier damage were evaluated by assessing brain water content and Evans blue extravasation.In addition,a cytokine array kit was used to detect inflammatory cytokines.Neuronal apoptosis in the brain and brainstem was quantified by immunofluorescence staining.Both the severe controlled cortical impact and severe free weight drop models exhibited significant neurological impairments and body temperature fluctuations.More severe motor dysfunction was observed in the severe controlled cortical impact model,while more severe cognitive dysfunction was observed in the severe free weight drop model.Brain edema,inflammatory cytokine changes and cortical neuronal apoptosis were more substantial and blood-brain barrier damage was more focal in the severe controlled cortical impact group compared with the severe free weight drop group.The severe free weight drop model presented with more significant apoptosis in the brainstem and diffused blood-brain barrier damage,with higher mortality and lower repeatability compared with the severe controlled cortical impact group.Severe brainstem damage was not found in the severe controlled cortical impact model.These results indicate that the severe controlled cortical impact model is relat 展开更多
关键词 nerve REGENERATION severe traumatic brain INJURY animal model comparison free weight drop controlled cortical impact NEUROLOGICAL impairment NEUROINFLAMMATION blood-brain barrier damage neuronal apoptosis diffuse AXONAL INJURY BRAINSTEM INJURY neural REGENERATION
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Effects of Da-Cheng-Qi decoction on enteroparalysis and serum inflammatory cytokines in patients with severe acute pancreatitis 预览
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作者 Xiao Wang Guo-Hong Yang +6 位作者 Chen-Xiao Wang Chun-Ying Li Min Guo Ming-Hao Liu Zhen-Jun Zeng Jun Ma Qin-Sheng Zhang 《TMR传统医学研究》 2019年第4期205-212,共8页
Objective: The objective of this study was to investigate the effects of Da-Cheng-Qi decoction (DCQD) on enteroparalysis and levels of the serum inflammatory cytokines C-C motif chemokine ligand 2 (CCL2) and interleuk... Objective: The objective of this study was to investigate the effects of Da-Cheng-Qi decoction (DCQD) on enteroparalysis and levels of the serum inflammatory cytokines C-C motif chemokine ligand 2 (CCL2) and interleukin-8 (IL-8) in patients with severe acute pancreatitis (SAP). Methods: A total of 48 patients diagnosed with SAP who hospitalized in First Affiliated Hospital of Henan Traditional Chinese Medicine University from May 1, 2016 to May 30, 2018 were randomly assigned to the control or treatment groups. Patients in the control group (n = 22) received conventional treatment and those in the treatment group (n = 26) received conventional treatment as well as additional DCQD for 10 days. The duration of abdominal pain and distension, the time when bowel sounds returned to normal, changes in the levels of serum amylase, lipase, C-reactive protein (CRP), CCL2 and IL-8, as well as acute physiology and chronic health evaluation (APACHE)Ⅱ scores of patients on days 1 and 10 were recorded and compared. Results: The duration of abdominal pain and distension, the time when bowel sounds returned to normal, the levels of blood amylase, lipase and CRP, and APACHE Ⅱ scores of patients in the treatment group decreased significantly compared with those of patients in the control group. Though there were no statistical differences in serum CCL2 and IL-8 concentrations on day 1 between patients in these two groups, the levels of serum CCL2 and IL-8 in the treatment group were lower than those in the control group on day 10. Conclusion: DCQD may decrease the levels of CCL2, CRP, and IL-8 in patients with SAP, quickly relieve enteroparalysis, and shorten hospitalization duration. 展开更多
关键词 Da-Cheng-Qi DECOCTION Severe acute PANCREATITIS CRP CCL2 IL-8
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支气管镜灌洗术在老年重症肺部感染治疗中的临床价值 预览
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作者 罗添桂 《中国卫生标准管理》 2019年第24期60-63,共4页
目的对支气管镜灌洗术在老年重症肺部感染治疗中的临床价值进行探讨。方法采集时间段为2017年4月-2019年5月内于我科接受治疗的重症肺部感染老年患者80例,通过随机法分为40例试验组与40例对照组,其中对照组接受常规治疗,试验组在常规治... 目的对支气管镜灌洗术在老年重症肺部感染治疗中的临床价值进行探讨。方法采集时间段为2017年4月-2019年5月内于我科接受治疗的重症肺部感染老年患者80例,通过随机法分为40例试验组与40例对照组,其中对照组接受常规治疗,试验组在常规治疗的基础上实施支气管镜灌洗术,对比两种治疗方法的实际临床效果。结果经过对比后,相较于对照组,试验组临床治疗有效率更高(P<0.05)。两组治疗前各指标差异小(P>0.05);治疗后相较于对照组,试验组CRP、WBC、PaO2、PaCO2指标的改善效果更好(P<0.05)。试验组治疗后湿啰音消失时间、体温恢复时间及住院时间均更低(P<0.05)。结论在老年重症肺部感染中,可通过支气管镜灌洗术进行治疗,可增强治疗效果,改善各项临床指标,促进肺通气功能的改善,有助于患者术后恢复,具备较高临床价值。 展开更多
关键词 支气管镜灌洗术 老年 重症 肺部感染 临床价值 治疗效果
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两种不同术式矫正不同程度先天性上睑下垂的效果探讨 预览
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作者 杜薇 李旭东 +1 位作者 凃惠芳 雷荣 《中国美容医学》 CAS 2019年第3期44-47,共4页
目的:探讨提上睑肌缩短术和额肌瓣悬吊术这两种术式对于不同程度先天性上睑下垂的矫正效果。方法:回顾性分析2000年-2008年在笔者医院接受提上睑肌缩短术或额肌瓣悬吊术的先天性上睑下垂患者37例53眼的临床资料,根据手术方式的不同,将... 目的:探讨提上睑肌缩短术和额肌瓣悬吊术这两种术式对于不同程度先天性上睑下垂的矫正效果。方法:回顾性分析2000年-2008年在笔者医院接受提上睑肌缩短术或额肌瓣悬吊术的先天性上睑下垂患者37例53眼的临床资料,根据手术方式的不同,将其分为提上睑肌缩短术组(n=17)和额肌瓣悬吊术组(n=20),比较两组不同程度先天性上睑下垂的矫正效果及术后并发症发生率。结果:提上睑肌缩短术对于轻度上睑下垂的正矫率为87.5%高于额肌瓣悬吊术组的55.6%,差异有统计学意义(P<0.05)。提上睑肌缩短术对于中、重度上睑下垂的正矫率分别为30.0%、50.0%,低于额肌瓣悬吊术组的90.0%、90.0%,差异有统计学意义(P<0.05)。提上睑肌缩短术组的并发症发生率为17.7%低于额肌瓣悬吊术组的20.0%,但两组间比较差异无统计学意义(P>0.05)。结论:提上睑肌缩短术适用于轻度先天性上睑下垂;额肌瓣悬吊术适用于中、重度先天性上睑下垂。 展开更多
关键词 先天性上睑下垂 轻度 中度 重度 提上睑肌缩短术 额肌瓣悬吊术
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