目的:分析本院住院部麻醉藥品應用的現狀及趨勢,并作客觀評價。方法:對2005~2008年本院麻醉藥品的種類、用量、金額、DDDs等進行歸類統計、比較和分析。結果:統計結果表明,本院住院部使用麻醉藥品的用量及金額呈上升趨勢。臨床應用以芬太尼類居首。新型麻醉藥品的應用也有上升趨勢。結論:本院住院部麻醉藥品應用基本合理,但仍存在一些不合理的習慣用法,需進一步提高合理用藥水平。
Objective To summarize the experience of preparation and administration of medical materials for the daytime-sickroom during the treatment of patients who were injured during Wenchuan earthquake in order to supply management experience for future emergency situations. Methods Data concerning the preparation and administration of medical materials and medical treatment for the daytime-sickroom were collected systematically. Results The high level of activity and order during the rescue provided quality care to patients injured in the earthquake. All 224 patients were treated effectively from May 12-29.Conclusion The daytime-sickroom acts as a combination sickroom, which allowed flexibility. The daytime-sickroom can manage medical materials and succesfully insure the treatement of patients when emergent events happen.
ObjectiveTo investigate the change of cellmediated immunity in gut mucosa after major hepatectomy and to study its relationship with the bacteria translocation.MethodsFortyeight Spraguedawley adult male rats were randomly allocated into two groups, the sham operation group and the operation group. Besides without the hepatectomy, the sham operation group has the same course with the operation group. Seventy percent hepatectomy rats are divided as postoperative 6 h group (n=6)，12 h group (n=6)，24 h group (n=6) and 72 h group (n=6). Sixhour, 12hour, 24hour and 72hour after operation specimens were taken from jejunoileum respectively. Immunohistochemical staining was performed on frozen sections and image pattern analysis was used. We also investigate the change of liver function. ResultsTwentyfour hours and 72 hours after 70% hepatectomy, there was a significant reduction in the number of CD3+，CD4+and CD8+ T lymphocytes in the mucosal lamina propria of the operation group compared with the sham operation group （Plt;0.05）. There was significant difference between these two groups in liver function change （Plt;0.05）.ConclusionThere is an altered pattern of intestinal mucosal T lymphocytes after major hepatectomy, then the local cellmediated immunity was depressed, which may be the cause of translocation of enteric bacteria.
After the promulgation of the “Ten New Measures” for coronavirus disease 2019 (COVID-19) pandemic, the Nursing Department of West China Hospital of Sichuan University promptly analyzed the development and changes of the epidemic situation and the key and difficult points of nursing manpower emergency management, and constructed a “1+2+4+X” nursing manpower emergency management model for COVID-19 patients, including establishing a dedicated management team, assessing manpower needs, constructing a nursing manpower management model, on-site and online training, and dynamic monitoring and adjustment. From December 7th, 2022 to February 1st, 2023, the Nursing Department mobilized a total of 693 nurses, covering 4 temporary intensive care units and 30 temporary general wards. The hospital-wide qualification rate of airway humidification management for patients in temporary general wards was 94.9%, the qualification rate of artificial airway fixation was 97.9%, and the compliance of bed head elevation was 100.0%. The “1+2+4+X” nursing manpower emergency management model constructed is helpful for the reasonable scheduling of nursing manpower during the epidemic period and provides a reference for the emergency deployment of nursing manpower for the treatment of infectious disease epidemics in large medical institutions in the future.
Objective To study the application of virtual reality bronchoscopy stimulation in novice trainees. Methods Four novice bronchoscopists entered the training programby using a VR bronchoscopy in the clinical skill center. After the program, the dexterity, speed, and accuracy of all the four doctors were tested using the virtual simulation models. Results were compared to four skilled physicians as control group who had performed at least 50 bronchoscopies. Before-training and after-training test scores were compared using paired t tests. For comparisons between after-training novice and skilled physician scores, unpaired twosample t tests were used. Results All of the four trainees finished the training program. The novices significantly improved their dexterity, speed and accuracy. The percentage of observed segments increased from ( 74. 0 ±5. 1) % to ( 89. 3 ±4. 0) % . The number of contacts with the bronchial wall decreased from 87. 5 ±13. 2 to 30. 5 ±9. 3, and total time spent shortened from ( 700. 8 ±56. 6) s to ( 607. 0 ±17. 8) s. There were no statistically significant differences between novice accuracy ( the percentage of observed segments) after training and skilled physician accuracy [ ( 89. 3 ±4. 0) % vs ( 91. 3 ±3. 0) % , P = 0. 456] . Conclusion Practice using a virtual bronchoscopy simulator help novice trainees to attain a level of skill at performing diagnostic bronchoscopy, and it might play an important role in the training of chest physicians.
目的 探討不同分子分型乳腺浸潤性導管癌手術病例標本中P53、表皮生長因子受體（EGFR）和Ki-67的表達及臨床意義。 方法 采用免疫組織化學鏈霉菌抗生物素蛋白-過氧化物酶連接法法對2010年1月－2011年7月446例乳腺浸潤性導管癌患者標本進行分子分型，并同時檢測其P53、EGFR、Ki-67等的表達。 結果 P53和Ki-67在人類表皮生長因子受體2（HER2）過表達型、基底細胞樣型、未分類型中的表達明顯強于管腔A型及管腔B型（P＜0.05）；HER2過表達型和未分類型中的EGFR表達明顯強于管腔A型及管腔B型（P＜0.05）。 結論 在使用雌激素受體、c-erbB-2等指標對浸潤性導管癌進行分子分型時同時檢測P53、EGFR及Ki-67等標記物，有助于更加精準的評估腫瘤的生物學行為及預后 ，對靶向藥物的個體化治療提供參考和療效預測有重要意義。
ObjectiveTo investigate the protective effect of SadenosylLmethionine on liver regeneration and liver function in cirrhotic rats after hepatectomy. MethodsCirrhosis was successfully induced by injection of 40% CCl4.Then,partial hepatectomy (about 30%) was performed in all rats. Cirrhotic rats were divided into 3 groups,namely,cirrhotic group (normal saline 5 ml/d,for 15 postoperative days，n=20),treatment group 1 〔S adenosylLmethionine 10 mg/(kg·d),for 15 postoperative days,n=16〕 and treatment group 2 〔SadenosylL methionine 20 mg/(kg·d),15 postoperative days,n=16〕,and normal control group was also established. Animals were sacrificed at the 15th postoperative day and 30th postoperative day to take samples for detection of liver function (Alb,ALT,TB,TBA) and serum TNFα.Liver tissues were also observed under light microscope and electron microscope. ResultsIn two treatment groups,at the time point (15 postoperative days or 30 postoperative days),concentrations of ALT,TB,TBA,Alb and TNFα were decreased significantly as compared with cirrhotic group (P ＜0.01),and concentration of Alb was increased significantly (P＜0.01).In contrast, there were no obvious difference in the same time point of different dosetreatment groups (Pgt;0.05),but the decrease of ALT,TB,TBA,TNFα and the increase of Alb were more significant at the second time point (30th postoperative day) than the first time point (15th postoperative day) when treated with same dose (P＜0.01).At the same time,concentration between TNF α and ALT,TB,TBA showed a positive correlation (P＜0.01),and the concentration between TNFα and Alb showed a negative correlation (P＜0.01).In addition, the histopathology showed SadenosylLmethionine had effects of protecting liver function and enhancing liver regeneration. ConclusionThe study suggests that SadenosylL methionine has the efficacy of enhancing liver regeneration and improving liver function.
【摘要】 目的 探討切開復位肱骨近端內固定鎖定系統(proximal humeral internal locking system，PHILOS)治療老年肱骨近端骨折的療效。 方法 2008年5月-2009年5月，對22例60歲以上肱骨近端新鮮移位骨折按Neer分型，二部分2例，三部分16例，四部分4例；采用肩前方入路切開復位PHILOS治療。 結果 22例患者獲12～18個月隨訪，平均14.6個月，采用Constant-Murley評分，優8例，良10例，可3例，差1例，優良率81.4%。 結論 切開復位PHILOS治療老年肱骨近端骨折療效肯定。【Abstract】 Objective To discuss the clinical effect of open reduction and internal fixation with the proximal humeral internal locking system (PHILOS) plate in treating elder patients with proximal humeral fracture. Methods From May 2008 to May 2009, we classified 22 cases of fresh displaced proximal humeral fracture according to the Neer classification. All patients were older than 60 years. There were two cases of two-part fracture, 16 cases of three-part fracture and four cases of four-part fracture. The open reduction and internal fixation with PHILOS plate was performed with the anterior deltopectoral approach. Results The 22 patients were followed up for 12 to 18 months with a mean period of 14.6 months. According to Constant-Murley Shoulder Score measurement, eight cases were graded as excellent, 10 good, three fair, and one poor with a excellent and good rate of 81.4%. Conclusion The open reduction and internal fixation with Philos plate is effective in treating elder patients with proximal humeral fracture.
目的 研究環氧合酶-2抑制劑藥物的應用狀況和發展趨勢，為臨床合理、有效、經濟地選用藥物提供科學依據。 方法 采用金額排序和用藥頻度（DDDs）、日均費用（DDC）方法，對四川大學華西醫院2008年－2010年環氧合酶-2抑制劑藥物的臨床應用情況進行統計分析。 結果 2008年－2010年間，該院環氧合酶-2抑制劑藥物的應用數量和銷售金額呈逐年上升趨勢，其中選擇性環氧合酶-2抑制劑藥物的用量增幅較大，非選擇性環氧合酶-2抑制劑藥物用量呈下降趨勢。 結論 該院環氧合酶-2抑制劑藥物臨床應用合理，選擇性環氧合酶-2占主導地位，有較好的發展前景。
Objective To investigate the effect of angiostatin gene combined with somastatin on inhibiting proliferation of human pancreatic cancer cell BXPC-3 and endothelial cell of vascular ECV-304 and on inducing their apoptosis in vitro. Methods The pcDNA3/angio was transfected BXPC-3 by liposome-mediated gene transfer method. RT-PCR and Western blot were used to detect the expression of angiostatin gene. In vitro, MTT and flow cytometry (FCM) were used to detect whether angiostatin gene combined with somastatin could effect the growth inhibition of BXPC-3 and ECV-304 cells. Results Angiostatin was expressed and secreted by transfected BXPC-3. The growth of BXPC-3 was inhibited by certain concentration of somatostatin (≥10 μg/ml, P＜0.01）, which was dependent on the dose of somatostatin in a concentration extent; Simultaneity apoptosis was induced （P＜0.01）. But the growth of ECV-304 was not inhibited with somatostation （Pgt;0.05）. Angiostatin could inhibit the growth of ECV-304 and induced apoptosis （P＜0.01）, but it had no effect on the growth of BXPC-3 （Pgt;0.05）. Angiostation gene combined with somatostation could inhibit the growth both of BXPC-3 and ECV-304 （P＜0.01）, and induce apoptosis of them （P＜0.01）; but the effect couldn’t be additived. Conclusions ①Somatostatin directly inhibits the proliferation of human pancreatic cancer cells and induces apoptosis, but it doesn’t directly inhibit angiogenesiso of human pancreatic cancer. ②Angiostatin specially inhibits the proliferation of endothelial cell of vascular and induces apoptosis. Angiostatin could inhibit angiogenesis of human pancreatic cancer to induce necrosis of cancer cell.