目的 探讨计划-实施-检查-处理（PDCA）循环法及根本原因分析法在持续正压通气治疗重症肺炎患儿中的应用效果。方法 选取2021年1月—2023年1月医院收治并接受鼻塞式持续正压通气治疗的重症肺炎患儿80例,基于随机数字表法分为两组,每组各40例。对照组接受常规护理,观察组采用PDCA循环法联合根本原因分析法护理干预。比较两组临床症状改善时间、血气指标[动脉血氧分压（PaO₂）、动脉血氧饱和度（SaO₂）、动脉血二氧化碳分压（PaCO₂）]、肺功能指标[第1秒用力呼气容积（FEV₁）、潮气量（VT）]、炎症免疫指标[单核细胞趋化蛋白-1（MCP-1）、可溶性髓系细胞触发受体-1（sTREM-1）、可溶性细胞间黏附分子-1（sICAM-1）]水平变化,比较两组患儿家属满意度情况。结果 观察组患儿咳嗽、气促、哮鸣音、心率恢复及紫绀等症状改善用时均低于对照组,比较差异有统计学意义（P<0.05）。干预前,两组患儿PaO₂、SaO₂、PaCO₂、FEV₁、VT、MCP-1、sTREM-1、sICAM-1水平比较差异均无统计学意义（P>0.05）;干预后,两组患儿上述指标水平均有不同程度变化（P<0.05）,观察组PaO₂（97.18±7.90 mmHg vs 90.30±7.12 mmHg）、SaO₂（93.58±3.82% vs 86.30±4.21%）、FEV₁（2.66±0.46 L vs 1.97±0.34 L）、VT（11.92±1.89% vs 9.83±1.10%）水平均高于对照组,观察组PaCO₂（36.70±3.97 mmHg vs 40.65±3.79 mmHg）、MCP-1（58.45±11.94 ng/L vs 74.46±16.69 ng/L）、sTREM-1（36.25±8.30 ng/L vs 51.57±9.51 ng/L）、sICAM-1（187.52±31.22 mg/L vs 243.73±46.79 mg/L）水平低于对照组,差异均有统计学意义（P<0.05）。观察组患儿家属满意度整体优于对照组（P<0.05）;观察组总满意率（97.5% vs 77.5%）高于对照组,差异有统计学意义（P<0.05）。结论 PDCA循环法及根本原因分析法应用于接受持续正压通气治疗的重症肺炎患儿,能够有效促进患儿临床症状改善,有利于血气及肺功能恢复,且可降低炎症反应,患儿家属满意度较高。

Objective To explore the application effect of Plan-Do-Check-Action（PDCA）circulation method and root cause analysis method in the treatment of children with severe pneumonia with continuous positive pressure ventilation．Methods From January 2021 to January 2023,80 children with severe pneumonia who were admitted to hospital and received nasal plug continuous positive pressure ventilation treatment were enrolled in this study．Based on the random number table method,they were divided into two groups,with 40 cases in each group．The control group received routine nursing,while the observation group received PDCA circulation method combined with root cause analysis nursing intervention．The improvement time of clinical symptoms,changes in blood gas indicators[arterial partial oxygen pressure（PaO₂）,arterial oxygen saturation（SaO₂）,arterial partial pressure of carbon dioxide（PaCO₂）],lung function indicators [（forced expiratory volume in 1 second,FEV₁）,tidal volume（VT）],and inflammatory immune indicators [monocyte chemotactic protein-1（MCP-1）,soluble myeloid cell trigger receptor-1（sTREM-1）,soluble intercellular adhesion molecule-1（sICAM-1）] levels between the two groups were compared,and the family members’ satisfaction of the two groups was also compared．Results The improvement time for symptoms such as cough,shortness of breath,wheezing,heart rate recovery and cyanosis in the observation group was lower than that in the control group,and the difference was statistically significant（P<0.05）．Before intervention,there was no statistically significant difference in the levels of PaO₂,SaO₂,PaCO₂,FEV₁,VT,MCP-1,sTREM-1 and sICAM-1 between the two groups of children（P>0.05）．After intervention,the levels of the above indicators in both groups of children showed varying degrees of change（P<0.05）．The levels of PaO₂（97.18±7.90 mmHg vs 90.30±7.12 mmHg）,SaO₂（93.58±3.82% vs 86.30±4.21%）,FEV₁（2.66±0.46 L vs 1.97±0.34 L）,VT（11.92±1.89% vs 9.83±1.10%）in the observation group were higher than those in the control group．The levels of PaCO₂（36.70±3.97 mmHg vs 40.65±3.79 mmHg）,MCP-1（58.45±11.94 ng/L vs 74.46±16.69 ng/L）,sTREM-1（36.25±8.30 ng/L vs 51.57±9.51 ng/L）and sICAM-1（187.52±31.22 mg/L vs 243.73±46.79 mg/L）in the observation group were lower than those of the control group,with statistically significant differences（P<0.05）．The overall satisfaction of the observation group was better than that of the control group（P<0.05）,the total family members’ satisfaction rate of the observation group was higher than that of the control group（97.5% vs 77.5%）,with a statistically significant difference（P<0.05）．Conclusions PDCA circulation method and root cause analysis method applied to children with severe pneumonia who receive continuous positive pressure ventilation treatment,can effectively promote the improvement of clinical symptoms,be conducive to the recovery of blood gas and lung function,and reduce inflammatory reaction,with high family members’ satisfaction．

目的 探讨在分化型甲状腺癌（DTC）患者的治疗中,采用早期积极心理进行干预,对患者负性情绪和癌因性疲乏的影响。方法 抽取2021年6月—2023年1月平煤神马医疗集团总医院收治的160例DTC癌患者,随机分为对照组（常规护理）和研究组（常规护理+早期积极心理干预）,每组各80例,评估患者干预前后的心理状态、癌因性疲乏、生活质量、护理工作满意度。结果 护理干预1~4周后,两组患者汉密尔顿抑郁量表（HAMD）评分、汉密尔顿焦虑量表（HAMA）评分均降低,并且研究组患者评分更低（P<0.05）;干预后,两组患者的癌因性疲乏评分均升高,但是研究组患者的以上指标升高幅度小于对照组（P<0.05）;此外,两组患者的护士观察量表（NOSIE）评分均明显改善,并且研究组变化幅度大于对照组（P<0.05）;研究组患者的护理满意度高于对照组（95.00% vs 82.50%,P<0.05）。结论 对DTC患者开展早期积极心理干预,能够帮助患者改善负性情绪,减轻癌因性疲乏,提高患者的生活质量和护理满意度。

Objective To investigate the effect of early positive psychological intervention on negative emotions and cancer-related fatigue in the treatment of differentiated thyroid cancer（DTC） patients．Methods From June 2021 to January 2023,160 patients with DTC admitted to General Hospital of Pingmei Shenma Group were randomly divided into the control group（routine nursing）and the research group（routine nursing + early positive psychological intervention）,with 80 patients in each group．The psychological state,cancer-related fatigue,quality of life and nursing satisfaction of patients before and after intervention were evaluated．Results After 1~4 weeks of intervention,the scores of Hamilton Depression Scale（HAMD）and Hamilton Anxiety Scale（HAMA）were decreased in both groups,and the scores of research group were lower（P<0.05）．After intervention,the cancer-related fatigue scores of both groups were increased,but the increase of research group were less than that of control group（P<0.05）．Moreover,NOSIE scores of both groups were significantly improved,and the change range of research group was greater than that of control group（P<0.05）．The nursing satisfaction of research group was higher than that of control group（95.00% vs 82.50%,P<0.05）．Conclusions Early positive psychological intervention for patients with DTC can effectively improve negative emotions,reduce cancer-related fatigue,and improve nursing satisfaction of patients．

目的 探讨血浆置换联合泼尼松（PDN）联合环磷酰胺（CTX）治疗抗黑色素瘤分化相关基因5（MDA5）抗体阳性皮肌炎（DM）伴肺间质纤维化（ILD）患者疗效及安全性。方法 回顾性分析2014年6月—2023年6月普洱市人民医院诊断的MDA5阳性DM伴ILD患者40例,其中治疗组20例,采用血浆置换联合PDN 1 mg/kg每日1次口服,4周后减量,每周减总量10%,CTX 1 g每月1次静脉滴注,共6次治疗;另20例设为对照组,采用PDN 1 mg/kg每日1次口服,4周后减量,每周减总量10%,CTX 1 g每月1次静脉滴注,共6次治疗,分别于治疗后3月、6月检测一氧化碳弥散量（DLCO）、第1秒用力呼气量（FEV₁）,血清铁蛋白（SF）、C-反应蛋白（CRP）、涎液化糖链抗原（KL-6）、MDA5转阴率行疗效评估。结果 在治疗3个月和6个月时,两组患者的DLCO、FEV1、SF、CRP、KL-6、MDA5转阴率等指标的完全缓解率不一致。其中,3个月时,治疗组上述指标的完全缓解率依次为95%、85%、90%、90%、90%、85%,对照组依次为15%、20%、20%、15%、0%、0%。两组患者在治疗3个月的DLCO、FEV1、SF、CRP、KL-6水平和MDA5转阴数均有所不同。其中治疗组的DLCO、KL-6、CRP水平均较对照组降低（P<0.01）,治疗组FEV₁水平较对照组升高（P<0.01）,治疗组SF水平较对照组降低（P<0.05）,两组治疗6个月时,治疗组上述指标缓解率依次为95%、85%、90%、90%、90%、85%,对照组依次为20%、25%、20%、20%、20%、5%。两组患者在DLCO、FEV₁、SF、CRP、KL-6水平以及MDA5转阴数和死亡例数方面比较差异均有统计学意义,其中治疗组的DLCO、KL-6和CRP水平均较对照组降低（P<0.01）,治疗组FEV₁水平较对照组升高（P<0.01）,SF水平治疗组较对照组降低（P<0.05）。结论 在MDA5抗体阳性DM伴ILD患者治疗中,给予血浆置换联合PDN、CTX治疗,可以提高疗效,降低病死率。

Objective To explore the effect of plasmapheresis combined with prednisone（PDN）plus cytoxan（CTX）on patients with anti-melanoma differentiation-associated gene 5（MDA 5）antibody-positive dermatomyositis（DM）with interstitial lung disease（ILD）. Methods The data of 40 patients with MDA 5 positive DM and ILD diagnosed in the People's Hospital of Pu'er City from June 2014 to June 2023 were retrospectively was analyzed．Twenty patients of the treatment group were treated with plasmapheresis combined with PDN 1mg / kg once daily,which was reduced by 10% per week after 4 weeks．The other 20 patients of the control group were treated with PDN 1mg / kg once daily,which was reduced after 4 weeks by 10% per week,and CTX 1g once per month．diffusing capacity of the lungs for carbon monoxide（DLCO）,forced expiratory volume in the first second（FEV₁）,serum ferritin（SF）,C-reactive protein（CRP）,Krebs Von den Lungen-6（KL-6）and MDA5 negative conversion rate were measured at 3 and 6 months after treatment,respectively. Results At 3 and 6 months of treatment,complete remission rates of DLCO,FEV₁,SF,CRP,KL-6,MDA 5 conversion and other indicators were inconsistent．Among them,at 3 months,the complete response rate of the above indicators in the treatment group was successively：95%,85%,90%,90%,90% and 85%．The control group was 15%,20%,20%,15%,and 0%,0%．Statistical analysis showed that the levels of DLCO,FEV₁,SF,CRP,KL-6 and MDA 5 significantly varied at 3 months of treatment．Pairwise comparison of LSD found that the DLCO,KL-6 and CRP levels in the treatment group were significantly lower than the control group（P<0.01）,the FEV₁ level in the treatment group was significantly higher（P<0.01）,and the SF level in the treatment group was significantly lower（P<0.05）．After 6 month of treatment,the complete response rate of the above indicators in the treatment group were 95%,85%,90%,90%,90% and 85%,and the complete response rate of the above indicators in the control group was 20%,25%,20%,20%,20% and 5%．Statistical analysis showed the levels of DLCO,FEV₁,SF,CRP,KL-6 for the amount of MDA 5 and the number of deaths between two groups were significantly different．Further pairwise comparison of LSD showed that the DLCO,KL-6 and CRP levels in the treatment group were significantly lower compared with the control group（P<0.01）,the FEV₁ level was significantly increased compared with the control group（P<0.01）,and the SF treatment group was significantly decreased compared with the control group（P<0.05）. Conclusions In the treatment of patients with MDA 5 antibody positive DM with ILD,the treatment of plasmapheresis combined with PDN and CTX can significantly improve the efficacy and reduce the mortality rate．

目的 分析抗中性粒细胞胞浆抗体(ANCA)阳性类风湿关节炎(RA)患者的临床及血清学特征。方法 回顾性比较分析2019—2020年本院住院113例核周型抗中性粒细胞胞浆抗体(P-ANCA)阳性及120例P-ANCA阴性RA患者的临床及实验室资料。结果 P-ANCA阳性组的抗环瓜氨酸肽(CCP)抗体为(171.47±130.48)U/mL,阴性组为(130.10±132.7)U/mL,t=2.250,P=0.026。阳性组的抗CCP抗体的阳性率为82/98(83.67%),阴性组为71/110(64.55%),χ²=9.749,P=0.003。阳性组CCP抗体高滴度率63/98(64.29%),阴性组为53/110(48.18%),χ²=5.449,P=0.025。阳性组的RF浓度:(205.14±276.08)U/mL,阴性组RF浓度:(136.94±201.51)U/mL,t=2.159,P=0.032;阳性组的RF阳性率为98/112(87.5%),阴性组的78/120(65.89%),χ²=16.016, P<0.001;阳性组的类风湿因子高浓度率73/112(64.60%),阴性组56/120(46.67%),χ²=8.042, P=0.005。结论 P-ANCA阳性的RA患者的抗体水平相对更高。

Objective To analyze the clinical and serological characteristics of rheumatoid arthritis (RA) patients with positive anti-neutrophil cytoplasmic antibodies (ANCA). Methods The clinical and laboratory data of 113 perinuclear-ANCA (P-ANCA) positive and 120 P-ANCA negative RA patients in our hospital from 2019 to 2020 were retrospectively analyzed. Results The anti-cyclic citrullinated peptide (CCP) antibody of P-ANCA positive group was (171.47±130.48) U/mL, and which in the negative group was (130.10±132.7) U/mL, t=2.250, P=0.026. The positive rate of anti-CCP antibodies in positive group was 83.67% (82/98), and that in the negative group was 64.55% (71/110), χ²=9.749, P=0.003. The high titre rate of CCP antibody in positive group was 64.29% (63/98), and that in the negative group was 53/110 (48.18%),χ²=5.449, P=0.025. The RF concentration of positive group was (205.14±276.08) U/mL, the negative group concentration was (136.94±201.51) U/mL, t=2.159, P=0.032; the RF-positive rate of positive group was 87.5% (98/112), 65.89% (78/120) in the negative group, χ²=16.016, P<0.001; the high concentration rate of rheumatoid factor in positive group was 73/112(64.60%), the negative group 56/120(46.67%), χ²=8.042, P=0.005. Conclusions RA patients with positive P-ANCA had relatively higher antibody levels.

目的 研究抗体筛查阳性输血患者的抗体与Rh抗原分布情况。方法 收集2019年10月1日—2022年12月31日中山大学孙逸仙纪念医院34 796例患者的不规则抗体筛查结果,以及抗体筛查阳性患者的抗体鉴定与Rh抗原分型结果,记录34 796例患者的年龄、性别、妊娠史、输血史等基本资料,分析各血型系统不规则抗体产生的阳性率及相关影响因素。结果 34 796例患者中,不规则抗体筛查阳性的患者237例,抗体筛查阳性率为0.68%。共检出不规则抗体260例,其中MNS系统83例（占31.93%）,Rh血型系统抗体70例（占26.93%）,Lewis血型系统14例（占比5.39%）。同种非特异性抗体79例,阳性率30.38%。同种特异性抗体中抗-E的占比最高,为20.77%;其次是抗-Mia,为20.39%。对237例抗体筛查阳性患者进行Rh抗原分型,CCDee抗原表型占比最高,为52.74%,其次是CcDEe占比29.16%。抗体筛查阳性率与性别、输血史、妊娠史有关,女性、有输血史、有妊娠史者的抗体筛查阳性率较高（P>0.05）。不同科室间抗体筛查阳性率比较差异有统计学意义（P>0.05）,其中风湿免疫科与血液科患者阳性率最高。结论 抗-E、抗-Mia为主要的红细胞不规则抗体,不规则抗体的产生与性别、输血史、妊娠史有关,输血前进行不规则抗体筛查、鉴定及Rh抗原分型,有利于提高输血安全。

Objective To explore the distribution of antibodies and Rh antigens in transfusion patients with positive antibodies screened in our hospital．Methods From October 1,2019 to December 31,2022,there were 34,796 patients undergoing irregular antibody screening in Sun Yat-sen Memorial Hospital of Sun Yat-sen University,antibody identification and Rh blood typing results of positive patients were collected．Meanwhile,the age,sex,pregnancy history,blood transfusion history and other basic data of 34 796 patients were collected,and the positive rate of irregular antibody production and related influencing factors of blood group system were analyzed．Results Among the 34,796 patients,237 patients were screened positive for irregular antibodies,and the antibody screening positivity rate was 0.68%．A total of 260 cases of irregular antibodies were detected,83 cases of MNS system,accounting for 31.93%;70 cases of Rh blood group system,accounting for 26.93%;14 cases of Lewis blood group system,accounting for 5.39%．There were 79 cases of homozygous non-specific antibodies,with a detection rate of 30.38%．The highest percentage of homo-specific antibodies was anti-E,accounting for 20.77%,followed by anti-Mia,accounting for 20.39%．Rh antigen typing was performed in 237 antibody-screening positive patients,and the highest percentage of CCDee antigen phenotype was 52.74%,followed by CcDEe with 29.16%．Antibody screening positive rate was correlated with gender,blood transfusion history and pregnancy history,and the positive rate was higher in female,patients with blood transfusion history and pregnancy history,and the difference was statistically significant（P>0.05）．There were differences in the positive detection rate of antibody-screening in different departments,and the differences were statistically significant（P>0.05）,and the highest positive rates were in Department of Rheumatology and Immunology and Hematology．Conclusions Anti-E,anti-Mia are the main erythrocyte irregular antibodies,and the production of irregular antibodies is related to gender,transfusion history and pregnancy history,and irregular antibody screening,identification and Rh antigen typing before transfusion are beneficial to improve transfusion safety．

目的 探讨以跨肺压导向的呼气末正压通气在急性呼吸窘迫综合征(acute respiratory distress syndrome,ARDS)的临床应用效果。方法 将2020年1月—10月重症医学科收治的100例ARDS患者随机分为对照组和观察组各50例,对照组采用小潮气量辅助控制通气治疗,观察组以跨肺压(transpulmonary pressure,Ptp)为导向选择最佳呼气末正压(positive end-expiratory pressure,PEEP)进行机械通气治疗,观察比较两组患者治疗前和治疗48 h的呼吸动力学指标、血气分析指标,随访28 d病死率。结果 治疗48 h,潮气量、PEEP、肺静态顺应性、PaCO₂、PaO₂、SaO₂、PaO₂/FiO₂观察组明显高于对照组(P＜0.05);随访28 d病死率观察组和对照组比较差异无统计学意义(P＞0.05)。结论 以Ptp为导向选择最佳PEEP的机械通气治疗ARDS可以有效改善患者的呼吸动力学指标和血气分析指标,不增加ARDS的病死率,值得临床推广应用。

Objective To investigate the clinical effect of positive end-expiratory pressure(PEEP) ventilation guided by transpulmonary pressure (Ptp) in acute respiratory distress syndrome (ARDS). Methods Between January and October 2020, 100 cases of ARDS treated in intensive care unit were randomly divided into control group and observation group with 50 cases each. Control group used auxiliary control small tidal volume ventilation therapy, and observation group used the best PEEP mechanical ventilation therapy with the guiding of Ptp. The respiratory dynamics index, blood gas analysis results, follow-up of 28d case fatality rate before and 48h after treatment between the two groups were compared. Results After 48h of treatment, tidal volume、PEEP、pulmonary static compliance、PaCO₂、PaO₂、SaO₂、PaO₂/FiO₂ of the observation group were all higher than those of the control group (P<0.05). There was no statistically significant difference in mortality between the two groups at 28d follow-up (P＞0.05). Conclusion Mechanical ventilation with the best PEEP guided by Ptp could effectively improve the respiratory dynamic index and blood gas analysis results of patients with ARDS, without increasing the mortality of ARDS, which is worthy of clinical application.

目的 分析平板运动试验阳性患者行冠脉造影检查后结果阳性者与冠心病的高危因素的关联性,从而预警冠心病。方法 选取浙江大学医学院附属第二医院2016年3月—2019年3月行平板运动试验的阳性患者经冠脉造影结果为阳性,且资料完整者280例患者为研究对象,筛选出影响冠心病的独立危险因素。结果 性别、体质量指数(BMI)、高甘油三酯、平板恢复1、2 min心率是影响冠心病的独立危险因素。结论 对于男性、BMI>24、高甘油三酯、平板恢复1、2 min心率异常的患者,当其平板运动试验为阳性时,应建议其进一步行冠脉造影检查。

Objective To analyze the correlation between coronary angiography and the risk factors of coronary heart disease in patients with positive treadmill exercise test, so as to give early warning of coronary heart disease. Methods A total of 280 patients who underwent treadmill exercise tests from March 2016 to March 2019 in the Second Affiliated Hospital of Medical College of Zhejiang University were selected as the study subjects with positive coronary angiography results and complete data to screen out independent risk factors for coronary heart disease. Results Gender, body mass index, high triglycerides, high cholesterol, heart rate after 1 or 2 minutes of tablet recovery were the risk factors for positive coronary angiography. Conclusion For men, patients with BMI>24, high triglycerides, and abnormal heart rate after 1 or 2 minutes of tablet recovery, when the treadmill exercise test is positive, further coronary angiography should be recommended.

目的 研究在新型冠状病毒COVID-19疫情期间,政府采取的干预措施对医院检测的流行性感冒(简称流感)阳性率的影响,为制定流感预防措施提供依据,也为间接评价新型冠状病毒的预防效果提供参考。方法 回顾性收集广州市第一人民医院总院2018—2020年年廿三至正月十五期间的流感抗原检测数据,对政府干预前后的流感抗原检测阳性率进行分析比较。结果 在春节前后,2018年和2019年的流感检测阳性率总体上维持稳定。其中,2018年春节前后,流感阳性率在15.6%～46.5%范围内波动,2019年春节前后,流感阳性率在11.9%～30.4%范围内波动。2020年同期的流感阳性率变化曲线与前两年不同,在正月初四前曲线变化较为稳定,维持在20.0%～44.1%范围内。在正月初四后曲线呈现显著下降趋势,在正月十二和正月十五,流感检测阳性率变为0。进一步的分析表明,政府干预对流感阳性率的影响无性别差异,对5～64岁人群效果最佳。结论 当前针对新型冠状病毒COVID-19的政府干预措施能显著降低流感阳性率,预防流感的发生,也为预防同样以呼吸道传播为主的新型冠状病毒的传播提供了间接证据。

Objective The aim of the study was to study the effect of government interventions on the positive rate of influenza detected in Guangzhou First People's Hospital during the outbreak of COVID-19, and to provide a basis to develop prevention measures against influenza and a reference for the indirect evaluation of the preventive effect of COVID-19. Methods Influenza antigen detection data of Guangzhou First People's Hospital were collected retrospectively from 23rd of the 12th lunar month to 15th of the 1st lunar month in 2018—2020, and the positive rates of influenza antigen detection before and after the government intervention were analyzed and compared. Results The positive rates of influenza were generally stable in 2018 and 2019 before and after the Spring Festival, where the positive rate fluctuated in the range of 15.6%～46.5% in 2018, and the positive rate fluctuates in the range of 11.9%～30.4% in 2019. The temporal change of the positive rate in 2020 was different from that of the previous two years. The positive rate curve was relatively stable before the fourth day of the first lunar month, maintaining a range of 20.0%～44.1% in 2020. After the fourth day of the first lunar month, the curve showed a significant downward trend. On the 12th and 15th day of the first lunar month, the positive rate of influenza became 0. Furthermore, the effect of government intervention on the positive rate of influenza showed no gender difference, and the effect was significant for people aged 5～64 years. Conclusion The current government intervention measures against COVID-19 could significantly reduce the positive rate of influenza, prevent the occurrence of influenza, and provide indirect evidence for the prevention of the spread of COVID-19, which was also mainly spread by respiratory tract.

目的 探究血清外泌体对小鼠烫伤伤口愈合的促进作用及机制。方法 选取我院60只NIH小鼠作为研究对象,对其血清中的外泌体进行提取和分离,建立起皮肤烫伤模型。采用血清外泌体进行治疗,评估治疗的效果,观察皮肤组织的病理变化,检测小鼠成纤维细胞增殖和表皮HaCat细胞迁移使用血清外泌体受到的影响。结果 空白对照组和血清外泌体小鼠烫伤创口愈合时间比较,差异有统计学意义(P＜0.05);血清外泌体作用24 h后,不同剂量OD值差异有统计学意义(P＜0.05);10 μL Exo组和PBS组内部不同时间点OD值差异均有统计学意义(P＜0.05);外泌体组和PBS组24 h的HaCat细胞迁移率相比较,差异有统计学意义(P＜0.05)。结论 血清外泌体可以促进小鼠烫伤伤口的愈合,对成纤维细胞的增殖和表皮HaCat细胞的迁移作用也比较显著,可能成为临床治疗烫伤的新手段。

目的 观察恩替卡韦治疗e抗原阳性慢性乙型病毒性肝炎慢加急性肝衰竭(CHB-ACLF)的近期疗效及安全性。方法 选择e抗原阳性CHB-ACLF患者60例,均为我院2016年6月—2017年6月收诊,随机分为各30例的治疗组(采用恩替卡韦治疗)与对照组(采用拉米夫定片治疗),连续用药6个月后,对比疗效及安全性差异。结果 治疗6个月后,治疗组的ALB、PTA水平高于对照组,TBIL、ALT水平低于对照组,MELD评分与HBV-DNA定量少于对照组(P＜0.05);治疗后6个月,两组的HBV-DNA转阴率均高于治疗后1、3个月,且治疗组高于对照组(P＜0.05);治疗期间,治疗组患者死亡4例(13.33%),对照组患者死亡6例(20.00%),两组的死亡率比较无统计学意义(P＞0.05)。结论 恩替卡韦分散片是一种安全、有效的抗e抗原阳性CHB-ACLF药物,能有效抑制病毒复制和改善肝功能,促进患者预后转归。