目的为临床合理使用人血白蛋白(HSA)提供参考。方法计算机检索The Cochrane Library、PubMed、Web of Science、中国知网、万方、维普数据库,收集HSA用于心外科围术期的随机对照试验(RCT),检索时限为自建库起至2023年8月31日。由2名研...目的为临床合理使用人血白蛋白(HSA)提供参考。方法计算机检索The Cochrane Library、PubMed、Web of Science、中国知网、万方、维普数据库,收集HSA用于心外科围术期的随机对照试验(RCT),检索时限为自建库起至2023年8月31日。由2名研究员筛选文献,并提取资料。采用Cochrane系统评价手册5.1.0风险偏倚评估工具对纳入文献质量进行评价。采用RevMan 5.4软件进行Meta分析、敏感性分析和发表偏倚分析。结果共纳入9项RCT,共计2223例患者。Meta分析结果显示,与对照组比较,观察组全因死亡率[RR=1.55,95%CI(0.62,3.86),P=0.35]、住院时间[MD=-0.40,95%CI(-0.89,0.09),P=0.11]、入住重症监护室(ICU)时间[MD=-0.26,95%CI(-0.66,0.13),P=0.20]、机械通气持续时间[MD=-0.21,95%CI(-0.91,0.49),P=0.55]、红细胞输注率[RR=0.96,95%CI(0.68,1.36),P=0.82]、血小板输注率[RR=0.70,95%CI(0.42,1.17),P=0.17]、血浆输注率[RR=0.83,95%CI(0.50,1.40),P=0.49]、急性肾损伤发生率[RR=0.98,95%CI(0.62,1.57),P=0.94]差异均无统计学意义。亚组分析结果显示,4%HSA组患者出血量显著多于对照组[MD=141.55,95%CI(115.02,168.07),P<0.00001];5%HSA组患者出血量与对照组无统计学差异[MD=20.94,95%CI(-131.80,173.68),P=0.79]。发表偏倚结果显示,本研究存在发表偏倚的可能性较大。结论当前证据表明,心外科围术期应用HSA不能显著改善患者的长期预后指标,减少血液制品的使用和降低不良反应发生风险;使用不同质量浓度的HSA,术后出血量可能不同。展开更多
The effects of different concentrations of Zn￣(2+)ion on root growth,cell division,and nucleoli of Allium cepa were studied. The test Zn￣(2+) ion concentration was made up from zinc sulphate (ZnSO4. 7H2O) ranging fr...The effects of different concentrations of Zn￣(2+)ion on root growth,cell division,and nucleoli of Allium cepa were studied. The test Zn￣(2+) ion concentration was made up from zinc sulphate (ZnSO4. 7H2O) ranging from 10￣(-7) to 10￣(-2) mol/L. The solutions were prepared in tap water (pH =6. 5).The results indicated that Zn￣(2+) could obviously inhibit root growth at concentrations from 10￣(-4)to 10￣(-2) mol/L.Roots treated with zinc sulphate showed the presence of c-mitosis, anaphase bridges,including sticky and fluidized bridges (at 10￣(-3) to 10￣(-2) mol/L) , chromosome stickiness, irregularly shaped nuclei, broken nuclei and micronuclei. A toxicity effect was also observed on the nucleoli using silver staining technique after 48h of treatment with 10￣(-4)to 10￣(-2) mol/L Zn￣(2+), e. g,the nucleolar particulate material scattered around the nucleoli in the nucleus of root tip cells.展开更多
多学科协作是实现高质量疼痛管理的关键。跨专业协作疼痛管理课程(Interprofessional Pain Curriculum,IPC)对于培养护理专业学生的疼痛管理能力至关重要。该文综述了国际疼痛研究学会(International Association for the Study of Pain...多学科协作是实现高质量疼痛管理的关键。跨专业协作疼痛管理课程(Interprofessional Pain Curriculum,IPC)对于培养护理专业学生的疼痛管理能力至关重要。该文综述了国际疼痛研究学会(International Association for the Study of Pain,IASP)制订的跨专业协作疼痛管理课程内容大纲(Interprofessional Pain Curriculum Content Outline,IPCCO),以及加拿大多伦多大学和美国杜肯大学在IPC实施方面的经验,旨在为我国护理院校开展IPC教学提供参考和启示。展开更多
文摘The effects of different concentrations of Zn￣(2+)ion on root growth,cell division,and nucleoli of Allium cepa were studied. The test Zn￣(2+) ion concentration was made up from zinc sulphate (ZnSO4. 7H2O) ranging from 10￣(-7) to 10￣(-2) mol/L. The solutions were prepared in tap water (pH =6. 5).The results indicated that Zn￣(2+) could obviously inhibit root growth at concentrations from 10￣(-4)to 10￣(-2) mol/L.Roots treated with zinc sulphate showed the presence of c-mitosis, anaphase bridges,including sticky and fluidized bridges (at 10￣(-3) to 10￣(-2) mol/L) , chromosome stickiness, irregularly shaped nuclei, broken nuclei and micronuclei. A toxicity effect was also observed on the nucleoli using silver staining technique after 48h of treatment with 10￣(-4)to 10￣(-2) mol/L Zn￣(2+), e. g,the nucleolar particulate material scattered around the nucleoli in the nucleus of root tip cells.
文摘多学科协作是实现高质量疼痛管理的关键。跨专业协作疼痛管理课程(Interprofessional Pain Curriculum,IPC)对于培养护理专业学生的疼痛管理能力至关重要。该文综述了国际疼痛研究学会(International Association for the Study of Pain,IASP)制订的跨专业协作疼痛管理课程内容大纲(Interprofessional Pain Curriculum Content Outline,IPCCO),以及加拿大多伦多大学和美国杜肯大学在IPC实施方面的经验,旨在为我国护理院校开展IPC教学提供参考和启示。
