中西结合治疗久治不愈的空洞型肺结核

目的：利用中西医结合的方法治疗久治不愈的空洞型肺结核，方法：选择140例复治肺结核病人，且都是二年以上空洞未关闭者，随机分成二组，每组都有70人，一组为试验组，用复治方案和本院研制的中药外治膏外敷加用红外线照射及中草药内服，一组为对照组，用复治方案不加中草药，疗效考核以分层片空洞关闭时间和痰菌阳性病人的痰菌阴转时间，结果：试验组空关闭时间和例数分别为2月内30例，3月内21例，6月内4例，1年内2例，1年以上未关闭者3例，试验组中痰菌阳性者62例，阴转时间和例数分别为2月内35例，4月内20例，6月内4例，1年内1例，1年以上未阴转者2例。对照组空尚关闭时间和例数分别为2月内10例，4月内12例，6月内14例，1年内2例，1年以上未关闭者32例。对照组中痰菌阳性 62例，阴转时间和例数分别为2月内8例，4月内10例，6月内15例，1年内10例，1年以上未阴转者19例，结论：试验组较对照组在久治不愈的空洞型肺结核空洞关闭时间明显缩短，痰菌阴转时间明显缩短，痰菌阴转速度明显加快。     

支气管镜局部治疗痰菌阳性肺结核病的效果

目的探讨痰菌阳性肺结核复治中辅助支气管镜下注入药物的效果。方法218例复治痰菌阳性的肺结核病人,按随机数字法分为2组：治疗组109例,每周行支气管镜下注入药物1次;对照组109例,不采用支气管镜下注入药物。两组化疗方案均采用2HRZES/6HRE。比较两组痰菌阴转率及阴转时间。结果治疗组和对照组在空洞型肺结核及支气管内膜结核中的溃疡型、增殖型、狭窄型痰菌阴转率及阴转时间比较差异有显著性（P〈0.05）。治疗组和对照组在单纯肺浸润型肺结核及支气管内膜结核中的浸润型痰菌阴转率及阴转时间比较差异无显著性（P〉0.05）。结论支气管镜下注入药物辅助治疗复治痰菌阳性肺结核能缩短痰菌阴转时间,提高痰菌阴转率。     

母牛分枝杆菌菌苗辅助治疗复治菌阳肺结核的临床分析

目的观察和评价母牛分枝杆菌菌苗在复治菌阳肺结核治疗中的作用。方法采用随机配对分组法,分微卡菌苗治疗组(A组,60例)和对照组(B组,60例)。2组方案均为2HRZES/1HRZE/5HRE,A组加用微卡菌苗治疗3月,B组不用微卡菌苗治疗。结果A组第1月涂片阴转率30%,培养阴转率40%;第2月涂片阴转率60%,培养阴转率66%。B组第1月涂片阴转率15%,培养阴转率13%;第2月涂片阴转率33%,培养阴转率40%。前二月痰菌阴转率A组显著高于B组(P<0.01)。疗程满8个月后A组涂片阴转率86%,培养阴转率86%;B组涂片阴转率85%,培养阴转率85%。A组和B组治疗满8个月痰菌阴转率无差异显著性(P>0.05)。病灶吸收好转及空洞缩小关闭速度,A组优于B组,A组的细胞免疫功能显著改善。随访A组和B组的细菌学复发率分别为5.3%和8.6%(P>0.05)。结论微卡菌苗能改善复治菌阳肺结核患者的细胞免疫功能,加快痰菌阴转、病灶吸收及空洞缩小关闭速度,不良反应少且轻微。微卡菌苗可用作复治菌阳肺结核的免疫治疗。     

卡介菌多糖核酸(斯奇康)对复治肺结核的疗效分析

目的探讨斯奇康(卡介菌多糖核酸)对复治肺结核的疗效.方法将53例复治肺结核患者随机分为试验组和对照组,试验组(27例)给予斯奇康加联合化疗,对照组(26例)只用化疗,观察两组患者治疗效果.结果试验组痰菌阴转率、病灶吸收好转率、空洞闭合率及临床表现有效率分别是74.08%、81.49%、75%及88.89%,显著高于对照组的53.84%、65.39%、60%及73.08%.实验中未发现斯奇康的不良反应.结论斯奇康是一种对复治肺结核疗效好、安全、方便的药物.     

肺泰胶囊辅助治疗初治肺结核的临床研究

目的:评价肺泰胶囊联合抗结核西药治疗初治肺结核的临床疗效和安全性.方法:53例初治肺结核患者,随机分为试验组和对照组,38例试验组病例服用肺泰胶囊 2HL2Z/4HL2治疗6月,15例对照组病例服用安慰剂 2HL2Z/4HL2治疗6月,观察治疗2月末和6月末痰结核菌阴转X线胸片上病灶和空洞变化情况.结果:治疗2月末痰结核菌阴转率试验组为93.8%,对照组为42.9%,病灶显吸率试验组为50%,对照组为13.3%;治疗6月末两组痰菌阴转率均为100%,病灶全吸率试验组为42.1%,对照组为13.3%,空洞闭合率试验组为78.6%,对照组为28.6%.试验组均优于对照组,差异有显著性意义(P＜0.05).肺泰胶囊未见不良反应.结论:肺泰胶囊与抗结核西药联合治疗初治肺结核患者,能加速痰结核菌阴转和病灶吸收,提高空洞闭合率,是一种有效而安全的抗结核中药制剂.     

经皮肺穿介入术治疗空洞性肺结核25例疗效分析

目的 :探讨经皮肺穿介入术在空洞性肺结核治疗中的地位、适应证及手术方法。方法 :对经内科治疗 6月以上仍排菌的 2 5例肺结核单发空洞行经皮肺穿介入术加全身抗痨治疗。结果 :6个月内 2 0例痰菌阴转 ,阴转率 80 % ,空洞闭合率 1 7例 ,占 68% ,另有 3例空洞有缩小。结论 :经皮肺穿介入术是继外科术 (采用不同术式切除不可逆灶或附加胸廓成型术 )后 ,解决空洞性肺结核复治失败或病情反复的另一种有效治疗手段     

含利福平方案失败的复治菌阳肺结核临床分析

对我院1983～1989年6月经含利福平方案治疗失败的22例复治菌阳肺结核作一分析。临床资料 1.一般资料:22例中男16例,女6例。年龄21～66岁,以中、老年偏多。浸润型结核12例,慢性纤维空洞型结核10例。16例伴有空洞,3例合并糖尿病。既往规则用9HRE11例,完成疗程时3例痰菌阳性,8例阴转,在停药半年至4年内痰菌复阳;规则用6HRE2例,痰菌阳性;     

抗结核板式组合药治疗涂阳肺结核效果观察

对151例初治涂阳和72例复治涂阳肺结核病例,应用抗结核板式组合药治疗的痰菌阴转和病灶变化情况进行观察。结果疗程结束时初、复治涂阳病例痰菌阴转率分别为98.7%和88.9%;病灶总有效率为90.1%和83.3%,空洞闭合或基本闭合率为70.5%和40.4%。认为板式组合药是目前治疗涂阳肺结核较理想的抗痨药。     

中西结合治疗复合菌阳肺结核52例疗效分析

用３ＳＨＲＺ／９ＨＲ方案加中药治疗复治菌阳肺结核病人，强化期３月后试验组与对照组痰菌阴转率分别为６１．５％和３４．１％，有显著差异性；病灶总吸收率试验组亦明显高于对照组，空洞缩小率亦有明显差异。     

经纤维支气管镜介入灌注治疗复治涂阳空洞型肺结核的疗效

目的探讨纤维支气管镜介入灌注给药对复治涂阳空洞型肺结核的治疗价值。方法经纤维支气管镜介入空洞病灶内灌注给药加化疗治疗复治涂阳空洞型肺结核32例,与单纯化疗31例进行对照研究。观察治疗后的痰菌阴转率、空洞病灶有效率和空洞闭合率等。结果经纤维支气管镜介入灌注治疗组疗程结束时痰菌阴转率91%,空洞病灶有效率88%,空洞闭合率53%,均显著高于单纯化疗组的65%、48%及29%(P<0.01或0.05)。结论经纤维支气管镜介入空洞病灶内灌注给药加化疗治疗复治涂阳空洞型肺结核,疗效显著优于单纯化疗,且无并发症及明显毒副反应。     

Value of D-Dimers in patients with acute aortic dissection

Objective: To evaluatel the value of D-dimers in patients with acute aortic dissection (AAD). Methods: This study consisted of 16 patients with AAD and 27 non-AAD patients. Serum D-dimets were measured by Sta-Liatest D-DI immunoturbidimetric assay. Results: D-dimer level was higher (P ＜ 0.001) in patients with AAD(7.91 ± 5.52 μg/ml) than that in non- AAD group(1.57±1.24 μg/ml). D-dimer was positive (＞0.4 μg/ml) in all patients with AAD and in 10 control group patients (37%). Among patients with acute AAD, D-dimers tended to be higher in Stanford A than in Stanford B (8.67 ± 4.31 μg/ml vs. 3.24±1.27 μg/ml, P ＜0.01). D-dimer values tended to be higher in more extended disease(3.84 ± 1.65 μg/ml, 8.57 ± 3.58 μg/ml and 11.87 ± 5.69 μg/ml in thoracic aorta, thoracic and abdominal aorta, thoracic and abdominal aorta and iliacal arteries, respectively, P ＜ 0.05 for both 8.57 ± 3.58 and 11.87 ± 5.69 vs. 3.84 ± 1.65 ). Including the control group into the analysis, we found a sensitivity of 100%, a negative predictive value of 100%, and a specificity of 66% and a positive predictive value of 64% for D-dimer in diagnosis of AAD in our patients with suspected AAD. Conclusion: D-dimer was elevated in patients with AAD. A negative D-dimer test result could be useful in excluding AAD.     

Research of combined liver-kidney transplantation model in rats

Objective： To set up a simple and reliable rat model of combined liver-kidney transplantation. Methods： SD rats served as both donors and recipients. 4℃ sodium lactate Ringer＇s was infused from portal veins to donated livers,and from abdominal aorta to donated kidneys, respectively. Anastomosis of the portal vein and the inferior vena cava （IVC） inferior to the right kidney between the graft and the recipient was performed by a double cuff method, then the superior hepatic vena cava with suture. A patch of donated renal artery was anastomosed to the recipient abdominal aorta. The urethra and bile duct were reconstructed with a simple inside bracket. Results： Among 65 cases of combined liver-kidney transplantation, the success rate in the late 40 cases was 77.5%. The function of the grafted liver and kidney remained normal. Conclusion： This rat model of combined liver-kidney transplantation can be established in common laboratory conditions with high success rate and meet the needs of renal transplantation experiment.     

BLOOD PRESSURE CHANGE WITH AGE IN SALT-SENSITIVE TEENAGERS

Objective To observe blood pressure change with age in salt-sensitive teenagers whose salt sensitivity were determined by repeated testing.Methods Salt sensitivity was determined through intravenous infusion of normal saline combined with volume-depletion by oral diuretic furosemide in 55 teenagers. After five years, salt sensitivity was re-examined and subject blood pressure was followed up. Blood pressure changes in salt-sensitive teenagers were compared to that of non-salt sensitive teenagers over five years.Results After 5 years, the repetition rate of salt sensitivity determined by intravenous saline loading is 92.7%. In teenagers with salt sensitivity on the baseline, both the systolic blood pressure increments and increment rates were much higher than non-salt sensitive teenagers (12.7±12.1 mmHg vs. 2.8±5.2 mmHg, P＜ 0.01; 12.2%± 12.0% vs. 2.5% ±4.4%, P＜ 0.001,respectively). There was a similar trend for diastolic blood pressure (8.4 ± 6.4 mmHg vs. 3.7 ± 6.4 mmHg, P = 0.052; 13.2% ±10.6 % vs. 6.8%± 10.1%, P = 0.053, respectively).Conclusions Salt sensitivity determined by intravenous saline loading showed good reproducibility. Blood pressure increments with age were much higher in salt-sensitive teenagers than non-salt sensitive teenagers, especially in terms of systolic blood pressure.     

Development on Adjustable Calibration Marker for Shock Wave Focus

Shock wave lithotripsy （SWL） is a treatment of choice for upper urinary stones. However, this procedure is inappropriate for obese patients because the focus is often unable to reach the target owing to the limited focal distance in shock wave source. Although treating such patients in a blast path may increase the application length of shock wave source, it＇s difficult to find this path on the lithotripter monitor. For this reason, we invented an adjustable calibration marker in order to set an effective focus in the shock wave hath.     

Study on the TCM Pathogenesis of Angiopathic Complications of Type II Diabetes

Excess production of reactive oxygen species(ROS)of mitochondrion mediated by hyperglycemia is the common pathogenesis of angiopathic complications of diabetes.TCM holds that the damp from the dysfunction of spleen.kidney and liver is the causative factor of complications of diabetes.This is similar to the mechanism of Ros resulting in angiopathic complications of diabetes.When the angiopathic complications of type II diabetes mellitus(T2DM)are difierentiated as caused by turbid damp in TCM can be explained as ROS.Since the obstruction of pathogenic damp in channels and collaterals is said to be the main pathogenesis,the treating principle should be dissolving the damp to remove the obstruction.     

Leptin, Ghrelin and TNF-α before and after Hypo-caloric Traditional Chinese Diet and Auricular Acupuncture

INTRODUCTION Obesity is a complex emergent problem, which can be possibly solved not only by the diet but also by the life style and promotion of a constant physical exercise. 1, 2 No doubt careful attentions must be given to the nutritional condition of obese people, the dietary habits, the somatic build (i.e. distribution of fat mass) and the organic functions linked to formation of the fat mass. All the parameters should be constantly monitored before, during and after a diet treatment. 3, 4, 5     

Relationship between Dysglycemia and Carotid Atherosclerosis in Tibetan Population

People with dysglycemia are at high risk for atherosclerotic diseases. This study aims at investigating the atherosclerotic vascular damage in dysglycemia and its metabolic origin in Tibetan population.     

APPLICATION OF LORNOXICAM TO PATIENT-CONTROLLED ANALGESIA IN PATIENTS UNDERGOING ABDOMINAL SURGERIES

FOR anesthesiologis s ,treatingpostoperativepainhas alwaysbeen a problem.Althoughopioidshave been provedtobe effective,theirsideeffectscouldnotbeignored.With thedevelopmentofscienceand pharmacology,many drugs with aspectsof satisfactoryanalgesicefficacyand couldbe welltoleratedby patientshave been developed.And lornoxicamisone of them, which isa non-steroidalanti-inflammatorydrug (NSAID ), with analgesic, anti-infl-ammatory,andantipyreticproperties.Itseliminationhalf-time(3 to 5 hours) isle…     

安心颗粒对急诊经皮冠状动脉介入术后生活质量影响的研究

目的：评价使用安心颗粒对急诊经皮冠状动脉介入术（PPCI）术后生活质量的影响.方法：将160例接受PPCI的急性ST段抬高型心肌梗死患者随机分为安心颗粒组（术前顿服安心颗粒8.8g,术后安心颗粒4.4 g/次,每日2次）和对照组（仅接受基础药物治疗）.所有患者均服用阿司匹林、氯吡格雷和阿托伐他汀.分别在入院时、出院前1d、出院后180 d时,应用心肌梗死多维度量表（MIDAS）、中文版SF-36评价量表对患者生活质量评分.并观察术后30 d以内的出血并发症、血小板减少症发生情况.结果：入院时和出院前1d,两组患者的心肌梗死MIDAS、SF-36量表评分比较无差异（P＞0.05）;出院后180 d时,与对照组比较,安心颗粒组MIDAS、SF-36评分明显减低（P＜0.05）;组内与入院时比较,两组出院前1d、出院后180 d时,MIDAS、SF-36评分均降低（P＜0.05）.两组患者在随访期间均无大量出血、少量出血、重度和极重度血小板减少症发生,安心颗粒组有4例、对照组有7例发生不明显出血（P＞0.05）.两组发生轻度血小板减少症的患者数比较无差异（P＞0.05）.结论：PPCI使用安心颗粒,能改善急性ST段抬高型心肌梗死患者的生活质量,且不增加出血风险.     

CLINICAL SIGNIFICANCE OF SERUM CYTOKINES IL-1β,sIL-2R,IL-6,TNF-α,AND IFN-v IN ACUTE CORONARY SYNDROME

Objectives To explore serum cytokines levels (including IL-1 β, sIL-2R, IL-6, TNF-α, and IFN-v) and their significance in patients with acute coronary syndrome (ACS) and the subsequent follow-ups, with attempt to estimate the role of various serum inflammatory markers in the diagnosis and assessment of ACS.Methods The study population include 40 patients with acute myocardial infarction (AMI), 40 patients with unstable angina pectoris (UAP), and 40 controls. Among the 80 patients, 60 patients attended a follow up 4 months later. Serum inflammatory markers including IL-1 β, sIL-2R, IL-6, TNF-α, and IFN-v were measured by enzyme linked immunosorbent assay.Results Serum IL- 1 β, sIL-2R, IL-6, TNF-α were significantly higher in AMI group or UAP group compared to the control group and became significantly lower 4 months later in the follow-up patients. Serum levels of IFN-v shows no significant difference between AMI group or UAP group and controls, also showing no significant change when measured in follow up patients. There was no correlation between serum creatine kinase-MB isoenzyme levels and serum inflammatory markers either in UAP or AMI group. Furthermore, when divided into two subgroups using Wagner's QRS scoring system in the AMI group, there is no difference of each serum inflammatory marker between ≤ 6 scores group and ＞ 6 scores group.Conclusion Serum levels of certain inflammatory markers may have some diagnostic value for ACS, and can be a useful marker reflecting disease stability.