宫颈炎康栓治疗宫颈高危型人乳头瘤病毒感染疗效观察

目的：评估对宫颈出现 HPV（高危型人乳头瘤病毒）感染的病人施予宫颈炎康栓展开治疗的效果。方法：选择2015年7月－2016年7月因宫颈出现 HPV 感染而进入本院实施诊治的73例女性病人，经宫颈液细胞学检测及相应妇科检查后，排除癌变可能性，将入选病例划分成实验组（37例）、参照组（36例），实验组以宫颈炎康栓展开阴道给药治疗，参照组观察期内不予以药物，评估两组病人病情改变及阴道给药疗效情况。结果：实验组第一次复诊、第二次复诊转阴率分别是35．14％（13／37）、20．83％（5／24），总转阴率48．65％（18／37）；参照组第一次复诊、第二次复诊转阴率分别是11．11％（4／36）、6．25％（2／32），总转阴率16．67％（6／36）。实验组病人复诊转阴率情况优越于参照组，差异显著（P ＜0．05）。结论：对宫颈感染上高危型 HPV 的女性病人施予宫颈炎康栓，可取得较高的 HPV 转阴率，值得积极推荐与运用。     

抗生物蛋白敷料对HPV感染宫颈CINⅠ级患者HPV转阴的改善作用及其安全性

目的:探讨抗生物蛋白敷料对HPV感染宫颈CINⅠ级患者HPV转阴的改善作用。方法:选取本院2015年7月-2017年2月收治的HPV感染宫颈CINⅠ级患者118例作为研究对象,按照随机数字表法将其分为对照组(n=59)和观察组(n=59)。对照组给予重组人干扰素α-2b阴道泡腾胶囊治疗,观察组给予抗生物蛋白敷料治疗。观察两组治疗3、6、12个月后HPV的转阴率,治疗前后的宫颈液基细胞学指标,以及不良反应发生情况。结果:治疗3、6个月后两组HPV转阴率比较,差异均无统计学意义(P0.05);治疗12个月后观察组的HPV转阴率为84.75%,明显高于对照组的66.10%,差异有统计学意义(x~2=4.12,P=0.04)。治疗前两组宫颈液基细胞学指标对比,差异均无统计学意义(P0.05)。治疗6、12个月后,两组正常宫颈液基细胞学指标均较治疗前增多;且观察组NILM明显高于对照组,ASCUS和LSIL均明显低于对照组,差异均有统计学意义(P0.05)。两组患者乏力、低热及阴道刺痛不良反应发生情况比较,差异无统计学意义(x~2=0.61,P=0.43)。结论:抗生物蛋白敷料可明显提高HPV感染宫颈CINⅠ级患者HPV转阴率,改善宫颈液基细胞学指标,且不良反应少,值得临床推广应用。     

康复新液治疗宫颈炎HPV阳性预防宫颈癌的临床分析

目的观察康复新液对HPV阳性患者转阴的治疗作用。方法对经门诊诊断为宫颈炎的患者行HPV、tct联合筛查,筛查HPV阳性的324例患者,随机分为研究组和对照组,分别给予康复新液、干扰素阴道用药治疗6个月,停药3个月及半年后复查,比较宫颈炎治疗效果和HPV转阴情况。结果研究组宫颈炎治愈率为75.31%,HPV转阴率为90.47%。治疗效果明显好于对照组(P0.05)。结论对于HPV阳性慢性宫颈炎患者给予康复新液治疗能够收到显著的效果,对于疾病的转阴具有重要意义,且有预防宫颈癌变的价值,值得在临床中进行推广应用。     

干扰素α-2b栓联合宫颈环形电切术治疗高危型HPV感染的临床疗效

目的探讨干扰素α-2b栓联合宫颈环形电切术治疗宫颈炎合并高危型人乳头状瘤病毒(HPV)感染的疗效。方法选择宫颈炎合并高危型HPV感染患者164例,均行阴道镜下宫颈活检和液基薄层细胞学检查,随机均分为对照组82例,联合治疗组82例。对照组接受宫颈环形电切术治疗,联合治疗组接受干扰素α-2b栓联合宫颈环形电切术治疗。术后6月,比较两组患者的整体疗效、HPV病毒载量、HPV转阴率和宫颈炎症指标,比较两组宫颈愈合时间、药物相关不良反应的发生情况。结果术后6月,联合治疗组疗效分级、总有效率均优于对照组(P＜0.05);联合治疗组HPV病毒载量低于对照组,HPV转阴率均高于对照组(P＜0.05)。联合治疗组阴道灌洗液中白细胞介素-2、白细胞介素-10、肿瘤坏死因子-α水平低于对照组(P＜0.05)。联合治疗组创面愈合时间、阴道流血时间、排液时间均短于对照组(P＜0.05)。两组间阴道局部红肿、干涩、瘙痒等不良反应发生率差异无统计学意义(P＞0.05)。结论干扰素α-2b栓治疗能够促进宫颈炎合并高危型HPV感染的术后恢复,提升疗效,且在治疗安全性方面较为可靠。     

宫颈上皮内瘤变LEEP术后HPV病毒感染的消退情况分析

目的检测术后HPV病毒感染的消退情况。方法应用LEEP术对77例宫颈上皮内瘤变患者、35例宫颈炎患者进行治疗,分析术前宫颈活检与及术后宫颈病理的符合情况,于术后1个月随访创面修复、阴道流血及分泌物情况,术后3、6、12个月复查宫颈修复情况、液基细胞学检查、HPV病毒检测、阴道镜检查,必要时取宫颈活检。结果1）宫颈LEEP术前及术后1、3、6、9个月阴道分泌物HPV阳性表达率依次下降（X2 1月与术前=7．12,X2 3月自1月=4．78,X2 6月与3月=22．22,X2 12月与6月=6．51,P均〈0．05）,差别均有显著性。2）术前HPV感染阳性组与HPV感染阴性组比较,术后病变残留率和复发率间比较均无显著性差异（P均〉0．05）,但是术后6个月HPV仍然持续感染阳性组较HPV感染阴性组残留和复发率均明显增高,有显著性差异（P均〈0．05）。结论LEEP治疗宫颈上皮内瘤变是一种安全而且有效的方法,在治疗的同时不仅可以明确诊断,而且有利于HR—HPV感染的清除。但是LEEP治疗术后有一定的病变残留和复发率。术后HPV持续阳性患者复发风险高,应密切随访。HPV病毒检测预示治疗后病变残留和复发有较高的灵敏度,是一种有效的随诊方法。对于HPV感染、TCT阴性的不满意的阴道镜患者,即使阴道镜下活检为炎症,也应高度重视,对持续感染的高危患者行LEEP术既可达到诊断目的又可达到治疗作用,防止宫颈癌前病变及癌变的漏检。     

细菌性阴道病与宫颈高危型HPV感染的关系研究

目的:探讨细菌性阴道病与宫颈高危型HPV感染的关系。方法:选取2017年7月-2018年6月就诊于本院门诊细菌性阴道病(BV)患者350例为BV阳性组,同时按1︰1配对,选择同一时期在该医院同科室就诊的其他疾病患者350例作为BV阴性组,调查BV发生率,以及BV患者中高危型HPV感染流行概况,探讨HPV感染危险因素,分析细菌性阴道病与宫颈高危型HPV感染的关系。结果:BV阳性组高危HPV阳性率6.57%(23/350)高于BV阴性组3.14%(11/350);高危HPV阳性患者BV阳性率67.65%(23/34)高于高危HPV阴性患者49.10%(327/666);Logisitic回归分析显示年龄、避孕方式、宫颈柱状上皮外移、BV阳性是宫颈高危型HPV感染发生的影响因素;BV阳性患者随访1年宫颈高危型HPV转阴率为34.78%(8/23)低于BV阴性组72.73%(8/11)。结论:年龄、避孕方式、宫颈柱状上皮外移、BV阳性是宫颈高危型HPV感染发生的影响因素,细菌性阴道病与宫颈高危型HPV感染有关,BV阴性者宫颈高危型HPV感染转阴率更高。     

槲皮素在HPV阳性的ASCUS患者中的临床应用

目的探讨槲皮素在HPV阳性的宫颈鳞状上皮不典型增生（ASCUS）患者中的临床应用效果。方法以宫颈癌高发区湖北五峰为试验点。使用TCT和HC-2筛查高危型HPV感染阳性的ASCUS患者90名,随机选取45名为实验组,另外45名为对照组。用中药槲皮素宫颈局部上药,6个月后复查,采用TCT和HC-2检测用药前后宫颈细胞学的变化以及高危型HPV阳性患者例数的改变。结果槲皮素治疗后,经TCT筛查,实验组正常患者38例,总有效率为84．4％。对照组正常患者20例,总有效率为44．4％。比较两组间差异有统计学意义（P〈0．05）。HC-2检测高危型HPV感染阳性例数的改变,实验组转阴30例,转阴率为66．7％,对照组转阴16例,转阴率为35．6％。比较两组间差异有统计学意义（P〈0．05）。结论槲皮素对HPV阳性的ASCUS患者有较明显的疗效。     

槲皮素治疗高危型人乳头瘤病毒阳性的宫颈上皮内瘤变患者30例疗效观察

目的：探讨槲皮素治疗高危型人乳头瘤病毒（ HPV）阳性感染的宫颈上皮内瘤变I（ CINⅠ）患者的临床疗效。方法选取2012年9月至2015年12月就诊于陕西中医药大学第二附属医院妇科门诊高危型HPV阳性的CINⅠ患者90例。按数字表法随机分为3组：治疗组用槲皮素3g阴道给药;阳性对照组用奥平栓6g阴道给药;空白对照组常规阴道擦洗。3组均每2 d给药1次,连续2周为1个治疗周期,治疗3个周期。3个月后复查HPV、液基细胞,进行病理检查。结果治疗组高危HPV转阴22例,转阴率73．3％;阳性对照组高危HPV转阴21例,转阴率70．0％;空白对照组高危HPV转阴10例,转阴率33.3％。治疗组和阳性对照组治疗后转阴率高于空白对照组,差异有统计学意义（P＜0．05）。治疗组液基细胞转阴28例,转阴率93．3％;阳性对照组液基细胞转阴18例,转阴率60．0％;空白对照组转阴10例,转阴率33．3％。治疗组转阴率显著高于阳性对照组和空白组,差异有统计学意义（P＜0．05）。治疗组病检结果转为正常21例,转阴率70．0％;阳性对照组转为正常19例,转阴率63．3％;空白对照组转为正常16例,转阴率53．3％。治疗组和阳性对照组治疗后转阴率高于空白组,差异有统计学意义（P＜0．05）。结论槲皮素治疗HPV感染的CINⅠ患者,疗效显著,而且具有一定的抗炎作用。     

高危型人乳头瘤病毒感染宫颈炎治疗方法研究

目的：对高危型人乳头瘤病毒（HPV）感染宫颈炎采用不同方法治疗的可行性进行探讨研究。方法：选择在该院确诊为高危型 HPV 感染宫颈炎患者120例，随机分成3组。在三组分别接受治疗后，检查患者的宫颈愈合情况和 HPV 转阴情况。结果：ABC 三组治疗效果都很明显，其中 C组的总有效率最高，差异具有统计学意义（P ＜0．05）。结论：三种治疗方法对于治疗宫颈高危型 HPV 感染的宫颈炎都有明显的效果，可以进行推广。     

宫颈柱状上皮异位及宫颈炎性反应对高危型HPV感染状态的影响

目的:明确宫颈柱状上皮异位及宫颈炎性反应对高危型HPV感染状态的影响。方法:选择同时行HPV加TCT检查的患者,分为宫颈炎性反应/宫颈柱状上皮异位组及正常宫颈组。两组中HPV阳性者均予以外用保妇康栓3个月治疗,宫颈炎性反应组予以常规口服抗生素药物治疗,每隔一年同时复查HPV加TCT检查。各组根据HPV不同结果(持续感染或转阴)再分两组进行统计学分析。结果:宫颈炎性反应或/和宫颈柱状上皮异位患者HR-HPV的感染率明显高于非宫颈柱状上皮异位的正常宫颈组(P<0.001),HR-HPV阳性者中,宫颈炎性反应或/和宫颈柱状上皮异位患者持续感染率明显高于非宫颈柱状上皮异位的正常宫颈组(P<0.05)。结论:宫颈炎及宫颈柱状上皮异位是HPV持续感染的促进因素。     

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.     

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…     

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.     

Acupuncture Combined with Spinal Tui Na for Treatment of Primary Dysmenorrhea in 30 Cases

Objective: To observe the therapeutic effects in acupunture treatment of primary dysmenorrhea combined with spinal Tui Na, and study its mechanism. Methods: Thirty cases of the treatment group were treated by acupuncture combined with spinal Tui Na, and thirty cases in the control group were treated by routine acupuncture. Results: The total effective rate was 93.3% in the treatment group, and 73.3% in the control group, with a significant difference between the two groups (P<0.05). Conclusions: Acupuncture combined with spinal Tui Na has good prospects for treatment of primary dysmenorrhea.     

Luo Lingjie's Experience in Treating Chronic Nephropathy

In treating chronic nephropathy,Luo Lingjie,a chief physician,pays attention to regulating the balance between yin and yang,treating infection if present,and removing pathogenic factors.He prescribes gentle drugs and uses carefully strongly warming-tonifying ones,emphasizes the importance of persuading the patient to persist in treatment with medication and nurse one's health for recuperation,and is good at combined use of TCM and western medicine therapy and brings the merits of various therapies into full play,with obvious theraoeutic effects.     

Dr.Zhang Ren's Experience in the Acupuncture Treatment of Different Diseases with the Same Therapeutic Principle

Dr.Zhang Ren,the chief physician,is the chairman of Shanghai Acupuncture and Moxibustion Association.Having been engaged in medicine for about 40 years,he is experienced in treating various intractable diseases.In his long years of clinical practice,he advocates taking the TCM differentiation as the basis to seek for the acupuncture method for treatment of modern intractable diseases.The author of this essay had the fortune to follow Dr.Zhang in study.The following is a summary of Dr.Zhang's experience in the acupuncture treatment for different intractable diseases with the same therapeutic principle.     

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.     

The comparative studies of the influences of Urapidil and Nicardipine on sino-atrial node function, atrio-ventricular node function and hemodynamics

Objective:To investigate the influences of urapidil and nicardipine on rabbit sinus function,atrio-ventricular node function and hemodynamics.Methods:Thirty-two Angora's rabbits were selected and randomly divided into four groups.U1 group:urapidil 0.25 mg/kg;U2 group:urapidil 0.5 mg/kg;N1 group:nicardipine 10 μg/kg;N2 group:nicardipine 20 μg/kg.All these medicine were administrated within 30 seconds.Measurements were taken before and after the administration of urapidil or nicardipine for the following data:mean blood pressure(MAP),heart rate(HR),sino-atrial conduction time(SACT),maximal sinoatrial recovery time(SNRTmax)corrected sinus node recovery time(CSNRT),index of sinus node recovery time(SNRTI),Wenckebach A-V conduction frequency (WB),and P-R interval.Results:Significant MAP and HR changes were identified in all of the four groups before and after administration of both urapidil and nicardipine.No significant changes could be found in the rest of the parameters.Intergroup analysis showed that SACT and CSNRT of N1 and N2 groups were shorter than those of the U2 group(P＜0.01);the MAP decreased(P＜0.01)and the HR increased drastically(P＜0.01).Conclusions:Neither urapidil(0.25 mg/kg,0.5 mg/kg)nor nicardipine(10μg/kg,20μg/kg)has any significant influence on rabbit sinus function or rabbit atrio-ventricular node function.Nicardipine could be a better choice than urapidil for parafunctional sinus node patients.