凯时联合弥可保治疗糖尿病周围神经病变的临床疗效观察

目的观察凯时与弥可保联合应用治疗糖尿病周围神经病变的疗效。方法120例糖尿病周围神经病变患者随机分为对照组和治疗组。对照组60例，单用弥可保肌注，每日500μg，连用4周；治疗组60例，在对照组基础上．加凯时10μg加于生理盐水100ml每日1次静点，共4周。结果治疗组有效率达96．7％，明显高于对照组48．3％（P〈0．01）；神经传导速度改善也明显优于对照组（P〈0．01）。结论凯时与弥可保联合应用可明显提高糖尿病周围神经病变的治疗效果。     

温阳补肾汤联合甲钴胺治疗糖尿病周围神经病变疗效观察

随机将80例糖尿病周围神经病变患者分为对照组与治疗组。在有效控制血糖的基础上,中医温阳补肾汤联合甲钴胺注射液治疗42例糖尿病周围神经病变患者（治疗组）,与单独应用甲钻胺注射液治疗的38例患者（对照组）的疗效进行对比,观察中医证候积分、神经传导速度、安全性。结果两组间疗效及中医证候积分差异有显著性（P〈0．05）。结论中药温阳补肾汤联合甲钴胺注射液治疗糖尿病周围神经病变疗效显著。     

雪乐通与弥可保联合治疗糖尿病周围神经病变的临床疗效观察

目的 观察雪乐通与弥可保联合治疗糖尿病周围神经病变的临床疗效。方法 选择60例糖尿病合并周围神经病变患者，将其随机分成两组，治疗组30例，用雪乐通20d加生理盐水500ml静滴，1次／d，同时应用弥可保500μg，肌肉注射，1次／d，连续2周。对照组30例用弥可保500μg，肌肉注射，1次／d，连续2周。结果 治疗2周后两组神经症状与检查评分均明显下降，但以治疗组下降显著，治疗后两组平均评分差异有统计学意义（P〈0．01）。结论 雪乐通与弥可保联合治疗糖尿病周围神经病变有较好疗效。     

α-硫辛酸治疗糖尿病周围神经病变84例临床观察

目的探讨抗氧化剂仅．硫辛酸对糖尿病周围神经病变的治疗效果。方法将168例糖尿病周围神经病变患者随机分为对照组和观察组,对照组采用传统的基础治疗,观察组在同对照组治疗的基础上加用α-硫辛酸治疗,观察两组患者临床疗效。结果观察组治疗总有效率为94．0％,对照组为84．5％,两组比较差异有统计学意义（P〈0．05）。结论抗氧化剂α-硫辛酸治疗糖尿病周围神经病变患者效果良好,值得临床推广应用。     

奥扎格雷钠与盐酸丁略地尔联合治疗DPN疗效观察

将58例2型糖尿病并发DPN患者随机分为治疗组32例，对照组26例，在控制血糖基础上，治疗组予以奥扎格雷钠80rag、盐酸丁咯地尔200rag静脉滴注；对照组与以丹参注射液20ml静脉滴注，连续14天。结果：两组患者治疗前病程、血压、血糖、血脂、周围神经系统病变程度的差异无显著性（P〉0．05）。治疗组患者的疼痛、麻木、感觉异常等症状较对照组减轻，膝腱反射也好转（P〈0．05）；同时正中神经、腓神经的传导速度较治疗前明显加快（P〈0．01），而对照组治疗前后变化无显著性差异（P〉0．05）。结论：奥扎格雷钠与盐酸丁咯地尔联合应用能改善糖尿病周围神经病变，临床应用安全、有效。     

前列腺素E1联合弥可保治疗糖尿病周围神经病变

将66例DPN患者随机分为治疗组给予凯时与弥可保,对照组给予弥可保与刺五加治疗,共两周,比较其疗效。结果：治疗组症状、体征的改善与对照组相比有显著性差异（P〈0．05）;神经传导速度改善明显高于对照组（P〈0．01）。结论：前列腺素E1与弥可保联用可明显改善DPN的疗效。     

脑苷肌肽注射液治疗脑梗死48例临床疗效观察

目的观察脑苷肌肽注射液治疗脑梗死的临床疗效。方法选择我院96例脑梗死患者，随机分为治疗组48例和对照组48例，两组患者均给予复方丹参16ml＋5％葡萄糖溶液250ml，1次／d静滴，有高血压、糖尿病者常规降压、降糖处理。梗死面积大、水肿显著者，用20％甘露醇注射液5～7d。治疗组患者在此基础上给予脑苷肌肤20ml＋0．9％氯化钠溶液250ml，1次／d；对照组患者给予胞二磷胆碱1．0g＋0．9％氯化钠溶液250ml，1次／d，连续14d为1个疗程。治疗前、后进行神经功能缺损评分和生活能力状态级别评分，并进行临床疗效评定。结果两组患者临床疗效间差异有显著性意义（P〈0．01）；两组患者治疗前、后神经功能缺损评分、生活能力状态级别评分间差异有显著性意义（P〈0．05），两组患者治疗后神经功能缺损评分间差异亦有显著性意义（P〈0．01）。结论脑苷肌肽能明显降低脑梗死患者神经功能缺损程度，提高患者的生活质量，具有可靠的疗效及安全性。     

甲钴胺联合α硫辛酸治疗糖尿病周围神经病变的临床观察

目的探讨治疗糖尿病周围神经病变的有效方法。方法将60例糖尿病周围神经病变患者随机分为治疗组和对照组。在常规降糖治疗的基础上,对照组用甲钴胺注射液500μg,1次／d;治疗组在此基础上加用α硫辛酸注射液600mg,1次／d;两组均治疗3周,观察两组治疗前后临床症状和神经传导速度的变化。结果治疗组症状改善明显优于对照组（P〈0．05）,两组感觉、运动神经传导速度较治疗前均有明显提高（P均〈0．05）,治疗组比对照组提高更显著（P均〈0．05）。结论甲钴胺联合仅硫辛酸治疗糖尿病周围神经病变疗效显著。     

甲钴胺联合银杏达莫注射液治疗老年糖尿病周围神经病变的疗效观察

选取200例老年糖尿病周围神经病变患者，随机分为联合治疗组（甲钴胺联合银杏达莫注射液）100例，对照组（甲钴胺）100例（2组均严格控制血糖），疗程均为4周。观察患者治疗前后对腓神经、正中神经等神经传导速度的影响。结果治疗4周后，2组患者主观症状和体征有较明显改善，联合治疗组总有效率为90％，对照组总有效率为、64％，2组疗效比较，差异有统计学意义（P〈0．05）。2组改善神经传导速度的程度比较，差异亦有统计学意义（P〈0．05）。结论甲钴胺联合银杏达莫注射液治疗老年人糖尿病周围神经病变的疗效显著。     

Lipo-PGE1治疗2型糖尿病周围神经病变疗效观察

将64例2型糖尿病周围神经病变患者随机分为治疗组、对照组各34例，两组均隔日肌注弥可保500μg，治疗组加用前列腺素E1脂微球载体制剂（Lipo—PGE1）110pg静滴，治疗3周观察临床疗效、肌电图神经传导速度及药物不良反应。结果与对照组比较，治疗组临床疗效、肌电图神经传导速度有显著性差异（P〈0．05）。提示Lipo—PGE1是治疗2型糖尿病周围神经病变较安全、有效的药物。     

Research and Evaluation of the Influence of the Construction of the Gate and the Influence of the Piston Velocity on the Distribution of Gases into the Volume of the Casting

Distribution of gasses to the cast volume and volume of pores can be maintained within the acceptable limits by means of correct setting of technological parameters of casting and by selection of suitable structure and gating system arrangement. The main idea of this paper solves the issue of suitability of die casting adjustment—i.e., change of technological parameters or change of structural solution of the gating system—with regards to inner soundness of casts produced in die casting process. Parameters which were compared included height of a gate and velocity of a piston. The melt velocity in the gate was used as a correlating factor between the gate height and piston velocity. The evaluated parameter was gas entrapment in the cast at the end of the filling phase of die casting cycle and at the same time percentage of porosity in the samples taken from the main runner. On the basis of the performed experiments it was proved that the change of technological parameters, particularly of pressing velocity of the piston, directly influences distribution of gasses to the cast volume.     

县级以下综合医疗机构医务人员对现代结控知识的认识现状调查

目的本文旨在了解医务人员现代结控知识掌握的现状及培训效果?方法于培训前后进行问卷调查,内容包括:病例发现?结核病诊断及化疗?结果培训前疫情报告和转诊,回答正确者占75.2%?71.7%;对临床表现?查痰和诊断依据,回答正确者占83.5%?42.5%?40.8%;抗痨药物?用药方法?化疗原则?短化方案?短化疗程?治愈标准六项,回答正确者占58%?14.4%?20.8%?9.2%?17%?24.3%?培训后再次调查发现,90%以上医务人员对现代结控基本知识已掌握?结论各级医务人员现代结控知识是很贫乏的,因此,对其进行系统培训是极为必要的,此项工作省时?省力?投入少,可收到事半功倍的效果。     

Preservation of the pylorus and resection of the head of the pancreas

The historical evolution of the pylorus-preservation resection of the head of the pancreas is traced from the first resections early in this century to relative standardization of the operation, to a lowering of the operative mortality, and to an interest in improving nutritional status after resection. There are many theoretical advantages for the function of the upper gastrointestinal tract after pylorus and gastric preservation, such as maintenance of gastric capacitance and equilibration of osmotic pressure in gastric digestants, foodstuff digestion and absorption, and bowel motility. After the pylorus-preserving resection, gastric emptying is normal, pyloric function to prevent duodenal reflux is often normal, and gastric acids and serum levels of duodenal hormones are at normal levels, whereas after standard pancreatoduodenectomy, all of these are often abnormal. No prospective blinded studies have been published comparing nutritional values after the two operative procedures, but evidence is presented of a satisfactory result with regard to gastric capacitance, body weight gain, and lack of postgastrectomy symptoms. An undoubted advantage of the pylorus-preserving feature is a simplification of the operation. These gains are achieved without increase in operative mortality, without increase in the incidence of jejunal ulcer, and without theoretical or actual decrease in value of the procedure as a cancer operation, except in patients with duodenal carcinoma proximal to the ampulla of Vater.     

Preservation of the pylorus in resection of the head of the pancreas

Pylorus preservation has been advocated to decrease the morbidity associated with the classical or standard pancreaticoduodenectomy. The proposed advantages are decreased incidence of peptic ulceration, dumping syndrome, and nutritional problems. However, after an initial period of enthusiasm for the procedure, it is now being found that marginal ulceration at the duodenojejunal anastomosis is encountered with increasing frequency. Delay in gastric emptying occurs frequently, with an overall incidence of 30%. With the availability of better pancreatic enzyme supplements, the current incidence of nutritional problems and weight loss after the standard Whipple procedure is unknown. Whether there is a difference in long-term survival after the two procedures performed for adenocarcinoma of the head of the pancreas is still debatable. A controlled trial is needed to answer many of these questions, and pylorus-preserving pancreaticoduodenectomy should be used cautiously until further data become available.