新疗法治疗瘢痕疙瘩的疗效观察

目的:比较目前常规疗法的优缺点,探讨治疗瘢痕疙瘩的新方法。方法:采用两种方法治疗瘢痕疙瘩:①采用特制的注射器向瘢痕内注射确炎舒松;②以手术为主。两组均为外涂去疤霜,并用透明敷料"安舒妥"密封的综合疗法。结果:20例患者的84块瘢痕用方法①,治愈率为68%,总有效率为98%;12例患者的32块瘢痕用方法②,治愈率为37%,总有效率为81%。统计学分析二者的差异有统计学意义(P<0.05)。结论:方法①疗效虽优于方法②但各有特点,在瘢痕疙瘩的治疗上应权衡利弊,根据具体情况选择合适的治疗方法。     

局部封闭治疗皮肤病60例临床观察及体会

本组旨在观察确炎舒松—Ａ局部封闭治疗神经性皮炎、湿疹、结节性痒疹及瘢痕疙瘩的疗效。1　方法常规皮肤消毒 ,抽取确炎舒松—Ａ混悬液 2 5ｍｇ ,2 %利多卡因 2ｍｌ。根据病种的不同 ,采用不同的方法。①局限性神经性皮炎、浸润肥厚显著的慢性湿疹或钱币状湿疹、结节性痒疹均作皮下浸润封闭 ,隔 7ｄ注射 1次 ,4次为 1疗程。②瘢痕疙瘩从瘢痕边缘基底部进针 ,深浅适中 ,边进针边缓慢推药 ,局部略变浅白色为度 ,瘢痕大者需选择 2个以上的注射点 ,每周 1次 ,6次为 1疗程。2　结果瘢痕疙瘩 2 0例 ,痊愈 6例 ,显效 9例 ,有效 4例 ,无效 1例 ,总…     

确炎舒松A联合自体血治疗白癜风355例疗效观察

目的　探讨确炎舒松A(以下简称确A)联合自体血治疗白癜风的疗效。方法　取确A混悬液适量、静脉血 2毫升 ,2 %利多卡因适量 ,充分混合后作局部封闭 ,每周 1次 ,5次为一疗程 ,进行 1～ 3个疗程不等。结果　治愈率为 2 3 .94% ,显效率为19.44 % ,有效率为 46.2 0 % ,总有效率达 89.5 8%。寻常型、进展期、病期≤半年的疗效分别高于节段型、静止期和病期 >半年。结论　本疗法操作简便 ,效果优良 ,尤其对病期短、寻常型、进展期的白癜风效果更佳。     

确炎疏松A食管内注射联合扩张治疗儿童食管瘢痕狭窄的效果分析

目的探讨确炎疏松A食管内注射联合扩张治疗儿童食管瘢痕狭窄的效果。方法 30例儿童食管瘢痕狭窄采用确炎疏松A食管狭窄处注射联合扩张治疗,观察其症状变化和治疗次数,并与32例单纯扩张治疗进行对比。全组病例获1~5年随访。结果 30例患儿均成功行确炎疏松A食管狭窄处注射及探条扩张,显效16例(53.3%),有效12例(40.0%),无效2例(6.67%),平均治疗(2.50±0.94)次,总有效率93.3%;单纯扩张治疗组显效13例(40.6%),有效9例(28.1%),无效10例(31.2%),平均治疗(4.47±2.14)次,总有效率为68.8%。两组有效率比较差异有统计学意义(P<0.05)。结论确炎疏松A食管内注射可提高儿童食管瘢痕狭窄的疗效。     

肩部瘢痕疙瘩综合药物注射治疗效果观察

目的评价肩部瘢痕疙瘩综合药物注射治疗的临床效果。方法α-干扰素100万U,肌注,每天1次,15次后改为隔日1次,共用30次。联合瘢痕疙瘩内注射曲安奈德混合液0.5~1.5 mL不等(用等量生理盐水或2%利多卡因注射液稀释),每15 d~30 d 1次,注射的次数和频率根据瘢痕的严重程度而定。注射时采用分层注射技术,尽量浅层注射,深层适当注射,注射时严格掌握层次,只将药液注入到瘢痕实体中。结果本组15例患者,9例治愈,5例显效,1例无效,治愈率为60%,总有效率为93.3%。结论对于肩部瘢痕疙瘩采用综合药物注射疗法,疗效较好,尤其适合于拒绝手术者,值得在基层医院推广。     

瘢痕内剥切即刻放射治疗及弹力加压三联治疗瘢痕疙瘩的临床研究

目的评价手术、放疗结合弹力加压的＂三联疗法＂治疗瘢痕疙瘩的临床疗效。方法患者分为A、B、C三组。A组行手术联合放射治疗：手术切除病灶,术后即可6MeV高能电子束（β射线）放射治疗,分割剂量300～400cCy/次,每天一次连续照射4～6次,照射总剂量15～20Gy。B组行手术联合糖皮质激素注射治疗：手术切除瘢痕,术中切口皮缘注射醋酸曲安奈德,术后每两周1次,连续2～4月。C组：瘢痕内直接注射醋酸曲安奈德,每两周1次,连续3～6月。结果 A、B、C三组总有效率分别为95.65%,87.50%和57.69%。A与B组比较无显著差异（P〉0.05）。A、B组分别与C组间比较均有显著性差异（P〈0.05）。结论 A、B组两种综合治疗方法均较C组单一治疗疗效更为满意。手术、放疗结合弹力加压的＂三联疗法＂是治疗瘢痕疙瘩的一种疗效可靠、副作用小的方法。     

确炎舒松—A局部注射治疗切口增生性瘢痕80例体会

1986～1997年，我们应用醋酸确炎舒松—A局部注射治疗各种手术引起的增生性瘢痕80例，取得了较满意的效果，报告如下。1资料与方法1．1对象男28例，女52例。年龄7～47岁。瘢痕为各种手术切口所致，其中颈横切口22例，肋缘下斜切日18例，腹部直切口16例，腋窝和胸部梭形切口各8例，膝部及手掌直切口各4例。瘢痕形成到接受治疗的时间最短6个月，最长36个月。治疗前主要症状为疼痛、瘙痒或短痕挛缩。1．2方法局部皮肤消毒，取普通sml消毒注射器和7号针头，针头与短痕纵轴成15～20”刺入瘫痕内，缓慢注入醋酸确炎舒松一A。因癫痕致密，每次推入…     

楔形切除耳廓瘢痕疙瘩的疗效观察

目的：探讨楔形切除耳廓瘢痕疙瘩联合放射治疗等疗法的临床效果。方法：本研究主要选取直径1．0～1．5cm耳廓瘢痕疙瘩行楔形切口，完整切除瘢痕组织及暴露的部分耳轮软骨，对位缝合，重塑耳轮外形，修复耳廓形态。术后1周内行放射治疗。对有复发倾向者行局部注射激素类抗瘢痕药物，每周1次，视瘢痕变化情况逐渐减量。结果：本组11例患者，术后随访1年，治愈9例（82％），显效2例（11％），有效率100％。结论：一定范围耳廓瘢痕疙瘩行楔形切口手术，重塑耳轮外形，耳廓形态完整，结合早期放疗，可取得满意效果，是治疗耳廓瘢痕疙瘩的选择方案之一。     

综合治疗肛周湿疹125例临床观察

为探讨治疗肛周湿疹的治疗方法,观察该病的治疗效果,我们采用以复方亚甲蓝注射液点状注射为主的综合疗法治疗该病,将235例的肛周瘙痒为主的肛周湿疹患者随机分治疗组125例和对照组11O例.治疗组采用综合治疗方法,对照组只采用中药熏洗法及外敷药物治疗,伴有痔、裂或皮肤病变均行手术切除.结果 显示:治疗组痊愈113例,显效12例,有效率100%.对照组痊愈45例,显效51例,无效14例,有效率87.3%.治疗组有效率明显高于对照组,P<0.01,随访6个月,治疗组复发6例,复发率为4.8%,对照组复发33例,复发率30%,二者对比,P<0.01.结果 表明:以局部多点注射复方亚甲蓝注射液为主的综合疗法治疗肛周湿疹,疗效满意,安全,复发率低.     

布地奈德联合特布他林雾化吸入治疗婴幼儿哮喘的观察及护理

目的探讨联合吸入布地奈德混悬液和特布他林雾化液雾化吸入治疗婴幼儿哮喘的疗效及护理体会。方法随机选择75例哮喘婴幼儿,分为单纯吸入特布他林雾化液（A组）、布地奈德混悬液和特布他林雾化液联合吸入（B组）、单纯吸入布地奈德混悬液（C组）三组,每组25例。观察比较三组疗效。结果A组治愈16例,显效3例,无效6例,总有效率76％;B组治愈22例,显效2例,无效1例,总有效率96％;C组治愈14例,显效4例,无效7例,总有效率72％。A、B组总有效率比较有显著性差异（P〈0．05）;B、C组总有效率比较有显著性差异（P〈0．05）;A、C组总有效率比较差异无显著性（P〉0．05）。结论联合吸入布地奈德混悬液和特布他林雾化液治疗婴幼儿哮喘疗效优于单纯吸入特布他林雾化液和单纯吸入布地奈德混悬液,不良反应少,安全性好。     

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.