高压氧治疗29例一氧化碳中毒致迟发脑病的效果分析

目的探讨高压氧治疗一氧化碳中毒致迟发性脑病患者的疗效及作用机制。方法对我院29例一氧化碳中毒致迟发性脑病患者在内科常规治疗基础上进行高压氧治疗,与同期仅进行内科常规治疗的同类患者进行比较。结果本组假愈期平均26.9d,高压氧平均治疗次数20.5次,治疗组痊愈24例,明显多于对照组的17例,迟发性脑病、死亡例数明显低于对照组（P〈0.05）;轻度和中度的总有效率（100.0%、92.86%）明显高于重度的总有效率（57.15%）（P〈0.05）;6h、24h及7d的总有效率（100.0%、100.0%、88.89%）明显高于8d以上的总有效率（P〈0.05）。结论高压氧治疗一氧化碳中毒致迟发性脑病具有疗效高、不良反应少的优点,治疗时间越早疗效越好。     

胞二磷胆碱联合高压氧治疗一氧化碳中毒临床疗效观察

目的观察胞二磷胆碱联合高压氧治疗急性一氧化碳中毒的临床疗效。方法 35例急性一氧化碳中毒患者随机分成两组,治疗组18例,常规＋胞二磷胆碱治疗（2-4周高压氧＋必要的糖皮质激素＋维生素＋30d胞二磷胆碱口服,0.2g/次,3次/d）,对照组17例,常规治疗（2-4周高压氧＋必要的糖皮质激素＋维生素）,对住院时间、入出院智能评分、神经伤残功能评分、随访迟发性脑病发病率等指标进行比较。结果两组住院时间无差异,P〉0.05,出院智能评分治疗组优于对照组,P〈0.05,神经伤残功能评分好于对照组,P〈0.05,随访迟发性脑病发病率明显低于对照组,P〈0.01。结论胞二磷胆碱联合高压氧治疗能明显改善一氧化碳中毒患者高级神经功能受损及减少迟发性脑病的发生。     

血府逐瘀汤合高压氧预防一氧化碳中毒迟发性脑病

目的：观察血府逐瘀汤合高压氧防治一氧化碳中毒（COP）迟发性脑病的临床疗效.方法：中、重度急性一氧化碳中毒患者98例.随机分成高压氧（HBO）组52例和血府逐瘀汤＋HBO治疗组46例.高压氧治疗压力0.2MPa,1日1次,共20次.在患者一氧化碳中毒后第15、20、25、30、45、60天判定是否出现迟发性脑病.结果：高压氧组52例中出现迟发性脑病6例,占11.54%.治疗组46例中出现迟发性脑病2例,占4.35%.结论：血府逐瘀汤＋高压氧治疗急性COP,迟发性脑病的发生率较单纯高压氧治疗明显降低.     

纳洛酮、依达拉奉与高压氧联用治疗急性一氧化碳中毒迟发型脑病的临床研究

目的探讨纳洛酮、依达拉奉与高压氧联用治疗急性一氧化碳中毒迟发型脑病的临床疗效。方法 182例一氧化碳中毒迟发型脑病（DEACMP）患者随机分为对照组和治疗组,对照组患者行高压氧、脑复新与纳洛酮治疗,治疗组患者行高压氧、依达拉奉与纳洛酮治疗。比较两组患者的临床疗效、运动功能和生活满意度评分。结果治疗组的痊愈率明显高于对照组,无效率明显低于对照组,而总有效率明显高于对照组,治疗后两组患者BBS评分明显比治疗前升高,而Barthel评分明显降低;治疗组BBS评分明显高于对照组,而Barthel评分明显低于对照组,治疗组SF-36各项评分明显高于对照组。上述结果差异均具有统计学意义（P〈0.05）。结论纳洛酮、依达拉奉与高压氧联用治疗急性一氧化碳中毒迟发型脑病疗效显著,不良反应少,可明显改善患者的运动功能障碍和精神障碍,值得临床推广。     

依达拉奉联合高压氧治疗急性一氧化碳中毒致迟发性脑病的临床观察

目的探讨依达拉奉联合高压氧治疗急性一氧化碳中毒致迟发性脑病的临床疗效。方法选取急性一氧化碳中毒致迟发性脑病患者80例,随机均分为2组（n=40）。对照组给予高压氧等综合治疗,观察组在对照组基础上加用依达拉奉,记录资料并进行回顾性分析。结果观察组总有效率大于对照组,差异有统计学意义（P〈0.05）;观察组无明显不良反应,未影响治疗。结论依达拉奉联合高压氧治疗急性一氧化碳中毒致迟发性脑病安全、有效,值得临床推广应用。     

早期强化高压氧治疗重度一氧化碳中毒的临床分析

目的探讨早期强化高压氧治疗重度一氧化碳中毒的疗效。方法 89例重度一氧化碳中毒患者分成对照组(49例)和强化治疗组(40例),对照组采用高压氧治疗及其他常规治疗;强化治疗组在治疗早期(1~5 d内)采用2次/d的强化高压氧治疗;评价两组的治疗效果、平均昏迷时间、迟发性脑病的发生率及不良反应等。结果强化治疗组治疗总有效率高于对照组(<0.05);强化治疗组的平均苏醒时间、迟发性脑病的发生率均小于对照组(均<0.05)。结论早期强化高压氧治疗重度一氧化碳中毒疗效确切,可缩短苏醒时间,降低迟发性脑病的发生率。     

急性一氧化碳中毒迟发性脑病的临床特征及危险因素

目的 分析急性一氧化碳中毒迟发性脑病的临床特征,并探讨其发生的危险因素。〖HTH〗方法〖HTK〗〓回顾性分析2016年1月~2019年1月在我院高压氧室治疗的急性一氧化碳中毒患者276例,根据迟发性脑病发生情况分为迟发性脑病组及非迟发性脑病组。单因素分析两组间的临床特征, Logistic回归分析迟发性脑病发生的危险因素。结果 41例（1 49%）为迟发性脑病组,235例（851%）为非迟发性脑病组。与非迟发性脑病组比较,迟发性脑病组的年龄偏大(641±135 vs 500±191,P=0014),取暖所致中毒（878% vs 613%,P=0004）及意识障碍时间大于10小时的比例(537%,vs 170%,P＜0.05)均较多。非迟发性脑病组患者首次予以高压氧治疗后24小时内清醒比例明显高于迟发性脑病组（P＜0.05）;Logistic 回归分析显示, 高龄（OR 1043,95%CI 1018,1069,P=0001）和较长的意识障碍时间（OR 4268,95%CI 2094,8701,P＜0.05）是影响迟发性脑病发生的独立危险因素。〖HTH〗结论〖HTK〗〓高龄及较长的意识障碍时间是迟发性脑病发生的危险因素,早期予以积极高压氧治疗,可能改善患者预后。     

甲氯芬酯治疗一氧化碳中毒迟发性脑病的研究

目的观察甲氯芬酯治疗一氧化碳中毒迟发性脑病的临床疗效。方法将符合标准的一氧化碳中毒迟发性脑病患者60例随机分为2组,对照组给予基础治疗和高压氧治疗,治疗组加用甲氯芬酯静滴,观察2组疗效。结果治疗组在治愈率和总有效率方面显著优于对照组（P〈0.05）,在显效时间和治愈时间方面显著短于对照组（P〈0.05）。结论甲氯芬酯可改善一氧化碳中毒迟发性脑病（ACMPDE）患者脑血液动力学,促进临床症状体征的恢复。     

醒脑静治疗急性重度一氧化碳中毒疗效观察

目的研究醒脑静对急性重度一氧化碳（CO）中毒的治疗作用。方法81例重度一氧化碳中毒患者[格拉斯哥昏迷评分（GCS）〈8）]随机分为两组：对照组40例,高压氧治疗后常规治疗;治疗组41例,高压氧治疗后加用醒脑静注射液及常规治疗。观察两组患者24 h清醒率及治疗2周时APACHE Ⅱ（acute physiology and chronichealth evaluation Ⅱ）评分。结果治疗组患者24 h内清醒率（87.8%）高于对照组（70%）,P〈0.05;2周时A-PACHE Ⅱ评分,治疗组低于对照组,P〈0.05.结论醒脑静可促进重度一氧化碳中毒患者早期苏醒,减轻病情,改善预后。     

脑复康配合高压氧治疗一氧化碳中毒迟发性脑病的临床疗效

目的：观察脑复康配合高压氧治疗一氧化碳中毒迟发性脑病的临床效果。方法：将符合标准的一氧化碳中毒迟发性脑病患者118例，随机分为治疗组59例和对照组59例。对照组给予基础治疗和高压氧治疗，治疗组在对照组的基础上加用脑复康注射液。观察两组治疗效果。结果：治疗组在痊愈率和总有效率方面显著优于对照组（P〈0．05），在显效时间和治愈时间方面显著短于对照组（P〈0．05），且脑中动脉血流阻力指数（RI）下降更为明显。结论：采用脑复康配合高压氧治疗一氧化碳中毒迟发性脑病能够改善缺血区的微循环，减轻缺血缺氧引起的组织损伤，能提高患者的治疗效果和生存质量，值得在临床上推广。     

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.