Ⅲb期宫颈癌同步放化疗中化疗方案的选择

目的:探讨治疗Ⅲb期宫颈癌同步放化疗的化疗药物选择.方法:60例中晚期宫颈癌患者同步放化疗,随机分成A组(放疗+PVB组)30例 和B组(放疗+BIP组)30例.观察两组的治疗效果和不良反应,并进行比较.结果:外照射结束时两组的有效率分别为87.6%和96.7%,差异有显著性(P<0.05),两组3年生存率分别为79.2%和82.4%,差异无显著性(P>0.05),5年生存率分别为51.5%和67.6%,差异有显著性(P<0.05),胃肠道反应及骨髓抑制为最常见的不良反应,两组差异无显著性(P>0.05).结论:BIP方案同步放化疗能明显提高患者的近期疗效及生存率,副作用较PVB方案并无明显增加.     

髂总动脉内药物灌注治疗股骨头缺血性坏死的临床研究

目的:探讨髂总动脉内药物灌注对股骨头缺血性坏死(ANFH)患者的临床疗效。方法:68例ANFH患者随机分为观察组及对照组各34例,对照组选择旋股内、外侧动脉及闭孔动脉药物灌注,观察组选择髂总动脉内药物灌注,对比分析两种药物灌注方法对患者临床治疗效果、血流指标及不良反应的影响。结果:观察组优良率为97.06%对照组为88.24%,但两组比较差异无统计学意义(P>0.05)。观察组手术时间、X线曝光时间、下床活动时间、平均住院时间短于对照组(P<0.05)。观察组皮下血肿、穿刺点疼痛、穿刺侧股神经刺激症状、侧臀部疼痛等不良反应发生率与对照组比较,差异无统计学意义(P>0.05)。观察组治疗后1个月、3个月、6个月Harris评分高于对照组(P<0.05)。结论:髂总动脉内药物灌注与旋股内、外侧动脉及闭孔动脉药物灌注治疗ANFH近期疗效相当,但髂总动脉内药物灌注能有效降低患者并发症发生率,缩短X线曝光对患者的影响,有利于患者远期预后。     

新辅助化疗方案治疗局部晚期宫颈癌的疗效及安全性评价

目的:探讨不同新辅助化疗(NACT)治疗局部晚期宫颈癌(LACC)的疗效及安全性。方法:选取于本院收治的LACC患者68例,根据化疗方案的不同分为观察组(n=34)和对照组(n=34)。观察组采用多西他赛+奥沙利铂(DTX+OXA)化疗方案,对照组采用紫杉醇+顺铂(TAX+DDP)化疗方案,21d为1周期,共治疗2个周期,治疗结束后行腹腔镜广泛子宫切除术+盆腔淋巴结清扫术+腹主动脉旁淋巴结取样术。观察两组近期疗效及不良反应发生情况;对两组术后标本进行病理学评估;检测并比较两组外周血T淋巴细胞亚群及NK细胞变化。结果:观察组ORR和DCR分别为47.09%、91.18%,对照组分别为44.12%、85.29%,两组间无显著性差异(P>0.05)。与治疗前比较,治疗后两组CD4~+、CD8~+及NK细胞比例均显著降低,CD4~+/CD8~+比值明显增加(P<0.01),但两组间无显著性差异(P>0.05)。术后经病理学检测两组PCR、PR1、PR2患者比例无显著性差异(P>0.05);同时宫颈浸润深度、外科切缘、宫旁浸润及盆腔淋巴结转移情况均无显著性差异(P>0.05)。观察组脱发、胃肠道反应、肾脏毒性患者比例低于对照组(P<0.05);但周围神经毒性患者比例高于对照组(P<0.05或P<0.01)。结论:腹腔镜术前应用DTX+OXA及TAX+DDP化疗方案治疗LACC近期疗效相当,但DTX+OXA方案对患者总体毒性反应相对较低,安全性好,值得临床推荐使用。     

爪型肋骨接骨板内固定治疗多发性肋骨骨折的作用价值

目的 探究爪型肋骨接骨板内固定治疗多发性肋骨骨折的临床疗效.方法 选取2017年5月至2019年10月本院收治的多发性肋骨骨折患者60例为研究对象,随机分为观察组和对照组,各30例.对照组行常规治疗,观察组实施爪型肋骨接骨板内固定术治疗,比较两组临床治疗效果(时间指标、疼痛评分、呼吸功能指标)及并发症发生率.结果 与治疗前相比,治疗后,两组PaCO2水平均下降,PaO2水平均上升(P<0.05).治疗后,观察组PaCO2水平低于对照组,PaO2水平高于对照组(P<0.05);观察组时间指标短于对照组(P<0.05);观察组疼痛评分低于对照组(P<0.05);观察组不良反应总发生率低于对照组(P<0.05).结论 采用爪型肋骨接骨板内固定术治疗多发性肋骨骨折患者,有助于患者术后呼吸功能恢复,减少患者痛苦,加快骨折愈合,避免术后出现不良反应,值得临床推广应用.     

自制芦黄散外敷治疗带状疱疹的临床疗效观察

目的 探讨自制芦黄散外敷治疗带状疱疹的临床疗效.方法 选择2009年1月～2010年5月在该院确诊并治疗的120例带状疱疹患者为研究对象,随机分为治疗组62例和对照组58例.治疗组采用自制芦黄散外敷联合阿昔洛韦口服治疗,对照组采用阿昔洛韦软膏外涂联合阿昔洛韦口服治疗.观察并比较两组疗效、皮肤损害(止疱、结痴)修复时间和疼痛缓解时间、后遗神经痛(PHN)发生率和不良反应情况.结果 两组患者均顺利完成实验,没有因为无法耐受药物而退出者,亦未发生明显不良反应.治疗组止疱、结痂和疼痛缓解时间均较对照组明显缩短,差异有显著性(P<0.05);PHN发生率明显低于对照组,差异有显著性(P<0.05).治疗14d后两组在总有效率方面比较差异无显著性(P>0.05),但在治愈率方面治疗组为82.26%,显著高于对照组,差异有显著性(P<0.05).结论 自制芦黄散外敷治疗带状疱疹明显缩短了止痛、止疱、结痂时间,疗程短,治愈率高,值得临床推广.     

复方芪麻胶囊治疗气虚痰浊型单纯收缩期高血压病60例临床观察

[目的]观察复方芪麻胶囊治疗气虚痰浊型单纯收缩期高血压病(ISH)的临床疗效.[方法]选择符合WHO/ISH高血压诊断标准的120例ISH患者,随机分为2组.治疗组60例采用复方芪麻胶囊治疗,对照组60例采用硝苯地平缓释片治疗.2组疗程均为1个月.观察2组的降压疗效和中医证候疗效,比较2组治疗前后血压、24 h动态血压的变化,并评价其安全性和不良反应.[结果](1)疗效方面:降压总有效率治疗组为73.3%,对照组为78.4%,2组比较差异无显著性意义(P>0.05);中医证候疗效总有效率治疗组为95.0%,对照组为73.3%,2组比较差异有显著性意义(P<0.05).(2)血压变化方面:治疗后2组收缩压(SBP)较治疗前均明显下降(P<0.05或P<0.01),但治疗后2组间比较差异无显著性意义(P>0.05).治疗后2组的24 h动态血压各项指标均明显改善(与治疗前比较,P<0.05),其中对照组24 h舒张压(DBP)、昼DBP、夜DBP下降幅度更明显(与治疗组比较,P<0.05).(3)安全性和不良反应方面:治疗过程中对照组有3例轻度不良反应,未影响继续治疗.[结论]复方芪麻胶囊可以有效降低气虚痰浊型单纯收缩期高血压病患者的收缩压,缩小脉压差,且能明显改善患者的临床症状,是治疗单纯收缩期高血压病的有效中药制剂.     

氯氮平+碳酸锂对难治性精神分裂症患者脑电图的影响分析

目的:分析氯氮平+碳酸锂对难治性精神分裂症患者脑电图的影响分析。方法:选取84例难治性精神分裂症患者,根据不同的治疗方案分为两组,对照组(n=42)采用氯氮平治疗,观察组(n=42)采用氯氮平+碳酸锂治疗,10周后比较两组治疗前、后的脑电图便变化情况、疗效和不良反应发生情况。结果:两组脑电图总异常率比较差异无统计学意义(P>0.05);观察组治疗有效率明显高于对照组(P<0.05);两组不良反应总发生率比较差异无统计学意义(P>0.05)。结论:氯氮平+碳酸锂治疗难治性精神分裂症未对脑电图产生明显影响,效果显著,安全性良好。     

中西药结合保守治疗异位妊娠的临床研究

目的 探讨中西药结合保守治疗异位妊娠的临床疗效.方法 选择120例患者,分为观察组和对照组,各60例,对照组用甲氨蝶呤+米非司酮,观察组在应用甲氨蝶呤+米非司酮的基础上加用破血逐瘀中药,比较两组临床指标变化情况,统计疗效和不良反应.结果 与对照组比较,观察组治愈率明显增高(P<0.05),手术率明显下降(P<0.05),差异有统计学意义,两组不良反应比较差异无统计学意义(P>0.05).结论 对于有生育要求拒绝手术治疗的异位妊娠患者,中西医结合保守治疗简单易行、治疗费用低、治愈率高,可在基层医院进一步推广.     

消癌平注射液联合CapeOX方案治疗晚期结直肠癌疗效观察

目的评价消癌平注射液联合Cape OX方案对晚期结直肠癌的疗效、不良反应及免疫功能的影响。方法73例晚期结直肠癌患者随机分为2组,观察组37例接受消癌平注射液联合Cape OX方案治疗,对照组36例接受Cape OX方案治疗,治疗2个周期后比较2组患者的近期疗效,生活质量,不良反应情况,血清肿瘤标志物癌胚抗原(CEA),糖蛋白抗原(CA-199),及CD3+、CD4+、CD8+、CD4+/CD8+变化。结果完成2个周期化学治疗后,观察组患者的客观缓解率、疾病控制率、生活质量总改善率均显著高于对照组(P<0.05)。2组患者均无因严重不良反应而停药者,各种不良反应发生率比较差异无统计学意义(P>0.05)。2组患者治疗前血清CEA、CA-199水平比较差异均无统计学意义(P>0.05);观察组和对照组患者治疗后血清CEA、CA-199水平均低于治疗前(P<0.05);治疗后观察组患者血清CEA、CA-199水平均低于对照组(P<0.05)。观察组和对照组患者治疗前血清CD3+、CD4+、CD8+水平及CD4+/CD8+比较差异均无统计学意义(P>0.05);2组患者治疗后血清CD3+、CD4+水平及CD4+/CD8+与治疗前比较差异均无统计学意义(P>0.05);治疗后观察组患者血清CD3+、CD4+水平及CD4+/CD8+均较对照组升高(P<0.05);2组患者治疗后血清CD8+水平比较差异无统计学意义(P>0.05)。结论消癌平注射液联合Cape OX方案治疗晚期结直肠癌患者可提高客观缓解率、疾病控制率及生活质量,改善机体免疫功能,值得临床进一步应用。     

卡尼汀在维持性血液透析患者中的应用分析

目的 观察卡尼汀在维持性血液透析患者中的应用方法与效果,观察其对患者血液指标与生活质量的影响.方法 40例维持性血液透析平分为治疗组和对照组各20例,在常规血液透析中,治疗组加用静脉注射卡尼汀,观察治疗效果与不良反应情况,同时分析治疗前后两组血清学指标与生活质量评分情况.结果经过治疗后,治疗组的血红蛋白(Hb)、三酰甘油(TG)、高密度脂蛋白 (HDL)和低密度脂蛋白(LDL)改善情况都明显好于对照组(P<0.05);治疗组治疗后SF-36总评分明显升高,与治疗前及对照组比较有显著性差异(P均<0.05).治疗组总有效率达93.8%;对照组总有效率75.0%,两组疗效差异显著(P<0.05).两组不良反应情况相比无显著性差异(P>0.05).结论卡尼汀可以提高维持性血液透析患者的临床疗效,纠正贫血,提高生活质量,具有重要的临床作用.     

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.     

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.     

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.