中心静脉导管引流联合顺铂IL-2胸腔内注射治疗恶性胸腔积液

目的：研究中心静脉导管置入引流联合顺铂IL-2治疗恶性胸腔积液的临床疗效。方法：采用经皮穿刺中心静脉置管间断性引流后胸腔注入顺铂和IL-2局部化疗的方法,治疗恶性胸腔积液患者26例。结果：所有病人置管均成功,经治疗后20例完全缓解,3例部分缓解,3例退组。有效率88．5％。结论：中心静脉导管胸腔引流,联合顺铂和IL-2胸腔注入,对于控制恶性胸腔积液疗效确切,且并发症少,患者生活质量改善,值得临床推广应用。     

传统胸腔闭式引流和中心静脉导管治疗创伤性血胸临床疗效对比观察

目的：探究传统胸腔闭式引流与中心静脉导管治疗创伤性血胸的临床疗效对比。方法参照组患者采用传统胸腔闭式引流手术治疗,给予治疗组患者中心静脉导管手术治疗,对比分析两组患者治疗后的效果。结果治疗组患者在留管手术时间、手术切口愈合时间等均少于参照组,其并发症发生率与切口感染率明显低于参照组,总有效率(96.67%)高于参照组(93.03%),两组差异显著。结论采用中心静脉导管治疗创伤性血胸的临床效果明显优于采用传统胸腔闭式引流治疗效果,具有临床应用价值。     

持续泵入奥 曲肽治疗重症胰腺炎的疗效观察

目的 研究持续泵入奥曲肽治疗重症胰腺炎的疗效及安全性。方法 选择2018年2月~2019年2月在我院诊治的重症胰腺炎患者84例,采用随机数字表法分为对照组和观察组,各42例。对照组给予前列地尔治疗,观察组在对照组基础上持续泵入奥曲肽。比较两组治疗总有效率、临床症状（腹痛、腹胀、恶心呕吐）消失时间、临床体征（胰腺水肿、血淀粉酶、尿淀粉酶、白细胞）恢复时间以及不良反应发生率。结果 观察组总有效率为95.23%,高于对照组的83.33%,差异有统计学意义（P＜0.05）;观察组临床腹痛、腹胀、恶心呕吐症状消失时间均短于对照组,差异有统计学意义（P＜0.05）;观察组胰腺水肿改善、血淀粉酶恢复、尿淀粉酶恢复、白细胞恢复时间均短于对照组,差异有统计学意义（P＜0.05）;观察组不良反应发生率为4.76%,低于对照组的16.67%,差异有统计学意义（P＜0.05）。结论 持续泵入奥曲肽治疗重症胰腺炎临床疗效确切,可快速改善临床症状和体征,促进血尿淀粉酶恢复,且不良反应少,安全性良好。     

中心静脉导管用于恶性胸腔积液引流的护理体会

目的探讨中心静脉导管用于胸腔引流术的利弊及护理体会。方法对恶性胸腔积液的患者在B超定位下进行中心静脉导管穿刺并留置引流管形成密闭引流装置。间断引流胸水及胸腔内给药,时间7~20d。留置期间B超定期复查,护理评价效果,并决定是否拨管。结果中心静脉导管用于恶性胸腔积液的患者,减轻患者反复穿刺的痛苦及创伤,简化传统的胸腔引流术,也减少了气胸、血气胸发生的机率等并发症。结论规范中心静脉导管用于恶性胸腔积液的护理措施,简化了传统的胸腔穿刺引流术,减少术中、术后感染及引流管脱落的几率。     

体温单绘制程序的设计意见

目的探索Selding法将中心静脉导管置入（微创置管）胸（心包）腔引流积液、积气,灌注药物治疗的可行性、安全性。方法用Selding法将单腔中心静脉导管置入胸（心包）腔引流积液、积气,腔内灌注药物治疗,观察不良反应,与同期进行穿刺抽吸及粗管引流的病人进行比较分析。结果868例病人置管913例次,胸腔置管845例,心包置管23例（胸腔、心包同时置管者5例）。微创置管的主要并发症是导管阻塞（57．3％）和脱落（8．9％）,灌注药物后的毒副作用主要是低热、胸痛、食欲减退。结论胸部微创置管引流操作简单、方便、安全,并发症少,并发症处理简单,腔内灌注药物治疗副作用小,可以作为临床诊疗常规运用。     

胸腔置管引流注入DDP香菇多糖治疗恶性胸腔积液

目的观察胸腔内置管引流并注入DDP香菇多糖治疗恶性胸腔积液疗效。方法34例恶性胸腔积液患者超声引导下置入中心静脉导管,尽量引流尽胸水后腔内注入DDP及香菇多糖。结果完全缓解（CR）12例,部分缓解（PR）16例,缓解不明显（NR）3例,进展（PD）3例,有效（CR＋PR）率82.35%。结论超声引导下微创置管引流并注入DDP,香菇多糖治疗恶性性胸腔积液有显著效果,毒副作用小,可提高患者生存质量。     

多西他赛在控制晚期非小细胞肺癌恶性胸腔积液的 疗效和安全性评估

目的 研究多西他赛在控制晚期非小细胞肺癌恶性胸腔积液的疗效和安全性。方法 将2016年1月~12月本院接收的晚期非小细胞肺癌恶性胸腔积液患者152例,根据按照电脑随机分组原则分为两组,每组76例。两组均行胸腔穿刺术,对照组给予培美曲塞,观察组给予多西他赛治疗。将两组患者的临床疗效、不良反应发生情况和ECOG评分进行比对。结果 观察组晚期非小细胞肺癌恶性胸腔积液患者的临床总有效率89.47%,高于对照组的65.79%,差异有统计学意义（P＜0.05）;胃肠道反应、胸痛、肾毒性不良反应的发生率和治疗后ECOG评分均低于对照组,差异有统计学意义（P＜0.05）。结论 多西他赛应用在晚期非小细胞肺癌恶性胸腔积液患者中取得疗效确切,临床安全性较高。     

细胞因子诱导的杀伤细胞联合白细胞介素2治疗恶性胸腔积液

目的 观察应用细胞因子诱导的杀伤（CIK）细胞联合白细胞介素2（IL-2）治疗恶性胸腔积液的疗效.方法 收集2009年7月至2013年7月于本院肿瘤科就诊的恶性胸腔积液患者50例,随机数字表法分为治疗组（n=24）和对照组（n=26）.胸腔积液引流净后,治疗组胸腔灌注CIK细胞联合IL-2,连续3d;对照组灌注IL-2联合顺铂,隔日1次,连续3次.治疗4周后评价疗效和不良反应.结果 治疗组有效率87.50％（21/24）,完全缓解率54.17％（13/24）;对照组有效率57.69％（15/26）,完全缓解率42.31％（11/26）.与对照组比较,治疗组的完全缓解率、有效率均增加（均P＜0.05）.不良反应比较显示,治疗组发热的发生率较高,而对照组胸痛、胃肠道反应、骨髓抑制的发生率较高（均P＜ 0.05）.与治疗前比较,治疗后两组患者的Karnofsky评分均增加（均P＜0.05）.结论 CIK细胞联合IL-2胸腔灌注治疗恶性胸腔积液不良反应小,疗效确切.     

集束化护理在行中心静脉导管ICU患者中的应用分析

目的:探讨集束化护理在中心静脉导管患者中的效果.方法:选取2018年3月-2020年9月于我院ICU且行中心静脉置管的524例患者作为研究对象.采用便利抽样法将患者分为对照组(259例)和观察组(265例).对照组给予常规护理,观察组采用集束化护理.分析比较两组导管相关血流感染发生率、炎症情况[拔管时体温≥38℃占比、白细胞(WBC)计数≥10×109?L-1占比及血清C反应蛋白(hs-CRP)≥10mg?L-1占比]、治疗情况[患者导管留置天数及ICU住院天数].结果:观察组导管相关血流感染发生率、拔管时体温≥38℃占比、白细胞计数≥10×109?L-1占比、C反应蛋白≥10mg?L-1占比均显著低于对照组;导管留置天数和ICU住院天数均显著短于对照组(P<0.05).结论:集束化护理可减低导管相关血流感染发生率,缓解炎症,改善治疗情况.     

两种不同方法治疗结核性包裹性胸腔积液200例疗效观察

目的探讨治疗结核性包裹性胸腔积液的最佳方式。方法将200例结核性包裹性胸腔积液患者随机分为两组,所有患者均采用2HRZE／6HR方案抗结核治疗,两组患者分别采用中性静脉导管胸腔置入加胸腔内注入尿激酶、胸穿加胸腔内注入尿激酶这两种方法引流胸腔积液,然后进行对比。结果治疗1个月时,两组的胸腔内分隔消失率分别为82．86％和58．95％;治疗2个月时,两组患者胸膜厚度与治疗前相比,均明显减少,差异有统计学意义;两组患者胸水消失时间比较有显著性差异;治疗6个月时两组的总有效率分别为81．90％和56．84％,两组对比有显著性差异。结论胸腔注入尿激酶可减少分房及分隔,减轻胸膜肥厚。胸腔置管＋胸腔内注入尿激酶是治疗结核性包裹性积液的最佳方式,且安全、简便,值得在临床推广使用。     

Secular change in menarche in women in Madrid

The age at menarche was estimated by recollection in 1617 women between the ages of 18 and 60 in Madrid and a nearby suburb, Pinto. The population of Pinto is working-class and the Madrid group, taken from residential neighbourhoods , belongs to the upper middle class. In both groups we found a diminution in average age at menarche, from 14.04 to 13.02 years in Madrid and from 14.55 to 13.16 years from about 1935 to about 1965 in Pinto. These changes have been more intense in the group which is less well-off economically, where living conditions have varied much more drastically.     

Intestinal helminthiasis in school children in Haiti in 2002

A survey on intestinal helminths in school children was conducted in Haiti in 2002. This first nationwide study involving the entire country was stratified by department according to urban and rural zones using the cluster method. Focusing on elementary school children (n=5792; age range 3 to 20 years), it involved 26 urban and 49 rural schools randomly selected. Stools were preserved in formalin and examined by the Ritchie technique. Thirty-four per cent of stools (1981/5792) tested positive for intestinal helminths with the following parasites identified: Ascaris lumbricoides (27.3%), Trichuris trichiura (7.3%), Necator americanus (3.8%), Hymenolepsis nana (2%), Taenia sp. (0.3%) and Strongyloides stercoralis (0.2%). The helminth prevalence was higher in rural (38.4%) compared to urban areas (30%). There was no significant difference in prevalence by sex and age. The importance of geohelminths changed from one department to another with the highest prevalence found in the Southern department of Grande Anse (73.7%) and the lowest prevalence in the Center department (20.6%). Five out of the country's nine departments had a similar prevalence varying from 25.5% to 28.2%. Intestinal helminthic polyparasitism was observed in a percentage of infested school children comprise between 3.4% and 28.6% according in relation to the geographical area. A program to fight against geohelminths in school children should be initiated as a public health priority. Albendazole is the drug of choice. Frequency of drug distribution should be based on the prevalence of geohelminths in each department.     

Experience in adult population in dengue outbreak in Delhi

A dengue outbreak has recently hit the Indian capital. We studied the clinical profile of adult patients. Five hundred and sixty patients of dengue infection were admitted in a specially created ward according to the criteria laid down by WHO. Haematemesis (28.28%), epistaxis (26.78%) and malena (14.28%) were some of the common presentations. Similarly lymphadenopathy, especially cervical (30.89%), palatal rashes (26.96%) and hepatomegaly (23.75%) were the most commonly encountered findings on physical examination. Most of the cases were of dengue fever with haemorrhage and only 2.5% cases were classified under dengue haemorrhagic fever or dengue shock syndrome. The average hospital stay was 3.4 days but only 9.8 hours in the eleven patients who died, suggesting their late arrival in preterminal situation giving little time for resuscitation. Thrombocytopenia was not a feature and only 12.85% patients had platelet count less than 70,000/cmm. Most of the patients who were admitted with thrombocytopenia, showed normalization in their platelet counts in next few days. Serological examination demonstrated evidence of recent dengue infection in 41.17% patients. Few patients required blood or platelet concentrate transfusion. Eleven patients died, three due to DIC, one of intracranial haemorrhage and seven due to massive gastric haemorrhage. Rest of the patients recovered completely. Thus we can conclude that recent outbreak in Delhi was of dengue fever with haemorrhage and mortality was very low in patients who came early to the hospital.     

Changes in the hypothalamic nuclei in in experimental allergy

Summary In rabbits subjected to prolonged sensitization and in which the Arthus phenomenon was induced there was a marked reaction of the hypothalamic nuclei. Staining by Gomori's method indicated a cellular swelling, loss of granules, and protoplasmic vacuolization in the supraoptic nucleus. There was a considerable increase in the size of the cross-sectional area of the cells. The same effects were much less well shown in the paraventricular nucleus. These results show that marked signs of increased neurosecretion developed in the animals at the height of the Arthus phenomenon.(Presented by Active Member AMN SSSR V. V. Parin) Translated from Byulleten Éksperimental'noi biologii i Meditsiny, Vol. 55, No. 4, pp. 110–113, April, 1963.