丹红注射液联合卡托普利治疗老年慢性肺源性心脏病急性加重期的疗效观察

目的：探讨丹红注射液联合卡托普利治疗老年慢性肺源心脏病（下称肺心病）急性加重期的临床疗效。方法：将入选患者分为治疗组与对照组,各35例。两组均给予抗炎、解痉、氧疗、强心利尿等常规治疗;治疗组同时加用丹红注射液40ml静脉输注,1次,d,卡托普利开始剂量12．5mg／次,2次,d,20d为一疗程,观察两组心功能改变情况。结果治疗组疗效优于对照组,两组比较差异有统计学意义（P〈0．05）。结论：丹红注射液联合卡托普利治疗肺心病急性加重期有一定疗效,值得临床推广应用。     

川芎嗪注射液与坎地沙坦酯联合治疗慢性肺心病急性加重期的疗效

目的观察探讨川芎嗪注射液与坎地沙坦酯联合治疗慢性肺心病急性加重期的临床疗效,总结其临床价值。方法选取我院2009年3月至2011年11月期间收治的慢性肺心病患者256例,其中有126例患者为慢性肺心病急性加重期的患者,随机分为观察组和对照组各63例,观察组给予川芎嗪注射液与坎地沙坦酯联合治疗,对照组给予常规治疗,经过一周治疗后,观察对比两组治疗效果,并总结其临床意义。结果观察组总有效率为92.1%;对照组总有效率68.3%,两组的疗效和不良反应发生率对比差异显著(P<0.05),具有统计学意义。结论使用川芎嗪注射液与坎地沙坦酯联合治疗慢性肺心病急性加重期的病患其的临床疗效显著,不良反应小,安全可靠,值得在临床上合理推广应用。     

几种药物联合治疗煤工尘肺合并慢性肺源性心脏病疗效观察

目的 探索煤工尘肺慢性肺心病急性加重期的治疗方法，以减少并发症、降低死亡率。方法 将80例患者随机分为两组。所有患者均接受内科常规基础治疗（吸氧、祛痰、平喘、控制感染、利尿等）；观察组在常规治疗的基础上采用卡托普利、硝酸甘油、多巴胺联合治疗，7．10d为1疗程。结果治疗组显效率为52．5％，对照组显效率22．5％。两组治疗显效率比较差异具有显著性（P〈0．05）。结论 三药联合治疗煤工尘肺合并慢性肺源性心脏病急性加重期疗效明显，值得临床应用。     

纳洛酮治疗慢性肺心病急性加重期疗效观察

目的探讨和观察纳洛酮在慢性肺心病急性加重期应用的价值和效果。方法将78例慢性肺心病急性加重期患者随机分为对照组及治疗组,两组均给予常规治疗,在此基础上,治疗组加用纳洛酮注射液,按1μg／（kg·min）的速度持续静滴10h,1次／d,10～14d为一个疗程,观察治疗前后临床疗效并作血气分析。结果治疗组总有效率为89．7％,对照组总有效率为71．8％,两组疗效比较差异有统计学意义（P〈0．05）,治疗组治疗前后对照,PaCO2明显下降,PaO2明显E升,差异有统计学意义（P〈0．01）,两组治疗后比较,治疗组PaCO2、PaO2均优于对照组,差异有统计学意义（P〈0．05或P〈0．01）。结论纳洛酮治疗慢性肺心病急性加重期疗效显著。     

红花注射液联合常规治疗慢性阻塞性肺疾病加重期47例疗效分析

目的:分析红花注射液联合常规治疗慢性阻塞性肺疾病急性加重期疗效。方法:使用随机平行对照方法,将94例住院患者随机分为两组。对照组47例常规治疗,祛痰、平喘、解痉、抗感染、纠正水电解质失衡。治疗组47例20mL红花注射液+250mL0.9%生理盐水(或5%葡萄糖溶液),1次/d,静滴。常规治疗同对照组。连续治疗15d为1疗程。观测临床症状、不良反应。治疗1疗程,判定疗效。结果:治疗组显效31例,有效9例,无效7例,总有效率85%。对照组显效20例,有效9例,无效18例,总有效率62%。治疗组疗效优于对照组(P0.01)。血液流变学指标两组均有改善(P0.01),治疗组改善优于对照组(P0.01)。结论:红花注射液联合常规治疗慢性阻塞性肺疾病急性加重期效果显著,值得推广。     

心脑舒通合用卡托普利治疗冠心病疗效观察

目的 探讨心脑舒通合用卡托普利治疗冠心病的疗效。方法 治疗组46例,给心脑舒通片2片＋卡托普利25 mg 3次/d,2周为1疗程;对照组44例,给予复方丹参注射液250 ml静脉滴注,1次/d,2周为1疗程。结果 治疗组临床总有效率（91%）,高于对照组（82%）。结论 心脑舒通片合用卡托普利治疗冠心病、心绞痛安全有效,疗效优于复方丹参注射液。     

注射用炎琥宁治疗小儿急性上呼吸道感染的疗效观察

目的探讨注射用炎琥宁(Potassium Sodium Pehydroandrographolide Succinate for Injection)治疗小儿急性上呼吸道感染的临床疗效。方法将156例急性上呼吸道感染患儿随机分为治疗组和对照组,治疗组86例给予注射用炎琥宁10 mg/(kg.d)加入5%葡萄糖注射液100～150 ml中静脉滴注,1次/d,疗程13 d。对照组70例给予利巴韦林10 mg/(kg.d)加入5%葡萄糖注射液100～150 ml中静脉滴注,1次/d,疗程3 d。观察患儿发热、鼻塞、流涕、咳嗽、打喷嚏、咽部充血、扁桃体肿大等症状及体征。结果治疗组86例中显效55例(63.95%)、好转25例(29.07%),总有效率为93.02%。对照组70例中显效29例(41.43%)、好转22例(31.43%),总有效率为72.86%。治疗组的总有效率显著高于对照组,差异有统计学意义(p<0.05)。结论注射用炎琥宁治疗小儿急性上呼吸道感染疗效好,显著优于利巴韦林,值得临床推广应用。     

COPD患者不同给药途径疗效对照

目的观察痰热清注射液雾化吸入联合静脉使用氨溴索治疗慢性阻塞性肺疾病急性加重期的疗效。方法将122例COPD急性加重期患者随机分为治疗组61例和对照组61例。治疗组在基础治疗的基础上,用痰热清注射液10ml,生理盐水20ml,进行雾化吸入,15min/次,4次/d;氨溴索45～60㎎,生理盐水100～250ml,进行静脉滴注,1～2次/d;对照组在基础治疗的基础上,用氨溴索45～60㎎,生理盐水100～250ml,进行静脉滴注,1～2次/d;两组疗程均为7d。结果治疗组总有效率及总显效率分别为93.44﹪和78.69﹪;对照组总有效率及总显效率分别为77.05﹪和59.02﹪;两组间疗效比较有显著差异(P<0.05﹚。且治疗组临床症状和体征改善率明显优于对照组(P<0.05﹚。结论痰热清注射液雾化吸入联合静脉使用氨溴索治疗慢性阻塞性肺疾病急性加重期,可明显提高疗效及改善症状和体征。     

喜炎平治疗慢性阻塞性肺疾病急性加重期35例疗效研究

目的:探讨喜炎平治疗慢性阻塞性肺疾病急性加重期的临床效果.方法:选取我院于2016年2月~2017年2月收治的慢性阻塞性肺疾病急性加重期患者70例,随机分为观察组和对照组,每组35例,对照组接受常规治疗,观察组在此基础上加用喜炎平治疗,对比两组临床疗效.结果:①观察组显效21例,总有效率91.4%,对照组显效13例,总有效率77.2%,组间差异具统计学意义(P<0.05);②治疗后,两组血气指标和pH值均有所好转,但观察组好转更为明显,与对照组相比差异具统计学意义(P<0.05).结论:喜炎平治疗慢性阻塞性肺疾病急性加重期疗效确切,值得推广.     

依那普利联合丹参酮在肺心病急性加重期患者治疗中的疗效

目的:探讨依那普利联合丹参酮在肺心病急性加重期患者中的临床疗效.方法:对我院在2010年02月到2012年10月收治的100例肺心病急性加重期患者随机分为治疗组和对照组,治疗组的患者给予依那普利联合丹参酮治疗,对照组的患者给予依那普利治疗,对两组患者在治疗前后血气和血流等进行监测.结果:治疗组临床疗效的总有效率为,对照组治疗疗效的总有效率为,治疗组临床疗效明显优于对照组(P<0.05);治疗组在治疗前后的各项指标均优于对照组患者(P<0.05).结论:依那普利联合丹参酮在肺心病急性加重期患者的临床疗效显著,值得在临床上广泛使用推广.     

长春新碱过量引起严重毒副反应1例的护理体会

报道1例霍奇金淋巴瘤患者因误用长春新碱（VCR）10mg一次性静脉推注后治疗护理情况。其出现间断性神志恍惚、眼睑闭合不全、言语不清、口腔黏膜糜烂、全身疼痛、麻痹性肠梗阻、尿潴留、手足麻木等症状,经积极解救,禁食,持续胃肠减压、胃管内注入麻油、开塞露、生理盐水灌肠,合理应用肠外营养,注重疼痛、心理护理,做好口腔、肛周护理,预防感染加重,患者病情得到控制好转出院。     

Correlates of stages of change of smoking among inhabitants of deprived neighbourhoods

BACKGROUND: This study examines the prevalence and correlates of stages of change of smoking, in terms of psychosocial, structural and sociodemographic factors, among inhabitants of deprived neighbourhoods. METHODS: Cross-sectional data were obtained from a survey on health related behaviour. Subjects were 2009 current and former smokers, aged 20-46, living in deprived neighbourhoods in Rotterdam, the second largest city in the Netherlands. Three groups of smokers were formed according to the stages of change-definitions of the Transtheoretical Model: smokers not planning to quit (precontemplators), smokers planning to quit (contemplators/preparators) and former smokers (actors/maintainers). Smokers planning to quit and smokers not planning to quit were compared regarding psychosocial factors (attitude, social norm, self-efficacy), structural factors (neighbourhood problems, material deprivation, financial problems, employment status) and sociodemographic factors (age, gender, marital status, cultural background, educational level). Former smokers were compared with smokers planning to quit regarding structural and sociodemographic factors. Logistic regression was used to assess correlates of stages of change. RESULTS: Smokers planning to quit (prevalence = 19%) reported a more positive attitude, stronger social norms and higher self-efficacy expectations in quitting smoking than smokers not planning to quit (prevalence = 57%). Smokers planning to quit less often were Dutch-born, more often had attended higher vocational schooling or university and more often reported experiencing two or more neighbourhood problems compared to smokers not planning to quit. Former smokers (prevalence = 24%) were older, more often Dutch-born, married, employed and higher educated, compared to smokers planning to quit. Furthermore, former smokers less often reported material deprivation and financial problems than smokers planning to quit. CONCLUSION: Among people living in deprived neighbourhoods, different factors correlate with different stages of change of smoking. Implications for health promotion are discussed.     

Choice of measures of vaccination and estimates of risk of pediatric pertussis

BackgroundVaccination uptake at the individual level can be assessed in a variety of ways, including traditional measures of being up-to-date (UTD), measures of UTD that consider dose timing, like age-appropriate vaccination, and risk reduction from individual doses. This analysis compared methods of operationalizing vaccination uptake and corresponding risk of pertussis infection.MethodsCity-wide case-control study of children in Philadelphia aged 3 months through 6 years, between 2001 and 2013. Multiple logistic regression was used to isolate the independent effects of each measure of vaccination uptake and the corresponding relative odds of pertussis.ResultsBeing UTD on vaccinations was associated with a 52% reduction in risk of pertussis (OR 0.48, 95% CI: 0.34, 0.69). Evaluation of delayed receipt of vaccine versus on-time UTD yielded similar results. There was a decrease in risk of pertussis for each additional dose received with the greatest reduction in pertussis infection observed from the first (OR 0.48, 95% CI: 0.28, 0.83) and second dose (OR 0.17, 95% CI: 0.08, 0.34). Additional doses conferred minimal additional protection in this age group.ConclusionExamining vaccination status by individual doses may offer improved predictive capacity for identifying children at risk for pertussis infection compared to the traditional UTD measure.     

上海市某医院骨科平均住院日影响因素分析

对上海市某医院2003年-2007年骨科出院病人的住院日描述性分析．2003年-2007年骨科的床位利用指数与平均住院日相关性分析．2003年-2007年骨科床位与医护比例分析．2007年骨科前10大病种平均住院目影响因素分别进行单因素相关性分析和多因素逐步回归分析（STATA软件）。通过对骨科10大病种住院日影响因素分析,术前等待天数、手术类型、是否输血分别对10个、9个和8个病种的住院目有影响。输血因素和手术类型是医院不可控、由病人的病情决定的,术前等待天数是管理因素,是最值得医院重视的影响因素。     

两种不同肌瘤剔除术治疗子宫肌瘤的临床疗效比较

目的:比较腹腔镜子宫肌瘤剔除术与腹式子宫肌瘤剔除术的临床疗效。方法:回顾分析63例腹腔镜子宫肌瘤剔除术与61例腹式子宫肌瘤剔除术的临床资料,比较2种手术方式的手术时间、术中出血量、肛门排气时间、使用抗生素时间、术后感染率、体温恢复正常时间、住院时间等情况。结果:两组患者接受子宫肌瘤剔除术顺利完成,腹腔镜组手术时间长于开腹组(P0.05),腹腔镜组术中出血量及剔除肌瘤个数均少于开腹组(P0.05),术后腹腔镜组体温恢复正常时间、肛门排气时间、抗生素使用及住院时间均短于开腹组,两组患者最多随访6个月,腹腔镜组平均康复时间较开腹组短(P0.05),两组随访B超均未发现明显肌瘤结节。结论:腹腔镜子宫肌瘤剔除术损伤小,恢复快,住院时间短,是值得推广的微创手术。     

尘肺病患者145例死因调查

目的分析汉中市尘肺病的发生、发展和死亡原因，以提高尘肺病患者的生存质量。方法对145例尘肺病患者的死因进行回顾性分析，计算其平均发病年龄、死亡年龄及患尘肺病后的存活年限。结果矽肺的平均发病年龄和死亡年龄均早于煤工尘肺和石棉肺，尘肺病的主要死因为患肺部疾患，患尘肺病后的平均存活年限为12a。结论加强职业健康体检工作，对尘肺病人做到早发现早治疗和预防并发症的发生。     

性发育异常发病机制的研究进展

正常的性腺分化可分为3个过程：原始性腺形成、性别决定和卵巢/睾丸发育。在任一环节中,基因表达或调控发生异常均有可能导致性发育异常疾病的发生。性发育异常是指染色体、性腺和解剖性别不典型。随着分子生物学技术的发展,不断地发现新的基因或信号通路参与性腺分化和发育,如SRY、SF1、WT1、Sox9等基因与睾丸发育密切相关,Wnt/Rspo1/B连环蛋白通路、Dax1、Foxl2等基因在卵巢分化中发挥着重要作用,一些非编码RNA和转化生长因子也有重要的调节功能,且睾丸和卵巢发育均为主动过程,即使在出生后因某些基因的改变两者间也可出现横向分化。这些为揭示性分化异常的发病机制提供了可能。     

西林瓶装注射用水的装量检查分析

为了检查西林瓶装注射用水的实际分装量是否符合2005年版《药典》三部要求,按照2005年版《药典》三部中“生物制品分装和冻干规程”,分装规格为0．8ml的西林瓶装注射用水10000瓶,随机在分装过程的前、中、后阶段共抽取100瓶,轧盖、目检。分别用1ml标定注射器及1ml普通无菌注射器抽取每瓶注射用水的实际体积,以t检验法对实际抽取量与标示量的差值进行统计学分析,结果显示其与2005年版《药典》三部要求分装附加量为0．1ml相比有显著性差异（P〈0．001）。     

One-year stability of the Measure of Processes of Care

BACKGROUND: The Measure of Processes of Care (MPOC) is a 56-item self-administered measure designed to examine what parents of a child with a chronic health problem think of the services they and their child receive, and to measure the extent to which these services are family-centred. Reliability and validity of the MPOC were established in prior studies. The aim of the present study was to assess the 1-year stability of the MPOC to justify its use as an evaluative tool. METHODS: Nine paediatric rehabilitation centres in the Netherlands participated in this short longitudinal survey study. Subjects were 205 parents (response rate 74.8%) of children aged 1-18 years who received care in one of the participating paediatric rehabilitation centres. All subjects filled out two MPOCs with a 1-year interval. RESULTS: All correlations between the scale scores of the MPOC at the first and second administration were relatively high and significant (range: 0.443-0.609, all P < 0.001), demonstrating high inter-individual stability. However, all mean scale scores, except for Providing General Information, significantly reduced after 1 year. CONCLUSIONS: The MPOC has a moderate 1-year stability. However, because of its tendency to score lower when repeated after 1 year, its use as an evaluative follow-up instrument to assess the effectiveness of a programme intervention is restricted.     

儿童皮质发育畸形的MRI诊断

目的探讨儿童皮质发育畸形(MCD)的MRI表现特点,为MCD的早期诊断提供依据。 方法选择2010年1月至2012年12月在四川省医学科学院·四川省人民医院放射科经MRI检查确诊为MCD的44例患儿为研究对象。回顾性分析及总结其MRI影像学特征。本研究遵循的程序符合四川省医学科学院·四川省人民医院人体试验委员会制定的伦理学标准,得到该委员会批准,征得受试对象及其监护人知情同意,并与监护人签署临床研究知情同意书。 结果本组44例经MRI确诊为MCD患儿中,巨脑回-无脑回为17例,多小脑回为14例,灰质异位为9例,脑裂畸形为4例。MCD的MRI特点中,巨脑回表现为脑回增宽、皮质增厚及白质变薄;无脑回表现为正常脑沟、脑回消失,皮质增厚及白质变薄;多小脑回表现为脑回增多、细小;灰质异位表现为皮质下及侧脑室周围深部白质区结节状、团块状或带状病灶,信号与灰质信号相同;脑裂畸形表现为从侧脑室到脑表面贯穿大脑半球的裂隙,表面覆盖灰质。 结论MRI是诊断儿童MCD的可靠影像学方法。