黄芪桂枝五物汤加减治疗椎动脉型颈椎病54例

目的 观察黄芪桂枝五物汤加减治疗椎动脉型颈椎病的疗效.方法 口服益气养血、活血通络汤剂治疗椎动脉型颈椎病.结果 可以明显缓解眩晕,提高治疗效果,缩短疗程.结论 椎动脉型颈椎病采用口服中药治疗,疗效确切.     

微波加脉冲治疗椎动脉型颈椎病的TCD疗效观察

目的：观察微波加脉冲治疗椎动脉型颈椎病的疗效。方法椎动脉型颈椎病90例、平均年龄53岁,采用经颅多普勒超声仪,对患者治疗前后椎动脉(VA)、基底动脉(BA)的峰值血流速度(Vp)、舒张末血流速度(Vd)、平均血流速度(Vm)进行检测分析。结果患病组治疗前后Vp Vm间差异均有统计学意义(<0.01)。结论 TCD可作为椎动脉型颈椎病诊断和疗效评定的一种手段,脉冲加微波是治疗椎动脉型颈椎病的一种方法。     

定坤汤联合敏使朗治疗椎动脉型颈椎病的临床疗效分析

目的观察定坤汤联合敏使朗治疗椎动脉型颈椎病的临床效果。方法随机选取106例门诊椎动脉型颈椎病患者,将106例患者随机分为治疗组与对照组,每组各53例。治疗组给予口服定坤汤、敏使朗,对照组给予口服敏使朗,分别观察治疗前后两组患者临床症状的变化。结果治疗组痊愈31例,显效11例,有效6例,无效5例,总有效率为90.57%;对照组痊愈21例,显效8例,有效12例,无效12例,总有效率为77.36%,两组疗效比较差异有统计学意义（P〈0.01）。结论定坤汤联合敏使朗治疗椎动脉型颈椎病的疗效可靠,值得临床推广应用。     

复方丹参直流电导入对椎动脉型颈椎病血液流变性的影响

颈椎病是一种常见多发病。颈椎的退行性变可能影响脊髓、神经根、椎动脉及交感神经，因而表现出多种多样的临床症状，形成几种不同类型的颈椎病。椎动脉型颈椎病（CSA）是颈椎病的一种类型，颈椎病患者中40％属此类型，其发病率仅次于神经根型颈椎病，严重危害中老年人的健康。本研究观察了CSA血液流变学状态及复方丹参直流电导入治疗对其影响。     

复方丹参片对麻醉犬脑循环的影响

目的观察复方丹参片对麻醉犬脑循环的影响.方法股动脉插管,测量血压,分离椎动脉和颈内动脉,用电磁流量计进行测量.结果给药后椎动脉和颈内动脉流量增加.结论复方丹参片能增加脑血流,减少脑血管阻力,具有改善麻醉犬脑循环的作用.     

针灸治疗椎动脉型颈椎病的研究现状及思考

目的探究针灸治疗椎动脉型颈椎病的研究现状和进展。方法研究分析2009~2012年期间针灸治疗椎动脉型颈椎病的方式和效果。结果针灸治疗椎动脉型颈椎病治疗效果显著，治疗穴位主要有风池、风府、百会穴等。结论针灸是治疗椎动脉型颈椎病的有效方式，值得临床推广。     

彩色多普勒和经颅多普勒对椎动脉型颈椎病牵引治疗效果的评价

背景:适宜方向、角度的牵引对于椎动脉型颈椎病疗效显著。选择性血管造影被公认为是确定血管疾病的"金标准",核磁共振血管造影虽为无创性检查,却存在检查时间较长、易受人为因素影响、具有一定侵袭性等不足。目的:通过彩色多普勒和经颅多普勒加转颈试验,对不同牵引方向和牵引角度治疗前后椎动脉型颈椎病患者血流参数变化进行比较分析。方法:选择椎动脉型颈椎病患者240例,根据解剖学角度按病变部位(上颈段病变、下颈段病变、混合型)和牵引方式、角度(坐位前倾分1°～10°、11°～20°、21°～30°组,坐位后伸1°～10°、11°～20°、21°～30°组,坐位中立位组)分组,以局部按摩为对照组。通过彩色多普勒加转颈试验检测治疗前后椎动脉最窄部位血管内径、收缩期峰值速度、平均血流速度。通过经颅多普勒加转颈试验测量治疗前后左、右椎动脉和基底动脉的收缩期峰值血流速度、平均血流速度等血流参数,并进行比较分析。结果与结论:①根据解剖部位确立了椎动脉型颈椎病的类型。椎动脉型颈椎病根据病变部位划分为上颈段(C1～C3)、下颈段(C4～C6)和混合型,这从椎骨形态和力学角度等方面为临床牵引治疗提供了指导。②确定了最佳牵引角度。即上颈段椎动脉型颈椎病患者坐位后伸11°～20°牵引疗效较好,下颈段椎动脉型颈椎病患者坐位前屈11°～20°牵引疗效较好,混合型椎动脉型颈椎病患者坐位前屈1°～10°疗效较好。③确立了彩色多普勒及经颅多普勒超声检测是指导椎动脉型颈椎病牵引治疗的简便、无创、安全可靠、重复性好的验证手段。     

高压氧干预交感神经型颈椎病患者椎基底动脉血流的变化

背景：交感型颈椎病病因、发病机制尚不明确,目前无明确的客观检查标准,经颅多普勒超声仪能够直接对椎-基底动脉系统进行血流动力学监测,可作为交感神经型颈椎病诊断的一项客观指标。高压氧治疗对交感型颈椎病患者椎基底动脉血流速度影响的报道较少。 目的：观察高压氧治疗对交感神经型颈椎病患者椎基底动脉血流速度及疗效的影响。 方法：将交感神经型颈椎病患者随机分为2组,观察组采用德国吕内堡医疗公司的电脑控制脉冲牵引和多人空气加压高压氧舱治疗;对照组仅采用德国吕内堡医疗公司的电脑控制脉冲牵引治疗。治疗前后均采用经颅多普勒超声仪检查右椎动脉、左椎动脉、基底动脉多普勒血流速度的变化情况。 结果与结论：观察组血流减慢41例患者在治疗后双侧椎动脉、基底动脉血流速明显增快(P < 0.01);血流增快22例患者治疗后双侧椎动脉、基底动脉血流速明显减低(P < 0.01)。对照组患者除左椎动脉收缩期血流速度及基底动脉舒张期血流速度有改变外,余无明显改变。观察组患者治愈率及总有效率显著高于对照组(P < 0.01)。提示高压氧对交感神经型颈椎病患者椎基底动脉血流速度有明显改善作用,具有双相调节性,血流速度监测可作为交感神经型颈椎病诊断和疗效判定的一项客观依据。同时高压氧是治疗交感神经型颈椎病较有效的方法。     

ES-100D失眠治疗仪对椎动脉型颈椎病继发睡眠功能障碍的影响

要目的：探讨ES-100D失眠治疗仪对椎动脉型颈椎病继发睡眠功能障碍的影响。方法：60例椎动脉型颈椎病继发睡眠功能障碍患者，经ES-100D失眠治疗仪治疗14天。观察睡眠功能改善及治疗前后听觉诱发电位变化情况。结果：经ES-100D失眠治疗仪治疗后，患者睡眠功能明显改善，总有效率为86．67％；治疗后听觉诱发电位中的Ⅱ、Ⅲ、Ⅴ波有显著性差异（P〈0．05或P〈0．01）。结论：ES-100D失眠治疗仪对椎动脉型颈椎病继发睡眠功能障碍有明显的疗效，同时明显改善脑干诱发电位。     

椎动脉型颈椎病的脑电图及临床分析

目的:了解椎动脉型颈椎病的脑电图(EEG)改变。方法:对120例椎动脉型颈椎病患者的EEG进行分析。结果:椎动脉型颈椎病患者EEG异常率为59.17%,且男、女性患者EEG表现无显著差异。结论:EEG对椎动脉型颈椎病有一定诊断价值。     

阴道放置米索前列醇在终止6~10周妊娠负压吸宫术前的应用

目的 探讨米索前列醇在终止6~10周妊娠负压吸宫术前的应用效果。方法 选取2018年5月~2019年5月我院收治的终止6~10周妊娠患者129例,按照随机数字表法分为对照1组、对照2组和研究组,每组43例。对照1组术前不使用药物干预,对照2组术前口服米索前列醇片联合米非司酮进行干预,研究组术前3 h阴道放置米索前列醇干预,比较三组宫颈软化程度、手术情况、出血量、人流综合征、术后疼痛、宫颈粘连及感染发生情况。结果 研究组宫颈软化有效率高于对照1组、对照2组（P＜0.05）;对照2组宫颈软化有效率高于对照1组（P＜0.05）;研究组手术时间、出血量、疼痛以及人流综合征发生低于对照1组、对照2组,且对照2组低于对照1组（P＜0.05）;研究组并发症发生率低于对照1组、对照2组,且对照2组并发症发生率低于对照组1组（P＜0.05）。结论 对于接受负压吸宫术治疗的妊娠10周内患者,术前3 h阴道置入米索前列醇进行治疗,可以有效提高患者宫颈软化效果,缩短手术时间,减少出血量,降低术后疼痛以及人流综合征的发生,提高负压吸宫术的治疗安全性,可在临床中进一步应用。     

Haemolytic uraemic syndrome: evidence of multiple viral infections in a cluster of ten cases

During July 1979, ten patients were admitted to the hospital with bloody diarrhoea followed by manifestations of haemolytic uraemic syndrome (HUS): acute microangiopathic haemolytic anaemia, intravascular coagulopathy, and impaired renal function. Ages ranged from 13 months to 58 yr, with only two patients more than 5 yr old. In a household that included seven children born to three sisters who married three brothers, six children required hospitalization for bloody diarrhoea and four developed HUS; the father of one case and the maternal grandmother also developed bloody diarrhoea. Echovirus type 11 was isolated from the pharyngeal secretions or faeces of all members of the household with bloody diarrhoea, with the exception of the grandmother. Picornavirus-like particles were seen by direct electron microscopy (E/M) in faeces from four other HUS patients and an adenovirus in one, but these viruses failed to replicate in cell cultures. Parvovirus-like particles were seen by E/M in faeces from six patients. Serological examination indicated recent infection with one or more enteroviruses (echovirus 11, coxsackieviruses A4, B2, B4) in nine cases. Combined viral studies revealed presumptive evidence of recent infection with two or more viruses in all of the patients with HUS. Stools were negative for bacterial pathogens including campylobacter, salmonella, shigella, and yersinia organisms. Only one of nine patients tested had circulating immune complexes. Our data support the concept that the pathology seen in HUS may be due to a Shwartzman-type reaction provoked by concurrent infection with two or more viral agents.     

The epidemiology and clinical aspects of the hemolytic uremic syndrome in Minnesota

BACKGROUND. The frequency of the hemolytic uremic syndrome, characterized by microangiopathic hemolytic anemia, thrombocytopenia, and renal failure, is increasing. Although Escherichia coli serotype O157:H7 has been implicated as a causative agent, more information is needed about the basic epidemiology and clinical aspects of this syndrome. METHODS. We conducted a retrospective population-based study of hemolytic uremic syndrome in Minnesota residents less than 18 years of age from 1979 through 1988 to assess trends in disease occurrence, describe the clinical illness, and identify predictors of disease severity and outcome. We also conducted a case-control study of patients with onsets of illness from 1986 through 1988 to examine risk factors. RESULTS. One hundred seventeen patients were identified. The mean annual incidence increased from 0.5 case per 100,000 child-years among children less than 18 in 1979 (6 cases) to 2.0 cases per 100,000 in 1988 (26 cases) (P = 0.000004). E. coli O157:H7 was isolated from 13 of 28 patients (46 percent) who had stool specimens submitted for testing. For those who presented with typical hemolytic uremic syndrome, an elevated polymorphonuclear-leukocyte count on hospital admission, a shorter duration of prodrome, and the presence of bloody diarrhea were predictive of severe disease. In the case-control study, the patients were more likely to attend large daycare centers (more than 50 children) than were the controls (odds ratio, 10.2; P = 0.03), suggesting that day-care attendance may be a risk factor. On the basis of the population-attributable risk, however, this factor could account for no more than 16 percent of the cases. CONCLUSIONS. This study provides evidence for an increase in the incidence of hemolytic uremic syndrome, which is probably related to an increased incidence of E. coli O157:H7 infections. Hemolytic uremic syndrome has become an important pediatric and public health problem.     

Colonic biopsy in verotoxin-induced hemorrhagic colitis and thrombotic thrombocytopenic purpura (TTP)

Sporadic cases and occasional outbreaks of hemorrhagic colitis recently have been associated with the rare Escherichia coli serotype O157:H7, which is now recognized as an important identifiable cause of bloody diarrhea in patients in whom more common gut pathogens cannot be detected. The authors report such a case in a 49-year-old woman who developed thrombotic thrombocytopenic purpura (TTP) and hemorrhagic transverse and descending colitis with a lesion having many of the features of pseudomembranous colitis. While pseudomembrane formation has been described in the hemolytic uremic syndrome (HUS), these features have not, to the authors' knowledge, been described in a patient with hemorrhagic colitis and TTP secondary to a verotoxin-producing serotype of E. coli.     

颈椎不稳与椎动脉缺血动物模型的实验与构建

背景：颈椎病是颈椎椎间盘组织退行性改变及其继发病理改变累及其周围组织结构。颈椎不稳与椎-基底动脉缺血的动物模型是研究颈椎病病理生理以及治疗的关键。 目的：对颈椎不稳与椎-基底动脉缺血的动物模型进行阐述,探讨动物模型实验研究的新进展。 方法：由作者应用计算机检索PubMed数据库及CNKI数据库1979至2012年,在英文标题和摘要中以“cervical instability,basal - vertebral artery ischemia”和“animal model”检索,中文文献检索以“颈椎不稳,椎动脉缺血,动物模型”为关键词,选择内容与颈椎不稳、椎动脉缺血、动物模型相关的文章,同一领域文献则选择近期发表或发表在权威杂志文章,共纳入43篇文献。 结果与结论：目前建立合适的理想的颈椎病模型尚需继续探讨。利用动物颈椎病模型进行的研究,目前多集中在病因、发病机制和生物化学等方面,由于颈椎病的病因及发病机制目前尚不清楚,现有的造模方法难以全面重现人类颈椎病模型,故模型成立、阳性率及造模时间合适的、理想的颈椎病模型尚需探讨。 中国组织工程研究杂志出版内容重点：肾移植;肝移植;移植;心脏移植;组织移植;皮肤移植;皮瓣移植;血管移植;器官移植;组织工程全文链接：     

17beta-estradiol vaginal tablet versus conjugated equine estrogen vaginal cream to relieve menopausal atrophic vaginitis

OBJECTIVES: The efficacy and safety of 25-microg 17beta-estradiol vaginal tablets (Vagifem) were assessed and compared with 1.25-mg conjugated equine estrogen vaginal cream (Premarin Vaginal Cream) for the relief of menopausal-derived atrophic vaginitis, resulting from estrogen deficiency. DESIGN: In a multicenter, open-label, randomized, parallel-group study, 159 menopausal women were treated for 24 weeks with either vaginal tablets or vaginal cream. Efficacy was evaluated by relief of vaginal symptoms and concentrations of serum estradiol and follicle-stimulating hormone. Safety was monitored by the incidence of adverse events, evaluation of endometrial biopsies, and clinical laboratory results. Patients also assessed the acceptability of the study medications. RESULTS: Composite scores of vaginal symptoms (dryness, soreness, and irritation) demonstrated that both treatments provided equivalent relief of the symptoms of atrophic vaginitis. At weeks 2, 12, and 24, increases in serum estradiol concentrations and suppression of follicle-stimulating hormone were observed in significantly more patients who were using the vaginal cream than in those who were using the vaginal tablets (p < 0.001). Fewer patients who were using the vaginal tablets experienced endometrial proliferation or hyperplasia compared with patients who were using the vaginal cream. Significantly more patients who were using the vaginal tablets rated their medication favorably than did patients who were using the vaginal cream (p < or = 0.001). Patients who were receiving the vaginal tablets also had a lower incidence of patient withdrawal (10% versus 32%). CONCLUSIONS: Treatment regimens with 25-microg 17beta-estradiol vaginal tablets and with 1.25-mg conjugated equine estrogen vaginal cream were equivalent in relieving symptoms of atrophic vaginitis. The vaginal tablets demonstrated a localized effect without appreciable systemic estradiol increases or estrogenic side effects. Vaginal tablet therapy resulted in greater patient acceptance and lower withdrawal rates compared with vaginal cream therapy.     

cyclin E、pl6ink4、ki67在宫颈脱落细胞中的表达及其与HPV16／18感染的相关性

目的研究cyclin E、p16ink4、ki67在宫颈脱落细胞中的表达水平及其与HPV16/18感染的相关性,探讨其对宫颈癌高危人群筛查的意义.方法采用免疫组织化学方法对78例官颈脱落细胞标本进行cyclin E、p16ink4、ki67检测,同时应用多重引物PCR技术检测HPV16/18.结果cyclin E、p16ink4、ki67在宫颈癌细胞中的表达水平均较鳞状上皮非典型增生(ASCUS)差异有统计学意义(P＜0.005);各级宫颈癌细胞中HPV16的阳性率均较ASCUS差异有统计学意义(x2=25.27,P＜0.005),且随着宫颈上皮细胞损伤程度加重阳性率升高,差异也有统计学意义(P＜0.01).p16ink4和ki67在宫颈癌细胞中的表达水平与HPV16高度相关(rs=1.0,P＜0.05);而cyclin E的表达与HPV16相关性较小(rs=0.4,P＜0.05).HPV18阳性例数较少,在各项分析中差异均无统计学意义(x2=3.68,P＞0.05).结论官颈癌细胞中cyclin E、p16ink4及ki67的高度表达与HPV16感染有关;它们均可能作为有价值的诊断指标应用于宫颈癌高危人群筛查,且cyclin E对宫颈癌的早期诊断意义更大.     

当归芍药散加味治疗颈性眩晕临床研究

目的:观察当归芍药散加味治疗颈性眩晕的疗效。方法:将57例患者随机抽出治疗组30名,用当归芍药散加味治疗。对照组27例用西比灵胶囊加甲磺酸倍他司汀片(敏使朗)治疗。结果:总有效率治疗组86.7%,对照组55.6%,差异有显著意义(P<0.05)。结论:当归芍药散加味对颈性眩晕有较好的疗效。     

LEEP刀宫颈环形电切术治疗宫颈上皮内瘤变102例临床观察

目的 分析LEEP刀宫颈环形电切术治疗宫颈上皮内瘤变疗效.方法 在200例宫颈上皮内瘤变患者中,102例患者采用LEEP刀宫颈环形电切术进行治疗,作为治疗组;98例患者采用传统冷刀宫颈锥切术进行治疗,作为对照组,分别比较了两种手术方法的手术时间、手术中出血量、切口愈合时间及手术前后病理变化.结果 对照组和治疗组疗效相当,治疗组手术时间以及切口愈合时间出血量少,具有显著统计学意义(P＜0.05).结论 该法术中出血量较少,优于冷刀宫颈锥切术,值得临床推广使用.     

Humoral Immune Response against Proteins E6 and E7 in Cervical Carcinoma Patients Positive for Human Papilloma Virus Type 16 during Treatment and Follow-Up

 To investigate the humoral immune response to transforming proteins E6 and E7 of human papillomavirus type 16 before and after treatment and during follow-up, consecutive serum samples from 36 cervical cancer patients whose tumours were found to contain human papillomavirus type 16 DNA by use of the polymerase chain reaction were tested using in vitro translated proteins E6 and E7 in a radioimmunoprecipitation assay and in an E7 synthetic peptide enzyme immunoassay. Antibody levels against E6 and E7 as measured by radioimmunoprecipitation assay showed a nearly identical pattern. Seronegative patients remained seronegative throughout treatment and follow-up. Seropositive patients showed either a decrease in antibody level or stable antibody levels during treatment. In contrast to patients without evidence of disease at the end of the study, the majority of patients with recurrent disease showed increasing antibody levels during the follow-up period. These results indicate that, in patients who are seropositive before treatment, antibody levels against E6 and E7 of human papillomavirus type 16 after treatment are closely linked to treatment response. The use of the more sensitive radioimmunoprecipitation assay did not lead to a better correlation of antibody levels with clinical disease status of the patients than the use of the enzyme immunoassay.