支气管肺泡灌洗术联合局部应用敏感抗生素对慢性阻塞性肺疾病合并支气管扩张患者的疗效

目的分析支气管肺泡灌洗术(BAL)联合局部应用敏感抗生素对慢性阻塞性肺疾病(慢阻肺)合并支气管扩张患者的肺功能、血气分析、炎症因子和气道阻力的影响。方法回顾性分析2018年1月至2021年1月在聊城市第二人民医院接受治疗的慢阻肺合并支气管扩张患者154例, 根据患者是否接受BAL将其分为对照组(63例)和观察组(91例)。对照组男35例、女28例, 年龄(58.3±8.3)岁, 采用常规治疗;观察组男56例、女35例, 年龄(57.8±7.1)岁, 在对照组基础上结合BAL治疗。比较两组治疗前和治疗10 d后肺功能指标[肺活量(VC)、第1秒用力呼气量(FEV1)、FEV1占用力肺活量比值(FEV1/FVC)、FEV1占预计值比值(FEV1/pre)、最大呼气流速峰值(PEF)]、血气分析指标[动脉血氧分压(PaO2)、动脉血氧饱和度(SaO2)、动脉血二氧化碳分压(PaCO2)]、炎症因子水平[超敏-C反应蛋白(hs-CRP)、肿瘤坏死因子-α(TNF-α)、降钙素原(PCT)、白细胞介素-6(IL-6)]、气道阻力指标[响应频率(Fres)、呼吸总阻抗(Zrs)、5 Hz时总气道阻...     

利那洛肽联合聚乙二醇对比番泻叶联合聚乙二醇在便秘病人肠道准备中的应用

目的 对比利那洛肽联合聚乙二醇（PEG）与番泻叶联合聚乙二醇对便秘病人肠道准备的有效性及安全性。方法 选取2020年10月至2022年5月在蚌埠医学院附属阜阳医院行肠镜检查的便秘病人150例,按数字表法分为A、B、C三组,每组50例。肠镜检查前,A组病人服用利那洛肽+2L PEG、B组病人服用番泻叶颗粒+2L PEG、C组病人服用3L PEG,其中C组为对照。主要观察指标为肠道准备效果,该指标根据波士顿肠道准备量表（BBPS）进行评分,次要观察指标为息肉检出率、再次肠道准备意愿及不良反应发生率。结果 A组病人三段BBPS评分[（2.22±0.65）分、（2.12±0.66）分、（2.12±0.69）分]、B组病人三段BBPS评分[（2.08±0.75）分、（2.02±0.74）分、（1.86±0.76）分]均优于C组[1.70±0.54）分、（1.60±0.58）分、（1.46±0.50）分]（均P<0.05）。A、B组总BBPS评分[（6.46±1.05）分、（5.96±1.03）分]优于C组（5.00±0.99）分（均P<0.05）,A组病人总BBPS评分优于B组（6....     

加替沙星相关血糖异常临床病例分析

目的:了解加替沙星对住院患者血糖水平的影响。方法:通过计算机管理系统进行回顾性研究,对2005年6月1日至2006年6月1日732例应用加替沙星患者及32例应用红霉素患者的血糖数据进行分析与比较,并采用排除法结合病例分析对加替沙星致血糖异常的因果关系与危险因素进行评估。结果:加替沙星引起血糖异常35例,其中高血糖27例(3.69%),低血糖8例(1.09%)。此外,35例中,非糖尿病患者为24例(68.57%),老年患者(>60岁)为27例(77.14%)。所有患者在停药及相应治疗后均恢复正常。32例应用红霉素患者未出现血糖异常。结论:加替沙星可引起血糖异常,尤其是老年患者。临床医师应了解该不良反应的风险,对使用加替沙星的患者进行血糖监测以保障患者安全。     

Interaction of triazolam with desipramine

The present study was undertaken to evaluate the effects of single and repeated doses of triazolam (1 mg/kg IP) and desipramine (DMI) (10 mg/kg PI) alone and in combination on certain pharmacologic responses and brain catecholamine levels in rats. The significant findings were: (1) triazolam and DMI given alone and in combination were synergistic with pentobarbital (PB) hypnosis; (2) repeated treatment with DMI alone repressed body weight gain; triazolam potentiated this anorectic effect; (3) triazolam induced muscle relaxation acutely, but was not affected by concomitant DMI treatment; and (4) triazolam and DMI given in combination produced hypothermia although the drugs given separately did not. Development of tolerance to hypothermia and to anorectic effects produced by triazolam and DMI significantly decreased norepinephrine (NE) levels in the hypothalamus as compared to the repeated treatment with triazolam, and significantly increased NE and dopamine (DA) levels in the striatum and DA levels in the cortex, as compared to the single treatments.     

药物联合神经阻滞治疗带状疱疹后神经痛的临床观察

目的观察药物联合神经阻滞治疗带状疱疹后神经痛的临床疗效。方法带状疱疹后神经痛患者37例,根据受损部位不同给予相应的神经阻滞,并联合药物进行综合治疗。于治疗后的第1、2、3、4周进行视觉模拟(VAS)和睡眠质量(QS)评分。结果治疗后1、2、3和4周VAS评分分别为(4.68±1.69)分、(3.13±0.53)分、(2.06±0.41)分和(1.10±0.58)分,均明显低于治疗前的(7.92±1.32)分(P<0.05);治疗后1、2、3和4周的QS评分分别为(1.50±0.52)分、(0.89±0.45)分、(0.74±0.37)分和(0.55±0.24)分,均明显低于治疗前的(3.15±0.68)分(P<0.05)。结论药物联合神经阻滞治疗带状疱疹后神经痛疗效好,能迅速解除疼痛,缓解临床症状。     

硝酸甘油缓释薄膜治疗冠心病心绞痛163例

本文报告用广州市医工所研制的硝酸甘油缓释薄膜(护心乐)治疗心绞痛163例,显效63例(38.9％),有效80例(49.1％),总有效率87.7％,效果较满意。有些患者发生头胀痛、贴敷处皮肤发红、发痒,个别起水疱等副作用,大多可耐受。此药能治疗频繁发作的心绞痛,应用方便。     

钉棒系统结合经椎体内与后外侧植骨治疗胸腰椎骨折

目的 分析钉棒系统结合椎体内及后外侧植骨治疗胸腰椎骨折近、远期疗效.方法 胸腰椎椎体骨折患者37例,采用AF及钉棒系统固定并进行伤椎植骨,术前、术后及末次随访对节段Cobb角、伤椎矢状位指数(SI)进行评价.结果 术后Cobb角和SI指数分别为(6.57±3.81)度和(7.84±5.40)度,末次随访分别为(7.18±4.13)度和(8.37±4.62)度,均明显小于术前的(21.95±4.74)度和(24.92±4.46)度(P＜0.01).结论 钉棒系统结合椎体内植骨联合后外侧植骨技术能够明显改善胸腰椎骨折患者阶段Cobb角及SI指数.     

生长抑素针联合三腔两囊管治疗肝硬化合并EGVB患者的效果

目的观察生长抑素针+三腔两囊管对肝硬化合并食管胃底静脉曲张破裂出血(EGVB)患者的疗效。方法本文为前瞻性随机对照试验, 选取2020年1月至2022年5月期间南阳医学高等专科学校第一附属医院收治的65例肝硬化合并EGVB患者为研究对象, 采用计算机随机数字表法将其分为观察组(33例)和对照组(32例)。观察组男20例、女13例, 年龄(65.11±0.22)岁;对照组男22例、女10例, 年龄(65.14±0.16)岁。两组患者均予以三腔两囊管治疗, 观察组采用生长抑素针辅助治疗。比较两组患者治疗后不同时间点止血成功率、治疗前后胃肠激素、血流动力学指标以及治疗后临床指标、不良反应发生情况。采用χ2检验、独立样本t检验。结果在不同治疗方案下, 观察组治疗8、12、24 h后止血成功率[33.33%(11/33)、60.61%(20/33)、90.91%(30/33)]均高于对照组[18.75%(6/32)、43.75%(14/32)、68.75%(22/32)], 差异均有统计学意义(均P<0.05)。治疗前, 两组患者生长激素(SS)、胃泌素(GAS)、胃动素(MLT)水平比较...     

丙戊酸钠联合拉莫三嗪治疗不同类型儿童癫痫的临床对比

目的 观察丙戊酸钠联合拉莫三嗪治疗不同类型儿童癫痫的临床效果.方法 选取本院收治的儿童癫痫患者127例,根据癫痫类型分为部分发作型(PS)组(52例)、部分发作继发全面发作(SGS)组(37例)、全面性发作(GS)组(28例)和Lennox Gastaut综合征(LGS)组(10例).所有患者均给予丙戊酸钠联合拉莫三嗪治疗,观察各组临床治疗效果.结果 SGS组完全控制率为35.14％,明显高于其他3组(P＜ 0.05);LGS组全控制率最低,为0.00％.SGS组治疗总有效率为64.86％,明显高于其他3组(P＜0.05);LGS组治疗总有效率最低,为30.00％.与治疗前比较,各组发作频次均有不同程度减少,差异均有统计学意义(P＜0.05).结论 丙戊酸钠联合拉莫三嗪治疗不同类型儿童癫痫均有不同程度的效果,均能够显著减少患儿癫痫发作次数,其中以SGS疗效最为明显.     

Treatment of advanced malignancies with ifosfamide under protection with mesna

Fifty-seven patients with advanced malignant tumours were treated with ifosfamide (Holoxan) and mesna (Uromitexan) in our department from November 1979 to December 1984. This series comprised eight cases of soft tissue sarcoma, nine cases of ovarian carcinoma, five cases of non-seminomatous testicular tumour, 11 cases of bronchogenic carcinoma, three cases of renal carcinoma, seven cases of non-Hodgkin's lymphoma, two cases of skeletal fibrosarcoma, two cases of breast carcinoma, one case each of Ewing's tumour, prostatic carcinoma, seminoma, plasma cell tumour, multiple myeloma, malignant teratoma, nasopharyngeal carcinoma, Wilms's tumour, neuroblastoma and mycosis fungoides. Out of these 57 cases, 53 were evaluable. There were five complete remissions and 20 partial remissions, corresponding to a total response rate of 47%. The overall median survival time (MST) of the 53 evaluable patients was 7.5 months. The responders had a longer survival time (MST 10 months) than the non-responders (MST 4.75 months) (p greater than 0.05). Analysis of the results according to sex, age, dosage of ifosfamide and degree of histological differentiation of the tumour cells failed to show any influence of these factors on the therapeutic results. The response rate to ifosfamide found in this study might be related to the histological origin of the tumours and to whether the primary tumours had been resected. The non-seminomatous testicular tumours, non-Hodgkin's lymphomas and ovarian carcinomas showed a high response rate. The response rate was higher in the group in which the primary tumour had been resected (61%) than in the non-resected group (12%) (except the non-Hodgkin's lymphoma). The side-effects of this regimen were moderate. Dyspepsia, nausea, vomiting, myelodepression, dizziness, and alopecia were common. Cystitis could be prevented nearly completely by concomitant administration of mesna, when given correctly, for preventing side-effects of ifosfamide on the urinary system (haemorrhagic cystitis, etc.).     

拉贝洛尔联合酚妥拉明对妊娠期高血压患者的疗效

目的探讨拉贝洛尔联合酚妥拉明对妊娠期高血压患者妊娠结局及爱帕琳肽(Apelin)、血栓调节蛋白(PTM)水平的影响。方法本研究为随机对照试验。选择2019年2月至2022年2月临沂市人民医院收治的86例妊娠期高血压患者为研究对象, 以随机数字表法分为观察组(43例)与对照组(43例)。对照组年龄(29.12±3.93)岁, 孕周(29.63±4.12)周;观察组年龄(28.23±3.19)岁, 孕周(31.01±4.13)周。对照组采用酚妥拉明治疗, 观察组在对照组的基础上给予拉贝洛尔治疗, 两组均持续治疗7 d后观察效果。对比两组患者的临床疗效及不良妊娠结局, 比较治疗前后Apelin、PTM水平。统计学方法采用χ2检验、独立样本t检验、配对t检验。结果观察组患者的临床总有效率高于对照组[93.02%(40/43)比76.74%(33/43)], 两组比较差异有统计学意义(χ2=4.440, P=0.035)。治疗前, 两组患者的Apelin、PTM水平比较差异均无统计学意义(均P>0.05);治疗后, 两组的Apelin、PTM均降低, 且观察组患者的Apelin、PTM水平...     

氟西汀联合抗精神病药物治疗伴有强迫症状的精神分裂症的效果研究

目的 分析氟西汀联合抗精神病药物治疗伴有强迫症状的精神分裂症的效果.方法 70例伴有强迫症状的精神分裂症患者,根据随机数字表法分为观察组与对照组,每组35例.对照组患者给予抗精神病药物治疗,观察组患者在对照组基础上增加氟西汀治疗.比较两组强迫症状改善时间、住院时间,治疗前后阳性和阴性症状量表(PANSS)评分、耶鲁-布...     

腹腔镜联合内镜治疗胆囊胆总管结石疗效观察

目的 探讨腹腔镜胆囊切除术联合内镜下十二指肠乳头括约肌切开术对胆囊胆总管结石的治疗作用。方法 回顾性分析2003年2月-2004年10月间实施的39例联合治疗的方法和经验。结果 手术成功37例，成功率94．9％，术后并发急性水肿性胰腺炎2例。结论 腹腔镜联合内镜治疗胆囊胆总管结石较外科开腹手术操作简便、迅速、安全。     

精氨酸联合纳洛酮治疗肝硬化合并肝性脑病的疗效

目的 探讨精氨酸联合纳洛酮治疗肝硬化合并肝性脑病的应用效果.方法 回顾分析86例肝硬化合并肝性脑病患者的临床资料,根据治疗方法不同分为对照组(41例)和观察组(45例).对照组则单纯采用精氨酸治疗,观察组在一般治疗的基础上采取精氨酸联合纳洛酮治疗.比较两组患者治疗前后的血氨(NH3)、血浆β-内啡肽(β-EP)水平以及...     

A cytochemical study of the livers of rats treated with diethylnitrosamine/phenobarbital, with benzidine/phenobarbital, with phenobarbital, or with clofibrate

Male Sprague-Dawley rats were treated with clofibrate (CLOF) in the diet for 2 years or with 4 i.p. injections of either diethylnitrosamine (DEN) or benzidine (BZ) followed by phenobarbital (PB) in the diet for 67 weeks, or just with PB for 41 weeks. Animals were killed at frequent intervals, some while still on treatment and others after 3 or 6 months withdrawal of treatment. The livers were subjected to cytochemical measurements of the parenchyma, foci, nodules and carcinomas. The parenchyma of the CLOF groups showed, in general, increases in glucose-6-phosphate dehydrogenase (G-6PD), alpha-glycerophosphate dehydrogenase (alpha-GPD), 5'-nucleotidase (5'-Nu), acid phosphatase (AP) and catalase and decreases in uricase and glutathione (GSH). CLOF induced a low incidence of GSH positive foci; nodules showed universally lower levels of catalase and GSH. In the DEN/PB and BZ/PB groups the parenchyma showed increases (even before PB treatment started) in G-6PD and in gamma-glutamyl transpeptidase (gamma-GT) and decreases in GSH. DEN raised and BZ lowered 5'-Nu. Neither initiator affected alpha-GPD. Both initiators caused a high incidence of foci positive for G-6PD and for gamma-GT; nodules induced by DEN/PB were mainly positive for gamma-GT and showed an erratic response to the other parameters. Carcinomas, found only after DEN/PB, were all positive for G-6PD and, with one exception, all were negative for alpha-GPD, 5'-Nu, AP and GSH. All changes regressed within 3 months of withdrawal of CLOF but not after withdrawal of PB from DEN-initiated animals. In conclusion G-6PD, alpha-GPD and 5'-Nu may be useful histocytochemical parameters for studying the precarcinogenic hepatic changes and nodules induced by peroxisome proliferators and by genotoxic hepatocarcinogens.     

Magnetohydrodynamic thermochemotherapy of malignant tumors with nanopreparations with magnetic resonance monitoring

Intravenous administration of dextran-ferrite sol was used to amplify T₂-weighed echo gradient (500/15) scanning MR images with visualization of the invasion margins of tumor cells into healthy tissues, along with macro-and micrometastases, in animals with lymphocytic leukemia and Ehrlich and Lewis carcinomas. Magnetohydrodynamic thermochemotherapy (MTCT) using a cyclophosphamide-containing magnetic fluid (saturation magnetization (M_s) 8.6 kA/m, pH 7.4, ζ + 13 mV) at 46°C for 30 min in an alternating magnetic field (0.88 MHz, 7.2 kA/m, 0.15 kW) with aspiration of necrotic material (ANM) produced regression of P388 tumors of volume ∼110 mm³ in BDF1 mice prior to metastasis by 40%, with an increase in lifetime (ILT) of 310%; in tumors of volume ∼330 mm³ after metastasis and MTCT-ANM with cyclophosphamide pretreatment, ILT was 220%. __________ Translated from Khimiko-Farmatsevticheskii Zhurnal, Vol. 42, No. 4, pp. 3–10, April, 2008.     

3种晶体液复苏对失血性休克大鼠的影响

目的 探讨不同晶体液复苏对失血性休克大鼠的影响.方法 雄性SD大鼠40只,随机分为对照组、休克组、生理盐水组、乳酸林格液组和醋酸林格液组,每组8只.生理盐水组、乳酸林格液组和醋酸林格液组放血至平均动脉压(MAP)30~40 mmHg后维持60 min,分别给予3倍失血量的晶体液进行复苏60 min.记录5组大鼠生理指标直至复苏结束.分别于基础阶段(0 min)、失血阶段(10 min)、休克阶段(70 min)和复苏阶段(130 min)行血气和生化检测,记录各组生存情况.结果 休克组和3个液体复苏组失血和休克阶段MAP、pH、红细胞比容(Hct)、碱剩余(BE)低于对照组,休克指数(SI)和乳酸(Lac)高于对照组(P<0.05).复苏阶段3个液体复苏组MAP低于对照组,高于休克组,SI高于对照组,低于休克组(P<0.05);休克组pH和BE均低于对照组,3个液体复苏组均高于休克组(P<0.05);休克组和3个液体复苏组Hct低于对照组,且3个液体复苏组低于休克组(P<0.05);休克组和乳酸林格液组Lac高于对照组、生理盐水组和醋酸林格液组(P<0.05).失血阶段休克组和3个液体复苏组丙氨酸转氨酶(ALT)均较对照组升高(P<0.05).休克阶段和复苏阶段休克组和3个液体复苏组生化指标均较对照组升高(P<0.05);复苏阶段3个液体复苏组生化指标低于休克组,乳酸林格液组乳酸脱氢酶(LDH)高于醋酸林格液组,生理盐水组肌酸激酶(CK)高于醋酸林格液组,乳酸林格液组ALT高于生理盐水组和醋酸林格液组(P<0.05).3个液体复苏组生存时间均长于休克组(P<0.05),醋酸林格液组生存时间长于生理盐水组和乳酸林格液组,但差异无统计学意义(P>0.05).结论 对于失血性休克进行晶体液复苏时,醋酸林格液相对于生理盐水和乳酸林格液在改善代谢情况、减缓脏器损伤和延长生存时间等方面具有一定优势.     

Reduced incidence of gastroduodenal ulcers associated with lumiracoxib compared with ibuprofen in patients with rheumatoid arthritis

BACKGROUND: Lumiracoxib (Prexige; Novartis Pharma AG, Basel, Switzerland) is a cyclooxygenase-2 selective inhibitor associated with improved gastrointestinal safety compared with nonsteroidal anti-inflammatory drugs, in patients with osteoarthritis. AIM: To compare the gastroduodenal safety of lumiracoxib with ibuprofen and celecoxib in patients with rheumatoid arthritis. METHODS: A total of 893 patients with rheumatoid arthritis were randomized to lumiracoxib 400 mg once daily, lumiracoxib 800 mg once daily, ibuprofen 800 mg three times daily or celecoxib 200 mg twice daily for 13 weeks, in a double-blind randomised controlled clinical trial. The primary endpoint was the cumulative incidence of gastroduodenal ulcers over 13 weeks. RESULTS: The incidence of gastroduodenal ulcers >/=3 mm with lumiracoxib 400 mg once daily (2.8%) or lumiracoxib 800 mg once daily (4.3%) was significantly lower than with ibuprofen (13.6%, all P < 0.01) and not different from celecoxib (1.9%). The incidence of adverse events was similar for lumiracoxib 400, 800 mg and celecoxib (78, 75 and 77%, respectively) and higher with ibuprofen (86%). Discontinuation for adverse events was highest for ibuprofen (12.5% vs. 7.9-8.8% for the other groups). CONCLUSIONS: Lumiracoxib demonstrated gastroduodenal safety superior to ibuprofen and similar to celecoxib in patients with rheumatoid arthritis.     

胺碘酮联合厄贝沙坦治疗高血压合并阵发性房颤的效果研究

目的探讨胺碘酮联合厄贝沙坦治疗高血压合并阵发性心房颤动(房颤)的临床效果。方法 108例高血压合并阵发性房颤患者,随机分为对照组(53例)和观察组(55例)。对照患者应用胺碘酮治疗,观察组患者在对照组基础上联合应用厄贝沙坦治疗。比较两组患者治疗3及6个月后的转复维持效果、血压、心率、左心房舒张末期容积(LAEDV)、左心房内径(LAD)、左心房射血分数(LAEF)。结果治疗3个月后,两组转复维持率比较差异无统计学意义(P>0.05);治疗6个月后,观察组转复维持率高于对照组,差异有统计学意义(P<0.05)。治疗3、6个月后,观察组舒张压、收缩压及心率均显著低于对照组,差异有统计学意义(P<0.05)。治疗3个月后,两组LAEDV、LAD、LAEF比较差异均无统计学意义(P>0.05);治疗6个月后,观察组患者LAEDV(142.3±69.4)ml、LAD(32.4±1.8)mm小于对照组的(178.6±63.2)ml、(37.5±2.6)mm, LAEF(0.35±0.40)%大于对照组的(0.25±0.20)%,差异有统计学意义(P<0.05)。结论胺碘酮联合厄贝沙坦治疗高血压合并阵发性房颤效果显著,可降低心脏负荷,延缓心肌重构,对阵发性房颤患者窦性心律维持效果优于单独应用胺碘酮治疗。     

参麦、苯那普利综合治疗局灶节段性肾小球硬化的实验研究

目的：观察参麦注射液及苯那普利对大鼠局灶节段性肾小球硬化（FSGS）的治疗作用。方法：30只Wistar大鼠均分5组：（1）正常对照组（A组）；（2）参麦治疗组（B组）；（3）苯那普利治疗组（C组）；（4）综合治疗组（D组）；（5）模型组（E组）。采用小剂量分次阿霉素-间羟胺-高脂饲料法建立大鼠FSGS模型。B组、C组及D组于实验第29d分别予参麦注射液或苯那普利或参麦注射液 苯那普利治疗。测定24h尿蛋白、血生化指标、肾脏组织血流量、光镜及电镜检查。结果：（1）治疗后2周时各治疗组尿蛋白排泄量开始降低。实验12周时各治疗组胆固醇升高的幅度均低于模型组。（2）肾组织血流量测定：综合治疗组肾组织血流量明显增加。（3）光镜检查：肾小球硬化指数（SI）：综合治疗组明显降低。肾小球细胞外基质（ECM）/肾小球面积（GA）：各治疗组均明显减低。（4）电镜检查：综合治疗组毛细胞血管通畅，未见足突融合及炎症细胞浸润。结论：参麦、苯那普利综合治疗可起到多靶位协同治疗FSGS的良好疗效。