慢性阻塞性肺疾病夜间症状观察及药物干预研究

<正>慢性阻塞性肺疾病(COPD)是以气流受限不完全可逆为特征的慢性炎症性疾病,气流受限呈进行性加重,逐渐出现低氧血症甚至呼吸衰竭。预计到2020年COPD将成为全球第三位的死亡原因[1]。COPD夜间症状主要是指COPD患者由于气流受限所致的呼吸系统症状及睡眠紊乱[2-3]。有文献[4]报道,COPD夜间症状发生率高达76%,是COPD患者发生慢性呼吸衰竭的独     

慢性阻塞性肺疾病康复研究进展

<正>慢性阻塞性肺疾病(COPD)是一种常见的以持续性气流受限为特征的慢性呼吸系统疾病,其特征为气流受限不完全可逆,呈进行性发展。随着发展中国家吸烟率的增高以及高收入国家人口老龄化的加重,预计COPD的患病率在未来30年内持续上升,到2030年COPD和其相关疾病每年可导致450多万人死亡~([1-2]),COPD的防控已经成为全球性的公共卫生     

慢性阻塞性肺疾病患者气道给药失败原因分析及护理干预

<正>慢性阻塞性肺疾病(COPD)是一组以气流受限为特征的肺部疾病,其气流受限不完全可逆,呈进行性发展[1]。目前在COPD的治疗用药中,由慢性阻塞性肺疾病全球创议推荐治疗方案中所提及的支气管扩张剂、糖皮质激素均有从气道给药的制剂,并已在COPD治疗中得到广泛应用且发     

慢性阻塞性肺疾病肺部微生物群的研究进展

<正>慢性阻塞性肺疾病(COPD)是一种常见的以持续性气流受限为特点的可防治疾病,其气流受限往往呈进行性发展,与有毒颗粒或气体所致的呼吸道慢性炎症不断增强有关。进行性发展的气流受限最终将导致肺功能的持续损伤。COPD目前位居全球死亡原因第4位,预计在2020年将成为全球第3位死亡原因[1]。吸烟、粉尘和化学物质的吸入、空气污染、遗传因素等被认为是COPD的高危因素,而其根本病因尚不明确。目前已有     

异丙托溴铵对慢性阻塞性肺疾病伴哮喘患者支气管痉挛的疗效

<正>慢性阻塞性肺病(COPD)是一种以进行性、持续性气流受限为主的慢性肺部疾病,是临床最常见的慢性疾病~([1])。支气管哮喘是一种以气道高反应、可逆性的气流受阻为主要病理特征的慢性气道炎症性疾病~([2-3])。COPD伴哮喘患者的气流受限最为严重,对患者生活质量和身体健康造成影响。临床应用支气管扩张剂、吸入糖皮质激     

通下降气法治疗COPD急性加重期的研究进展

正慢性阻塞性肺病(COPD)是一种具有气流受限特征的疾病,气流受限不完全可逆,呈进行性发展,与肺部对有害气体或有害颗粒的异常炎症反应有关。目前,COPD居当前死亡原因的第4位;根据世界银行、世界卫生组织发表的研究,至2020年COPD将成为世界疾病经济负担的第5位[1]。慢性咳嗽常为COPD首发症状,气短和呼吸困难是COPD最主要     

N-乙酰半胱氨酸治疗慢性阻塞性肺疾病急性发作期的临床观察

慢性阻塞性肺疾病（COPD）是一种具有气流受限特征的肺部疾病,气流受限不完全可逆,呈进行性发展。COPD是有较大危害的常见疾病,在全球范围内是导致死亡的第4位原因,     

慢性阻塞性肺疾病诊疗中应关注的问题

慢性阻塞性肺疾病(chronic obstructive pulmonary disease,COPD)是一种以不完全可逆性气流受限为特征的疾病,气流受限逐渐加重,与肺部对有害气体或有害颗粒的异常炎症反应有关. COPD是发病率和死亡率均较高的慢性呼吸系统疾病.在世界范围内,COPD居死亡原因的第4位.     

慢性阻塞性肺疾病患者运动训练的效果及其评价

慢性阻塞性肺疾病(chronic obstructive puhonary disease,COPD)是一种以不完全可逆性气流受限为特征的疾病,且气流受限逐渐加重.     

慢性阻塞性肺疾病若干进展

慢性阻塞性肺疾病（COPD）是一种具有气流受限特征的疾病，气流受限不完全可逆、呈进行性发展，与肺部对有害气体或有害颗粒的异常炎症反应有关。与其它慢性疾病相比，在全球范围COPD的共性是危害大，确诊晚，疗效差。近年不少国家已将COPD作为慢性疾病中重点防治项目。     

Guns and Knives in New Mexico: Patterns of Penetrating Trauma, 1978–1993

Objective: To identify patterns of nonfatal and fatal penetrating trauma among children and adults in New Mexico using ED and medical examiner data.
Methods: The authors retrospectively sampled in 5-year intervals all victims of penetrating trauma who presented to either the state Level-1 trauma center or the state medical examiner from a 16-year period (1978–1993). Rates of nonfatal and fatal firearm and stabbing injury were compared for children and adults.
Results: Rates of nonfatal injury were similar (firearm, 34.3 per 100,000 person-years; stabbing, 35.1). However, rates of fatal injury were significantly different (firearm, 21.9; stabbing, 2.7; relative risk: 8.2; 95% confidence interval: 5.4, 12.5). From 1978 to 1993, nonfatal injury rates increased for children (p = 0.0043) and adults (p < 0.0001), while fatal penetrating injury remained constant. The increase in nonfatal injury in children resulted from increased firearm injury rates. In adults, both stabbing and firearm nonfatal injury rates increased.
Conclusions: Nonfatal injury data suggest that nonfatal violence has increased; fatal injury data suggest that violent death rates have remained constant. Injury patterns vary by age, mechanism of trauma, and data source. These results suggest that ED and medical examiner data differ and that both are needed to guide injury prevention programs.     

Systematic Reviews Published in the January 2011 Issue of The Cochrane Library

ABSTRACT

The Cochrane Library of Systematic Reviews is published quarterly as a DVD and monthly online. The January 2011 issue (first quarterly DVD for 2011) contains 4515 complete reviews, 1985 protocols for reviews in production, and 13,521 one-page summaries of systematic reviews published in the general medical literature. In addition, there are citations of 641,000 randomized controlled trials, and 14,018 cited papers in the Cochrane methodology register. The health technology assessment database contains over 9300 citations. One hundred and seven new reviews have been published in the last 3 months, of which five have potential relevance for practitioners in pain and palliative medicine.     

Prise en charge des entorses externes de cheville : étude clinique préliminaire sur l’efficacité du dispositif Myolux™

Ankle sprains are the most common injury of the musculoskeletal system and are associated with significant societal and economic impacts. It has been proven that classical therapeutic strategies may not be effective in preventing recurrent injuries: the recurrence rates reported in the literature can reach 73%. In order to provide an effective rehabilitation solution, a destabilizing orthosis was developed. This device is equipped with a mechanical articulator reproducing the subtalar mechanics and placed under the heel. In this paper, we present the main results of a preliminary clinical study conducted between 2004 and 2007. All subjects included in this study were treated with the abovementioned orthosis during 10 rehabilitation sessions of 30 minutes each. Data show a relatively low recurrence rate of 12% for the overall population. Moreover, it's of primary importance to note that this satisfactory ratio is largely reduced (3% of recurrence rate) for the 29 patients who performed one training session per month after the 10th initial rehabilitation sessions. Hence, the destabilizing orthosis appears to be an effective solution to prevent recurrent ankle sprains. However, joint protection requires long-term and regular training sessions. This result has motivated the development of a similar device allowing patients to perform training sessions at home. Finally, data obtained in this study are promising awaiting the final results of the comparative, multicentric and independent clinical trials currently managed by the Hospices Civils de Lyon.     

Clinical Trial Updates and Hotline Sessions presented at the European Society of Cardiology Congress 2007

This article provides information and commentaries on trials which were presented at the Hotline and Clinical Trial Update Sessions at the European Society of Cardiology Congress 2007 in Vienna. The key presentations were performed by leading experts in the field with relevant positions in the trials or registries. It is important to note that unpublished reports should be considered as preliminary data, as the analysis may change in the final publications. The comprehensive summaries have been generated from the oral presentation and the webcasts of the European Society of Cardiology and should provide the readers with the most comprehensive information of relevant publications.     

Balance and Boundaries in Grief Counseling: An Intervention Framework for Volunteer Training

Volunteers or paraprofessional counselors are commonly used to provide supportive care to the bereaved. These counselors generally are trained in basic listening skills, providing a generic, nonspecific approach to intervention that remains to be proven effective. The present paper outlines a framework that provides paraprofessionals with a broader model for intervention with the bereaved. Attention to boundaries as a helper and balance in the grief recovery are central to the model. Interventions are described that provide the paraprofessional counselor with more options for tailoring their counseling strategy to the individual. These include techniques that are presumed to be more specific to the enhancement of grief recovery.     

A new method for the simultaneous analysis of unmodified and modified urinary nucleosides and nucleobases by high performance liquid chromatography

Details are given of a new, rapid and simple pre-fractionation method and an isocratic high performance liquid chromatography system suitable for parallel analysis of nucleosides and nucleobases from urine and other biological fluids. The quantitative recovery and excellent reproducibility of the method is demonstrated by analysis of representative standard RNA catabolites. The advantage of this new method for application to biological samples is discussed.     

Adsorption of Charged Non-albumin Bound Drugs by Amorphous Silica

We investigated the in vitro drug adsorption of PQ 10150 sodium silicate gel (AIS, Santa Clara, CA) with particle size of 230 um and surface area of 400 nr/g. We observed 99% to 88% adsorption of gentamicin; a mean 91 % of disopyramide; a mean 89% of quinidine at low concentration, falling to 75% at higher concentration. Insulin was 88% adsorbed at low concentrations but less so (65%) at higher concentrations. We observed a mean 83 % adsorption of procainamide, a mean 84% of N-acetyl procainamide, 74% oflidocaine, 73% of amitriptyline; and 44% of desipramine. We found an average 14% reduction of total digoxin concentration when serum containing digoxin (2 to 33 ng/mL) was exposed to sodium silicate, while the reduction in free digoxin concentration was 16%. Five percent ethosuximide was also removed. The adsorption of theophylline, phenobarbital, acetaminophen, phenytoin, ethylene glycol, methotrexate, salicylate, thiocyanate and diazepam was minimal and not significant. We conclude that significant amounts of charged, non-albumin bound drugs can be removed by PQ 10150 sodium silicate gel.     

自动化酸碱平衡图在急诊社区获得性肺炎诊治中的应用

目的 探讨自动化酸碱平衡图在急诊科社区获得性肺炎(CAP)患者诊断中的价值.方法 根据病史、肺功能测定结果、慢性阻塞性肺疾病(COPD)诊断标准,将111例CAP患者分为单纯CAP组(56例)和COPD合并CAP组[即慢性阻塞性肺疾病急性加重(AECOPD)组,55例].询问患者病史后即刻抽取动脉血测血气并进行自动化酸碱平衡图分析.结果 血气分析结果显示,AECOPD组动脉血二氧化碳分压(PaCO2,kPa)、HCO3- (mmol/L)、剩余碱(BE,mmol/L)均显著高于CAP组(PaCO2:7.714±2.414比5.896±1.308,HCO3-:30.767±7.185比25.014±3.043,BE:4.345±5.371比-0.354±3.180,均P＜0.01).自动化酸碱平衡图分析结果显示,AECOPD组患者酸碱平衡紊乱高达89.1％,CAP组为66.1％.将AECOPD组和CAP组患者中正常(10.9％、33.9％)、急性呼吸性酸中毒(急性呼酸,12.7％、14.3％)、慢性呼吸性酸中毒(慢性呼酸,49.1％、10.7％)、呼吸性碱中毒(呼碱,7.3％、14.3％)、代谢性酸中毒(代酸,12.7％、17.9％)、代谢性碱中毒(代碱,12.7％、8.9％)综合进行x2分析,差异有统计学意义(x2=24.421,P=0.001),而将正常、急性呼酸、呼碱、代酸及代碱进行x2分析,差异无统计学意义(x2=5.280,P=0.260),提示AECOPD患者慢性呼酸的发生率较单纯CAP患者显著增加.结论 自动化酸碱平衡图能帮助急诊科医师快速识别CAP患者是否存在多重酸碱平衡紊乱,并可快速识别急、慢性呼吸系统疾病.