食管静脉曲张套扎加硬化治疗后再出血的防治

食管静脉曲张破裂出血是肝硬化门脉高压症患者的致命性的并发症。近年来 ,继食管静脉曲张硬化剂治疗后 ,又开展套扎或套扎加硬化剂治疗 ,大量临床资料证实其疗效确实可靠 ,病人易于接受。但脱痂期并发食管粘膜糜烂、溃疡 ,如果饮食粗糙或便秘、剧烈咳嗽、呃逆等易导致过早脱痂引起大出血 ,如不及时处理 ,会影响治疗效果 ,严重者危及生命。我们对 12 0例肝硬化患者进行食管静脉曲张结扎加硬化治疗 ,现将结扎加硬化治疗后并发症的综合防治情况报告如下。1　临床资料12 0例肝硬化并食管静脉曲张破裂出血患者 ,均是住院病人 ,其中男 114例 ,女 6…     

3种方法治疗肝硬化伴食管静脉曲张破裂出血的比较分析

肝硬化患者晚期多发食管静脉曲张,由多种诱因引起的食管静脉曲张破裂出血往往能够导致患者死亡［1,2］,从而使得食管静脉曲张破裂出血成为肝硬化最严重的并发症［3］。由于单纯的内科保守治疗出血复发率较高,需要进行预防治疗,目前临床上有3种主要治疗方法［4,5］：内镜下食管静脉曲张套扎术、内镜下食管静脉曲张硬化剂注射术以及内镜下食管静脉曲张套扎联合硬化剂治疗。统计显示,近年来食管静脉曲张的预防治疗能够明显延长患者的生存期,取得了明显的效果［6,7］。本文通过对3组采用不同方法治疗的患者术后恢复情况进行统计学分析,探讨何种方式治疗能够起到最佳效果。     

三腔二囊管联合急诊内镜套扎治疗食管静脉曲张破裂出血临床研究

<正>本研究回顾性分析29例肝硬化或肝癌引起首次食管静脉曲张破裂出血患者资料,旨在探讨导丝辅助插入三腔二囊管压迫止血联合急诊内镜下套扎治疗患者食管静脉曲张破裂出血疗效。资料和方法一、一般资料收集2014年4月至2015年4月我院29例食管静脉曲张破裂首次活动性出血的患者资料,有酒精性或血吸虫性或乙型肝炎后或丙型肝炎后肝硬化或肝癌病史,无肝性脑病及内镜检查或套扎治疗禁忌证。治疗组22例,男12例,女10例,年龄     

内镜下套扎术和硬化剂注射对食管静脉曲张的治疗效果

内镜下套扎术和硬化剂注射对食管静脉曲张的治疗效果苏秉忠邹景林马丽丽张占军套扎术和硬化剂注射治疗肝硬化门脉高压症引起的食管静脉曲张破裂出血是目前主要和有效的方法，多单独使用，我们将两者联合应用，以探讨其治疗效果，并研究了术后预防溃疡及引起食管狭窄的方法...     

硬化剂和套扎治疗食管胃底静脉曲张破裂出血34例临床观察

目的对比分析硬化剂注射术和套扎术治疗食管胃底静脉曲张破裂出血的临床疗效。方法收集在西京医院进修学习期间2014年8月至2015年2月期间经硬化剂注射术治疗的34例食管胃底静脉曲张破裂出血患者设为观察组,另选同期的34例经套扎术治疗的食管胃底静脉曲张破裂出血患者设为对照组,观察两组患者的止血成功率、并发症发生率及病死率。结果观察组和对照组在止血成功率和病死率方面比较差异无统计学意义(P0.05),而观察组并发症发生率明显低于对照组(P0.05)。结论硬化剂注射术和套扎术治疗食管胃底静脉曲张破裂出血均具有良好的临床疗效,而采用硬化剂注射术更能减少并发症发生。     

肝硬化食管静脉曲张破裂出血的内镜治疗

食管静脉曲张破裂出血是肝硬化的严重并发症。内镜治疗是预防和治疗食管静脉曲张破裂出血的主要手段之一,包括套扎术、硬化剂注射及超声内镜引导下硬化剂注射、组织胶注射、自膨式覆膜金属支架、联合治疗及其他内镜治疗方式等。现就各种内镜下治疗方式的适应证、临床疗效、并发症等情况作一概述。     

内镜下硬化剂联合组织粘合剂治疗肝硬化食管胃底静脉曲张破裂出血的临床疗效

目的探究内镜下硬化剂联合组织粘合剂对肝硬化食管胃底静脉曲张破裂出血的临床疗效。方法对青海省中医院121例内镜治疗的肝硬化食管胃底静脉曲张破裂出血的病例资料进行回顾性分析,其中食管静脉曲张破裂出血行硬化剂治疗而胃底静脉曲张破裂出血行组织粘合剂治疗的患者共60例,作为单一组;食管、胃底静脉曲张破裂出血均行硬化剂联合组织粘合剂治疗的患者共61例,作为联合组。对比分析两组患者治疗的有效率、并发症发生率、静脉曲张消除情况及再出血率。结果治疗后,联合组有效率为80.3%,显著高于单一组的61.7%(P 0.05)。单一组术中出血的发生率显著高于联合组(P 0.05)。联合组首次治疗静脉曲张消除率为77.0%,显著高于单一组的58.3%(P 0.05)。单一组术后6个月内的再出血率显著高于联合组(P 0.05)。结论内镜下硬化剂联合组织粘合剂在治疗肝硬化食管胃底静脉曲张破裂出血中具有较好的疗效和安全性,值得临床推广应用。     

介入治疗食管胃底静脉曲张破裂出血的体会

在中国,肝硬化是常见病,食管胃底静脉曲张破裂出血是失代偿期肝硬化患者的严重并发症,死亡率在20％～50％。近年来随着内镜技术的普及,更多的消化科医师可以较熟练采用内镜下套扎和硬化剂注射技术治疗和预防食管胃底静脉曲张破裂出血,这显著降低了出血复发率,改善了患者的预后。因此,国内外在制定食管胃底静脉曲张破裂出血治疗指南时均将内镜下治疗作为一线治疗方案。     

无痛胃镜下食管静脉曲张套扎治疗术的护理配合

<正>食管静脉曲张破裂出血是肝硬化门静脉高压最严重的并发症之一,内镜下食管静脉曲张套扎治疗术可有效控制急性出血和预防早期再出血。本研究回顾性分析济南军区总医院消化内镜中心2012至2014年实施套扎治疗并取得满意效果的765例食管静脉曲张破裂出血患者,现将护理操作配合及体会介绍如下。一、资料与方法1.一般资料:选择济南军区总医院2012至2014年食管静脉曲张出血患者765例,其中男604     

自身免疫性肝炎并肝硬化食管静脉曲张破裂出血硬化剂治疗的临床分析

目的分析自身免疫性肝炎肝硬化食管静脉曲张破裂出血硬化剂治疗的疗效。方法收集福建医科大学附属漳州市医院2012至2014年自身免疫性肝炎肝硬化失代偿期合并食管静脉曲张破裂出血患者4例,予内镜下硬化剂治疗。结果 4例患者均再发出血,2例3天内再出血,1例1周后再出血,1例1个月后再出血。结论自身免疫性肝炎肝硬化食管静脉曲张破裂出血硬化剂治疗效果较差。     

Isolation of Circular DNA from a Mitochondrial Fraction from Yeast

Breakage and fractionation of respiratory competent yeast in the presence of ethidium bromide, and subsequent centrifugation of a detergent lysate of the mitochondrial fraction by the dye-buoyant-density technique, results in the isolation of closed-circular DNA. After removal of bound dye, this DNA has two components when analyzed by equilibrium buoyant density in the analytical ultracentrifuge. A minor component has a buoyant density of 1.684 g/cm(3), which is characteristic of mitochondrial DNA, but the major component has a buoyant density of 1.701 g/cm(3). This species of DNA is also present in yeast that have been mutagenized to respiratory deficiency in the presence of the highest concentration of ethidium bromide compatible with cell growth. The closed-circular DNA of buoyant density 1.701 g/cm(3), and free of linear DNA, is associated with the sole particulate band obtained on sucrose gradient centrifugation of a mitochondrial preparation from respiratory-deficient cells. Two particulate bands are obtained on sucrose gradient centrifugation of a mitochondrial preparation from respiratory-competent cells, the upper band containing DNA of buoyant density 1.701 g/cm(3) and the lower band DNA of buoyant density 1.684 g/cm(3). The suggestion is advanced, in view of the reputed sedimentation behaviour of yeast peroxisomes, that the closed-circular DNA of buoyant density 1.701 g/cm(3) may be located in peroxisomes.     

Isolation of gram-negative bacteria from cockroaches trapped from urban environment

Three different areas--hospital, food-handling establishments and human dwellings, were surveyed for pathogenic gram-negative bacteria carried on the cuticles of cockroaches. Fifty species of bacteria were identified from all cockroaches. Escherichia coli, Klebsiella pneumoniae, Citrobacter freundii and Enterobacter cloacae were the most frequently found. Pathogenic and potentially pathogenic bacteria represented 58% of all bacteria identified. The numbers of pathogenic and potentially pathogenic bacteria were similar in hospital areas and food-handling establishments, while, human dwellings possessed a poorer bacterial flora. E. coli, K. pneumoniae and E. cloacae were dominant species in hospital areas, while in food-handling establishments and human dwellings, E. coli, K. pneumoniae and C. freundii predominated. Therefore, cockroaches can play a role in bacterial transmission, due to the bacteria carried on their cuticles.     

Identification of Swallowing Events from sEMG Signals Obtained from Healthy Adults

Surface electromyography (sEMG) is being used with increasing frequency to identify the occurrence of swallowing, to describe swallow physiology, and to treat impaired swallowing function in dysphagic patients. Despite this increased utilization, limited information is available regarding the validity and reliability of investigators and clinicians to interpret sEMG data in reference to swallowing. This study examines the validity and interjudge reliability of swallow identification using sEMG records obtained from healthy adults. Validity and reliability estimates were compared between experienced and naïve judges in the identification of swallows from graphic sEMG records. Multiple validity estimates were high, indicating a strong degree of accuracy in identification of swallows versus nonswallow movements from sEMG traces. Experienced judges were more accurate than naïve judges (classification accuracy: experienced = 90% vs. naïve = 81%; p = 0.006, kappa: experienced = 0.89 vs. naïve 0.62; p = 0.008). Judges in both groups were more likely to classify swallows as nonswallow movements (false negatives) than to classify nonswallow movements as swallows (false positives). Interjudge reliability estimates indicated a high degree of agreement among judges in the identification of swallows versus nonswallow movements from the sEMG signal, with higher agreement among experienced judges (average kappa coefficient: experienced = 0.75 vs. naïve = 0.51). These results suggest that the sEMG graphic record is a valid and reliable tool for identifying normal swallows and that experience with this technique results in better identification and interjudge agreement.     

Prediction of protein-folding mechanisms from free-energy landscapes derived from native structures

Guided by recent experimental results suggesting that protein-folding rates and mechanisms are determined largely by native-state topology, we develop a simple model for protein folding free-energy landscapes based on native-state structures. The configurations considered by the model contain one or two contiguous stretches of residues ordered as in the native structure with all other residues completely disordered; the free energy of each configuration is the difference between the entropic cost of ordering the residues, which depends on the total number of residues ordered and the length of the loop between the two ordered segments, and the favorable attractive interactions, which are taken to be proportional to the total surface area buried by the ordered residues in the native structure. Folding kinetics are modeled by allowing only one residue to become ordered/disordered at a time, and a rigorous and exact method is used to identify free-energy maxima on the lowest free-energy paths connecting the fully disordered and fully ordered configurations. The distribution of structure in these free-energy maxima, which comprise the transition-state ensemble in the model, are reasonably consistent with experimental data on the folding transition state for five of seven proteins studied. Thus, the model appears to capture, at least in part, the basic physics underlying protein folding and the aspects of native-state topology that determine protein-folding mechanisms.     

中国新疆灰仓鼠真菌多样性

目的 监测分析灰仓鼠真菌多样性。方法 60只成年灰仓鼠来自中国新疆地区,安乐死后剖解采集标本。应用TaqMan MGB探针实时荧光定量PCR、核糖体克隆测序、真菌培养鉴定技术对灰仓鼠真菌多样性进行分析。结果 鉴定出60株真菌,包括白假丝酵母、阿萨丝孢酵母、烟曲霉、黑曲霉、聚多曲霉、日本曲霉、焦曲霉、杂色曲霉、产黄青霉、宛氏拟青霉、黄灰青霉、好食脉孢菌、间型脉孢菌、芽枝状枝孢。灰仓鼠携带的真菌多为人兽共患病病原体。结果显示,曲霉菌是最主要优势菌群,青霉菌是次优势菌群。这些菌株对制霉菌素、克霉唑、沃尔康唑等药物敏感。结论 本研究首次应用TaqMan MGB探针实时荧光定量PCR和核糖体克隆测序、真菌鉴定培养技术能有效分析灰仓鼠真菌多样性。研究结果为我国灰仓鼠微生物学监测及质量标准制定提供了科学依据。本研究第一个广泛报道了灰仓鼠真菌菌群多样性。     

Relationship of Different Properties from Non-Destructive Testing of Heavy Concrete from Magnetite and Serpentinite

Radiation-shielding concrete has been analyzed by several methods of destructive and non-destructive testing (NDT). Concretes made of crushed basalt, magnetite, serpentinite, and two different types of cement (Portland cement CEM I and slag cement CEM III/A) were studied. In this study, we analyzed concrete columns with a height of 1200 mm and a cross-section of 200 × 200 mm². The top and bottom of the column were analyzed using data from compressive strength, dynamic modulus of elasticity, water penetration, and diffusion coefficients derived from the electrical resistivity test. This article presents the properties of fresh concrete and concrete after two years of setting. It was determined how the different ratios of basalt, magnetite, and serpentinite affect the individual measured parameters. Furthermore, correlation relations between individual resulting values were analyzed. It was observed that compressive strength generally does not correlate with other results. The diffusion coefficient correlated well with density and water penetration. Little or no correlation was observed in the diffusion coefficient with compressive strength and modulus of elasticity. The results of the study make it possible to refine the testing of heavy concretes in terms of electrical resistivity, and point to the possible use of NDT methods. The results also show which composition of heavy concrete is better in terms of effective diffusivity.