急性重症胰腺炎手术与非手术治疗的对比研究

目的寻找急性重症胰腺炎的最佳治疗方法。方法回顾性分析我院从1992年9月～2006年3月收治的急性重症胰腺炎48例治疗经过,治愈29例,死亡9例,多数病人死于急性肾功能衰竭、成人呼吸窘迫综合征。手术治疗21例,非手术治疗27例,比较手术疗法和非手术疗法的优缺点。结果中西医结合非手术治疗的结果优于手术治疗,死亡率低。结论是否手术治疗应该具体问题具体分析、区别对待,不能一概而论;早期手术治疗从治疗效果上来看是失败的。     

重症急性胰腺炎非手术治疗的临床诊治体会

重症急性胰腺炎发病急、病情危重、进展快、并发症多、病死率高。早期由于对该病认识不足，多采取手术治疗，但结果往往适得起反，增加了并发症和病死率。传统治疗方法是以手术治疗为主，但随着对重症急性胰腺炎的发病机理的研究，加上影像学诊断技术和重症监护水平的提高，非手术治疗为主的综合疗法越来越受到重视。本院从1996年7月～2014年3月间收治了20例重症急性胰腺炎，均予非手术治疗为主的综合疗法，现报告如下。     

急性重症胰腺炎手术治疗与非手术治疗的比较

目的分析急性重症胰腺炎患者实施手术、非手术疗法的效果。方法本次60例急性重症胰腺炎患者从我院随机抽选,按数字学方法将其平均分成两组:22例A组患者实施手术疗法,38例B组患者实施非手术疗法,统计疾病结果。结果 A组患者疾病缓解率为90.9%,并发症率为9.1%;B组患者疾病缓解率为65.8%,并发症率为31.6%,两组有区别,P0.05;a组患者的住院时间(86.25±11.10)天,B组患者的住院时间(37.36±5.20)天,两组有区别,P0.05。结论临床治疗急性重症胰腺炎时不可强调单一疗法,需于非手术治疗中加强监测力度,评估手术指征,及时手术治疗,对于改善生活现状、提高治疗结果来说,意义重大。     

重症急性胰腺炎早期手术与非手术治疗的探讨

目的：探讨重症急性胰腺炎早期手术和非手术治疗与并发症、死亡率的关系。方法：对近１０年内６９例重症急性胰腺炎的临床资料进行回顾分析。结果：重症急性胰腺炎早期非手术治疗与早期手术治疗的比较前者能显著降低患者的并发症和死亡率。结论：重症急性胰腺炎在早期阶段尽量采取非手术治疗,严格掌握手术指征。     

重症急性胰腺炎60例综合治疗分析

目的 总结重症急性胰腺炎的临床综合治疗效果。方法 回顾性分析1990～2003年本科收治的60例重症急性胰腺炎，在治疗上分两个阶段。第一阶段1990～1997年以手术治疗为主（手术组）28例，第二阶段1998～2003年以非手术治疗为主（保守组）32例。结果 手术组：治愈20例，死亡8例，治愈率71.4%;保守组：治愈30例，死亡2例，治愈率93.8%。结论 早期手术并不能降低病死率；以非手术治疗为主的综合治疗能提高重症急性胰腺炎的治疗效果。     

重症急性胰腺炎非手术治疗方法的探讨

目的探讨急性重症胰腺炎的非手术治疗方法。方法回顾性分析2001年～2004年50例急性重症胰腺炎患者非手术治疗的临床资料。结果急性重症胰腺炎(SAP)是一病情凶险、并发症多的急腹症,非手术疗法可纠正SAP引起的一系列早期病理生理改变,并取得满意治疗效果。结论对SAP不再是针对清除胰周及胰腺坏死组织的手术治疗,而主要是应用积极、有效、综合的非手术治疗,处理胰腺感染等并发症。可取得满意的治疗效果。     

重症急性胰腺炎的非手术疗法的体会

目的总结重症胰腺炎非手术治疗的体会。方法回顾20例重症胰腺炎病人的临床资料。结果5例病人中4例经保守治疗自行吸收，1例囊肿较大，有破裂可能，经手术治疗后痊愈。讨论大多数重症急性胰腺炎经上述非手术治疗均可痊愈，但在积极非手术治疗的过程中，应严密观察病情变化，有手术适应症者应适时中转手术治疗。     

急性重症胰腺炎中转手术时机探讨

目的 探讨非手术治疗急性重症胰腺炎中转手术的时机及指征。方法 回顾分析1991年5月～2003年12月我科收治的308例急性重症胰腺炎患者的并发症发生率、死亡率及中转手术情况。结果 治愈284例(92．2％)，死亡24例(7．8％)。治疗过程中109例出现并发症，其中胰腺坏死组织继发感染12例，胰腺假性囊肿52例，多器官功能损害或衰竭24例，单个器官功能损害27例。中转手术23例(7．5％)，其中行胰腺坏死组织清除12例，胰腺假性囊肿感染引流2例，腹腔引流5例，胰腺脓肿引流1例，因急性坏死性胆囊炎和急性化脓性胆囊炎行胆道手术各1例，穿孔修补 胰包膜减压术1例。结论 急性重症胰腺炎早期采取积极的非手术治疗可获得满意的效果；对在非手术治疗过程中出现胰腺感染、不能控制的胆道感染、病情无好转且进行性恶化者或有其他外科并发症者及时中转手术，可望提高急性重症胰腺炎的治愈率。     

重症急性胰腺炎非手术治疗方法的探讨

目的 探讨急性重症胰腺炎的非手术治疗方法。方法 回顾性分析2001年一2004年50例急性重症胰腺炎患者非手术治疗的临床资料。结果 急性重症胰腺炎（sAP）是一病情凶险、并发症多的急腹症，非手术疗法可纠正SAP引起的一系列早期病理生理改变，并取得满意治疗效果。结论 对SAP不再是针对清除胰周及胰腺坏死组织的手术治疗，而主要是应用积极、有效、综合的非手术治疗，处理胰腺感染等并发症。可取得满意的治疗效果。     

重症急性胰腺炎160例手术治疗分析(摘要)

目的探讨重症急性胰腺炎手术治疗的时机方法·方法回顾性分析2000年至2005年我院160例重症急性胰腺炎的临床资料,根据手术治疗时机分为早期手术治疗组和感染期手术治疗组·并对治愈率、并发症发生率、病死率作回顾性对比分析·结果两组治愈率、并发症发生率、病死率差异不大(P>0·05)·结论重症急性胰腺炎早期手术并不能降低并发症发生率和病死率,治愈率亦不能提高·手术治疗应遵循“个体化”原则,即:出现坏死感染者应手术治疗,未感染者应作非手术治疗,对于爆发型急性胰腺炎应作为重症急性胰腺炎的亚型,采取早期手术治疗·重症急性胰腺炎16…     

APPLICATION OF LORNOXICAM TO PATIENT-CONTROLLED ANALGESIA IN PATIENTS UNDERGOING ABDOMINAL SURGERIES

FOR anesthesiologis s ,treatingpostoperativepainhas alwaysbeen a problem.Althoughopioidshave been provedtobe effective,theirsideeffectscouldnotbeignored.With thedevelopmentofscienceand pharmacology,many drugs with aspectsof satisfactoryanalgesicefficacyand couldbe welltoleratedby patientshave been developed.And lornoxicamisone of them, which isa non-steroidalanti-inflammatorydrug (NSAID ), with analgesic, anti-infl-ammatory,andantipyreticproperties.Itseliminationhalf-time(3 to 5 hours) isle…     

Dr.Zhang Ren''''s Experience in the Acupuncture Treatment of Different Diseases with the Same Therapeutic Principle

Dr.Zhang Ren,the chief physician,is the chairman of Shanghai Acupuncture and Moxibustion Association.Having been engaged in medicine for about 40 years,he is experienced in treating various intractable diseases.In his long years of clinical practice,he advocates taking the TCM differentiation as the basis to seek for the acupuncture method for treatment of modern intractable diseases.The author of this essay had the fortune to follow Dr.Zhang in study.The following is a summary of Dr.Zhang's experience in the acupuncture treatment for different intractable diseases with the same therapeutic principle.     

Luo Lingjie''''s Experience in Treating Chronic Nephropathy

In treating chronic nephropathy,Luo Lingjie,a chief physician,pays attention to regulating the balance between yin and yang,treating infection if present,and removing pathogenic factors.He prescribes gentle drugs and uses carefully strongly warming-tonifying ones,emphasizes the importance of persuading the patient to persist in treatment with medication and nurse one's health for recuperation,and is good at combined use of TCM and western medicine therapy and brings the merits of various therapies into full play,with obvious theraoeutic effects.     

Acupuncture Combined with Spinal Tui Na for Treatment of Primary Dysmenorrhea in 30 Cases

Objective: To observe the therapeutic effects in acupunture treatment of primary dysmenorrhea combined with spinal Tui Na, and study its mechanism. Methods: Thirty cases of the treatment group were treated by acupuncture combined with spinal Tui Na, and thirty cases in the control group were treated by routine acupuncture. Results: The total effective rate was 93.3% in the treatment group, and 73.3% in the control group, with a significant difference between the two groups (P<0.05). Conclusions: Acupuncture combined with spinal Tui Na has good prospects for treatment of primary dysmenorrhea.     

猪肺磷脂注射液联合经鼻持续气道正压通气对呼吸衰竭早产儿的临床疗效及肌酸激酶同工酶活性的影响

目的 探讨猪肺磷脂注射液联合经鼻持续气道正压通气(NCPAP)对呼吸衰竭早产儿的临床疗效及肌酸激酶同工酶活性(CK-MB)的影响.方法 选取呼吸衰竭早产儿80例,分为观察组和对照组各40例.对照组采用NCPAP给氧治疗,观察组给予NCPAP给氧联合猪肺磷脂气管内给药.观察两组患儿治疗前及治疗12h、24 h后PaO2、PaCO2、血氧饱和度(SaO2)、pH的变化情况,检测治疗前及治疗5d后血清CK-MB水平;评估两组患儿的临床治疗效果.结果 两组患儿PaO2、PaCO2、SaO2、pH比较,差异均有统计学意义(P＜0.05),其中观察组治疗后的PaO2、SaO2、pH均高于对照组,PaCO2则低于对照组.两组的PaO2、SaO2、pH均随观察时间延长而升高(P＜0.05),PaCO2均随观察时间的延长而降低(P＜0.05).观察组治疗有效率为87.5％,显著高于对照组的70.0％ (P ＜0.05).治疗5d后两组患儿血清CK-MB水平均较前降低(P＜0.05),且观察组明显低于对照组(P＜0.05).结论 猪肺磷脂注射液气管内给药联合NCPAP可以显著降低呼吸衰竭早产儿CK-MB的含量,提高治疗有效率,起到很好的呼吸循环支持作用.     

Survey and practice of reporting quality of randomized controlled clinical trials on traditional Chinese medicine

Evidence obtained from randomized controlled trials （RCTs） has been generally accepted as the gold standard in the evaluation of clinical effectiveness. Readers need to understand the trial design, implementation, results, analysis and interpretation, so as to fully Jnderstand the results of RCTs. Thus, the investigators of RCTs have to report these items in a complete, accurate and clear manner. Since 1998, we have conducted several evaluations on the reporting quality of RCTs published in Chinese journals on traditional Chinese medicine （TCM） and results have shown that there is an urgent need for higher quality RCTs on TCM.     

TCM Treatment of Ankylosing Spondylitis by Tonifying the Kidney and Strengthening the Governor Vessel

Ankylosing spondylitis is a chronic and progressive disorder with inflammation mainly involving the central axis joints. It mainly affects the cervical spine and the lumbosacral area, with the pathogenesis closely related to the kidney and the Governor Vessel (GV). TCM holds that the syndrome is deficiency in origin and excess in superficiality, which is due to insufficiency of the kidney, deficiency of GV, and blocking of the channels with the invasion of exogenous evil, leading to poor circulation of qi and blood and malnutrition of the bones, muscles and joints. The TCM method of tonifying the kidney and strengthening GV to regulate circulation of qi and blood and check the arthralgia pain should be adopted, with the Kidney-Tonifying and GV Strengthening Decoction (益肾强督汤) prescribed.     

IMPROVING P-gp EXPRESSION IN HUMAN MONONUCLEAR CELLS IN VITRO TRANSFECTED BY MULTIDRUG RESISTANCE-1 mRNA

CHEMOTHERAPY playsa greatrolein the treat- ment of malignanttumors,especiallyingynecolo- gicalones.But inanticancerchemotherapy,leuko-cytopeniaisfrequentlytheprimarydose-limitingsideeffect factor.Moreover,cancersarefrequentlychemoresistantbe-causeof overexpressionof P-glycoprotein(P-gp), which isencodedby multidrugresistancegene (MDR1 ) and detectableinup to50% ofhuman cancersand renderscellsresistancetoanticancerdrugs.The safetyand potentialtherapeuticbenefitof mdr1 gene transferredto h…