重组人脑利钠肽治疗顽固性心力衰竭疗效观察

目的比较重组人脑利钠肽(rhBNP)和米力农治疗顽固性充血性心力衰竭(CHF)的治疗效果和安全性。方法入选的84例CHF患者,随机分为试验组42例,对照组42例,在常规纠正CHF的基础上,对照组加用米力农,起始剂量为50μg/min,连用7天;试验组加用rhBNP,首次负荷剂量2.0μg/kg,静注,继而以速率0.01μg/(kg.min),连续静滴,3天,观察并比较两组治疗前后血浆B型脑钠肽(BNP)水平以及左室射血分数(LVEF)等情况。结果 BNP水平的下降程度以及LVEF恢复比较,试验组显著优于对照组(P<0.01)。结论 rhBNP能明显改善CHF患者的血流动力学,在全身临床状况缓解方面优于米力农,疗效显著,安全性较高。     

米力农佐治老年顽固性心力衰竭60例疗效观察

目的观察米力农佐治老年顽固性心力衰竭的疗效及其对血浆B型脑钠肽(BNP)浓度的影响。方法将118例老年顽固性心力衰竭患者随机分为治疗组和对照组。治疗组60例,在常规治疗的基础上加用米力农,首剂负荷量50μg/(kg.min),缓慢推注10 min,再以0.5μg/(kg.min)静脉滴注,时间4 h,1次/d。7 d为1疗程。对照组58例,给予常规药物治疗。治疗前后均测其血浆BNP浓度、左室射血分数(LVEF)及左室舒张末径(LVEDD)变化。结果疗效:观察组总有效率95%,对照组为60.34%,观察组高于对照组(χ2=20.62,P<0.01);两组治疗后LVEF及LVEDD比较均有统计学意义(t=10.46,4.61,P<0.01);两组治疗后血浆BNP浓度有统计学意义(t=20.83,P<0.01)。结论米力农短期应用治疗老年顽固性心力衰竭安全有效。     

冻干重组人脑利钠肽联合米力农治疗急性心力衰竭的效果

目的探讨冻干重组人脑利钠肽(rhBNP)联合米力农治疗急性心力衰竭(AHF)的效果。方法选取2018年1月至2019年8月长垣市中医医院收治的98例AHF患者。将接受米力农治疗的49例患者纳入对照组,将接受rhBNP联合米力农治疗的49例患者纳入观察组。比较两组疗效及治疗前后血清肿瘤坏死因子-α(TNF-α)、单核细胞趋化因子-1(MCP-1)、脑利钠肽(BNP)。比较两组治疗前后心功能指标[左心室舒张末期内径(LVEDD)、左心室射血分数(LVEF)、左心室短轴缩短率(LVFS)]。结果观察组治疗总有效率[93.88%(46/49)]较对照组[77.55%(38/49)]高(P<0.05)。治疗后,两组血清TNF-α、MCP-1、BNP水平低于治疗前,观察组血清TNF-α、MCP-1、BNP水平低于对照组(P<0.05)。治疗后,两组LVEDD小于治疗前,LVEF、LVFS高于治疗前(P<0.05);治疗后,观察组LVEDD小于对照组,观察组LVEF、LVFS高于对照组(P<0.05)。结论采用米力农联合rhBNP治疗AHF效果确切,有助于降低患者血清TNF-α、MCP-1、BNP水平,促使心功能恢复。     

重组人脑利钠肽辅助治疗顽固性心力衰竭的临床疗效

目的 观察重组人脑利钠肽(rhBNP)辅助治疗顽固性心力衰竭的短期疗效和安全性。方法将入选的58例顽固性心力衰竭患者,在基础抗心力衰竭治疗的基础上,应用rhBNP辅助治疗,观察治疗前后患者心率、呼吸频率、肺部啰音、24小时尿量、左室射血分数(LVEF)、左室舒张末内径(LVEDD)、血清氨基末端B型脑钠肽前体(NT-proBNP)的变化。结果rhBNP治疗后患者心率减慢、呼吸趋于平稳、肺部啰音减少、24小时尿量增加、左室射血分数(LVEF)升高、左室舒张末内径(LVEDD)缩小、血清氨基末端B型脑钠肽前体(NT-proBNP)明显下降。差异有统计学意义,(P0.05),未发生症状性低血压及其它与rhBNP相关性不良反应。结论rhBNP辅助治疗顽固性心力衰竭,临床症状明显改善,安全有效,值得基层医院推广应用。     

新活素治疗老年顽固性心力衰竭的疗效观察

目的 观察新活素(重组人脑利钠肽,rhBNP)治疗老年顽固性心力衰竭的临床疗效。 方法 选取2015年3月-2017年2月于蚌埠市第二人民医院住院治疗的顽固性心力衰竭老年患者94例为研究对象,根据随机数字表法将患者分为观察组和对照组,观察组47例,对照组47例,对照组采用心力衰竭常规治疗方案,给予多巴胺或洋地黄类强心剂、血管紧张素抑制剂类药物、呋塞米利尿剂等药物治疗,观察组在对照组治疗基础上,给予患者新活素治疗。观察比较治疗前后患者血清氨基末端脑钠肽前体(NT-proBNP)水平、左室舒张末期内径(LVEDd)、左室射血分数(LVEF)、心率变化以及药物不良反应。 结果 经药物治疗,观察组用药7 d后顽固性心力衰竭的治疗有效率显著高于对照组(P<0.01),差异有统计学意义;与治疗前相比,治疗后2组患者NT-proBNP值明显下降,LVEF升高,心率降低,差异有统计学意义(均P<0.05);与对照组治疗后相比,观察组NT-proBNP值显著降低,LVEF明显升高,心率显著降低,差异有统计学意义(均P<0.05);不良反应率在2组患者中比较差异无统计学意义(P>0.05)。 结论 新活素治疗老年顽固性心力衰竭能够明显改善患者心衰临床症状和心功能,显著降低NT-proBNP水平,提高LVEF分值,降低患者心率,同时无明显药物不良反应。新活素治疗老年顽固性心力衰竭疗效显著,改善顽固性心力衰竭患者临床症状,安全可行。      

血液透析对扩张型心肌病合并顽固性心力衰竭的疗效观察

目的：观察血液透析对扩张型心肌病合并顽固性心力衰竭患者的临床效果。方法选取42例扩张型心肌病扩心病合并顽固性心衰心力衰竭患者,将42例患者按血液透析治疗和常规治疗分成2组,其中观察组22例,常规对照组20例。观察2组临床效果。结果观察组、对照组总有效率分别为86.3%、40.0%,差异具有统计学意义(P<0.05);观察组LVEF、HTR、24h尿量与对照组治疗后对比,差异具有统计学意义(P<0.05)。结论血液透析对扩张型心肌病合并顽固性心力衰竭患者进行治疗,效果显著,可有效改善患者LVEF、HTR情况,提高患者24小时尿量。     

重组人脑利钠肽治疗顽固性心衰58例临床观察

目的探讨重组人脑利钠肽(rhBNP)治疗顽固性心衰的临床效果.方法将58例心力衰竭患者经常规抗心力衰竭药物治疗后无明显改善的患者,应用rhBNP1.5ug/kg静脉冲击后,继以0.0075ug/kg/min治疗,连续应用72h,检测治疗前后患者的心率,血压、左室射血分数(LVEF)、左室内径(LVEDD).结果治疗后患者的心率、LVEF、LVEDD、呼吸、尿量分别与治疗前比较均有改善,差异有统计学意义,P<0.05.血压改善不明显.结论静脉应用rhBNP治疗顽固性心衰临床治疗效果显著,有较好的安全性和耐受性,值得临床借鉴.     

间断重复静脉应用左西孟旦对老年扩张型心肌病患者心功能及BNP水平的影响

目的:探讨间断重复静脉应用左西孟旦对老年扩张型心肌病患者心功能及血浆B型尿钠肽(BNP)水平的影响。方法:收集我院2016年1月—2018年6月收治的86例老年扩张型心肌病患者,按随机数字表法分为观察组与对照组,各43例。对照组给予常规抗心衰治疗,观察组在对照组基础上间断重复静脉应用左西孟旦治疗,比较两组心功能改善效果、治疗前后超声心动图指标及血浆BNP水平变化情况。结果:观察组心功能改善总有效率显著高于对照组,差异有统计学意义(P<0.05)。治疗后,相较于治疗前,两组LVEF明显提升,LVEDD、BNP明显降低,且观察组LVEF明显高于对照组,BNP水平明显低于对照组,差异均有统计学意义(P<0.05),而两组LVEDD比较差异无统计学意义(P>0.05)。结论:间断重复静脉应用左西孟旦可有效改善老年扩张型心肌病患者心功能,下调BNP水平,预后好,值得推广。     

重组人脑利钠肽对急性失代偿性心力衰竭合并急性肾功能损伤的临床效果

目的探讨重组人脑利钠肽(rhBNP)对急性失代偿性心力衰竭(ADHF)合并急性肾功能损伤(AKI)的应用效果。方法选取2016年4月至2018年4月河南医学高等专科学校附属医院收治的83例ADHF合并AKI患者。按抽签法将患者分为对照组(41例)和观察组(42例)。给予对照组患者常规治疗。观察组在常规用药基础上增加静脉注射rhBNP治疗。比较两组治疗前后心指数(CI)、脑钠肽(BNP)、左心室射血分数(LVEF)、血肌酐(SCr)、利尿剂用量及24 h尿量。结果治疗后,两组CI和LVEF水平均高于治疗前,观察组CI和LVET水平均高于对照组,差异有统计学意义(均P<0.05)。治疗后,两组BNP水平低于治疗前,观察组BNP水平低于对照组,差异有统计学意义(均P<0.05)。治疗后,两组SCr水平均低于治疗前,观察组SCr水平低于对照组,差异有统计学意义(均P<0.05)。观察组治疗后利尿剂用量小于同组治疗前,对照组治疗后利尿剂用量大于同组治疗前,治疗后观察组利尿剂用量小于对照组,差异有统计学意义(均P<0.05)。治疗后,两组24 h尿量多于治疗前,观察组24 h尿量多于对照组,差异有统计学意义(均P<0.05)。结论 rhBNP有助于改善ADHF合并AKI患者的心功能和肾功能。     

重组人脑利钠肽治疗扩张型心肌病伴重度失代偿性心力衰竭的疗效观察

目的评价扩张型心肌病(DCM)患者发生重度失代偿性心力衰竭时应用重组人脑利钠肽(rh BNP)的疗效及安全性。方法68例临床诊断为扩张型心肌病合并重度失代偿性心力衰竭患者,按照随机化的原则,将其分为对照组(34例)和治疗组(34例),在常规抗心衰治疗的基础上,分别给予硝普钠和重组人脑利钠肽。观察两组临床疗效、心功能改善情况及NT-pro BNP水平、平均住院时间及不良反应。结果治疗5天后,治疗组临床症状明显改善(治疗组总有效率86%、对照组总有效率70%)、左室射血分数(LVEF)上升(治疗组16.9%、对照组11.1%),左室收缩末内径缩小(治疗组0.95mm、对照组0.66mm),左室舒张末内径缩小(治疗组1.16mm、对照组0.86mm),每分钟排血量(CO)增加,NT-pro BNP明显下降,6分钟步行距离延长,平均住院时间缩短,两组差异具有统计学意义(P0.05),两组均无明显不良反应。结论 rh BNP治疗扩张型心肌病伴重度失代偿性心力衰竭患者,有效改善临床症状,缩短平均住院时间,安全有效,值得基层医院临床应用。     

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…