5例神经型布氏杆菌病患者的调查分析

目的提高对神经型布氏杆菌病的认识。方法对5例神经型布氏杆菌病患者的流行病学资料、临床表现、实验室检查等进行回顾性分析。结果男4例、女1例,年龄30~60岁之间,5例患者中有4例病前有与羊的密切接触史,1例有经常进食涮羊肉史。5例患者均有不同程度的发热、头疼、关节疼痛,2例恶心、呕吐伴脑膜刺激征,2例手足麻木,1例双下肢无力。5例患者确诊后除一般治疗及对症治疗外,均应用米诺环素、利福平及头孢曲松3种药物联合治疗,预后良好。结论神经型布氏杆菌病传播途径复杂,临床表现多样,影像学又无特异性改变,故易漏诊、误诊。当遇到患者出现不明原因的神经症状时,应特别注意有无布氏杆菌流行病学史。患者脑脊液布氏杆菌抗体及血清凝集试验检测应作为常规检查,做到早诊断、早治疗,改善预后。     

6例神经型布氏杆菌病临床特点与分析

目的:分析探讨神经型布氏杆菌病的临床特点.方法:回顾性分析本院自2009年1月～2012年1月收治的6例神经型布氏杆菌病病例.结果:经临床对症治疗,4例治愈,2例好转.结论:神经型布氏杆菌病传播途径复杂,临床表现多样,易导致误诊;治疗需早期、联合用药、足够疗程治疗方可改善预后.     

神经型布氏杆菌感染脑膜炎的研究进展

神经型布氏杆菌病(NB)是布氏杆菌累及中枢神经系统后出现的罕见且严重并发症，其临床表现复杂多样。脑膜炎是神经型布氏杆菌病最常见的临床表现，在疾病早期即可出现。神经型布氏杆菌病所致脑膜炎的研究尚处于初级阶段，致病机制及代谢通路尚不明确，为提高临床工作者对神经型布氏杆菌感染脑膜炎的认识，本文将对神经型布氏杆菌病患者常见临床表现脑膜炎进行讨论，现将其发病机制、临床特点、辅助检查、诊断及治疗综述，希望通过利用代谢组学、宏基因二代测序等技术明确诊断，在疾病早期进行治疗干预，改善患者病情及预后，提高患者生活质量。     

布氏杆菌病合并脑膜炎27例临床分析

目的 探讨布氏杆菌病合并脑膜炎的临床表现、诊断及治疗、预后情况.方法 采用回顾性随机抽样的方法,描述、总结、分析了我院2007-2011年收治的27例布氏杆菌病合并脑膜炎病人的临床资料.结论 布氏杆菌病病人临床表现多种多样,诊断主要依据流行病学史、临床表现及实验室检查.经过规范化治疗后,预后良好.     

神经型布氏杆菌病1例报告及相关文献资料复习

目的报告1例神经型布氏杆菌病病例,复习相关资料,以提高对其认识.方法通过对病例的回顾,分析其发病机制,总结神经型布氏杆菌病的多种临床表现.结果神经型布氏杆菌病临床表现多种多样,极易误诊.结论神经型布氏杆菌病临床少见,遇到反复波动性发热,合并有神经系统症状、体征者,要详细询问牧区居住史以及牛羊制品食用史,并进行必要的血清学、病原学检查,以排除或确诊神经型布氏杆菌病.     

神经型布氏杆菌病1例报告及相关文献资料复习

目的：报告1例神经型布氏杆菌病病例，复习相关资料，以提高对其认识。方法：通过对病例的回顾，分析其发病机制，总结神经型布氏杆菌病的多种临床表现。结果：神经型布氏杆菌病临床表现多种多样，极易误诊。结论：神经型布氏杆菌病临床少见，遇到反复波动性发热，合并有神经系统症状、体征者，要详细询问牧区居住史以及牛羊制品食用史，并进行必要的血清学、病原学检查，以排除或确诊神经型布氏杆菌病。     

不典型布氏杆菌病诊疗体会

目的 总结不典型布氏杆菌病临床症状及治疗效果,提高布氏杆菌病的诊治水平.方法 回顾性分析33例布氏杆菌病患者的临床资料,并对其临床表现及治疗方法和效果进行分析.结果 典型临床表现者为76％,初诊确诊者72.7％,复诊确诊者24.2％,多次复诊确诊者3％.33例患者全部治愈出院,6个月内复查无复发.结论 布氏杆菌病临床表现复杂,临床医生要熟悉其发病机理、临床表现及实验室检查,早诊断,早治疗.     

广州地区布氏杆菌病的临床分析

目的 探讨广州市布氏杆菌病的流行情况、诊断及治疗.方法 对2例布氏杆菌病的流行病学、临床资料、治疗经过行系统分析.结果 2例布氏杆菌病患者均为广州市人,本地发病,以不规则低热为主要表现,因血培养阳性确诊,利福平、强力霉素治疗效果佳.结论 布氏杆菌病广州市多年已未发现,且可因临床表现不典型,极易误诊,临床医生应提高警惕,对抗生素治疗效果欠佳的低热患者,血培养为简单、易行的方法.     

以脊髓压迫症起病的布氏杆菌病1例报道并文献复习

<正>当今神经系统感染性疾病发病呈现散发趋势,但神经型布氏杆菌病有增多趋势。其表现多样,以脑膜炎、脑膜脑炎、脊髓炎和脊髓病多见,而以脊髓压迫症发病的还未见报道。回顾性分析保定市第一医院2013年3日诊断明确的1例神经布氏杆菌病的临床表现、辅助检查结果以及诊断与治疗经过,并结合文献分析其发病特点。1临床资料患者,男性,39岁,主因发热20 d伴颈部疼痛向双上肢放射15 d入院。既往体健,否认结核等传染病     

布氏杆菌脑膜炎临床及脑脊液特点

目的 探讨布氏杆菌脑膜炎的临床表现及脑脊液特点,加深对该病的临床认识,减少误诊误治.方法 对我院近几年确诊的布氏杆菌脑膜炎进行回顾性分析,探讨其临床表现及脑脊液特点,检索国内文献,进行总结分析.结果 患者均有发热及明显头痛,伴有不同程度关节、肌肉疼痛,颅压明显增高,且持续时间较长;患者均出现脑膜刺激征.血布氏凝集实验（＋）;脑脊液细胞数增高,蛋白轻-中度增高,糖低于正常,氯化物正常或稍低于正常.结论 布氏杆菌脑膜炎临床表现及脑脊液检查均无特异性,但颅内压增高持续时间较长,高颅压症状相对较轻,易被误诊为病毒性脑膜炎或结核性脑膜炎而延误甚至错误治疗.对病史较长的脑膜炎患者,需行流行病学调查,尽早行血布氏凝集试验,早发现、早治疗.     

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.     

Acupuncture Treatment of Vomiting

CASE HISTORY A female patient, 46 years old, head of the foreign affairs department of a certain university in Beijing, paid her first visit on October 9, 2006, with the chief complaint of vomiting for one month. She got vomiting after meals in early September. Before that, she had discomfortable sensation in the stomach due to angry with others, but she didn't pay much attention. Later, it developed into vomiting after eating. After the vomiting, the discomfort would be relieved, but with slight hypodynamia. She was once diagnosed as having 'neurogenic vomiting'. Having taken some western and Chinese drugs, the above symptoms were a little bit improved, but she would have nausea upon eating and with regurgitation. Because of the fear for vomiting, she did not dare to have food intake, with body weight reduction of 6 kilos in one month.     

Qiu Baoguo''''s Experience in Treating Consumptive Syndromes after Radio-Chemotherapies

Radiotherapy and chemotherapy are the important modern medical therapies for malignant tumors,yet they can also bring about serious local and systemic toxic side reactions so to decrease the patient;'s life quality,manifested by a series of consumptive symptoms.Having engaged in the combined work of Chinese and western medicine for nearly 50 years,the research fellow Qiu Baoguo in Henan Provincial Academy of TCM has developed his unique views on the TCM study of consumptive syndromes.The author of this essay had once the fortune tO follow Dr.Qiu in clinic,and specially would like to introduce in the following Dr.Qiu's experience in treating consumptive syndromes after radio-chemotherapies for patients with malignant tumor.     

Insomnia Due to Deficiency of Both the Heart and Spleen Treated by Acupuncture-Moxibustion and Chinese Tuina

OBJECTIVE: To observe therapeutic effects of the comprehensive therapy of acupuncture-moxibustion and Chinese Tuina for treatment of insomnia due to deficiency of both the heart and spleen. METHODS: 92 cases were divided randomly into the treatment group (treated by acupuncture-moxibustion and Chinese Tuina) and the control group (treated by acupuncture-moxibustion). RESULTS: The therapeutic effect of the treatment group was obviously superior to that of the control group (the CHI2 test showed P < 0.01). CONCLUSIONS: The comprehensive therapy of acupuncture-moxibustion and Chinese Tuina can give marked therapeutic effects for treatment of insomnia due to deficiency of both the heart and spleen.     

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.