白细胞介素—2联合顺铂治疗癌性腔内积液临床观察

目的：比较采用①白细胞介素－２（ＩＬ－２）加顺铂（ＰＤＤ）；②单用ＩＬ－２或合并非ＰＤＤ药物；③除ＩＬ－２以外其他抗肺癌药物腔内注射治疗癌性积液的疗效。方法：５０例癌性腔内积液患者分为１组（ＩＬ－２＋ＰＤＤ组）２５例；２组（ＩＬ－２或＋非ＰＤＤ药物组）８组；３组（其他药物组）１７例；进行随机研究。结果：一总有效率９２％，平均生存期１０．５月；ＩＬ－２或＋非ＰＤＤ药组总有效率７１．５％，平均生存期６     

51例病毒性心肌炎患儿血清柯萨奇 B 组病毒特异性 IgM 检测分析

用间接ＥＬＩＳＡ法检测５１例病毒性心肌炎患儿血清中柯萨奇Ｂ组病毒（ＣＶＢ）ＩｇＧ、ＩｇＭ，结果ＣＶＢ－ＩｇＭ≥１∶１００（＋）２１例，占４１．２％。３５例非心肌炎组患儿ＣＶＢ－ＩｇＭ≥１∶１００（＋）２例，占５．７％。经统计学处理，两者有非常显著差异（Ｐ＜０．０１）。说明ＣＶＢ是合肥地区病毒性心肌炎的主要病原；ＣＶＢ－ＩｇＭ检测，方法简便，准确可靠，具有早期诊断价值。ＩｇＭ阳性组病程均在两个月以内，９０．５％有明确的上呼吸道或肠道感染史，ＳＴ－Ｔ改变占２８．６％，与ＩｇＭ阴性组比较差异显著（Ｐ＜０．０５）；ＩｇＭ阳性组心脏扩大、心功能不全均较阴性组多，但经χ２检验没有差异（Ｐ＞０．０５）；ＩｇＭ阳性组与阴性组在心律紊乱、酶学异常上没有差异。     

运动~(99m)Tc-MIBI心肌断层显像肺摄取判断左室收缩功能异常的价值

目的探讨应用运动９９ｍＴｃ－ＭＩＢＩ心肌断层显像肺摄取判断左室收缩功能异常的可靠性及临床价值。方法冠心病组３４例、对照组２７例于１周内完成运动心肌断层显像和平衡法核素心室显像。肺摄取用心肌断层显像中肺与心肌计数比值（ＬＨＲ）来表示，利用平衡法核素心室显像获得以下左室收缩功能指标：左室射血分数（ＬＶＥＦ）、高峰充盈率（ＰＥＲ）、平均充盈率（ＡＥＲ）、１／３射血期的射血分数（１／３ＥＦ）。结果运动ＬＨＲ与ＬＶＥＦ、ＡＥＲ、１／３ＥＦ呈负相关，ｒ值分别为－０．７１２、－０．６４１和－０．７２９，Ｐ均＜０．０１。运动ＬＨＲ判断左室收缩功能异常的敏感性为６１．９％，特异性为８１．２％，准确度为７３．５％。结论运动９９ｍＴｃ－ＭＩＢＩ心肌断层显像中肺摄取（ＬＨＲ）可初步判断左室收缩功能异常，其重复性高，可靠性好，具有一定的临床价值     

糖尿病患者红细胞膜Na~＋－K~＋－ATPase、Ca~（2＋）－ATPase活性变化

目的探讨糖尿病患者红细胞膜ＡＴＰａｓｅ活性的变化。方法１７例胰岛素依赖型（ＩＤＤＭ）和４８例非胰岛素依赖型糖尿病（ＮＩＤＤＭ）患者红细胞膜Ｎａ~＋－Ｋ~＋－ＡＴＰａｓｅ、Ｃａ~（２＋）－ＡＴＰａｓｅ活性分别用改良的Ｈａｎａｈａｎ法和Ｌｕｔｈｒａ法测定，并设相应年龄对照组。统计方法用ｔ检验和直线相关分析。结果ＮＩＤＤＭ患者红细胞膜Ｎａ~＋－Ｋ~＋－ＡＴＰａｓｅ、Ｃａ~（２＋）－ＡＴＰａｓｅ活性分别下降了２４．３３％和１７．１１％，ＮＩＤＤＭ患者则分别下降２１．２４％和１６．４２％。两组糖尿病患者ＡＴＰａｓｅ活性均与糖化血红蛋白呈负相关，与年龄、空腹血糖或胰岛素水平无相关。结论糖尿病患者均有红细胞膜Ｎａ~＋－Ｋ~＋－ＡＴＰａｓｅ、Ｃａ~（２＋）－ＡＴＰａｓｅ活性下降，其原因与慢性高血糖有关。     

多巴酚丁胺心电与^99mTc—MIBI心肌显像对冠心病诊断价值比较

目的；比较多巴酚丁胺心电图（Ｄｏｂｕ－ＥＣＧ）与＾９９ｍＴｃ－ＭＩＢＩ心肌显像（Ｄｏｂｕ－ＥＣＴ）诊断冠心病的价值。方法；对６９例拟诊冠心病而无心肌梗塞患者在行冠状动脉影时进行多巴酚丁胺心肌显像检查。结果；Ｄｏｂｕ－ＥＣＴ诊断冠心病的恶性循环 和准确度优于Ｄｏｂｕ－ＥＣＧ（９１．７％对４７．２％，Ｐ〈０．０１，８５．５＾对６６．７％，Ｐ〈０．０５），特异性二者之间无差异。诊断冠状动脉单坛、双支、三     

重症肌无力自身抗体、T淋巴细胞亚群及其临床意义的探讨

目的：探讨重症肌无力（ＭＧ）抗乙酰胆碱受体抗体（ＡｃｈＲａｂ）、抗突触前膜受体抗体（ＰｓｍＲａｂ）和Ｔ淋巴细胞亚群与临床的关系。方法：应用ＥＬＩＳＡ法检测４０例重症肌无力病人血清中上述两种自身抗体，应用Ｔ淋巴细胞亚群单克隆抗体微量细胞毒法检测该组病人Ｔ淋巴细胞亚群。结果：①ＡｃｈＲａｂＩｇＧ型阳性２４例（６０％）、ＩｇＭ型阳性１５例（３７．５％），ＰｓｍＲａｂＩｇＧ型阳性２４例（６０％）、ＩｇＭ型阳性１１例（２７．５％）；②仅ＡｃｈＲａｂＩｇＧ型阳性３例（７．５％）、ＩｇＭ型阳性１例（２．５％），只有ＰｓｍＲａｂＩｇＧ型阳性２例（５％），二种抗体的ＩｇＧ型和ＩｇＭ型均阴性７例（１７．５％）；③ＡｃｈＲａｂ与ＰｓｍＲａｂ存在直线正相关；④本组病人ＣＤ＋４增高、ＣＤ＋８降低、ＣＤ＋４／ＣＤ＋８比率增高；⑤ＣＤ＋４／ＣＤ＋８比率与这两种自身抗体无相关关系；⑥年龄大于４０岁组的ＣＤ＋８低于４０岁以下组，而ＣＤ＋４／ＣＤ＋８高于４０岁以下年龄组；⑦病程大于或等于３年组的ＣＤ＋８、ＣＤ＋４／ＣＤ＋８分别低于、高于病程小于３年组。结论：ＭＧ病人存在体液免疫和细胞免疫的异常；ＭＧ可受到ＡｃｈＲａｂ和ＰｓｍＲａｂ的免疫性损害     

DDP＋IL—2治疗恶性胸腔积液疗效评价

目的 探讨ＤＤＰ（顺铂）＋ＩＬ－２（白细胞介素－２）治疗恶性胸腔积液的疗效。方法 对已证实的３２例恶性胸腔积液患者采用ＤＤＰ＋ＩＬ－２联合胸腔内用药,每周１次,共２－５次,结果 总有效率为８７．５％,其中ＣＲ６２．５％（２０／３２）,ＰＲ２５％（８／３２）胸水中癌细胞消失者２８例,结论 ＤＤＰ＋ＩＬ－２联合胸腔内用药对恶性胸腔积液进行疗效高,副作用小,值得推广使用。     

运动及静态核素心肌断层显像对心肌炎诊断价值的探讨

目的为临床心肌炎的诊断提供心肌核素显像的依据。方法经确诊的心肌炎４０例与正常对照５０例均行静态状态、运动状态９９ＭＴｃ心肌核素显像。结果对照组５０例均示放射性分布均匀，无明显放射性稀疏缺损、过浓集区或再“充填”现象；心肌炎４０例表现为：分布均匀１４例（３５％），呈花斑状改变且运动与静息状态基本一致１０例（２５％），局限性稀疏区９例（２２％），花斑状改变伴局限性过浓集区２例（５％），运动状态下局部稀疏，静息状态下该局部再“充填”者５例（１２．５％）；总阳性率为６５％。结论放射性再“充填”是心肌炎核素心肌断层显像的一种类型。     

中晚期鼻咽癌放疗前大剂量顺铂及卡铂化疗颈淋巴结疗效对比分析

目的：比较二种铂类药物治疗鼻咽癌（ＮＰＣ）的临床疗效和毒副作用，方法：３４例有颈淋巴结转移的ＮＰＣ患者分两组（各１７例）进行放疗前化疗，两组化疗第１～５ｄ（ｄ１～５）均给以５－Ｆｕ１０００ｍｇ／ｍ＾２静滴（ｉｖｄｒｏｐ）外第１ｄ（ｄ１）Ａ组卡铂（ＣＢＰ）３００ｍｇ／ｍ＾２ｉｖｄｒｏｐ；Ｂ组顺铂（ＤＤＰ）１００ｍｇ／ｍ＾２ｉｖｄｒｏｐ，结果：ＯＲ（ＣＲ＋ＰＲ）；Ａ组５２．９４％，Ｂ组为６４．７１％，     

硫酸镁治疗妊娠高血压综合征时红细胞膜三磷酸腺苷酶及红细胞内离子水平的变化

对硫酸镁治疗妊娠高血压综合征（妊高征）时红细胞膜三磷酸腺苷酶（ＡＴＰａｓｅｓ）和红细胞内离子变化进行对比研究。结果妊高征患者Ｎａ￣＋－Ｋ￣＋－ＡＴＰａｓｅ、Ｃａ￣（２＋）－ＡＴＰａｓｅ活力明显低于未孕妇女和正常孕妇，Ｍｇ￣（２＋）－ＡＴＰａｓｅ活力无明显改变；妊高征者红细胞内Ｎａ￣＋、Ｃａ￣（２＋）明显高于未孕妇女和正常孕妇，Ｍｇ￣（２＋）明显低于未孕妇女和正常孕妇，Ｋ￣＋无明显变化。妊高征者静脉持续滴注２５％硫酸镁（ｌｇ／ｈ×５ｈ）上述异常可被纠正。     

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.