急性高脂血症胰腺炎临床特点研究

目的对急性高脂血症胰腺炎的临床特点进行探讨分析。方法选取2015年6月至2016年12月来本院进行治疗的150例急性胰腺炎患者,依据其病情不同将其分为四组,分别为急性高脂血症性胰腺炎(AHP)组,共34例;胆源性胰腺炎(ABP)组,共81例;酒精性胰腺炎组,共14例;其他组,共21例。结果数据显示,急性高脂血症性胰腺炎组的患者的糖尿病、脂肪肝、急性重症胰腺炎和高血脂的发病率均高于胆源性胰腺炎组。对于血清淀粉酶的浓度和肝功能受损情况,急性高脂血症性胰腺炎组优于胆源性胰腺炎组。数据差异具有统计学意义(P0.05)。结论在临床上,急性高脂血症胰腺炎的患者相比于普通的急性胰腺炎患者具有病情较严重,血脂含量较高,血清中的淀粉酶较少等特点,对患者临床资料进行回顾性分析可以总结其病因病机,指导其临床的诊断和治疗。     

急性胰腺炎患者白蛋白和甘油三酯与高密度脂蛋白胆固醇比值的变化及意义

目的探讨急性重型胰腺炎(SAP)、急性轻型胰腺炎(MAP)时血浆白蛋白、血脂的变化及发生机制.方法使用自动生化分析仪,分别测定22例SAP、45例MAP患者发病24 h内及45例健康成年人的血浆白蛋白、血清甘油三酯(TG)与胆固醇(TC),高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C).结果 24h内SAP和MAP组的血浆白蛋白、高密度脂蛋白胆固醇(HDL-C)与对照组间差别有非常显著性意义(P<0.01),且SAP组较MAP组间差别有非常显著性意义(P<0.01);SAP和MAP组甘油三酯(TG)、TG/HDL-C与对照组间差别有非常显著性意义(P<0.01),且SAP组较MAP组间差别有非常显著性意义(P<0.01).SAP组血浆白蛋白降低的发生率及TG/HDL-C比值升高的发生率与MAP组间差别有非常显著性意义(P<0.01).结论血浆白蛋白、TG/HDL-C比值可以作为评价急性胰腺炎(AP)严重程度的指标.     

高血糖对脑卒中病情的影响

目的探讨脑卒中后高血糖对脑卒中患者病情的影响。方法检测200例脑卒中急性期(发病后24 h内)患者的首次空腹血糖,分为高血糖组、血糖正常组。根据颅脑CT或MR I记录高血糖组病灶的性质、大小及部位。结果高血糖组患者和血糖正常组患者神经功能缺损评分间差别有显著性意义(P<0.05);两组患者疗效间差别有显著性意义(P<0.05);血糖正常组脑卒中急性期预后与高血糖组间差别有显著性意义(P<0.05);出血组和大病灶组患者的血糖水平分别较缺血组和小病灶组患者明显升高(P<0.01);高血糖组不同病变部位患者血糖水平间差别有显著性意义(P<0.05)。结论脑出血较脑梗死、大病灶较小病灶、近中线部位较远离中线部位患者血糖升高明显,血糖可作为急性脑卒中评估病情的指标之一,高血糖可加重脑卒中患者的病情,应避免引起血糖升高的各种因素。     

高脂血症性胰腺炎临床特点及预后分析研究

目的 分析高脂血症性胰腺炎(HLAP)的临床特点及预后。方法 回顾性分析 收治的98例急性胰腺炎的临床资料,按入院时血清三酰甘油（TG）水平分为高TG组和正常TG组。结果 高TG组患者以男性居多,男女比例3∶1,发病年龄平均(36.5±12.6)岁,合并脂肪肝者占81.25%,BMI( 28.17±4.19)kg/m2,高TG组男性所占比例高、发病年龄较低;全身炎症反应综合征(SIRS)发生率、入院时APACHEⅡ评分、肺、心血管和肾脏功能不全、假性囊肿的发生率高于正常TG组。住院时间长[(38.67±26.46)d vs(17.48±21.84)d ] （P<0.05),非手术治疗痊愈率高。结论 高脂血症引起的急性胰腺炎并不少见,病情更严重。应重视对HLAP早期诊断,并尽早对高脂血症病因进行干预,以缓解病情,预防胰腺炎的复发。     

高脂血症性胰腺炎的临床特点及预后

目的 分析高脂血症性胰腺炎(HLAP)的临床特点及预后.方法 回顾性分析收治的98例急性胰腺炎的临床资料,按入院时血清三酰甘油(TG)水平分为高TG组和正常TG组.结果 高TG组患者以男性居多,男女比例3∶ 1,发病年龄平均(36.5±12.6)岁,合并脂肪肝者占81.25%,BMI(28.17±4.19) kg/m2.相比正常TG组,高TG组男性所占比例高、发病年龄较低;全身炎症反应综合征(SIRS)发生率、入院时APACHEⅡ评分、肺、心血管和肾脏功能不全、假性囊肿的发生率高于正常TG组;住院时间长[(38.67±10.46) d vs (17.48±7.52)d](P＜0.05),非手术治疗痊愈率高.结论 高脂血症引起的急性胰腺炎并不少见,病情更严重.应重视对HLAP早期诊断,并尽早对高脂血症病因进行干预,以缓解病情,预防胰腺炎的复发.     

C反应蛋白在高脂血症和冠心病病变程度的相关性及转归的预测价值

目的:探讨血清C-反应蛋白(CRP)与高脂血症在冠心病的发生与发展中的关系及临床应用价值。方法:选取130例冠心痛(CHD)患者按国际标准分为急性心肌梗死组(AMI)、不稳定型心绞痛组(UA)、稳定型心绞痛组(SA)。选取同期健康体检人群作为空白对照组,入院或体检时抽取空腹静脉血,测定血清CRP含量。同时将CHD患者按病情转归情况分为好转组及恶化组,动态观察其CRP的变化,血清CRP、血清TG、Ch均采用免疫透射比浊法测定。结果:SA组患者血清CRP水平与对照组差异无显著性(P>0.05)。UA及AMI组与对照组和SA组的血清CRP含量差异有非常显著性(P<0.01),前者明显高于后者,而AMI组与UA组的CRP含量差异亦有显著性(P<0.05),AMI组明显高于UA组.同时观察到好转组血清中CRP含量逐渐下降,恶化组患者血清CRP逐渐升高,两组间差异有显著性。结论:CRP水平与CHD的病变程度有相关性,检测CHD患者CRP水平,有利于高危人群的发现.积极进行预防,减少急性事件的发生。     

急性复发性胰腺炎的临床特点与病因探讨

目的:探讨研究急性复发性胰腺炎的临床特点和发病原因。方法:选择急性胰腺炎患者198例,其中150例初发者作为对照组,48例复发者作为试验组,对两组患者临床资料和相关数据进行对比分析。结果:急性复发性胰腺炎复发率最高的时间段是在距初次发病1~6个月内,有22例,占45.83%;其复发的主要因素是胆源性因素,而且试验组因该病因致病率高于对照组(P<0.05);对照组高脂血症明显低于试验组(P<0.05),试验组因乙醇、不当饮食和其他因素致病低于对照组,但两组间比较,差异无统计学意义(P>0.05);两组间重症胰腺炎发生率、手术率以及病死率差异均无统计学意义(P>0.05)。结论:急性复发性胰腺炎的发生率与胆源性疾病以及高脂血症息息相关,为降低其复发率,需提前做好预防治疗措施。     

急性复发性胰腺炎33例的临床分析

目的探析急性复发性胰腺炎患者临床特点以便临床收治此类患者可有相关数据参考。方法取本院2017～2019年收治急性复发性胰腺炎患者33例并将其设为观察组,另取本院同期收治的初发急性胰腺炎患者40例并将其设为对照组。对两组患者相关临床数据进行比较并归纳急性复发性胰腺炎的临床特点。结果距离首次发病,观察组患者在1～6个月出现复发的概率相对较高;诱发急性胰腺炎的原因主要为胆源性因素,观察组因胆源性疾病复发的例数显著高于对照组(P0.05);观察组患者存在高脂血症比例显著高于对照组且有统计学意义(P0.05)。复发性急性胰腺炎及初发急性胰腺炎患者重症胰腺炎出现率、手术发生率、病死率之间并无显著差异。结论胆源性疾病、高脂血症是导致急性胰腺炎复发的重要因素,对急性胰腺炎患者在合理的时机采取有效外科介入治疗手段能够控制急性胰腺炎患者复发率。     

什邡地区308例急性胰腺炎的病因分析

目的:调查近5年来什邡地区急性胰腺炎病例的发病因素,为本地区急性胰腺炎的防治提供依据。方法:对什邡市人民医院消化内科2011年7月-2016年8月收治的具有完整有效病例资料的308例急性胰腺炎病例进行回顾性分析,依病因分为胆源性、脂源性、酒精性、过度进食、不明原因各5组,统计各组病例的组成,比较不同病因组患者的性别、年龄及病情情况。结果:(1)病因构成:胆源性128例,脂源性52例,酒精性44例,不明原因64例,过度进食20例。(2)病因与性别:男性160例,女性148例,比例为1.08:1,男性发病主要为胆源性,其次为酒精性,分别占35%和27.5%;女性发病主要为胆源性,其次为不明原因,分别占49%和29.7%。(3)病因与病情:脂源性胰腺炎中重症胰腺炎占35.2%,较其他组高(P0.05),其次为胆源性,占27.8%。结论:胆源性胰腺炎为什邡地区急性胰腺炎的主要病因,高脂血症及饮酒为本地区急性胰腺炎的重要病因,但脂源性胰腺炎更易发展为重症胰腺炎。     

高脂血症性急性胰腺炎的临床特点分析

目的探讨高脂血症性急性胰腺炎(HLAP)的临床特点。方法回顾性分析本院1999年9月至2009年9月收治的19例HLAP患者的临床资料,并与同期的147例胆源性急性胰腺炎(ABP)患者进行比较。结果 HLAP患者占同期急性胰腺炎(AP)患者的7.8%。与ABP组相比,HLAP组男性发病率高,多伴有肥胖,合并代谢性疾病,发病年龄较低,血、尿淀粉酶水平低,易并发肺部感染、呼吸衰竭,可反复发作,但病情的严重程度、住院时间及病死率与ABP组比较差异无统计学意义。结论 HLAP并不少见,且易复发,在发病情况及并发症等方面有自身的特点。     

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…