慢性肝炎患者面部色部区位点色度学差异性研究

目的 探讨健康人群与慢性肝炎人群面部脏腑不同区位点色度学的差异.方法 应用Lab颜色法和面部整体-自然标志分区-中心坐标定点三级色部定位法,测定面部心、肺、肝、脾、肾各区位点的Lab值,分别对健康人群与慢性肝炎患者进行比较分析.结果 健康人群与慢性肝炎患者面部心、脾、肾、肝、肺各区位点色度值的差异均有统计学意义(P＜0.01);健康人群各区位点L值均高于患者群,a值均低于患者群(P＜ 0.001),健康人群心、脾、肝、肺区位点b值均高于患者群,差异均有统计学意义(P＜ 0.001),但肾区位点两组比较未见差异.结论 健康人群和慢性肝炎患者不同脏腑面部色部区位点色度值有明显的差异.慢性肝炎患者面部各区位点色泽明度(L值)较健康人群降低,脾、肝、肺区b值(蓝色或黄色感觉)较健康人群升高.     

气体信号分子硫化氢在肝硬化患者中的表达和意义

目的:了解肝硬化患者血清中硫化氢(H2S)的变化,探讨气体信号分子H2S在肝硬化发病过程中的作用.方法:对43例肝硬化失代偿期患者、16例肝硬化代偿期患者和28例健康对照分别采用敏感硫电极法测定血清H2S浓度;用全自动生化分析仪测定血清ALT和ALP含量.结果:肝硬化各组(代偿期、失代偿期)血清H2S浓度较对照组明显降低(P<0.01),血清ALT、ALP浓度较健康对照组明显升高(P<0.01),随肝功损害程度更加显著.H2S与ALT、ALP的相关系数分别为0.731和0.702(P<0.01).结论:H2S浓度的降低可能是加重肝硬化程度的重要因素,H2S含量的检测对肝硬化的诊断、治疗以及病情判断有重要意义.     

肝硬化及肝癌患者血浆内皮素含量变化的初步观察

检测16例原发性肝癌和肝硬化失代偿期患者血浆内皮素水平,结果显示,这些肝病患者血浆内皮素水平较正常健康人明显升高;而失代偿期肝硬化患者血浆内皮素水平又较肝癌患者上升显著。     

整体护理对肝硬化失代偿期患者的影响

目的:探讨整体护理对肝硬化失代偿期患者生活质量及疾病预后的影响.方法:本组126例患者全部采取整体护理措施进行整体护理.结果:肝硬化失代偿期患者通过系列合理的护理措施,好转102例(81%),减轻痛苦21例(17%),不仅改善了患者的心理、生活状况,还延长了患者的生命.结论:整体护理对肝硬化失代偿期患者生活质量及疾病预后有着非常积极的影响.     

肝病患者血清和腹水CA125水平变化

目的　探讨肝炎、肝硬化代偿期、肝硬化失代偿期、肝癌患者血清肿瘤抗原 12 5 (CA12 5 )水平与肝损害的关系。方法　采用放射免疫分析法检测 2 0例正常对照、3 0例肝炎患者、2 0例肝硬化代偿期患者、3 0例肝硬化失代偿期患者、2 5例肝癌患者血清CA12 5水平 ,并比较 2 5例肝硬化患者腹水CA12 5值与血清CA12 5值的相关性。结果　肝炎组、肝硬化代偿期组、肝硬化失代偿期组、肝癌组患者血清CA12 5值均显著高于对照组 (P <0 .0 5 ) ;肝硬化失代偿期组患者血清CA12 5值显著高于肝硬化代偿期组 (P <0 .0 1) ,肝癌组患者血清CA12 5值明显高于肝硬化失代偿期组 (P <0 .0 1)。 2 5例肝硬化患者腹水CA12 5值显著高于血清CA12 5值 ,二者之间呈线性相关 (r =0 .766,P <0 .0 0 1)。结论　肝硬化患者血清CA12 5水平升高及升高程度与肝病严重程度密切相关 ,血清CA12 5水平可作为反映肝病患者肝损害程度的指标之一 ,同时血清CA12 5水平可能成为监测肝硬化患者腹水消长的一项有用指标。     

肝炎后肝硬化失代偿期血液流变学变化的探讨

目的 :探讨肝炎后肝硬化失代偿期血液流变学变化及临床意义。方法 :对 4 0例肝炎后肝硬化失代偿期患者进行血液流变学测定 ,并与 4 2例健康者作对照。结果 :肝炎后肝硬化失代偿期患者血细胞压积、全血粘度均低于健康者 ,血浆粘度、血沉、血沉方程 k值均不同程度高于健康者 ,P<0 .0 1。结论 :血液流变学指标能反映肝炎后肝硬化失代偿期患者的微循环障碍情况 ,可考虑作为其病情诊断和疗效判断的参考指标     

健康教育干预对肝硬化失代偿期患者心理健康的影响

目的:探讨健康教育对肝硬化失代偿期患者心理健康的影响。方法:选择肝硬化失代偿期患者60例作为研究对象,在干预前、后采用SCL-90量表测评患者的心理变化。结果:干预后患者在抑郁及焦虑等维度得分较干预前显著降低(P<0.05)。其中人际关系敏感、抑郁、焦虑等因子变化更为显著(P<0.01)。结论:对肝硬化失代偿期患者实施健康教育,可提高患者的心理健康水平,有效提高其生活质量。     

IL-21对乙肝肝硬化患者T淋巴细胞亚群及NK细胞的影响

目的观察乙肝肝硬化患者血清IL-21水平,研究IL-21在体外对T淋巴细胞亚群及NK细胞的影响。方法纳入乙肝肝硬化患者60例,其中代偿期组30例,失代偿期组30例,同时以30例健康人为对照组,采用ELISA法检测血清IL-21水平;采用流式细胞术检测T淋巴细胞亚群及NK细胞的含量,分离出的外周血单个核细胞与IL-21共培养后,再检测上述指标。结果与健康对照组相比,乙肝肝硬化患者代偿期组和失代偿期组血清IL-21水平均明显升高(P0.05);与健康对照组比较,乙肝肝硬化失代偿期患者外周血中CD4+T淋巴细胞和NK细胞的含量均明显下降,而CD8+T淋巴细胞的含量则上升(P0.05);加入IL-21体外培养后可使乙肝肝硬化患者代偿期组和失代偿期组的CD8+T淋巴细胞含量升高(P0.05)。结论 IL-21在特异性和非特异性免疫中发挥重要作用,提示IL-21可应用于乙肝肝硬化患者的免疫治疗。     

健康教育在失代偿期肝硬化患者护理应用体会

在系统化整体护理开展过程中,健康教育起着重要的作用.我科自开展系统化整体护理来,通过对失代偿期肝硬化患者进行有计划、有目的、分阶段的教育活动,有效地预防了各种并发症的发生,缩短了病程,提高了失代偿期肝硬化患者的自我保健和卫生防御能力,提升了患者的生活质量.现将具体做法和体会报告如下:     

护理干预对肝硬化失代偿患者生活质量的影响

目的 探讨护理干预对肝硬化失代偿期患者生活质量的影响.方法 将138例肝硬化失代偿期患者随机分为观察组和对照组,各69例,两组均采用常规治疗和护理,观察组给予护理干预;采用生活质量测评表(QOL)评价两组患者生活质量.结果 出院时观察组在痰病相关知识、并发症的防治、自我护理方法的掌握和负性心理控制方面与对照组相比,差异有显著性;健康教育可改善肝硬化失代偿期患者生活质量.结论 护理干预可明显地提高肝硬化失代偿期患者治疗效果以及生活质量.     

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…