75例肺减容手术的临床分析

目的探讨肺减容手术（LVRS）治疗重度慢性阻塞性肺疾病（COPD）的可行性和临床效果。方法75例重度COPD患者行LVRS，术前及术后6个月测肺功能、动脉血气及6min步行距离（6MWD），对其结果进行分析。结果75例手术患者中72例术后临床症状改善，呼吸困难减轻，痊愈出院；3例死亡。术后6个月肺功能FEV。增加，RV和TLC均下降（P〈0．01），动脉血氧分压PaO2平均上升12．5mmHg，6MWD增加72m（P〈0．01）。结论重度COPD患者施行LVRS可改善患者肺功能和生活质量，是一种极有前途的治疗方法。     

肺减容术治疗重度阻塞性肺气肿的临床研究

目的：研究肺减容手术（LVRS）对重度慢性阻塞性肺气肿患者肺功能等临床指标及生存质量的影响。方法：对15例重度阻塞性肺气肿患者施行LVRS，并于LVRS后随访24个月，分别于手术后6，12及24个月测定有关临床的指标：肺功能，血气分析，6分钟步行距离（6MMD）。结果：术后6，12及24月与术前比较，1秒种用力呼气容积（FEV1）显著增加（P＜0．01）。肺总量（TLC），残气容积（RV），残总比（RV／TLC）均明显降低（P＜0．01），6MWD增加（P＜0．05，P＜0．01）。日常生活主社会生活能力评分均提高（P＜0．05，P＜0．01）。结论：LVRS能明显改善重度阻塞性肺气肿患者的肺功能及PaO2等临床指标，生活质量有所提高。     

对肺减容手术机制的探讨

目的　探讨肺减容手术 (LVRS)改善慢性阻塞性肺疾病 (COPD)患者肺功能等的机制。方法　对 2 0例LVRS手术 (切除范围为 2 0 %～ 30 %)患者 ,于手术前及手术后 3个月进行肺功能 (FEV1、RV、TLC)、动脉血气分析 (PO2 、PCO2 )、心脏超声多普勒 (CO、Cl、EF、PAP)等指标的比较分析。结果　LVRS手术后患者的FEV1、RV、TLC等都有明显提高 (P <0 .0 1)。PO2 术后比术前有提高 (P <0 .0 5 ) ,PCO2 显著减小 (P <0 .0 1)。心功能指标 :Cl、CO、EF及肺动脉压力 (PAP)术后 3个月较术前无明显变化 (P >0 .0 5 )。 2 0例患者术后 6min走 (6MWT)为 (2 86± 85 )m ,比术前 (182± 10 2 )m显著增加 (P <0 .0 1)。结论　切除范围在 2 0 %～ 30 %的LVRS可明显改善COPD患者的肺功能 ,提高PO2 ,降低PCO2 ,而对心功能、肺动脉压力影响不明显。其机制可能在于余肺血管及肺单位的代偿及功能的重新恢复     

电视胸腔镜肺减容术治疗重度肺气肿36例

目的探讨重度肺气肿患者应用电视胸腔镜行肺减容手术的方法及疗效。方法回顾性分析36例非均质型重度肺气肿患者在胸腔镜辅助下施行肺减容手术的临床资料,其中单侧21例,双侧15例,对比分析FEV1、TLC、RV、PaO2、PaCO2、6-MwD指标的变化。结果本组病人治愈率97.3%,死亡率2.7%,术后并发急性呼吸衰竭6例。35例于术后7-30d康复出院,1例因术后出现对侧张力性气胸、继发肺部感染、呼吸功能衰蝎而临床死亡;术后TLC、PaO2和PaCO2与术前比较差异有统计学意义（P〈0.05）;FEV1、RV和6-MwD与术前对比亦有统计学意义（P〈0.001）。结论选择非均质型重度肺气肿患者进行电视胸腔镜肺减容术能明显改善病人的主观症状和增加活动能力,疗效确切、死亡率低,但远期效果有待观察。     

吸入糖皮质激素对稳定期慢性阻塞性肺疾病的肺功能治疗效果

目的：观察吸入糖皮质激素对稳定期慢性阻塞性肺疾病（COPD）的肺功能治疗效果。方法：72例稳定期COPD患者分为支气管舒张试验阳性，阴性两组。观察吸入糖皮质激素前后其FVC，FEV1，PaO2,PaCO2的变化情况。结果：支气管舒张试验阳性组FVC，FEV，PaO2较治疗前明显提高，PaCO2明显下降（P＜0．01）。支气管舒张试验阴性者FVC，FEV1无改善（P＞0．05），PaO2,PaCO2得到了改善（P＜0．05）。结论：糖皮质激素对存在可逆性气流阻塞的COPD患者的肺功能有很好的治疗价值。     

Effect of lung volume reduction surgery on early function of lung and pulmonary hemodynamics in COPD

Objective To evaluate the effects of lung volume reduction surgery (LVRS) on early lung function and pulmonary hemodynamics in severe chronic obstructive pulmonary disease (COPD). Methods 31 patients with severe COPD underwent LVRS, bilateral LVRS in 11 patients and unilateral in 20 patients. The results of lung function (FEV1, RV, TLC), arterial blood gas analysis (PAO2, PACO2 ) and color Doppler echocardiography (CD,CI,FS,EF,PAP) were analyzed before and 3 month after LVRS in 26 cases. Results FEV1, RV and TLC were improved significantly after surgery ( P < 0. 01). PaO2 increased (P < 0. 05 ) and PaCO2, decreased postoperatively (P < 0. 01). According to the Doppler echocardiography, there were no statistic differences in cardiac functions (CO, CI, FS, EF, and PAP) between pre- and post-operation. The 6-minute-walk-distance in 26 patients was (227 ± 88) m, significantly increased after surgery. Conclusion LVRS is effective in the treatment of patients with severe COPD. 3 months after operation, the l     

肺减容手术治疗重度慢性阻塞性肺疾病的临床观察

目的观察肺减容手术治疗重度慢性阻塞性肺疾病(COPD)的指征、疗效及其术后并发症等。方法57例重度COPD病人行肺减容手术,术前及术后6个月测肺功能、动脉血气及6分钟步行距离(6MWD),对其结果进行分析。结果57例重度COPD患者接受肺减容术,切除一侧肺组织的20%~30%。术后3例死亡,1例病情加重,其余病人临床症状改善,呼吸困难减轻,活动能力增强,术后6个月第1秒用力呼气容积(FEV1)及6MWD较术前分别提高31·9%和53·1%(P<0·05),残气容积(RV)、肺总量(TLC)较术前分别降低30·8%和27·3%(P<0·05),PaO2较术前提高23·1%(P<0·05),PaCO2由术前平均45·86mm Hg变为术后平均46·28mm Hg,无明显变化(P>0·05)。结论重度COPD患者行肺减容手术可取得较好的近期治疗效果,疗效与手术指征的掌握有一定的关系。     

电视胸腔镜肺减容术治疗重度肺气肿的疗效分析

目的 评价电视胸腔镜下肺减容术(LVRS)治疗重度肺气肿的临床疗效.方法 36例重度肺气肿患者在电视胸腔镜辅助下施行LVRS,比较LVRS术前及术后3个月的肺功能、活动能力和血气指标的变化.结果 36例患者均于术后8～27 d康复出院,术后2例并发急性呼吸衰竭,1例并发肺部感染,3例并发持续漏气(时间最长达5 d).术后3个月呼吸困难指数从Ⅲ～Ⅳ级转为Ⅰ～Ⅱ级,肺总量(TLC)及功能残气量(RV)较术前改善(P<0.05);第1秒用力呼气容积(FEV1)、PaO2、PaCO2和6 min步行距离等明显改善(P<0.01).结论 对重度肺气肿患者, 电视胸腔镜LVRS是一种有效的治疗方法,能显著改善其呼吸功能、缓解临床症状、改善生活质量.     

肺减容手术治疗重度慢性阻塞性肺疾病的临床分析

目的 观察肺减容手术治疗重度慢性阻塞性肺疾病(COPD)的疗效、手术适应证. 方法 29例重度COPD病人行肺减容手术,术前及术后6个月测肺功能、动脉血气及6分钟步行距离(6MWD),对其结果进行分析. 结果 全部病人临床症状改善,呼吸困难减轻,活动能力增强,术后6个月第1秒用力呼气容积(FEV1)及6MWD较术前分别提高32.4%和54.1%(P<0.05),残气容积(RV)、肺总量(TLC)较术前分别降低31.5%和27.9%(P<0.05),PaO 2较术前提高22.8%(P<0.05),差异具有显著性.PaCO 2由术前平均45.3 mm Hg降为术后43.2 mm Hg,差异无显著性(P>0.05).无手术死亡病例,术后并发症发生率为37.9%,主要有漏气、肺部感染、切口感染等.结论 LVRS可以改善具备手术指征的COPD患者的临床症状和肺功能.     

单侧肺减容术治疗重度阻塞性肺气肿的临床分析

目的评价单侧肺减容术(LVRS)治疗重度阻塞性肺气肿的疗效、手术适应证和禁忌证,总结手术操作要点。方法对23例重度阻塞性肺气肿患者施行单侧LVRS,并于LVRS后随访24个月,分别于手术后6,12,24个月测定肺功能、血气分析、6min步行距离(6MWD)。结果术后6,12,24个月与术前比较,1s用力呼气容积(FEV1)显著增加(P<0.01),肺总量(TLC)、残气容积(RV)、残总比(RV/TLC)均明显降低(P<0.01),6MWD增加(P<0.05,P<0.01)。日常生活质量Karnofsky评分明显提高。本组1,2年生存率分别为95%和91%,无手术死亡,术后并发症发生率为30%。结论单侧LVRS可以改善具备手术指征的重度阻塞性肺气肿患者的临床症状,且手术病死率低。尽量切除术侧无功能肺组织,防止肺漏气为手术要点,术前、术后呼吸功能锻炼有助于患者术后呼吸功能恢复。     

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.     

Analysis of CK-19,PDX-1,Nestin,Ngn3 in different donor islet purity in rats

Objective: To investigate if there are the CK-19, PDX-1, Nestin, Ngn3 positive cells in the donor islets of different purity in rats. Methods: Thirty male adult SD rats were randomly divided into 3 groups. Islets were isolated using digestion by ductal injection of collagenase. Group Ⅰ (n=10): Separating cell preparations were not purified, Group Ⅱ(n=10): Islet sediment was purified with 25% Ficoll400 ,Group Ⅲ (n=10): Islet sediment was purified with 25% and 11% Ficoll-400. The levels of protein of CK-19, PDX-1, Nestin and Ngn3 were detected by immunohistochemistry and the mRNA of CK-19, PDX-1, Nestin, Ngn3 was amplified by RT-PCR. Results: After two different purification methods applied, three islet preparations of different purities were obtained. The difference of islet purity was significant among various groups (P＜0.05). Compared with group Ⅱ and group Ⅲ,the protein and mRNA of CK-19, PDX-1, Nestin,Ngn3 were both higher in group Ⅰ; group Ⅲ was poorly expressed. Conclusions: The three different islet purity donor islet have different CK-19, PDX-1, Nestin, Ngn3 positive cells within them, indicating that there are some islet stem cells in the purified donor islet.     

A preliminary screening study on the associated proteins in human psoriasis vulgaris by serum proteomics technologies

Objective：To investigate the optimum screening conditions of associated proteins in human psoriasis vulgaris by serum proteomics technique, and to screen the different expression proteins related with psoriasis vulgaris. Methods：Serum samples of peripheral blood were collected from newly diagnosed psoriasis vulgaris patients in the clinic, and 20 matched healthy persons. Serum albumin IgG was removed by filtering with ProteoExtract Albumin/IgG. After comparative proteomics analysis the different protein spots were identified using 2-DE and MS. Results ：Electrophoresis figures with high resolution and reproducibility were obtained. Three different expression proteins were found only in the serum from psoriasis vulgaris patients, while nine other different proteins expressing from healthy volunteers. Conclusion：The protein expression was different in the serum between the psoriasis vulgaris patients and healthy volunteers. It was hoped that we could find the biomarkers related to psoriasis vulgaris by using proteomics.     

A CASE OF HUGE GASTRIC DISOPYROBEZOAR

PYTOBEZOARS are common bezoars in gastrontestinal tract, commonly seen in stomach and mall intestine,1but huge disopyrobezoars are     

Acupuncture Treatment of Chest Bi Syndrome

CASE HISTORY A male,a retired officer of 61 years old,paid his first visit on May 12,2006.The patient stated that 2 weeks before he suddenly got paroxysmal precordial choking pain,with irregular attacks.Each attack would last several seconds to several minutes.The attack was accompanied with heavy oppressed sensation in the precordial region,palpitation,lassitude,and in severe cases,sweating,which was once diagnosed by a hospital as'coronary heart disease'.Recalling the case history,the patient said that several days before he got angry with others because of some affairs in work,and he was not so used to the life pattern since he had just retired from his busy working post.At usual times,he was quick tempered and peevish.In recent days,he had poor appetite,and loose stool.     

Instructions to Contributors

The English edition of Chinese Journal of Integrative Medicine is edited and published by the Chinese Journal of Integrated Traditional and Western Medicine Press.Original scientific papers of advanced clinical and experimental medicine in the field of complementary/alternative medicine or integrative medicine are expected.     

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