脑动脉静脉畸形血管内治疗73例临床分析

为观察血管内注入栓塞材料治疗脑动静脉畸形（ＡＶＭＳ）的疗效。６５例脑ＡＶＭＳ用真丝线段栓塞，８例用α－氰基丙烯酸正丁ＮＢＣＡ栓塞，通过微导管注入脑ＡＶＭｓ内，结果Ｌ：完全栓寒３例（１８％），栓塞病变９０％以上２１例（２９％），７０－７９％２６例（３５％），５０－７０％８例（１１％），栓塞２次着７例（１０％）症状改善２者７０例（９６％），神经功能失者４例（５％）＿，６６例治疗后经颅多普勒超声（ＴＣＤ     

Alzheimer氏病与多灶脑梗塞性痴呆的临床对照分析

对５１例ＡＤ及５０例ＭＩＤ进行了临床对照分析。结果显示ＭＩＤ９４．０％（４７／５０）有精神症状，而ＡＤ８０．４％（４１／５１）有精神症状，两组病人在发病年龄、性别、家族史、病程及住院时间相同的情况下ＭＩＤ的痴呆程度轻于ＡＤ。经治疗ＭＩＤ痴呆的好转率大于ＡＤ（Ｎ＜０．０１），精神症状则有不同程度减轻（Ｐ＞０．０５）。     

结缔组织病肺部损害32例临床分析

目的：对３２例结缔组织病肺损害的临床资料进行总结。结果：以呼吸症状为首发者１１例（３４．４％），并发肺腺癌１例。临床症状以咳嗽为最多见（６４．３％），其次呼吸困难（４３．１％）、胸痛发生率低（６．１％）。行纤维支气管镜肺活检１４例，经光镜检查确诊率为７１．４％，经电镜检查确诊率为８５．５％。结论：认为部分结缔组织病以呼吸症状首发者应引起重视，经纤维支气管镜肺活检结合光镜、电镜检查有利于提高确诊率。     

脑动静脉畸形的微导管血管内栓塞治疗

目的 评价微导管血管内栓塞术对脑动静脉畸形（ＡＶＭ）的治疗价值。方法：采用微导管超选择性插管用真丝线段、ＮＢＣＡ及ＰＶＣ栓塞治疗２８例脑ＡＶＭ病人。结果 ２８例ＡＶＭ病人３１次栓塞,成功率９７％。栓塞５０＾％以上者８２％,其中完全栓塞１８％。栓后症状减轻、消失,有效率达８６％。随访５月～８年,未再发生出血。术中血管痉挛５例（１６％）,２例致导管嵌顿、滞留颅内。１例（３％）偏瘫、失语,经处理１月后恢     

154例老年急性心肌梗死临床特点分析

收集我院近１０年间资料完整确诊为急性心肌梗死（ＡＭＩ）的老年患者１５４例,年龄６５～８７岁,平均６９－７±４－２７岁。以胸痛为首发症状者占５８％（９０例）,以突然加重的呼吸困难或心衰,恶心及呕吐、烦躁、乏力、频死为首发症状者分别占１１％（１７例）,１２％（１８例）,６％（１０例）,８％（１３例）和４％（６例）。伴有高血压者占５１％,糖尿病者占４８％,高血脂占６４％,而冠心病家族史占２３％,吸烟占３３％,饮酒占２９％等项不明显。梗死部位以广泛前壁和下壁多见,各占２７％和２３％,两部位以上的梗死占１…     

2型糖尿病并心肌梗死102例临床观察

目的探讨2型糖尿病临床特点。方法对本院1999年7月——2008年7月内科、急诊科2型糖尿病并心肌梗死病人共102例的临床资料进行回顾性分析。结果102例中：以典型胸骨后疼痛或胸闷为首发症状者占56％（56／102），以呼吸困难、咳嗽为首发症状者占12％（12／102），以恶心、呕吐、纳差为首发症状者占10％（10／102），以心悸为首发症状者占2％（2／102），以下肢浮肿为首发症状者占2％（／2102），以晕厥为首发症状者占1％（1／102），猝死者占1％，无明显症状者占16％（／16102），以上腹痛、左肩痛、颈部痛、下颌痛、牙痛、鼻尖痛为首发症状者共占6％；。结论2型糖尿病并急性心肌梗死首发症状表现常不典型，病情重，并发症多，死亡率高；早发现，合理治疗是减少并发症、降低死亡率的关键。     

2型糖尿病并心肌梗死102例临床观察

目的探讨2型糖尿病临床特点。方法对本院1999年7月——2008年7月内科、急诊科2型糖尿病并心肌梗死病人共102例的临床资料进行回顾性分析。结果102例中：以典型胸骨后疼痛或胸闷为首发症状者占56％（56／102），以呼吸困难、咳嗽为首发症状者占12％（12／102），以恶心、呕吐、纳差为首发症状者占10％（10／102），以心悸为首发症状者占2％（2／102），以下肢浮肿为首发症状者占2％（／2102），以晕厥为首发症状者占1％（1／102），猝死者占1％，无明显症状者占16％（／16102），以上腹痛、左肩痛、颈部痛、下颌痛、牙痛、鼻尖痛为首发症状者共占6％；。结论2型糖尿病并急性心肌梗死首发症状表现常不典型，病情重，并发症多，死亡率高；早发现，合理治疗是减少并发症、降低死亡率的关键。     

家庭干预对住院首发精神分裂症患者自知力的影响

目的：探讨家庭干预对住院首发精神分裂症农村患者自知力的影响，寻求适合农村家庭干预的方法。方法：对符合ＣＣＭＤ－２标准的实施开放管理的５０例农村住院首发精神分裂症患者（Ａ组），进行为期８周的家庭干预，并与采取传统治疗的５０例农村首发精神分裂症住院患者（Ｂ组）对照，用ＩＴＡＱ、ＢＰＲＳ量表评定自知力及精神症状的变化。结果：Ａ、Ｂ两组患者治疗前后ＩＴＡＱ、ＢＰＲＳ评分均有显著差异（Ｐ＜０．０１），但以Ａ组减分更显著（ｔ＝４．６９，Ｐ＜００１；ｔ＝２．２９，Ｐ＜０．０５）。结论：药物治疗基础上的对农村首发精神分裂症患者进行家庭干预，对自知力恢复较传统治疗具较好效果，具有一定推广价值。     

286例化学烧伤病人的流行病学调查

目的：为预防化学烧伤提供资料和提出预防对策。回顾性流行病学调查。对象：近１０多年来我科住院的化学烧伤病人。方法：统计分析病人的性别、年龄、职业、烧伤环境、烧伤原因、致伤化学物质、烧伤总面积（ＴＢＳＡ）、烧伤部位、烧伤深度、创面处理、合并症、死亡率。结果：化学烧伤２８６例，占同期烧伤病人的８．５０％，男女之比为３．２７：１，１５～６０岁的病人２２５例（８９．１６％）病人职业以工人最多，共１８８例（６５．７３％），１９４例病人（６７．８３％）是在工作环境受伤。２５３例病人（８８．４６％）是意外受伤，３３例病人（１１．５４％）是人为致伤，最常见的致伤化学物质是酸（６０．８４％），其次为碱（３３．９２％），大多数化学烧伤的面积〈１０％（７２．７３％），面积超过５０％的仅占２．１０％，烧伤部位以四肢多见，占５６．６４％，     

心肌灌注断层显像和冠状动脉造影结果差异的分析

目的：回顾性分析６０例病人冠状动脉造影（ＣＡＧ）和心肌灌注显像（ＭＰＩ）结果不一致的资料。方法：所有 ＭＰＩ检查用Ｔｏｓｈｉｂａ ＧＣＡ－７１００Ａ／Ｄ型 ＳＰＥＣＴ仪完成。以ＣＡＧ结果示冠状动脉狭窄≥５０％为有临床意义的冠状动脉狭窄。结果：６０例中ＣＡＧ结果和ＭＰＩ结果不符合者１５例（２５％）。１５例病人平均年龄５２．７±９．５岁，男１１例，女４例。ＭＰＩ显示心肌缺血而ＣＡＧ正常者９例，其中临床诊断Ｘ综合征３例、陈旧性心肌梗塞１例、心绞痛（冠状动脉狭窄３０％～４０％）３例、高血压病２例；ＭＰＩ显示正常而ＣＡＧ有临床意义狭窄６例（狭窄５０％～６０％者６例次，累及右冠状动脉者３例次，分支狭窄者３例次，伴良好侧枝循环２例次）。结论：心肌灌注断层显像不正常而ＣＡＧ正常者，不能认为显像均为假阳性，其中有７８％的ＭＰＩ诊断与临床诊断符合；心肌显像阴性、ＣＡＧ证实狭窄≥５０％，大部分为冠状动脉远端分支狭窄和临界性冠状动脉狭窄及右冠状动脉狭窄。     

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.