慢性肺源性心脏病合并低渗性脑病32例临床分析

目的 探讨肺心病合并低渗性脑病的临床特点.方法 回顾性分析32例低渗性脑病患者的临床表现及辅助检查与治疗情况.结果 低渗性脑病患者的临床表现,以嗜睡、反应迟钝最常见.结论 血钠＜125 mmol/L,血浆渗透压＜260 mOsm/L,应考虑低渗性脑病,治疗以补充高渗性盐水为主.     

慢性肺心病合并低渗性脑病32例

目的：探讨肺心病合并低渗性脑病的临床特点。方法：回顾性分析32例低渗性脑病患者的临床表现，辅助检查与治疗情况。结果：低渗性脑病患者的临床表现以嗜睡、反应迟钝最常见。结论：血钠〈125mmol／L，血浆渗透压〈260mosM／L，应考虑低渗性脑病，治疗以补充高渗性盐水为主。     

慢性肺源性心脏病并发低渗性脑病临床分析

目的探讨慢性肺源性心脏病并发低渗性脑病的病因及防治方法。方法对37例出现神经精神症状的慢性肺源性心脏病患者,测定其血浆渗透压和血气分析,并根据测定结果进行有针对性的治疗。结果37例慢性肺源性心脏病患者血气分析排除了呼吸衰竭所致的肺性脑病,其血浆渗透压为206-259mmol／L,均明显降低,经补充电解质和综合治疗,35例（94．6％）恢复正常或接近正常,2例（5．4％）因并发多器官功能衰竭死亡。结论慢性肺源性心脏病患者出现神经精神症状时,不应只考虑肺性脑病、脑血管意外等疾病,应常规测电解质、血浆渗透压,了解是否合并低渗性脑病,以免误诊。一旦发现低渗性脑病,应立即补充电解质,综合治疗,以尽可能获得满意疗效。     

慢性肾功能衰竭合并低渗性脑病11例临床分析

目的探讨慢性肾功能衰竭并发低渗性脑病的病因及防治方法。方法对11例出现神经精神症状的慢性肾功能衰竭患者,测定其血浆渗透压和血气分析,并根据测定结果进行有针对性的治疗。结果 11例慢性肾功能衰竭患者血气分析其血浆渗透压为206～259mmol/L,均明显降低,经补充电解质和综合治疗,10例（90.91%）恢复正常或接近正常,1例（9.09%）因并发多器官功能衰竭死亡。结论慢性肾功能衰竭患者出现神经精神症状时,不应只考虑继发中枢神经系统的损害、脑血管意外等疾病,应常规测电解质、血浆渗透压,了解是否合并低渗性脑病,以免误诊。一旦发现低渗性脑病,应立即补充电解质,综合治疗,以尽可能获得满意疗效。     

肺心病并发低渗性脑病的护理

低渗性脑病是肺心病治疗过程中常见的并发症之一 ,病情多凶险 ,病死率较高。现将 7例慢性肺心病合并低渗性脑病的观察与护理体会总结如下。1　临床资料本组 7例均按 1980年第三次肺心病专业会议修订的标准确诊为肺心病 ,并伴有意识障碍及精神症状 ,血浆渗透压低于 2 70 mmol/ L,其中 3例合并肺性脑病 ,男 4例 ,女 3例 ,年龄 6 1～ 82岁 ,平均 73岁 ,病人均有纳差、恶心、呕吐 ,同时有嗜睡 ,肌张力减退 5例 ,抽搐、膝反射消失 3例 ,神志恍惚、烦燥 2例 ,昏迷 2例。血电解质 :Na+ 98～ 12 0 mmol/ L、K+ 2 .2～3.5 mmol/ L、Cl170～ 95 mmo…     

AECOPD合并低渗性脑病39例临床分析

目的 探讨慢性阻塞性肺病急性加重期 (AECOPD)合并低渗性脑病的临床特点.方法 对39例AECOPD合并低渗性脑病患者进行回顾性分析.结果 发现AECOPD合并低渗性脑病主要表现为神经系统症状,与肺性脑病很相似,处理不当易死亡.结论 AECOPD治疗中注意水、电解质平衡及早期不同程度的神经系统症状是预防、诊断、治疗低渗性脑病的关键.     

肺心病合并低渗性脑病20例临床分析

目的：探讨肺心病合并低渗性脑病的病因、临床分析、治疗。方法：对20例肺心病合并低渗性脑病进行回顾性分析。结果：本组20例低渗性脑病均在2～5天内血钠补至138mmol／L左右，低渗状态恢复，治愈18例，2例因严重心功能不全合并休克死亡。结论：肺心病合并低渗性脑病常见病因是低钠血症，临床表现与肺性脑病有相似之处，易造成误诊。鉴别可根据血气分析和血钠浓度。治疗首先纠正晶体渗透压的降低，针对低钠血症用0．9％～3％高渗盐水补充。肺心病合并低渗性病须早期诊断、早期治疗。     

老年肺心病合并低渗性脑病24例分析

对２４例老年肺心病合并低渗性脑病进行分析。２４例患者除有慢性肺心病的临床表现外，均有不同程度的低钠血症和低渗透压及精神症状，２９％患者有精神萎靡不振，２５％有嗜睡、烦躁、昏睡者各占１６％，１２．５％有浅昏迷。提示凡老年肺心病患者出现精神症状，宜及时检测血电解质及血浆渗透压，以便早期发现及时治疗     

肺心病并发低渗性脑病36例临床分析

1989年5月至1990年5月我们收治肺心病并发低渗性脑病36例。本文结合临床分析报道于后。临床资料一、一般资料:36例均为急诊科观察室及监护病房病人,其中男11例,女25例;年龄37～83岁,平均69.3岁,单纯性低渗性脑病22例(61.1％),合并肺脑14例(38.9％)。血浆渗透压260～240mosm/L15例(41.7％),240～220mosm/L 17例(47.2％),低于220mosm/L 4例(11.1％)。36例血钠全都低于130mmol/L,血钾低于3.5 mmol/L21例(58.3％),血氯低于90mmol/L 27例(75％)。28例作了血气分析检测,只有低氧血症(PaO_2<8 kPa)者17例(60.7％),既有低氧血症,又有高碳酸血症(PaCO_2>7 kPa)者11例(39.3％)。20例作了血液流变学检测,均有高粘血症存在。二、诊断标准:     

尿毒症肺49例临床表现及胸部X线分析

目的:进一步了解尿毒症肺的临床表现及胸部X线特点。方法:对北京大学人民医院1998～2001年住院的49例尿毒症肺患者进行临床表现和胸部X线特点分析。结果:住院慢性肾功能不全尿毒症期病人141例,其中尿毒症肺的病人49例(34.75％)。无症状者11例(22.45％),咳嗽、咳痰者20例(40.81％)。呼吸困难27例(55.10％);胸部X线表现为肺淤血期20例(40.81％),肺泡性肺水肿期20例(40.81％);血清尿素氮(25.05±9.57)mmol/L,血清肌酐(730.49±251.87)μmol/L。全部病例进行了血液透析治疗,死亡5例(10.2％),结论:临床症状以咳嗽、咳痰、呼吸困难为主,胸部X线表现以肺淤血,肺泡性肺水肿多见。其形成原因与血尿素氮、肌酐、血压及左心衰竭等因素有关。最有效的治疗方法是血液透析。     

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…     

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.     

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.