泌科泼尼松治疗格雷夫斯病合并甲状腺机能亢进性心房颤动

目的了解泼尼松治疗格雷夫斯病合并甲状腺机能亢进性心房颤动的临床效果.方法患者分为传统抗甲状腺药物组(10例,男2例,女8例)和泼尼松治疗组(14例,男3例,女11例).治疗方案传统抗甲状腺药物组采用他巴唑15～30 mg/d,心得安15～30 mg/d,而泼尼松治疗组药物为泼尼松30 mg/d,他巴唑15～30 mg/d,心得安15～30 mg/d.比较二组患者心房颤动转复效果.结果泼尼松治疗组14例患者有12例心律转复为窦性心律,平均转复时间为3.8(3.8±2.6)个月,缓解率达86%.而传统抗甲状腺药物组10例患者有4例心律转复,缓解率为40%,平均转复时间2.8(2.8±1.0)个月,泼尼松治疗组的转复效果明显高于传统抗甲状腺药物组(P<0.05).结论泼尼松治疗格雷夫斯病合并甲状腺机能亢进性心房颤动可能更有利于窦性心律的恢复.     

甲状腺功能亢进并发心房颤动50例药物转复疗效分析

目的探讨甲状腺功能亢进合并心房颤动患者的临床治疗情况。方法将笔者所在医院2009年9月-2012年10月收治的甲状腺功能亢进合并心房颤动患者50例随机分成对照组和观察组两组,每组25例。对照组行常规甲状腺功能亢进治疗。观察组在对照组基础上加用抗心律失常药物转复心房颤动。对比观察两组患者的甲状腺功能亢进及心房颤动转复情况。结果观察组甲状腺功能亢进治疗的总有效率为84．00％,显著高于对照组的76．00％．两组比较差异有统计学意义（P〈0．05）。两组治疗后患者T3、T4水平及HR与治疗前比较明显降低,差异有统计学意义（P〈0．05）。对照组心房颤动转复时间为（127．69±25．34）d,观察组心房颤动转复时间为（36．77±8．54）d,两组比较差异有统计学意义（P〈0．05）。两组不良反应比较,差异无统计学意义（P〉0．05）。结论用复律药物可改善甲状腺功能亢进的治疗,缩短心房颤动的转复时间,患者不良反应较少。     

辛伐他汀对高血压并发阵发性心房颤动患者的影响

目的观察辛伐他汀治疗高血压病并发阵发性心房颤动的临床疗效。方法将190例高血压并发阵发性心房颤动病人随机分成辛伐他汀治疗组（治疗组,93例）和常规治疗组（对照组,97例）,治疗组93例在常规胺碘酮治疗基础上加辛伐他汀,治疗随访1年,比较两组治疗窦性心律维持率。结果用药1月治疗组心房颤动转复窦性心律78例,有效率83．87％,对照组心房颤动转复窦性心律69例,有效率71．13％（P〈0．05）。6个月治疗组心房颤动转复窦性心律70例,有效率75．27％,对照组心房颤动转复窦性心律59例,有效率60．82％（P〈0．05）。12个月治疗组心房颤动转复窦性心律62例,有效率66．67％,对照组心房颤动转复窦性心律49例,有效率50．52％（P〈0．05）。治疗组窦性心律维持率均优于对照组。结论辛伐他汀具有提高高血压病人合并心房颤动患者窦性心律维持率的作用。     

小剂量乙胺碘呋酮维持心房颤动转复后窦性心律的疗效观察

目的:观察小剂量乙胺碘呋酮用于心房颤动转复后维持窦性心律的有效性和安全性。方法:166例慢性心房颤动的住院患者转复为窦性心律后给予小剂量乙胺碘呋酮平均215mg/d(100～300mg/d)维持窦性心律。结果:乙胺碘呋酮维持窦性心律半年有效率为71.60%;1年有效率为62.96%;负反应发生率为11.11%;减量或停药2个月内副反应消失。因此,小剂量乙胺碘呋酮为心房颤动转复后维持窦性心律的有效药物且安全可靠。     

静脉应用胺碘酮转复急性发作心房颤动的临床观察

目的 :观察静脉应用胺碘酮转复患者急性发作快室率心房颤动的临床疗效和安全性。方法 :4 4例器质性心脏病急性发作快室率心房颤动患者 ,先静脉注射胺碘酮复荷量 3mg/kg,10～ 15min内注入 ,后以维持量 1 0～ 1 5mg/min静脉泵入 ,如 15～ 30min未转复 ,且室率仍快的患者追加一次胺碘酮 1 5mg/kg,一旦转复窦性心律根据病人情况改用口服胺碘酮或停用。结果 :患者负荷量内均未转复窦性心律 ,当累积量达 2 10～ 4 5 0mg时 38例 (86 36 % )患者转复窦性心律 ;达 5 5 0～ 70 0mg时 6例 (13 6 3% )患者转复窦性心律 ,总有效率 10 0 %。无明显不良反应。结论 :应用小于推荐计量 (5mg/kg)胺碘酮静脉注射并给予持续静脉泵入转复急性发作房颤是安全有效的     

胺碘酮治疗不稳定型心绞痛并发阵发性心房颤动疗效分析

目的:观察胺碘酮治疗不稳定型心绞痛并发心房颤动的疗效及安全性。方法:42例不稳定型心绞痛并发心房颤动患者,随机分为胺碘酮治疗组(21例)和毛花甙C对照组(21例)。治疗组静脉注射胺碘酮150mg,未转复为窦性心律者,重复给予75~150mg,后改为静脉滴注150~450mg;对照组静脉注射毛花甙C0.4~0.8mg。结果:治疗组用药后转复为窦性心律16例(76.2%),3h内转复者7例,3~8h转复者9例,平均复律时间为6.2h,治疗有效率90.5%;毛花甙C组用药后转复为窦性心律9例(42.9%),3h内转复者3例,3~8h转复者6例,平均复律时间为5.5h。治疗有效率为76.2%。两组用药后心室率均比用药前明显下降,胺碘酮组平均起效时间为(15±8)m in,毛花甙C组平均起效时间为(30±5)m in,两组平均起效时间及心率下降幅度差异无统计学意义。两组治疗前后QT间期及不良反应差异无统计学意义。讨论:静脉注射胺碘酮控制不稳定型心绞痛并发心房颤动的作用迅速、安全,其疗效高于毛花甙C。可作为不稳定型心绞痛并发心房颤动的首选药物之一。     

抗甲状腺药物致粒细胞减少症的诊治体会

对甲状腺机能亢进主要采用抗甲状腺药物进行治疗 ,而粒细胞减少是其严重的副作用 ,因而易引起感染、败血症、甲亢危象 ,甚至危及生命。 1998～ 2 0 0 0年 ,我院收治抗甲状腺药物所致粒细胞减少症 8例 ,结合国、内外文献 ,报告如下。1　临床资料　　本组女 7例 ,男 1例 ,年龄 18～ 47岁。甲状腺机能亢进诊断符合临床、生化标准。除外药物过敏、妊娠及血液系统疾病 ,停用影响粒细胞的药物。5例给予他巴唑 30 mg/ d,3例患者给予丙基硫氧嘧啶 30 0 mg/ d。于治疗 2～ 2 0周出现白细胞(WBC) 2 .8～ 4.0× 10 9/ L,粒细胞 1.0～ 1.5× 10 9/ L,…     

老年人阵发性房颤转复后小剂量胺碘酮维持窦性心律疗效观察

我们用小剂量胺碘酮长期维持老年人阵发性心房颤动心律转复后的窦性心律 ,疗效满意 ,从而为老年人阵发性心房颤动心律转复后的药物维持窦性心律提供一种药物选择方案。1　对象及方法4 8例老年人阵发性房颤系 1997年 3月至 2 0 0 1年 1月来我院急诊患者 ,常规体检、胸部X线片、超声心动图、心电图、心电监护或 2 4h动态心电图证实为阵发性房颤 ,经胺碘酮静脉滴注转复窦性心律后 (其中 3例自然转复 ) ,随机分为小剂量胺碘酮口服维持 (治疗 )组及常规剂量口服维持(对照 )组。治疗组 2 5例 ,男 14例 ,女 11例 ,年龄 6 0～ 83(6 9± 6 )岁 ,阵发…     

静脉注射伊布利特转复心房扑动或心房颤动14例疗效分析

目的:比较伊布利特与胺碘酮转复心房扑动(AFL)或心房颤动(AF)的临床疗效。方法:将符合入选标准的27例AFL或AF患者随机分为伊布利特组14例,给予伊布利特注射液1 mg于10 min内静脉注射(静注);如无效10 min后再给予1 mg静注。胺碘酮组13例,给予胺碘酮注射液150 mg于15 min内静注;如无效10 min后再给予75 mg静注。观察转复为窦性心律的例数及时间。结果:伊布利特组转复为窦性心律的时间短于胺碘酮组(P0.05);伊布利特组与胺碘酮组分别有11例与6例在给药后0～30 min内转复为窦性心律;分别有3例与2例在给药后30～90 min内转复为窦性心律,总转复率分别为100.0%和61.54%。2组差异无统计学意义(P=0.167)。结论:伊布利特是一种快速、安全、有效的新型抗心律失常药物,为AFL或AF转复为窦性心律提供了新的选择。     

胺碘酮治疗阵发性心房颤动24例

本文旨在探讨口服胺碘酮用于转复窦性心律及小剂量维持窦性心律的疗效和安全性。1　临床资料本组 2 4例为 2 0 0 0年 1月— 2 0 0 4年 3月住院经心电图证实为阵发性心房颤动患者。其中男 14例 ,女 10例 ,年龄 4 2～ 74岁 ,平均 ( 6 0 .5± 7.6 )岁。给药方法 :①停用其他抗心律失常药。②行心电图、X线胸片及肝肾功能、电解质、甲状腺功能、超声心动图检查。③给予国产胺碘酮。负荷量 6 0 0mg d ,口服 3～ 5d。心律转复为持续窦性心律 ,即减量为 4 0 0mg d ,口服 ,2 d ,5d后减量为 2 0 0mg d ,1 d ,口服维持。以后视情况可以进一步减到 2 …     

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.