上消化道出血145例临床诊断

目的 :探讨常见上消化道出血的病因。方法 :按年龄 ,性别对相关病人分组 ,并对诊断过程进行回顾性分析。结果 :14 5例上消化道出血中肝硬化食道静脉曲张破裂出血占 5 4例 (37.2 4 % ) ,胃溃疡出血 30例(2 0 6 9% ) ,十二指肠球部溃疡出血 37例 (2 5 5 2 % ) ,胃粘膜病变 10例 (6 90 % ) ,其余病变出血者占 14例(9 6 6 % )。其中肝硬化食道静脉曲张破裂出血者男性较女性多见。年龄在 4 0岁以上发病增多。结论 :食道静脉曲张破裂出血 ,胃溃疡 ,十二指肠球部溃疡 ,胃黏膜病变是引起上消化道出血的常见病因 ,其中在食道静脉曲张破裂出血中 ,男性发病较女性高 ,年龄大于 4 0岁者上消化道出血发病率明显增高 (P <0 0 1)。     

上消化道出血病因及相关因素临床分析

目的:探讨上消化道出血的病因及相关因素.方法:回顾性分析我院消化内科2007-06-2010-03期间263例上消化道出血病人的临床资料.结果:男性上消化道出血明显高于女性(P＜0.05).青年组、中年组、老年组各占3.29%、43.21%、53.50%.不同性别、年龄组出血原因不相同.结论:上消化道出血的病因主要为消化性溃疡、食管胃底静脉曲张、消化道肿瘤、急性胃黏膜病变,性别、年龄为相关因素.     

老年人上消化道出血165例临床分析

目的 :探讨老年人上消化道出血的病因及临床特点。方法 :回顾性总结分析老年上消化道出血病人 16 5例与非老年病人 15 0例比较。结果 :老年人上消化道出血病因主要为消化性溃疡共 6 5例 ,占 39 39% ,其次为癌症共 46例 ,占 2 7 88% ;药物因素 :老年组 31例 ,显著高于非老年组 9例 (P <0 0 1)。结论 :老年人上消化道出血以消化性溃疡和癌症为主要原因 ,且以少量出血和黑便为主要特点 ,临床表现不典型 ,及时诊断与有效治疗非常重要     

50例老年人上消化道出血的特点及护理

我院 1999年 7月～ 2 0 0 0年 12月收治 5 5岁以上消化道出血病人 5 0例 ,现将老年人上消化道出血的特点与护理总结如下。出血特点　　 1.一般资料　男性 32例 (6 4% ) ,女性 18例 (36 % )。 5 5～ 6 0岁 18例 (36 % ) ,6 1～ 6 5岁 2 0例 (4 0 % ) ,6 6～ 70岁 8例(16 % ) ,70岁以上 4例 (8% )。2 .老年人上消化道出血的特点　①老年人上消化道出血之前多无明显诱因 ,也无先兆症状 ,易误诊与漏诊。本组19例以突发呕血和 (或 )黑便为首发症状 ,占 38%。②老年人上消化道出血持续时间长 ,出血量大 ,难以止血( 1) 。本组出血量 >10 0 0ｍｌ者 …     

490例房颤病人回顾性分析

目的:探讨房颤发生的原因与年龄、性别、民族的关系。 方法 :对心电图和 /或动态心电图确诊为房颤的 490例住院病人 ,依据病因、年龄、性别、民族分组 ,进行回顾性分析。结果 :房颤以风心病房颤和冠心病房颤最为常见 ,分别为 31.6 %和 2 1.4%,其次是特发性房颤 (2 0 .6 %)和高心病房颤 (11.6 %)。房颤不同病因的年龄、性别和民族的构成差异明显 ,在风心病房颤病人中 ,中年龄组 (4 0～ 6 0岁 )占 5 2 .90 %,女性占 5 9.35 %;冠心病房颤病人中 ,老年组 (>6 0岁 )占 80 .95 %,男性占 81.90 %;特发性房颤病人各年龄组均有分布 ,男性明显多于女性 ,男性占74.2 5 %;风心病房颤病人的平均年龄 ,维吾尔族为 45 .0 2岁 ,与汉族 5 4.2 5岁存在显著性差异。 结论 :房颤各种病因的年龄、性别和民族各有差异 ,年龄因素对参估房颤病因有一定的参考价值。     

老年人上消化道出血的临床特点及意义

目的　探讨老年人上消化道出血临床特点及意义。方法　回顾性分析上消化道出血老年患者 16 4例 ,并与同期非老年组 130例比较。结果　老年人上消化道出血病因中主要为酸相关性疾病 93例 (73 2 % ) ;胃癌 15例(11 8% ) ;低血压或休克老年组 2 7例 ,非老年组 12例 (P <0 0 5 ) ;使用非甾体类抗炎药物老年组 36例 ,非老年组 9例 (P <0 0 1) ;老年组死亡 2 1例 (其中 18例因全身慢性疾病恶化和出血后并发症死亡 ) ,非老年组死亡 5例 (P <0 0 1)。结论　酸相关疾病是老年人上消化道出血的主要病因 ,其次为胃癌。全身慢性疾病恶化和出血后并发症是影响老年人上消化道出血预后的主要因素     

急性脑卒中与上消化道出血相关因素分析

目的 :探讨急性脑卒中并发上消化道出血相关的危险因素。方法 :对 391例急性脑卒中住院患者的临床资料 ,按年龄、脑卒中类型、病变部位、病情程度、病死率及上消化道出血发生率六个方面进行回顾性分析。结果 :391例急性脑卒中并发上消化道出血 6 2例 ,发生率为 15 .9% ,上消化道出血随年龄增长而多发 ,≥ 70岁者占5 1.6 % ,出血性脑卒中组明显高于缺血性脑卒中组 (P <0 .0 1) ,丘脑出血、脑出血破入脑室高于其它部位出血(P <0 .0 5 ,P <0 .0 1) ,大面积脑梗死、多发性脑梗死高于其它脑梗死 (P <0 .0 1,P <0 .0 5 ) ,重型脑卒中高于轻、中型 (P <0 .0 1) ,并发上消化道出血组病死率 2 4 .2 % ,未并发出血组病死率 3.6 % ,两组间差异非常显著 (P <0 .0 1)。结论 :急性脑卒中并发上消化道出血与脑卒中类型、病变部位、病情危重程度等危险因素相关。     

上消化道出血病因及相关因素分析

目的:分析上消化道发生出血的病因和相关因素。方法:以2013年1月到2014年2月在我县医院接受诊治的上消化道出血病人中,随机抽取47例病人研究对象。对其临床资料进行回顾性分析。结果:病因:致使上消化道出血的病因:6例为胃癌所致,其占12.8%;14例为十二指肠溃疡所致,占29.8%;8例为胃溃疡所致,占17.0%;11例为急性胃黏膜损伤所致,占23.4%;5例为食管胃底静脉发生曲张破裂所致,占10.6%;4例为其它因素所致,占8.5%。相关因素:男性的发病率比女性高;中老年的发病率比青年高;冬春季节的发病率比夏秋季节高。结论:致使上消化道发生出血的病因比较复杂,其病因分布不仅同性别、年龄相关,还与季节变化存在关系。     

上消化道出血1562例分析

目的 探讨上消化道出血的原因和相关因素.方法 回顾性分析我院10年来1562例上消化道出血的临床资料.结果 1562例中通过检查有明确病因者1479例,主要病因依次为消化性溃疡、胃癌、急性胃粘膜病变、食管胃底静脉曲张;男性明显高于女性;消化性溃疡占各年龄组上消化道出血的首位,中青年组以十二指肠溃疡多见,老年组以胃溃疡多见;胃癌位于老年组上消化道出血的第二位,显著高于中青年组(P＜0.01).结论 上消化道出血的病人以消化性溃疡、胃癌、急性胃粘膜病变、食管胃底静脉曲张为最常见的病因,性别、年龄等均为上消化道出血的相关因素.     

农村地区上消化道出血126例临床分析

目的探讨农村地区上消化道出血（UGB）的病因及相关因素。方法回顾性分析本院2004年1月-2007年8月126例UGB住院病人的临床资料,对其病因诊治方法和预后进行统计分析。结果本组消化性溃疡73例占57.9%、胃癌9例占7.1%、急性胃粘膜病变占17例13.5%为UGB的常见病因.冬春季节高于夏秋季节;男性发病高于女性;不同性别、年龄者出血病因不尽相同。结论确诊是治疗上消化道出血的关键,内镜检查是诊断上消化道出血最简便而又实用的方法,上消化道出血病人尽快行内镜检查确诊病因,以指导治疗。     

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…