手术治疗缩窄性心包炎68例的体会

目的总结手术治疗缩窄性心包炎的经验。方法缩窄性心包炎患者68例,均行胸前正中切口劈骨入路心包剥离术,观察术后临床疗效及并发症。结果手术治疗缩窄性心包炎68例,存活67例,术后死亡1例,病死率为1.5%,死于严重低心排综合征。术后并发低心排综合征11例和心力衰竭9例;术后中心静脉压下降（10.7±2.8）cmH2O。心功能恢复至Ⅰ级52例,Ⅱ级15例。随访期间无缩窄复发及死亡病例。结论胸前正中切口劈骨入路心包剥离术治疗缩窄性心包炎临床效果好,可作为首选治疗手段。     

26例慢性缩窄性心包炎的外科治疗

目的：探讨慢性缩窄性心包炎的手术治疗效果.方法：26例慢性缩窄性心包炎患者,术前心功能Ⅱ级5例、Ⅲ级17例、Ⅳ级4例,采用全麻下心包剥脱术,观察治疗效果.结果：术前死亡1例,25例在全麻下行心包剥脱术均治愈出院;随访19例,失访6例,术后心功能Ⅰ～Ⅱ级15例,Ⅲ级4例.结论：外科手术是治疗慢性缩窄性心包炎的有效方法,准确把握手术时机及手术方法是提高治愈率的关键.     

手术治疗缩窄性心包炎16例临床分析

目的探讨提高手术治疗缩窄性心包炎的经验。方法对16例缩窄性心包炎患者的手术治疗情况进行总结分析。结果16例术后1个月心功能I级(12例),心功能Ⅱ(4例),术后症状改善明显。结论手术治疗缩窄性心包炎是最有效的方法,一旦确诊应尽早手术治疗。     

缩窄性心包炎外科治疗72例临床分析

目的探讨外科手术治疗缩窄性心包炎的经验。方法对72例缩窄性心包炎病人的外科治疗情况进行总结分析。结果72例术后1个月心功能Ⅰ级(59例)、Ⅱ级(11例)。1例术中死于急性心肌膨胀,1例术后死于低心排综合征。结论心包切除程度、手术时机、手术方法是此类手术成功的关键。     

110例缩窄性心包炎的外科治疗

目的总结缩窄性心包炎外科手术治疗经验及手术效果。方法回顾性分析1985年2月-2010年12月,新疆医科大学第一附属医院心脏外科收住的外科治疗缩窄性心包炎110例的临床资料,男性75例,女性35例。术前心功能Ⅰ级3例,Ⅱ级15例,Ⅲ级54例,Ⅳ级38例。手术采用左前外侧切口60例,胸骨正中切口50例。其中35例行心包切除,75例行心包部分切除。结果术后中心静脉压平均降至(12.2±4.4)cmH2O;12例出现低心排综合征,2例死亡,死亡率1.8%;术后复查心功能Ⅰ级42例,Ⅱ级63例,Ⅲ级5例;术后病理诊断示结核42例,非特异性病变68例。结论恰当的手术时机、手术径路的选择、合理的心包切除范围及围术期处理是缩窄性心包炎外科手术治疗获得满意疗效的关键。     

缩窄性心包炎外科治疗72例临床分析

目的 探讨外科手术治疗缩窄性心包炎的经验。方法 对72例缩窄性心包炎病人的外科治疗情况进行总结分析。结果 72例术后1个月心功能I级（59例）、Ⅱ级（11例）。1例术中死于急性心肌膨胀，1例术后死于低心排综合征。结果 心包切除程度、手术时机、手术方法是此类手术成功的关键。     

手术治疗慢性缩窄性心包炎51例

目的探讨提高手术治疗慢性缩窄性心包炎疗效的经验。方法回顾分析手术治疗的慢性缩窄性心包炎51例的临床表现、辅助检查及手术资料。结果全组51例均全麻下行心包切除术,治愈46例,好转3例,死亡1例。病理报告：结核性心包炎32例（62．75％）,慢性炎症10例（19．6％）,非特异性炎症2例（3．9％）,化脓性心包炎7例（13．73％）。结论手术治疗慢性缩窄性心包炎是最有效的方法,一旦确诊应尽早手术治疗;掌握心包切除范围,重视围术期处理是取得良好疗效的关键。     

缩窄性心包炎29例外科治疗

目的 总结外科手术治疗缩窄性心包炎的经验及疗效.方法 回顾性分析29例经治疗手术的缩窄性心包炎患者的临床资料.结果 本组均在全麻下行心包剥脱术,治愈28例,死亡1例.对21例患者随访3个月～3.5年,均无复发.结论 心包剥脱术是治疗缩窄性心包炎的有效方法,正确掌握手术适应证、合理的心包剥脱范围及正确的围术期处理是手术成功和提高远期疗效的关键.     

79例缩窄性心包炎的外科治疗

目的：总结79例缩窄性心包炎的外科治疗体会，结合文献对病因、术前准备、手术操作、术后管理等方面进行讨论。方法：1990年1月～2000年3月为79例缩窄性心包炎病人实行了心包部分切除术，其中70例采用胸骨正中切口，9例采用左前外侧切口。结果：病检结果48例为结核性，占60．7％，说明结核为最常见的病因，术后早期死亡3例，死亡率为3．78％。结论：缩窄性心包炎一经确诊，应尽早手术，术后绝大多数病人心功能均有明显的进步。     

慢性缩窄性心包炎20例的诊断及手术治疗

目的　总结慢性缩窄性心包炎的诊断、手术技巧及围术期处理经验。方法　回顾性分析手术治疗慢性缩窄性心包炎2 0例 ,总结其手术经验及围术期管理方法。结果　本组 1例术后死于顽固性低心排综合征 ,其余患者症状明显改善。结论　心包剥脱术是手术治疗慢性缩窄性心包炎的最佳方法 ,早期明确的诊断 ,最佳手术时机和方法及完善的围术期管理是手术成功的几大关键要素。     

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…