非甾体类药物致急性胃粘膜病变的临床表现与内镜特征

目的:探讨非甾体类药(NSAIDs)致急性胃粘膜病变的临床表现及内镜特点。方法:回顾性分析54例NSAIDs导致急性胃粘膜病变患者的临床资料。结果:服用NSAIDs后临床表现为上腹痛,返酸、嗳气者32例(593%)、呕血8例(14.8%)、黑便25例(46.3%)、呕血伴血便10例(18.5%)。内镜下表现为弥漫性胃粘膜充血、水肿及多发性糜烂49例(90.7%),伴应激性浅表溃疡23例(42.6%)。结论:NSAIDs是急性胃粘膜病变的重要病因,对于需长期服用NSAIDs的高危患者,既往有溃疡病史,年龄>60岁,同时服用两种以上NSAIDs或与糖皮质激素同服者应给予预防性治疗。     

非甾体抗炎药致急性胃粘膜病变68例临床分析

目的探讨非甾体类抗炎药所致急性胃粘膜病变的临床特点。方法对2009年6月到2010年5月就诊的68例急性胃粘膜病变患者的临床资料进行回顾性分析,并根据出血前10天内是否服用非甾体类抗炎药分为服NSAIDs组20例和非NSAIDs组48例,比较2组患者临床资料和内镜下特点。结果两组患者年龄构成、心脑血管病史、消化道症状、溃疡、Hp感染有显著性差异（P〈0.05）。结论加强对非甾体抗炎药所致急性胃粘膜病变的临床特点认识,采取相应措施,减少非甾体类抗炎药引起急性胃粘膜病变的风险。     

非甾体消炎药致上消化道出血56例临床特点及内镜分析

目的：探讨非甾体类消炎药物导致上消化道出血的临床与内镜特征。方法：回顾性分析56例非甾体类消炎药物导致上消化道出血患者的临床资料。结果：服用非甾体类消炎药物后5 d内出血38例（68%）,表现为上腹痛39例（69%）,呕血伴黑便34例（61%）,单纯黑便22例（39%）,内镜下表现为弥漫性胃黏膜充血,水肿及多发糜烂38例（68%）,胃溃疡14例（25%）。结论：非甾体类消炎药物致上消化道出血的主要临床表现为腹痛、呕血伴黑便或单纯黑便。内镜下为弥漫性胃黏膜充血、水肿,多发性糜烂和溃疡。     

老年人非甾体抗炎药相关性胃十二指肠损伤的胃镜特点及临床表现分析

目的观察老年人非甾体抗炎药（NSAIDs）相关性胃十二指肠损伤的胃镜特点及临床表现。方法将167例我院胃镜下发现的老年性胃、十二指肠粘膜损伤患者,根据胃镜发现胃、十二指肠粘膜损伤时是否正在服NSAIDs分为A组77例（服用NSAIDs组）和B组90例（未服用NSAIDs组）。观察两组患者临床表现和胃镜下特点。结果 A组患者胃、十二指肠粘膜损伤所致相关临床表现与胃镜检查结果不一致,A组患者内镜下常伴有较严重的多发、巨大溃疡等,而缺乏典型的胃肠粘膜损伤的上消化道症状。结论长期使用NSAIDs可引起NSAIDs相关性胃十二指肠损伤,严重者可导致消化性溃疡、胃肠穿孔和出血等严重并发症。     

上消化道出血急诊胃镜检查及转归124例分析

目的：探讨急诊胃镜检查对上消化道出血患者病因诊断及内镜下治疗措施对疾病转归的影响。方法：对124例上消化道出血患者急诊胃镜检查及治疗结果进行回顾性分析。结果：124例急诊胃镜检查出血病变检出率100%,出血原因依次为消化性溃疡、急性胃黏膜病变、食管胃底静脉曲张、、贲门及胃恶性肿瘤、Mallory-Weiss综合征、十二指肠憩室,其他原因不明。内镜治疗的总有效率为94.11%（32/34）,总止血率98.38%（122/124）,病死率0.80%（1/124）。结论：上消化道出血患者,应尽早行急诊胃镜检查明确病因,有活动性出血者用镜下止血是安全而有效的治疗措施,可增加止血率,降低病死率。服用NSAIDs的患者,应重视对胃黏膜的保护性治疗。     

NSAIDs相关性肠病14例的临床分析

目的：分析因服用非甾体类抗炎药物（ NSAIDs）而并发相关性肠病的临床特征。方法：对我院2008年2月～2014年8月间收治的14例NSAIDs相关性肠病患者的临床资料进行回顾性分析。结果：本组14例NSAIDs 相关性肠病患者均存在不同程度的消化道出血,伴或不伴腹痛、腹部不适等症状,便血者多见;经过服药史的调查,14例均存在 NSAIDs 长期服用史,胃镜下均未发现明显出血灶,结肠镜结果示肠道黏膜糜烂,偶可见出血;停用NSAIDs药后,应用抑酸剂及黏膜保护剂可达到治疗效果。结论：服用NSAIDs能显著增加消化道溃疡患者并发出血的风险,NSAIDs相关肠病症状较为隐匿,具有非特异性,临床诊断在考虑用药史、临床症状和主诉的基础上,应结合胃肠镜、胶囊内镜或小肠镜检以帮助提高诊断率。     

老年非甾体抗炎药相关性溃疡58例临床分析

目的探求老年非甾体抗炎药相关性溃疡的临床特点。方法调查我院2002年6月～2009年8月期间经胃镜检查确诊为胃十二指肠溃疡或/和出血的60岁以上住院患者,根据入院前有无服用NSAIDs将患者分为NSAIDs组（58例）及非NSAIDs组（51例）,对两组病人的临床资料进行分析比较。结果NSAIDs组腹痛发生率明显低于非NSAIDs组;黑便或/和呕血发生率则明显高于非NSAIDs组,两组差异显著,有统计学意义（P〈0.05）。胃镜下表现：NSAIDs组胃、十二指肠溃疡、多发溃疡、大溃疡（直径〉10mm）发生率均明显高于非NSAIDs组,差异显著,有统计学意义（P〈0.05）。但两组Hp感染率相近,无统计学意义（P〉0.05）。结论应加强对老年人NSAIDs相关性溃疡临床特点的认识,采取适宜策略降低NSAIDs的不良反应。     

肝便化门脉高压性胃粘膜病变(附58例临床分析)

肝硬化门脉高压患者首次出血原因,食管下端流脉曲张破裂出血约占抓％【IJ,但胃粘膜病变亦是出血的重要原因。安阳地区医院消化科自lop年1月至lop年9月收治住院220例门脉高压井上消化道出血患者,经急诊内窥检查均有食管静脉曲张,同时出现胃粘膜病变58例,现结合文献作简要分析。l！防床资料一般资料：本组58例门脉高压并急性胃粘膜病变病人,男52例,女6例,平均年龄48．2岁（历岁一兀岁）。均有呕血、黑便,日出血量均在5（X：）Ill以上,24h内急诊内镜检查,发现胃粘膜糜烂18例（占力叽）,急性浅而小溃疡13例（占22．6％）,弥漫点…     

老年人非甾体抗炎药相关性溃疡并发出血的临床研究

目的:研究非甾体抗炎药(NSAIDs)致老年人相关性胃十二指肠溃疡并发出血的临床特点。方法:调查我院2006年1月至2007年12月期间经胃镜检查确诊为胃十二指肠溃疡并出血的60岁以上住院患者,根据入院前1周内有无服用NSAIDs将患者分为NSAIDs组(46例)及非NSAIDs组(38例),对两组病人的临床资料进行分析比较。结果:老年人服用NSAIDs所致的溃疡出血发病率持续上升,其占同期老年人消化性溃疡并出血的30.3%(46/152),与国内2006年文献报道27.17%接近,高于国内2001年文献报道16.51%;其起病隐匿,多以出血为首发症状,就诊时多已存在不同程度的贫血,内镜下复合溃疡、多发溃疡多见,病变损害范围更广泛,导致其病情较非NSAIDs组严重;而NSAIDs组幽门螺杆菌(Hp)阳性者和Hp阴性者的溃疡发生率无明显差异。结论:应加强对老年人NSAIDs相关性胃十二指肠溃疡并发出血临床特点的认识,采取适宜策略降低NSAIDs的不良反应。     

非甾体类抗炎药致上消化道出血的临床特征分析

目的研究非甾体类抗炎药（NSAIDs）诱发上消化出血的临床特征。方法调查亳州市人民医院2008年1月～2011年5月因诊断上消化道出血收住院治疗142例患者,根据入院前10 d内有无服用过NSAIDs的病史,将患者分为NSAIDs组（49例）及非NSAIDs组（93例）两组进行分析比较。结果两组比较,患者的性别、消化道溃疡病史差异无统计学意义,但NSAIDs组患者在年龄、心血管病史、出血前消化道症状、血红蛋白含量、内镜下消化道溃疡、住院时间、72 h止血率等方面与非NSAIDs组比较,差异有统计学意义（P〈0.05）。结论 NSAIDs是上消化道出血的重要病因,年老、患有心脑血管疾病者更易出现并发症,且止血效果欠佳。应掌握NSAIDs类药物的适应证和禁忌证,可同时使用胃肠道保护药。     

Value of D-Dimers in patients with acute aortic dissection

Objective: To evaluatel the value of D-dimers in patients with acute aortic dissection (AAD). Methods: This study consisted of 16 patients with AAD and 27 non-AAD patients. Serum D-dimets were measured by Sta-Liatest D-DI immunoturbidimetric assay. Results: D-dimer level was higher (P ＜ 0.001) in patients with AAD(7.91 ± 5.52 μg/ml) than that in non- AAD group(1.57±1.24 μg/ml). D-dimer was positive (＞0.4 μg/ml) in all patients with AAD and in 10 control group patients (37%). Among patients with acute AAD, D-dimers tended to be higher in Stanford A than in Stanford B (8.67 ± 4.31 μg/ml vs. 3.24±1.27 μg/ml, P ＜0.01). D-dimer values tended to be higher in more extended disease(3.84 ± 1.65 μg/ml, 8.57 ± 3.58 μg/ml and 11.87 ± 5.69 μg/ml in thoracic aorta, thoracic and abdominal aorta, thoracic and abdominal aorta and iliacal arteries, respectively, P ＜ 0.05 for both 8.57 ± 3.58 and 11.87 ± 5.69 vs. 3.84 ± 1.65 ). Including the control group into the analysis, we found a sensitivity of 100%, a negative predictive value of 100%, and a specificity of 66% and a positive predictive value of 64% for D-dimer in diagnosis of AAD in our patients with suspected AAD. Conclusion: D-dimer was elevated in patients with AAD. A negative D-dimer test result could be useful in excluding AAD.     

Research of combined liver-kidney transplantation model in rats

Objective： To set up a simple and reliable rat model of combined liver-kidney transplantation. Methods： SD rats served as both donors and recipients. 4℃ sodium lactate Ringer＇s was infused from portal veins to donated livers,and from abdominal aorta to donated kidneys, respectively. Anastomosis of the portal vein and the inferior vena cava （IVC） inferior to the right kidney between the graft and the recipient was performed by a double cuff method, then the superior hepatic vena cava with suture. A patch of donated renal artery was anastomosed to the recipient abdominal aorta. The urethra and bile duct were reconstructed with a simple inside bracket. Results： Among 65 cases of combined liver-kidney transplantation, the success rate in the late 40 cases was 77.5%. The function of the grafted liver and kidney remained normal. Conclusion： This rat model of combined liver-kidney transplantation can be established in common laboratory conditions with high success rate and meet the needs of renal transplantation experiment.     

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 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.     

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.     

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.     

安心颗粒对急诊经皮冠状动脉介入术后生活质量影响的研究

目的：评价使用安心颗粒对急诊经皮冠状动脉介入术（PPCI）术后生活质量的影响.方法：将160例接受PPCI的急性ST段抬高型心肌梗死患者随机分为安心颗粒组（术前顿服安心颗粒8.8g,术后安心颗粒4.4 g/次,每日2次）和对照组（仅接受基础药物治疗）.所有患者均服用阿司匹林、氯吡格雷和阿托伐他汀.分别在入院时、出院前1d、出院后180 d时,应用心肌梗死多维度量表（MIDAS）、中文版SF-36评价量表对患者生活质量评分.并观察术后30 d以内的出血并发症、血小板减少症发生情况.结果：入院时和出院前1d,两组患者的心肌梗死MIDAS、SF-36量表评分比较无差异（P＞0.05）;出院后180 d时,与对照组比较,安心颗粒组MIDAS、SF-36评分明显减低（P＜0.05）;组内与入院时比较,两组出院前1d、出院后180 d时,MIDAS、SF-36评分均降低（P＜0.05）.两组患者在随访期间均无大量出血、少量出血、重度和极重度血小板减少症发生,安心颗粒组有4例、对照组有7例发生不明显出血（P＞0.05）.两组发生轻度血小板减少症的患者数比较无差异（P＞0.05）.结论：PPCI使用安心颗粒,能改善急性ST段抬高型心肌梗死患者的生活质量,且不增加出血风险.     

The comparative studies of the influences of Urapidil and Nicardipine on sino-atrial node function, atrio-ventricular node function and hemodynamics

Objective:To investigate the influences of urapidil and nicardipine on rabbit sinus function,atrio-ventricular node function and hemodynamics.Methods:Thirty-two Angora's rabbits were selected and randomly divided into four groups.U1 group:urapidil 0.25 mg/kg;U2 group:urapidil 0.5 mg/kg;N1 group:nicardipine 10 μg/kg;N2 group:nicardipine 20 μg/kg.All these medicine were administrated within 30 seconds.Measurements were taken before and after the administration of urapidil or nicardipine for the following data:mean blood pressure(MAP),heart rate(HR),sino-atrial conduction time(SACT),maximal sinoatrial recovery time(SNRTmax)corrected sinus node recovery time(CSNRT),index of sinus node recovery time(SNRTI),Wenckebach A-V conduction frequency (WB),and P-R interval.Results:Significant MAP and HR changes were identified in all of the four groups before and after administration of both urapidil and nicardipine.No significant changes could be found in the rest of the parameters.Intergroup analysis showed that SACT and CSNRT of N1 and N2 groups were shorter than those of the U2 group(P＜0.01);the MAP decreased(P＜0.01)and the HR increased drastically(P＜0.01).Conclusions:Neither urapidil(0.25 mg/kg,0.5 mg/kg)nor nicardipine(10μg/kg,20μg/kg)has any significant influence on rabbit sinus function or rabbit atrio-ventricular node function.Nicardipine could be a better choice than urapidil for parafunctional sinus node patients.     

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.