恩丹西酮预防椎管内阻滞后寒战的效果

①目的观察麻醉前静脉注射恩丹西酮预防椎管内阻滞后寒战的效果和对腋温的影响.②方法选择腰麻-硬膜外联合麻醉下行经腹全子宫切除术病人160例,随机分为两组,实验组(n=80)麻醉前静脉注射恩丹西酮8mg;对照组(n=80)麻醉前静脉注射生理盐水4mL,观察两组术中平均动脉压、心率、腋温变化和寒战发生情况.③结果实验组8例出现寒战(10.0%),对照组26例出现寒战(32.5%),两组比较差异有显著性(x2=7.05,P＜0.01).两组平均动脉压、心率、腋温变化差异无显著性(t=0.14～1.71,P均＞0.05).④结论恩丹西酮可预防椎管内阻滞后寒战的发生,但对腋温无影响.     

Comparison of efficacy and safety of daily oral L-arginine and PDE5Is alone or combination in treating erectile dysfunction: A systematic review and meta-analysis of randomised controlled trials

The meta-analysis was performed to assess the efficacy and safety of daily oral L-arginine and phosphodiesterase type 5 inhibitors (PDE5Is) alone or combination in treating patients with erectile dysfunction (ED). We performed a search of randomised controlled trials in the following databases: PubMed, EMBASE and Cochrane Library databases. Four articles including 373 patients were studied. Erectile functions were significantly improved in three therapy groups compared with baseline. Patients who received the combination of L-arginine and PDE5Is showed significant improvement compared to those treated with L-arginine and PDE5Is alone, as assessed by sexual function index (p <0.00001 and p =0.005, respectively) and total testosterone (p <0.00001 and p =0.0007, respectively). Furthermore, patients who treated with PDE5Is alone exhibited the better efficacy than those treated with L-arginine alone in respects of sexual function index (p <0.00001) and total testosterone (p =0.0001). However, the combination of L-arginine and PDE5Is had no obvious difference relative to PDE5Is alone in terms of various adverse events (AEs). Conclusively, compared with monotherapy, the combination of L-arginine and PDE5Is showed a greater improvement of sexual function and total testosterone, and did not significantly increase the AEs. Besides, PDE5Is alone revealed a better effect than those treated with L-arginine alone for patients with ED.     

Analysis of pharmacological mechanisms of Yinyanghuo as treatment of erectile dysfunction with network pharmacology-based strategy

Erectile dysfunction is considered an important health problem that impacts the quality of life of men. Yinyanghuo, also called Epimedium or Horny Goat Weed, is a frequently used Chinese traditional herbal medicine, commonly used in treating erectile dysfunction in China. A network pharmacology method was performed systematically, at a molecular level, to analyse the pharmacological mechanism of Yinyanghuo as erectile dysfunction therapy. The network pharmacology method used in this study primarily includes prescreening of the active compounds, prediction of targets, network analysis and gene enrichment analysis. This network analysis proved that 4 targets (AR, NR3C2, PDE5A and BMP2) could be the targets of Yinyanghuo therapy on erectile dysfunction. Besides, gene enrichment analysis predicted that Yinyanghuo might have a role in erectile dysfunction by regulating 10 molecular functions, 8 cellular components, 10 biological processes and 36 possible targets related to 10 signalling pathways. Our study demonstrated the molecular and pharmacological mechanisms of Yinyanghuo against erectile dysfunction with a holistic approach and demonstrated a powerful method for analysing pharmacological mechanisms and rational utilisation of Traditional Chinese Medicine clinically.     

耳源性脑脓肿105例临床分析

目的 本文的目的为探讨耳源性脑脓肿的发生、诊断和治疗。方法 对1952～2002年治疗的105例耳源性脑脓肿患者(颞叶66例,小脑38例),对疾病的发生、诊断和治疗方式进行回顾性分析,特别是手术所见、诊断方法、治疗方法和结果。结果本组中发病年龄主要在10～30岁,10岁以内和更高的年龄组较少见。头痛(99.05％)、淡漠和昏迷(91.43％)是较常见的症状。105例中神经系统检查异常者78例。23例经CT诊断。经乳突腔穿刺抽脓者63例,外科钻颅穿刺抽脓26例,脓肿切除17例。死亡15例,其中66例颞叶脓肿中11例死亡,38例小脑脓肿中3例,脓肿部位不明者1例。结论 正确掌握经乳突腔穿刺抽脓的适应证对耳源性脑脓肿的治疗十分重要。颅骨钻孔穿刺引流和脑室引流是脑疝的有效的紧急处理措施。自CT用于耳源性脑脓肿的诊断和随访以来,死亡率明显下降。     

新生儿缺氧缺血性脑病血浆Th2 源细胞因子水平的研究

目的　研究新生儿缺氧缺血性脑病 (HIE)患儿辅助性T淋巴细胞亚群 2 (Th2 )细胞功能变化及其与HIE间的关系。　方法　采用ELISA法和单克隆抗体间接免疫荧光法 ,检测 4 6例HIE患儿不同病期血浆和外周血单个核细胞 (PBMC)体外分别产生白细胞介素 (IL) 6、IL 8、IL 10水平和T细胞IL 2受体 (IL 2R)表达率 ,并与正常足月新生儿脐血 (2 0例 )进行对照。　结果　HIE病程第 1天血浆及PBMC体外产生IL 6 [分别为 6 6 .3、80 4 .5ng L(中位数 ,以下同 ) ]、IL 8(4 10 .5、1983.6ng L)和IL 10 (2 7.9、14 0 .1ng L) ,明显高于正常脐血对照组 (分别为 1.9、187.7;91.0、76 6 .8;2 .6、16 .4ng L) (Z =4 .6 5 3～ 5 .85 6 ,P <0 .0 1) ;中重度组及并发多器官功能损害 (MOD)的HIE患儿血浆及PBMC体外产生IL 6 (分别为 86 .0、12 36 .4 ;111.3、174 6 .9ng L)、IL 8(分别为5 79.5、2 812 .2 ;5 32 .8、2 94 3.3ng L) ,分别高于轻度组 (分别为 5 2 .6、5 83.4 ;335 .3、15 2 8.9ng L)及无MOD组 (分别为 5 6 .6、713.8;35 2 .4、15 72 .4ng L)患儿 (Z =2 .2 2 8～ 2 .70 1,P <0 .0 5 ;Z =2 .877～4 .187,P <0 .0 1) ,而IL 10差异无显著性 (Z =0 .4 5 0～ 1.85 0 ,P >0 .0 5 ) ;T细胞IL 2R表达率 [(5 2 .8± 13.4 ) % ]明显     

308 nm准分子激光联合富血小板血浆治疗白癜风有效性与安全性Meta分析

目的: 比较308 nm准分子激光联合富血小板血浆(platelet-rich plasma,PRP)与单用308 nm准分子激光治疗白癜风的有效性与安全性.方法: 检索PubMed、Embase、Web of Science、Cochrane Library、中国知网、万方、维普、中国生物医学文献数据库中关于308 ...     

PNH的回顾性研究

目的 分析阵发性睡眠性血红蛋白尿症(PNH)临床表现及实验室检测各指标的诊断价值。方法 对PNH患者进行糖水试验,酸化血清溶血试验(Ham实验),尿含铁血黄素试验(Rous),血液常规,骨髓形态学检查,铁染色,网织红细胞计数测定和临床表现的分析。结果 糖水试验阳性率100％、酸化血清溶血试验(Ham实验)阳性率为100％、Rous试验阳性率为2.8％,糖水实验、Ham实验、Rous实验均反映PNH的病理特征。中、重度贫血者占83.3％。WBC减少者占44.4％,BPC减少者占50％,三系列皆减少占33.3％,BM象示增生低下者仅占5.5％,以幼红增生为主。铁染色时,铁粒幼红细胞<15％者有11例,网织红细胞计数增高。结论 用一组相关试验诊断PNH可相互印证,加上临床实践,可提高确诊率。     

Angiographic uterine artery embolization followed by immediate curettage: an efficient treatment for controlling heavy bleeding and avoiding recurrent bleeding in cervical pregnancy

Two cases of cervical pregnancy with heavy bleeding successfully treated by uterine artery embolization (UAE) followed by immediate curettage are described in this report. Case 1 demonstrated intermittent bleeding after serious bleeding was successfully controlled by UAE. Serum beta human chorionic gonadotropin (beta-hCG) level rose remarkably after a short time decline. Transvaginal sonography consistently revealed a heterogeneous mass in the cervix. Repeated UAE followed by immediate curettage was performed and complete resolution was achieved. Case 2 was also successfully managed by UAE followed by immediate curettage after failure of medical treatment. This report suggests that UAE followed by immediate curettage is a safe and efficient procedure for controlling heavy bleeding and avoiding recurrent bleeding when fertility capacity is desired in cases of cervical pregnancy with fetal cardiac activity and high beta-hCG concentration.     

MMP-9基因rs17577多态性与脑梗死的关系

目的探讨青岛地区汉族人群基质金属蛋白酶-9(MMP-9)基因rs17577多态性与脑梗死关系。方法采用多聚酶链反应-限制性内切酶片段长度多态性技术和基因序列测定技术,检测脑梗死组和对照组MMP-9基因型及等位基因频率并进行比较。结果脑梗死组MMP-9基因GA基因型频率、A等位基因频率均显著高于对照组,差异有统计学意义(χ2=8.74、7.79,P<0.01)。Logistic回归分析显示,A等位基因与脑梗死发病有关(OR=1.855,95%CI=1.206～2.854,P<0.01)。结论 MMP-9基因rs17577多态性与脑梗死可能相关,A等位基因可能是脑梗死的危险因素。