超声评价前列腺素E1治疗肺动脉高压疗效

目的观察不同剂量前列腺素E1(PGE1)治疗肺动脉高压的效果。方法选择57例不同病种引起的肺动脉高压患者,采用前列腺素E1(PGE1)治疗,分成三组,分别予以20ng/kg/,min,30ng/kg/,min,40ng/kg/minq.d.×7天治疗,观察用药前后肺动脉高压改善情况。结果所有患者治疗后经心超和/或右心导管测定肺动脉压力均有下降。治疗前肺动脉压力愈高改善愈明显,PGE1剂量愈高,改善愈明显。结论心超检查有助于评价PGE,治疗肺动脉高压的疗效。     

晚期肝癌伴门脉癌栓介入治疗的体会

目的：回顾分析40例晚期肝癌伴门脉癌栓病人介入治疗疗效和肝动脉栓塞安全性。方法：靶血管内灌注化疗并碘化油乳剂栓塞治疗。结果：经介入治疗后病人存活6个月至18个月不等。较文献报道仅生存平均14周为佳。结论：肝动脉化疗栓塞术对门脉癌栓病人是安全有效的。     

肝源性溃疡临床特点与治疗探讨

目的 研究乙肝后肝硬化患者消化性溃疡的临床特点,探讨小剂量心得安对肝源性溃疡愈合的影响。方法 肝源性溃疡４５例,观察其发病年龄、临床表现、溃疡部位、ＨＰ感染率和并出血及溃疡愈合率等特点。随机分为治疗组用心得安＋泰胃美治疗;对照组,用维生素Ｂ６＋泰胃美治疗,另外选单纯性消化２２例,作为对照２例,治疗方法与对照组相同,结果 肝源性溃疡发病年龄较单纯性消化性溃疡晚１０年,溃疡部位以胃溃疡居多和并出血率高     

心肌肌钙蛋白T快速检测对急性心肌梗死诊断的临床应用

目的探讨心肌肌钙蛋白T(cTnT)快速检测对急性心肌梗死(AMI)的早期诊断和不良后果预测价值.方法对123名高度可疑的AMI患者在发病后24小时内系列检测cTnT和肌酸激酶同工酶MB(CK-MB)活性.结果 (1)在发病后6小时、12小时和24小时内cTnT检测AMI的敏感性分别为38.8%、85.4%和94.2%,特异性为100%;(2)在发病后6小时和24小时内,CK-MB(活性)检测AMI的敏感性分别为70%和77.7%;(3)AMI患者随着cTnT水平升高,30天死亡率显著增加(P<0.01).结论 cTnT快速检测对诊断AMI具有高度的敏感性和特异性,并能预测患者的不良后果.该方法简单快速,适宜床边检测.     

手捻针干预重症抑郁障碍共病失眠:证据来自多导睡眠图及血清生物标志物

ObjectiveThis study is conducted to determine effects of manual acupuncture (MA) in patients with a diagnosis of major depressive disorder (MDD) and comorbid insomnia.MethodsA total of 67 participants who met the inclusion criteria were randomly enrolled in a two-arm randomized, placebo controlled, patients-blind trial and allocated to a real-MA group (patients = 34) and a sham-MA group (patients = 33). Patients in the real-MA group were treated on ‘Five-shen acupoints’, including Sìshéncōng (四神聪 EX-HN 1), Shéntíng (神庭 GV 24), Shéndào (神道 GV 11), bilateral Běnshén (本神 GB 13), and bilateral Shénmén (神门 HT 7). Though being punctured on the same acupoints, patients in the sham-MA group were treated by a placebo acupuncture approach (Streitberger Placebo-needle). Each group received corresponding interventions every other day, three times a week for total eight weeks. Both polysomnography (PSG) and testing of serum biological markers such as neuropeptide Y (NPY) and substance P (SP) were performed at pre- and post-treatment. Additionally, the global scores of Pittsburgh sleep quality index (PSQI) and the global scores of 17-items Hamilton Depression Rating Scale (HAMD17) were used for assessing the subjective sleep and emotion experience of patients, respectively. Meanwhile, adverse effects were monitored and recorded.ResultsAfter eight-week treatment, the global scores of PSQI and global scores of HAMD17 declined significantly (both P < 0.05) in the real-MA group but not in the sham-MA group (both P > 0.05). According to the parameters of PSG, striking decline were observed in sleep latency (SL) and wake after sleep onset (WASO) and striking climb were observed in total sleep time (TST) and sleep efficiency (SE) in the real-MA group after treatment (P < 0.05, respectively) but not in the sham-MA group (P > 0.05, respectively). Additionally, there were no significant differences in awakening times (ATs) and rapid eyes movement sleep latency (REM-SL) in both two groups after treatment (both P > 0.05). Meanwhile, the expression of NPY increased significantly and the expression of SP decreased significantly in the real-MA group after interventions (both P < 0.05) while those indicators only slightly fluctuated in the sham-MA group (P > 0.05). No serious adverse event was reported in either real- or sham- MA group.Conclusion(1) MA may be a potential alternative therapy for improving MDD and comorbid insomnia (particularly in extending total sleep time and shortening wake-up duration and sleep latency) via upregulating the expression of NPY and downregulating the expression of SP; more importantly, this efficacy of acupuncture can not be replaced by sham-acupuncture acting on the same acupoints with the same treatment frequency. (2) There is insufficient evidence to prove that MA can effectively reduce the number of arousals.     

中药浸膏用真空带式干燥机及其小型装置的研制

真空带式干燥机是一种适合于中药浸膏的真空干燥设备,不仅具有真空干燥的优点且能够连续操作,其优点是更高效和节能,符合GMP规范,是中药现代化进程中一种值得推广的先进的浸膏干燥设备.     

上海郊区自然人群队列和生物样本库建设

城镇化建设导致人口聚集、环境危险因素暴露风险增加和居民生活方式的改变, 人群间健康差异等问题也更加凸显。为了深入研究城镇化快速发展过程中居民慢性非传染性疾病(慢性病)的发病特点及变化趋势, 分析环境、生活方式和遗传等因素与主要慢性病的关系, 为慢性病的精准防控提供科学依据, 复旦大学公共卫生学院依托上海市"高峰学科建设项目", 自2016年4月起在城镇化快速发展的上海市松江、嘉定、闵行和徐汇区启动了"上海郊区自然人群队列和生物样本库"(SSACB)建设工作, 招募69 116名20～74岁常住居民作为队列成员。队列采用流行病学调查、体格检查和实验室检测等方法收集成员基本资料, 采集血、尿等标本建立生物标本库, 建立包括队列成员电子医疗病历系统、慢性病管理系统、肿瘤登记系统、传染病报告系统和死亡登记系统在内的区域健康信息共享平台。本文围绕SSACB队列设计理念、建设进程以及今后发展目标进行阐述。