自我护理在消化性溃疡病人中的应用效果

目的 探讨自我护理工作在消化性溃疡病人中应用的可行性，提供更好的护理干预措施。方法 选择消化性溃疡病人60例，随机分为观察组与对照组，采取自我护理和常规护理两种模式，应用自行设计问卷，参照Zung焦虑自评量表（SAS）、抑郁量表（SDS）、生命质量评定量表和自理能力分级量表对病人入院、出院时评分结果进行对比。结果 出院时观察组各项评分均优于对照组。结论 自我护理适用于消化性溃疡病人。     

Three advantages of using traditional Chinese medicine to prevent and treat tumor

Traditional Chinese medicine (TCM), an important component of complementary and alternative medicine, has evolved over thousands of years with its own unique system of theories, diagnostics and therapies. TCM has been increasingly used in the last decades and become well known for its significant role in preventing and treating cancer. We believe that TCM possesses advantages over Western medicine in specific aspects at a certain stage of cancer treatment. Here we summarize the advantages of TCM from three aspects: preventing tumorigenesis; attenuating toxicity and enhancing the treatment effect; and reducing tumor recurrence and metastasis.     

先天性心脏病肺动脉高压与血管内皮生长因子水平及基因多态性相关研究

目的探讨血管内皮生长因子（VEGF）以及VEGF 936C／T基因多态性与先天性心脏病（先心病）肺动脉高压（PH）之间的关系。方法应用ELISA方法测定左向右分流型先心病PH患儿组、不伴PH患儿组和正常对照组血清VEGF浓度；运用PCR-RFLP技术分析3组VEGF 936C／T基因频率。结果①先心病PH组血清VEGF浓度明显高于不伴PH组和正常对照组（P〈0．05），先心病不伴PH组与正常对照组比较差异无显著性，中、重度PH组血清VEGF浓度明显高于轻度PH组（P〈0．05）；②3组VEGF 936C／T基因多态性比较，差异无显著性（P〉0．05）；③3组CT型血清VEGF浓度明显低于CC型，差异均有显著性（P〈0．05）。结论VEGF在先心病PH形成和进展过程中有一定的介导作用。VEGF 936T等位基因血清VEGF浓度有偏低倾向。VEGF 936C／T基因多态性可能不是先心病PH的主要基因危险因素．有待大样本量进一步证实。     

Functional outcome after surgical treatment of spinal meningioma

ObjectiveSpace-occupying spinal meningiomas (SM), commonly diagnosed due to gradual neurological deterioration, are treated surgically by decompression and tumor resection. In this series of patients with surgically treated SM, we determined individual predictors of functional outcome in the context of intraoperative neuromonitoring (IOM).MethodsThis retrospective study included 45 patients (39 women, 6 men; mean age 63 years). We reviewed pre- and postoperative charts, surgical reports, radiographic data for demographics, use of IOM, duration of symptoms, histopathology, co-morbidities, radiographic extension, surgical strategy, neurological performance (Japanese Orthopedic Association Score [JOA score]. Median follow-up was 34 months (12–190 months).ResultsMost frequent surgical approaches were laminectomy (71.1%, n = 32) and hemi-laminectomy (28.9%, n = 13). Predominant SM site was the thoracic spine (55.6%, n = 25). Most common symptoms were sensory deficits (77.8%, n = 35), gait disorders (55.6%, n = 25), motor deficits (42.2%, n = 19), and radiating pain (37.8%, n = 17). Simpson grade 1 resection was achieved in 6 patients, most common type of resection was Simpson grade 2 in 36 patients. During follow-up, 80.0% of patients had fully recovered sensory deficits (p < 0.001), 76.0% of patients with preoperative gait disorders had been asymptomatic (p < 0.001), and motor deficits in 12/19 (63.1%). Pain had decreased significantly from admission to follow-up (p = 0.001). IOM was used in 20 (44.4%) patients. Postoperatively, 6 (13.3%) patients had developed a new neurological deficit, 4 of them operated without IOM.ConclusionResection of SM with IOM showed good recovery, excellent functional results with low surgical morbidity.     

Performance of an on-site urine multidrug test used by forensic physicians in determining the cause of death

Forensic physicians in the region of Amsterdam routinely collect blood and urine samples during external examinations. A rapid on-site multidrug test is used to screen the urine samples for the presence of commonly used drugs classes. Urine and blood samples are sent to the laboratory for additional toxicological analysis. This study aimed to investigate how the substances found in urine using the on-site multidrug test relate to the substances identified with laboratory methods. In 2018 and 2019, 465 cases underwent an on-site multidrug test as well as toxicological laboratory analyses and were included in this study. Fifty-three percent (n = 247) of these cases included a positive on-site multidrug test for at least one substance. The level of total agreement between the on-site multidrug test performed by the forensic physician and the laboratory analyses either in urine or in blood varied per substance groups, with the best results for barbiturates, cocaine, ecstasy and methadone. In conclusion, the on-site multidrug test appeared to perform well for certain substance groups and is an economical and rapid tool. However, the results from the laboratory analyses in blood occasionally provided additional insights concerning the circumstances that could be of importance in the cause of death.     

肾络宁对IgA肾病大鼠肾间质细胞外基质代谢的影响

[目的]通过复制免疫球蛋白A肾病(IgAN)大鼠模型,探讨肾络宁对IgAN大鼠肾间质细胞外基质(ECM)代谢的影响。[方法]口服并定时尾静脉注射牛血清白蛋白,复合葡萄球菌肠毒素感染的方法复制IgAN模型,同时给予肾络宁治疗,利用原位分子杂交和免疫组织化学的方法,结合计算机病理图像分析,观察肾络宁对IgAN大鼠肾间质Ⅲ型胶原(ColⅢ)、纤溶酶原激活物抑制剂1(PAI-1)、基质金属蛋白酶1(MMP-1)及组织型基质金属蛋白酶抑制剂1(TIMP-1)基因及蛋白表达的影响。[结果]1)肾络宁组肾间质ColⅢ蛋白及PAI-1、TIMP-1mRNA表达与模型组相比明显降低(P<0.01或0.05)。2)肾络宁组肾间质MMP-1mRNA表达与模型组相比显著升高(P<0.01)。[结论]肾络宁能降低IgAN模型大鼠肾间质ColⅢ蛋白的表达,下调PAI-1、TIMP-1mRNA的表达,上调MMP-1mRNA的表达,从而发挥调节ECM代谢的作用。     

一贯煎在肝胆病中的运用

一贯煎是疏肝滋阴的名方,"肝为五脏之贼,肝病如邪",慢性肝炎、肝硬化、肝癌、胆结石、胆囊炎等肝胆病严重危害现代人的健康,结合临床,对一贯煎在肝胆病中的应用和心得体会进行总结,从一贯煎方名由来、一贯煎组方分析,到临床应用及治法治则,认为治疗慢性肝炎,重在滋养肝肾;治疗老年性肝炎,养阴法为关键;治疗乙型肝炎,宜肝肾同补;治疗肝硬化,疏泄为主,气血兼顾;辅助治疗肝癌,疏肝行气,化痰散结止痛;治疗胆石症,疏肝解郁,利胆通腑;治疗胆囊炎,滋阴养血,柔肝利胆。用药体会是:用药加减恰当,注意通权达变;注重脏腑制化关系,酌情遣方用药;治病为本,合理变通;注重辩证,异病同治。     

100例冠心病的颈动脉彩色多普勒超声分析

目的 探讨冠状动脉粥样硬化心脏病变的颈动脉超声改变与其相关性，以及与血脂的关系。方法 对82例冠心病、18例心肌梗塞患和正常对照组20人的颈动脉作彩色多普勒超声检查以及血液中血脂测定。结果 91．5％冠心病人和100％心肌梗塞病人存在血管内膜-中层(IMT)增厚，斑块和管腔狭窄等变化。斑块以颈总动脉分叉处(BIF)多见、以硬斑为主。血脂检查示LDL-C增高和ApoAⅠ下降。结论 冠状动脉病变与颈动脉粥样硬化密切相关。测定血液中LDL-C和ApoAⅠ的含量，可作为提示颈动脉粥样硬化的危险因素。     

醒脑静治疗脑梗塞所致老年痴呆症临床观察

以醒脑静治疗脑梗塞所致之老年痴呆症３０例，有效率为７０％，生脉针剂对照组３０例，有效率２０％（Ｐ〈０．０５）。提示醒脑静能提高颈总动脉的血流速度，降低脑血管外周阻力，提高ＨＤＳ积分，改善神经功能，痴呆症状和生活能力等。     

复杂移位型髋臼骨折的临床研究

目的：探讨复杂移位型髋臼骨折的临床治疗效果。方法：从2000年2月—2002年7月收治23例髋臼骨折患者，其中后柱合并后壁骨折11例，前柱合并后半横形骨折6例，双柱骨折5例，“T”形骨折1例。本组复杂移位型髋臼骨折均采用手术治疗。手术采用髂腹股沟入路11例，Kocher—Langen—beck(K—L)入路5例，髂骨股骨入路4例，前后联合入路3例。结果：根据Matta评分标准，解剖复位16例(69．6％)，满意复位6例(26．1％)，不满意复位1例(4．3％)。昕有病例随访6～26个月，平均19．6个月，随访疗效与X线优良率分别为81．8％，83．9％。结论：复杂移化型髋臼骨折尽早手术治疗可取得满意的骨折复位和临床疗效，手术医师的手术技巧和临床经验与疗效密切相关。