推拿治疗重度粘裢肩周炎宜分三步方案浅析——附一典型病例与同道商榷

1 病例 患者,麦某某,女性,52岁,1998年6月8日就诊. 患者于1989年1月初,自觉右肩疼痛,夜甚,遇寒或右手劳累则疼痛加剧,自行服食消炎痛或茶普生片而痛减轻,于同年2月发觉患肩上肢不能抬举,曾在本院内科、骨科、针灸科诊治;又到省某某医院神经科、骨科就诊,检查:风湿、血糖、尿酸、肩部X线照片,均未发现异常,均诊为肩周炎.经过中药外洗、内服,消炎止痛类药物及肩部皮质类固醇药品局封,并持续用红外线照射、中频电疗、针灸等治疗均无进展,后因回避外科建议麻醉下手术剥离治疗,而经上述日期试来我科诊治.     

他汀类药物降低重度心力衰竭病死率

1153例重度心力衰竭者,左心室射血分数均小于0.30,心功能为纽约心脏协会Ⅲ～Ⅳ级,病因包括缺血和非缺血性。随机分为接受他汀类药物的治疗组134例(12%),或未用药对照组(88%)。人均随访1.3年,观察两组病死率的差异。结果,随访期内两组共有413例不幸死亡(29%/年)。校正年龄、性别     

神经节苷脂 抚触对缺氧缺血性脑病新生儿行为神经能力的影响

<正>新生儿缺氧缺血性脑病(hypoxic-ischemic encephalopa-thy,HIE)是因围产期缺氧和缺血,导致胎儿和新生儿脑损伤,临床上出现一系列脑病后遗症。我们将药物联合抚触治疗中     

52例牙列重度磨损修复病例分析

目的:探讨口腔修复特别是牙列重度磨损修复的特征与方法。方法:对我院近两年诊治的52例牙列重度磨损口腔修复病例进行回顾性分析。结果:52例患者经过治疗后,口腔修复均一期成功,随访情况良好。结论:咬合重建对牙列重度磨损病例的修复有积极的意义。     

Changes in T .lymphocyte subsets after severe traumatic brain inJury

BACKGROUND： Besides local changes of cranial parenchymal cells, hemorrhage, etc., severe traumatic brain injuries also cause the changes of total body fluid and various functions, and the changes of lymphocytes and T lymphocyte subsets should be paid more attention to. OBJECTIVE： To reveal the changing laws of T lymphocyte subsets after severe traumatic brain injury, and compare with mild to moderate brain injury. DESIGN： A comparative observation. SETTINGS： Department of Neurosurgery, Longgang District Buji People＇s Hospital of Shenzhen City; Central Laboratory of Shenzhen Hospital of Prevention and Cure for Chronic Disease. PARTICIPANTS： All the subjects were selected from the Department of Neurosurgery, Longgang District Buji People＇s Hospital of Shenzhen City from August 2002 to August 2005. Thirty patients with severe brain injury, whose Glasgow coma score （GCS） was ≤ 8 points, were taken as the experimental group, including 21 males and 9 females, aging 16 - 62 years. Meanwhile, 30 patients with mild traumatic brain injury were taken as the control group （GCS ranged 14- 15 points）, including 18 males and 12 females, aging 15 -58 years. All the subjects were in admission at 6 hours after injury, without disease of major organs before injury Informed consents were obtained from all the patients or their relatives. METHODS： （1） The T lymphocytes and the subsets in peripheral blood were detected with immunofluorescent tricolor flow cytometry at l, 3, 7 and 14 days after injury in both groups. （2） The conditions of pulmonary infections were observed at 4 days after injury. The differences of measurement data were compared with the t test. MAIN OUTCOME MEASURES： Changes of T lymphocytes subsets at 1 - 14 days after severe and mild or moderate traumatic injury. RESULTS： Finally, 28 and 25 patients with mild to moderate traumatic brain injury, whereas 25 and 21 patients with severe traumatic brain injury were analyzed at 7 and 14 days respectively, and the missed ones died due to the development of disease. （1） Changes of T lymphocyte subsets： At 1 and 3 days after injury, CD3, CD4, CD8, CD4/CD8 began to decrease, whereas CD8 increased in the experimental group, which were very significantly different from those in the control group （t =2.77 - 3.26, P 〈 0.01）, and began to recover at 7 days, which were significantly different from those in the control group （t = 2.06 - 2.24, P 〈 0.05）, and generally recovered to the normal levels at 14 days （P 〉 0.05）. （2） Conditions of pulmonary infections： At 4 days after injury, the rate of pulmonary infection was significantly different between the experimental group and control group [73% （22/30）, 0, x2=37.29, P 〈 0.01]. CONCLUSION： Patients with severe traumatic brain injury suffer from damages of cellular immune function at early period （within 7 days）, and they are easily to be accompanied by pulmonary infections.     

维生素D受体基因多态性与汉族人群慢性牙周炎易感性的关系

目的 探讨维生素D受体(VDR)基因多态性与汉族人群慢性牙周炎(CP)易感性的关系。方法 收集汉族轻、中、重度CP患者共166例及80名无牙周炎对照者的颊黏膜拭子，以Chelex-100法提取DNA，采用聚合酶链反应-限制性片段长度多态性(PCR-RFLP)方法测定VDR BsmI、VDR ApaI和VDR TaqI的基因型，分析组间基因型分布和等位基因频率的差异。结果 轻、中、重度CP患者中VDR ApaI等位基因A携带者明显多于对照组，重度CP与中度CP、重度CP与轻度CP患者间VDR ApaI基因型的分布差异均有统计学意义，中度CP与轻度CP患者间VDR ApaI基因型分布差异无统计学意义，而VDR BsmI、TaqI位点的基因型分布在患者组和对照组间差异无统计学意义。结论 VDR ApaI等位基因A可能与汉族人群CP的易感性有关。     

异维A酸联合白花蛇舌草注射液治疗重度痤疮36例

痤疮是青年人群中最常见的一种皮肤病，重度痤疮常因面部出现较多炎性皮疹、囊肿、结节而使容貌受损，极大地影响患者身心健康。本病治疗方法较多，但疗效不满意。2000年以来，笔者应用口服异维A酸联合白花蛇舌草针肌肉注射治疗本病，取得较好效果，现报道如下。     

急性重度一氧化碳中毒伴皮下气肿、气腹1例报告

急性重度一氧化碳中毒伴皮下气肿、气腹甚为少见,现将我们遇到的1例报告如下。 患者,男,61岁。因室内煤火取暖发生一氧化碳中毒,于1988年10月22日晨3时许急诊入院。 体查:T35℃,P84次/分,Bp21.3/12.0kPa(160/90mmHg),R10次/分,有间断性呼吸停止;深度昏迷,被动体位,小便失禁;颈及前胸皮下有握雪感,听诊有捻发音;双侧瞳孔圆形,对光反射消失,两肺满布湿性罗音,心音不清;两上肢时有抽搐,生理反射减弱,病理反射未引出。 诊断:急性重度一氧化碳中毒,重度中毒性脑病     

纳洛酮在急性重度酒精中毒治疗中的应用观察

目的观察纳洛酮治疗急性重度酒精中毒的临床疗效。方法97例患者随机分为治疗组47例和对照组50例，两组患者在常规治疗的基础上给予维生素C、维生素B6、肌苷及胰岛素，治疗组加用纳洛酮。结果治疗组苏醒时间，症状消失时间均明显优于对照组。结论纳洛酮治疗急性重度酒精中毒疗效好，安全可靠。