曲美他嗪治疗慢性心力衰竭疗效观察

目的：探讨万爽力（曲美他嗪）治疗慢性心力衰竭（CHF）的疗效。方法：CHF患者共158例，随机分为2组：曲美他嗪治疗组、常规治疗组。结果：曲美他嗪治疗组总有效率为87．5％，常规治疗组总有效率67.5％，两组有显著性差异（P〈0．05）。结论：曲美他嗪治疗慢性心力衰竭疗效显著。     

Skin absorption and human exposure estimation of three widely discussed UV filters in sunscreens – In vitro study mimicking real-life consumer habits

Due to health concerns about safety, three UV-filters (Benzophenone-3, BP3, 10%; Ethylhexyl Methoxycinnamate, EHMC, 10%; Butyl Methoxydibenzoylmethane, BMDBM; 5%) were examined in vitro for absorption on full-thickness pig-ear skin, mimicking human in-use conditions. Kinetic profiles confirmed the rapid permeation of BP3; after the first hour of skin (frozen-stored) exposure to 2 mg/cm² (W/O sunscreen; recommended but unrealistic amount), about 0.5% of the applied dose passed into the receptor fluid. The absorption rate of filters was higher from W/O than from O/W emulsions. The fresh/frozen-stored skin permeability coefficient (0.83–0.54) for each UV filter was taken into account. Systemic Exposure Dosage of BP3, EHMC, BMDBM for humans as a consequence of (i) whole-body and (ii) face treatment with 0.5 mg/cm² of W/O sunscreen for 6-h skin exposure followed by washing and subsequent 18-h permeation (a realistic scenario) were estimated to be (i) 4744, 1032 and 1036 μg/kg-bw/day, and (ii) 153, 33 and 34 μg/kg-bw/day, respectively. From Margin of Safety for BP3, EHMC and BMDBM (i) 42, 485 and 192 as well as (ii) 1307; 15,151 and 5882, respectively, only the value of 42 (<100) for BP3 indicated a possible health risk. Escalation of a phobia towards all organic UV filters is undesirable.     

环孢菌素联合抗人淋巴细胞球蛋白治疗重型再生障碍性贫血5年随访研究

目的 :探索环孢菌素 (赛斯平 ,CYS)联合抗人淋巴细胞球蛋白 (ALG)或单用ALG治疗重型再生障碍性贫血 (SAA)患者的远期疗效及不良反应。方法 :对 119例SAA患者分别采用ALG加CYS和单用ALG两种治疗方案进行治疗 ,随访 5年并对两组的疗效及不良反应进行对比研究。结果 :ALG加CYS组的 5年有效率为67.2 % ( 41/ 61) ,长期生存率为 70 .4% ( 43 / 61) ;ALG组 5年有效率为 40 .3 % ( 2 8/ 5 8) ,长期生存率为 3 6.2 % ( 2 1/5 8) ,ALG加CYS组的总有效率及长期生存率均明显高于后者 ( χ2 =4.3 76,P <0 .0 5 ;χ2 =14.0 5 9,P <0 .0 1) ,且联合应用无不可逆性的不良反应发生。结论 :CYS是纠正SAA患者免疫功能异常的有效药物 ,促使T淋巴细胞免疫功能的恢复。联合应用ALG是治疗SAA的理想治疗方法 ,CYS是减少SAA复发、提高ALG疗效的必需用药     

顺腋窝皮纹美容切口治疗腋臭56例疗效观察

目的探讨总结顺腋窝皮纹美容切口治疗腋臭的临床疗效。方法对2012年3月-2013年2月就诊的56例不同程度的腋臭患者,在局部肿胀麻醉下顺腋窝皮纹做美容切口,并用腋臭刮匙刮除或眼科剪剪除局部汗腺、脂肪球及汗腺导管,观察治疗效果。结果56例患者中,3例患者术后出现血肿,但其中2例患者于术后48 h清除血肿并加强换药后未影响伤口愈合;1例患者腋窝中央皮肤坏死,面积约1 cm×1.5 cm,于术后7 d行扩创缝合术治疗后愈合;其余患者手术切口均顺利愈合,效果满意。3个月后复诊,所有患者手术切口均愈合良好,无瘢痕增生;除3例患者仍有轻微异味外,其余患者均无异味。结论顺腋窝皮纹美容切口治疗腋臭效果满意,该术式简便易操作,患者满意度高,值得临床推广。     

180例外伤患者对瘢痕担忧及早期美容缝合的满意度调查

目的通过调查统计患者外伤后来本科室就诊的主要原因及对伤后瘢痕发生的担忧情况,了解患者对瘢痕的重视程度,对瘢痕防治方法的了解程度,以及对早期美容缝合的满意度。方法对180例因皮肤外伤而进行早期缝合的患者,采用问卷调查的形式对其入院缝合的主要原因及疗效满意度进行调查。结果 180例患者对瘢痕形成的重视度达85.0%以上:对瘢痕防治方法的了解程度达95.0%,对早期美容缝合的满意度达94.2%。结论外伤患者对创面愈合后的美观要求较高,因此早期美容缝合对外伤患者的意义重大,可明显减少瘢痕,提高患者满意度。     

Repeatability， reproducibility and agreement when measuring central corneal thickness with SS-1000 swept-source optical coherence tomography and ultrasound pachymetry

ObjectiveTo assess the repeatability of central corneal thickness （CCT） measurements in healthy eyes by comparing measurements obtained with an SS-1000 swept-source optical coherence tomography （SS-1000 OCT） or by ultrasound pachymetry （USP）; to evaluate the agreement between these two devices. MethodsIn this prospective study, CCT was recorded after consecutive measurements with SS-1000 OCT and then with USP by a single skilled operator in 62 right eyes of healthy subjects. Intraclass correlation coefficient （ICC）, Bland-Altman plots and repeated-measures analysis of variance （ANOVA） were used to evaluate the repeatability of SS-1000 OCT. Paired t-tests and Bland-Altman plots were used to evaluate the agreement between the two devices. ResultsThe ICC of the SS-1000 OCT measurements was 0.999. Bland-Altman plots showed excellent agreement between any two of the three measurements （95％ limits of agreement were -2.4 to 1.8 µm, -2.8 to 2.1 µm, and -2.8 to 2.7 µm）. There was no statistical significance found with repeated-measures ANOVA. The mean values of CCT obtained from the SS-1000 OCT and USP were 534.38±24.52 µm and 538.40±25.36 µm, respectively. 95％ limits of agreement were -12.6 to 4.5 µm for these two devices. ConclusionThe SS-1000 OCT shows excellent repeatability of CCT measurements in healthy eyes. High agreement between CCT measurements suggests that SS-1000 OCT and USP can be used interchangeably in normal subjects.     

Clinical results versus subjective improvement with anterior transposition in cubital tunnel syndrome

This study was conducted to compare the results of anterior transposition methods and to determine the time needed to attain subjective well-being in patients with cubital tunnel syndrome. A total of 49 cases were retrospectively evaluated. Patients were called for follow-up, completed a questionnaire, and were reexamined. They were assigned to one of 3 groups: subcutaneous transposition (SCT), submuscular transposition (SMT), or intramuscular transposition (IMT). The McGowan classification and Wilson-Krout criteria were used for classification and outcomes assessments. Categorical variables were analyzed with the chi2 test, and metric variables by analysis of variance or through Kruskal-Wallis variance analysis. Improvement of at least 1 McGowan grade was observed in 87.63% of patients. The least responsive group was assigned a McGowan grade of III. The most effective procedure for resolving clawing was SMT. Clinical results were excellent in 26 patients (53.06%), good in 12 (24.48%), fair in 4 (8.16%), and poor in 7 (14.28%). At the latest follow-up, overall grip and pinch strength had improved by 23% and 34%, respectively, compared with the contralateral side. Thirty-six patients exhibited an improvement in grip power and 38 in fine dexterity. Complete resolution of numbness was observed in 32 patients, and complete resolution of pain was noted in 30 patients. The preoperative mean visual analog scale score of 6.82 improved to 3.36 postoperatively. Clawing improved in 4 patients and atrophy in 7. The mean time to subjective improvement was shortest in the SMT group and longest in the IMT group. The greatest pain relief was reported in the IMT group and the least in the SMT group. One case with IMT required reoperation because of recompression of the nerve. The most frequent complication in the SMT and IMT groups was muscular tenderness. In conclusion, SCT offers an alternative to other anterior transposition methods because of its simplicity and quicker recovery time, especially in mild to moderate cases.     

微创保胆内镜取石术的临床观察及护理

目的 :总结 6 7例微创保胆内镜取石术的临床疗效及护理体会。方法 :术前做好患者的心理护理 ,说明手术过程 ,让患者主动配合治疗 ,提高手术成功率 ,术后加强护理。结果 :6 7例胆结石患者术后B超显示取净率达10 0 % ,胆绞痛消失率为 97% ,饮食改善 93%。结论 :微创保胆内镜取石术对患者打击小 ,手术风险小 ,护理简单 ,术后恢复快 ,住院时间短 ,费用低     

采血方法对检验结果的影响研究

目的 :比较真空采血法和普通采血法对检验结果的影响。方法 :选取 165名健康体检者 ,随机以真空采血法和普通采血法采取左右肘正中静脉血 ,比较检验结果的差异。结果 :真空采血法放置 2h后发生白细胞分类比例改变 ,普通采血法易发生溶血和凝血 ,且测得的血糖值较真空采血法低 ,血清钾、血清镁和凝血酶原结果较真空采血法高。结论 :两种采血法对部分检验项目有影响 ,临床要根据检验项目选择适宜的采血法     

Periprosthetic Joint Infection with Negative Culture Results: Clinical Characteristics and Treatment Outcome

Negative culture result is frequently encountered in periprosthetic joint infection, but its clinical feature has not been well studied. In this study, clinical characteristics and treatment outcome were compared in two patient groups: (1) 40 periprosthetic joint infections with negative culture results (culture-negative group) and (2) 135 patients with positive culture results (culture-positive group). In comparison of two groups, the culture-negative group showed significantly higher incidence of prior antibiotic use (p = 0.005), higher incidence of prior resection surgery (p < 0.001) and lower ESR (p = 0.02) than the culture-positive group. The success rate of infection control was higher in the culture-negative group (p = 0.006), which suggests that culture negativity may not necessarily be a negative prognostic factor for periprosthetic joint infection.