星状神经节阻滞联合局部注射治疗颞下颌关节功能紊乱综合征30例临床报告

目的 观察星状神经节阻滞联合局部注射治疗颞下颌关节紊乱综合征的疗效.方法 选择症状典型患者60例,随机分为两组.A组为治疗组,星状神经节阻滞联合局部注射治疗.B组为对照组,采用电针针刺治疗.结果 A组治愈26例,有效3例,无效1例,治愈与有效率96.7%;B组治愈12例,有效9例,无效9例,治愈与有效率70%.结论 星状神经节阻滞联合局部注射治疗颞下颌关节紊乱综合征是一种较单纯电针针刺更有效的方法.     

Characteristics and behaviors of mothers who have a child with fetal alcohol syndrome

Fetal alcohol syndrome (FAS) is a leading cause of birth defects and developmental disabilities. The objective of this study was to identify the characteristics and behaviors of mothers of children with FAS in the United States using population-based data from the FAS Surveillance Network (FASSNet). FASSNet used a multiple source methodology that identified FAS cases through passive reporting and active review of records from hospitals, specialty clinics, private physicians, early intervention programs, Medicaid, birth certificates and other vital records, birth defects surveillance programs, and hospital discharge data. The surveillance included children born during January 1, 1995-December 31, 1997. In the four states included in our analysis - Arizona, New York, Alaska, and Colorado - there were 257 confirmed cases and 96 probable cases for a total of 353 FAS cases. Compared to all mothers in the states where surveillance occurred, mothers of children with FAS were significantly more likely to be older, American Indians/Alaska Natives, Black, not Hispanic, unmarried, unemployed, and without prenatal care, to smoke during pregnancy, to have a lower educational level, and to have more live born children. A significant proportion of mothers (9-29%) had another child with suspected alcohol effects. Compared to all US mothers, they were also significantly more likely to be on public assistance, to be on Medicaid at their child's birth, to have received treatment for alcohol abuse, to have confirmed alcoholism, to have used marijuana or cocaine during pregnancy, to have their baby screen positive for alcohol or drugs at birth, to have had an induced abortion, to have had a history of mental illness, to have been involved in binge drinking during pregnancy, and to have drunk heavily (7 days/week) during pregnancy. These findings suggest that it is possible to identify women who are at high risk of having a child with FAS and target these women for interventions.     

后胡桃夹综合征的多层螺旋CT血管造影诊断

目的研究与探讨使用多层螺旋CT血管造影(MSCTA)对后胡桃夹综合征进行诊断的方法。方法选择20例(病变组)已确诊的PNCS患者的肾血管MSCTA与60例(正常组)正常人进行D1、D2、D2/D1、S1、S2、S1/S2比较分析。结果病变组与正常组MSCATC比对显示,病变组LRV受压狭窄,回流受阻,近肾端管腔明显扩张。测量结果指标显示,两组在D1、D2/D1、S1、S2、S1/S2指标上均有显著性差异,差异有统计学意义(P<0.05)。结论使用MSCTA对PNCS进行诊断,能明显观测LRV的形态及其立体走向,测量截面积准确,能准确评估LRV受压程度,是一种新型的、无创的PNCS诊断方法。     

替勃龙联合更美宁胶囊治疗围绝经期综合征临床观察

目的:观察替勃龙(利维爱)联合更美宁胶囊治疗围绝经期综合征的临床疗效。方法:将110例患者随机分为治疗组及对照组。两组采用相同的基础治疗,对照组口服尼尔雌醇及安宫黄体酮。治疗组予利维爱及更美宁胶囊。两组均以3个月为1个疗程。结果:总有效率治疗组92.72%,优于对照组80.00%(P<0.05);两组对卵泡刺激素、黄体生成素和雌二醇具有相似的调节作用,但治疗组在降低临床症状积分方面更具优势;治疗后治疗组TG、TC、LDL-c均较治疗前显著降低(P<0.05),与对照组比较亦有显著性差异(P<0.05)。结论:利维爱联合更美宁胶囊治疗围绝经期综合征疗效确切,作用安全,值得推广。     

HIV实验室检测及其研究进展

目的:艾滋病又称获得性免疫缺陷综合征(AIDS),由人类免疫缺陷病毒(HIV,又称艾滋病病毒)引起,是危胁人类健康甚至导致死亡的一种严重传染病,其实验室检测方法需要进一步探讨。方法:本文从常用HIV检测方法及HIV检测新进展两个方面总结了HIV实验室检测及进展。结果:HIV的实验室检测是预防AIDS的主要方法,可直接影响到AIDS的筛查及诊治。结论:在经历20多年后,HIV的实验室检测法有了飞跃的发展,如今的HIV的实验室检测目标聚焦在如何开发更加准确、更加敏感、更加快速、更加简单化、更加自动化几个方向上,其研究任重而道远,需要我们共同努力携手完成。     

康斯特保护液与含血冷停搏液在机器人心脏瓣膜手术中的比较

目的对比康斯特保护液(HTK液)和4:1含血冷停搏液(St.Thomas液)在全机器人心脏瓣膜直视手术中的心肌保护效果及其对手术的影响。方法 2007年3月至2012年8月使用达芬奇(da Vinci.S)机器人手术系统在周围体外循环(PECC)下完成心脏瓣膜直视手术111例,其中二尖瓣成形79例,二尖瓣置换32例。在食道超声(TEE)引导下,经右侧股动脉、股静脉及颈内静脉插管建立PECC。心肌保护分别采用HTK液(n=46)和4∶1含血冷停搏液(n=65)灌注,使用BD14G静脉穿刺针作为停搏液灌注针,经胸壁穿刺进入胸腔后插入升主动脉,TEE评估停搏液灌注针插入的深度、位置及停搏液灌注效果。HTK液经升主动脉一次性灌注1 300～3 000 ml(25～30 ml/kg),灌注时间4～6 min,灌注压力200～250 mm Hg;使用4∶1含血冷停搏液者,首次灌注剂量1 000～1 500 ml(20 ml/kg),灌注压力300～380 mm Hg,灌注流量250～350 ml/min,以后每20～30 min半量复灌。结果两组患者体外循环时间、升主动脉阻断时间、心脏自动复苏率均无显著性差异(P>0.05),术后心肌酶CK、多巴胺用量、呼吸机辅助时间及胸腔引流量等亦无显著差异(P>0.05);HTK液组停搏液用量明显多于含血停搏液组(P<0.01);术中钠离子明显降低(P<0.05);液体总量显著增加(P<0.05)。结论 HTK液和含血冷停搏液在机器人心脏瓣膜手术中均能获得相同的心肌保护效果,HTK液不影响手术进程,较为实用,但易导致血液过度稀释及低钠血症,需积极处理。     

Porcine regulatory T cells: mechanisms and T-cell targets of suppression

Tregs are known for their suppressive capacity on various immune reactions. In swine, existence as well as suppressive activity of Foxp3⁺ Tregs could be demonstrated but detailed functional investigations are lacking. Therefore, we analysed the functional properties of porcine Tregs. We observed that besides TCR stimulation Tregs require IL-2 for activation. Furthermore, we investigated the following mechanisms of suppression: (i) cell–cell contact dependency, (ii) production of soluble suppressive factors and (iii) competition for growth factors. Our experiments revealed that suppression by porcine Tregs is abrogated by blocking cell–cell contact or by supplementing excessive amounts of IL-2. Additionally it could be shown that porcine Tregs produce immunosuppressive IL-10. Thereby, we demonstrated that porcine Tregs can use all main mechanisms of suppression mentioned above. Further investigations on the suppressive activity of Tregs using CFSE proliferation assays demonstrated that suppression affects T-helper cells as well as cytotoxic T lymphocytes and TCR-γδ T cells.     

下颌第二磨牙不同类型根管热牙胶及冷侧压法根管治疗效果评价

目的 比较下颌第二磨牙的不同类型根管采用热牙胶法及冷侧压法根管治疗的效果.方法 下颌第二磨牙诊断为牙髓炎或根尖炎的患牙120颗.其中I、C型根管各60例,随机采用热牙胶法及冷侧压法对患牙进行根管治疗,根据术后X线观察根管三维充填严密性、术后疼痛反应及1年后复诊效果来评价不同类型的根管采用两种不同根充方法的疗效.结果 下颌第二磨牙I型根管用热牙胶及冷侧压法根管充填其恰填率、术后疼痛率及失败率差异无统计学意义(P均＞0.05).与冷侧压组比较,热牙胶对C型根管治疗的恰填率高、术后失败率低,差异有统计学意义[分别为90.0％ (27/30)比66.7％(20/30),6.7％(2/30)比26.7％(8/30),P均＜0.05].结论 对于I型根管两种根充方法效果基本相同;C型根管采用热牙胶垂直加压法优于冷侧压法.     

芎劳通脉合剂治疗冠心病稳定劳累性心绞痛的临床疗效评价及对颈动脉内中膜厚度的影响

目的通过比较分析加用芎劳通脉合剂治疗与常规二级预防治疗冠心病稳定劳累性心绞痛的临床疗效评价及对颈动脉内中膜厚度的影响,探讨中药制剂对冠心病心绞痛的疗效评价及颈动脉粥样硬化的影响。方法将79例冠心病住院患者随机分为治疗组和对照组,通过对于心绞痛症状计分分级、中医证候、颈动脉内中膜厚度变化的观察,进行疗效对比。结果治疗3月后进行疗效评价,与对照组相比,芎劳通脉合剂治疗组改善症状疗效优于对照组（P〈0．05）;两组均能明显改善患者中医证候,治疗组疗效优于对照组（P〈0．01）;治疗后治疗组颈动脉内中膜厚度减少优于对照组,差异有统计学意义（P〈0．05）。结论组方后的芎劳通脉合剂对扩张冠脉、改善循环、缓解心绞痛症状,改善中医证候,该方剂明显减少颈动脉内中膜的厚度,从而具有抗动脉硬化的功效,值得临床推广。     

化红胶囊治疗围绝经期综合征50例临床研究

目的观察化红胶囊治疗围绝经期综合征的临床疗效。方法将符合围绝经期综合征诊断标准的100名患者,随机分为治疗组（50例）和对照组（50例）,治疗组采用化红胶囊治疗,对照组采用戊酸雌二醇片和谷维素治疗,连续用药3个月。疗程结束后观察治疗前后两组患者的临床症状、内分泌变化及安全性指标等情况。结果治疗组总有效率为80%,高于对照组的52%（P〈0.05）;治疗组的临床证候改善显著优于对照组;而治疗后两组E2均上升,FSH、LH均下降,与本组治疗前比较,差异均有统计学意义（P〈0.05或P〈0.01）;两组治疗后组间比较,差异无统计学意义（P〉0.05）,证明两组用药均在改善女性围绝经期激素水平上面起到积极的作用。结论化红胶囊能有效治疗女性围绝经期综合征,明显改善临床症状,并在一定程度上改善血清性激素水平,临床应用安全有效,无明显毒副作用,值得进一步研究和临床推广使用。