156例脑梗塞的临床分析

本文报道脑梗塞患者156例,就其发病情况,诱发因素,临床特点,治疗及预防进行了分析讨论。脑梗塞的发病高于脑出血,高血压动脉硬化是发生脑梗塞的主要危险因素。积极预防和治疗高血压有极其重要的意义。脑梗塞的治疗应根据脑水肿的情况进行,不宜普遍首先应用扩血管治疗。本病复发率高,反复发作可引起广泛性脑部损害,其病死率、病残率明显高于首次发病。小剂量阿斯匹林等药物应用对预防复发可能有一定作用。     

Implication of biofilm formation in the persistence of urinary tract infection caused by uropathogenic Escherichia coli

Escherichia coli is the most frequent microorganism involved in urinary tract infection (UTI). Acute UTI caused by uropathogenic E. coli (UPEC) can lead to recurrent infection, which can be defined as either re-infection or relapse. E. coli strains causing relapse (n = 27) and re-infection (n = 53) were analysed. In-vitro production of biofilm, yersiniabactin and aerobactin was significantly more frequent among strains causing relapse. Biofilm assays may be helpful in selecting patients who require a therapeutic approach to eradicate persistent biofilm-forming E. coli strains and prevent subsequent relapses.     

Do changes in mood and concerns about weight relate to smoking relapse in the postpartum period?

Summary The majority of women who quit smoking during pregnancy will resume smoking during the postpartum period. Little is known, however, about the predictors of postpartum relapses to smoking. Changes in mood and increases in concerns about weight are common during the postpartum period, and these factors may affect womens postpartum smoking behavior. In this paper, we present a model of the relationship among mood, weight concerns and postpartum smoking. Data from previous postpartum relapse prevention trials are reviewed and evidence of a connection between changes in mood and weight concerns to postpartum relapse is presented. Directions for future research on the prevention of smoking relapses during the postpartum period, and the roles of mood and weight concerns in smoking relapse are presented.     

熏眼与按摩治疗干眼症的持续护理改进对策

目的探讨熏眼与按摩治疗干眼症的持续护理改进对策。方法选择2018年6月—2019年6月于我院接受中药熏眼与睑板腺按摩治疗的干眼症患者196例,以随机数字表法将其随机分为两组,其中对照组与研究组各98例。对照组患者接受常规护理,研究组在此基础上应用持续护理改进对策。评价两组患者的治疗效果、干眼症的复发情况,以及护理满意度。结果研究组治疗的总有效率为97.96%高于对照组90.80%(P<0.05)。研究组复发率3.06%低于对照组12.24%(P<0.05)。研究组护理满意率98.98%高于对照组90.82%(P<0.05)。结论持续护理改进对策能够保证熏眼与按摩治疗干眼症的效果,抑制疾病复发,并增强了患者对护理服务的满意度。     

Survival effect of systemic therapy on patients developing metastatic breast carcinoma

A multivariate analysis was performed to assess the effect of post-relapse systemic therapy on a series of patients with metastatic breast cancer who at initial presentation had no detectable metastases (M), were 70 years of age, presented with unilateral localized disease and no other associated malignancy, and were treated between 1965 and 1984 with successive protocols for primary disease and subsequently developed distant metastasis. All 760 patients analyzed relapsed with at least one metastasis, and were studied retrospectively with no selection criteria according to any specific protocol. All had recorded clinical data on menopause, stage, clinical tumor aggressiveness (PEV), initial chemo or hormonal therapy, and time to relapse, and had ongoing follow up at our Center, with salvage chemotherapy and/or hormonal therapy having been given to some but not all patients.A brief metastasis-free survival (p < 0.000001), and factors associated with electing pre-relapse chemotherapy (p < 0.000001) were associated with shortened post-relapse survival, while post-relapse therapy (chemo p < 0.0001, and hormonal p < 0.00001, replacing chemotherapy in the model) apparently increased post-relapse survival in the group overall. This result was similar in the inoperable patient group [with inflammatory breast carcinoma an additional risk factor (p < 0.0005)], as well as the operable group. However, in the operable group, when the pathologic criteria of histologic grade and nodal status were introduced into the analysis, post-relapse therapy was not seen to be an important factor for survival in any subgroup. Histograde (p < 0.000001), nodal status (p < 0.0001), metastasis-free survival (p < 0.001), and menopausal status (p = 0.03) were the only significant factors for post-relapse survival.     

Pathogenetic role ofHelicobacter pylori in duodenal ulcer disease

The pathogenesis of duodenal ulcer disease is multifactorial and the contribution ofHelicobacter pylori in relation to the other factors to the release of duodenal ulcer is unknown. To investigate this, we studied 147 patients with endoscopically proven healed ulcers. These patients were randomized to receive either placebo, misoprostol 200 g or misoprostol 300 g four times daily, and clinical, personal, physiological and endoscopic characteristics were obtained prospectively. Endoscopy was performed at the active phase of the ulcer and when the ulcer healed. Biopsies were taken from the antrum to assess histologically for: (1) the activity of gastritis as assessed by the degree of polymorph infiltration, (2) the degree of chronic inflammation by the degree of chronic inflammatory cells infiltration and degree of mucosal degeneration, and (3) bacteriologically for the presence ofH. pylori. The severity of the gastritis and the bacterial density were graded independently by two pathologists. The patients were assessed at two-month intervals for 12 months or until the ulcer relapsed. The results demonstrated that the relapse rates of duodenal ulcer were similar in the three treatment groups. The relapse rate was higher in the group with higher density of the bacteria (P<0.05). The degree of gastritis did not affect the relapse rate of duodenal ulcer in either the placebo or misoprostol group or in all patients combined. Stepwise logistic regression analysis identified that increased duodenal inflammation, male sex, early-onset disease, andH. pylori adversely affected relapse of the ulcer. We conclude that multiple factors affect the relapse of duodenal ulcer andH. pylori is one of them.     

砷剂治疗维甲酸诱导缓解后复发的早幼粒细胞白血病的研究

目的　观察砷剂治疗维甲酸诱导缓解后复发的急性早幼粒细胞白血病 (APL)的疗效。方法　对 30例APL患者采用三氧化二砷 (As2 O3 )注射液 10mg静脉滴注 ,每日 1次 ,2 8d为 1个疗程 ,间歇 7～ 14d。结果　第 1疗程CR率 73% (2 2 / 30 ) ,PR率 17% (5 / 30 ) ,NR率 7%(2 / 30 ) ,病死率 3% (1/ 30 ) ,有效率 90 % ;第 2疗程CR率 5 7% (4 / 7) ,PR率 2 9% (2 / 7) ,病死率14 % (1/ 7) ,有效率 86 % (5 / 7) ;第 3疗程CR率 5 0 % (1/ 2 ) ,病死率 5 0 % (1/ 2 ) ;总有效率为 90 %(2 7/ 30 )。该药与全反式维甲酸 (ATRA)药物无交叉耐药 ;不良反应较少。结论　As2 O3 注射液对复发性APL疗效较好 ,不良反应较轻 ,是一种较理想的治疗复发性APL的诱导分化剂     

Three cases of pyogenic sacro-iliitis,and factors in the relapse of the disease

Pyogenic sacro-iliitis (PS) is a rare disease in childhood. Three cases of PS are reported that were difficult to diagnose. Scintigraphy and magnetic resonance imaging (MRI) were useful for diagnosis. One patient suffered from an episode of relapse. Seventeen other cases of PS were reviewed in the literature to investigate the incidence of abnormal imaging findings and various factors in disease relapse. It was found that the incidence of abnormal findings by scintigraphy was significantly higher than that by computed tomography (P = 0.0057). The duration of intravenous antibiotic administration of the relapse group (14.7 ± 4.7 days) was significantly shorter than that of the non-relapse group (24.3 ± 10.7 days; P = 0.0376). The statistical analysis suggested that intravenous antibiotic administration is necessary at least for 20 days to prevent a relapse of PS.     

Donor Lymphocyte Infusion for the Treatment of Relapse after Allogeneic Hematopoietic Stem Cell Transplantation

The results of donor lymphocyte infusion (DLI) for treatment of relapse after bone marrow transplantation (BMT) are reviewed. Durable complete remission can be achieved at the molecular level for a majority (more than 70%) of patients with CML, when treated at early relapse. Results are less favourable for acute leukemias, although useful responses have been reported. Data are scarce though promising for myelodysplastic syndromes and multiple myeloma. Major treatment-associated toxicities are GVHD and bone marrow aplasia. The latter complication can be predicted by evaluating the level of residual donor-derived hematopoiesis. Modification of infused cells (CD8 negative selection or transduction with a suicide gene), addition of peripheral blood stem cells, and early implementation of escalating doses may counteract the complications and increase the response rate. Response rate is variably influenced by the presence of chronic GVHD after initial BMT, T-cell depleted BMT, underlying disease and stage at relapse, and the level of mixed chimerism. DLI is a direct demonstration of the graft-versus-leukemia effect (GVL). Because GVL after BMT is sometimes the predominant cause of cure, it may be advisable in such situations to redirect the conditioning regimens for BMT towards engraftment and less immediate cytotoxicity.     

Acetylcholine Transmission in Nucleus Accumbens and VTA on Heroin- Seeking Elicited by Contextual and Conditioned Cues

The involvement of cholinergic transmission in heroin self - administration and the reinstatement of heroin - seeking was examined in rats trained to nose - poke for intravenous heroin. Systemic treatment with physostigmine modestly reduced the acquisition and rate of heroin self-administration. Following 10 -14 days of self-administration, rats were left in the home environment for 14 days. Withdrawn animals were evaluated for context-induced nosepokes during the first hour after being returned to the self-administration apparatus. One hr later a conditioned stimulus （ house light, light in the nose-poke hole, sound of the infusion pump） was presented to initiate cue-induced reinstatement.