铁制剂治疗缺铁性贫血的随机对照临床研究

目的 了解硫酸铁控释片、琥珀酸亚铁、多糖铁复合物治疗缺铁性贫血的疗效及不良反应。方法 将105例不诊于血液科门诊的缺铁性贫血患者，按照入选标准，以随机区组的方法随机分入3个治疗组，分别予以硫酸业铁控释片（福乃得，500mg，每日1次）、琥珀酸业铁（速力菲,，0．1g，每日3次）、多糖铁复合物（力蜚能，0．15g，每日2次）治疗8周，每1－2周随访1次，随访血常规、网织红细胞计数及药物的不良反尖。治疗前及治疗结束检查血清铁、总铁结合力、血清铁蛋白等有关铁参数。结果与结论 以血红蛋白和血清铁蛋白恢复正常作为完全缓解的标准，硫酸亚铁控释片、琥珀酸亚铁、多糖铁复合物3种药治疗8周，缺铁性贫血的完全缓解率分别为74％、76％、40％（P＝0．004），总的有效率分别为81％、89％、76％（P＞0．05）。主要的不良反应为胃肠道反应，3种药中以多糖铁复合物的不良反应最少，其次为琥珀酸亚铁，硫酸铁控释片的不良反应最常见，但大多数能够耐受。     

染色内镜和放大内镜技术是提高早期大肠癌诊治水平的重要手段

应用常规内镜技术难以发现大肠平坦型病变和凹陷型病变。近年来染色内镜和放大内镜技术已经发展成熟,在国外已获广泛应用,可以发现大肠微小病变和早期大肠癌。应用腺管开口分型方法可以预测肿瘤病变的组织学类型及肿瘤的浸润深度,据此可确定行内镜下粘膜剥离术或分片粘膜剥离术将肿瘤切除,抑或行外科手术治疗。在当前我国的胃肠内镜医疗界,应广泛开展染色内镜和放大内镜的临床应用,以早期发现大肠病变,提高我国大肠癌的内镜诊治水平。     

李翠萍治疗多囊卵巢综合征的临床经验

李翠萍教授认为多囊卵巢综合征发病机理在于肾虚,应从肾论治,同时结合女性月经生理周期中阴阳变化规律进行治疗。临证以补肾调周法为主,中西医结合,取得了较好疗效,并附验案1例佐证。     

A randomized,double‐blind,placebo controlled,multi‐center study of intravenous iron sucrose and placebo in the treatment of restless legs syndrome

Iron deficiency may exacerbate symptoms in the Restless Legs Syndrome (RLS). We investigated the effect of intravenous iron sucrose or placebo on symptoms in patients with RLS and mild to moderate iron deficit. Sixty patients with primary RLS (seven males, age 46 (9) years, S‐ferritin ≤45 μg/L) recruited from a cohort of 231 patients were randomly assigned in a 12‐months double‐blind, multi‐centre study of iron sucrose 1000 mg (n = 29) or saline (n = 31). The primary efficacy variable was the RLS severity scale (IRLS) score at week 11. Median IRLS score decreased from 24 to 7 (week 11) after iron sucrose and from 26 to 17 after placebo (P = 0.123, N.S. for between treatment comparison). The corresponding scores at week 7 were 12 and 20 in the two groups (P = 0.017). Drop out rate because of lack of efficacy at 12 months was 19/31 after placebo and 5/29 patients after iron sucrose (Kaplan–Meier estimate, log rank test P = 0.0006) suggesting an iron induced superior long term RLS symptom control. Iron sucrose was well tolerated. This study showed a lack of superiority of iron sucrose at 11 weeks but found evidence that iron sucrose reduced RLS symptoms both in the acute phase (7 weeks) and during long‐term follow up in patients with variable degree of iron deficiency. Further studies on target patient groups, dosing and dosing intervals are warranted before iron sucrose could be considered for treatment of iron deficient patients with RLS. © 2009 Movement Disorder Society     

Needle electromyography

Physiologic assessment of diseases of the motor unit from the anterior horn cells to the muscles relies on a combination of needle electromyography (EMG) and nerve conduction studies (NCS). Both require a unique combination of knowledge of peripheral nervous system anatomy, physiology, pathophysiology, diseases, techniques, and electricity is necessary. Successful, high‐quality, reproducible EMG depends on the skills of a clinician in patient interaction during the physical insertion and movement of the needle while recording the electrical signals. These must be combined with the skill of analyzing electric signals recorded from muscle by auditory pattern recognition and semiquantitation. 10 , 52 This monograph reviews the techniques of needle EMG and waveform analysis and describes the types of EMG waveforms recorded during needle EMG. © 2009 Wiley Periodicals, Inc. Muscle Nerve 39: 244–270, 2009     

The pattern evoked response in disorders of the optic nerve

The pattern evoked electroretinogram (PERG) was investigated in 11 patients with unilateral optic nerve disease and in a series of age-matched controls. The visually evoked potential (VEP) was also measured. The PERG showed a similar reduction to the VEP in optic nerve disease. Serial studies indicate that the PERG may not be affected immediately in some instances but may show a gradual decline over several months.     

制作缺血性中风气虚血瘀证大鼠模型的实验研究

目的 探索建立缺血性中风气虚血瘀证大鼠模型的制作方法和评价体系。     

缩泉丸对肾阳虚多尿大鼠内分泌及免疫功能的影响

目的 观察缩泉丸对肾阳虚多尿模型大鼠内分泌及免疫功能的影响.方法 用腺嘌呤250 mg/kg灌服大鼠4周,造成肾阳虚多尿模型,分别给予缩泉丸、肾气丸和去氨加压素(dDAVP)治疗4周,检测缩泉丸对体重、脏器系数、血清中皮质酮浓度和外周血T淋巴细胞亚群水平的影响.结果 模型组大鼠体重比正常对照组大鼠明显降低,dDAVP组、缩泉丸中、高剂量组与模型组大鼠体重相比,具有显著性差异(P<0.05或P<0.01).与正常对照组比较,模型组大鼠胸腺、肾上腺和垂体系数明显降低(P<0.05或P<0.01);与模型组比较,除缩泉丸低剂量组外,其余各治疗组的胸腺系数均明显提高,差异具有显著性(P<0.05);与模型组比较,垂体和肾上腺系数,仅在肾气丸组和缩泉丸高剂量组发现有明显提高,差异具有显著性(P<0.05).模型组具有较低的血清中皮质酮浓度,与正常对照组比较,具有非常显著性差异(P<0.01),肾气丸组和缩泉丸中、高剂量组血清中皮质酮浓度比模型组明显增加,具有显著性差异(P<0.05或P<0.01).与正常对照组比较,肾阳虚多尿模型组大鼠外周血T淋巴细胞CD3+百分比、CD3+/CD4+百分比明显减少,CD3+/CD8+百分比明显增加,差异具有显著性(P<0.05或P<0.01);与模型组比较,肾气丸组和缩泉丸低、中、高剂量组CD3+百分比、CD3+/CD4+百分比明显增加,CD3+/CD8+百分比明显减少,差异具有显著性,与模型组相比dDAVP组CD3+百分比、CD3+/CD4+百分比和CD3+/CD8+百分比均无显著性差异.结论 缩泉丸能够调节肾阳虚多尿大鼠的内分泌及免疫功能.     

对诊断PADAM的游离睾酮指数的评估

目的 评价诊断中老年男子部分雄激素缺乏综合征（PADAM）的游离睾酮指数（FTI）.方法 对129例45岁以上健康男性的FTI进行年龄相关分析.以推算的游离睾酮（CFT）值为依据,对FTI进行有效性检验.结果 男子在中老年期FTI与增龄呈明显的负相关.FTI敏感性97.78%,特异性58.33%.结论 计算简单的FTI可用于PADAM病人的筛选和随访,尤其对70岁以上男子是血清FT较为有效的参数.     

云南新型农村合作医疗评价指标体系及标准研究

介绍了新型农村合作医疗评价指标体系及标准的产生过程、研究采用的方法 ,指标体系包括可行性评价和效果评价两个部分。