中西医结合治疗糖尿病肾病35例

目的:观察中西医结合治疗糖尿病肾病的临床疗效。方法:选择2014年4月—2015年4月本院收治的70例糖尿病肾病患者,随机分为对照组和观察组,每组各35例。对照组给予厄贝沙坦,观察组在对照组的基础上口服复方丹参滴丸。观察两组患者治疗前后肾功能检测指标、血液流变学指标及不良反应发生率。结果:两组患者治疗后血尿素氮(blood urea nitrogen,BUN)、肌酐(serum creatinine,Scr)、尿β2-微球蛋白(β2-Microsphere protein,β2-MG)及24 h尿蛋白定量水平较治疗前明显下降,且观察组低于对照组,具有显著性差异(P0.05)。两组患者治疗后血液流变学各项指标较治疗前明显下降,且观察组低于对照组,具有显著性差异(P0.05)。观察组不良反应发生较低于对照组,具有显著性差异(P0.05)。结论:中西医结合治疗糖尿病肾病,可明显改善肾功能指标和血液流变学指标,降低不良反应。     

两种药物联合治疗小儿疱疹性口腔炎临床分析

目的分析热毒宁注射液联合阿糖腺苷治疗小儿疱疹性口腔炎效果。方法选取本院2015年4月—2016年4月治疗的85例疱疹性口腔炎患儿予以回顾性分析,根据治疗时不同的方案分为对照组与研究组,前者40例予阿糖腺苷治疗,后者45例联合热毒宁注射液治疗,比较两组临床症状改善及不良反应。结果研究组口腔疼痛消退、口腔疱疹消退、体温恢复正常时间均比对照组短,比较差异显著,具有统计意义(P0.05);对照组40例患儿中3(7.50%)例出现恶心呕吐,2(5.00%)例出现皮疹,研究组45例患儿中无一例出现明显不良反应。结论疱疹性口腔炎行热毒宁注射液联合阿糖腺苷治疗,可有效改善患儿临床症状,且安全性高。     

穴位注射预防胃癌患者化疗性恶心呕吐效果观察

目的:观察胃复安足三里穴位注射预防胃癌患者化疗性恶心呕吐的临床及护理效果。方法:将进行化疗的胃癌患者98例随机分为2组,每组49例,对照组静脉滴注托烷司琼治疗,同时实施常规护理,治疗组采用胃复安足三里穴位注射+静脉滴注托烷司琼治疗,同时实施个性化护理。比较2组患者呕吐反应发生率及呕吐程度。结果:胃复安足三里穴位注射及个性化护理预防发生呕吐的有效率治疗组高于对照组(P0.05)。结论:胃复安足三里穴位注射及个性化护理对预防胃癌患者化疗性恶心呕吐具有较好的效果。     

黄芪注射液联合丹红注射液穴位注射治疗糖尿病周围神经病变临床观察

目的:观察黄芪注射液联合丹红注射液穴位注射治疗糖尿病周围神经病变的临床疗效。方法:将糖尿病周围神经病变患者120例随机分为治疗组和对照组各60例。2组均取胰俞并辨证加减,治疗组每穴每侧分别注射黄芪注射液和丹红注射液各1 m L,对照组每穴每侧分别注射甲钴胺各1 m L。2组均每日注射1次,10天为1个疗程,疗程间隔3天,治疗3个疗程后观察2组正中神经和腓总神经感觉传导速度(SNCV)和运动传导速度(MNCV)的变化情况并统计疗效。结果:与治疗前相比,治疗后2组均能明显提升神经传导速度(P0.05)。治疗组较对照组在提升MNCV方面比较差异有统计学意义(P0.05),在提升SNCV方面比较差异有统计学意义(P0.01);治疗组总有效率为96.67%(58/60),优于对照组的66.67%(40/60)(χ~2=30.745,P0.01)。结论:黄芪注射液联合丹红注射液穴位注射治疗糖尿病周围神经病变的临床疗效优于甲钴胺穴位注射。     

基于UPLC-Q-TOF-MS分析通络清脑注射剂在大鼠体内的代谢产物

目的:研究大鼠尾静脉注射通络清脑注射剂后尿液中的代谢产物,为该制剂的作用机制分析提供参考。方法:大鼠尾静脉注射通络清脑注射剂,收集0~12 h尿液,采用超高效液相色谱-四级杆-飞行时间串联质谱(UPLC-Q-TOF-MS)分析尿液样品,流动相0.1%甲酸水溶液-乙腈梯度洗脱,流速0.3 m L·min~(-1),电喷雾离子源,正离子模式,扫描范围m/z 100~1 400。结果:检测并鉴定到7个原型成分(黄芩苷,栀子苷,三七皂苷R1,人参皂苷Rg1,Rb1,Rd和Re)及10个可能的代谢产物(其中4个来源于黄芩苷,6个来源于栀子苷)。10个可能的代谢产物分别为葡萄糖基化代谢物(B-M1,G-M2和G-M4),葡萄糖醛酸化代谢物(B-M2),甲基化代谢物(B-M3),水解代谢物(B-M4),去甲基化代谢物(G-M1),脱氢代谢物(G-M3)和羟基化代谢物(G-M5和G-M6),而人参皂苷类成分则暂时未能在尿液中检测到代谢产物。结论:尾静脉注射通络清脑注射剂后,大鼠尿液中能检测到黄芩苷和栀子苷的原型及不同途径的10个代谢产物,而三七总皂苷各成分则只检测到药物原型,暂时未能检测到代谢产物。     

Intranodal injection of anticancer drugs into fixed cervical metastatic lymph nodes

OBJECTIVE: In patients with head and neck carcinoma, fixed enlarged metastatic lymph nodes (LNs) are sometimes inoperable and carry an increased risk of mortality. To control metastatic LNs, we attempted intranodal injection of anticancer agents.
SUBJECTS AND METHODS: Fifteen patients with squamous cell carcinoma arising in the gingiva (8), tongue (3), floor of the mouth (1), or maxillary sinus (3) were enrolled. These patients consisted of two groups, those in the early era in which the fixed LNs of six patients were treated with ⁶⁰Co (RA group) and those in the late era in which both radiation and intranodal injection of anticancer agents were administered to nine patients (IN group). Intranodal injection consisted of peplomycin, 5-fiuorouracil, and cis-diamminedichloroplatinum.
RESULTS: In the IN group, LNs regressed from about 40% to nearly 100%, although two patients showed no appreciable response. The LNs treated by combination therapy regressed considerably while LNs in the same patients treated with ⁶⁰Co alone showed a minor response or grew gradually. In three patients, the LNs regressed sufficiently to be extirpated safely. The good clinical response in the locally injected LNs was histologically associated with distinct evidence of tumor cell degeneration. In the RA group, none of the LNs responded to radiation with ⁶⁰Co; one LN exhibited slight regression, but the others enlarged during and soon after the radiation. Compatible with the clinical effects, many patients in the IN group demonstrated a good prognosis; three are alive without disease, and four survived for prolonged periodS. However, all patients in the RA group died due to progression of the positive LNs or pulmonary complication within 10 months.
CONCLUSION: These results indicate that intranodal injection of anticancer drugs is useful for the management of fixed enlarged LNs.     

局部注射VEGF挽救大鼠背部随意型超比例皮瓣成活的最佳注射层次的实验性研究

目的 :探讨局部注射VEGF挽救大鼠背部随意型超比例皮瓣成活的最佳注射层次。方法 :选用 4 0只Wistar大鼠 ,随机分成四组 ,在其背部形成 2cm× 8cm的全厚随意型皮瓣。术后即刻作如下处理 :在其远蒂端 6cm以及 8cm处选择五个对称的注射位点 ,对照组皮瓣掀起后立即原位缝合 ;VEGF1 组皮瓣掀起后经组织面向皮下每一位点给予 2 0ng 10 0 μl的VEGF溶液 1ml;VEGF2 组皮瓣掀起后立即原位缝合 ,经皮垂直进针 ,将药物注入受区表面 ,剂量同VEGF1 组 ;VEGF3组皮瓣掀起后立即原位缝合 ,经皮垂直进针 ,有落空感后 ,继续垂直进针约 1mm ,将药物注入受区下 ,剂量同VEGF1 组。术后观察 5d后 ,将动物处死 ,计算皮瓣成活面积。结果 :术后第 3d皮瓣成活率 :对照组为6 5 .8% ,VEGF1 组为 83.5 6 % ,VEGF2 组为 75 .79% ,VEGF3组为 83.4 5 %。VEGF2 组与对照组间有显著性差异 (P <0 .0 5 ) ;VEGF1 组、VEGF3组与对照组间有显著性差异 (P <0 .0 1)。结论 :本研究结果提示 :皮瓣内、受区表面、受区下注射VEGF都能显著提高皮瓣的成活率 ;而皮瓣内和受区下注射效果要明显好于受区表面注射     

Clinical and radiographic evaluation of pulpotomies performed under intrapulpal injection of anaesthetic solution

AIM: The purpose of this study was to evaluate clinically and radiographically pulpotomies carried out under intrapulpal injection of anaesthetic solution. METHODOLOGY: Forty-one permanent mandibular molar teeth presenting with deep carious lesions and/or exposed pulps, with or without periapical changes on radiographic examination, were treated with pulpotomy and dressed with calcium hydroxide. The teeth were divided into three groups. Group A consisted of 15 teeth, where intrapulpal anaesthesia was administered by a slow injection of lidocaine hydrochloride 2%. Group B, with 14 teeth, where intrapulpal anaesthesia was obtained with lidocaine hydrochloride 2% with adrenaline 1:100,000. Group C consisted of 12 teeth in which anaesthesia was performed with a mandibular block using prilocaine hydrochloride 3% with felypressin 1: 100,000. Healing was evaluated using clinical and radiographic criteria: dentine barrier formation, absence of clinical symptoms and resolution of periapical involvement. RESULTS: After an observation time of 6-8 weeks (postoperative control) and 24-32 weeks (intermediate control), healing occurred in 13 teeth from group A (87%), in 11 teeth from group B (79%) and in 10 teeth from group C (83%). No statistical difference was demonstrated between the three groups (Fisher's exact test). CONCLUSIONS: Based on the methodology adopted, intrapulpal injection of anaesthetic solution did not impair healing in pulpotomized teeth.     

The extent and nature of dental fear and phobia in Australia

Background: For the general dental practitioner, fearful patients are harder and more stressful to treat and are most likely to attend irregularly. This study presents updated and refined dental fear and phobia prevalence estimates in Australia as well as information on the nature of dental fear and phobia. Methods: A total of 1084 Australian adults (response rate = 71.7%) completed a mailed questionnaire. The survey contained four measures of dental fear and phobia, as well as questions regarding potentially anxiety‐eliciting dental stimuli and past aversive dental experiences. Results: The prevalence of high dental fear ranged from 7.8% to 18.8%, and more incapacitating dental phobia from 0.9% to 5.4%, depending upon the scale, cut‐point and specific criteria used. Dental phobia was significantly associated with blood‐injection‐injury (BII) concerns. The cost of dental treatment was endorsed as the most anxiety‐eliciting dental situation (64.5%), followed by fear of needles/injections (46.0%) and painful or uncomfortable procedures (42.9%). Anxiety‐eliciting stimuli and the type of aversive dental experiences varied significantly by gender, age, income, education, language spoken at home and dental visiting frequency. Conclusions: High dental fear and dental phobia are common in Australia although prevalence estimates are highly dependent on both the scale and cut‐points used.     

Is peripheral alcohol injection of value in the treatment of trigeminal neuralgia? An analysis of 100 cases

This retrospective study assessed the effectiveness and complications of peripheral alcohol injections in the management of trigeminal neuralgia (TN). 100 patients were analyzed who received 250 peripheral alcohol injections from June 2004 to January 2010. The duration of effect of alcohol blocks, the effect of repeated administration, and complications associated with alcohol injections were examined. The distal injection technique was applied. The branch of the nerve was identified and confirmed. After carefully anesthetizing the nerve with local anesthesia, 1-1.5 ml of absolute alcohol was injected depending on the nerve involved. Pain relief lasted for a mean of 14.13 ± 8.66 months. There was a fall in the duration of effect with subsequent injections. No serious complications were reported. Only 3% patients presented with non-neuralgic pain, swelling, burning sensation, trismus, dysesthesia, soreness, infection and the expected loss of sensation along the branch involved in TN. The combination of efficacy and reduced morbidity makes this procedure preferable for the treatment of TN. Alcohol injections are useful in those who are refractory to drug therapy, the elderly, medically compromised patients, unwilling to undergo neurosurgical procedures and in whom surgery is delayed for any reason.