PRP在颅骨缺损修复中血管化的实验研究

目的观察富血小板血浆(PRP)在颅骨缺损修复中血管化的作用。方法在Wistar大鼠颅骨正中缘备出1.0 cm×0.8 cm大小缺损,随机分为4组,模型组只植入煅烧骨,BM SCs组植入煅烧骨+BM SCs(简称复合体),对照组植入复合体+VEGF,PRP组植入复合体+PRP;观察各组大鼠4、8、12周在颅骨缺损修复中血管化情况并检测1、4周血清NO、SOD、GSH-px和MDA含量变化。结果术后4、8和12周新生血管面积比,PRP组(3.08±0.21)%、(4.41±0.32)%、(5.71±0.47)%,对照组(2.26±0.17)%、(3.75±0.29)%、(4.53±0.42)%,BM SCs组(1.47±0.19)%、(2.62±0.27)%、(3.45±0.35)%,模型组(0.99±0.18)%、(1.71±0.23)%、(2.02±0.39)%,PRP组新生血管多,面积大,血管化情况明显优于模型组、BM SCs组(P<0.01)和对照组(P<0.05);PRP组NO、GSH-px和SOD的活性显著增高,与新生血管形成呈正相关,M DA含量明显降低,与血管形成呈负相关(P<0.01)。结论 PRP能促进新生血管形成,加快颅骨缺损的修复。     

自体富血小板血浆痛点注射治疗肩周炎的临床疗效评估

目的 评估自体富血小板血浆（Platelet-rich plasma,PRP）痛点注射治疗肩周炎的临床疗效。方法 本研究以2018年1月至2019年10月在空军军医大学第二附属医院骨科门诊就诊的肩周炎患者共74例为研究对象。根据治疗方式分为两组：对照组采用普鲁卡因和醋酸氢化可的松治疗,观察组采用PRP治疗,每组37例。记录两组患者的基本临床资料,并随访其并发症情况和治疗效果;同时采用视觉模拟评分法（visual analogue scale,VAS）和美国加利福尼亚大学洛杉矶分校（University of California at Los Angeles,UCLA）肩关节评分,比较两组在治疗前、治疗后1周、1个月、3个月和6个月的疼痛情况和功能评估。结果 两组患者的年龄、性别、疼痛部位、病程、治疗前VAS评分和UCLA评分等基本临床资料一致,差异无统计学意义（P>0.05）。与治疗前相比,两组患者治疗后各观察点（1周、1个月、3个月、6个月）VAS评分均显著降低,UCLA评分均显著升高,差异均有统计学意义（P<0.05）;治疗后1个月、3个月和6个月,VAS评分均显著低...     

不同浓度富血小板血浆治疗早中期膝骨关节炎的临床疗效研究

目的 观察不同浓度富血小板血浆治疗早期膝关节骨关节炎的临床疗效,寻找治疗早中期膝骨关节炎的最佳血小板浓度.方法 将160例符合入选标准的膝关节骨性关节炎患者随机分为甲、乙、丙、丁四组,所有患者均随访半年,共有155例患者获得随访,根据患者分组予不同血小板浓度富血小板血浆膝关节内注射治疗,于治疗前和治疗后3d、3个月、6...     

Randomized trial to assess safety and clinical efficacy of intensive blood pressure reduction in acute spontaneous intracerebral haemorrhage

Background

Haematoma expansion due to raised blood pressure in spontaneous intracerebral haemorrhage may determine outcome. The aim of this study was to determine safety and efficacy of lowering blood pressure in acute spontaneous intracerebral haemorrhage.

自体富血小板血浆对促进腕管综合征减压术后正中神经功能恢复的随机对照临床研究

目的 研究自体富血小板血浆（platelet-rich plasma,PRP）对促进腕管综合征减压术后正中神经功能恢复的疗效。 方法 选取腕管综合征的患者40例,按随机数字表法随机分为对照组和PRP注射组各20例。对照组行腕管切开减压正中神经松解术;PRP注射组行腕管切开减压正中神经松解+PRP注射术。观察比较两组患者感觉、肌力及肌电图指标恢复情况。 结果 共有31例患者得到随访,对照组有4例患者失访,PRP注射组有5例患者失访,均随访12个月以上。2组术后1、3、6和12个月的视觉模拟疼痛量表（Visual Analogue Scales,VAS）评分、肌力分级、正中神经感觉神经传导速度（sense nerve conduction velocity,SNCV）和运动神经传导速度(motor nerve conduction velocity,MNCV)在组间、时点间、组间和时点间的交互作用差异均有统计学意义(P＜0.01)。 结论 PRP 能促进腕管综合征减压术后正中神经的感觉及运动功能的恢复。     

Randomized study on the safety and efficacy of dual-axis rotational versus standard coronary angiography in

Background  Dual-axis rotational coronary angiography (DARCA) was developed as an innovative adaptation of rotational angiography (RA), but it requires a longer coronary injection compared to standard coronary angiography (SA). As the body of the average Chinese patient is smaller than that of most western patients, with the same contrast injection time, the risk of complications from the contrast agent is increased in this population. The purpose of this study was to assess the clinical safety and efficacy of DARCA in the diagnosis of coronary artery disease (CAD) in the Chinese population by directly comparing it to SA.

Methods  Two hundred Chinese patients were randomized to either the SA group (n=100) or DARCA group (n=100). Contrast utilization, radiation exposure and procedure time were recorded for each modalities. Blood pressure (BP), heart rate (HR) pre and post injection symptoms and any arrhythmias were recorded.

Results  Compared to the SA group, there was a 42% reduction in contrast utilization, 55% reduction in radiation exposure and a 31% shorter procedure time in the DARCA group. In both groups, there were slight declines in the systolic BP values in the left coronary artery (LCA) post injection (P <0.01). Moreover, post injection HRs for the LCA were also reduced in the DARCA group (P <0.01). But all of these changes were small, transient and without clinical importance. Only one patient (1%) in the DARCA group had an attack of ventricular tachycardia immediately post injection and it resolved by itself during LCA angiography. No arrhythmias occurred in the SA group.

Conclusion  DARCA is a safe, efficient, and clinically comparable alternative to SA in the diagnosis of coronary artery disease in the Chinese population with less contrast utilized, which is less radiation exposure and a shorter procedure time than SA.

     

持续缓慢血浆置换透析治疗重型肝炎的疗效及安全性评估

目的评估重型肝炎患者持续缓慢血浆置换透析的疗效及安全性。方法选取2016年3月~2017年2月期间本院住院的重型肝炎患者200例,均予持续缓慢血浆置换透析治疗,治疗405例次。收集治疗前后患者肝功能(ALT、AST、TBIL、CHE、ALB),凝血功能(PTA、INR),血常规(WBC、HGB、PLT),电解质(K~+、Na~+、Cl~-、Ca~(2+)),肾功能(BUN、Cr)。记录治疗前后患者症状的变化(乏力、纳差、腹胀、精神状况等),以及观察记录患者治疗过程中的并发症。计量资料组间比较采用t检验,非正态分布用wilcoxon秩和检验。结果持续缓慢血浆置换透析治疗后,患者精神、食欲、乏力感及消化道等临床症状有不同程度改善。ALT、AST、TBIL均显著下降,CHE、ALB显著升高,显示肝功能明显改善。PTA上升,INR下降,凝血功能显著改善。患者的K~+、Na~+、Cl~-、Ca~(2+)明显改善,持续缓慢血浆置换透析治疗能调节电解质。患者发生并发症69例次,经一般对症处理后,不良反应均恢复正常,对人工肝治疗没有影响。结论持续缓慢血浆置换透析治疗重型肝炎的黄疸下降显著,调节电解质、肾功能,既能去除与蛋白质结合的毒素,又能清除水溶性毒素,对重型肝炎患者安全有效。     

A clinical trial of the efficacy and safety of montelukast as monotherapy in patients with chronic stable bronchial asthma

This study is aimed to evaluate the efficacy and safety of montelukast, as monotherapy, in the treatment of chronic stable bronchial asthma in adults. This was a multicentre, open label, non-comparative, prospective, 4-week study. Eligible patients discontinued all anti-inflammatory medication (steroids, chromoglycate sodium) 2 weeks prior to starting therapy with montelukast (10 mg daily). The primary efficacy criteria were improvements in forced expiratory volume in one second (FEV1), peak exploratory flow rate (PEFR) after 4 weeks of therapy. Secondary efficacy criteria were improvement in the patients' symptoms (assessed on an ordinal scale), decrease in discomfort levels (scored on a scale of 0-100), change in peripheral eosinophil counts, decrease in total daily dose of inhaled beta2 agonist (salbutamol). A total of 148 patients, mean age (+/- SD) 40.21 +/- 13.70 years, were enrolled into the study. At the end of the study there were significant improvements in FEV1 and PEFR (29% and 28% increase respectively from baseline values, p<0.000001). The mean total daily dose of inhaled salbutamol decreased significantly from prestudy values of 461 +/- 332 microg/day to 161 +/- 207 microg/day (p<0.000001). The mean eosinophil counts fell from 5.80 +/- 4.90% (+/- SD) to 4.84 +/- 4.42% (+/- SD) (p=0.02). Symptom scores improved significantly as did subjective assessment of discomfort. A total of 29 (19.6%) adverse events were reported, all of which were of mild to moderate intensity. Monotherapy with montelukast significantly improved parameters of asthma control. It was well tolerated with no reports of serious or severe adverse events.     

Comparison of the efficacy, safety and tolerability of telmisartan with losartan in Indian patients with mild to moderate hypertension: a pilot study

A prospective, randomised, double-blind, parallel group study was carried out to compare the efficacy, safety and tolerability of telmisartan 40 mg once daily with losartan 50 mg once daily in Indian patients with mild to moderate hypertension. It had a placebo run-in period of 2 weeks followed by drug treatment (telmisartan 40 mg, once daily or losartan 50 mg once daily) for 8 weeks. Supine BP was assessed at the end of every 2 weeks. Tolerability and safety was assessed by physical examination, laboratory parameters and evaluation of adverse events. Treatment with telmisartan resulted in a significant reduction of SBP of 10.3% and 13.7% as compared to 6.6% and 10.6% in losartan group at the end of 6th and 8th weeks respectively. At the end of 6th and 8th weeks, the reduction was 14.3% and 18.1% among telmisartan which was significantly more as compared to 8.8% and 14.3% in losartan group respectively. The laboratory values were within normal limits. Both drugs were well tolerated. Telmisartan monotherapy in a dose of 40 mg once daily has a clinically better therapeutic effect as compared to losartan 50 mg and a good tolerability profile in patients with mild to moderate hypertension.     

A pilot study for evaluation of the efficacy and safety of telmisartan in reducing microalbuminuria in hypertensive patients with type 2 diabetes mellitus

To evaluate efficacy and tolerability of telmisartan, an angiotensim II receptor blocker, in reducing microalbuminuria in adult Indian hypertensive patients with type 2 diabetes mellitus, a prospective, open-label, non-comparative, assessor-blind, multicentric, pilot study was conducted in 60 eligible hypertensive patients with type 2 diabetes mellitus and microalbuminuria after obtaining their informed consent. The study was approved by the respective institutional review boards. Each patient received telmisartan 40 mg initially once daily for first 4 weeks which was titrated upwards to 80 mg once daily for the next 8 weeks. Blood pressure was assessed at the end of every 2 weeks and urinary albumin excretion and creatinine clearance were measured at baseline and after 12 weeks of therapy. Safety outcome measures included monitoring of physical examination, laboratory parameters and monitoring treatment-emergent adverse events. Fifty-five patients completed the study while 5 cases were lost to follow-up. The mean age of the patients was 48.27 years. Of the total patients 63.6% were males and 46.4% were females. At baseline the mean urinary albumin excretion rate was 131.81 +/- 38.82 mg/minute. A statistically significant (p < 0.05) reduction (32.96%) in urinary albumin excretion rate occurred after 12 weeks of therapy (118.36 +/- 37.22). The mean pre-study systolic blood pressure was 165.05 +/- 15.24 mmHg which was significantly (p < 0.05) reduced to 123.72 +/- 5.88 mmHg at the end of 12 weeks. At baseline the mean diastolic blood pressure was 103.55 +/- 9.84 mmHg which was significantly (p < 0.05) reduced to 84.71 +/- 8.54 mmHg. The JNC-VII goal of blood pressure below 130/80 was achieved in 34 (61.8%)of the 55 patients at the end of 12 weeks. Both fasting and postprandial blood sugar levels were well-controlled at the end of the study. Telmisartan was well tolerated with only 9.09% of the patients reported mild and transient adverse events like fatigue, dizziness, nausea and diarrhoea. No abnormalities were detected in the laboratory parameters. The results of this pilot study indicate that telmisartan is effective, safe and well tolerated while reducing microalbuminuria in adult Indian hypertensive patients with type 2 diabetes mellitus.     

Efficacy and safety of obinutuzumab for the first-line treatment of follicular lymphoma: a subgroup analysis of Chinese patients enrolled in the phase III GALLIUM study

Backgrounds: GALLIUM is a global phase III study that demonstrated significant improvements in progression-free survival (PFS) for obinutuzumab plus chemotherapy (G-chemo)vs. rituximab plus chemotherapy (R-chemo) in previously untreated patients with follicular lymphoma (FL). This study aimed to report the results of a subgroup of patients in China.Methods: Patients were randomized to G-chemo or R-chemo. Responders received maintenance therapy for 2 years or until disease progression. The primar...     

奥氮平治疗55例精神分裂症患者的疗效和安全性研究

目的:验证奥氮平治疗精神分裂症的临床疗效和安全性。方法:采用随机入组,开放式临床自身对照研究,入组60例,给予奥氮平5～20 mg/日,口服,治疗8周。采用阳性和阴性症状量表(PANSS)及临床总体印象量表(CGI-SI)评价疗效,采用药物不良反应量表(TESS),并通过体检、实验室检查、心电图检查和其它不良事件的描述性记录资料的收集,评价安全性。结果:完成8周治疗的55例精神分裂症患者,基本痊愈19例(34.54%),显进21例(38.18%),进步11例(20.00%),无效4例(7.27%),总有效率为92.72%。不良反应少。结论:奥氮平片剂治疗精神分裂症具有良好的疗效和耐受性。     

国产头孢吡肟治疗下呼吸道细菌感染疗效及安全性评价

目的:评价国产头孢吡肟治疗呼吸系统细菌感染的有效性与安全性.方法:采用多中心随机双盲对照试验设计,以进口头孢吡肟为对照药,试验组和对照组剂量均为每次2g,静脉滴注,每日2次,疗程7～14天.结果:试验组30例,对照组30例.试验组与对照组的临床有效率与痊愈率分别为93.33%、63.33%与96.67%、70%,细菌清除率分别为96%和100%,不良事件发生率分别为3.3%和0%,以上结果统计学均无显著性差异(P＞0.05).MIC值测定显示,头孢吡肟对大多数细菌的MIC值低于或与其它5种抗菌药物相近.结论:国产头孢吡肟抗菌谱广、抗菌活性强,是一个治疗下呼吸道细菌性感染的高效、安全的抗菌药物,与进口头孢吡肟相当.     

托吡酯与丙戊酸钠治疗小儿癫痫的有效性及安全性对照研究

目的评估托吡酯与丙戊酸钠在治疗小儿癫痫的疗效及安全性的差异。方法54名癫痫患儿随机分为托吡酯治疗组（n=30）与丙戊酸钠治疗组（n=24）。托吡酯治疗组接受托吡酯治疗,剂量从每晚1次1—3mg·kg-1·d-1（最大：25mg）增加到5-9mg·kg-1·d-1,分2次;丙戊酸钠治疗组接受丙戊酸钠20mg／kg（分2次）,逐渐加量,严重病例在检测血药浓度情况下,可加量至最高40mg／kgo记录住院期间的可能副作用。结果两组总有效率分别为70％、667％％,差异不具有统计学意义（P=0．793）;不良反应发生率分别为26．67％和16．67％,差异不具有统计学意义（P=0．583）。结论治疗小儿癫痫,托吡酯与丙戊酸钠的有效性及安全性不存在明显差异。     

恒河猴前额叶执行控制功能的行为和电生理研究

目的　研究恒河猴前额叶执行控制的行为和电生理特点。方法　 3只恒河猴用于行为研究 ,其中 2只恒河猴执行视觉分辨的go nogo任务时 ,记录其两侧前额叶皮层神经元电活动 ,用matlab做事后分析。结果　①三只猴执行go nogo任务的反应时分别为 (4 19± 18)ms、(3 76± 2 6)ms和 (5 40± 2 1)ms ;②在 2只猴的前额叶皮层共进行了 41次穿刺 ,记录到 92个任务相关的神经元 ,共分为 5类 :视觉信号相关的神经元 ;决策 (延迟期 )相关的神经元 ;go运动相关的神经元 ;奖励相关的神经元 ;多事件相关的神经元 ;③go反应错误时神经元对go线索的反应低于go反应正确时神经元对go线索的反应 ,nogo反应错误时神经元对nogo线索的反应高于nogo反应正确时神经元对nogo线索的反应 ;正确决策时 ,go决策相关的神经元放电频率显著高于nogo决策相关的神经元放电频率 ,但决策错误时则相反。结论　①前额叶皮层由多种神经元组成 ;②恒河猴执行go nogo任务错误可能有两类 :一类是线索期错误 ,另一类是决策期错误。提示注意和决策是执行控制的核心。     

磷酸奥司他韦治疗流感疑似患者临床疗效分析

目的观察磷酸奥司他韦治疗流感流行季节中临床诊断的流感疑似患者的临床疗效。方法本研究为随机、对照、开放临床试验。入选患者72例,随机分为2组。治疗组36例,服用磷酸奥司他韦75mg,每日2次,共5d;对照组36例,服用症状缓解药物美息伪麻片。结果治疗前2组患者的病情严重程度无显著性差异(P>0·05)。治疗后,奥司他韦治疗组和对照组发热平均缓解时间分别为(38·67±20·31)h和(72·67±38·80)h,显著有统计学意义(P<0·0001)。发热持续时间治疗组比对照组平均缩短36h。奥司他韦治疗组和对照组其它症状的曲线下面积(AUC)分别为(410·33±290·55)分和(675·00±451·82)分,显著有统计学意义(P<0·005)。其他流感症状持续时间治疗组比对照组平均缩短27h。平均缓解时间分别为(46·45±31·71)h和(73·09±41·39)h(P<0·005)。2组观察期间并发症发生率和不良反应发生率显著均无统计学意义(P>0·05)。结论磷酸奥司他韦治疗临床诊断的流感疑似患者可以快速有效缓解症状,且不良反应少,应用安全。     

正畸-牙周手术-修复联合治疗保存残根的效果观察

目的观察正畸-牙周手术-修复联合治疗保留残根的效果,为临床工作提供参考。方法选择2009年6月～2010年5月收治的残根牙患者28例(30牙)。在完善根管治疗后对患牙残根进行垂直颌向牵引,暴露残根牙断面结构,并在此基础上进行牙周手术和修复治疗。结果 26例患者(28牙)经联合治疗后均取得较满意的效果,成功率为93.33%。2例(2牙)患者因不配合而拔除残根。结论采用正畸-牙周手术-修复联合治疗,既可保存残根,又可制作出功能良好和效果美观的修复体。     

重组人血小板生成素治疗特发性血小板减少性紫癜的临床疗效

目的 评价重组人血小板生成素（rhTPO）对糖皮质激素治疗无效的成人特发性血小板减少性紫癜（ITP）的有效性与安全性。方法 选择对糖皮质激素治疗无效的ITP患者74例,分为rhTPO+达那唑组(观察组)37例,达那唑组(对照组)37例。观察组皮下注射rhTPO 1.0μg/kg（300U/kg）,1次/d, 共14d,停用rhTPO后再观察14d。对照组口服达那唑14d后,如血小板≤20×109/L可皮下注射rhTPO(1.0μg/kg),1次/d, 14d ,停用rhTPO后观察14d。两组在整个试验阶段口服达那唑200mg/次,3次/d。比较两组前14d血小板计数的最高值和不同时间点血小板计数值的曲线下面积及有效率,比较对照组应用rhTPO前后的血小板计数及其差值。结果 观察组前14d血小板计数和升高值均显著高于对照组(P＜0.01）。14d内血小板计数值的曲线下面积中位数明显高于对照组（P＜0.001）;观察组rhTPO治疗14d内显效者（血小板计数升高至≥100×109/L）(16例、43.24%)明显高于对照组（3例、8.10%）（P＜0.01）。观察组良效者（血小板计数升高≥30×109/L）(9例、24.32%）与对照组(10例、27.03%）差异无统计学意义（P>0.01）。观察组近期有效observation率（显效+良效）明显高于对照组（P＜0.05）。对照组14d血小板升高未达有效的患者给予rhTPO治疗后血小板计数与使用rhTPO前相比明显升高,有效率达到62.50%。两组均无严重不良事件发生。结论 rhTPO治疗糖皮质激素治疗无效的ITP患者安全、有效。