狂犬病诊治进展

人类的狂犬病是一种中枢神经系统病毒感染性疾病,常由患狂犬病动物的唾液污染伤口而传染;一旦出现症状,病人基本上100%死亡,从狂犬病后康复的病例极为罕见,仅有3例报道。临床表现为特有的恐水怕风、咽肌痉挛、进行性瘫痪等。狂犬病在87个国家有流行,主要流行于东南亚、非洲及拉     

布洛芬对乙酰氨基酚退热疗效对比

长期以来,发热是儿科关注的问题,发热程度有助于判断病情,儿童多因与病情不成比例,轻微疾病即可出现发烧,父母常常不了解这一现象而引起不必要的恐慌,随意应用退热药即成为儿科普遍的现象[1].采用安全有效的退热药物值得临床探讨.     

Establishment of a mouse model of cancer cachexia with spleen deficiency syndrome and the effects of atractylenolide I

Cancer cachexia is a multifactorial metabolic syndrome that affects～50%–80%of cancer patients,and no effective therapy for cancer cachexia is presently available.In traditional Chinese medicine,a large portion of patients with cancer cachexia was diagnosed as spleen deficiency syndrome and treated with tonifying TCMs that produce clinic benefits.In this study we established a new animal model of spleen deficiency and cancer cachexia in mice and evaluated the therapeutic effects of atractylenolide I,an active component of tonifying TCM BaiZhu,in the mouse model.Cancer cachexia was induced in male BALB/c mice by inoculation of mouse C26 colon adenocarcinoma cells,whereas spleen deficiency syndrome was induced by treating the mice with spleen deficiency-inducing factors,including limited feeding,fatigue,and purging.The mouse model was characterized by both cachexia and spleen deficiency characteristics,including significant body weight loss,cancer growth,muscle atrophy,fat lipolysis,spleen,and thymus atrophy as compared with healthy control mice,cancer cachexia mice,and spleen deficiency mice.Oral administration of atractylenolide I(20 mg·kg?1per day,for 30 days)significantly ameliorated the reduction in body weight and atrophy of muscle,fat,spleen,and thymus in mice with spleen deficiency and cachexia.The established model of spleen deficiency and cancer cachexia might be useful in the future for screening possible anticachexia TCMs and clarifying their mechanisms.     

精于颐养走过百年——许德珩的长寿要诀

许德珩一生精于摄生颐养,享年100岁.他的养生要诀主要有如下几条: 重视饮食条理 许老的饮食以清淡为主,定时定量,不饱食,不偏食,不挑食.早餐一般是一碗稀饭,一个小馒头,少许咸菜;午餐以蔬菜为主,加上少许牛肉(晚年不食猪肉),主食100克;晚餐则以素为主.一日三餐既不随意增减,更不暴饮暴食.饮酒微量,只喝一点果酒,不饮白酒等烈性酒.爱吃新鲜水果,不吃甜食.     

浅谈如何加强医疗器械的管理

医疗器械的应用在疾病的诊断、治疗及预防等各个环节都发挥着不可替代的作用,其质量的好坏直接关系到人民群众的身体健康和生命安危.2000年国务院颁布了第一部医疗器械监管法规-<医疗器械监督管理条例>,标志着我国医疗器械监管正式走上了法制化轨道,但是由于种种原因,目前我国在医疗器械的生产、经营以及使用等各个环节都存在着较为普遍和严重的问题,其监管已显得相对滞后,成为食品药品部门监管中的一个"软肋",以至于频频出现像钢板等植入性器械断裂现象和发生举国震惊的"眼球事件".本文就我县医疗器械的经营、使用现状和如何加强对医疗器械的监管作以下分析和探讨.     

黑米:滋肾补胃益气血

黑米因外皮乌黑而得名,又称补血糯米、贡米、黑珍珠,是一种具有诸多保健功效的珍贵稻米.黑米含有淀粉、蛋白质、脂肪、多种维生素,又含钙、磷、镁、铁、锌、钼、硒等多种矿物质和微量元素.黑米所含蛋白质不但比普通大米高37%,而且其中氨基酸的含量亦比白米高25.4%,人体所需的赖氨酸、精氨酸、氮氨酸、色氨酸等,黑米中也都具有,营养价值很高.     

捕捉蛛丝马迹,让恶性肿瘤早现身——常见恶性肿瘤发病的早期信号(二)

痣 痣可发生在皮肤的任何部位,如面部、手掌、脚底、腰部、前胸、后背和阴囊等处.痣如出现下述现象,可能是癌变信号:反复发生感染;突然有痒感,不由自主地用手搔抓,甚至抓破出血;表面潮湿或有结痂形成;原为棕色,逐渐颜色变深变黑;有出血倾向,稍微触碰即发生出血;周围有炎性红晕,触之有痛感;痣上原有毛发突然自行脱落;痣的中央部出现硬结或自发性出血、溃疡形成和周围出现散在的呈卫星状小黑痣.     

克隆病并穿孔1例

1病例介绍病人,女,35岁,因突发下腹部疼痛半小时就诊,病史诉说欠清,(家属补充,腹痛时间约4～5年),查体:脉搏96次/分,血压84/60 mmHg,表情淡漠、四肢湿冷。全腹压痛呈板状腹,叩诊移动浊音可疑,以脐下压痛明显,B超提示腹腔内有少许积液,右侧卵巢囊肿,约44 cm大小。实验室检查白细胞16×109/L,中性0.80。考虑腹腔脏器穿孔,在全麻下行剖腹探查,取下腹正中切口进腹,腹腔内有臭味溢出,吸出浑浊性液体约250 ml,有食物残渣,距回盲部约50 cm处,向上见约45 cm长的回肠充血水肿     

刺五加注射液致过敏反应2例报告

例1:患者男性,51岁,因患冠心病人院治疗.给予刺五加注射液60mL加5%葡萄糖250mL中静脉注射.输人约50mL时,患者面色潮红,瘙痒感,开始发现前臂有散在的米粒大小的红色小点,继而遍及颈、四肢部以及全身出现点状红色皮疹,甚痒.立即停药,给予扑尔敏、Vc、葡萄糖酸钙口服无效.改为肌注盐酸肾上腺素、静滴地塞米松,1天后上述症状逐渐减轻.     

小便带血,源于结石

市运动会就要开幕了,体校的学生都在紧张地"备战",准备在运动会上崭露头角.小董一直是学校的"尖子生",这段时间练得更加刻苦.可是,最近每次锻炼小董都会感到小腹疼痛难忍,而且小便常常带血,他又怕去医院会耽误比赛,一直不敢告诉老师和家人.后来,还是同宿舍的小张告诉了老师.老师得知这种情况后,马上带着小董到了医院.医生做了X线摄片检查,才知道小董是患了尿路结石.     

替勃龙治疗去势大鼠骨质疏松症的研究

目的探讨替勃龙对去势大鼠骨质疏松症的治疗效果。方法选用3月龄雌性W istar大鼠按体重随机分为假手术组、模型组、替勃龙组、雌激素组4组,假手术组和模型组每天等量赋型剂灌胃,替勃龙组和雌激素组分别给予替勃龙和雌激素灌胃,于用药后50d处死全部动物,分别测定大鼠股骨的骨密度和骨组织形态计量参数。结果(1)骨密度(BMD)检测结果:模型组BMD低于假手术组(P<0.05),替勃龙组和雌激素组BMD高于模型组(P<0.05),替勃龙组BMD高于雌激素组(P<0.05)。(2)骨组织形态计量学分析结果:模型组骨小梁体积(TBV)、骨小梁表面(TBS)、纵向骨生长率(LBGR)、骨皮质矿化率(mAR)低于假手术组(P<0.05),骨小梁形成表面(TFS)、活性生成面(AFS)、骨小梁骨生成率(BFR)、骨小梁吸收表面(TRS)四项指标则高于假手术组(P<0.05);模型组TBV、TBS、LBGR、mAR低于替勃龙组和雌激素组(P<0.05);TFS、AFS、BFR、TRS则高于替勃龙组和雌激素组(P<0.05);替勃龙组TBV、TBS高于雌激素组(P<0.05);AFS、BFR、TRS低于雌激素组(P<0.05)。结论替勃龙治疗骨质疏松症疗效优于雌激素,明显改善去势大鼠骨小梁厚度,使骨小梁体积百分比增加,皮质骨平均厚度变厚,骨量增加。     

阿拉瑞林加7-甲异炔诺酮治疗子宫内膜异位症

目的探讨促性腺激素释放激素激动剂(GnRHa)———国产阿拉瑞林与进口高舍瑞林(Zoladex),对子宫内膜异位症(内异症)的治疗作用,7-甲异炔诺酮(利维爱)在反加疗法中的应用。方法采用随机对照研究,将36例内异症患者分为两组:①阿拉瑞林组,分为HRTO组(单用阿拉瑞林)和HRT1组(加用利维爱);②高舍瑞林组,分为HRT’0组(单用高舍瑞林)和HRT’1组(加用17β-E2和MPA)。结果两组患者征象明显改善,超声检查卵巢巧克力囊肿缩小或消失,血清学指标CA125、AEmAb阳性率下降。阿拉瑞林与高舍瑞林两种药物疗效无显著性差异。HRT0与HRT’0组出现低雌激素综合征,HRT0组2例腰椎骨密度降低。HRT’1组低雌激素征象明显减轻,HRT1组未出现低雌激素征象,两反加组无腰椎骨密度降低,未影响GnRHa的疗效。阿拉瑞林组、高舍瑞林组停药后6月内妊娠率分别为53.3%、41.7%。结论国产药物阿拉瑞林与进口药物高舍瑞林具有相同的疗效。反加疗法能减轻GnRHa的不良反应而不影响疗效。小剂量利维爱用于反加疗法,与其它反加方案组比更具优越性。     

替勃龙片联合双唑泰泡腾片治疗老年性阴道炎疗效观察

目的探讨替勃龙片联合双唑泰泡腾片治疗老年性阴道炎的临床疗效。方法选取2016年1月—2016年7月在信阳市第四人民医院接受诊治的老年性阴道炎患者90例,所有患者根据用药方案的不同分为对照组和治疗组,每组各45例。对照组每晚清洁外阴后于阴道深处置入双唑泰泡腾片,1片/次,1次/d。治疗组在对照组基础上口服替勃龙片,1片/次,1次/d。两组患者均连续治疗3个月。观察两组的临床疗效,比较两组的临床症状消失时间和生活质量。结果治疗后,对照组和治疗组的总有效率分别为77.78%、95.56%,两组比较差异有统计学意义(P0.05)。治疗后,治疗组外阴瘙痒、阴道黏膜充血和阴道分泌物消失时间明显短于对照组,两组比较差异具有统计学意义(P0.05)。治疗后,两组躯体功能、心理功能、社会功能和物质生活评分均明显升高,同组治疗前后比较差异有统计学意义(P0.05);且治疗组这些观察指标的升高程度明显优于对照组,两组比较差异具有统计学意义(P0.05)。结论替勃龙片联合双唑泰泡腾片治疗老年性阴道炎具有较好的临床疗效,可缩短临床症状消失时间,改善生活质量,具有一定的临床推广应用价值。     

联合应用阿仑膦酸钠及替勃龙对围绝经期及绝经后妇女骨质疏松症的疗效观察

目的评价联合应用阿仑膦酸钠及替勃龙对围绝经期及绝经后妇女骨质疏松症的影响。方法征集2008年7月~2010年12月妇科更年期门诊骨量减少或骨质疏松症的围绝经期及绝经后患者77例,随机分为两组,实验组:口服阿仑磷酸钠70mg每周1次+替勃龙2.5mg每日1次+复方氨基酸鳌合钙1000mg每日1次;对照组:口服复方氨基酸鳌合钙1000mg每日1次。两组均连续服药48周。治疗前、后采用双能X线吸收法测定腰锥1-4节(L1-L4)、股骨颈、大粗隆及Ward′s三角区骨密度(BMD);同时抽血清检测FSH及E2水平。结果两组在治疗48周后临床疼痛等症状均明显改善与好转,有效率分别为89.19%和63.64%,有显著差异(P<0.05);试验组股骨颈、大粗隆、Ward′s三角区及平均骨密度均较治疗前显著提高(P<0.05),两者增幅为0.81%、1.05%、1.64%和0.89%;试验组能有效降低FSH和升高E2水平,与治疗前相比,差异均有显著性(P<0.05);治疗后两组相比,两者改变率差异均有显著性(P<0.05)。结论联合应用阿仑膦酸钠及替勃龙在治疗围绝经期及绝经后妇女骨质疏松症效果良好。     

替勃龙对大鼠神经细胞Bcl-2、Bax表达的影响

目的探讨雌激素对去势大鼠脑缺血再灌注后神经细胞Bcl-2、Bax表达的影响和替勃龙的神经保护作用。方法 30只雌性成年SD大鼠,随机分为假手术组,手术对照组,替勃龙组,每组10只;采用大鼠大脑中动脉闭塞制成局灶性脑缺血模型。在缺血2h、再灌注24h后立即断头取脑,应用TTC染色观察脑梗死体积,TUNEL法检测凋亡细胞,链酶菌抗生物素蛋白过氧化物酶(SP)法检测抗凋亡基因Bcl-2、细胞凋亡诱导因子Bax的表达。结果替勃龙用药组较手术对照组脑梗死体积显著缩小(P<0.05),TUNEL阳性细胞数少(P<0.01),Bcl-2阳性细胞增多(P<0.01),Bax阳性细胞减少(P<0.01)。结论替勃龙可抑制去卵巢大鼠局灶性脑缺血再灌注时神经细胞凋亡,具有神经保护作用。     

Effects of tibolone on the development of osteopenia induced by ovariectomy in rats

Experimental osteopenia caused by ovariectomy in rats may reflect postmenopausal bone changes, which are the effect of osteogen deficiency. The aim of the present study was to investigate the effects of tibolone (0.25 mg/kg/day and 2.5 mg/kg po) administered for 4 weeks on the development of osteopenia caused by bilateral ovariectomy in 3-month-old female Wistar rats. The experiments were carried out on six groups of animals: I (C) - control sham operated rats, II (OVX) - ovariectomized rats, III (OVX + T-0.25) - ovariectomized rats which were administered tibolone at a dose of 0.25 mg/kg, IV (OVX + T-2.5) - ovariectomized rats which were administered tibolone at a dose of 2.5 mg/kg, V (T-0.25) - sham operated rats which were administered tibolone at a dose of 0.25 mg/kg, VI (T-2.5) - sham operated rats which were administered tibolone at a dose of 2.5 mg/kg. The following parameters were examined in all the groups: body weight gain, bone mass, length and diameter, mineral and calcium contents in the tibia and femur, endosteal and periosteal transverse growth, endosteal and periosteal osteoid width, transverse cross-section area of the cortical diaphysis and that of the marrow cavity in the tibia, epiphyseal cartilage width, trabeculae width in the epiphysis and metaphysis of the femur. Mechanical properties of the femur were also studied. Bilateral ovariectomy induced osteopenic skeletal changes in mature female rats. Tibolone (0.25 mg/kg/day and 2.5 mg/kg/day po) administered to ovariectomized rats for 28 days decreased the development of osteopenic skeletal changes induced by bilateral ovariectomy.     

3种不同用药方案治疗老年萎缩性阴道炎的临床疗效比较

目的:比较3种不同用药方案治疗老年萎缩性阴道炎的临床疗效。方法:将150例生殖道感染的绝经后患者随机均分为3组。A组给予甲硝唑+替勃龙,B组给予甲硝唑+雌三醇软膏,C组单纯给予甲硝唑治疗。比较3组抗菌药物使用时间、治愈率、复发率。结果:治疗后,A、B组治愈率、生活质量均有显著提高,但2组治愈率、生活质量、抗菌药物使用时间、生活质量比较,差异无统计学意义(P>0.05)。A、B组治愈率、生活质量显著高于C组,停药后3个月和6个月内复发率低于C组(均P<0.001)。C组的抗菌药物使用时间显著长于A、B组(P<0.001)。3组均未见严重不良反应发生。结论:替勃龙与雌三醇软膏联合甲硝唑治疗老年萎缩性阴道炎疗效均较满意、安全性较好,但停药后复发率逐渐升高。     

Pathological-anatomical results on the effect of coumarin in animal experiments (author's transl)

Pathological-anatomical results on the effect of coumarin in animal experiments5 groups of rats were fed in chronic feeding studies extending over a period of up to 2 years a diet to which coumarin (1,2-benzopyrone) had been added in concentrations of 0.1% (group 1), 0.25% (group 3), 0.5% (group 2) or 0.6% (groups 4 and 5). The groups consisted of 20 male and 20 female rats of each of the groups 1 and 2, 25 male and 25 female rats of each of the groups 3 and 4 or 32 male rats of the group 5. Control rats: 40 rats to groups 1 and 2, 50 rats to group 3, 4 and 5. 14 rats from the group 2 which had received 0.5% coumarin in their diet and 25 rats from the two groups 4 and 5 that had been fed 0.6% coumarin survived until the end of the experimental period. In the group that had been fed 0.5% coumarin, 12 of the 14 surviving animals developed liver carcinomas; in the two groups that had received 0.6% coumarin, but with a reduced uptake of food, 5 of the 25 survivors had carcinomas. The rats in the groups fed 0.1% or 0.25% coumarin in their diet exhibited only some benign adenomas or proliferations of the bile ducts.Gross autopsy revealed a number of small to massive greyish-white tumours with a nodular and uneven surface in different areas of the liver. Microscopically, all carcinomas corresponded to an identical type — that of bile duct carcinoma. The histological findings are described in detail.     

辛伐他汀-β-环糊精包合物片对高脂血症模型大鼠血液流变学的影响

目的:考察自制的辛伐他汀-β-环糊精包合物片(简称自制片)对高脂血症模型大鼠血液流变学的影响。方法:随机将60只大鼠中的10只设为空白组(蒸馏水),另50只高脂饲料喂养4周建立高脂血症大鼠模型,造模成功后随机分为5组:模型组(蒸馏水)、辛伐他汀片组(5.0mg·kg-1·d-1)和自制片高、中、低(10.0、5.0、1.0mg·kg-1·d-1)剂量组,每组10只,灌服给予相应药物,连续给药4周后,检测各组大鼠给药前、后全血黏度、红细胞沉降率(简称血沉)、红细胞压积以及血浆黏度等血液流变学参数的变化。结果:与模型组比较,辛伐他汀片组和自制片各剂量组大鼠的全血黏度、血沉、血浆黏度均明显降低(P<0.05),但辛伐他汀片组与自制片组比较无显著性差异;6组大鼠红细胞压积比较无显著性差异。结论:自制片可改善高脂血症模型大鼠的血液流变学特性,与辛伐他汀片作用相似。     

GLUT4及瘦素在大鼠非酒精性脂肪性肝病中的作用

目的:探讨GLUT4及瘦素在大鼠非酒精性脂肪性肝病(NAFLD)中的作用.方法:64只SD大鼠随机分成正常对照组(32只)和高脂饮食组(32只),每组又分为2用、4周、8周、12用四组,按时间点处死各组大鼠,测定大鼠肝组织中GLUT4的含量、血清瘦素含量、空腹血糖(FBG)、空腹血清胰岛素水平(FIns),现察肝组织病...