丹参注射液和纳洛酮治疗急性重度安定中毒疗效观察

目的 :观察复方丹参注射液和盐酸纳洛酮治疗急性重度安定中毒的疗效。方法 :70例急性重度安定中毒患者随机分为 2组。对照组 34例用传统方法治疗 ;治疗组 36例在对照组基础上 ,加用复方丹参注射液和盐酸纳洛酮治疗 ,观察患者意识恢复及自觉症状改善、消失的时间。结果 :在取得     

复方丹参注射液、纳洛酮联用治疗新生儿颅内出血33例临床分析

目的:探讨复方丹参注射液、纳络联用治疗新生儿颅内出血(NICH)的临床疗效。方法:64例NICH患儿随机分为2组,治疗组33例在常规治疗的基础上采用复方丹参注射液、纳洛酮分别静滴治疗;对照组31例用常规方法治疗。结果:治疗组总有效率90.90%,对照组总有效率64.51%,2组比较有显著性差异(P<0.01),治疗组的临床症状、体征全部消失的时间(6.26±3.48)d,较对照组(9.84±3.28)d明显缩短(P<0.01)。结论:复方丹参注射液、纳洛酮联用治疗新生儿颅内出血明显优于常规治疗,而且安全、无副作用。     

醒脑注射液联合纳洛酮对急性重度酒精中毒患者氧化应激水平与预后的影响

目的 研究醒脑注射液联合纳洛酮对急性重度酒精中毒患者氧化应激水平与预后的影响.方法 按照随机数字表法将齐齐哈尔市第一医院2018年12月至2020年10月收治的90例急性重度酒精中毒患者分成对照组(45例,采用纳洛酮治疗)与观察组(45例,采用醒脑注射液联合纳洛酮治疗).对比两组患者治疗后24 h临床疗效;对比两组患者...     

纳洛酮联合醒脑静治疗急性重度酒精中毒56例临床分析

目的:观察纳洛酮注射液联合醒脑静注射液治疗急性重度酒精中毒的临床疗效.方法:将2005年1月至2009年12月收治的符合急性重度酒精中毒诊断标准的110例患者随机分为两组,研究组(n=56)用纳洛酮注射液联合醒脑静注射液治疗,对照组(n=54)仅用纳洛酮注射液治疗,比较两组开始治疗至神志清醒和至症状消失的时间.结果:研究组和对照组自治疗至神志清醒时间和至症状消失时间分别为(2.5±1.2)h和(3.5±1.5)h,(12.5±2.5)h和(16.6±3.3)h,P均<0.05.结论:纳洛酮注射液联合醒脑静注射液治疗急性重度酒精中毒临床疗效显著,值得临床推广使用.     

纳洛酮治疗急性酒精中毒68例临床分析

我院自 1 997年 7月以来应用盐酸纳洛酮注射液治疗急性酒精中毒患者 68例 ,取得较好疗效 ,现报道如下。1　临床资料及方法1 .1　一般资料　纳洛酮治疗组 68例 ,男 58例 ,女 1 0例 ,年龄 1 9～ 4 5岁 ,平均 2 6 7岁 ;常规方法治疗组 65例 ,男 51例 ,女 1 4例 ,年龄 1 7～ 4 1岁 ,平均 2 7 4岁。1 .2　饮酒量与中毒分期　本组按急性酒精中毒三期分组 ,兴奋期、共济失调期、昏睡昏迷期。见表 1。表 1　两组急性酒精中毒患者一般情况及中毒分期对比组别 饮酒量(ｍｌ)就诊时间(分钟 ) 兴奋期 共济失调期昏睡昏迷期治疗组 390± 6 5 45 0 42 0 44…     

醒脑静注射液联合不同剂量纳洛酮治疗急性重度酒精中毒的疗效观察

目的对比分析醒脑静注射液联合不同剂量纳洛酮治疗急性重度酒精中毒的临床疗效。方法选取82例急性重度酒精中毒患者,随机分为观察组和对照组,给予醒脑静注射液联合不同剂量纳洛酮治疗,比较两组患者临床疗效,清醒时间、呼吸恢复平稳时间、临床症状消失时间及不良反应。结果观察组患者临床疗效有效率显著高于对照组,清醒时间、呼吸恢复平稳时间及临床症状消失时间较对照组均显著缩短,差异均具有统计学意义(P<0.05),两组患者均未出现不良反应。结论醒脑静注射液联合纳洛酮治疗急性重度酒精中毒安全有效,静脉注射0.4mg纳洛酮,0.8mg纳洛酮加入到5%250ml葡萄糖注射液,该剂量疗效更显著,值得在临床上推广。     

纳洛酮治疗急性重度酒精中毒34例临床观察

目的:探讨纳洛酮对急性重度酒精中毒的疗效。方法:前瞻性将2000年1月至2003年1月收治的68例急性重度酒精中毒患者随机分为34例纳洛酮治疗组(治疗组)和34例传统药物治疗组(对照组),观察和比较两组患者的清醒时间。结果:治疗组病人平均清醒时间和住院时间分别为4.6小时和5.2小时,较对照组的12.8小时和16.6小时有显著差异(P<0.01)。结论:纳洛酮对急性重度酒精中毒的催醒效果好。     

静脉应用纳洛酮治疗急性重度酒精中毒临床分析

目的:观察纳洛酮与传统药物治疗急性重度酒精中毒时的疗效。方法:将2001年1月至2003年1月间收治的108例急性重度酒精中毒患者随机分为55例纳洛酮治疗组(治疗组)与53例常规药物治疗组(对照组),观察和比较两组患者的清醒时间和住院时间。治疗组在对照组的基础上首剂用纳洛酮0.8 mg静注,以后每隔30-45 min再0.4 mg静注,直至患者清醒、症状消失为止。结果:治疗组病人平均清醒时间和住院时间分别为4.8 h和6.5 h,较对照组的11.6 h和17.4 h均明显缩短(P<0.01)。结论:纳洛酮治疗急性重度酒精中毒催醒效果好,住院时间短,安全性高。     

复方丹参注射液治疗急性重度酒精中毒的疗效观察

目的：观察复方丹参注射液治疗急性重度酒精中毒的疗效。方法：４５例急性重度酒精中毒患者随机分为２组。对照组２２例主要用纳络酮治疗；治疗组２３例在对照组治疗基础上，加用复方丹参注射液治疗，观察患者意识恢复及自觉症状改善、消失时间。结果：在取得起效、显效和痊愈时间上，治疗组分别为（３２．６±４．２）分钟，（５７．９±７．４）分钟和（１３２．２±１１．１）分钟，均明显早于对照组〔（５８．７±７．６）分钟，（８９．６±１０．３）分钟和（２０７．１±１５．３）分钟，Ｐ均＜０．０１〕；结论：复方丹参注射液与纳络酮合用治疗急性重度酒精中毒患者可缩短病程，提高疗效。     

复方丹参注射液治疗急性胰腺炎的疗效分析

目的探讨复方丹参注射液治疗急性胰腺炎的疗效。方法 73例急性胰腺炎患者按病情随机分为观察组与对照组 ,观察组在给予常规治疗同时 ,加用复方丹参注射液。观察治疗前后实验室指标及临床表现积分变化 ,评估复方丹参注射液治疗急性胰腺炎的效果。结果观察组与对照组实验室指标和临床表现均可改善 ,但观察组对临床症状体征的改善优于对照组 (P <0 .0 5 )。结论复方丹参注射液有助于改善急性重症胰腺炎患者临床症状及体征。     

Determination of creatine kinase isoenzyme MB activity in serum using immunological inhibition of creatine kinase M subunit activity. Activity kinetics and diagnostic significance in myocardial infarction.

This is a new method for the determination of creatine kinase isoenzyme MB activity in serum. The method uses direct activity measurement of creatine kinase B subunit activity after blocking of CK-M subunit activity by inhibiting antibodies. The test takes no longer than 15 min. The method yields an intra-serial C.V. of 2.0-12.9%, and a C.V. from day to day of 5.5%. The detection limit is 3.4 U/l creatine kinase MB. In the 95 cases with proven myocardial infarction several types of creatine kinase MB activity kinetics could be determined. The percentage of creatine kinase MB of peak CK-total is 6-25%, with a mean of 11.1%. The amount of creatine kinase MB with respect to total CK activity after reinfarction is higher than the amount after initial infarction.     

俯卧位通气对高海拔地区肺复张治疗无效急性呼吸窘迫综合征患者氧合的影响

目的 探讨俯卧位通气对高海拔地区肺复张术(RM)治疗无效急性呼吸窘迫综合征(ARDS)患者的治疗作用.方法 从海拔2260m的地区医院筛选RM治疗无效的41例ARDS患者[平均氧合指数( PaO2/FiO2)较RM前升高＜20％视为RM无效],依不同病因分为肺内源性ARDS组(ARDSp组)和肺外源性ARDS组(ARDSexp组),每组再按信封法随机分为俯卧位组和仰卧位组,即ARDSp俯卧位组(11例)、ARDSp仰卧位组(9例)、ARDSexp俯卧位组(10例)、ARDSexp仰卧位组(11例).在通气前及通气1、2、3、4h监测动脉血氧分压( PaO2)、PaO2/FiO2、静态顺应性(Cst)、气道阻力(Raw)的变化.结果 通气lh时,ARDSexp俯卧位组PaO2/FiO2( mm Hg,l mm Hg=0.133 kPa)即较通气前显著升高(157.4±40.6比129.3±48.7,P＜0.05),并随通气时间延长呈持续增高趋势,4h达峰值(219.1 ±41.1);且ARDSexp俯卧位组通气3h内PaO2/FiO2较其他3组显著增高,另3组间则差异无统计学意义.ARDSp俯卧位组、ARDSexp俯卧位组通气4h时PaO2/FiO2均较相应仰卧位组显著增高(208.8±39.7比127.4±47.1,219.1±41.1比124.9±50.8,均P＜0.05).4组通气前后Cst无显著改变,各组间差异也无统计学意义.ARDSp俯卧位组通气4h时Raw(cmH2O·L-1·s-1)较通气前显著降低(6.8±1.7比10.7±1.8,P＜0.05),且明显低于其他3组;其他3组各时间点Raw组内及组间比较差异均无统计学意义.结论 俯卧位通气作为ARDS机械通气重要策略之一,可以改善RM无效高原ARDS患者的氧合,为抢救患者赢得宝贵的时间.     

Digital imaging among medical facilities

The Department of Veterans Affairs (VA) in the USA operates a network of 172 medical centres which all utilize a hospital information system (HIS) which has been developed and is currently maintained by the VA. During the past several years, an image management and communication module has been developed, installed and clinically utilized at the Washington DC and Maryland VA Medical Centres. This image management and communication system, referred to as the decentralized hospital computer program (DHCP) imaging system, is fully integrated with a commercial picture archiving and communication system (PACS). The system is utilized to capture, archive, and display all images generated within the hospital including radiology, nuclear medicine, pathology, endoscopy, bronchoscopy, and dermatology, intraoperative photographs, ECG data, and a limited number of paper documents. The ultimate goal of the project is to have all patient text and image data available at any clinical workstation to any authorized user anywhere within the network of medical centres. Clinical requirements for an imaging workstation include ease of use, rapid and reliable access to the complete set of patient information, and images which are of acceptable quality to meet the requirements of the user and the subspecialty. Patient confidentiality and data security must be safeguarded at all times. Integration of the images with the remainder of the patient's database was found to be critical to the success of the project. The experience at the Washington and Maryland facilities suggests that an imaging system that is successfully integrated with a hospital information system can provide substantial clinical and economic benefits both within and among medical centres. Clinical acceptance and utilization of the system has been excellent, particularly in diagnostic radiology where DHCP Imaging has been interfaced to a commercial PAC system. Based upon this initial experience, the VA has begun to deploy the system throughout its large network of medical centres.     

Myocardial elastography at both high temporal and spatial resolution for the detection of infarcts

Myocardial elastography is a novel method for noninvasively assessing regional myocardial function, with the advantages of high spatial and temporal resolution and high signal-to-noise ratio (SNR). In this paper, in-vivo experiments were performed in anesthetized normal and infarcted mice (one day after left anterior descending coronary artery [LAD] ligation) using a high-resolution (30 MHz) ultrasound system (Vevo 770, VisualSonics Inc., Toronto, ON, Canada). Radiofrequency (RF) signals of the left ventricle (LV) in longitudinal (long-axis) view and the associated electrocardiogram (ECG) were simultaneously acquired. Using a retrospective ECG gating technique, 2-D full field-of-view RF frames were acquired at an extremely high frame rate (8 kHz) that resulted in high-quality incremental displacement and strain estimation of the myocardium. The incremental results were further accumulated to obtain the cumulative displacements and strains. Two-dimensional and M-mode displacement images and strain images (elastograms), as well as displacement and strain profiles as a function of time, were compared between normal and infarcted mice. Incremental results clearly depicted cardiac events including LV contraction, LV relaxation and isovolumetric phases in both normal and infarcted mice, and also evidently indicated reduced motion and deformation in the infarcted myocardium. The elastograms indicated that the infarcted regions underwent thinning during systole rather than thickening, as in the normal case. The cumulative elastograms were found to have higher elastographic SNR (SNR(e)) than the incremental elastograms (e.g., 10.6 vs. 4.7 in a normal myocardium, and 6.0 vs. 2.4 in an infarcted myocardium). Finally, preliminary statistical results from nine normal (m = 9) and seven infarcted (n = 7) mice indicated the capability of the cumulative strain in differentiating infracted from normal myocardia. In conclusion, myocardial elastography could provide regional strain information at simultaneously high temporal (>/=0.125 ms) and spatial ( approximately 55 microm) resolution as well as high precision ( approximately 0.05 microm displacement). This technique was thus capable of accurately characterizing normal myocardial function throughout an entire cardiac cycle, at the same high resolution, and detecting and localizing myocardial infarction in vivo.     

Clinical Pharmacokinetics of Morphine

Morphine, the most widely used mu-opioid analgesic for acute and chronic pain, is the standard against which new analgesics are measured. A thorough understanding of the pharmacokinetics of morphine is required in order to safely and effectively use this analgesic in a wide variety of patients with different levels of organ function. A MEDLINE search was conducted to identify literature published between 1966 and January 2002 relevant to the pharmacokinetics of morphine. These publications were reviewed and the literature summarized regarding unique and clinically important elements of morphine disposition relative to its parenteral administration (including intravenous, intramuscular, subcutaneous, epidural and intrathecal administration), absorption profile (immediate release, controlled release, and sublingual/buccal, and rectal administration), distribution, and its metabolism/ excretion. Special populations, including infants, elderly, and those with renal/liver failure, have a unique morphine pharmacokinetic profile that must be taken into account in order to maximize analgesic efficacy and reduce the risk of adverse events.     

手转胎头术失败的原因与分娩结局临床分析

目的 探讨手转胎头术失败的原因与分娩结局.方法 选择2008年1月至2010年12月于我院住院分娩的持续性枕横位、枕后位产妇198例,根据行手转胎头术后结果分为成功组126例、失败组72例.比较两组分娩结局,对比分析失败原因.结果 失败组胎儿体质量≥3500 g的发生率[76.4％(55/72)]明显高于成功组[31.7％(40/126)],差异有统计学意义(x2=30.177,P=0.001)、失败组宫缩乏力发生率[58.3％(42/72)]高于成功组[38.1％ (48/126)],差异有统计学意义(x2=7.569,P=0.006)、失败组骨盆临界或轻度狭窄发生率[38.9％ (28/72)]高于成功组[23.8％(30/126)],差异有统计学意义(x2 =5.030,P=0.002)、失败组手转胎头时机不当(宫口开大＜6 cm、胎头位于坐骨棘上及宫口开大8～10 cm、胎头位于坐骨棘下≥2 cm)发生率[61.1％(44/72)]高于成功组[38.9％(49/126)],差异有统计学意义(x2=9.084,P=0.003).失败组母儿并发症(产后出血、产褥病率、胎儿窘迫、新生儿窒息)发生率高于成功组(x2 =9.586,P=0.002、x2=9.334,P=0.002、x2=5.910,P=0.015、x2=5.240,P=0.022)、失败组剖宫产发生率[72.2％(52/72)]明显高于成功组[34.1 ％(43/126),x2=26.641,P=0.001)].结论 手转胎头术能使难产变顺产,降低剖宫产率,减少母儿并发症,但须积极预防、处理导致手转胎头术失败的原因,对矫正失败后继续矫正及试产应慎重.     

Evidence-Based Pain Management and Palliative Care in Issue Four for 2009 of The Cochrane Library

ABSTRACT

The Cochrane Library of Systematic Reviews is published quarterly. Issue 4 for 2009 contains 4027 complete reviews, 1906 protocols for reviews in production, and 11447 one-page summaries of systematic reviews published in the general medical literature. In addition, there are citations of 600,000 randomized controlled trials, and 12,200 cited papers in the Cochrane methodology register. The health technology assessment database contains over 7500 citations. This edition of the Library contains 90 new reviews, of which 19 have potential relevance for practitioners in pain and palliative medicine.     

Wie zuverlässig sind Angaben zu nichtentzündlichen ausgedehnten Schmerzen?

ZusammenfassungFragestellung Es wurde geprüft, wie sich der Differenziertheitsgrad zweier Schmerzmessmethoden auf Angaben zur Ausgedehntheit klinischer Schmerzen auswirkt. Zugleich wurde der Referenzzeitraum variiert, über den die Patienten berichten sollten.Methode Erfasst wurde der Einfluss zu Lasten der Befragungsdifferenziertheit durch den Vergleich zweier Körperschema-Bildvorlagen. Drei Referenzzeiträume (Schmerz aktuell, letzte Woche, letztes halbes Jahr) wurden vorgegeben.Ergebnisse Patienten mit ausgedehnten Schmerzen gaben bei differenzierter Befragung um so mehr Schmerzen an, je weiter die Schmerzen zurück lagen und je größer der Berichtszeitraum war. Patienten mit gelenknahen Schmerzen gaben bei hoch differenzierter Befragung weniger ausgedehnte Schmerzen in der Vergangenheit an als bei globaler Einschätzung. Patienten mit Rückenschmerzen berichteten bei differenzierter Befragung zum aktuellen Schmerz über weniger ausgedehnte Schmerzen als bei globaler Befragung.Schlussfolgerung Die Angaben zur Schmerzausdehnung variieren vor allem bei Patienten mit ausgedehnten Schmerzen in Abhängigkeit von der Differenziertheit der Befragung. In diesen Fällen ist die Wahrscheinlichkeit erhöht, dass sich die Beschwerdesymptomatik zumindest teilweise erst in der Reaktion auf die situativen Befragungsbedingungen konstituiert und daher nicht auf andere Befragungsbedingungen generalisiert werden kann.