经消化内镜上止血夹与注射肾上腺素治疗胃十二指肠出血的效果比较

目的 比较经消化内镜上止血夹与注射肾上腺素治疗胃十二指肠出血的临床效果。方法 86例胃十二指肠出血患者,随机分为参照组与研究组,各43例。参照组经消化内镜注射肾上腺素止血治疗,研究组经消化内镜上止血夹治疗。对比两组止血效果、住院相关指标及疼痛改善情况、并发症发生率。结果 两组初次止血成功率比较,差异无统计学意义(P>0.05);研究组再次出血率2.33%、转急诊手术率6.98%均低于参照组的16.28%、23.26%,差异有统计学意义(P<0.05)。研究组总出血量(316.34±45.15)ml少于参照组的(545.48±74.36)ml,完全止血时间(1.65±0.38)d、住院时间(5.78±1.07)d短于参照组的(2.94±0.42)、(8.61±1.43)d,差异有统计学意义(P<0.05);治疗前,两组视觉模拟评分法(VAS)评分比较差异无统计学意义(P>0.05);治疗后,研究组VAS评分(1.39±0.35)分低于参照组的(2.96±0.47)分,差异有统计学意义(P<0.05)。研究组并发症发生率4.65%低于参照组的20.93%,差异...     

消化内镜应用于上消化道出血治疗的效果观察

目的:探讨应用消化内镜治疗上消化道出血的临床效果。方法:选取上消化道出血患者102例,随机分为对照组(n=51例)与研究组(n=51例)两个组别,对照组采用传统治疗方式,研究组则在其基础上应用消化内镜进行治疗,对其治疗效果进行比较。结果:通过治疗,研究组患者的总有效率、临床指标(住院时间、不良反应发生率、止血时间)均明显优于对照组患者,数据差异具有统计学意义(P0.05)。对照组患者的再次出血率则明显高于对照组患者,数据差异具有统计学意义(P0.05)。结论:上消化道出血治疗中应用消化内镜的临床效果比较明显,值得推广。     

消化内镜联合四联疗法在胃溃疡出血中的临床分析

目的分析消化内镜联合四联疗法在胃溃疡出血中的临床效果。方法选取我院2017年8月至2018年12月收治的494例胃溃疡出血患者为研究对象,随机将其分为研究组和对照组,其中研究组294例,对照组200例,对比患者临床疗效、治疗不良事件发生率及患者治疗前后胃动力学指标。结果研究组临床效果好于对照组(P <0.05),且研究组患者治疗不良事件发生率显著低于对照组(P <0.05),同时研究组患者治疗后胃动力学指标显著优于对照组(P <0.05)。结论消化内镜联合四联疗法对胃溃疡出血患者治疗具有一定的临床疗效,不仅可以提升患者临床治疗水平,同时在患者治疗不良事件控制和治疗后的胃动力学指标的衡量上也都具有一定影响,因而在临床治疗中,应将该种治疗方法推广。     

白芨散治疗胃十二指肠出血临床分析

目的 总结分析中药白芨散治疗胃、十二指肠出血的临床疗效.方法 对96例胃及十二指肠出血患者随机分为2组,用白芨散治疗者为研究组45例,用凝血酶治疗者为对照组41例.结果 止血率:研究组为93.33%,对照组为90.24%,P＞0.05;止血时间:研究组为(26±16)h,对照组为(36±20)h,P＜0.05,但2组重度出血的止血时间比较差异无显著性,P＞0.05;研究组用药期间血小板计数(PLT)、出血时间(BT)、凝血时间(CT)、凝血酶原时间(PT)等与对照组比较均无明显变化(P＞0.05).结论 中药白芨散治疗胃及十二指肠出血的止血效果确切,止血时间快,价格便宜,且对患者全身凝血机能无影响,是治疗胃及十二指肠出血的一种好方法 .     

消化内镜治疗胃十二指肠出血的手术技巧及症状转归分析

目的探讨消化内镜治疗胃十二指肠出血的手术技巧及症状转归。方法纳入我院80例2017年3月16日至2018年6月11日胃十二指肠出血患者。随机数字表分组,对照组采取普通药物治疗,内镜组则采取普通药物加上消化内镜治疗。比较效果。结果内镜组疗效、输血和出血量、止血以及住院时间、应激状态指标相比较对照组更好,P <0.05。内镜组并发症和对照组无明显差异,P> 0.05。结论普通药物加上消化内镜治疗胃十二指肠出血的效果理想。     

内镜下金属钛夹联合注射肾上腺素治疗消化性溃疡出血的疗效及安全性评价

目的 探究内镜下金属钛夹联合注射肾上腺素治疗消化性溃疡出血的疗效及安全性.方法 抽取2014年8月至2016年1月本院接收的86例消化性溃疡出血患者,通过随机数表法分为两组,各43例.研究组联合内镜下金属钛夹及肾上腺素治疗,对照组仅注射肾上腺素治疗;统计两组临床疗效、临床症状缓解时间,并于术后4个月进行随访,统计两组并发症发生率.结果 研究组总有效率(95.35％)高于对照组(79.07％),差异有统计学意义(P＜0.05);研究组呕血消失时间为(2.51±0.45)d、大便潜血转阴时间为(4.21±0.25)d、胃引流液变清时间为(23.23±6.07)h,均明显少于对照组,差异均有统计学意义(均P＜ 0.05);两组均未出现并发症.结论 内镜下金属钛夹联合注射肾上腺素治疗消化性溃疡出血效果显著,可有效减少临床症状缓解时间,提高治疗效果,且不会引发并发症,具有安全性.     

循证护理干预对奥曲肽联合奥美拉唑治疗上消化道出血的效果观察

目的 探讨循证护理干预对奥曲肽联合奥美拉唑治疗上消化道出血的临床效果及生活质量的影响.方法 选取2012年8月～2015年6月我院50例上消化道出血患者,均接受奥曲肽联合奥美拉唑临床治疗,随机分为研究组和对照组,每组25例.对照组采用内科常规护理,研究组采用循证护理干预,随访6个月,使用SF-36量表评价生活质量,对两组患者的止血时间、住院时间、再出血率及护理前后生活质量进行综合比较.结果 研究组的止血时间、住院时间分别为(28.8±2.3)h、(5.0±1.1)d,短于对照组的(35.4±4.4)h、(7.6±1.7)d(P＜0.05);研究组再出血率较对照组低(P＜0.05);护理后研究组在生活质量各维度评分均较对照组优(P＜0.05).结论 循证护理干预应用于上消化道出血患者效果确切,可显著增强奥曲肽联合奥美拉唑的治疗效果,提高患者的生活质量.     

消化内镜联合四联疗法治疗胃溃疡出血治疗的可行性探究

目的:探讨消化内镜联合四联疗法治疗胃溃疡出血治疗的可行性研究。方法:选取2018年84例收治胃溃疡出血患者作为研究对象,按照随机数字表法将患者均分为研究组和对照组每组42例,对照组应用消化内镜方法,研究组应用消化内镜联合四联疗法。结果:研究组的总有效率明显高于对照组(P0.05),研究组患者再出血发生率限度低于对照组(P0.05),且生活质量评分高于对照组(P0.05)。结论:消化内镜联合四联疗法对于治疗胃溃疡出血具有可行性,对患者的治疗具有显著的意义,能够在保证手术安全的情况下,提高手术的成功率,值得推广。     

脊柱微创手术治疗骨质疏松性椎体骨折临床疗效及疼痛度分析

目的分析脊柱微创手术治疗骨质疏松性椎体骨折临床疗效及疼痛度分析。方法选择2017年1月～2019年1月本院收治70例骨质疏松性椎体骨折患者,按随机数字表法分为两组,对照组35例给予保守治疗,研究组35例使用脊柱微创手术治疗,对两组患者临床疗效果及疼痛度进行比较。结果研究组患者住院时间(15.30±1.28)d和卧床时间(3.30±1.22)d比对照组低(P 0.05);研究组患者疼痛评分为(3.98±0.62)分比对照组低(P 0.05);研究组患者心理功能(95.75±1.11)分、躯体疼痛(95.75±1.12)分、社会功能(96.40±1.33)分及生理功能等各项指标比对照组优(P 0.05)。结论临床使用脊柱微创手术治疗骨质疏松性椎体骨折,可缩短患者住院时间,减轻疼痛程度,有效提高患者生活质量,值得临床推广使用。     

NSAID类药物使用与上消化道出血相关性的临床研究

目的探究非甾体抗炎类药物(NSAID)的使用与上消化道出血相关性。方法选取2012年3月至2015年8月我院收治的应用NSAID类药物导致上消化道出血的患者100例归为观察组,另外选取我院收治的应用非NSAID类药物导致上消化道出血的患者100例归为对照组,比较两组患者临床特征以及内镜检查特征。结果观察组患者内镜检查特征表现为复合性溃疡的比率与对照组患者无显著性差别(P> 0.05);观察组患者内镜检查特征表现为胃溃疡、胃黏膜损伤、十二指肠溃疡、糜烂型十二指肠溃疡、十二指肠球溃疡、多发性溃疡、胃单纯糜烂的比率高于对照组患者(P <0.05);临床特征方面,观察组患者有消化性溃疡史的比率与对照组患者无显著性差异(P> 0.05);观察组患者年龄<40岁消化道出血的比率低于对照组(P <0.05);观察组年龄> 60岁消化道出血的比率明显高于对照组(P<0.01);观察组患者出血前出现症状的比率明显低于对照组(P <0.01);观察组患者心血管病史的比率明显高于对照组(P <0.01)。结论 NSAID类药物是导致上消化道出血的原因明确,且年龄> 60岁、心血管病史的患者服用NSAID类药物容易导致上消化道出血,出血前症状不明显。     

抗生素后效应

目的：介绍各种抗生素的抗生素后效应，为临床给药间隔提供参考数据。方法：综述各种抗生素的抗生素后效应概况。结果：提供了各类常用抗生素和联合用药后效应的时间。结论：抗生素后效应为临床设计合理的给药方案提供科学依据，指导临床更合理地使用抗生素。     

Parkinson's disease-like effects of S-adenosyl-L-methionine: effects of L-dopa.

The major symptoms of Parkinson's disease (PD) are due to degeneration of the nigrostriatal pathway and depletion of dopamine (DA). Tyrosine hydroxylase (TH), norepinephrine (NE), serotonin (5-HT), and melanin pigments are also decreased and acetylcholinergic activity increased. Biochemically, increased methylation can cause the depletion of DA, NE, 5-HT, and melanin pigments and also an increase of acetylcholine; thus, increased methylation can present a biochemical picture that resembles the biochemical changes that occur in PD. During the therapy of PD with L-dopa, it is well known that L-dopa reacts avidly with S-adenosyl-L-methionine (SAM), the biologic methyl donor, to produce 3-O-methyl-dopa. Correspondingly, L-dopa has been shown to deplete the concentration of SAM, and SAM has been found to induce PD-like motor impairments in rodents; therefore, an excess of SAM-dependent methylation may be associated with Parkinsonism. To further study the effects of methylation, SAM was injected into the lateral ventricle of rats. SAM caused tremors, rigidity, abnormal posture, and dose-related hypokinesia. Doses of 9.38, 50, and 400 nM/rat caused 61.9, 73.4, and 94.8% reduction, respectively, of motor activity. A 200-mg/kg IP dose of L-dopa, given before 50 nM SAM, blocked the SAM-induced hypokinesia. SAM also caused a decrease in TH immunoreactivity, apparent degeneration of TH-containing fibers, loss of neurons, and the accumulation of phagocytic cells in the substantia nigra. These results showed that excess SAM in the brain, probably due to its ability to increase methylation, can induce symptoms that resemble some of the changes that occur in PD.     

Ventilatory effects of low-dose paraoxon result from central muscarinic effects

Paraoxon induces respiratory toxicity. Atropine completely reversed parathion- and paraoxon-induced respiratory toxicity. The aim of this study was to assess the peripheral or central origin of ventilatory effects of low-dose paraoxon. Male Sprague-Dawley rats were given paraoxon 0.215 mg/kg subcutaneously and treated with either atropine (10 mg/kg sc) or ascending doses of methylatropine of 5.42 (equimolar to that of atropine), 54.2, and 542 mg/kg administered subcutaneously 30 min after paraoxon. Ventilation at rest was assessed using whole-body plethysmography and rat temperature using infra-red telemetry. Results are expressed as mean ± SE. Statistical analysis used two-way ANOVA for repeated measurements. Paraoxon induced a significant decrease in temperature 30 min after injection lasting the 90 min of the study period. This effect was partially corrected by atropine, but not by methylatropine whatever the dose. Paraoxon induced a decrease in respiratory rate resulting from an increase in expiratory time associated with an increase in tidal volume. Atropine completely reversed the ventilatory effects of low-dose paraoxon while the equimolar dose of methylatropine had no significant effects. The 54.2 and 542 mg/kg doses of methylatropine had no significant effects. Atropine crosses the blood-brain barrier and reverses peripheral and central muscarinic effects. In contrast, methylatropine does not cross the blood-brain barrier. Atropine completely reversed the ventilatory effects of low-dose paraoxon, while methylatropine had no significant effects at doses up to 100-fold the equimolar dose of atropine. We conclude that the ventilatory effects of low-dose paraoxon are mediated by disrupted muscarinic signaling in the central nervous system.     

Metabolic effects as a cause of myotoxic effects of fluoroquinolones

Objectives:

To investigate if fluoroquinolones (FQs) influence skeletal muscle metabolism of healthy and malignant hyperthermia susceptible (MHS) pigs.

Materials and Methods:

After approval from of the Animal Care Committee, 10 MHS pigs, and 6 MHS pigs were anesthetized with hemodynamic and systemic metabolic monitoring. Microdialysis catheters were placed intramuscularly. After equilibration, levofloxacin and ciprofloxacin were injected as a rapid bolus and continuous infusions. Lactate was measured in the dialysate and statistically analyzed was done (Wilcoxon-test; U-test; P < 0.05).

Results:

There were no differences in age, weight, and baseline lactate levels between the groups. Both applications of levofloxacin- and ciprofloxacin-induced an increase of local lactate levels in healthy and MHS pigs. No difference between the two groups was observed.

Conclusion:

FQs influence skeletal muscle metabolism. Myotoxic effects of FQs can, therefore, be explained by an influence on the cellular energy balance.KEY WORDS: Fluoroquinolones, malignant hyperthermia, metabolism, myotoxicity