来氟米特合并小剂量激素治疗肾病综合症的疗效观察

目的：研究与探讨来氟米特合并小剂量激素治疗难治性肾病综合征的临床疗效。方法：对28例难治性肾病综合征患者给予来氟米特合并小剂量激素治疗,观察患者并对其临床疗效进行回顾性分析。结果：28例患者治疗后完全缓解15例,部分缓解9侧,无效4例。总有效率为88．5％。结论：来氟米特合并小剂量激素治疗难治性肾病综合征具有治愈率高,并发症少等特点,值得临床推广使用。     

红光治疗激素依赖性皮炎

1973年首先报道用含氟激素形成药物依赖,20年后重提引起人类关注。2006年JAAD一篇综述中报道激素依赖性皮炎出现痤疮、酒渣鼻、口周皮炎、毛细血管扩张等症状。以后出现激素递减疗法、替代疗法,其不良反应或刺激加重。笔者应用红光治疗激素依赖性皮炎患者157例,迅速减轻急性刺激症状,和其他治疗中的反跳症状,取得满意疗效。     

拜新同联合应用小剂量倍他乐克治疗中青年高血压的临床分析

目的探讨分析拜新同联合应用小剂量倍他乐克治疗中青年高血压的临床疗效。方法选取2011年12月-2013年12月收治的107例中青年高血压患者为研究对象,将其用数字表法随机分成两组,观察组57例患者给予拜新同联合小剂量倍他乐克治疗,对照组50例患者给予拜新同治疗,观察两组临床疗效。结果观察组患者总有效率为98.2%,显著高于对照组86.0%,差异具有统计学意义（P〈0.05）;两组患者舒张压（DBP）、收缩压（SBP）及心率（HR）改善情况均优于治疗前,观察组改善情况显著优于对照组,差异具有统计学意义（P〈0.05）。结论拜新同联合应用小剂量倍他乐克治疗中青年高血压的临床疗效较显著,能有效提高患者生活质量。     

小剂量重组人脑利钠肽在心力衰竭利尿剂抵抗患者中的应用

目的：观察小剂量重组人脑利钠肽在心力衰竭利尿剂抵抗经常规治疗无效患者中的疗效。方法总结近3年来12例心功能不全出现利尿剂抵抗患者经常规药物治疗无效,加用小剂量重组人脑利钠肽治疗后的疗效。观察治疗前后患者在尿量、临床症状、体征及心功能分级（ NYHA）等方面的变化。结果经加用小剂量重组人脑利钠肽治疗后12例患者中9例尿量增加、心功能分级（ NYHA）改善,病情好转,2例经床旁持续超滤治疗后心功能改善,1例死亡。结论对终末期心衰伴利尿剂抵抗,经常规治疗无效的患者,加用小剂量重组人脑利钠肽能取得较为满意的治疗效果,改善患者预后。     

连续肾脏替代治疗在多脏器功能不全患者中的疗效观察

目的 观察连续肾脏替代治疗(CRRT)在不同病因所致多脏器功能不全(MODS)患者中的应用效果.方法 纳入2011年9月-2012年9月在解放军总医院第一附属医院重症医学科治疗期间发生的MODS患者47例,根据发病原因分为脓毒症组(n=28)和非脓毒症组(n=19).分别在CRRT开始前即刻和CRRT治疗后12h采集患者的全身血流动力学指标、脑部血流动力学指标、氧合指标及代谢指标.根据每组患者的APACHEⅡ评分计算预期病死率,通过与实际病死率比较得到标准化病死率(SMR),规定SMR＜0.9为生存率改善.结果 经12h CRRT后,脓毒症组患者的临床及实验室指标大部分得到明显改善(平均动脉压和脑部血流动力学指标除外),最终存活出院17例,SMR为0.70;非脓毒症组患者仅3例存活出院,SMR为1.77,观察指标中仅吸入氧浓度得到明显改善.结论 CRRT可显著改善由脓毒症引发的MODS患者的临床指标及生存率,而在非脓毒症为基础因素引发的MODS患者中,未观察到显著疗效.     

秋水仙碱治疗肝炎系列研究报告——动物实验及临床病例观察

以ICR和BALB/C小鼠实验证明秋水仙碱能减轻肝脏病理损害,防止肝内纤维化,降低中毒性肝坏死死亡率,加用睾酮可提高雌鼠存活率、对雄鼠不显。加用雌激素对雌鼠有明显保护作用,对雄鼠则促进死亡。皮质激素无明显疗效。 临床试验证明秋水仙碱对急、慢性肝炎有消退黄疸和改善肝功的疗效,能降低重型肝炎病死率,经5～8年长期随访疗效巩固。对应用激素治疗的重肝和慢活肝患者加用秋水仙碱后,可逐步撤除激素,既可减少激素的副作用,又可避免撤除激素后的黄疸和ALT反跳。 秋水仙碱小剂量长期服用,无明显副作用。偶可引起血小板减少,有明显出血倾向者慎用。     

小剂量克拉霉素治疗支气管哮喘疗效观察

目的观察小剂量克拉霉索治疗支气管哮喘的疗效。方法将92例支气管哮喘患者随机分为治疗组和对照组各46例,两组给予相同的基础治疗,基础治疗包括口服茶碱,口服或吸入支气管扩张剂及激素,不允许使用其他大环内酯类药;治疗组给予口服克拉霉素0.25 g,1次/d,两组疗程均为8周,观察两组患者治疗前后肺功能和临床症状改善情况。结果治疗组患者症状及肺功能(FEV l、PEF)较对照组明显改善(P<0.05)。结论小剂量克拉霉素治疗支气管哮喘具有良好疗效。     

昆明山海棠在治疗原发性肾小球疾病中的应用

本文对56例原发性肾小球疾病患者,随机分为昆明山海棠(山海棠)加小剂量激素治疗组及常规剂量激素、免疫抑制剂对照组两组进行观察。结果示两组疗效相近(P>0.05),而复发及药物副作用,治疗组较对照组明显减少(P<0.05,P<0.005)。初步提示山海棠对治疗原发性肾小球疾病是一有希望的药物。     

糖皮质激素治疗SARS的探讨

目的　探讨糖皮质激素在严重急性呼吸综合征 (SARS)治疗中的作用。方法　对 2 0 0 3年 1月～ 5月在本院收治的 99例SARS患者的临床治疗进行回顾性分析。结果　糖皮质激素多采用早期、小剂量、短疗程方案。激素组 4 6例 ,非激素组 5 3例。激素组与非激素组年龄与性别构成比差异均无统计学意义(P >0 0 5 ) ;退热时间和肺部炎症吸收时间 ,激素组分别为 6 3±3 5天和 1 8 2± 7 8天 ,非激素组分别为 8 1± 3 2天和 2 1 7±8 9天 ,两组比较差异有统计学意义 (P <0 0 5 )。结论　早期、小剂量、短疗程使用糖皮质激素能明显缩短SARS的病程 ,加快肺部炎症的吸收     

前列腺素E1与依那普利治疗重度心衰46例

近4年来,我们应用小剂量前列腺素E1(PGE1)与依那普利治疗重度充血性心力衰竭患者46例,取得了较好的临床疗效,现报告如下.     

Knee injury and Osteoarthritis Outcome Score (KOOS) - validation of a Swedish version

The Knee injury and Osteoarthritis Outcome Score (KOOS) is a self-administered instrument measuring outcome after knee injury at impairment, disability, and handicap level in five subscales. Reliability, validity, and responsiveness of a Swedish version was assessed in 142 patients who underwent arthroscopy because of injury to the menisci, anterior cruciate ligament, or cartilage of the knee. The clinimetric properties were found to be good and comparable to the American version of the KOOS. Comparison to the Short Form-36 and the Lysholm knee scoring scale revealed expected correlations and construct validity. Item by item, symptoms and functional limitations were compared between diagnostic groups. High responsiveness was found three months after arthroscopic partial meniscectomy for all subscales but Activities of Daily Living.     

The acutely limping child

Acute limping may be the result of multiple pathologies in children. The differential diagnosis varies based on the age of the child. Irrespective of age, the initial imaging work-up includes AP and frog leg radiographs of the pelvis and ultrasound; MRI may sometimes be helpful. In children less than 3 years, infections and trauma are most frequent. MRI is the imaging modality of choice when osteomyelitis is clinically suspected. Between the ages of 3 and 10 years, transient synovitis of the hip and Legg-Calvé-Perthes disease are main considerations but infection, inflammation and focal bony lesions are also considered. In children over 10 years, slipped capital femoral epiphysis also is considered.     

Do Balance Board Training Programs Reduce the Risk of Ankle Sprains in Athletes?

Introduction Ankle sprains are the most common musculo-skeletal injury that occurs in athletes,particularly in sports that require jumping and landing on one foot such as soccer,and basketball(1-4).These injuries often result in significant time loss from participation,long-term disability,and have a major impact on health care costs and resources(5-8).     

High Intensity Interval Training:New Insights

KEY POINTS ·High-intensity interval training(HIT)is characterized by repeated sessions of relatively brief，intermittent exercise.often performed with an“a11 out”effort or at an intensity close to that which elicits peak oxygen uptake(i.e.，≥90%of VO2 peak).     

Endovascular management of carotid-cavernous fistulas

Objective To investigate endovascular treatment of traumatic direct carotid-cavernous fistulas （CCF） and their complications such as pseudoaneurysms. Methods： Over a five-year period, 22 patients with traumatic direct CCFs were treated endovascularly in our institution. Thirteen patients were treated once with the result of CCF occluded, 8 twice and 1 three times. Treatment modalities included balloon occlusion of the CCF, sacrifice of the ipsilateral internal carotid artery with detachable balloon, coll embolization of the cavernous sinus and secondary pseudoaneurysms, and covered-stem management of the pseudoaneurysms. Results All the direct CCFs were successfully managed endovascularly. Four patients developed a pseudoaneurysm after the occlusion of the CCF with an incidence of pseudoaneurysm formation of 18.2% （4/22）. A total number of 8 patients experienced permanent occlusion of the ICA with a rate of ICA occlusion reaching 36.4% （8/22）. Followed up through telephone consultation from 6 months to 5 years, all did well with no recurrence of CCF symptoms and signs. Conclusion Traumatic direct CCFs can be successfully managed with endovascular means. The pseudoaneurysms secondary to the occlusion of the CCFs can be occluded with stent-assisted coiling and implantation of covered stents.     

Developmental validation of the PowerPlex(®) ESI 16 and PowerPlex(®) ESI 17 Systems: STR multiplexes for the new European standard

In response to the ENFSI and EDNAP groups’ call for new STR multiplexes for Europe, Promega^® developed a suite of four new DNA profiling kits. This paper describes the developmental validation study performed on the PowerPlex^® ESI 16 (European Standard Investigator 16) and the PowerPlex^® ESI 17 Systems. The PowerPlex^® ESI 16 System combines the 11 loci compatible with the UK National DNA Database^®, contained within the AmpFlSTR^® SGM Plus^® PCR Amplification Kit, with five additional loci: D2S441, D10S1248, D22S1045, D1S1656 and D12S391. The multiplex was designed to reduce the amplicon size of the loci found in the AmpFlSTR^® SGM Plus^® kit. This design facilitates increased robustness and amplification success for the loci used in the national DNA databases created in many countries, when analyzing degraded DNA samples. The PowerPlex^® ESI 17 System amplifies the same loci as the PowerPlex^® ESI 16 System, but with the addition of a primer pair for the SE33 locus. Tests were designed to address the developmental validation guidelines issued by the Scientific Working Group on DNA Analysis Methods (SWGDAM), and those of the DNA Advisory Board (DAB). Samples processed include DNA mixtures, PCR reactions spiked with inhibitors, a sensitivity series, and 306 United Kingdom donor samples to determine concordance with data generated with the AmpFlSTR^® SGM Plus^® kit. Allele frequencies from 242 white Caucasian samples collected in the United Kingdom are also presented. The PowerPlex^® ESI 16 and ESI 17 Systems are robust and sensitive tools, suitable for the analysis of forensic DNA samples. Full profiles were routinely observed with 62.5 pg of a fully heterozygous single source DNA template. This high level of sensitivity was found to impact on mixture analyses, where 54–86% of unique minor contributor alleles were routinely observed in a 1:19 mixture ratio. Improved sensitivity combined with the robustness afforded by smaller amplicons has substantially improved the quantity of data obtained from degraded samples, and the improved chemistry confers exceptional tolerance to high levels of laboratory prepared inhibitors.     

Bronchial stump fistula :treatment with covered retrievable hinged metallic stents-preliminary clinical experience

Objective To evaluate the preliminaily clinical efficacy and retrievability of a retrievable hinged covered metallic stent in the treatment of the bronchial stump fistula （BSF）. Methods Between April 2003 and March 2005, 8 patients with bronchial stump fistula after pneumonectomy or lobectomy were treated with two types （A and B） of retrievable hinged covered metallic stents. Type A stent was placed in 6 patients and type B in 2 under fluoroscopic guidance. The stent was removed with a retrieval set when BSF was healed or complications occurred. Results Stent placement in the bronchial tree was technically successful in all patients, without procedure-related complications. Immediate closure of the BSF was achieved in all patients after the procedure. Stents were removed from all patients but one. Removal of the stents was difficult in two patients due to tissue hyperplasia. Patients were followed up for 6 - 21 months. Placement of the stents remained stable in all patients except one due to severe cough. Permanent closure of BSF was achieved in 7 （87.5%） of 8 patients. Conclusion Use of a retrievable hinged covered expandable metallic stent is a simple, safe, and effective procedure for closure of the BSF. Retrieval of the stent seems to be feasible. （J Intervent Radiol, 2007, 16： 253-257）     

Prevalence and severity of hip and groin pain in sub‐elite male football: a cross‐sectional cohort study of 695 players

The purpose of this study was twofold: (a) to investigate the prevalence of hip and groin pain in sub‐elite male adult football in Denmark and (b) to explore the association between prevalence and duration of hip and groin pain in the previous season with the Copenhagen Hip and Groin Outcome Score (HAGOS) in the beginning of the new season. In total 695 respondents from 40 teams (Division 1–4) were included. Players completed in the beginning of the new season (July–Sept 2011) a self‐reported paper questionnaire on hip and/or groin pain during the previous season and HAGOS. In total 49% (95% CI: 45–52%) reported hip and/or groin pain during the previous season. Of these, 31% (95% CI: 26–36%) reported pain for >6 weeks. Players with the longest duration of pain during the previous season had the lowest HAGOS scores, when assessed at the beginning of the new season, P < 0.001. This study documents that half of sub‐elite male adult football players report pain in the hip and/or groin during a football season. The football players with the longest duration of pain in previous season displayed the lowest HAGOS scores in the beginning of the new season.