原发性肾病综合征联合药物治疗的前瞻性研究

目的:前瞻性应用强的松、雷公藤多甙及灯盏细辛治疗原发性肾病综合征(PNS),观察其疗效。方法:64例确诊的PNS患者随机分为A、B两组。A组应用灯盏细辛注射液90mg,1次/d,雷公藤多甙20mg,3次/d;强的松1mg/(kg.d)口服。B组常规应用强的松、双嘧达莫和舒降之。2w为1个疗程,连用2个疗程。观察患者浮肿、尿量变化及药物副作用。每周检查TUP、TC、TG、LDL-C、TP、ALB、SCr和BUN。结果:两组的完全缓解率分别为71.88%和56.25%(P<0.01);总有效率分别为93.75%和81.25%(P<0.05)。治疗组TC、TG、LDL-C显著下降,HDL-C明显上升(P<0.01),TP、ALB显著升高(P<0.01),TUP显著下降(P<0.01)。两组尿量及SCr、BUN无明显变化。两组均未见明显药物副作用发生。结论:本研究将传统免疫抑制剂强的松和免疫调节剂雷公藤多甙及改善微循环药物灯盏细辛联合应用,疗效显著,为原发性肾病综合征提供了一个新的治疗方法。     

雷公藤多甙在子宫内膜异位症术后的应用

目的　探讨雷公藤多甙预防子宫内膜异位症术后复发的价值。方法　于术后 1周开始用药 ,治疗组 4 1例口服雷公藤多甙片 ,30mg/d ,连续服用 6个月 ;对照组 35例口服米非司酮 12 .5mg/d ,连续服用 6个月。 结果　治疗组 12例月经量明显减少 ,2 9例治疗周期中出现闭经 ,对照组治疗期间均闭经。停药后 1年内 ,治疗组复发率为 14 6 3% ;对照组复发率为 14 2 8% ,两组比较无显著差别。治疗组副反应发生低于对照组。结论　雷公藤多甙可降低子宫内膜异位症术后复发率     

复发性多发软骨炎引起气道狭窄

作者报告2例复发性多发软骨炎。例1,女16岁,低烧,声嘶哑,咽喉痛,两眼结合膜炎,青霉素治疗无效。左耳廓肿痛,唯耳垂得免。直接喉镜见会厌、假声带和气管有炎性改变。强的松治疗后除声嘶哑外,症状消退。两月后发生呼吸困难。颈部侧位X线片和正位断层显示声门下明显狭窄。行气管切开,并用强的松维持治疗。例2,女35岁,追忆生后不久发生外耳肿痛,近三年前鼻塌陷变形,并有进行性双侧耳聋。近期出现发烧、声嘶哑、     

口服雷公藤多甙致过敏性荨麻疹1例

1 临床资料 患者,男,30岁,因反复浮肿、尿少4a,加重1周,于1999年4月6日入院。既往无药物过敏史。经检查确诊为肾病综合征,予强的松、氢氯噻嗪、氯化钾、双嘧达莫口服治疗。4月16日起加用雷公藤多甙20mg,3/d(湖南省珠洲市制药三厂,湘卫药准字(90)66—002号,10mg/片),次日全身遍布大小不一的红色斑丘疹,胸背部、腹部多见,呈片状,压之褪色,伴全身瘙痒,即停雷公藤多甙,予抗过敏药口服,10％葡萄糖酸钙、     

复发性多软骨炎10例诊治体会

复发性多软骨炎（RP）是一种少见的、累及全身多处软骨的自身免疫性疾病。病变可侵犯包括耳鼻咽喉、气管支气管、关节及心血管等全身重要器官的软骨结构及其结缔组织，可造成多系统功能紊乱。其临床表现多种多样，具有慢性、复发性、多软骨性及萎缩性特点，起病隐袭，极易误诊，早期诊断、及时治疗有利于控制症状。     

糖皮质激素联合硫唑嘌呤治疗复发性淋巴细胞性垂体炎后自然妊娠1例报告

目的 观察糖皮质激素联合硫唑嘌呤治疗复发性淋巴细胞性垂体炎(LyH)的远期效果.方法 回顾性分析1例被误诊为垂体瘤并进行手术治疗的女性LyH患者的临床资料,并长期随访患者确诊后的治疗转归.结果 本例患者因头痛、复视误诊为"垂体瘤"行手术治疗,疗效显著.术后4个月后再次出现头痛、复视和左上睑下垂等症状,垂体MRI显示鞍内及鞍上池异常软组织信号并侵犯双侧海绵窦,解放军总医院重新核实"垂体瘤组织切片"证实为LyH.给予患者大剂量甲泼尼龙冲击治疗(HDMPT)后1周症状缓解,3周垂体MRI恢复正常,5个月时激素减量并停用;18个月时再次出现头痛、复视和右侧眼球活动受限,MRI显示垂体形态正常、鞍背右侧和邻近小脑幕可见异常强化.重复HDMPT 1周后症状明显改善,继而予硫唑嘌呤100mg/d×16周+泼尼松30mg/d(每周减5mg直至停用).停止治疗3年后首次妊娠并顺利分娩和正常哺乳,无疾病复发征象.结论 糖皮质激素联合硫唑嘌呤可有效治疗女性复发性LyH并能自然妊娠.     

耳廓创伤42例治疗体会

本文自1984年6月至1994年6月收治耳廓创伤42例，经清创缝合术，抗生素治疗，Ⅰ期愈合38例，4例因耳廓软骨膜感染至软骨坏死，形成耳廓畸形，现将治疗体会报告如下。1临床资料1．1一般情况本组男38例，女4例。年龄16～46岁，平均32岁。伤后就诊时间：1h～15d.致伤原因：工作中不慎受伤11例，打架致伤23例，手术致伤3例，交通事故致伤4例，冻伤1例。1．2临床表现单纯耳廓创伤28例，均有软骨挫伤及软骨膜撕裂伤。合并有其他部位受伤7例。伤后耳廓软骨部分缺损3例。就诊时耳廓软骨已大部或部分坏死4例。1．3治疗结果伤后即来院治疗者38例，经彻…     

复发性多软骨炎7例报告

目的探讨复发性多软骨炎的临床特点和诊疗方法。方法回顾性分析7例复发性多软骨炎患者的临床特点、治疗结果并复习相关文献。结果7例患者中侵犯呼吸道5例,耳4例,鼻3例,关节2例,眼1例,耳蜗和前庭1例。平均漏诊或误诊时间为2.1年。均给予糖皮质激素治疗,其中3例因气道狭窄行气管支架置入术,患者症状明显缓解。结论复发性多软骨炎临床表现复杂多样,极易误诊、漏诊,临床需提高对该病的认识。糖皮质激素治疗疗效明显,合并气道狭窄的可行纤支镜引导下气管支架置入术。     

雷公藤多甙并潘生丁治疗小儿过敏性紫癜性肾炎临床观察

目的:观察口服雷公藤多甙加潘生丁对治疗过敏性紫癜性肾炎的疗效。方法:回顾性调查并随访2003—2006年用雷公藤多甙加潘生丁治疗50例小儿过敏性紫癜性肾炎为治疗组,并随机选择同期患儿口服单剂雷公藤多甙30例作为对照。结果治疗组治愈44例(88%),有效6例(12%),对照组治愈18例(60%),有效12例(40%),两组间差异显著(P<0.05),对蛋白尿、血尿、高血压及水肿疗效亦差异显著(均为P<0.01)。结论:提示雷公藤多甙加潘生丁治疗小儿过敏性紫癜性肾炎优于单剂雷公藤多甙,值得临床应用。     

膀胱癌阴茎转移化疗的作用

膀胱癌侵犯阴茎罕见,近期有人复习文献的73例,其生存均未超过20个月,并认为常在病变很晚才出现阴茎转移,且有效转移,且有效的治疗少。作者报告4例膀胱癌转移至阴茎,采用顺铂60mg/m~2与MTX60mg/m~2联合化疗,其中3例无癌生存为22、20及27个月;另1例死亡,该例伴多处骨转移,只是单一化疗,即在2次150mg顺铂无效后又给MTX100mg3次,然骨痛无缓解,终因全身     

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.     

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.     

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).     

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.