醒脑静注射液治疗老年急性感染性高热70例

感染性高热容易出现意识障碍、惊厥、脑血管和心血管疾病加重或引发其他新的疾病等,不及时处理常常会危及生命。常规的退热药物虽然能够降低体温,但是随之出现的大汗、乏力、低血压等情况,更易出现脑血栓和心血管病等并发症。醒脑静注射液广泛应用于急性脑血管病、中毒等昏迷患者,起保护脑细胞、促清醒等作用〔1,2〕。近年有很多文献报道在小儿和     

欢迎订阅《心血管病防治知识》杂志

音乐能陶冶人的情操、给人以美的享受、能改变人的心境和心情。人大约从四十岁起开始有衰老的迹象,明显的外表生理变化有:皱纹、动作迟缓、白发、记忆力衰退等。生理上的衰老与其生活环境(自然的和社会的)和人的心理因素密切相关,所以说人的衰老是包含生理、心理、自然和社会环境等因素的综合发展进程。人的生理衰老反映在神经感知觉(如味觉、视力、听力、平衡性、触觉等)、肌肉骨胳、心血管、呼吸、消化、泌尿生殖和内分泌等系统的衰退上。然而据统计75岁以上的老人25%有精神问题,包括抑郁症、妄想症、焦虑症、痴呆症等疾病。多年来音乐已…     

深部真菌感染的实验室诊断研究进展

深部真菌感染一般包括侵袭真皮、皮下组织和内脏器官的深部真菌病,引起深部真菌感染的病原菌主要有念珠菌、曲霉菌、新型隐球菌、卡氏肺孢菌等机会性致病菌,另外还有一些如粗孢子球菌、荚膜组织胞浆菌、皮炎芽生菌及巴西副球孢子菌等南美洲和北美洲等地出现的地方性致病菌以及毛霉菌属、镰刀菌属、青霉属和申克孢子丝菌等罕见菌种。随着广谱抗生素、     

戒毒人员便秘处方专家共识(2021年)

海洛因、鸦片等毒品和美沙酮等脱毒药物属于阿片类, 可抑制中枢神经系统, 阻止排便反射的下传和肠道平滑肌的运动, 使肠管蠕动不协调而导致便秘, 加之吸毒者普遍存在焦虑、抑郁、睡眠障碍等不良精神因素, 且生活习惯不规律, 蔬菜、水果类补充不足等促使便秘发生。因此, 吸毒者便秘的发生率远高于普通人群。很多戒毒人员在戒毒期间存在严重的戒断反应和心理依赖, 同时, 他们还要承受便秘带来的痛苦。为此, 必须对戒毒人员的便秘进行综合治疗。国内相关专家坚持先进性、科学性、实用性和循证医学证据的原则, 经多次研讨后, 就戒毒人员便秘的流行病学、病因、发病机制、诊断和治疗达成共识, 并针对戒毒人员的便秘提出治疗建议, 包括非药物治疗如调整生活方式、精神心理治疗等, 药物治疗如促胃肠动力药、各类泻剂、微生态制剂的应用等, 以规范戒毒人员便秘的诊治, 供戒毒相关管理人员、医师等在戒毒工作中参考应用。     

肠道病毒(EV71)感染诊疗指南(2008年版)

肠道病毒EV71感染多发生于学龄前儿童,尤以3岁以下年龄组发病率最高。可引起手、足、口腔等部位的斑丘疹、疱疹,个别患者可引起脑炎、脑脊髓炎、脑膜炎、肺水肿、循环衰竭等。传染源为现症患者和隐性感染者,主要通过人群消化道、呼吸道和分泌物密切接触等途径传播。     

电化学发光免疫分析方法及其应用

电化学发光免疫分析方法是近年来在生物分析领域兴起的一种非放射性微量检测技术,该方法具有灵敏度高、线性范围宽和适用面广等特点,被广泛应用于激素、肿瘤标志物和细胞因子等物质的检测,在医学、食品和环境分析等方面具有广阔的应用前景.该文就该方法的基本原理、类型、应用和发展作简要综述.     

经皮穿刺冠状动脉内成形术后的再狭窄:挑战与希望

经皮穿刺冠状动脉内成形术(PTCA)后的再狭窄是当前心血管专业的一个重要课题.再狭窄发生率高低与病人临床状况、病变冠状动脉解剖特点及 PTCA 操作本身等有关,也与分析方法、诊断标准和随访时间等有关.目前用药物治疗,包括抗血小板药物、抗平滑肌增殖药物、钙通道拮抗剂、降脂药物和抗炎症药物等,以及非药物方法,包括激光、机械方法和移植模等对预防和治疗 PTCA 后的再狭窄有一定作用.尚需对这些方法作进一步论证和/或探讨新的方法。     

益肾化湿颗粒和舒洛地特软胶囊联合治疗糖尿病肾病的疗效

目的探讨益肾化湿颗粒和舒洛地特软胶囊联合治疗糖尿病肾病(DN)的效果。方法选取2013年1月至2014年1月该院收治的老年DN患者60例并进行益肾化湿颗粒和舒洛地特软胶囊联合治疗。另选取60例同期接受常规降糖、降血脂和舒洛地特软胶囊治疗的老年DN患者作为对照。联合治疗组在对照组的基础上采用益肾化湿颗粒(10 g/次,3次/d)治疗。2个月为1个疗程,两组均治疗2个疗程。观察两组疗效并分析用药前后两组血肌酐(Scr)、血尿素氮(BUN)和尿白蛋白排泄率(UAER)等肾功能指标、血脂、凝血功能、C反应蛋白(CRP)和白介素(IL)-8等炎性因子水平、空腹血糖(FPG)、平均动脉压(MAP)和不良反应和并发症发生情况。结果联合治疗组疗效为显著的患者比例和治疗有效率(分别为35.00%和98.33%)均高于对照组的23.33%和91.67%(P<0.05)。治疗前两组TC、TG、HDL-C和LDL-C等血脂指标、APTT、PT、FDP、D-D和FIB等凝血功能指标、FPG、MAP、Scr、血BUN、血脂、凝血功能、UAER、CRP以及IL-8等水平比较差异无统计学意义(P>0.05)。治疗后,两组TC、TG、HDL-C和LDL-C等血脂指标、APTT、PT、FDP、D-D和FIB等凝血功能指标、FPG、MAP、Scr、BUN、UAER、CRP、IL-8等水平均出现不同程度下降,且联合治疗组TC、TG、HDL-C和LDL-C等血脂指标、APTT、PT、FDP、D-D和FIB等凝血功能指标、MAP、Scr、BUN、UAER、CRP、IL-8等水平均较对照组降低(P<0.05)。联合治疗组治疗后的不良反应和并发症发生率为1.67%,低于对照组的5%(t=4.26,P<0.05)。结论益肾化湿颗粒和舒洛地特软胶囊联合治疗糖尿病肾病效果良好,可有效控制患者的血糖和血压水平,保护患者的肾功能并降低患者的血脂、凝血功能和炎性指标水平,且不良反应和并发症少,值得临床推广。     

牛胰蛋白酶抑制剂研究进展

牛胰蛋白酶抑制剂具用广泛的蛋白酶抑制活性,在机体中参与凝血、纤溶、细胞迁移、细胞分化、调亡和炎症反应等,在临床上应用于细胞调亡、凝血、骨质疏松和肿瘤等的治疗。本文综述了牛胰蛋白酶抑制剂的分子结构和功能及生物学特性,牛胰蛋白酶抑制剂的临床应用及对脏器保护的应用等进行探讨。     

电化学发光免疫分析方法及其应用

电化学发光免疫分析方法是近年来在生物分析领域兴起的一种非放射性微量检测技术,该方法具有灵敏度高、线性范围宽和适用面广等特点,被广泛应用于激素、肿瘤标志物和细胞因子等物质的检测,在医学、食品和环境分析等方面具有广阔的应用前景.该文就该方法的基本原理、类型、应用和发展作简要综述.     

胰岛素瘤的解剖分布特点分析

目的胰岛素瘤是最常见的胰腺神经内分泌肿瘤，因其临床表现多样，导致诊断困难。影像学诊断尤其是超声内镜(EUS)在胰岛素瘤的诊断中起着重要作用，拥有较高的敏感性和特异性。本研究拟通过明确胰岛素瘤的解剖分布特点，以期有助于提高影像学的诊断准确率和降低漏诊率，尤其是在教育和培训实践中对于EUS的学习者更具有指导价值。 方法回顾性分析解放军总医院第一医学中心病案资料数据库1993年1月至2019年11月经外科手术、病理确诊为胰岛素瘤的患者的临床资料，检索方法采取搜索术后病理诊断为"胰岛素瘤"的病例，通过查阅病例的方法，提取出胰岛素瘤的大小和解剖分布等数据，进一步分析其特点。 结果共检索到确诊为胰岛素瘤的患者116例，其中，男45例、女71例，年龄13～76岁，平均年龄(44.4±14.85)岁。胰岛素瘤单发110例(94.8%)、多发6例(5.2%)。位置分布：头颈部46例(39.7%)，单发45例、多发1例；体尾部68例(58.6%)，单发65例、多发3例；全胰腺多发2例(1.7%)。病变大小特点：最大径0.4～3.4 cm，平均大小(1.53±0.58)cm。≤1 cm 29例、>1 cm而≤1.5 cm41例、>1.5 cm而≤2.0 cm28例，≤3 cm 15例，>3 cm 3例。年龄与肿瘤的大小相关，≤44岁患者肿瘤平均大小为(1.36±0.51)cm、>44岁患者肿瘤平均大小为(1.70±0.60)cm，P<0.05。头颈部的肿瘤大于体尾部的肿瘤，头颈部肿瘤平均大小(1.66±0.63)cm，体尾部(1.42±0.52)cm，P<0.05。 结论胰岛素瘤在胰腺体尾部较头颈部更好发；绝大多数单发，但可以全胰腺多发；多数小于1.5 cm，肿瘤的大小与患者年龄和肿瘤的解剖分布相关。     

Influence of spasmolytic analgesics on motility of sphincter of oddi

The effects on the sphincter of Oddi of intravenous administration of dipyrone, 2.5 g; tramadol, 50 mg; indomethacin, 75 mg;N-butylscopolamine, 20 mg; and nitroglycerin, 1 mg, in comparison to physiological saline were assessed in a single-blind study in 36 patients hospitalized with upper abdominal pain. Basal sphincter pressure and sphincter motility were measured for a 5-min period after treatment by endoscopic manometry. Nitroglycerin and dipyrone both caused a significant fall in basal sphincter pressure, whileN-butylscopolamine and nitroglycerin produced a significant decrease in contraction frequency. Therefore, dipyrone, in contrast to tramadol and indomethacin, exhibits spasmolytic activity in addition to analgesia in biliary pain.This study was sponsored by Hoechst AG, Frankfurt/M., Germany     

Effectiveness of Four Hours of Education in Interpretation of Radiographic Studies

Clinicians working with oropharyngeal swallowing disorders often use videofluoroscopy to define their patients' swallowing abnormalities. This study examined the effect of 4 hours of training in the identification of head and neck anatomy and oropharyngeal swallowing disorders viewed radiographically. Ninety clinicians particiapted in a 5-hour session which included 30-minute pre- and post-tests requiring identification of head and neck anatomy and oropharyngeal swallowing disorders and a 4-hour training period. Results showed significant improvement in identification of both radiographic anatomy and swallowing disorders. The change in pre- and post-test measures was negatively correlated with extent of prior experience in dysphagia. Similar studies are needed with clinicians or students inexperienced in dysphagia to define the number of hours of education needed in order for students to reach a desired accuracy level in their identifications.     

A comparison of methods of pathogen inactivation of FFP

Introduction Current methods for pathogen inactivation of plasma involve four major processes using solvent–detergent (SD), methylene blue (MB), amotosalen and riboflavin as additives. Three of these methods involve the use of visible or ultraviolet light. Methods A comparison of the four methods was made using publications in Medline, Pubmed, Embase and Biosis to obtain data on the logistics of use, the quality of the plasma proteins and the effectiveness of pathogen inactivation. Results Three of the methods, MB, amotosalen and riboflavin, are designed for use in a blood bank; the SD method is generally applied at a centralized manufacturing centre and involves large plasma pools. All methods result in a reduction in protein values with the per cent retention of FVIII activity in the range of 67–78% and fibrinogen of 65–84%. Protein S and alpha₂‐antiplasmin are lower following solvent–detergent treatment. Alterations in fibrinogen structure have been reported with methylene blue. Discussion Three of the methods are designed for small volume use in a blood bank. All four methods have some effect on the coagulant proteins; however, the final concentrations are within regulated limits. While there is variability in the effectiveness against pathogens, direct comparison is difficult because of the methodologies used. Nonetheless, all are effective in inactivating HIV and other lipid‐enveloped pathogens. Clinical studies on the effectiveness of these products are surprisingly sparse, and no randomized clinical trials have yet been performed with amotosalen or riboflavin plasmas.     

辽宁省城市体检人群代谢综合征肾脏损害调查研究

目的:探讨沈阳市代谢综合征(MS)人群肾脏损害情况。方法:选取辽宁省城市体检人群与社区人群进行分层抽样调查,共调查2000人,其中体检人群1000人,社区人群1000人(来自辽宁省各城市)。根据MS的诊断标准,研究对象被分为超重肥胖组(460人)和正常体重组(1540人),高血糖组(140人)和正常血糖组(1860人),高血压组(399人)和正常血压组(1601人),血脂异常组(486人)和血脂正常组(1514人),比较各分组间肾脏损害的患病率。结果:调查人群中肾脏损害患病率为15%,男性与女性之比为1:1。超重肥胖组和非超重肥胖组肾脏损害患病率分别为10%和1%;高血糖组和正常血糖组肾脏损害患病率分别为10%和1%;高血压组和正常血压组肾脏损害患病率分别为10%和2%;血脂异常组和血脂正常组肾脏损害患病率分别为10%和1%,以上两组间比较差异均有显著性(P0.01)。结论:辽宁省城市代谢综合征患者的肾脏损害患病率较正常人群显著升高。     

Comparison of effectiveness of thyrotropin-suppressive doses of d- and l-thyroxine in treatment of hypercholesterolemia

In an attempt to compare the cholesterol-lowering effects of equivalent doses of d- and l-thyroxine, 10 euthyroid, hypercholesterolemic subjects were treated with graded doses of each medication in a cross-over design using thyrotropin suppression following thyrotropin-releasing hormone administration as the end-point. The mean thyrotropin-suppressive dose of d-thyroxine was 2.4 ± 0.66 mg per day, which resulted in mean reductions of 10 percent in total plasma cholesterol, 10 percent in plasma low-density lipoprotein cholesterol, and 11 percent in plasma high-density lipoprotein cholesterol. The mean thyrotropin-suppressive dose of l-thyroxine was 135 ± 46 μg per day, which resulted in mean reductions of 7 percent in total plasma cholesterol, 6 percent in plasma low-density lipoprotein cholesterol, and 14 percent in plasma high-density lipoprotein cholesterol. The reductions in total, low-density, and high-density cholesterol achieved with d-thyroxine were not significantly different from those achieved with l-thyroxine. Neither medication produced a significant increase in heart rate or ventricular ectopy as determined by Holter monitoring. These data do not support the belief that d-thyroxine has a preferential cholesterol-lowering effect in humans when compared with equivalent doses of l-thyroxine. In addition, both d- and l-thyroxine reduced plasma high-density lipoprotein cholesterol.     

我国山丘型流行区血吸虫病防治工作面临的主要挑战和防治对策

本文阐述了当前我国山丘型流行区血吸虫病流行特征和疫情态势，分析了山丘型流行区血吸虫病防治工作面临的主要挑战，对今后的防控重点和措施提出了针对性建议，以期推动山丘型流行区血吸虫病消除工作进程、促进我国《“十三五”全国血吸虫病防治规划》和《地方病防治专项三年攻坚行动方案（2018–2020年）》目标的实现。     

Effect of exposure of rats to cigarette smoke on the metabolism of lipids

Prolonged exposure of rats to cigarette smoke resulted in significant alterations in the metabolism of lipids. There was a significant increase in the concentration of cholesterol, triglycerides and phospholipids in most of the tissues, particularly the heart, aorta and lungs. Cholesterol, triglycerides and phospholipids decreased in the serum HDL and increased in LDL + VLDL. There was increased cholesterogenesis in the heart, lungs and liver, as evidenced by increased activity of HMG-CoA reductase and increased incorporation of labelled acetate into cholesterol. Incorporation of label into the triglycerides also increased in these tissues. Activity of lipoprotein lipase in the extrahepatic tissues was decreased. Activity of glucose-6-phosphate dehydrogenase and malic enzyme increased in the heart and lungs. There was decreased concentration of bile acids in the liver.     

胃祺饮阻断慢性萎缩性胃炎的机制

观察胃祺饮对慢性萎缩性胃炎(CAG)的阻断作用及可能机制。方法以综合法诱发大鼠癌前病变状态,用胃祺饮与叶酸参与预防和治疗,观察对胃粘膜急性损伤及萎缩的预防治疗作用,以及对病变粘膜组织中髓过氧化脂质(MPO)、一氧化氮(NO)、谷胱甘肽过氧化酶(CSH-Px)、表皮生长因子(EGF)及其受体(EGFR)水平的影响。结果中药组能明显阻断有害因素对粘膜的炎症损伤,改善病变组织粘膜萎缩程度,优于叶酸组(P＜0.05)。中药组治疗后可提高GSH-Px水平,阻断NO的过度产生,下调组织中EGF及EGFR水平,有效地消除多种有害因素对胃粘膜的诱癌作用。结论胃祺饮对胃癌前病变细胞的增殖有良好的阻断作用。     

Study of constancy of hydrogen-consuming flora of human colon

The constancy of the hydrogen consuming flora of the human colon was studied in 15 healthy subjects via two measurements obtained 18 to 36 months apart. Hydrogen disappearance rate and the major products of H₂-consuming bacteria, methane and sulfide, were measured during incubation of fecal homogenates with excess hydrogen and sulfate. In 11/15, the hydrogen consumption rate and the predominant hydrogen-consuming pathway (methanogenesis, sulfate reduction, or neither) remained constant. However, major shifts in these pathways were observed in four subjects, with two losing and two gaining the ability to produce methane. Methanogenesis was associated with the highest hydrogen consumption rate. This study demonstrates that clinically unrecognizable, major alterations of the colonic flora occur in healthy subjects. Understanding of the factors responsible for these alterations might allow for therapeutic manipulation of the colonic flora.Supported in part by the Department of Veterans Affairs and NIDDKD RO1 DK 13309-25.