保胆健素对胆囊炎胆石症溶石排石作用近期疗效观察

保胆健素对胆囊炎胆石症溶石排石作用近期疗效观察王巨昌于加珍南京医科大学附属南京第一医院（２１０００６）表１２组腹痛症状缓解情况比较表（％）症状消失症状减轻无变化治疗组（ｎ＝１０２）８６（８４．３）＊１６（１５．７）＊０＊对照组（ｎ＝９８）８（８．２）...     

口服UDCA和CDCA溶石治疗胆石症

胆石症患者口服药物UDCA和CDCA溶石疗法作为一种非创伤性治疗方法已广泛地应用于临床,但其疗效受多种因素的影响,本文就其临床应用及影响疗效的因素作一综述。 一、应用范围 1.适应症 口服药物溶石疗法并不能溶解所有胆石,只对胆固醇结石有效,有严格的适应症。其适应症包括:(1)X线可透过的胆固醇结石;(2)胆囊造影提示胆囊机能良好;(3)胆石     

胆系结石体外冲击波碎石及排石探讨

我院近一年来采用国产KDE—2型X线、B超定位ESWL配合药物及辅助排石治疗,对202例胆系结石取得较满意疗效,现报告如下: 临床资料一、一般资料202例中年龄21～74岁。结石部位:胆囊体部168例(83.7%),胆囊颈部30例(14.8%),胆总管3例(1.5%)。结石数量:单发101例(50%),二枚28例(13.9%),三枚39例(19.3%),四枚以上34例(16.8%)。     

溶石Ⅰ号治疗胆石症48例临床观察

自1989年以来,采用溶石排石法治疗胆石症共计82例,现将定期随访、资料完整的48例治疗情况,总结报告如下。 1 对象和方法 1.1 对象 全部病例均由门诊定期观察,并按观察与对照,随机分2组。①治疗组(A组):服用自制溶石Ⅰ号,共48例。男20例,女28例,男与女之比1:1.4,年龄最大74岁,最小30岁,平均年龄50岁,其中21-30岁2人,31-40岁11人,41-50岁16人,51-60岁12人,61-70岁4人,71-80岁3人。48例中诊断为胆囊结石23例,胆总管结石3例,多部位结石7例,肝内结石11例,术后残留结石4例。结石最大为:3.7cm×1.7cm,最小为:0.5cm×0.6cm,病史最长达40年之久,最短     

自制碎石篮机械破碎胃柿石的临床疗效观察

胃柿石是常见的植物性胃石，临床上常并发胃溃疡、上消化道出血、幽门梗阻等，治疗上通常采用胃镜下机械碎石、激光碎石等，我院2004年6月-2008年6月期间应用胆道取石网篮改制成的碎石篮在胃镜直视下机械碎石治疗胃柿石42例，取得了较好的临床效果，现报道如下。     

体外冲击波碎石联合体外物理震动排石治疗肾结石的疗效观察

目的观察体外冲击波碎石联合体外物理震动排石治疗肾结石的疗效。方法选取2016-01～2018-01在该院就诊的肾结石患者80例。采用随机数字表法将其分为观察组和对照组,每组40例。对照组接受常规体外冲击波碎石术治疗,观察组接受体外冲击波碎石联合体外物理震动排石治疗,比较两组术后排石效果及一般手术情况。结果观察组术后2周、3周、5周时排石率显著高于对照组(P0.05)。观察组结石排尽时间、止痛时间、住院时间显著短于对照组(P0.05),术后并发症发生率也显著低于对照组(P0.05)。结论采用体外冲击波碎石联合体外物理震动排石治疗肾结石疗效显著,可有效促进术后结石的快速排出,并且治疗方案更为安全可靠,具有临床应用及推广价值。     

经皮胆镜碎石术治疗胆石症552例

目的:研究经皮胆镜碎石术(PCLC)治疗胆囊结石的疗效。方法:1990年11月—1993年5月作者采用PCLC治疗胆囊结石症552例。采用X光片胆囊目测定位法寻找胆囊,切开皮肤将胆囊牵至切口处后即行经皮胆镜碎石取石治疗胆囊结石。结果:对552例胆囊结石患者行经皮胆镜碎石术成功538例,碎石成功率97.5％,14例改行胆囊切除术。有3例发生胆汁性腹膜炎,3例出现急性胆囊感染,其中1例行胆囊切除术证实有结石残留。对184例患者作18—30个月的随访,结石残留7例,占3.8％,结石复发14例,占7.6％。结论:经皮胆镜碎石术是治疗结石的有效方法,创伤小,能保留胆囊,但应注意提高结石清除率,并预防结石复发。     

体外震波碎石治疗胆石症721例临床报告

体外震波碎石是我国近二、三年来应用于临床治疗结石病人的一种新方法。我院于1989年间使用BD—8828型超声定位于式体     

Combined treatment of symptomatic gallbladder stones by extracorporeal shock-wave lithotripsy (ESWL) and instillation of methyl,Tert-butyl ether (MTBE)

Twenty-four patients with symptomatic gallbladder stones (12 radiolucent and 12 calcified) were treated by a combined approach of extracorporeal shock-wave lithotripsy (ESWL) and subsequent instillation of methyltert-butyl ether (MTBE). The patients received a mean of 1500±185 shock-wave discharges. The mean instillation time of MTBE was 13±4.2 hr. Treatment was tolerated without major adverse effects. Within a time period of three to five days eight of 12 patients with pure radiolucent stones and four of 12 with calcified stones became stone-free. After a median follow-up of five months (range: one week to 26 months), a total of 11 patients (92%) with radiolucent stones and of eight patients (66%) of those with calcified stones were free of stones, fragments, or debris. These clearence rates appear high when compared with reports on monotherapy with ESWL or MTBE, suggesting a positive effect of a combined approach in selected patients. Two patients exhibited recurrent stones after six and seven months respectively.Supported partly by a grant from the Koerber Foundation.     

痰热清注射液合用倍能治疗肺部感染的临床研究

目的研究痰热清与广谱抗生素倍能合用能否减少肺部真菌感染发生率。方法采用病例对照研究的方法,调研2007年9月-2008年10月我院使用倍能与痰热清合用患者61例,采用病例与对照1：1配比,通过追踪痰涂片真菌发生率。结果痰热清注射液合用倍能组真菌发生率与单用倍能组真菌发生率相比下降,优势比OR=5．71,OR的95％置信区间：2．75～11．88,P〈0．001。结论痰热清与倍能合用,可以减少倍能的不良反应,使真菌发生率下降。     

Study on the Ignition Mechanism of Inert Fuel Tank Subjected to High-Velocity Impact of Fragments

Nowadays, aircraft fuel tanks are protected by measures such as inerting, fire and explosion suppression, which significantly improve their ability to mitigate mechanical damage and prevent fire in the case of an accidental attack. In this study, an equivalent inert fuel tank with fire and explosion suppression was designed according to the vulnerabilities of a typical fighter. Then, a ballistic gun, a 37 mm gun and a two-stage light-gas gun were used to propel different fragments in tank damage experiments at different speeds (1400 m/s–2600 m/s). Experimental results show that the disassembly of a fuel tank is a prerequisite for igniting fuel. When the fragments hit the gas phase of the tank, the fuel tank was not disassembled and the fuel was not ignited. The calculation results show that the internal oxygen concentration was always lower than the limiting oxygen concentration (12%) before the fuel tank was disassembled. In addition, the minimum ignition speeds of inerted fragments with different masses as predicted by the ignition criterion when hitting the liquid fuel are consistent with the test results. This shows that increasing the mass of inert fragments will increase the minimum ignition speed and reduce the probability of ignition of the fuel. However, the implosion effect of the energetic fragments released about 3 times the chemical energy of its own kinetic energy, and the high-temperature and high-pressure products were very beneficial to the disintegration and ignition of the fuel tank compared to inert fragments.     

平肝祛痰化瘀治疗高血压伴肥胖30例临床研究

目的观察平肝祛痰化瘀治疗对高血压伴肥胖病人的临床疗效。方法60例原发性高血压伴肥胖病人随机分为平肝祛痰化瘀加尼群地平组(治疗组)和非诺贝特加尼群地平组(对照组),疗程均为30d。结果治疗组治疗前后比较,血压、症状积分、总胆固醇(TC)、三酰甘油(TG)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)、体重指数均有统计学意义(P<0.01);对照组治疗前后血压、症状积分、TC、TG、HDL-C比较有统计学意义(P<0.01或P<0.05);治疗后治疗组舒张压、症状积分、TC、LDL-C、体重指数与对照组比较有统计学意义(P<0.01或P<0.05)。结论平肝祛痰化瘀治疗高血压伴肥胖病人有较好疗效。     

剖宫产术中硬膜外泵注不同镇痛药液的效果比较

目的比较剖宫产术中接泵以舒芬太尼或吗啡镇痛液行术后硬膜外镇痛的效果。方法选择在腰-硬联合麻醉下行剖宫产的患者60例,手术开始后15min即将硬膜外导管与一次性止痛泵连接,并按2ml／h的速度持续硬膜外腔注入不同配方的镇痛药液。根据硬膜外镇痛药配方的不同随机分为两组。SF组（n=30）：舒芬太尼0．5mg＋氟哌利多5mg＋0．125％布比卡因100ml;MF组（n=30）：吗啡5mg＋氟哌利多5mg＋0．125％布比卡因100ml。观察和比较两组术后镇痛的效果和不良反应。结果两组在各时点的平均VAS评分都小于2,说明两组的总体镇痛效果满意。术后镇痛总有效率SF组为100％,MF组为93．3％,两组患者术后镇痛疗效间差异有统计学意义（P〈0．05）;SF组的并发症也明显低于MF组（P〈0．05）。结论两组总体镇痛效果满意,但SF组并发症少优于MF组。     

Computerized Algorithms: Safety and Effectiveness of a Computerized Subcutaneous Insulin Program to Treat Inpatient Hyperglycemia

Background

This proof of concept study was designed to evaluate the safety and effectiveness of a computerized insulin program, the Clarian GlucoStabilizer™ Subcutaneous Insulin Program (CGS-SQ). This paper discusses the CGS-SQ''s impact on the glycemic control of hospitalized patients with hyperglycemia.

Methods

Patients at Methodist and Indiana University Hospitals requiring subcutaneous insulin were treated using the CGS-SQ. This program calculates subcutaneous bolus insulin doses based on the current blood glucose (BG), using an insulin sensitivity factor, the number of grams of carbohydrates eaten, and an insulin-to-carbohydrate ratio, with a goal of maintaining the patient''s BG in a prespecified target range. The target range, insulin sensitivity factor, and insulin-to-carbohydrate ratio are established by the physician.

Results

From April 2006 to September 2007, the CGS-SQ treated 1772 patients at Methodist and Indiana University Hospitals, with 46,575 BGs in its database. For these patients, the average BG was 158.3 mg/dl, 40.5% percent of BGs were in the default target range of 100–150 mg/dl, and 69.8% were in the wider range of 70–180 mg/dl. The hypoglycemia (BG <40 mg/dl) rate was 0.18%.

Conclusions

The CGS-SQ provided a means to deliver insulin in a standardized manner, resulting in satisfactory BG control with a low hypoglycemia rate, thus serving as a tool for safe and effective insulin therapy for hospitalized patients.     

莱菔子行气消食的机制研究

目的 :研究莱菔子行气消食的作用机制。方法 :观察莱菔子促进胃肠运动的活性部位对小鼠排空液体和固体、对阿托品和多巴胺所造成的小鼠胃肠运动抑制以及大鼠血浆胃动素 (MTL )水平的影响 ,并与西沙比利对照。结果 :莱菔子促进胃肠运动的活性部位能增加大鼠血浆 MTL的含量 ,但可被阿托品所拮抗。与阳性对照药西沙比利比较差异无显著性意义 (P >0 .0 5 )。结论 :莱菔子行气消食的作用机制可能与促进 MTL的分泌和作用于 M受体有关。     

腰穿脑脊液置换术治疗蛛网膜下腔出血的临床研究

目的探讨腰穿脑脊液置换术在蛛网膜下腔出血(SAH)患者治疗中的作用。方法将120例SAH患者随机分为观察组(n=60)和对照组(n=60),对照组给予常规治疗,观察组在对照组基础上加用脑脊液置换术治疗。观察比较两组患者头痛、颈项强直消失时间,脑脊液血红蛋白(Hb)清除时间,平均住院时间,并发症发生率及临床疗效等。结果观察组患者头痛、颈项强直消失时间,脑脊液Hb清除时间,平均住院时间均短于对照组(P<0.001),并发症发生率低于对照组(P<0.05),临床总有效率高于对照组(P<0.01)。结论脑脊液腰穿置换术是一种操作简单、安全有效的治疗方法,对SAH疗效确切,有利于缩短患者治疗时间,降低并发症发生率。     

异甘草酸镁注射液治疗各类肝病临床疗效分析

目的观察异甘草酸镁注射液治疗各类慢性肝病的作用。方法选择188例慢性肝病,分为2组治疗。治疗组93例,给予异甘草酸镁注射液100mg加入5%10%GS250ml中,静脉点滴,1次/d,连续4周。对照组95例,给予硫普罗宁注射液200mg加入5%10%GS250ml中,静脉点滴,1次/d,连续4周。治疗结束后进行疗效分析。结果乏力、消化道症状的复常率治疗组分别为91.3%、95.7%;对照组分别为80.6%、77.7%;P均0.05,差异均有统计学意义。肝区不适复常率治疗组70.6%;对照组65.7%;P0.05,差异无统计学意义。平均复常天数治疗组分别为15.8d、11.7d、35.2d;对照组分别为21.9d、21.7d、44.5d;P均0.05,差异均有统计学意义。ALT、AST、TBil明显改善,治疗组复常率分别为95.5%、89.2%、89.2%;对照组分别为80.9%、77.7%、65.2%;P均0.05,差异均有统计学意义。平均复常天数治疗组分别为17.8d、15.7d、17.8d;对照组分别为27.5d、21.7d、30.2d;P均0.05,差异均有统计学意义。2组均无明显的不良反应。结论异甘草酸镁能明显改善病毒性、药物性、酒精性等肝脏急性或慢性炎症的临床症状和肝功能指标,并优于硫普罗宁。