中药熏洗治疗肛门病术后水肿疗效观察

目的:观察自拟中药熏洗方治疗肛门病术后肛缘水肿的临床疗效。方法:将68例肛门病术后患者随机分为2组,治疗组34例,予自拟中药熏洗方治疗;对照组34例采用1∶5000高锰酸钾溶液治疗。疗程均为7天。结果:治疗组有效率97.1%,对照组为70.6%,2组比较有显著差异(P<0.05)。结论:自拟中药熏洗方治疗肛门病术后肛缘水肿的疗效优于高锰酸钾熏洗。     

中药熏洗在肛门病术后的应用价值探讨

研究中药熏洗疗法在肛门病术后的应用价值。选取180例我院收治的肛门病手术病人,随机分为研究组和对照组各90例,两组均进行常规的治疗,研究组在此基础上选用中药熏洗,对照组选用高锰酸钾溶液熏洗,比较两组患者术后疼痛、水肿情况、症状消失时间及伤口愈合时间。两组患者分别进行治疗后,疼痛评分与水肿评分均具有显著性降低(P0.05),研究组降低程度更显著(P0.05),研究组患者临床症状(疼痛、水肿)消失时间及伤口愈合时间均短于对照组,差异具有显著性(P0.05)。中药熏洗疗法在对于肛门病术后并发症得治疗上具有良好的效果和较高的应用价值。     

超声中药熏洗对肛门病术后伤口愈合的临床疗效观察

目的 观察超声中药熏洗对肛门病术后伤口愈合的临床疗效。方法 肛门病手术患者315例,随机分治疗组210例,对照组105例。治疗组于手术后第2 d开始行超声中药熏洗伤口,每次10 min;对照组术后,每次排便后用1：5000高锰酸钾溶液坐浴10min。两组均予坐浴后创面换药,每日1次,连续7 d。结果 治疗组术后首次排便和第5、7 d的疼痛评分显著低于对照组,术后第5、7 d的肛门坠胀评分显著低于对照组,术后肛缘水肿平均积分也显著低于对照组,治疗组住院时间显著短于对照组,且满意度明显高于对照组。结论 超声中药熏洗防治肛门病术后并发症安全有效,疗效优于高锰酸钾坐浴。     

疼痛管理联合超声熏洗对肛门手术后创面愈合的效果

目的探讨疼痛管理联合超声熏洗对肛门手术后患者创面愈合恢复的效果。方法选取2013年7月—2014年9月收治于上海市青浦区肛肠科行肛门疾病手术的患者120例,随机分为观察组和对照组各60例,两组患者术后第2天均给予超声中药熏洗,观察组在超声熏洗的基础上实施规范化疼痛管理,比较两组患者术后不同时间内疼痛程度、术后7 d内并发症发生情况及创面愈合情况。结果观察组术后6~48 h内的疼痛评分均显著低于对照组,差异有统计学意义(P均<0.05)。观察组术后水肿、渗液和出血的发生率均低于对照组,且创面愈合时间亦较对照组更短,差异均有统计学意义(P均<0.05)。结论应用疼痛管理联合超声熏洗可明显缓解肛门手术后患者的疼痛,加速水肿消退,能够有效缩短创面愈合时间,有利于患者的康复。     

中药坐浴熏洗配合红光治疗对混合痔外剥内扎术后创面愈合及肛缘水肿的影响

目的 探究中药坐浴熏洗配合红光治疗对混合痔外剥内扎术后的影响,并观察创面愈合及肛缘水肿的程度。方法 选择2022年5月—2023年2月东台市中医院收治的86例混合痔患者为研究对象,所有患者入院后,完成肛门镜检等相关诊断措施,并实施混合痔外剥内扎术。术后按随机数表法分为观察组与对照组,每组43例。对照组采用红光治疗措施,观察组在采用红光治疗的基础上,联合中药坐浴熏洗。对比两组患者创面愈合时间,术后一周肛缘水肿和疼痛程度,肛门失禁评分和排便控制评分,疼痛、水肿评分、创面愈合、肛门下坠和便血症状消失时间。结果 治疗3、7 d后,观察组肛缘水肿（1.12±0.13）分、（1.01±0.11）分和疼痛程度（6.74±0.41）分、（4.48±0.21）分明显低于对照组的（1.22±0.21）分、（1.08±0.17）分、（7.05±0.51）分、（5.65±0.36）分,差异有统计学意义（t=2.483、2.267、3.106、18.408,P均<0.05）。治疗3、7 d后,观察组肛门失禁评分、排便控制评分均低于对照组,差异有统计学意义（P均<0.05）。观察组创面愈合时间、肛门下...     

中药熏洗联合微波理疗治疗痔疮术后水肿的效果分析

目的探讨中药熏洗联合微波理疗用于环状混合痔术后水肿的临床疗效。方法将住院治疗60例患者随机分为观察组和对照组,每组各30例,对照组术后常规采用高锰酸钾溶液坐浴,观察组采用中药熏洗配合微波理疗治疗环状混合痔术后水肿,比较两组的临床疗效。结果术后第3天、第5天观察组水肿、疼痛评分均较对照组低,差异有统计学意义(P0.05),而术后第7天两组在水肿、疼痛评分上差异无统计学意义(P0.05)。结论中药熏洗联合微波理疗用于治疗痔疮术后水肿有较好的临床效果,可以缓解患者早期的水肿和疼痛,值得临床推广和应用。     

地奥司明联合中药洗剂治疗痔疮术后肿痛临床分析

目的 观察地奥司明联合中药洗剂对痔疮术后肛门水肿、疼痛的临床疗效.方法 兆维集团职工医院2008-03-2010-11共实施痔疮手术92例,随机分成治疗组和对照组,治疗组术后地奥司明片口服联合应用中药洗剂熏洗,对照组给予1∶5 000高锰酸钾溶液熏洗,7d为1个疗程.结果 治疗组术后疼痛、水肿缓解及总有效率均明显高于对照组(P＜0.05).结论 本方法对痔疮术后水肿、疼痛效果确切,值得临床推广应用.     

痔疮术后中药薰洗配合光子照射的疗效观察

目的：探讨中药薰洗配合光子照射应用于环状混合痔术后的效果。方法将住院治疗的220例病人随机分为观察组110例和对照组110例，对照组患者术后采用高锰酸钾溶液坐浴，观察组患者采用中药熏洗配合光子照射，比较两组的护理效果。结果观察组患者术后疼痛、肛周水肿、出血、渗液、发热均较对照组患者轻（P＜0．05），切口愈合时间较对照组短（P＜0．05）。结论采用中药薰洗配合光子照射法对环状混合痔术后病人实施护理，能减轻痔疮术后疼痛、水肿、出血、感染等症状，促进伤口愈合，缩短病人住院时间。     

穴位贴敷联合中药坐浴熏洗对混合痔外剥内扎术后患者的效果观察

目的 探讨穴位贴敷联合中药坐浴熏洗对混合痔外剥内扎术后患者的效果。方法 按照简单随机化法将行混合痔外剥内扎术后患者66例分为对照组和观察组各33例,对照组给予中药坐浴熏洗,观察组在对照组基础上加入穴位贴敷。对比两组临床疗效、肛门功能指标、疼痛程度、临床症状改善时间及生活质量。结果 观察组总有效率高于对照组;与治疗前相比,治疗后两组肛门功能均升高,且观察组高于对照组;观察组疼痛程度低于对照组;观察组肛缘水肿、出血、创面肉芽生长及创面愈合时间均短于对照组（P<0.05）。结论 与单纯中药坐浴熏洗治疗相比,穴位贴敷联合中药坐浴熏洗对混合痔外剥内扎术后患者的效果更好,可有效缩短康复时间,改善肛门功能,降低疼痛程度。     

中药熏洗联合生物反馈对Ⅲ-Ⅳ度混合痔术后疼痛疗效观察

目的探讨中药熏洗联合生物反馈对Ⅲ-Ⅳ度混合痔术后疼痛的影响。方法选择我院2014年10月—2015年11月收治的混合痔患者90例为研究对象,采用随机数字编号分为中药熏洗组30例,生物反馈组30例,联合组30例,分别在术后采用单纯中药熏洗、物反馈及二者联合干预,比较3组患者疼痛、水肿及生活质量情况。结果手术后3组患者疼痛及水肿评分均较高,差异无统计学意义(P0.05),干预后,三组患者疼痛及水肿评分均下降,与术后第一时间比较差异有统计学意义(P0.05)。结论中药熏洗联合生物反馈后能有效减轻术后肛门部疼痛、水肿症状,提高患者的生活质量,值得临床推广和应用。     

Determination of creatine kinase isoenzyme MB activity in serum using immunological inhibition of creatine kinase M subunit activity. Activity kinetics and diagnostic significance in myocardial infarction.

This is a new method for the determination of creatine kinase isoenzyme MB activity in serum. The method uses direct activity measurement of creatine kinase B subunit activity after blocking of CK-M subunit activity by inhibiting antibodies. The test takes no longer than 15 min. The method yields an intra-serial C.V. of 2.0-12.9%, and a C.V. from day to day of 5.5%. The detection limit is 3.4 U/l creatine kinase MB. In the 95 cases with proven myocardial infarction several types of creatine kinase MB activity kinetics could be determined. The percentage of creatine kinase MB of peak CK-total is 6-25%, with a mean of 11.1%. The amount of creatine kinase MB with respect to total CK activity after reinfarction is higher than the amount after initial infarction.     

Dissociable correlates of two classes of retrieval processing in prefrontal cortex

Although substantial evidence suggests that the prefrontal cortex (PFC) implements processes that are critical for accurate episodic memory judgments, the specific roles of different PFC subregions remain unclear. Here, we used event-related functional magnetic resonance imaging to distinguish between prefrontal activity related to operations that (1) influence processing of retrieval cues based on current task demands, or (2) are involved in monitoring the outputs of retrieval. Fourteen participants studied auditory words spoken by a male or female speaker and completed memory tests in which the stimuli were unstudied foil words and studied words spoken by either the same speaker at study, or the alternate speaker. On "general" test trials, participants were to determine whether each word was studied, regardless of the voice of the speaker, whereas on "specific" test trials, participants were to additionally distinguish between studied words that were spoken in the same voice or a different voice at study. Thus, on specific test trials, participants were explicitly required to attend to voice information in order to evaluate each test item. Anterior (right BA 10), dorsolateral prefrontal (right BA 46), and inferior frontal (bilateral BA 47/12) regions were more active during specific than during general trials. Activation in anterior and dorsolateral PFC was enhanced during specific test trials even in response to unstudied items, suggesting that activation in these regions was related to the differential processing of retrieval cues in the two tasks. In contrast, differences between specific and general test trials in inferior frontal regions (bilateral BA 47/12) were seen only for studied items, suggesting a role for these regions in post-retrieval monitoring processes. Results from this study are consistent with the idea that different PFC subregions implement distinct, but complementary processes that collectively support accurate episodic memory judgments.     

俯卧位通气对高海拔地区肺复张治疗无效急性呼吸窘迫综合征患者氧合的影响

目的 探讨俯卧位通气对高海拔地区肺复张术(RM)治疗无效急性呼吸窘迫综合征(ARDS)患者的治疗作用.方法 从海拔2260m的地区医院筛选RM治疗无效的41例ARDS患者[平均氧合指数( PaO2/FiO2)较RM前升高＜20％视为RM无效],依不同病因分为肺内源性ARDS组(ARDSp组)和肺外源性ARDS组(ARDSexp组),每组再按信封法随机分为俯卧位组和仰卧位组,即ARDSp俯卧位组(11例)、ARDSp仰卧位组(9例)、ARDSexp俯卧位组(10例)、ARDSexp仰卧位组(11例).在通气前及通气1、2、3、4h监测动脉血氧分压( PaO2)、PaO2/FiO2、静态顺应性(Cst)、气道阻力(Raw)的变化.结果 通气lh时,ARDSexp俯卧位组PaO2/FiO2( mm Hg,l mm Hg=0.133 kPa)即较通气前显著升高(157.4±40.6比129.3±48.7,P＜0.05),并随通气时间延长呈持续增高趋势,4h达峰值(219.1 ±41.1);且ARDSexp俯卧位组通气3h内PaO2/FiO2较其他3组显著增高,另3组间则差异无统计学意义.ARDSp俯卧位组、ARDSexp俯卧位组通气4h时PaO2/FiO2均较相应仰卧位组显著增高(208.8±39.7比127.4±47.1,219.1±41.1比124.9±50.8,均P＜0.05).4组通气前后Cst无显著改变,各组间差异也无统计学意义.ARDSp俯卧位组通气4h时Raw(cmH2O·L-1·s-1)较通气前显著降低(6.8±1.7比10.7±1.8,P＜0.05),且明显低于其他3组;其他3组各时间点Raw组内及组间比较差异均无统计学意义.结论 俯卧位通气作为ARDS机械通气重要策略之一,可以改善RM无效高原ARDS患者的氧合,为抢救患者赢得宝贵的时间.     

Digital imaging among medical facilities

The Department of Veterans Affairs (VA) in the USA operates a network of 172 medical centres which all utilize a hospital information system (HIS) which has been developed and is currently maintained by the VA. During the past several years, an image management and communication module has been developed, installed and clinically utilized at the Washington DC and Maryland VA Medical Centres. This image management and communication system, referred to as the decentralized hospital computer program (DHCP) imaging system, is fully integrated with a commercial picture archiving and communication system (PACS). The system is utilized to capture, archive, and display all images generated within the hospital including radiology, nuclear medicine, pathology, endoscopy, bronchoscopy, and dermatology, intraoperative photographs, ECG data, and a limited number of paper documents. The ultimate goal of the project is to have all patient text and image data available at any clinical workstation to any authorized user anywhere within the network of medical centres. Clinical requirements for an imaging workstation include ease of use, rapid and reliable access to the complete set of patient information, and images which are of acceptable quality to meet the requirements of the user and the subspecialty. Patient confidentiality and data security must be safeguarded at all times. Integration of the images with the remainder of the patient's database was found to be critical to the success of the project. The experience at the Washington and Maryland facilities suggests that an imaging system that is successfully integrated with a hospital information system can provide substantial clinical and economic benefits both within and among medical centres. Clinical acceptance and utilization of the system has been excellent, particularly in diagnostic radiology where DHCP Imaging has been interfaced to a commercial PAC system. Based upon this initial experience, the VA has begun to deploy the system throughout its large network of medical centres.     

Myocardial elastography at both high temporal and spatial resolution for the detection of infarcts

Myocardial elastography is a novel method for noninvasively assessing regional myocardial function, with the advantages of high spatial and temporal resolution and high signal-to-noise ratio (SNR). In this paper, in-vivo experiments were performed in anesthetized normal and infarcted mice (one day after left anterior descending coronary artery [LAD] ligation) using a high-resolution (30 MHz) ultrasound system (Vevo 770, VisualSonics Inc., Toronto, ON, Canada). Radiofrequency (RF) signals of the left ventricle (LV) in longitudinal (long-axis) view and the associated electrocardiogram (ECG) were simultaneously acquired. Using a retrospective ECG gating technique, 2-D full field-of-view RF frames were acquired at an extremely high frame rate (8 kHz) that resulted in high-quality incremental displacement and strain estimation of the myocardium. The incremental results were further accumulated to obtain the cumulative displacements and strains. Two-dimensional and M-mode displacement images and strain images (elastograms), as well as displacement and strain profiles as a function of time, were compared between normal and infarcted mice. Incremental results clearly depicted cardiac events including LV contraction, LV relaxation and isovolumetric phases in both normal and infarcted mice, and also evidently indicated reduced motion and deformation in the infarcted myocardium. The elastograms indicated that the infarcted regions underwent thinning during systole rather than thickening, as in the normal case. The cumulative elastograms were found to have higher elastographic SNR (SNR(e)) than the incremental elastograms (e.g., 10.6 vs. 4.7 in a normal myocardium, and 6.0 vs. 2.4 in an infarcted myocardium). Finally, preliminary statistical results from nine normal (m = 9) and seven infarcted (n = 7) mice indicated the capability of the cumulative strain in differentiating infracted from normal myocardia. In conclusion, myocardial elastography could provide regional strain information at simultaneously high temporal (>/=0.125 ms) and spatial ( approximately 55 microm) resolution as well as high precision ( approximately 0.05 microm displacement). This technique was thus capable of accurately characterizing normal myocardial function throughout an entire cardiac cycle, at the same high resolution, and detecting and localizing myocardial infarction in vivo.     

Clinical Pharmacokinetics of Morphine

Morphine, the most widely used mu-opioid analgesic for acute and chronic pain, is the standard against which new analgesics are measured. A thorough understanding of the pharmacokinetics of morphine is required in order to safely and effectively use this analgesic in a wide variety of patients with different levels of organ function. A MEDLINE search was conducted to identify literature published between 1966 and January 2002 relevant to the pharmacokinetics of morphine. These publications were reviewed and the literature summarized regarding unique and clinically important elements of morphine disposition relative to its parenteral administration (including intravenous, intramuscular, subcutaneous, epidural and intrathecal administration), absorption profile (immediate release, controlled release, and sublingual/buccal, and rectal administration), distribution, and its metabolism/ excretion. Special populations, including infants, elderly, and those with renal/liver failure, have a unique morphine pharmacokinetic profile that must be taken into account in order to maximize analgesic efficacy and reduce the risk of adverse events.