新活素在心衰病人的药效观察

目的 观察冻干重组人脑利钠肽(新活素)治疗急性心力衰竭(AHF)的临床疗效.方法 AHF患者随机分为新活素组与硝酸甘油组各50例,2组均给予常规治疗,新活素组在常规治疗基础上加用新活素,硝酸甘油组加用硝酸甘油,观察2组疗效及肺毛细血管楔嵌压(PCWP)、肺动脉压(PAP)的变化.结果 新活素组总有效率为96%高于对照组的64%,差异有统计学意义(P<0.05).新活素组给药后第1、3、6小时的PCWP、PAP降低值高于硝酸甘油组,差异均有统计学意义(P<0.05).结论 新活素治疗AHF临床疗效确切,值得临床推广应用.     

脑活素治疗新生儿缺氧缺血性脑病54例疗效分析

目的明确脑活素治疗HIE的疗效.方法对明确诊断HIE者分为治疗组54例、对照组74例,治疗组在对照组综合治疗的基础上加用脑活素5ml/次、静脉注射、每日1次,连用10-14天.结果治疗组显效31例,有效19例,无效4例,总有效率94.3%,无效中死亡2例,与对照组比较总有效率具有显著差异(x2=16.82,P＜0.01).结论脑活素治疗HIE疗效肯定,使用方便,副作用少.     

新活素治疗低心排血量综合征的效果观察

目的 观察新活素（重组人脑利钠肽）治疗低心排血量（CO）综合征患者的临床疗效。方法 收集2018年1月~2019年1月在我院心血管内科、CCU和河南省人民医院CCU住院的低心排血量综合征患者189例,采用随机数字表法分为常规治疗组和新活素治疗组。常规治疗组患者接受常规治疗,新活素治疗组患者在常规治疗组基础上加用新活素治疗,比较两组治疗前后收缩压、舒张压、心率、血肌酐水平、心脏指数、NT-pro-BNP及尿量。结果 治疗后,两组患者心率、收缩压、舒张压、血肌酐、心脏指数等指标均较治疗前改善,差异有统计学意义（P＜0.05）;新活素治疗组患者心脏指数、NT-proBNP、尿量分别为（2.81±0.46）L/（min·m2）、（452.53±62.13）pg/ml、（1206.56±64.52）ml/24h,均优于常规治疗组的（2.42±0.69）L/（min·m2）、（525.23±66.25）pg/ml、（836.52±59.32）ml/24h,差异有统计学意义（P＜0.05）;两组收缩压、舒张压、血肌酐比较,差异无统计学意义（P＞0.05）。结论 在常规治疗低心排血量综合征基础上,给予新活素治疗,可以提高低心排血量综合征的疗效,改善患者生活质量,减少住院时间。     

人工肝支持系统治疗重症肝炎32例临床分析

目的　探讨人工肝血浆置换法治疗重症肝炎的疗效及影响疗效的因素。方法　 3 2例重症肝炎患者在内科治疗基础上给予血浆置换治疗 5 2例次 ,血浆置换量平均 3 0 0 0ml。结果　 3 2例重症肝炎患者经血浆置换后 ,临床症状都得到一定程度的改善 ,肝功能明显好转。总有效率为 62 .5 % ,其中早期为 87.5 % ,中期为 70 .5 9% ;与对照组相比 ,总胆红素由治疗前 3 77.1mmol/L降至 197.6mmol/L (P <0 .0 1)。结论　血浆置换对重症肝炎中、早期治疗效果较好     

重症慢性心力衰竭患者的个体化药物治疗

目的 选择一种治疗重症慢性心力衰竭的治疗药物.方法 将94例重症慢性心力衰竭患者随机分为治疗组与对照组.两组均给予利尿剂、醛固酮拮抗剂、洋地黄类正性肌力药和血管紧张素转换酶抑制剂、及血管紧张素Ⅱ受体拮抗剂等,治疗组在此基础上服用卡维地洛,25mg/次,2次/d.2组均以治疗2周为1个疗程,治疗1个疗程后观察疗效.结果 治疗组临床控制率为53.19%,时照组临床控制率为30.42%,两组相比有显著差异(P＜0.05);治疗组总有效率为91.49%,对照组总有效率为74.47%,两组相比有显著差异(P＜0.05).LVDD、LVEF两组治疗后与治疗前比较有明显差异(P＜0.05),两组治疗后组间相比有明显差异(P＜0.05).结论 在常规治疗的基础上使用卡维地洛治疗重症慢性心力衰竭临床疗效好,可改善心功能.     

巨细胞病毒感染与急性冠状动脉综合征患者血清sP-选择素和肿瘤坏死因子的变化

目的　探讨人巨细胞病毒(HCMV)感染与急性冠状动脉综合征(ACS)患者血清sP 选择素、肿瘤坏死因子(TNF α)的变化及相关性。方法　采用酶联免疫吸附技术检测79例ACS患者、30例稳定性心绞痛(SA)患者和30例正常对照组血清HCMV IgM、HCMV IgG、sP 选择素和TNF α的水平。结果　(1)在ACS、SA及正常对照组中,血清HCMV IgM、IgG的阳性率分别为30 4 % (2 4 79)、10 0 %(3 30 )和6 7% (2 30 ) ;86 1% (6 8 79)、80 0 % (2 4 30 )和5 3 3% (16 30 )。HCMV IgM的阳性率在ACS组中明显高于SA组和对照组(P <0 0 1) ,HCMV IgG的阳性率在ACS和SA组中明显高于对照组(P <0 0 1)。(2 )与SA组和对照组相比,ACS组中血清sP 选择素和TNF α水平显著升高,分别为(15 2 0 0±112 7)和(14 81 0±10 9 1)pg ml比(6 4 37 3±6 6 6 9)pg ml,(2 7 3±13 7)pg ml和(2 8 1±11 3)pg ml比(5 6 2±18 4 )pg ml,组间差异有统计学意义(P <0 0 1)。随着冠状动脉(冠脉)病变程度的增加,ACS中急性心肌梗塞(AMI)组与不稳定性心绞痛(UA)组相比,sP 选择素和TNF α水平显著升高(P <0 0 1) ,而SA组与对照组间差异无统计学意义(P >0 0 5 )。(3)ACS组中HCMV IgM阳性患者血清中sP 选择素和TNF α水平较HCMV IgM阴性患者明显升高(P <0 0     

重症慢性心力衰竭患者的个体化药物治疗

目的选择一种治疗重症慢性心力衰竭的治疗药物。方法将94例重症慢性心力衰竭患者随机分为治疗组与对照组。两组均给予利尿剂、醛固酮拮抗剂、洋地黄类正性肌力药和血管紧张素转换酶抑制剂、及血管紧张素Ⅱ受体拮抗剂等,治疗组在此基础上服用卡维地洛,25mg/次,2次/d。2组均以治疗2周为1个疗程,治疗1个疗程后观察疗效。结果治疗组临床控制率为53.19%,对照组临床控制率为30.42%,两组相比有显著差异（P〈0.05）;治疗组总有效率为91.49%,对照组总有效率为74.47%,两组相比有显著差异（P〈0.05）。LVDD、LVEF两组治疗后与治疗前比较有明显差异（P〈0.05）,两组治疗后组间相比有明显差异（P〈0.05）。结论在常规治疗的基础上使用卡维地洛治疗重症慢性心力衰竭临床疗效好,可改善心功能。     

阿魏酸钠静脉滴注协同治疗慢性肾功能衰竭的临床疗效

目的:观察静脉注射阿魏酸钠协同治疗慢性肾功能衰竭的临床疗效。方法:2011-03-2014-02本院收治的82例慢性肾功能衰竭患者,随机分为治疗组和对照组各41例。对照组采用临床常规治疗;治疗组在对照组治疗基础上加用阿魏酸钠0.3g加入生理盐水250ml中静脉滴注,1次/天。3周后观察比较两组血肌酐(Scr)、血尿素氮(BUN)、内生肌酐清除率(Ccr)变化的差异。结果:治疗组和对照组治疗前BUN、Scr、Ccr值两组间差异无统计学意义(P0.05);治疗组治疗后BUN、Scr下降及Ccr上升均较对照组明显(P0.05)。治疗组临床总有效率为88.00%,对照组为57.00%,治疗组明显高于对照组(P0.05)。结论:阿魏酸钠静脉滴注协同治疗慢性肾功能衰竭可明显改善肾功能,提高临床总有效率。     

人工肝支持系统治疗重症肝炎24例临床分析

目的　了解人工肝支持系统 (ALSS)治疗重症肝炎临床疗效。方法　应用WLXGX - 888型人工肝支持系统(北京伟力公司生产 )对 2 4例重症肝炎进行血浆置换、血液滤过等方法治疗 40例次。对患者治疗前后的肝功能、前白蛋白 (PA)、凝血酶原活动度 (PTa)、血氨、电介质进行分析。结果　ALSS治疗后患者的肝功能明显改善 ,总胆红素(TBIL)、血氨均明显下降 (P <0 .0 0 1) ,总蛋白下降 (P <0 .0 0 1) ;白蛋白下降 ,但无显著性差异 (P >0 .0 5 ) ;前白蛋白提高明显 (P <0 .0 0 1)。亚急性、慢性重症肝炎的早、中期治愈好转率分别为 71.43 %、44 .44 % ,而晚期则无一例存活。结论　ALSS治疗重症肝炎安全 ,效果显著 ,可明显提高重症肝炎的生存率     

乙型肝炎患者外周血单个核细胞凋亡的检测及意义

目的研究激活诱导细胞死亡 (AICD)现象在乙型肝炎慢性化和重型化机制中的意义。方法分离 2 0例慢性 /慢性重型乙型肝炎病人与 10例健康献血员外周血单个核细胞 (PBMC) ,在 PHA的刺激下培养 72 h后收集细胞 ,经流式细胞仪检测凋亡。结果 PBMC凋亡率乙型肝炎组明显高于正常对照组 [(2 5 .48± 14.0 7) % vs(11.45± 5 .2 7) % ,P<0 .0 1];慢性乙型肝炎组 [(30 .5 7± 13.43) % ]明显高于正常对照组 [(11.45± 5 .2 7) % ,P<0 .0 1]和慢性重型乙型肝炎组 [(13.5 9± 6 .44 ) % ,P<0 .0 1];PBMC凋亡率乙型肝炎 HBe Ag(+ )组明显高于正常对照组 [(2 9.5 0± 12 .5 4) % vs(11.45± 5 .2 7) % ,P<0 .0 1]。结论 AICD可能是形成 HBV慢性感染免疫耐受的一个重要机制。     

Determination of serum B12 vitamin and folic acid levels in patient with stroke

The aim of this study is to evaluate whether any relationship between stroke and vitamin B12, folic acid concentration. We examined 50 patients with stroke (male: 26 and female: 24) aged between (mean +/- SD, year) 59 +/- 14 and 16 control subjects (male: 6 and female: 10) aged between (mean +/- SD, year) 53 +/- 11. Patients were classified into two groups as infarct and hemorrhagic by using Computerised Brain Tomography and Cranial Nuclear Magnetic Resonance Imaging techniques. The percentage of patients with infract was 47.5% in female and 52.5% in male while it was 40% in female and 60% in male with hemorrhagic. The vitamin B12 levels of patients with infarct, hemorrhagic and control group were found as mean +/- SEM, 355 +/- 47 pg/ml, 313 +/- 58 pg/ml, 1569 +/- 258 pg/ml and folic acid levels 13.4 +/- 2.6 ng/ml, 7.7 +/- 1.0 ng/ml, 14.8 +/- 4.0 ng/ml, respectively. The significant difference was found between subgroups of patients with stroke and control group in both folic acid and B12 vitamin levels (p < 0.001 and p < 0.0001, respectively). But, there was no significant difference between vitamin B12 and folic acid levels of patients with hemorrhagic and infarct. In order to well understand the effects of these vitamin in patients with stroke, more detailed follow up studies with long period are needed.     

凉血活血法治疗肝炎高胆红素血症36例临床疗效观察

目的 观察凉血活血法对肝炎高胆红素血症（TBIL）的临床疗效。方法 72例肝炎高胆红素血症患者随机分为治疗组36例,对照组36例,治疗组在常规西药综合治疗的基础上给予凉血活血中药煎剂,1剂／d,分2次日服,疗程4周,对照组在常规西药综合治疗的基础上加用促肝细胞生长素80-120mg,10％葡萄糖250ml静脉滴注,1次/d,疗程4周,治疗4周后比较两组患者肝功能高胆红素（TBIL）、丙氨酸转氨酶（ALT）、天冬氨酸转氨酶（AST）、血清白蛋白（ALB）的变化。结果 治疗组显效率80．55％,对照组显效率50％,两组比较差异有统计学意义（P〈0．05）。结论 凉血活血法治疗病毒性肝炎高胆红煮血症疗效肯定,无毒副作用。     

益气活血法对冠心病心绞痛及血液流变学的影响

目的:观察益气活血法对冠心病心绞痛及血液流变学的影响。方法:益气活血法治疗冠心病心绞痛35例;对照组 35例采用活血法,疗程均为4周,观察两组疗效及血液流变学各项指标的变化。结果:治疗组总有效率97．1％,对照组总有效率77．1％,二者相比有显著性差异(p<0．05)。治疗组血液流变学各项指标治疗前后均有明显改变(p<0．05或p< 0．01),对照组除血浆粘度和红细胞压积外治疗前后均有明显改变。(p<0．05或p<0．01)。结论:益气活血法在治疗冠心病心绞痛及改善血液流变学方面优于活血法。     

The effects of cypermethrin pour-on and piperonyl butoxide on Triatoma infestans under laboratory conditions

The effect of exposing Triatoma infestans to chickens treated with cypermethrin pour-on combined with piperonyl butoxide (PBO) was studied. Four groups of treated chickens and one control group were used. Each treatment received 1 or 2 ml of the cypermethrin formulation with and without PBO. Independent groups of nymphs were fed 1, 7, 15, 30, and 45 d after the treatment application. Blood intake was estimated after each feeding occasion. Up to 15 d after the pour-on application, high mortality was observed in all nymphs fed on treated chickens (> 93% +/- 12), and lower than the nymphs of the control group (< 33% +/- 15). After 30 d of the pour-on application, there was significantly different mortality between the treatment with 1 ml (80% +/- 9) and 2 ml (> 96% +/- 5); no difference was observed between groups with or without PBO addition. After 45 d of the pour-on application, the treatments did not show significant differences (77% +/- 7), although all treatments showed higher mortality than the control group (10% +/- 9). Up to 45 d after the pour-on application, blood intake by nymphs exposed to treated chickens (0.85 +/- 0.96 mg/nymph) was lower than blood intake by nymphs exposed to control chickens (6.7 +/- 5 mg/nymph). This study shows that cypermethrin pour-on produces high mortality and reduces the blood intake of third-instar nymphs of T. infestans up to 45 d after the insecticide application to chickens. PBO did not produce a detectable effect.     

Effect of recombinant human erythropoietin (r-HuEPO) therapy on plasma FT3, FT4, TSH, FSH, LH, free testosterone and prolactin levels in hemodialysis patients.

The aim of this study was to evaluate the effect of r-HuEPO treatment on free triiodothyronine (FT3), free thyroxine (FT4), thyroid stimulating hormone (TSH), follicle-stimulating hormone (FSH), luteinizing hormone (LH), free testosterone and prolactin levels in uremic hemodialysis patients. Twenty-four uremic hemodialysis patients were given r-HuEPO with a dose 60 U/kg as intravenous bolus injection at the end of each dialysis session. Once the hematocrit value of the patient had reached a range of 30-35%, the dose was adjusted so as to keep the hematocrit levels constant. Twenty uremic dialysis patients were taken as control group. The above-mentioned hormone levels of patients and control group were determined before and 4 months after r-HuEPO treatment. After the treatment, serum prolactin levels significantly decreased in both sexes (36.8 +/- 7.8 vs 22.9 +/- 6.3 ng/ml and 78.3 +/- 13.3 vs 37.4 +/- 10.4 ng/ml male and female, respectively). FT3 and FT4 significantly increased (1.17 vs 1.67 pg/ml, p < 0.05, and 0.64 vs 0.084 ng/dl, p < 0.05, respectively). TSH levels increased but those changes were not significant. There was no change in the level of any hormone in the control group. Also, the sexual functions of eight male patients treated with r-HuEPO improved and menstruation started again in four female patients. We concluded that r-HuEPO treatment especially decreases prolactin level in uremic hemodialysis patients. It is conceivable that correction of elevated prolactin levels could improve sexual disorders in these patients.     

自拟方红藤活血汤治疗湿热瘀结型盆腔炎的临床疗效

目的 观察自拟方红藤活血汤治疗湿热瘀结型盆腔炎的临床疗效。方法 选择2017年3月~2018年10月我院收治的湿热瘀结型盆腔炎患者80例,随机分为对照组和治疗组,各40例。治疗组给予红藤活血汤治疗,对照组给予盐酸左氧氟沙星治疗,两组均在药物治疗基础上配合红外线治疗仪,疗程均为2周。比较治疗后两组临床综合疗效、中医症候疗效、创伤指标、免疫学指标及安全性。结果 患者综合临床疗效比较:治疗组总有效率（90.00%）及愈显率（77.50%）分别高于对照组的75.00%、60.00%,统计学意义显著（P＜0.01）;两组患者中医证候疗效比较:治疗组总有效率（85.00%）及愈显率（70.00%）均高于对照组的67.50%、37.50%,统计学意义显著（P＜0.01）;治疗后两组CRP和WBC的值均较治疗前下降,统计学意义显著（P＜0.01）;治疗后治疗组TNF-α水平高于对照组,统计学意义显著（P＜0.01）;两组治疗后C3水平相比,差异无统计学意义（P＞0.05）。极少数病例的血常规、肝治疗前存在轻度异常,治疗后未明显加重,未出现新发异常病例,治疗组治疗前后血、尿常规,肝、肾功能等相比,差异无统计学意义（P＞0.05）。结论 自拟方红藤活血汤治疗湿热瘀结型盆腔炎的临床疗效明显,且安全性好。     

HBeAg阴性乙型肝炎ACLF患者的临床特征及抗病毒治疗短期疗效

目的 观察HBeAg阴性乙型肝炎慢加急性肝衰竭患者的临床特征及应用恩替卡韦抗病毒治疗的短期疗效.方法 132例HBeAg阴性和51例HBeAg阳性乙型肝炎慢加急性肝衰竭患者,分为常规治疗组及抗病毒治疗组,抗病毒组在常规内科治疗基础上加用恩替卡韦0.5 mg/d治疗,比较两组患者临床特征、病死率及抗病毒治疗短期疗效差异.结果 与HBeAg阳性组比较,HBeAg阴性组年龄较大(P=0.001),血清HBV DNA定量较低(P=0.001).HBeXS阴性组与HBeAg阳性组肝衰竭分期构成比及常规治疗病死率比较无差异.应用恩替卡韦抗病毒治疗时HBeAg阴性组生存率为54.24%,高于常规治疗组(35.62%),P=0.032,低于HBeAg阳性抗病毒组(80.00%),P=0.004.HBeAg阴性组血清HBV DNA在(3～5)log10拷贝/ml时,抗病毒治疗组生存率为55.56%,高于常规治疗组(20.00%),P=0.011.结论 乙型肝炎慢加急性肝衰竭患者中,常规治疗下HBeAg阴性患者与HBeAg阳性患者的病死率无差异.采用恩替卡韦抗病毒治疗能提高HBeAg阴性患者的生存率.在HBV DNA低水平复制的HBeAg阴性患者中恩替卡韦抗病毒治疗能提高生存率.     

Venous blood ammonium levels in control subjects and in patients with disorders of the liver

Venous blood ammonium levels were studied in 106 control subjects and 47 patients with varying degrees of liver disorder. The resting venous blood ammonium was normally distributed in both male and female control subjects and was not influenced by either the sex or the fasting state of the subject. In general it was also uninfluenced by age except that the level was found to be a little lower in subjects over 60 years of age probably due to their state of greater muscular inactivity.The mean resting ammonium level in controls was 80.0 mug/100 ml +/- 17.17 mug/100 ml and the range (mean +/- 2 SD) 46-114 mug/100 ml. Raised levels were obtained in 16.7% of patients with subclinical liver disorder, 62.5% with moderate liver disorder, and 85.5% with severe liver disorder, indicating a relationship between the severity of liver disorder and the resting venous blood ammonium level. As the majority of patients with severe liver disorder were known to have varices the raised ammonium levels are likely to have been related to the greater magnitude and incidence of portal systemic shunts in those with severe liver disease.     

The effect of leptin on engraftment in patients undergoing peripheral blood stem cell transplantation

AIM AND BACKGROUND: To evaluate the alterations of serum leptin levels during stem cell transplantation and its possible role in engraftment. Thirty-two patients (19 male, 13 female) with various hematological and solid tumors and 28 healthy subjects (15 male, 13 female) as a control group were enrolled in the study. METHODS: Serum leptin levels were measured on the day before administering G-CSF, at the time of leukapheresis harvest, on day +1st and +7th after transplantation and on the day of leukocyte engraftment. RESULTS: There was no significant difference in serum leptin levels between patients (mean +/- SEM, 11.62 +/- 2.75 ng/ml) before transplantation and control groups (9.79 +/- 1.73 ng/ml). Pre-G-CSF (baseline) level of serum leptin (11.62 +/- 2.75 ng/ml) was significantly decreased to 7.73 +/- 2.02 ng/ml at the time of apheresis harvest (P = 0.0029). Later, serum leptin levels increased to 16.75 +/- 3.26 ng/ml on day +1 after transplantation (P < 0.0001). Subsequently serum leptin levels both on day +7th posttransplant (12.11 +/- 2.17 ng/ml) and leukocyte engraftment day (9.26 +/- 1.50 ng/ml) were gradually decreased. There was no correlation between the serum leptin levels and the leukocyte or platelet engraftment. CONCLUSION: The present study concludes that serum leptin level does not change remarkably during peripheral blood stem cell transplantation and no association exists between circulating leptin levels and the onset of engraftment suggesting that circulating serum leptin does not have a significant direct influence on engraftment.     

血浆胆红素吸附在高胆红素血症治疗中的应用

目的探讨血浆胆红素吸附治疗高胆红素血症疗效及临床价值。方法选择青岛市传染病医院65例非乙型、丙型肝炎急性肝损害重度黄疸住院治疗患者,随机分为2组。治疗组33例,其中男性25例,女性8例,年龄33～75岁,平均年龄59.39岁;对照组32例,其中男性26例,女性6例,年龄34～77岁,平均年龄58.12岁。对照组32例患者只给予药物综合治疗,治疗组33例患者在药物综合治疗的基础上给予血浆特异性胆红素吸附治疗,并分别观察2组治疗前后症状、体征、肝功能、凝血酶原活性（PTA）、血常规、电解质及治疗中并发症的发生。检测治疗前和治疗后2、4周的肝功能、PTA等并追踪近期转归。结果治疗组经血浆胆红素吸附治疗后2周、4周较治疗前,总胆红素（TBiL）下降明显（P〈0.01）,PTA上升明显（P〈0.05）。治疗组4周治愈率39.40%,对照组4周治愈率12.50%（P〈0.05）,治疗组8周治愈率66.67%,对照组8周治愈率40.63%（P〈0.05）。结论血浆胆红素吸附治疗急性肝损害重度黄疸患者能显著改善肝功能,阻止病情恶化,明显提高临床治愈好转率,特别适合于不宜血浆置换治疗的重度黄疸患者。