α-硫辛酸与甲钴胺联合治疗糖尿病周围神经病变的临床效果及对氧化应激和炎症反应的作用分析

目的分析在患有糖尿病周围神经病变患者的药物治疗当中,患者同时接受甲钴胺与α-硫辛酸治疗的具体效果。方法选择该院在2017年4月—2018年1月期间收治的92例糖尿病周围神经病变患者为主要对象,将其随机均分成为参照组与分析组,参照组患者接受基础治疗与甲钴胺治疗,分析组患者则在上述治疗方案基础上同时接受α-硫辛酸治疗,对比两组患者接受不同方式治疗后的氧化应激指标与炎症反应指标,并分析两组患者治疗前后的生活质量。结果分析组患者接受治疗后的氧化应激指标与炎症反应指标要好于参照组,患者治疗之后的生活质量也要优于参照组,相关数据对比差异有统计学意义(P0.05)。结论针对糖尿病周围神经病变患者的临床治疗而言,让其同时接受甲钴胺与α-硫辛酸治疗的整体效果较好,该方案值得在临床中推广。     

奥美拉唑联合醋氨己酸锌治疗胃溃疡的临床疗效观察

[目的]观察奥美拉唑联合醋氨己酸锌治疗胃溃疡的临床效果和不良反应发生情况.[方法]选择接受治疗的胃溃疡患者121例,按照治疗方法分成3组.A组43例接受奥美拉唑联合醋氨己酸锌治疗,B组36例接受奥美拉唑治疗,C组42例接受醋氨己酸锌治疗.统计并比较各组显效率、有效率以及不良反应发生情况.[结果]A组有效率和治愈率均显著高于B组和C组(P＜0.05),B组和C组的有效率和治愈率比较差异无统计学意义(P＞0.05).A组不良反应发生率均显著低于B组和C组(P＜0.05).[结论]奥美拉唑联合醋氨己酸锌治疗胃溃疡效果显著,不良反应低.     

晚期肝恶性肿瘤患者接受经桡和经股入路肝动脉灌注化疗的患者体验及入路相关并发症分析

目的分析晚期肝细胞癌及结直肠癌肝转移患者, 接受经桡动脉入路(TRA)与经股动脉入路(TFA)肝动脉灌注化疗(HAIC)在患者体验、术后并发症及患者倾向性方面的差异。探讨TRA在HAIC中是否比TFA有更好的患者体验、依从度, 以及是否更安全。方法该研究是一项纳入了接受HAIC治疗的晚期肝细胞癌及结直肠癌肝转移患者的回顾性队列研究。研究收集了2022年11月至2023年5月就诊于天津医科大学肿瘤医院介入治疗科及肝胆内科的共91例接受HAIC治疗的晚期肝恶性肿瘤患者, 患者被分为3组:TRA组(n=20, 仅接受TRA HAIC治疗)、TFA组(n=33, 仅接受TFA HAIC治疗)和交叉组[n=19, 先接受TFA HAIC(Cross-TFA组)治疗, 后接受TRA HAIC(Cross-TRA组)治疗]。同时为了部分结果方便表述, 将接受TRA HAIC的全部患者定义为TRA-HAIC组(n=39, TRA组+Cross-TRA组), 接受TFA HAIC的全部患者定义为TFA-HAIC组(n=52, TFA组+Cross-TFA组)。主要研究指标是关于生活质量的可视化量表(QO...     

高纤维营养液对危重症高血糖患者血糖水平及预后的影响

目的探讨危重症患者治疗中给予高纤维营养液对血糖水平及预后的影响。方法选择75例出现高血糖反应的危重症患者,随机分为接受普通营养液治疗的常规组、接受普通营养液50%+高纤营养液50%治疗的中间组、单纯接受高纤维营养液治疗的试验组,每组25例,对比应用不同营养液对患者血糖水平及预后的影响。结果三组接受治疗前血糖水平比较无统计学意义,经治疗3 d后,试验组血糖明显下降,与中间组、常规组比较差异明显(P<0.05);三组治疗前APACHE评分大体相近,而在接受治疗后,试验组APACHE评分明显优于中间组、常规组(P<0.05);试验组和中间组,在院期间死亡率为8.0%,而常规组死亡率为32.0%,生存分析也证明实验组、中间组疗效明显优于常规组(P<0.05)。结论高纤维营养液可有效改善危重症患者的高血糖状态,并可改善患者的预后。     

不同剂量卡维地洛治疗冠心病合并2型糖尿病的效果对比

目的探讨不同剂量卡维地洛治疗冠心病合并2型糖尿病的效果。方法该研究选取2017年1月—2018年1月之间在该院接受治疗150例冠心病合并2型糖尿病患者的临床资料进行统计分析,依据不同的治疗方法分为高剂量组、低剂量组和对照组,对照组接受安慰剂治疗,其余两组分别接受高剂量和低剂量卡维地洛治疗,对比两组临床治疗效果。结果低剂量组总有效率为78%,高剂量组总有效率为86%,对照组总有效率为52%。3组差异有统计学意义(P<0.05)。高剂量组观察对象治疗后血糖水平明显低于对照组,3组患者临床治疗效果差异有统计学意义(P<0.05)。结论冠心病合并2型糖尿病患者接受高剂量卡维地洛治疗,有助于其血糖水平的控制和降低,且治疗效果较为理想。     

多烯磷脂酰胆碱与还原型谷胱甘肽治疗肝衰竭临床疗效比较

目的探讨多烯磷脂酰胆碱与还原型谷胱甘肽治疗肝衰竭的临床疗效。方法 47例肝衰竭患者接受多烯磷脂酰胆碱治疗,50例接受还原型谷胱甘肽治疗,另47例仅接受基础治疗。观察治疗4周时患者谷丙转氨酶、总胆红素、白蛋白和凝血酶原活动度的变化。结果多烯磷脂酰胆碱治疗组患者各项指标改善情况优于还原型谷胱甘肽组和基础治疗组;还原型谷胱甘肽治疗组患者各项指标改善情况优于基础治疗组。结论无论是多烯磷脂酰胆碱还是还原型谷胱甘肽治疗肝衰竭都是有效的,近期疗效均好于基础治疗组。     

糖尿病周围神经病变的中医治疗研究

目的该次研究主要针对自拟中医药方在糖尿病周围神经病变患者中的治疗效果及进展进行研究。方法选取2015年10月—2017年4月期间在该院接受治疗的糖尿病周围神经病变患者共计64例,这些患者均由于糖尿病引发周围神经病变,且均接受口服药物降糖治疗。将64例患者随机平均分为两组,其中一组患者采用口服甲钴胺进行治疗作为对比组,另外一组患者在此基础上采用中药熏洗双下肢的方式进行治疗作为观察组。在经过3个疗程的治疗后,统计并对比两组患者的治疗效果以及疼痛减轻程度。结果对比组患者在接受治疗后治疗效果明显、较为明显及显效人数共计21例,治疗有效率为65.6%;观察组患者在接受治疗后治疗效果明显、较为明显及显效人数共计28例,治疗有效率为87.5%。对比组患者在接受治疗前疼痛评分VAS为(7.32±0.49)分,治疗后评分为(6.51±0.33)分;观察组患者在接受治疗前疼痛评分VAS为(7.41±0.52)分,治疗后评分为(4.83±0.71)分。结论自拟药方对于糖尿病周围神经病变患者具有较好的治疗效果,可以推广该药方的使用。     

核苷类似物在乙型肝炎相关性肝癌患者治疗中的作用

<正>【据《Hepatol Res》2014年6月报道】题:核苷类似物在乙型肝炎相关性肝癌患者治疗中的作用(作者Nishikawa H等)来自大阪红十字医院的Nishikawa H等进行了一项研究,旨在评价核苷类似物对根治性治疗的乙型肝炎相关性肝癌患者临床预后的影响。此研究共对131名接受根治性治疗的乙型肝炎相关性肝癌患者进行了分析。将患者分为接受核苷类似物治疗的A组(n=99)和不接受核苷类似物治疗的对照组B组(n=32)。A组又进一步分为肝癌治疗前接受核苷类似物治疗的A a组(n=     

小脑顶核电刺激辅助治疗脑梗死48例临床疗效观察

将96例脑梗死患者随机分为治疗组及对照组各48例，两组均接受常规神经内科药物及高压氧治疗，治疗组在此基础上接受小脑顶核电刺激治疗。治疗组总有效率明显高于对照组（P〈0．05）。提示小脑顶核电刺激治疗能提高脑梗死患者的疗效。     

不同治疗方式对老年急性ST段抬高心肌梗死的临床疗效分析

目的 评价老年急性ST段抬高心肌梗死不同再灌注治疗的临床治疗现状及疗效.方法 回顾性分析2001年3月至2003年6月国内12个心脏中心随机入组的236例年龄≥60岁的急性ST段抬高心肌梗死(STE-MI)患者住院期间的临床资料,比较再灌注治疗和非再灌注治疗组的临床疗效及转归.结果 (1)有接近32%的患者未接受任何形式的再灌注治疗;(2)接受再灌注治疗组患者于发病12 h内就诊比例明显高于未接受再灌注治疗组(67.8%对32.2%);(3)糖尿病病史是未能接受再灌注治疗的预测因素(OR值为3.216,95%可信区间为2.127～6.432);(4)再灌注治疗组住院期间再发心绞痛、充血性心力衰竭者明显低于未接受再灌注治疗组(P<0.05);(5)接受再灌注治疗组患者的病死率明显降低(5.6%对21.7%).结论 再灌注治疗可以降低年龄≥60岁的急性STEAMI患者的住院病死率,减少住院期间不良心血管事件的发生,且不增加该组患者住院期间的并发症.     

轻断食治疗糖耐量异常的临床效果

目的 观察轻断食治疗糖耐量异常患者的临床效果。方法 将糖耐量异常患者120例,随机均分为轻断食组和阿卡波糖组（每组n=60）。轻断食组应用轻断食方法进行治疗,阿卡波糖组应用阿卡波糖进行治疗。治疗6个月后,比较两组患者各项临床指标的改善情况。结果 2组患者接受治疗后,较本组治疗前三酰甘油(TG)、空腹血糖(FPG)和餐后2 h血糖(P2hPG)均显著降低(P<0.01);轻断食组总胆固醇(TC)治疗后较治疗前显著降低,而阿卡波糖组治疗前后TC并无显著差异。两组治疗前TC无显著差异,而治疗后轻断食组TC显著低于阿卡波糖组(P<0.01)。结论 糖耐量异常患者应用轻断食疗法能够收到较好的临床治疗效果。     

Capillary filtration and ankle edema in patients with venous hypertension treated with TTFCA

The variation of capillary filtration rate (CFR), ankle circumference (AC), and ankle edema (AE) was evaluated in three groups of patients with venous hypertension (ambulatory venous pressure greater than 42 mmHg) and in a group of normal subjects before and after treatment for four weeks with Total Triterpenic fraction of Centella Asiatica (TTFCA), a venoactive drug acting on the microcirculation and on capillary permeability. Group A (20 patients) was treated with TTFCA 60 mg tid; Group B (20 patients) was treated with 30 mg tid; Group C (12 patients) was treated with placebo; and Group D (10 normal subjects) was treated with TTFCA 60 mg tid in an open study. Capillary filtration rate was assessed by venous occlusion plethysmography, ankle edema by a new system called AECT (Ankle edema coin tester). Subjective symptoms of venous hypertension were assessed by an analogue scale line considering four symptoms: swelling sensation, restless lower extremity, pain and cramps, and tiredness. CFR, AC, and AE were significantly higher in patients in comparison with normal subjects. After four weeks of TTFCA treatment there was a significant decrease of the abnormally increased CFR, AC, and AECT time in patients. This was also greater in the higher dose group. No significant change was observed in the placebo group and in normal subjects treated with TTFCA. Symptoms were also significantly improved in the two groups treated with the active drug according to the dose. No significant changes were observed in the placebo group.(ABSTRACT TRUNCATED AT 250 WORDS)     

The role of implantable cardioverter defibrillator for primary vs secondary prevention of sudden death in patients with idiopathic dilated cardiomyopathy.

AIM: To analyse the characteristics and outcome of patients with idiopathic dilated cardiomyopathy (DC) considered at high risk of sudden death (SD) and treated with implantable cardioverter defibrillators (ICD) for primary prevention (Group A) in comparison with patients treated with ICDs because of previous sustained ventricular tachyarrhythmias or syncope (Group B). METHODS: Group A consisted of 27 patients with at least two of the following criteria: left ventricular end-diastolic diameter (LVEDD) > or =70 mm (74%), LV ejection fraction (LVEF) < or =30% (78%), non-sustained ventricular tachycardia (VT) (56%), long history of disease (> or =48 months since diagnosis, 85%) and family history of SD (11%). Group B consisted of 27 patients treated with ICDs because of sustained VT/fibrillation (n=18) or syncope (n=9). RESULTS: NYHA class, LVEF, LVEDD and amiodarone treatment were similar in the two groups. Patients in group A were younger (46+/-15 vs 59+/-17 years, P=0.0008), were more often treated with beta-blockers (89% vs 62%; P=0.02) and had a longer interval since diagnosis (86+/-60 vs 40+/-50 months; P=0.004). Twelve month rates of appropriate intervention (AI) were 41% in Group A and 57% in group B (P NS). In group A, after a mean follow-up of 21+/-14 months, patients showing the combination of LVEF < or =30% and LVEDD > or =70 mm had the highest frequency of AI (76% vs 10%, P=0.005). In group B, after a mean follow-up of 33+/-23 months, 78% of patients with syncope had AI. Total and sudden deaths were 11% and 4% in group A and 19% and 4% in group B (P NS). CONCLUSIONS: Patients with idiopathic DC treated with ICD for primary prevention because they were considered at high risk of SD according to clinical criteria showed a high rate of AI, similar to that of patients treated for secondary prevention. The highest rate of AI was seen in patients with both severe dysfunction and dilatation and in those with previous syncope.     

二甲双胍对原发性高血压伴糖耐量异常患者左心室舒张功能的影响研究

目的研究二甲双胍对原发性高血压伴糖耐量异常的患者左心室舒张功能的影响。方法选取60例原发性高血压伴糖耐量异常的患者。随机分为两组,A组30例在常规降血压治疗基础上服用二甲双胍治疗,B组30例仅给予常规降血压治疗。结果经治疗,A组患者较B组患者左心室舒张功能有所改善,差异有统计学意义（P〈0.05）。结论二甲双胍对原发性高血压伴糖耐量异常的患者左心室舒张功能有一定的改善作用。     

参松养心胶囊联合胺碘酮治疗充血性心力衰竭伴室性心律失常的疗效及安全性观察

目的观察参松养心胶囊联合胺碘酮治疗慢性充血性心力衰竭(CHF)伴室性心律失常(VA)的疗效及安全性。方法选择充血性心力衰竭合并室性心律失常患者168例,随机分为A组(52例)、B组(56例)及C组(60例)。A组给予参松养心胶囊口服,B组给予胺碘酮口服,C组给予参松养心胶囊与胺碘酮口服。观察用药4周后3组的临床疗效与安全性。结果治疗4周后总有效率A组76%,B组78%,C组86%,C组显著高于A组和B组(P<0.05)。结论参松养心胶囊治疗慢性心力衰竭室性心律失常与盐酸胺碘酮疗效相当,且副反应小;参松养心胶囊与胺碘酮联用治疗CHF室性心律失常的疗效优于单用胺碘酮或单用参松养心胶囊的疗效,并可明显减少胺碘酮的用量。     

老年连续性非卧床腹膜透析相关性腹膜炎临床分析

目的分析老年连续性非卧床腹膜透析患者的临床资料,探讨老年腹透患者发生腹透相关性腹膜炎的影响因素。方法回顾性分析上海市第一人民医院松江分院肾内科自2003年1月至2009年5月行连续性非卧床腹膜透析患者70例,分为两组：A组年龄≥60岁,48例,B组年龄〈60岁,22例;比较两组的平均年龄、平均腹透龄、文化程度、血浆白蛋白、札红蛋白、腹膜炎的致病菌及合并其他脏器感染、合并心衰并发症的病例数;比较两组的平均住院日、死亡率、分析腹膜炎发生的影响因素。结果A组老年组文化水平偏低（P〈0．01）,血浆白蛋白及血红蛋白较低,腹透龄较B组缩短,但无统计学意义。A组腹膜炎的发生率明显增加,致病菌组成无差异,并发感染、心哀较多,死产病例增加,且有统计学意义（P〈0．05）。结论老年连续性非卧床腹膜透析患者腹膜炎的发生率高,合并症多,致平均住院日延长,死产病例增加。     

Role of Surgery in Infective Endocarditis

ABSTRACT. One-hundred-and-thirteen patients with endocarditis and valvular insufficiency were studied retrospectively with special regard to indications for operation and the optimum time for cardiac valve surgery. Thirty patients (group I) had acute, 63 (group II) subacute and 20 (group III) prosthetic valve endocarditis. Group I: Eleven patients underwent surgery in the acute stage, 8 while bacteremic; 5 of the latter died perioperatively. Of the 19 patients treated medically, 16 died. Group II: All patients underwent operation in a bacteria-free state. The mortality was 5%. Group III: Eight patients had early (<60 days postoperatively) and 12 late endocarditis. Total mortality was 40% (71 % early and 25% late mortality). Ten patients underwent reoperation, with a mortality of 20%, compared with 60% in the medically treated group. The results support the indication for early operation in acute endocarditis with progressive cardiac failure and renal failure and prosthetic valve endocarditis, even during bacteremia.     

中西药联用治疗慢性乙型肝炎的疗效分析

目的 探讨国产抗病毒药物单磷酸阿糖腺苷(Ara—AMP)、苦参素、胸腺肽联合治疗慢性乙型肝炎(CHB)的疗效。方法 将136例CHB患者分为4组：A组30例，单独使用Ara-AMP,400mg加入10％葡萄糖200ml静滴，1／d，30d为1个疗程；B组30例，单独使用苦参素注射液6ml肌注，1／d，3个月为1个疗程；C组46例，苦参素、胸腺肽、Ara-AMP联合应用，胸腺肽100mg，静滴，1／d，30d为1个疗程；D组30例，为对照组，仅应用保肝药。结果 A、B、C组均有不同程度抗病毒作用，治疗后1年HBeAg、HBV DNA转阴率分别为33．33％、33．33％、52．34％和33．33％、30％、50％，均明显高于对照组(10％和10％)，P＜0．05；C组ALT复常率高于A、B2组，P＜0．05。HBeAg、HBV DNA转阴率与A、B组比较无明显差异，P＞0．05。结论 Ara—AMP、苦参素、胸腺肽联合治疗CHB疗效可靠，无毒副作用。     

OUTCOME OF PATIENTS WITH GRAVES' DISEASE AFTER LONG-TERM MEDICAL TREATMENT GUIDED BY TRIIODOTHYRONINE (T3) SUPPRESSION TEST

The value of the T3 suppressed 20-min uptake test for the prediction of post-treatment outcome was studied in 193 unselected patients with GRAVES' disease treated with thionamide drugs and T3. One hundred and twenty-nine of 193 patients were studied previously and followed thereafter (Group A). Sixty-four were newly treated patients: thirty-three (Group B) were treated at the same hospital as Group A; thirty-one (Group C) were treated at another hospital. In total, 126 patients out of 193 satisfied our criteria for suppression (total suppression rate, 65%). The suppression rate for new patients (55% in Group B, 52% in Group C) was similar to that for Group A in 1977 (49%) after comparable duration of treatment. The suppression rate for Group A increased with prolongation of the treatment period (49% in 1977 and 71% in 1981). As to the time course of suppression, it was observed that about two-thirds of the suppressed patients satisfied the criteria for suppression within 3 years of starting treatment. The number of suppressed patients per year decreased thereafter as the treatment periods increased. However, the yearly suppression rate did not decrease with time. The time course of suppression in each patient could not be predicted from the results of initial thyroid function tests. The overall remission rate among the 120 suppressed patients followed for 1–13 (mean, 4) years was 96%, which was almost equal to the value obtained in Group A in 1977 (95%) with the average follow-up period of 2 years. Among the 46 patients in Group A followed for 5–13 (mean, 7) years, no increase in relapse was observed with prolonged follow-up periods. Examination on the relationship between the duration of treatment and the post-treatment outcome     

Four-year results after brachytherapy for diffuse coronary in-stent restenosis: will coronary radiation therapy survive?

BACKGROUND: Prior to the introduction of drug-eluting stents (DES), diffuse coronary in-stent restenosis (ISR) was mainly treated by brachytherapy (BT), with good short-term and mid-term results. However, there exist limited data on the long-term effects of BT that justify its continuous use. MATERIALS AND METHODS: Two hundred patients with diffuse ISR treated with intravascular BT were retrospectively followed over 4 years. Group A (n=134) was treated with the noncentered (90)Sr/Y BetaCath radiation system, whereas Group B (n=66) was treated with the centered 32P Galileo source wire system. Primary endpoints after 4 years were target lesion restenosis (TLS) and target lesion revascularization (TLR). Secondary endpoints were target vessel revascularization (TVR) and nontarget vessel revascularization (NTVR), as well as major adverse cardiac events (MACE). RESULTS: Follow-up at 4 years yielded a TLS rate of 37.6% (Group A, 40.8%; Group B, 31.1%; P=.48). TLR was performed in 34.8% of patients (37.5% in Group A vs. 29.5% in Group B; P=.55). Ten percent of patients underwent coronary bypass surgery. Percutaneous coronary intervention was performed more often in Group A (27.5%) than in Group B (19.7%), while TVR was less frequent in Group A (10.0%) than in Group B (18.0%). NTVR was undertaken in 25.0% of Group A patients versus 21.3% of Group B patients, and MACE occurred in 1.7% of Group A patients versus 3.3% of Group B patients. These differences were not statistically significant (P>.05). CONCLUSIONS: While excellent short-term and mid-term results after coronary BT are widely accepted, a high TLS rate can be observed after 4 years. The potential superiority of DES to BT will depend on the availability of long-term clinical data.