丹红注射液联合依达拉奉治疗急性脑梗死的疗效观察及对血液流变学、神经功能的影响

目的探讨丹红注射液联合依达拉奉治疗急性脑梗死的疗效及对血液流变学、神经功能的影响。方法将2017年1月—2018年7月在我院诊断为急性脑梗死的98例病人作为研究对象,随机分为研究组和对照组各49例。对照组使用依达拉奉进行治疗,研究组使用丹红注射液联合依达拉奉进行治疗。结果两组治疗前血液流变学指标比较差异无统计学意义(P0.05),在经过治疗后,研究组与对照组血液流变学指标均有改善(P0.05),但研究组指标与对照组比较差异有统计学意义(P0.05);两组病人在治疗前神经功能缺损评分比较差异无统计学意义(P0.05),在经过治疗后研究组和对照组神经功能缺损评分均有下降(P0.05),但研究组低于对照组(P0.05);研究组的总有效率明显高于对照组(P0.05)。结论丹红注射液联合依达拉奉治疗急性脑梗死效果比单用依达拉奉的治疗效果更佳。     

依达拉奉联合血塞通注射液治疗急性脑梗死的疗效观察

目的观察依达拉奉联合血塞通注射液治疗急性脑梗死的临床疗效。方法选取2010年3月—2012年3月我院收治的54例急性脑梗死患者,将其随机分为观察组27例(采用常规治疗+依达拉奉+血塞通注射液)和对照组27例(采用常规治疗+血塞通注射液),治疗2周后对两组患者的神经功能缺损评分以及治疗效果进行比较。结果对照组总有效率为66.7%,观察组总有效率为88.8%,两组疗效比较,差异有统计学意义(P<0.05)。治疗后观察组神经功能缺损评分低于对照组,差异有统计学意义(P<0.05)。结论依达拉奉联合血塞通注射液治疗急性脑梗死疗效佳,且能改善患者的预后,促进急性脑梗死患者的康复。     

补阳还五汤加减联合依达拉奉治疗脑梗死的临床研究

目的观察补阳还五汤加减联合依达拉奉治疗脑梗死的临床疗效。方法选择急性脑梗死患者130例,随机分为治疗组和对照组。对照组予依达拉奉加复方丹参静脉输注,治疗组予依达拉奉联合补阳还五汤加减治疗。结果治疗组与对照组总有效率分别为93.85%和81.54%,两组比较有统计学意义(P<0.05)。治疗组治疗后14 d2、1 d神经功能缺损评分量表(NIHSS)评分与对照组比较差异有统计学意义(P<0.05)。结论补阳还五汤加减联合依达拉奉治疗急性脑梗死,对脑组织有显著保护作用。     

依达拉奉联合低分子肝素治疗急性进展型脑梗死的疗效观察

目的观察依达拉奉联合低分子肝素治疗急性进展型脑梗死的疗效。方法选取我院2014年6月~2015年1月收治的急性进展型脑梗死患者80例,根据不同治疗方案分为对照组45例与研究组35例,对照组给予常规治疗,研究组给予依达拉奉联合低分子肝素治疗,对比两组治疗前后神经功能缺损程度(NIHSS)评分变化情况与疗效。结果治疗后研究组NIHSS评分低于对照组,差异有统计学意义(P0.05);研究组总有效率为94.29%高于对照组的71.11%,差异有统计学意义(P0.05)。结论依达拉奉联合低分子肝素治疗急性进展型脑梗死疗效显著,值得临床推广。     

依达拉奉联合奥扎格雷钠治疗进展性脑梗死的临床疗效观察

目的观察依达拉奉联合奥扎格雷钠治疗进展性脑梗死的临床疗效。方法选取舞阳县中心医院2009年1月—2013年9月收治的进展性脑梗死患者102例,根据患者入院尾号随机分为对照组和观察组,各51例。对照组患者给予依达拉奉联合维生素C治疗,观察组患者给予依达拉奉联合奥扎格雷钠治疗,均以14 d为1个疗程。比较治疗前、治疗1周及治疗2周后两组患者神经功能缺损评分、临床疗效及治疗期间不良反应发生情况。结果两组患者治疗前神经功能缺损评分比较,差异无统计学意义(P>0.05);观察组患者治疗1周及2周后神经功能缺损评分低于对照组(P<0.05)。观察组临床疗效优于对照组(P<0.05);观察组不良反应发生率为11.8%(68/51),与对照组的17.6%(9/51)比较,差异无统计学意义(P>0.05)。结论依达拉奉联合奥扎格雷钠治疗进展性脑梗死的临床疗效显著,能有效改善患者神经功能缺损程度,延缓脑梗死进展,且未增加药物不良反应。     

依达拉奉联合巴曲酶治疗发病6h后前循环脑梗死的初步观察

目的 评价依达拉奉与巴曲酶联用治疗脑梗死的疗效.方法 78例脑梗死的患者随机分为治疗组和对照组各39例,治疗组用依迭拉奉30mg加入0.9%氯化钠溶液100ml静脉滴注,2次/d,共14d;于第1、3、5d同时给予巴曲酶,剂量分别为10BU,5BU,5BU,加入0.9%氯化钠溶液250ml稀释后静脉滴注.对照组仅用巴曲酶,剂量和用法同治疗组.现察两组治疗前后神经功能缺损评分变化、神经功能改善情况及血浆纤维蛋白原定量变化,不良反应发生情况.结果 两组患者治疗前神经功能缺损评分问差异无统计学意叉(P>0.05).治疗后两组比较神经功能缺损评分间差异有统计学意义(P<0.05).两组患者临床疗效问差异有统计学意义(P<0.01).两组患者治疗后未见明显不良反应,无一例继发颅内出血或消化道出血,血生化及血、尿常规均无明显变化.结论 依达拉奉与巴曲酶合用能显著提高脑梗死怠者的疗效.     

奥扎格雷钠联合依达拉奉治疗急性脑梗死的疗效观察

目的观察奥扎格雷钠联合依达拉奉治疗急性脑梗死的疗效。方法将80例急性脑梗死患者随机分为治疗组和对照组,各40例,治疗组给予奥扎格雷钠、依达拉奉联合治疗,对照组给予复方丹参液、胞二磷胆碱治疗。结果治疗组总有效率为95.0%,对照组总有效率为60.0%,两组疗效比较,差异有统计学意义(P<0.05);治疗7、14、30d后两组神经系统功能损害程度评分比较,差异有统计学意义(P<0.05)。结论联合应用奥扎格雷钠、依达拉奉治疗急性脑梗死,疗效好,不良反应小,值得临床推广应用。     

奥扎格雷钠联合依达拉奉治疗急性脑梗死的疗效观察

目的探讨奥扎格雷钠联合依达拉奉治疗急性脑梗死的临床疗效。方法将60例急性脑梗死患者随机分为观察组和对照组各30例,观察组给予奥扎格雷联合依达拉奉治疗,对照组给予长春西汀,比较两组患者的治疗情况。结果观察组和对照组的总有效率分别为100.00%和83.33%,观察组疗效明显优于对照组,两组比较,差异有统计学意义(P<0.05)。结论奥扎格雷钠联合依达拉奉治疗急性脑梗死安全、有效,无明显不良反应,值得推广应用。     

依达拉奉治疗急性脑梗死的系统评价

目的对急性脑梗死患者采用依达拉奉治疗的临床效果进行评价。方法将80例急性脑梗死患者随机分为观察组和对照组,对照组实施普通治疗,观察组在对照组基础上使用依达拉奉实施治疗,比较两组的治疗效果。结果治疗有效率,观察组为92.5%,对照组为70.0%,观察组好于对照组,具有统计学差异(P0.05);对两组患者治疗后神经功能发生缺损的程度进行比较,观察组好于对照组,具有统计学差异(P0.05),两组患者不良反应情况比较没有统计学差异(P0.05)。结论急性脑梗死患者实施普通治疗基础上配合使用依达拉奉进行治疗,临床效果显著,治疗安全性高,可以进行推广。     

人尿激肽原酶联合依达拉奉治疗急性脑梗死的疗效观察

目的 探讨人尿激肽原酶联合依达拉奉治疗急性脑梗死的临床疗效.方法 选择起病48 h内脑梗死急性期患者86例,随机分为联合用药组和对照组各43例.两组均合并使用胞二磷胆碱钠注射液、抗血小板凝集药物、控制血压、控制血糖、调脂以及对症支持治疗.在此基础上,联合用药组予人尿激肽原酶联合依达拉奉治疗,对照组予依达拉奉单独治疗,14d为1个疗程.结果 治疗14 d后,联合治疗组总有效率为79.1％,对照组则为66.67％;联合治疗组疗效优于对照组(P＜0.05).治疗前后神经功能缺损评分(NIHSS)联合治疗组分别为(19.88±2.99)、(8.91±2.59)分,对照组分别为(19.93±3.56)、(10.51±2.19)分,治疗后两组NIHSS比较差异有统计学意义(P＜0.05).两组治疗过程中均未见明显不良反应.结论 人尿激肽原酶联合依达拉奉治疗急性脑梗死安全、有效.     

Correlates of Stimulant Treatment Outcome Across Treatment Modalities

Objective: This study evaluated variables associated with stimulant use outcomes in stimulant users (N = 800) receiving care in community outpatient psychosocial or methadone maintenance treatment clinics as part of a national multi-site clinical trial. Methods: Results from the full sample were examined first, and then predictors were examined separately in the two treatment modalities. Results: A cocaine-positive urine sample at study intake was the most robust and consistent correlate of stimulant use outcome in all analyses. Psychiatric distress, social environment and employment had differential effects on outcome across modalities. Conclusions/Significance: This study confirms that intake assessments have considerable value in identifying problems to be addressed in treatment.     

Treatment of ascites

Opinion statement Ascites is the most common complication of cirrhosis and occurs in more than half of all patients with cirrhosis. The development of ascites indicates progression of the underlying cirrhosis and is associated with a 50% 2-year survival rate. Conventional therapies used for the treatment of ascites include sodium restriction (<88 mmol/d), diuretics, and large volume paracentesis (LVP) (>5 L). The most effective diuretic combination is that of a potassium-sparing, distal-acting diuretic (eg, spironolactone) with a loop diuretic (eg, furosemide). LVP provides rapid resolution of symptoms with minimal complications and is well tolerated by most patients. Post-paracentesis circulatory dysfunction (PPCD) may occur after LVP and is characterized by hyponatremia, azotemia, and an increase in plasma renin activity. PPCD is associated with an increased mortality and may be prevented by administration of albumin intravenously (6 to 8 g/L of ascites removed) along with LVP. The development of either diuretic-resistant or diuretic-intractable ascites occurs in approximately 5% to 10 % of all cases of ascites. This is a poor prognostic sign, as 50% of such patients die within 6 months of its development. The only definitive therapy for refractory ascites with cirrhosis is orthotopic liver transplantation. The other options that are available include LVP, peritoneovenous shunts, and transjugular intrahepatic portosystemic shunts (TIPS). The TIPS procedure has not been shown to have any influence on survival in patients with cirrhosis and refractory ascites, and TIPS is contraindicated in patients who have advanced liver failure because it can hasten death in such individuals. Peritoneovenous shunts are associated with a high incidence of complications and frequent occlusion. They are, therefore, rarely used for refractory ascites. Spontaneous bacterial peritonitis (SBP) is a common complication of cirrhotic ascites. It may precipitate hepatorenal syndrome. The overall mortality rate from an episode of SBP is approximately 20%. Following an episode of SBP, the 1-year mortality rate approaches 70%. Hospitalized patients should be treated with intravenous third-generation cephalosporins (eg, cefotaxime), and patients at risk should receive prophylaxis with either orally administered quinolones (eg, norfloxacin) or cotrimoxazole.     

Treatment of hyperlipidemia

The correlation between elevated cholesterol and coronary artery disease (CAD) has emerged slowly, with the strongest statistical links appearing recently. Every major epidemiologic study carried out to date has verified the association between the concentration of serum cholesterol and the risk of CAD. Despite this, much of the medical profession continues to underrate the significance of cholesterol and lipoproteins. Programs to increase physicians' awareness of this problem are essential. The National Heart, Lung, and Blood Institute's Coronary Primary Prevention Trial showed that diet and drug therapy lower cholesterol by 9% and low density lipoprotein (LDL) cholesterol by 12.5%, on average, in at-risk patients compared with control subjects. CAD death or nonfatal myocardial infarctions were reduced collectively by 19%. Significant decreases also occurred in the incidence of angina pectoris, new positive electrocardiograms and coronary artery bypass surgery. Data from a number of important secondary prevention trials also support lowering cholesterol and LDL to retard the growth of atherosclerotic plaque. The risk from LDL elevations depends on the extent of the increase, the concentration of high density lipoprotein cholesterol and the presence of other major risk factors (e.g., hypertension and smoking). The ratio of total cholesterol or LDL to the high density lipoprotein concentration is the best indicator for CAD risk. Monitoring cholesterol levels should become an annual routine in the physician's office. A simple, economical blood test for cholesterol, which should be widely available soon, will make screening programs possible, but before such screening begins, plans must be in place for follow-up. The identification of high risk persons and their treatment with diet and, when necessary, drugs are essential.(ABSTRACT TRUNCATED AT 250 WORDS)     

Treatment of hyperferritinemia

Elevated serum ferritin, or hyperferritinemia, is a common finding on routine bloodwork and often prompts referral for further evaluation. In the following review, we outline the various causes of hyperferritinemia and point out that, in the majority of cases, this does not represent true iron overload. Despite much research interest in this area, the precise mechanism of hyperferritinemia and its impact on disease severity in various clinical conditions continues to be debated. While some research suggests that iron reduction in cases of hyperferritinemia is of benefit, the decision to treat such patients should be individualized, and may be influenced by the presence of other features of iron overload.     

Treatment of hyperlipidemia

In the treatment of hyperlipidemia, when to begin and end therapy is important. In recent years, potent anti-hyperlipidemia drugs have been widely used, and the results of many intervention trials have shown that combinations of diet, exercise and drug therapies are effective for the primary and secondary prevention of coronary heart disease. The present paper summarizes these trials; introduces the therapy guidelines for adult hyperlipidemia established by Japan Atherosclerosis Society in 1997; and discusses the drugs for hyperlipidemia.     

Treatment of diarrhea

Diarrheal diseases remain a leading cause of morbidity and mortality in the developing countries and represent at least a nuisance in the industrialized world. Fluid and electrolyte replacement, particularly via oral rehydration, is the mainstay of therapy for the prevention and treatment of dehydration associated with these illnesses. Antibiotics are not indicated for the majority of enteric infections, and their promiscuous use can contribute to the escalating prevalence of bacterial resistance worldwide. Used judiciously, however, antimicrobial agents can ameliorate illness or curtail pathogen excretion and spread of disease, or both, in some diarrheal infections. Antimicrobial agents are indicated for shigellosis, cholera, traveler's diarrhea, amebiasis, and giardiasis. They are indicated in some specific circumstances to treat infections caused by Campylobacter, some categories of diarrheagenic E. coli, C. difficile, nontyphoidal Salmonella, and certain Vibrionaceae. Few adjunctive treatments provide proven benefit without risk of adverse reactions; most offer no advantage over placebo, and their general use is not encouraged.     

Treatment of hypercalcemia

Severe hypercalcemia is a potentially life-threatening complication of several diseases. Most commonly it is caused by cancers that enhance bone resorption. Impaired renal calcium excretion resulting from a combination of volume contraction and calcium-induced renal injury (nephrocalcinosis) plays a critical role in the genesis and aggravation of hypercalcemia. Treatment of hypercalcemia is based on treating the underlying disease, restoring extracellular volume, correcting electrolyte deficiencies (potassium and magnesium), and reducing bone resorption. Several measures are available to reduce bone resorption, of which the most efficacious are the bisphosphonates and plicamycin (mithramycin). One of these agents in combination with volume expansion can reduce serum calcium concentrations to near normal in most patients within 3 to 6 days. Because of the delayed hypocalcemic action of these agents, they should be administered early. Calcitonin has a more modest hypocalcemic action than the bisphosphonates or plicamycin but has a more rapid effect. Combining calcitonin with plicamycin or a bisphosphonate can enhance the rate of decline of the serum calcium level. Bone resorption also can be reduced by getting patients out of bed to stand or walk. Glucocorticoids may be effective in patients with hypercalcemia associated with high levels of vitamin D, such as sarcoidosis, some lymphomas, or vitamin D intoxication. Patients with mild to moderate hypercalcemia may be asymptomatic. Therapy in these patients should be directed at the primary disease as well as at preventing complications that could raise the level of serum calcium. Efforts should be made to prevent volume contraction and prolonged bed rest. Sedatives and narcotic analgesics, by reducing activity and oral intake, can raise serum calcium levels. In the future it may be possible to predict which patients with cancer are likely to develop accelerated local tumor-mediated or humorally mediated osteolysis. For example, high circulating levels of PTH-like peptides in patients with lung cancer might suggest a greater risk of developing hypercalcemia. These patients could be monitored more closely by periodically measuring urinary calcium. Another prophylactic approach would be to treat patients at risk of developing hypercalcemia with drugs, such as the bisphosphonates, that inhibit bone resorption.