银翘温胆汤治疗放射性肺病180例临床疗效观察

目的观察中药银翘温胆汤治疗放射性肺病的临床疗效。方法将180例放射性肺炎患者按完全随机数字表法分为两组,对照组90例患者使用单纯西药治疗,治疗组90例患者采用银翘温胆汤联合西药治疗。治疗2、4、6周后以放射性肺炎临床疗效、肺功能检测、血清转化生长因子-β1(TGF-β1)为标准进行临床观察。结果与对照组比较,治疗组患者的放射性肺炎临床疗效、肺功能恢复时间、症状控制起效时间及完全缓解时间均优于对照组(P<0.05)。治疗后两组患者的TGF-β1表达水平均随治疗时间呈递减趋势,但治疗组患者各期的表达水平明显低于同期对照组的表达水平,差异有统计学意义(P<0.05)。结论中药银翘温胆汤对放射性肺炎有一定治疗作用,与西药联合应用有增效作用,并可明显缩短治疗时间。     

银翘温胆汤干预大鼠放射性肺纤维化的初步实验研究

目的应用大鼠放射性肺纤维化模型观察银翘温胆汤对早期放射性肺炎和晚期肺纤维化的干预效果。探讨其在治疗放射性肺纤维化中的作用机制,以期为临床应用提供实验依据。方法将雄性大鼠45只随机分为对照组(0Gy+生理盐水)、照射组(20Gy+生理盐水)、银翘温胆汤组(20Gy+中药),单次6MV X线20Gy照射大鼠双肺,建立放射性肺纤维化模型。分别于2、4、6周时各处死5只大鼠取肺组织,进行HE染色观察肺组织病理变化,检测肺系数,用免疫组化法测转化生长因子-β1(TGF-β1)的表达。结果照射组大鼠肺损伤明显,肺系数、肺纤维化和TGF-β1的表达较对照组明显增高(P<0.05),而银翘温胆汤组大鼠比照射组的肺充血、出血、渗出性改变及肺泡壁增厚、肺纤维化程度减轻,且肺系数和TGF-β1的表达有一定程度的下降。结论银翘温胆汤对大鼠早期放射性肺炎和肺纤维化有一定程度的保护作用,其机制可能是通过抑制TGF-β1表达,使放射性肺炎及肺纤维化病变减轻。     

中西医结合治疗脂肪肝61例临床观察

目的：观察中西医结合治疗脂肪肝的临床疗效.方法：将120例患者随机分为治疗组和对照组,时照组59例采用西药治疗;治疗组61例在西药治疗的基础上加入健脾疏肝汤治疗.结果：两组临床疗效总有效率经统计学处理,P＜0.05,有显著差异,治疗组优于对照组.结论：健脾疏肝汤联合西药治疗脂肪肝,发挥中西医的协同作用,疗效明显优于单纯运用西药.     

内生场热疗联合激素治疗放射性肺炎45例

目的：观察内生场热疗联合糖皮质激素治疗放射性肺炎的临床疗效。方法：45例放射性肺炎的患者进行内生场热疗联合地塞米松治疗,根据治疗后症状、体征和影像学表现来判断疗效。结果：45例经内生场热疗联合地塞米松治疗后,显效15例,有效26例,总有效率91．11％。治疗后临床症状改善显著,患者生活质量明显改善。结论：内生场热疗联合糖皮质激素是一种治疗放射性肺炎的有效方法,值得临床推广应用。     

中西医结合治疗小儿支原体肺炎52例疗效观察

目的观察中西医结合治疗小儿支原体肺炎的疗效,观察其治疗结果和疗效,用于指导临床治疗。方法选择小儿支原体肺炎102例,随机分为治疗组52例和对照组50例,对照组50例常规西药治疗,治疗组52例常规西医治疗加自拟口服清热化痰养阴方（中药颗粒剂）,疗程10天。结果观察组采用西医治疗,观察和比较两组退热时间、咳嗽症状减轻时间,肺部罗音消失时间均较对照组明显缩短两组比较差异有统计学意义（P〈0．05）。结论中西医结合治疗小儿支原体肺炎可缩短疗程,改善症状,提高疗效,且副作用小,不良反应少,值得临床推广应用。     

脉冲微波联合中药经皮导入辅助治疗儿童肺炎疗效观察

目的：观察脉冲微波联合中药在肺俞穴经皮导入辅助治疗儿童肺炎的临床疗效。方法：将肺炎患儿265例随机分为观察组135例和对照组130例,观察组在常规治疗（抗感染、退热、化痰止咳、吸氧等）基础上加用脉冲微波在肺俞穴经皮导入中药,2次/d,每次20min,连续治疗5天为1个疗程;对照组采用常规治疗。结果：观察组发热病例退热时间、肺部啰音消失时间、咳嗽消失时间均显著短于对照组（P〈0.01）。观察组总有效率85.9%,对照组72.3%,两组比较差异显著（P〈0.05）。结论：儿童肺炎在常规治疗基础上辅以脉冲微波联合中药经皮导入疗效优于常规治疗。     

双嘧达莫联合阿奇霉素治疗小儿支原体肺炎疗效观察

目的：观察双嘧达莫联合阿奇霉素治疗小儿支原体肺炎的临床疗效及不良反应。方法：将小儿支原体肺炎92例随机分为观察组和对照组各46例。两组均常规给予止咳、祛痰、退热等对症治疗,缺氧者给予鼻导管吸氧。对照组采用阿奇霉素治疗,10mg/（kg.d）,静脉滴注;观察组在对照组治疗方案基础上加用双嘧达莫3~5 mg/（kg.d）,分3次口服。7天为1个疗程。比较两组临床症状、体征消失时间,X线肺部阴影吸收时间及不良反应。结果：观察组临床症状、体征消失及X线肺部阴影吸收时间,与对照组比较均差异显著或非常显著（P〈0.05,P〈0.01）;两组不良反应差异不显著（P〉0.05）。结论：双嘧达莫联合阿奇霉素治疗小儿支原体肺炎临床疗效优于单用阿奇霉素治疗,且安全。     

黄芪桂枝五物汤与西药治疗糖尿病周围神经病变疗效对比研究

目的：对比黄芪桂枝五物汤与西药治疗糖尿病周围神经病变的临床疗效。方法选择收治的糖尿病周围神经病变患者136例作为研究对象,把全部患者随机分为对照组与观察组,对照组采用常规西药治疗,观察组在此基础上采用黄芪桂枝五物汤治疗,对比两组患者的临床疗效。结果观察组治疗后患者的下肢腓总与上肢正中的MNCV与SNCV均显著高于对照组与治疗前（ P＜0．05）;对照组临床总有效率是83．8％,观察组临床总有效率是95．6％,观察组临床疗效要显著好于对照组（ P＜0．05）。结论黄芪桂枝五物汤联合西药治疗糖尿病周围神经病变的临床疗效要显著优于单纯应用西药治疗,值得在临床上大力推广应用。     

泄泻方加减对放射性肠炎的临床观察

目的：观察中药复方对放射性肠炎的临床疗效及安全性。方法：随机选择放射性肠炎患者87例,其中观察组45例中药复方治疗,对照组42例常规西药治疗。观察两组治疗前后肠镜改变及症状积分,比较其有效率,症状积分差异。结果：治疗组和对照组总有效率分别为91.1%、71.4%,组间疗效比较有统计学意义（P〈0.05）;症状积分比较,治疗前两组无统计学意义（P〉0.05）;治疗后治疗组各症状积分均明显降低（P〈0.01）,对照组仅腹痛、腹泻积分明显降低（P〈0.05,P〈0.01）;治疗后组间比较,各症状积分差异均有统计学意义（P〈0.01）;两组均未见血、尿、肝、肾功及心电图等方面异常。结论：采用中药复方治疗放射性肠炎疗效肯定,安全、副作用少,为放射性肠炎的有效治疗方法之一。     

阿奇霉素联合匹多莫德治疗小儿支原体肺炎临床疗效观察

目的观察阿奇霉素联合匹多莫德治疗小儿支原体肺炎的临床疗效。方法选取我科收治的80例小儿支原体肺炎患儿,其中阿奇霉素贯序疗法治疗40例为对照组,阿奇霉素联合匹多莫德治疗40例为观察组．对比分析两组患儿的临床疗效、住院时间及不良反应情况。结果观察组总有效率明显高于对照组（P〈0．05）,观察组患儿平均住院天数少于对照组（P〈0．05）。观察组患儿不良反应例数少于对照组,两组比较差异无统计学意义（P〉0．05）。随访2个月,观察组患儿复发率低于对照组（P〈0．05）。结论阿奇霉素联合匹多莫德治疗小儿支原体肺炎可快速改善临床症状,缩短患儿住院时间,明显提高治愈率。     

Optimization of the system of medical service of students of Cadet Schools of the Ministry of Defense of the Russian Federation

One of the factors of the successful military career guidance Cadet schools students is preserving and promoting their health. Medical support of children and adolescents aged 10-17 years should include the full range of medical and preventive measures defined for this group. The state of providing outpatient care for pupils at the Cadet School in St. Petersburg was studied. These results show that full medical care in accordance with the standards can be based only on children's health clinics. It is important that the organization of medical support pupils cadet schools should be cooperate with civilian health care.     

带状疱疹83例误诊原因分析

带状疱疹是由水痘—带状疱疾病毒引起的皮肤科常见疾病。其主要的病理损害,一是受累神经的严重炎症性浸润,继而导致受侵犯神经节内神经细胞变性、坏死;二是皮肤的水泡。迅速抑制神经节和相应的感觉神经纤维的充血、水肿和坏死,防止粘连形成,达到迅速镇痛、改善皮损,缩短病程及防止后遗症的发生是治疗的关键。因而,尽早明确诊断,     

Estimation of accumulated dose of radiation by method of ESR-spectrometry of dental enamel of mammals

ESR-spectrometry was used to investigate radiation-induced paramagnetic centers in enamel of mammals: carnivores (polar bear and fox), ungulates (reindeer, European bison, moose), and man. Values at half the microwave power saturation of the radiation signal, P_1/2, evaluated at room temperature, was found to range from 16 to 26 mW for animals and man. A new approach to discrimination of the radiation induced signal from the total ESR spectrum of reindeer enamel is proposed. ‘Dose-response’ dependencies of enamel of different species mammals were measured within the dose range from 0.48 up to 10.08 Gy. Estimations of ‘radiosensitivity’ enamel of carnivores and ungulates showed good agreement with radiosensitivity enamel of man by ESR method.     

Analysis of the results of the international comparison of activity measurements of a solution of Fe

The results of an international comparison of activity measurements of a solution of ⁵⁵Fe organized by the BIPM in 2005 are reported and analysed. This exercise, which follows the procedures of the CIPM mutual recognition arrangement to update older comparisons, is a renewal of the comparison organized by the BIPM that took place in 1978. A EUROMET comparison was organized in 1996 specifically to compare activity measurements of a ⁵⁵Fe solution by means of liquid-scintillation techniques. Results of these three comparisons are presented and discussed in this paper.

The radionuclide solution was provided by the NPL, which also distributed the samples to the participants. The activity of the ampoules was measured by 16 laboratories using 12 methods producing 25 results. Some general considerations on uncertainty assessments pertaining to the different techniques used are drawn. The outcome of four different estimators is compared from which the presence of at least one outlier can be confirmed. Further measurements should be made to try to reduce the discrepancy between the results. To date the outcome of the present comparison does not show an improvement to that of the 1996 comparison.     

Evaluation of the results of various technics of non-surgical therapy of varicocele

A new method of non-surgical treatment of varicocele syndrome is described: it consists in sclerotherapy of spermatic vein by trans-femoral percutaneous catheterization with balloon-catheters. In 8 cases venous thrombosis has been induced by direct electric clotting. The techniques and a 6 months follow-up are discussed. It is pointed out that this procedure should be considered as the method of choice for tubular lesions and sub-fertility prophylaxis in young people and in childhood.     

延迟性脾破裂误漏诊原因分析

目的探讨延迟性脾破裂误漏诊原因和预防措施.方法回顾性分析总结12例延迟性脾破裂中的诊断和误漏诊的经验与教训.结果本组延迟性脾破裂的误漏诊5例(41.66%).对多发伤与脾破裂并存可能认识不足,外伤史轻微或伤员隐瞒外伤史,缺乏腹痛-缓解-突然再腹痛的典型病史,缺乏“对冲性脾破裂”力学分析和整体化诊断思路等为其误漏诊的主要原因.结论详细的外伤史和全面系统检查,重视腹以外多发伤掩盖腹内脏器伤及延迟性脾破裂可能.确立外伤-腹内脏器伤-脾破裂整体化诊断思路.不间断地辅以B超检查脾形态学变化和腹内有无积液,腹腔穿刺确定有无血腹、X线胸腹部检查观察左侧胸肋角和膈肌运动情况、必要时CT检查以尽早发现脾包膜下血肿,降低延迟性脾破裂误漏诊率.