美托洛尔与左旋氨氯地平二联疗法用于轻中度原发性高血压治疗临床研究

目的探讨美托洛尔与左旋氨氯地平二联疗法用于轻中度原发性高血压临床效果。方法选取轻中度原发性高血压患者400例,采用随机抽样方法分为对照组和二联疗法组,每组各200例;对照组患者给予左旋氨氯地平单用治疗,二联疗法组患者在对照组治疗基础上,加用关托洛尔治疗;比较两组患者血压控制总有效率,治疗后血压下降程度及不良反应发生率等。结果二联疗法组患者血压控制总有效率显著高于对照组（P〈0．05）;二联疗法组患者治疗后收缩压和舒张压下降程度均显著高于对照组（P〈0．05）;二联疗法组患者心悸、面色潮红及下肢水肿等不良反应发生率均显著低于对照组（P〈0．05）。结论美托洛尔与左旋氨氯地平二联疗法治疗轻中度原发性高血压有助于提高降压效果,减少不良反应。     

联合用药治疗老人原发性高血压病60例的疗效观察

目的：观察替米沙坦联合氨氯地平治疗老人高血压病临床疗效。方法：选择120例高血压病早期肾损害患者,随机分为观察组和对照组各60例。对照组给予替米沙坦治疗,观察组在对照组基础上增加氨氯地平片口服。两组疗程均为4周。比较两组临床疗效、血压变化和药物不良反应情况。结果：观察组总有效率为96．7％,对照组总有效率为83．3％,两组比较差异有显著性意义（P〈0．05）,同时观察组降低血压的时间明显优于对照组（P〈0．05）,两组药物不良反应差异无显著性意义（P〉0．05）。结论：替米沙坦联合氨氯地平治疗老人原发性高血压,可以明显改善高血压病症状,提高临床治疗效果。     

高血压合并冠心病患者经氨氯地平阿托伐他汀钙片治疗的临床效果分析

目的：对高血压合并冠心病患者行氨氯地平联合阿托伐他汀钙片治疗效果进行科学分析。方法将确诊为高血压合并冠心病者200例随机分为对照组和观察组,对照组口服单药氨氯地平,观察组予氨氯地平联合阿托伐他汀钙片治疗。结果治疗后,观察组血压控制情况、心绞痛发作情况显著优于对照组（ P＜0．05）,观察组血清总胆固醇、甘油三酯、低密度脂蛋白胆固醇显著低于对照组（ P＜0．05）,观察组高密度脂蛋白胆固醇水平显著高于对照组（P＜0．05）。观察组总治疗有效率显著高于对照组（P＜0．05）。结论联合应用氨氯地平和阿托伐他汀钙片对于高血压合并冠心病患者较单药氨氯地平效果更好。     

氨氯地平联用依那普利治疗非构型老年高血压病的疗效观察

目的：观察氨氯地平单用及与依那普利联合应用治疗非构型老年高血压病恢复其构型血压昼夜节律情况。方法：筛选非构型高血压患者60例,随机分成两组。第1组予氨氯地平5mg,1次/d,第2组予氨氯地平2.5mg,1次/d,依那普利2.5mg,2次/d。4周后,两降压未达标者,第一组氨氯地平增至7.5mg,1次/d,第二组依那普利增至5mg,2次/d。达标者维持愿剂量继续治疗4周。结果：治疗8周后,两组血压较治疗前明显下降（P〈0.05）。联合用药组血压达标率（86.7%）显著高于对照组（66.7%）（P〈0.05）。结论：两组治疗后均使血压的昼夜节律从非构型转为构型,氨氯地平加依那普利组降压作用优于单用氨氯地平组,尤其是对夜间血压的降压作用,并能24h平稳降压。     

复方氨氯地平阿托伐他汀钙片治疗高血压合并冠心病60例临床分析

目的探讨复方氨氯地平阿托伐他汀钙片治疗高血压合并冠心病的临床效果。方法选择收治的60例高血压合并冠心病患者为研究对象,随机分为对照组和观察组,对照组采用硝苯地平治疗,观察组采用复方氨氯地平阿托伐他汀钙片治疗。比较两组治疗效果,治疗前后血压改善情况、心电图改善情况及不良反应发生情况。结果观察组治疗总有效率显著高于对照组,差异有统计学意义（P〈0．05）。观察组治疗后收缩压、舒张压显著低于对照组,差异有统计学意义（P〈0．05）。观察组不良反应发生率显著低于对照组,差异有统计学意义（P〈0．05）。结论复方氨氯地平阿托伐他汀钙片治疗高血压合并冠心病疗效优于硝苯地平,不良反应少,值得临床推广应用。     

非洛地平治疗糖尿病肾病120例临床研究

目的：探讨非洛地平治疗120例糖尿病肾病的临床研究。方法：对治疗糖尿病肾病患者120例,随机分为治疗组和对照组,每组各60例。治疗组给予药物非洛地平进行治疗,对照组采用氨氯地平进行治疗,比较两组患者的治愈率,分析两组患者治疗前后的肾功能指标包括24h尿蛋白定量变化,血肌酐（Scr）和尿素氮（BUN）,观察两组患者治疗前后的血压变化。结果：治疗组的治愈率为90．00％,与对照组的50．00％相比较差异显著（P〈0．05）。两组患者治疗前后的肾功能指标以及血压具有明显差异（P〈0．05）。两组患者治疗后的Scr和BUN以及血压水平均未见显著性差异（P〉0．05）,而两组的24h尿蛋白定量变化具有显著性差异（P〈0．05）。结论：非洛地平治疗糖尿病肾病不失为一种优良的治疗方案,在临床上值得推广。     

拉贝洛尔在妊娠高血压治疗中的价值分析

目的：分析拉贝洛尔对于妊娠高血压治疗效果的影响。方法将接受药物治疗的252例妊娠高血压患者分为联合组126例（拉贝洛尔＋硫酸镁治疗）和单独组126例（单用硫酸镁）,对比两组治疗前后血压和血流动力学变化,并跟踪随访统计分析两组妊娠结局情况。结果治疗后,联合组患者的血压控制效果明显优于单独组（ P＜0．05）;治疗后,联合组血流动力学指标改善程度明显高于单独组（ P＜0．05）;联合组不良分娩结局发生率明显低于对照组（ P＜0．05）,组间数据差异显著。结论拉贝洛尔能够明显提高妊娠高血压的治疗效果,改善分娩结局。     

左旋卡尼汀治疗非酒精性脂肪肝伴代谢综合征临床观察

目的评价左旋卡尼汀治疗非酒精性脂肪肝（NAFLD）伴代谢综合征（MS）的疗效。方法NAFLD伴MS患者168例,随机均分为2组,治疗组给予左旋卡尼汀口服液1g,3次,d,对照组给予门冬氨酸钾镁片2片,3次／d口服治疗。两组疗程均为24周。结果治疗组和对照组治疗后患者临床症状评分、AST、GGT、B超积分均较治疗前改善（P〈0．05）,对照组ALT较治疗前也有明显下降（P〈0．05）,治疗组ALT下降不明显（P〉0．05）。两组治疗后各指标比较差异均无统计学意义（P值均〉0．05）。治疗组治疗后腹围、血糖、甘油三酯、动脉血压较治疗前有所下降（P〈0．05）,而对照组均无明显变化（P〉0．05）。治疗组和对照组问治疗后腹围、动脉舒张压差异有统计学意义（P值分别为0．025和0．023）。两组均未出现明显不良反应。结论左旋卡尼汀联合饮食、运动等基础治疗可有效改善NAFLD伴有代谢综合征患者的血糖、血脂代谢,降低动脉血压,减轻脂肪肝程度,耐受性较好,不良反应少。     

厄贝沙坦联合氨氯地平治疗早期糖尿病肾病合并高血压临床疗效观察

目的观察厄贝沙坦联合氨氯地平治疗早期糖尿病肾病合并高血压的临床效果。方法将183例早期糖尿病肾病合并高血压患者随机分为观察组和对照组。观察组给予厄贝沙坦和氨氯地平治疗,对照组给予以厄贝沙坦治疗。记录治疗期间的血压、血清肌酐值、肾小球滤过率及不良心血管事件。结果两组与治疗前相比,血压均显著下降（P〈0.01）,但观察组收缩压较对照组下降更为显著（P〈0.05）;治疗前后两组血清肌酐和肾小球滤过率均无显著变化;而在降低不良心血管事件发生方面,观察组显著低于对照组（P〈0.05）。结论厄贝沙坦坦联合氨氯地平对于高血压合并早期糖尿病肾病患者临床疗效显著,在控制血压和减少不良心血管事件方面均优于单用厄贝沙坦。     

贝那普利联用他汀类药物治疗高血压远期疗效观察

目的观察贝那普利联用他汀类药物治疗高血压远期疗效。方法将121例患者随机分为对照组54例，治疗组67例。对照组单纯使用贝那普利10mg／d，治疗组给予贝那普利10mg／d、辛伐他汀20mtg／d联用，分别在疗程结束、治疗2个月、4个月和6个月的各阶段进行疗效分析。结果疗程结束后，治疗组总有效率98．50％，对照组总有效率83.33％，两组比较差异有统计学意义（P〈0．05）。2个月后两组病例血压无特殊变化。治疗组血脂开始下降；4个月、6个月，对照组出现血压反弹，血压上升至150±14／104±8mmHg，反弹例数18例，占治疗总有效率40％。治疗组血压恒定，血脂下降显著，差异有统计学意义（P〈0．05）。两组在治疗前患者一般情况、血压、血脂均无统计学意义（P〉0．05）。治疗后治疗组调脂效果优于对照组（P〈0．05），远期血压稳定性优于对照组（P〈0．05）。结论贝那普利联用调脂药治疗高血压远期疗效显著，尤其是高血脂合并高血压患者。     

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.