丁苯酞注射液联合依达拉奉治疗急性脑梗死的疗效观察

目的观察丁苯酞注射液联合依达拉奉治疗急性脑梗死的临床疗效。方法选择2016-01～2017-06收治的急性脑梗死患者80例,按随机数字表法分为依达拉奉组和联合组,每组40例,分别在常规治疗的基础上给予依达拉奉治疗和丁苯酞联合依达拉奉治疗,2周为一疗程。比较两组患者治疗前后美国国立卫生院卒中量表(NIHSS)评分变化、临床疗效以及脑梗死灶体积变化情况。结果两组患者治疗后NIHSS评分较治疗前降低,差异有统计学意义(P0.05),且联合组治疗后NIHSS评分降低较依达拉奉组显著,差异有统计学意义(P0.05)。联合组基本治愈10例,显著进步11例,进步14例,无变化3例,恶化2例,依达拉奉组分别为4例、7例、13例、10例和6例,联合组的临床疗效明显优于依达拉奉组(P0.05)。两组患者治疗后脑梗死灶体积缩小(P0.05),且联合组缩小体积明显大于依达拉奉组(P0.05)。结论丁苯酞注射液联合依达拉奉治疗急性脑梗死,可以有效提高患者生活质量,提高治疗有效率,减少急性脑梗死后梗死体积,值得临床推广。     

丁苯酞联合依达拉奉治疗脑梗死疗效观察

目的观察丁苯酞联合依达拉奉治疗脑梗死的临床疗效。方法选择2008年3月—2012年3月在我院进行治疗的脑梗死患者116例,按照治疗方法不同将其分为对照组和治疗组,各58例。对照组进行常规治疗,并给予依达拉奉注射液静脉滴注;治疗组在对照组治疗的基础上给予丁苯酞注射液静脉滴注。治疗两周后比较两组疗效,观察治疗前后两组患者神经功能缺损评分(NIHSS)和日常生活能力评分(ADL)。结果治疗后,对照组总有效率为79.3%(46/58),低于治疗组的93.1%(54/58)(χ2=4.64000,P0.05)。治疗后,治疗组NIHSS评分低于对照组,ADL评分高于对照组(P0.05)。结论丁苯酞联合依达拉奉治疗脑梗死效果显著,可快速恢复神经功能,改善患者生活质量。     

依达拉奉联合丁苯酞治疗急性脑梗死疗效观察

目的观察依达拉奉联合丁苯酞治疗急性脑梗死临床疗效。方法将84例急性脑梗死的病人随机分为单独使用依达拉奉治疗组(对照组,44例)和依达拉奉联合丁苯酞治疗组(治疗组,40例)。比较两组治疗14 d和90 d的美国国立卫生院卒中量表评分(NIHHS)和日常生活能力评分(ADL)。结果两组治疗后14 d9、0 d NIHSS评分、ADL评分均较治疗前明显改善(P<0.05),但治疗组改善程度优于对照组(P<0.05)。结论依达拉奉联合丁苯酞治疗急性脑梗死可有效减低治疗后14 d和90 d的神经功能缺损,提高病人日常生活能力。     

丁苯酞联合依达拉奉对急性脑梗死患者血清神经元特异性烯醇化酶和S-100β的影响及疗效评定

目的通过观察治疗前后患者血清神经元特异性烯醇化酶(NSE)和S-100β的变化,探讨丁苯酞联合依达拉奉治疗急性脑梗死的作用机制,从而评价其临床疗效。方法将114例急性脑梗死患者随机分为依达拉奉组、丁苯酞组和联合用药组,每组各38例,分别于治疗前、治疗后7 d及14 d测定其血清NSE和S-100β浓度,并进行临床神经功能缺损程度评分,并比较3组临床疗效。结果治疗后,3组均可降低急性脑梗死患者血清NSE和S-100β浓度,有效降低神经功能缺损评分,联合用药组效果更显著(P0.05)。结论依达拉奉联合丁苯酞治疗急性脑梗死可明显降低患者血清NSE和S-100β浓度,有效降低神经功能缺损评分,促进神经功能的恢复,改善患者预后。     

丁苯酞联合依达拉奉对急性脑梗死患者血清SOD、MDA的影响

目的探讨丁苯酞胶囊及依达拉奉注射液治疗急性脑梗死的作用机制。方法将80例急性脑梗死患者随机分为丁苯酞组和实验组,各40例,分别于发病后1 d、7 d及14 d测定其血清超氧化物歧化酶(SOD)、丙二醛(MDA)的浓度,并于入院1 d和14 d进行临床神经功能缺损程度评分与日常生活活动能力量表评分。结果治疗后,两组均可降低急性脑梗死患者血清MDA浓度、升高SOD活力,有效降低神经功能缺损评分,丁苯酞联合依达拉奉效果更显著(P<0.05);结论丁苯酞联合依达拉奉治疗急性脑梗死可明显降低患者血清MDA浓度、升高其SOD活力,有效降低神经功能缺损评分,两者有协同治疗效果。     

依达拉奉联合丁苯酞对急性脑梗死患者的影响研究

目的探讨依达拉奉联合丁苯酞对急性脑梗死患者的影响。方法选取2016年3月—2017年8月沧州市盐山县人民医院收治的急性脑梗死患者106例,采用随机数字表法分为对照组52例和观察组54例。在常规治疗基础上,对照组患者给予依达拉奉治疗,观察组患者给予依达拉奉联合丁苯酞治疗;两组患者均连续治疗14 d。比较两组患者治疗前后血清基质金属蛋白酶9(MMP-9)、内皮素1(ET-1)、血管内皮细胞生长因子(VEGF)水平,治疗前、治疗结束时、随访3个月美国国立卫生研究院卒中量表(NIHSS)评分、功能独立性量表(FIM)评分,并观察两组患者治疗期间不良反应发生情况。结果治疗前两组患者血清MMP-9、ET-1、VEGF水平比较,差异无统计学意义(P0.05);治疗后观察组患者血清MMP-9、ET-1水平低于对照组,血清VEGF水平高于对照组(P0.05)。治疗前两组患者NIHSS评分、FIM评分比较,差异无统计学意义(P0.05);治疗结束时、随访3个月观察组患者NIHSS评分低于对照组,FIM评分高于对照组(P0.05)。两组患者治疗期间不良反应发生率比较,差异无统计学意义(P0.05)。结论依达拉奉联合丁苯酞可有效降低急性脑梗死患者血清MMP-9、ET-1水平,升高血清VEGF水平,改善神经功能及日常生活活动能力,且安全性较高。     

依达拉奉联合丁苯酞治疗急性脑梗死的疗效观察

目的观察依达拉奉联合丁苯酞治疗急性脑梗死的疗效。方法将72例急性脑梗死患者随机分为治疗组和对照组,每组各36例。治疗组常规治疗基础上应用依达拉奉联合丁苯酞治疗。对照组给予阿司匹林、丹参、胞二磷胆碱等治疗,治疗前后分别对疗效、神经功能缺损评分进行检测。结果两组评分总有效率比较差异有统计学意义（P〈0.01）;治疗组神经功能缺损评分第3、7、21、28天均优于对照组（P〈0.01）。结论依达拉奉联合丁苯肽治疗急性脑梗死疗效肯定,能有效改善神经功能缺失。     

丁苯酞治疗糖尿病合并急性脑梗死的效果分析

目的探讨丁苯酞治疗糖尿病合并急性脑梗死的效果。方法收集2017年12月—2018年12月间该科收治的84例糖尿病合并急性脑梗死患者,随机分为两组,每组42例,对照组给予依达拉奉,观察组在对照组的基础上给予丁苯酞。结果观察组治疗有效率92.9%,显著优于对照组81.0%(P0.05);观察组FPG、2 h PG、NIHSS评分显著低于对照组(P0.05),ADL评分显著高于对照组(P0.05)。结论糖尿病合并急性脑梗死采用丁苯酞治疗,可有效控制血糖,促进神经功能恢复,改善预后。     

丁苯酞软胶囊联合依达拉奉治疗脑梗塞的临床研究

目的探讨丁苯酞软胶囊联合依达拉奉治疗脑梗塞的疗效。方法选取我院收治的脑梗塞患者60例,用丁苯酞软胶囊联合依达拉奉治疗,以探讨其疗效。结果治疗后对照组患者NIHSS(美国国立卫生院神经功能缺损评分)为(14.4±2.6)分,高于研究组的(8.2±1.7)分,差异有统计学意义(P0.05)。两组患者治疗后NIHSS评分均有下降,差异有统计学意义(P0.05),研究组患者治疗后下降幅度明显较对照组大。两组患者不良反应发生情况差异无统计学意义(P0.05)。结论丁苯酞软胶囊联合依达拉奉治疗脑梗塞结合了两药各自的优势,配合互补,从保护脑细胞、改善脑组织供血、清除自由基等多个方面改善了患者病情,取得较为理想的疗效,可在临床推广。     

依达拉奉联合奥扎格雷对急性脑梗死患者脑血流指标及颈动脉粥样斑块的影响

目的探讨依达拉奉联合奥扎格雷对急性脑梗死患者脑血流指标以及颈动脉粥样斑块的影响。方法急性脑梗死患者120例,根据随机数字表分为对照组和观察组各60例。对照组给予疏血通,依达拉奉、瑞舒伐他汀钙、阿司匹林进行治疗,观察组在对照组基础上给予奥扎格雷进行治疗。评估两组临床疗效、神经功能缺损、日常生活能力、脑血流指标以及颈动脉粥样斑块等指标。结果观察组总有效率显著高于对照组(χ2=8.010,P<0.05)。治疗后,观察组美国国立卫生研究院卒中量表(NIHSS)评分显著低于对照组,日常生活能力量表指数(BI)显著高于对照组(均P<0.05)。治疗后观察组收缩期血流速度(Vs)、平均血流速度(Vm)显著高于对照组,阻力指数(RI)和脉动指数(PI)均显著低于对照组(均P<0.05)。治疗后观察组颈动脉内膜中层厚度和斑块面积均显著低于对照组(P<0.05)。结论依达拉奉和奥扎格雷联合应用能够恢复脑组织血液循环,减小颈动脉粥样斑块,显著提高临床对急性脑梗死的治疗效果,具有较高的临床应用价值。     

A patient with rectal ulcer with severe stenosis presenting with perforated peritonitis

We report a patient with rectal ulcer with severe stenosis, who underwent urgent surgical treatment for perforated peritonitis. The 54-year-old man suddenly developed cramping abdominal pain and fever while hospitalized, with signs of peritoneal irritation. An emergency laparotomy was performed, and severe stenosis of the rectum and a perforated lesion on the oral side approximately 10 cm distant from the stenosis were found, with massive abdominal purulent fluid. He was treated by rectosigmoid colon resection with transverse colon loop colostomy. Histopathologically, the stenosis was caused by ulceration extending to all muscular layers of the rectum, with inflammatory changes. Benign rectal stenosis is so rare that differential diagnosis from malignancy may be difficult when there are inflammatory changes in the surrounding tissues. However, it is necessary to keep in mind the likelihood of this disease in differentiation from rectal cancer. Received: December 21, 1998 / Accepted: May 28, 1999     

Evaluation of atrial vulnerability with transoesophageal stimulation in patients with atrioventricular junctional: Comparison with patients with ventricular pre-excitation and with normal subjects

The aim of our work was to evaluate the inducibility of atrialfibrillation in a group of patients with atrioventricular junctionalreentrant tachycardia and to compare it with that of patientswith a Kent-type ventricular pre-excitation (Wolff-Parkinson-Whitesyndrome) and a control group. One hundred and twenty-five subjects were separated into groups.Group 1 comprised 49 Wolff-Parkinson-White patients, with amean age of 26.4, range 10.66 years; group 2, 51 patients withatrioventricular junctional reentrant tachycardia inducibleby transoesophageal atrial stimulation andlor clinically documented,with a mean age of 43.4, range 16–78 years; group 3, 25control subjects with a mean age of2.64, range 13–76 years. Each subject underwent atrial transoesophageal stimulation withthe following protocol: programmed atrial stimulation with 1and 2 stimuli during atrial pacing of 100. min^–1 and 150.min^–1; atrial stimulation for 10 s at a rate of 200–300–400–500–600.min^–1 with intervals of 10 s between stimulations, fivesuccessive ‘ramp-up’ atrial stimulations for 9 swith the rate increasing from 100 to 800. min^–1 with intervalsof 10 s between stimulations. The end point was the completionof the protocol or induction of sustained atrial fibrillation(>1 min). The chi-square test was used for statistical analysis. Our resultsshowed that in group 1 atrial fibrillation was induced in 27149patients (55.1%); this was sustained in 13149 (26.5%) and non-sustainedin 14149 (28.5%); in group 2, atrial fibrillation was inducedin 22151 patients (43.0%); it was sustained in 7151 (13.7%)and non-sustained in 15151 (29.4%); in group 3, sustained atrialfibrillation was not induced in any subject and in only onesubject was a non-sustained atrial fibrillation (4 s) induced. The chi-square test showed that group 2 vs group 1 were non-significant,while group 2 vs group 3 and group 1 vs group 3 were significant(P<0.003 and P<0.0007, respectively). Therefore group 2 patients showed a greater atrial vulnerabilityin comparison to the control subjects and a similar vulnerabilityto group 1 patients. It is possible that the greater atrialvulnerability in the patients of group 2 was due to the doublenodal pathway.     

肿瘤病人弓形虫感染分析

在肿瘤的发生和发展进程中 ,多伴有免疫功能低下或缺陷 ,从而极易遭受各种感染。弓形虫是机会感染因子 ,当患者免疫功能受损时 ,易于感染 ,还会使隐性感染激活 ,引起低热不退、淋巴结肿和脑神经系统的反应 ,此现象尚未引起临床医师的重视。近年来 ,我们对 4 0 9例肿瘤病人进行了弓形虫感染及弓形虫病的分析观察 ,报告如下 :1　材料与方法1 1　材料　 30 4例病人血清取自江西省肿瘤医院住院或门诊病人 ,随机抽样后低温保存待检 ,10 5例取自其他医院送检样品 ,有急性症状者随到随检 ,以便及时做病原学检测。1 2　弓形虫病诊断方法1 2 1　免疫…     

Infection with Rhodococcus equi in a patient with sarcoidosis treated with corticosteroids

A 51-year-old female farmer was diagnosed as having sarcoidosis. During 4 years of observation, slow radiological progression was observed. Cough then developed, necessitating treatment with corticosteroids. After 28 months of continuous treatment with prednisolone in low doses (5-7.5 mg daily), she suffered fever episodes, recurrent haemoptyses, general malaise and loss of weight. A chest roentgenogram showed a left upper lobe infiltrate, which progressed and finally cavitated, and rib destruction. Despite efforts, including a thoracotomy, 22 months passed before a diagnosis could be made. Blood and sputum cultures and cultures from the destroyed rib showed growth of Rhodococcus equi, a common soil organism which can cause infections in foals and other animals. Treatment with rifampicin and erythromycin was successful. R. equi has been reported to cause infection in patients with neoplastic disease and/or immunosuppression, but the disease might be more common than is suggested by the sparse case reports in the literature, owing to lack of familiarity with the organism, which will tend to be overlooked as a contaminant.     

Treating patients with lupus with B-cell depletion

A new era in the treatment of systemic lupus erythematosus has dawned with the increasing introduction of monoclonal antibodies and other approaches, that target the key molecules involved in the pathogenesis of the disease. At present the ability to block the CD20 molecule on those B cells that carry this marker has proved the most effective way to treat patients resistant to conventional immunosuppressive drugs. However, these studies have all been open label and the results of double blind controlled studies are eagerly awaited.