高血压患者红细胞胞浆游离钙含量与血压的相关性

1　临床资料　高血压组 :选择未经降压治疗或停降压药 1个月以上者共 5 8例(男 40例 ,女 18例 ,平均年龄 5 2 3岁 )。其中Ⅰ期 2 3例 ,Ⅱ期 35例 ,均排除肝、肾功能异常及合并糖尿病或有糖尿病家族史。治疗组 :9例 ,男 6例 ,女 3例 ,年龄 38～46岁。服用氨氯地平与硝苯地平 2周以上。健康组 :血压正常的健康志愿者 38例 ,男 2 8例 ,女10例 ,年龄 19～ 6 8岁。无高血压和糖尿病家族史 ,体检正常。2　方　法　静脉采血 2ｍｌ,注入ＥＤＴＡ3Ｋ+ 。 10 0 0ｒ/ｍｉｎ ,离心 10ｍｉｎ,分离膜及血浆避免损失红细胞。用冷生理盐水洗 3次以上 ,每次1…     

黄芪注射液治疗冠心病疗效观察

1999年 9月～ 2 0 0 0年 9月 ,我院应用黄芪注射液治疗冠心病 50例 ,取得满意疗效 ,报道如下。1　对象和方法1 1　对象　 10 0例均符合ＷＨＯ冠心病诊断标准 ,随机分为 :黄芪组 50例 ,男 3 5例 ,女 15例 ,年龄 4 3～ 79岁 ,平均 55 8岁 ,病程 5个月～ 2 3年 ;复方丹参组 50例 ,男 3 6例 ,女 14例 ,年龄 4 0～ 76岁 ,平均年龄 55 4岁 ,病程 4个月～ 2 0年。1 2　治疗方法　黄芪注射液 (成都地奥九泓制药厂生产 ) 2 0ｍｌ,加入 5%葡萄糖液 2 50ｍｌ静脉点滴 (合并糖尿病的患者加入生理盐水 2 50ｍｌ) ,每日 1次 ,有心功能不全者 ,黄芪剂量增加…     

维生素B_6救治偏二甲基肼中毒的体会

本文旨在讨论维生素B_6(VB_6)救治偏二甲基肼(UDMH)急性中毒的临床疗效。本组UDMH急性中毒患者44例均为男性,18～30岁。轻度中毒33例,中度中毒3例,重度中毒5例,极重度中毒1例。按临床表现分型:(1)轻度中毒表现为恶心、流涎、胸闷、步态不稳;(2)中度中毒为躁动、肢体抽搐、阵发性全身痉挛发作,每次历时1～2min,发作2～4次,发作问期表情淡漠;(3)重度中毒为阵发性全身痉挛发作每次历时3～5min,发作5～7次,发作间期呈嗜睡或浅昏迷状态;(4)极重度中毒为突发强直性     

以下消化道出血为主要表现的遗传性出血性毛细血管扩张症一例

患者 女，40岁，因间断便血5个月加重6h入院。患者无明显诱因出现每日排暗红色血便4～5次，每次约50g．伴头晕、全身乏力，在外院曾行胃镜、肠镜等检查，均未发现异常。家族史：3代8人中有4例（父、姐及女儿）反复发作鼻出血或口腔出血。此次入院前6h症状加重，排暗红色血便6次，总量约500g。入院体检：贫血貌，全身皮肤未见出血点，舌部可见3枚米粒大小血管瘤样皮损，直径约3mm，色鲜红，表面光滑，     

自服僵蚕粉过敏1例

1　病例报告患者女 ,45岁 ,因偏头痛多年。于 1999年 11月 6日 11∶30自服僵蚕粉 6 ｇ ,1ｈ后出现心慌 ,剧烈呕吐 ,呕吐物为胃内容物。 2ｈ后门诊部就诊时 ,意识清楚 ,烦躁不安 ,面色苍白 ,全身颤抖 ,血压为 0 ,心率 90 /ｍｉｎ呼吸 2 4/ｍｉｎ ,脉搏未触及 ,呈休克状态。立即抗休克治疗 ,予肾上腺素 1ｍｇ皮下注射 ,地塞米松 10ｍｇ 生理盐水 5 0 0ｍｌ静点 ,并洗胃 1次。10ｍｉｎ后血压上升至 14/ 8ｋＰａ ,并出现全身抽搐。静注10 %葡萄糖酸钙 10ｍｌ后 ,四肢颤抖减轻。经急诊处理 4ｈ后病情稳定 ,生命体征基本恢复正常。于当日 18∶0 0…     

静滴头孢唑林钠致胃肠道反应3例

我科1998年10月～1999年9月使用不同批号的头孢唑林钠,出现恶心、呕吐等胃肠道反应,滴入药物浓度均在1ｍｇ/(ｋｇ·ｍｉｎ)以上,经减慢药物滴速后症状缓解或消失。1　病例报告例1　女,8岁。因慢性阑尾炎急性发作静滴头孢唑林钠,以3ｍｇ/(ｋｇ·ｍｉｎ)速度静滴,15ｍｉｎ后感恶心,呕吐出胃内容物。例2　女,77岁。因糖尿病合并右下肺炎静滴头孢唑林钠1ｍｇ/(ｋｇ·ｍｉｎ),20ｍｉｎ后出现恶心,呕吐出胃容物。例3　男,52岁。因脑梗死合并泌尿系感染静滴头孢唑林钠,2ｍｇ/(ｋｇ·ｍｉｎ),20ｍｉｎ后恶心、欲吐。3例均经减慢滴速后症状消失。2　…     

刺五加注射液治疗冠心病疗效观察

冠心病是常见病、多发病 ,西药治疗常有不良反应 ,故探寻不良反应少而有效的治疗药物是一项重要课题。 1 998年 2月～ 2 0 0 0年 1 0月 ,我们采用刺五加注射液治疗冠心病 ,取得较好效果 ,报告如下1　对象和方法1 1　对象　 2 85例随机分为剌五加注射液组 1 48例 ,男 86例 ,女 62例 ,年龄 48～ 89岁 ,平均 66 5岁 ,其中冠心病 76例 ,冠心病合并高心病 48例 ,冠心病合并糖尿病 2 4例 ,病程 1 8～ 2 6年 ,平均 1 6 9年 ;极化液组 1 3 7例 ,男 81例 ,女 5 6例 ,年龄 5 1～87岁 ,平均 66 1岁 ,其中冠心病 72例 ,冠心病合并高心病 42例 ,冠心病…     

罕见视觉性癫痫1例报告

1　临床资料　患者男 ,武警战士 ,19岁。反复发作口角抽搐 1周 ,再发 12ｈ于 1998年 5月 2 4日入院。患者 1周前开始出现发作性意识障碍伴左侧口角抽动、颈项向左侧歪斜、躁动、吼叫、双手乱抓 ,每次发作持续 3～ 5ｍｉｎ自动停止 ,发作后感头痛、头昏、嗜睡、不进食、不言语、不能回忆发作过程。无两眼上翻 ,口吐白沫、大小便失禁等。以“抽搐原因待查 ?”入院。查体 :Ｔ 36 5℃ ,Ｐ 80次 /ｍｉｎ ,Ｒ2 0次 /ｍｉｎ ,ＢＰ 15 / 11ｋＰａ。神志清楚 ,检查合作 ,问答切题 ,吐词流利。轻刺激口角向左歪斜伴头颈向左侧偏斜。同时躁动不安、吼…     

阵发性室上性心动过速155例消融治疗

目前 ,采用射频电流导管消融根治阵发性室上性心动过速 (PSVT)的经验已日臻成熟。但仍会遇到一些不典型或比较复杂的电生理现象 ,如不能及时正确的判断 ,会贻误手术操作时间 ,甚至直接影响手术成败。现将我们近年治疗 15 5例PSVT的初步经验报道如下。材料与方法一、临床资料15 5例患者 ,男 76例 ,女 79例 ,年龄为 13～ 76岁 ,平均 (14± 18)岁。心动过速病史 3个月～ 35年。11例合并冠心病 ,8例合并高血压病 ,3例合并心动过速性心肌病。体表心电图示A型预激 14例 ,B型预激 12例 ,各有 1例为间歇预激 ,其他均无预激表现。心动过速发作时 …     

耳穴按压治疗冠心病便秘

冠心病患者便秘时用力排便往往可诱发心绞痛发作 ,因此 ,治疗冠心病便秘有重要意义。我科以耳穴按压治疗冠心病便秘 4 7例 ,其中男 2 1例 ,女 2 6例 ;年龄 38～ 90岁 ,其中4 0～ 5 5岁 39例。大便 2～ 3d 1次 2 5例 ,4～ 5d 1次 1 7例 ,1周 1次 5例。具体方法为 :取耳穴直肠下段、大肠、便秘点、肺、内分沁等穴。找出与疾病有关敏感点 ,将王不留行用胶布固定穴上 ,早晚按压 1～ 2min ,3d换王不留行 1次 ,两耳交替进行。结果治愈 (大便 1～ 2次 /d) 2 4例 ,占 5 1 % ;显效 (大便间隔时间比原来缩短 ,不超过 1次 / 2d) 8例占 1 7% ;有效 (大便…     

Dealing with cancer--conversations with radiotherapy patients

Thirty in-patients treated by radiotherapy were questioned in qualitative interviews about the information they had received from the physicians and their way to deal with the disease and the physicians. Furthermore 18 persons out of this group were accompanied continuously. The confidential relationships between the patients and the author of the study brought about spontaneous conversations showing some new aspects of the way to experience disease and therapy. Despite a poor prognosis and an initially insufficient information, the patients formulated their questions openly. Generally they desired a clearer communication. They criticized above all the lack of information and attention from the physicians. A need for confidence, frankness, and the conveyance of a justified hope was expressed. The physician's stress and resulting lack of time was complained of. During the time of accompanying which lasted several weeks, it became evident that information means a way to deal with the disease to which the patient can make his individual contribution. The majority of questions as well as emotional reactions as fear or depression came from those patients who seemed to be quiet persons.     

Radiochemotherapy with temozolomide for patients with glioblastoma

Background

The objective of this retrospective analysis was to assess long-term outcome and prognostic factors of unselected patients treated for glioblastoma (GB) at a single center with surgery, standard radiotherapy (RT), and concomitant temozolomide (TMZ). From 1999?C2005, the institutional protocol included surgery and RT with TMZ. From 2005 on, adjuvant TMZ was routinely added.

Patients and Methods

Between April 1999 and September 2009, 181 patients with GB were treated with RT (60 Gy in 30 fractions) and concomitant TMZ (75 mg/m²/day throughout RT). Biopsy only had been performed in 53 patients (29.3%), 128 patients (70.7%) had undergone resection, which was complete based on postoperative MRI in 51 patients (28.2%). Adjuvant TMZ was applied in 67 of 181 patients (37%).

Results

Median overall survival (OS) and progression-free survival (PFS) were 15.0 (95% CI, 13.1?C16.8) and 7.2 months (95% CI, 5.9?C8.5), respectively. After complete resection, partial/subtotal resection and biopsy, median OS was 23.20, 14.75, and 7.89 months (p < 0.001), respectively. In multivariate Cox proportional hazards regression models, extent of resection (p < 0.0001), Karnofsky??s performance score (p < 0.0001) and adjuvant TMZ (p = 0.001) were significant independent prognostic factors for OS. RT with concomitant TMZ was well tolerated in the majority of patients and could be completed as scheduled in 146 patients (80.7%), while 11 patients (6.1%) discontinued RT. Another 35 patients (19.3%) interrupted concomitant chemotherapy.

Conclusion

RT with concomitant TMZ is a feasible regimen with acceptable toxicity in routine practice. Our data are compatible with a beneficial effect of adjuvant TMZ on OS and PFS.     

湿润烧伤膏与手术联合治疗褥疮的护理

目的 :减少溃疡期褥疮的术前准备时间 ,缩短褥疮的总病程。方法 :将 1996年 5月至 2 0 0 2年 5月收住院的 4 2例溃疡期褥疮病人按随机原则分为 2组 ,2 1例术前用湿润烧伤膏纱换药处理 ,为A组 (试验组 ) ;2 1例用庆大霉素紫草油纱布换药处理 ,为B组 (对照组 )。 2组病例的年龄、性别、发病原因、病灶部位、病灶范围等经统计学处理 ,无显著性差别 ,有可比性。两组病人均换药至创面新鲜行皮瓣转移手术 ;比较两组平均术前换药时间 ,及换药 +手术的总住院日。术前术后两组患者均运用护理程序施行整体护理。结果 :A组术前平均换药时间为 8 4 9± 2 2 3天 ,B组为 15 6 0± 6 70天 ;A组平均治愈时间为 2 0 5 0± 4 81天 ,B组为 35 31± 7 70天。结论 :湿润烧伤膏换药与庆大霉素紫草油纱布换药比较 ,前者可明显缩短褥疮手术的术前准备时间及病人的总住院天数。     

Bronchogenic carcinoma: staging with MR compared with staging with CT and surgery

Thirty-three patients suspected of having bronchogenic carcinoma were studied prospectively using magnetic resonance (MR). In this group, 30 underwent examination with computed tomography (CT), 15 underwent thoracotomy, six had mediastinal biopsy procedures performed, and eight underwent bronchoscopy. MR studies, which included transaxial spin-echo imaging (TR, 0.5 and 2.0 sec; TE, 28 and 56 msec) of all patients and sagittal or coronal imaging of 18, were performed without knowledge of CT findings, using only plain radiographs as a guide. CT and MR studies were interpreted separately. CT and MR provided comparable information regarding the presence and size of mediastinal lymph nodes. MR better discriminated mediastinal nodes from vascular structures. However, in two of 11 patients who had multiple mediastinal lymph nodes that were normal in size at CT examination and surgery, MR suggested a confluent abnormal mass, probably because of its poorer spatial resolution. MR was superior to CT in showing enlarged hilar lymph nodes, but CT was better for demonstrating bronchial abnormalities. In three of four patients who had a proved hilar mass with distal obstructive pneumonia, MR (TR, 2.0 sec) helped distinguish between the mass and collapsed lung.     

多虑平、雷尼替丁治疗消化性溃疡81例临床观察

1995年 1月～ 1 998年 2月 ,我们采用多虑平、雷尼替丁治疗消化性溃疡 (ＰＵ) ,并与雷尼替丁为对照组进行治疗观察 ,疗效满意 ,现总结报告如下。1　临床资料1 1　一般资料　本组 81例ＰＵ均因上腹痛、返酸、腹胀及食欲不振等症状 ,经胃镜诊断为溃疡活动期患者。病程 2个月～ 5ａ,平均 1 7ａ。伴有焦虑、抑郁及夜眠欠佳等症者59例。随机分为 2组 :治疗组 4 1例 ,男 3 8例 ,女 3例 ;年龄 1 8～ 3 6岁 ,平均 2 4岁。其中胃溃疡 1 1例 ,十二指肠球部溃疡 3 0例。对照组 4 0例 ,男 3 7例 ,女 3例 ;年龄 1 9～ 3 5岁 ,平均 2 4 5岁 ;胃溃疡 1 2…     

臭氧治疗船员下肢损伤89例

2006年10月至2007年4月,我科采用引进的德国赫尔曼Medozon型臭氧发生装置系统产生的臭氧治疗船员下肢损伤89例,疗效满意.现报告如下.     

Tumor Burden Assessment with Positron Emission Tomography with

Objective: In patients with advanced cancer, total tumor burden affects the likelihood of tumor response and has important implications for prognosis. The aim of this study was to select the optimum 2-[F-18]fluoro-2-deoxy-D-glucose-positron emission tomography (FDG PET) tumor uptake parameter to accurately measure tumor burden in advanced metastatic renal cell cancer, in comparison with volumes measured with computed tomography (CT), as a reference test.Materials and Methods: Six patients with metastatic renal cell carcinoma measurable on CT were studied. CT and FDG PET scans were carried out on all patients within 4 weeks prior to their entry into a phase I-II radioimmunotherapy trial. CT-based evaluation of disease extent (tumor volume) and 4 PET-based measurements (standardized uptake value[SUVmax], SUVav, volume, and total lesion glycolysis [TLG]) were performed independently by a radiologist (VN) and a nuclear medicine physician (TA). The degree of correlation between conventional (CT) extent of disease and parameters describing tumor concentration of FDG was then determined.Results: Fifty-seven CT-measurable metastatic lesions in lung, abdomen, and scalp were evaluated in 6 patients. There was a high correlation between CT and FDG PET volume estimates for lesions greater than 5 cm(3) in size. However, a PET-derived parameter that embodies both FDG uptake and lesion size, the TLG, correlated better with CT-derived tumor volume than did FDG PET volume alone.Conclusion: Using CT volume as a gold standard, the optimal PET-based estimate of total tumor burden in patients with metastatic renal cancer is the sum over all lesions of the total lesion glycolysis.     

MEBO药纱门诊治疗烧(烫)伤71例的体会

作者报道用MEBO药纱敷盖门诊治疗烧（烫）伤71例，均获治愈。经随访1年，深Ⅱ度创面疤痕发生率为15％（3／20），浅Ⅲ度创面疤痕发生率为38．9％（7／18）。