熊去氧胆酸对肝移植术后受肝者肝功能异常的治疗作用

熊去氧胆酸(UDCA)在肝移植后主要拮抗疏水性胆汁酸的细胞毒性,但其对肝移植患者的保护作用尚存争议[1].本研究观察了华西医院127例肝移植术后患者使用UDCA的临床资料,现报道如下.一、资料与方法1.研究对象:收集我院2002年1月-2009年3月712例肝移植患者.术后平均随访35个月,随访方案采用移植术后3月内每半月随访1次,术后3～6个月患者每月随访1次,术后6～ 12个月患者每2个月随访1次,术后1年以上患者每3个月随访1次.符合本实验入组条件者127例(1例患者因不良反应退出研究).     

慢性心力衰竭患者出院后第1、3个月时自我护理的行为状况调查

目的旨在探讨慢性心力衰竭患者出院后第1、3个月时自我护理的行为状况,以期能为临床干预提供科学参考。方法选取100例住院的慢性心力衰竭患者,在出院时进行一般资料调查问卷调查,出院后1个月、3个月时行慢性心力衰竭自我护理行为量表调查,分析结果。结果一般资料调查问卷及出院后1个月、3个月时心力衰竭自我护理行为量表问卷均完整者共84例,占调查患者的84.00%,资料完整患者出院后1个月时评分为79.21±13.66分高于出院后3个月时评分为67.94±15.70分（P〈0.05）,出院后3个月时3个最低得分条目平均得分1.13±1.21分低于出院后1个月时1.69±1.20分（P〈0.05）。结论慢性心力衰竭患者自我护理行为随着出院时间呈现下降趋势,对出院后患者应针对性的加强自我护理行为指导及管理。     

择期经皮冠状动脉介入治疗急性心肌梗死伴心功能Killip Ⅱ～Ⅲ级患者的预后评价

目的 :探讨急性心肌梗死伴心功能KillipⅡ～Ⅲ级患者 3 0天内行经皮冠状动脉介入治疗 (PCI)对预后的影响。方法 :168例急性心肌梗死患者根据心功能Killip分级分为心功能KillipⅠ级组 91例 ,其中接受PCI治疗 3 8例 ;心功能KillipⅡ～Ⅲ级组 77例 ,其中接受PCI治疗 44例。分别比较第 1个月、第 2～ 12个月患者死亡率。结果 :在心功能KillipⅡ～Ⅲ级组中 ,接受PCI治疗患者第 1个月、第 2～ 12个月死亡率较非PCI治疗患者明显下降 ( 6 8%vs.18 2 %、9 1%vs.12 1% ) ,均有显著性差异 (P <0 0 5～ 0 0 1)。心功能KillipⅠ级组中 ,接受PCI治疗患者第 1个月死亡率较非PCI治疗患者下降 ( 2 6%vs .5 7% ) ,有显著性差异 (P <0 0 5 ) ,但第 2～ 12个月死亡率较非PCI治疗患者无显著差别。结论 :急性心肌梗死伴心功能KillipⅡ～Ⅲ级患者 1个月内行PCI治疗能减少死亡率 ,改善预后     

急性早幼粒细胞白血病缓解4年后继发急性淋巴细胞白血病1例

患者,男,14岁,因反复鼻出血1个月加剧2周,于2004年3月1日入院。患者入院前1个月无明显诱因出现反复鼻腔出血,出血量少可缓慢自     

灯银脑通胶囊联合井穴放血疗法治疗丘脑梗死所致肢体麻木的临床疗效及其对患者血清同型半胱氨酸和胰岛素样生长因子Ⅱ水平的影响

目的 分析灯银脑通胶囊联合井穴放血疗法治疗丘脑梗死所致肢体麻木的临床疗效及其对患者血清同型半胱氨酸（Hcy）、胰岛素样生长因子（IGF）Ⅱ水平的影响。方法 选取2019年4月至2021年1月石家庄市中医院脑病一科门诊接收的丘脑梗死患者80例为研究对象。采用随机数字表法将患者分为治疗组和对照组,各40例。对照组采用井穴放血疗法治疗,治疗组采用灯银脑通胶囊联合井穴放血疗法治疗。比较两组患者治疗前、治疗1个疗程后、治疗2个疗程后感觉障碍评定积分表评分,临床疗效,治疗前、治疗1个疗程后、治疗2个疗程后血清Hcy、IGFⅡ水平。结果治疗组患者治疗1、2个疗程后感觉障碍评定积分表评分低于对照组（P<0.05）;对照组、治疗组患者治疗1、2个疗程后感觉障碍评定积分表评分分别低于本组治疗前,治疗2个疗程后感觉障碍评定积分表评分分别低于本组治疗1个疗程后（P<0.05）。治疗组患者临床疗效优于对照组（P<0.05）。治疗组患者治疗1、2个疗程后血清Hcy水平低于对照组,治疗1个疗程后IGFⅡ水平低于对照组（P<0.05）;对照组、治疗组患者治疗1、2个疗程后血清Hcy、IGFⅡ水...     

口腔矫治器对阻塞性睡眠呼吸暂停综合征并高血压患者血压的影响分析

目的 分析口腔矫治器（oralappliance,OA）对阻塞性睡眠呼吸暂停综合征（obstructive sleep apnea syndrome,OSAS）并高血压患者血压的影响。方法 文中将我院收治的90例OSAS合并高血压患者均提供OA治疗,针对患者治疗后前、治疗后1个月、3个月AHI、LAaO2、ODI、SBP、DBP进行观察与对比。结果 治疗后1个月、3个月患者AHI、ODI、LaSO2治疗前对比具有统计学意义（P<0.05）,LaSO2升高,而AHI、ODI则降低,且以治疗后3个月低于治疗后1个月;治疗前患者间SBP、DBP对比无统计学意义（P>0.05）,治疗后1个月、3个月均降低,并以治疗后3个月低于治疗前、治疗后1个月,经对比具有统计学意义（P<0.05）。结论 针对OSAS合并高血压患者提供OA治疗具有满意疗效,能有效改善患者血压。     

川芎清脑颗粒治疗慢性脑缺血伴头痛的疗效研究

目的 比较川芎清脑颗粒治疗慢性脑缺血伴头痛的疗效。方法 选择2017年1月1日至2019年12月31日哈尔滨医科大学附属第二医院等5家医院诊治的慢性脑缺血伴头痛患者224例作为研究对象。采用随机数字分组法将患者分成对照组和试验组（各112例）。两组患者均接受基础治疗,包括控制血压和对症等治疗,均给予阿司匹林口服100 mg,1次/d。对照组患者使用吡拉西坦治疗,口服0.8 mg,1次/d,连续治疗2个月。试验组患者口服川芎清脑颗粒治疗,10 g/次,3次/d,连续治疗2个月。在治疗前后比较两组患者疼痛情况、认知功能、头痛频次、临床疗效。结果 治疗前两组患者VAS评分差异比较无统计学意义（P>0.05）。在治疗1个月和2个月后试验组患者VAS评分（2.51±0.12,1.87±0.17）均低于对照组（P<0.05）。治疗前两组患者MoCA评分差异比较无统计学意义（P>0.05）。在治疗1个月和2个月后试验组患者MoCA评分（24.69±4.65,28.65±4.15）均高于对照组（P<0.05）。在治疗1个月和2个月后试验组患者头痛频次（1.69±0.41,0.6...     

动态血压与射血分数保留型心衰患者短期预后的关系分析

目的分析动态血压与射血分数保留型心力衰竭(HFp EF)患者短期预后的关系。方法选取2015年1月至2016年12月在我院内科住院治疗的HFp EF患者60例进行规范治疗。随访1年,根据1年内是否因心衰再入院治疗的情况,将再入院治疗患者设为观察组,未再入院治疗的患者设为对照组,比较两组患者入院时,出院1个月、3个月、9个月的24小时动态血压以及血压昼夜节律的差异。结果 60例患者失访9例,死亡6例。再入院治疗患者(观察组) 29例,未再入院治疗患者(对照组)患者16例。观察组患者出院后1个月、3个月、9个月白昼平均收缩压及舒张压均显著低于对照组,出院后1个月、3个月的24小时平均收缩压和舒张压均也显著低于对照组,差异有统计学意义(P 0. 05)。观察组患者出院后1个月、3个月血压昼夜节律异常(非勺型血压)率显著高于对照组,差异有统计学意义(P 0. 05)。结论血压降低和血压昼夜节律减弱(消失)与射血分数保留型心衰患者预后不良密切相关。     

儿童寄生虫感染所致急性心包炎2例报道

1病例资料例1：患者男性,10岁,因“反复低热、咳嗽、气促、腹痛1个月”于2012—06—25入住广东省人民医院。1个月前患者因上述症状于外院就诊,诊断为肺部感染,予以抗感染治疗后患者病情反复转入我院。入院体检：体温36．5℃     

5-氟尿嘧啶节律性化疗对晚期胃癌患者的临床疗效观察

目的观察5-氟尿嘧啶节律性化疗对晚期胃癌患者的临床疗效。方法选择我院24例晚期胃癌患者,使用5-氟尿嘧啶500 mg静脉持续泵入12 h d1-21,4周1个疗程,3～9个疗程后,对接受至少3个疗程的患者进行疗效评价。结果 24例患者随访8～24个月,3例部分缓解(12.5%),9例病情稳定(37.5%),无1例患者完全缓解,12例患者病情进展(50.0%),疾病控制率为50.0%。治疗有效患者的中位疾病进展时间(TTP)为3.2个月。结论 5-氟尿嘧啶节律性化疗可以有效控制老年晚期胃癌患者的病情进展,不良反应少且轻。     

Options for screening for colorectal cancer

Unlike other types of cancer, there are several options for screening for colorectal cancer (CRC). The most extensively examined method, faecal occult blood testing (FOBT), has been shown, in three large randomized trials, to reduce mortality from CRC by up to 20% if offered biennally and possibly more if offered every year. Recently published data from the US trial suggest that CRC incidence rates are also reduced by up to 20%, but only after 18 years. In this study, the number of positive slides was associated with the positive predictive value both for CRC and adenomas larger than 1 cm, suggesting that the reduction in CRC incidence was caused by the identification and removal of large adenomas. In this respect, this study supports the concept that removing adenomas prevents CRC. More efficient methods of detecting adenomas include the use of colonoscopy or flexible sigmoidoscopy (FS). Considerable evidence exists from case-control and uncontrolled cohort studies to suggest that endoscopic screening by sigmoidoscopy reduces incidence of distal colorectal cancer. However, in the absence of evidence from a randomized trial, several countries have been reluctant to introduce endoscopic screening. Three trialsare currently in progress (in the UK, Italy and the US) to address this issue. Two of these trials are examining the hypothesis that a single FS screen at around age 55-64 might be a cost-effective and acceptable method for reducing CRC incidence rates. Recruitment and screening are now complete in both studies and the first analysis of results on incidence rates is expected in 2004. Colonoscopy screening at 10-year intervals has recently been endorsed in the US on the basis that the reductions in incidence observed with distal CRC screening can be extrapolated to the proximal colon. However, data are lacking and a pilot study for a trial of the acceptability and efficacy of colonoscopy screening is in progress in the US. It has also been suggested that FOBT testing should be used to detect proximal CRC missed by sigmoidoscopy screening, but the small amount of published data suggest that supplementing FS with FOBT offers very little advantage over FS alone. Other forms of CRC screening are under investigation and represent exciting options for the future. Extraction of DNA from stool is now feasible and a number of research groups have shown high sensitivity for CRC using a panel of DNA markers including mutations in k-ras, APC, p53 and BAT26. Data so far indicate that, with the exception of k-ras, these markers are highly specific and therefore represent a significant improvement over FOBT. Whether these tests will replace or supplement existing methods of screening has yet to be determined. It has been suggested that BAT26, which is a marker of microsatellite instability, a feature of proximal sporadic CRC, might be a useful adjunct to sigmoidoscopy screening. Others have suggested that a test for occult blood should be included with the DNA markers to further increase sensitivity. It is not yet known how sensitive these markers are for adenomas--it is only by detecting adenomas that CRC incidence rates can be reduced. A final exciting new option for screening is virtual colonoscopy (VC), which by screening out people without neoplasia allows colonoscopy to be reserved for patients requiring a therapeutic intervention. The sensitivity of VC for large adenomas and CRC appears to be high, although results vary by centre and there is a steep learning curve. Sensitivity for small adenomas is low, but perhaps it is less essential to find such lesions. Some groups have suggested that virtual colonoscopy might be a useful option for investigating patients who test positive with stool-based screening tests. Whichever CRC screening method is finally chosen (and there is no reason why several methods should not ultimately be available), high quality endoscopy resources will always be required to investigate and treat neoplastic lesions detected.