戊酸雌二醇联合醋酸甲羟孕酮治疗围绝经期功血患者的疗效分析

目的探讨戊酸雌二醇联合醋酸甲羟孕酮治疗围绝经期功血的疗效。方法选取2016年2月～2018年9月我院收治的围绝经期功血患者131例,按随机数字表法分观察组66例和对照组65例。对照组予以醋酸甲羟孕酮治疗,观察组予以戊酸雌二醇联合醋酸甲羟孕酮治疗。比较两组临床疗效、不良反应情况,比较两组治疗前后经量、月经期天数,比较两组治疗前后血清雌二醇(E_2)、孕激素(P)水平。结果两组总有效率均达100%,且观察组治愈率为75.76%,高于对照组的56.92%,差异有统计学意义(P0.05);治疗后两组经量、月经期天数、血清E_2、P水平较治疗前均显著改善,且观察组经量少于对照组,月经期天数短于对照组,血清E_2、P水平低于对照组,差异均有统计学意义(P0.05);观察组不良反应发生率为3.03%,与对照组的1.54%比较,差异无统计学意义(P0.05)。结论戊酸雌二醇联合醋酸甲羟孕酮疗效显著,能有效调节围绝经期功血患者内分泌,改善月经状态,且不增加不良反应。     

突发性耳聋与血液流变学和甲襞微循环改变的关系

选取突发性耳聋患者50例作为观察组,同期选取50例无突发性耳聋症状的正常者为对照组。对观察组和对照组进行血浆黏度、血小板聚集率、纤维蛋白原、红细胞压积、全血黏度及甲襞微循环的检测,对比结果检测。结果观察组血浆黏度、血小板聚集率、纤维蛋白原、红细胞压积、全血黏度及甲襞微循环的检测值明显高于对照组,其差异存在着统计学意义(P<0.05)。血液流变学和甲襞微循环的变化情况与突发性耳聋的发生有着一定的关系。     

全髋关节置换术患者围术期血液流变学及甲襞微循环指标的变化

目的观察全髋关节置换术患者围术期血液流变学及甲襞微循环指标的变化情况,为促进患者术后康复提供依据。方法选取2012年6月至2014年7月进行全髋关节置换术治疗的41例患者为观察组,选择同期41名健康同龄者为对照组,对观察组术前和术后1、3、7、10、14 d的血液流变学及甲襞微循环指标进行检测,并与对照组进行比较。结果观察组术前和术后1、3、7 d的血黏度及其他血流变指标均高于对照组(P均<0.05),同时观察组术前和术后1、3、7、10、14 d的甲襞微循环指标均高于对照组,观察组术后1、3 d的检测水平均高于同组其他时间段(P均<0.05)。结论全髋关节置换术患者围术期血液流变学及甲襞微循环指标的变化较大,尤其应重视其术后短时间(3 d)内的血液流变学及甲襞微循环的改善。     

不同术后镇痛方式对老年下肢骨折患者感染发生率及足甲襞微循环的影响比较

目的:研究不同术后镇痛方式对老年下肢骨折患者感染发生率及足甲襞微循环的影响,为降低感染率提供依据。方法:选取2014年12月-2015年12月医院诊治的100例老年下肢骨折患者资料进行分析,将患者根据随机数字方法分为两组,每组50例。对照组采用静脉自控镇痛,实验组采用硬膜外自控镇痛,比较不同术后镇痛方式对老年下肢骨折患者感染发生率及足甲襞微循环的影响。结果:试验组患者术后发热、咳嗽咳痰、血白细胞15×109/L、炎症、以及术后感染率,显著低于对照组(P0.05);两组患者术后1h以及术后48h VAS评分差异不具有统计学意义;试验组术后4h、术后8h以及术后12h VAS评分,显著低于对照组(P0.05);两组患者手术前足甲襞微循环中流态积分、管襻积分、襻周状态积分以及综合积分差异不具有统计学意义(P0.05);试验组手术后足甲襞微循环中流态积分、管襻积分、襻周状态积分,显著低于对照组(P0.05);两组患者术后足甲襞微循环综合积分差异不具有统计学意义(P0.05)。结论:老年下肢骨折患者手术后采用硬膜外自控镇痛效果理想,能降低术后感染发生率,改善足甲襞微循环,值得推广应用。     

系统性硬化病甲襞微循环改变的特点分析

目的评估系统性硬化病(SSc)患者甲襞微循环改变的特点。方法选取2011年11月至2015年2月在山西大医院风湿科就诊的有雷诺现象的患者102例,其中SSc患者51例,其他风湿性疾病患者51例,所有患者均行甲襞微循环检查。结果与其他风湿性疾病患者相比,SSc患者甲襞微循环管袢数减少,输入支管径、输出支管径、袢顶直径均增宽,畸形管袢数、渗出增多,乳头以浅波纹状和平坦为主,差异均具有统计学意义(均P<0.05)。SSc相关肺动脉高压患者甲襞微循环管袢数目少,乳头以浅波纹状或平坦多见,差异均具有统计学意义(均P<0.05)。SSc甲襞微循环管袢数、输入支管径和渗出与修订的Rodnan皮肤评分方法(m RSS)评分相关(r=0.360,P=0.021;r=0.338,P=0.030;r=0.340,P=0.030)。SSc合并指端溃疡患者甲襞微循环改变与无指端溃疡患者比较差异无统计学意义(P>0.05);有、无肺间质病变的SSc患者比较,甲襞微循环改变差异无统计学意义(P>0.05)。结论 SSc患者甲襞微循环有特征性改变,有利于疾病的诊断、鉴别诊断和病情评估。     

戊酸雌二醇联合甲羟孕酮对围绝经期综合征患者骨密度的影响

目的探讨戊酸雌二醇联合甲羟孕酮对围绝经期综合征患者骨密度的影响。方法选择2017年8月至2018年6月80例围绝经期综合征患者作为研究对象,依据治疗方案分为对照组与研究组,每组40例。对照组口服甲羟孕酮片,观察组在对照组基础上联合使用戊酸雌二醇片,比较两组骨密度及激素水平。结果治疗前,两组第1～4腰椎(L1-4)骨密度、股骨颈骨密度比较,差异未见统计学意义(P0.05);治疗3个月,观察组L1-4骨密度、股骨颈骨密度均高于对照组,差异有统计学意义(P0.05);治疗前,比较两组雌二醇(E2)、黄体生成素(LH)和卵泡刺激素(FSH)水平,差异未见统计学意义(P0.05);治疗3个月,观察组FSH、LH水平均低于对照组,E2水平高于对照组,差异有统计学意义(P0.05)。结论围绝经期综合征采用戊酸雌二醇联合甲羟孕酮治疗能够调节机体激素水平,增加骨密度。     

中药桔丙酯联合降糖治疗对2型糖尿病患者甲襞微循环及血液流变学的影响

目的观察中药桔丙酯注射液联合降糖治疗对2型糖尿病甲襞微循环及血液流变学的影响,探讨其治疗机制.方法于2005-10/2006-08选择河北北方学院附属校医院、张家口市第一人民医院门诊及住院收治的2型糖尿病患者48例,为治疗组.应用注射用桔丙酯治疗,桔丙酯180 mg,次,1次,d,连用2周;健康志愿者30例为对照组.采用微循环显微镜,于治疗前后常规检查左手第4指甲襞第一排管袢,按田牛加权积分法对16项指标综合定量分析,判断疗效和甲襞微循环的变化.同时观察2型糖尿病患者治疗前后血液流变学各项指标的变化.结果①治疗组治疗前甲襞微循环及血液流变学各项指标均表现为不同程度的异常,治疗后甲襞微循环及血液流变学各项指标明显改善.甲襞微循环由治疗前的中、重度异常恢复到大致正常,治疗后总积分值低于治疗前(分别为1.52±0.69,4.52±0.82,t=3.96,P＜0.05).②血液流变学指标变化表明,血浆黏度、全血黏度、纤维蛋白原及红细胞电泳等各指标经桔丙酯治疗后均明显降低(P＜0 05).结论中药桔丙酯联合降糖治疗能够明显改善2型糖尿病患者血流变异常及微循环障碍.     

丹奥治疗脑梗死甲襞微循环及血流变学研究

目的：分析急性脑梗死甲襞微循环和血流变学指标在治疗前后检查结果的变化。方法：脑梗死组治疗前及治疗后（二周）进行甲襞微循环和血流变学指标检查，同时设对照组进行检查；将87例脑梗死组治疗前检查结果与79例对照组检查结果进行比较。并将脑梗死组治疗前及治疗后检查结果进行比较。结果：脑梗死组治疗前检查结果与对照组检查结果比较均有显著差异（P＜0．05），脑梗死组前后检查结果比较均有显著差异（P＜0．05）。结论：甲襞微循环和血液流变学指标检查是指导治疗 脑梗死和观察疗效的可靠指标。     

中药棓丙酯联合降糖治疗对2型糖尿病患者甲襞微循环及血液流变学的影响

目的:观察中药棓丙酯注射液联合降糖治疗对2型糖尿病甲襞微循环及血液流变学的影响,探讨其治疗机制。方法:于2005-10/2006-08选择河北北方学院附属校医院、张家口市第一人民医院门诊及住院收治的2型糖尿病患者48例,为治疗组。应用注射用棓丙酯治疗,棓丙酯180mg/次,1次/d,连用2周;健康志愿者30例为对照组。采用微循环显微镜,于治疗前后常规检查左手第4指甲襞第一排管袢,按田牛加权积分法对16项指标综合定量分析,判断疗效和甲襞微循环的变化。同时观察2型糖尿病患者治疗前后血液流变学各项指标的变化。结果:①治疗组治疗前甲襞微循环及血液流变学各项指标均表现为不同程度的异常,治疗后甲襞微循环及血液流变学各项指标明显改善。甲襞微循环由治疗前的中、重度异常恢复到大致正常,治疗后总积分值低于治疗前(分别为1.52±0.69,4.52±0.82,t=3.96,P<0.05)。②血液流变学指标变化表明,血浆黏度、全血黏度、纤维蛋白原及红细胞电泳等各指标经棓丙酯治疗后均明显降低(P<0.05)。结论:中药棓丙酯联合降糖治疗能够明显改善2型糖尿病患者血流变异常及微循环障碍。     

康艾注射液对恶性肿瘤患者血液流变学及微循环的影响探究

目的探索康艾注射液对恶性肿瘤患者患者血液流变学及微循环的影响。方法从收治的恶性肿瘤患者中随机选出132例作为观察对象,随机分成观察组和对照组,对照组单纯给予化疗治疗;而观察组则给予化疗+康艾注射液治疗,对比分析两组的血液流变学指标及甲襞微循环状况。结果治疗前两组血液流变学和甲襞微循环各项指标差异均不大(P0.05);治疗后,观察组血液流变学和甲襞微循环各项指标值均比对照组低(P0.05)。结论对恶性肿瘤患者在化疗的基础上给予康艾注射液有助于降低血液黏稠度,改善微循环,控制病情进展,值得临床推广应用。     

Measurement of L-carnitine and acylcarnitines in body fluids and tissues in children and in adults

We have developed a reliable and validated radio-enzymatic method for the assay of L-carnitine and acylcarnitines, using a modification of existing methods. The sensitivity of the assay is 10 mumol/l using 10 microliters of plasma or urine. It is also suitable for measurements of carnitine in a 10 mg sample of liver or muscle obtained by percutaneous biopsy. The use of N-ethylmaleimide in the reaction mixture together with an excess of [1-14C]acetyl CoA ensures that the reaction proceeds to completion and a linear response is obtained. Using this method control ranges have been established for plasma and urine carnitine concentrations in healthy children and adults, and for the carnitine content of liver and muscle in adults. No significant difference was found between fasting and post-prandial plasma carnitine levels. An age-related increase was found in urinary total carnitine and acylcarnitine concentration throughout childhood. These data provide a reliable basis for studies of patients with abnormal carnitine and acylcarnitine metabolism, distribution and excretion.     

Activity of amikacin and ampicillin in succession and in combination

One strain each of Escherichia coli and Streptococcus faecalis were exposed to amikacin and ampicillin in combination as well as in succession. Exposure to ampicillin for 1 hr followed by amikacin for 3 or 4 hr had the greatest antibacterial activity when the antibiotics were applied in succession. The least effective exposures for both organisms were 1 hr to amikacin followed by 3 or 4 hr to ampicillin. Exposure to the antibiotics in combination each at 1 MIC had the overall greatest antibacterial activity. Simultaneous exposure to the antibiotic combination does not necessarily mean simultaneous activity of both ampicillin and amikacin on the E. coli. The cell wall autolytic activities produced by ampicillin are triggered within 10 min after physical contact with the bacteria. In contrast, amikacin requires at least 30 min after physical contact to manifest its activity on the ribosome. Although physical exposure to both antibiotics in the combination is simultaneous, the specific activity of each is in fact sequential, with ampicillin acting first. This explains the synergistic effect of the combination. It appears, therefore, that the synergistic or antagonistic affect of a drug combination is determined by the sequence and timing of the antibacterial manifestations of its components.     

纤维支气管镜在儿童咯血诊断与治疗中的应用

目的 评价纤维支气管镜术在儿童咯血病因诊断及治疗中的价值以及安全性.方法 应用用日本产Olympus BF 3c-40纤维支气管镜(最小外径3.6 mm)给58名咯血原因不明的患者行纤维支气管镜检查,并予镜下局部止血治疗.判断出血部位、观察病变情况和出血的原因、临床表现、其他辅助检查、治疗及转归等进行综合分析.结果 引起咯血的主要疾病为气管支气管、肺部的炎症24例(41.3%)、支气管内膜结核12例(20.7%)、支气管异物8例(13.7%)、特发性肺含铁血黄素沉着症7例(12.1%)、支气管扩张4例(6.9%)、心肺血管发育异常1例,原因不明2例.诊断阳性率为96.5%.镜下发现有活动性出血18例,镜下局部止血治疗后显效者10例,有效者8例,有效率为100%.术中并发短暂低氧血症(SaO2＜85%,＜20 s)15例,加大吸氧流量后均改善;术后发热3例均为低热,24 h后热退.结论 纤维支气管镜检查可明确出血部位及原因并可进行局部治疗,且安全的有效.     

Sites of in vivo extraction and interconversion of testosterone and androstenedione in dogs

The interconversion and extraction of testosterone and androstenedione across and within different tissues or areas have been studied by the constant infusion technique. The results were calculated using the (3)H/(14)C ratios and radioactive concentrations of testosterone and androstenedione obtained from afferent and efferent blood and tissues at equilibrium. In each tissue studied, the interconversion between testosterone and androstenedione inside the tissue was significantly higher than the corresponding interconversion across the tissue. The pulmonary contribution to the total interconversion between testosterone and androstenedione was far more important than that of any of the other tissues studied. The hepatic metabolic clearance rates of testosterone and androstenedione were not different from their metabolic clearance rates in the mesenteric area. The extraction of each of these compounds, although not negligible, was lower in the kidney and the femoral bed compared with the extraction in the liver and the mesenteric area. Finally, with the possible exception of the liver, testosterone and androstenedione were more completely metabolized when they originated from the cells than from afferent blood.The evaluation of these different tissue transfer constants provides more precise information concerning the relative importance of different sites in the metabolism of these interconverting hormones.     

Role of oxidants and antioxidants in atherosclerosis: results of in vitro and in vivo investigations

Both in vitro and in vivo studies have shown that oxidants are central in the development of atherosclerosis. Consequently, additional studies evaluated the protective effects of various natural and synthetic antioxidants, alone and in combination, with most studies focusing on alpha-tocopherol (vitamin E). Here, we summarize the role of oxidants in the pathomechanism of atherosclerosis. We also discuss epidemiological studies and others focused on the protective effect of vitamin E against atherosclerosis. Other antioxidants are also considered if they were included in studies involving vitamin E. The protective effect of antioxidants on atherosclerotic pathomechanisms has been confirmed in vitro, but only in some animal studies. Various epidemiological and observational studies have produced conflicting results on the protective effect of antioxidants. Most studies of primary or secondary prevention failed to show a protective effect. These conflicting results are biased by a number of factors, including differences between the study groups. Therefore, we describe these studies in detail.     

Pharmacokinetics and tolerance of flunitrazepam in neonates and in infants.

OBJECTIVE: To study the pharmacokinetics of flunitrazepam (used for sedation in neonates and infants), to determine the influence of both gestational and postnatal age on the pharmacokinetic parameters, and to analyze the relationship between the hemodynamic parameters and flunitrazepam plasma concentration. METHODS: Flunitrazepam was infused for 20 minutes as a single dose (0.2 mg x kg(-1)) and as multiple doses (0.1 mg x kg(-1)). Six to eight 1-mL blood samples were collected per patient. Flunitrazepam plasma concentration was measured by gas chromatography-mass spectrometry. RESULTS: Thirty-one patients (25 neonates and six infants) were included in the study. Only three of them received multiple doses. After the single dose (n = 28), half-life was 22.6 +/- 7.3 hours, clearance was 0.15 +/- 0.14 L x kg x h(-1), and volume of distribution was 4.6 +/- 4.1 L x kg(-1) (mean +/- SD). Plasma clearance and volume of distribution significantly increased with postnatal age (P < .05), but no pharmacokinetic parameter varied significantly with gestational age. Diastolic blood pressure significantly decreased with increasing flunitrazepam plasma concentrations (P < .05). CONCLUSION: Postnatal age but not gestational age influenced flunitrazepam pharmacokinetic parameters in neonates and infants. Diastolic blood pressure was inversely correlated to flunitrazepam plasma concentration.