5-氨基酮戊酸光动力疗法对尖锐湿疣皮损HPV6/11型DNA载量的影响及疗效观察

目的 分析研究5-氨基酮戊酸光动力疗法对尖锐湿疣(CA)皮损HPV6/11型DNA载量及疗效的影响。方法 此次研究对象均为尖锐湿疣患者,共计58例,纳入患者起始时间是2017年03月,截止时间是2019年04月,以随机数字表法实施分组,分别是对照组29例(予其电离子手术治疗)和治疗组29例(予其5-氨基酮戊酸光动力疗法治疗),比较两组总体治疗效果、HPV6/11型DNA载量、复发情况。结果 治疗组在治疗三个月后,其HPV6/11型DNA载量下降幅度较之对照组明显更加突出,差异比较存在显著性(P＜0.05);在治疗总有效率的比较上,治疗组显著高于对照组,有统计学意义(P＜0.05);在复发率的比较上,治疗组显著低于对照组,有统计学意义(P＜0.05)。结论 在治疗尖锐湿疣期间应用5-氨基酮戊酸光动力疗法,可促使HPV病毒载量显著降低,保证治疗效果实现最优化,避免病情的反复发作,具有推广价值。     

5-氨基酮戊酸-光动力疗法治疗尖锐湿疣疗效分析

目的:分析5-氨基酮戊酸-光动力疗法治疗不同部位尖悦湿疣的临床疗效.方法:278例尖锐湿疣患者按照发病部位不同分为5组.A组疣体位于尿道口,B组疣体位于肛门及肛门周围.C组疣体位于大小阴唇、阴道口、阴道前庭.D组疣体位于龟头、冠状沟、包皮内侧及阴茎体,E组疣体分散于≥2个上述部位,5组患者均采用5-氨基酮戊酸-光动力疗法治疗,比较各组疗效.结果:33例因自身原因未完成治疗,余245例应用5-氨基酮戊酸-光动力疗法治疗总有效率85.7%,总复发率11.4%,A,B,C,D,E组治疗有效率分别为94.4%,82.9%,84.0%,80.0%,73.3%,复发率分别为6.7%,l4.3%,l2.0%,12.5%,20.0%;A组有效率优于B,C,D,E组(P＜0.05);B,C,D,E组间比较差异无统计学意义(P＞0.05).结论:5-氨基酮戊酸-光动力疗法治疗尖锐湿疣临床疗效确切,治疗尿道口尖锐湿疣临床疗效明显优于其他部位.     

新型三阶段疗法治疗肛周尖锐湿疣的临床疗效以及对患者免疫功能的影响

目的探讨新型三阶段疗法治疗肛周尖锐湿疣的临床疗效以及对患者免疫功能的影响。方法 2015年2月~2016年1月,本院收治肛周尖锐湿疣患者70例,随机分为观察组和对照组。观察组患者采用新型三阶段疗法,包括CO2激光疗法、5-氨基酮戊酸光动力疗法联合黄甘颗粒治疗。对照组患者采用5-氨基酮戊酸光动力疗法联合黄甘颗粒。观察两组患者的临床疗效以及对患者免疫功能的影响。结果两组患者治疗1个月后,观察组治愈率为94.29%,对照组为85.71%,比较差异有统计学意义(P0.05)。随访3个月后,观察组治愈患者中有2例复发,复发率为6.06%,对照组治愈患者的复发率为16.13%,比较差异有统计学意义(P0.05)。治疗后观察组患者IL-2、LTN、TNF-α以及CD4+/CD8+比值分别为(84.45±6.67)μg/L、(468.34±76.61)pg/ml、(0.781±0.02)μg/L和(1.79±0.17),而对照组为(63.23±7.01)μg/L、(352.51±80.21)pg/ml、(0.401±0.02)μg/L和(1.02±0.080),比较差异均有统计学意义(P0.05)。结论新型CO2激光疗法、5-氨基酮戊酸光动力疗法联合黄甘颗粒三阶段疗法可以提高肛周尖锐湿疣的治愈率、降低复发率,并且可以提高患者免疫力,有着较好的治疗效果。     

5-氨基酮戊酸光动力疗法治疗尖锐湿疣的疗效观察

目的观察以温敏凝胶为光敏剂载体的5-氨基酮戊酸光动力疗法（ALA-PDT）治疗尖锐湿疣的疗效及安全性。方法采用ALA-PDT对50例尖锐湿疣患者（观察组）进行治疗,以同期进行CO2激光治疗的54例尖锐湿疣患者（对照组）作对照。结果随访3个月,观察组经4次光动力治疗后在32例痊愈患者中复发6例,复发率为12.0%;对照组复发34例,复发率为62.9%。2组复发率相比,差异有统计学意义（P〈0.05）。结论以温敏凝胶为光敏剂载体的ALA-PDT疗法能降低尖锐湿疣的复发率,并有较好的安全性。     

5-氨基酮戊酸光动力疗法治疗尖锐湿疣临床疗效观察

选取我院2013年4月~2014年4月收治的80例尖锐湿疣患者。分为对照组和试验组各40例。对照组采用电灼疗法治疗,试验组采用5-氨基酮戊酸光动力疗法治疗,比较两组治疗效果。结果试验组25例非尿道CA,患者治疗后22率治愈,复发率为12%,低于对照组(26例,复发率为34.61%)(P<0.05);试验组15例尿道CA,复发率为13.3%,低于对照组(7例复发,复发率为50%)(P<0.05);试验组平均复发周期为15.6周,长于对照组(11.75%)(P<0.05)。尖锐湿疣发病率较高且复发率也比较高,临床上采用5-氨基酮戊酸光动力疗法治疗效果理想,能够降低复发率,延长复发时间,值得推广使用。     

4%5-氨基酮戊酸光动力疗法治疗痤疮疗效分析及对皮肤生理指标的影响分析

目的:分析和研究4%5-氨基酮戊酸光动力疗法治疗痤疮临床疗效及对皮肤生理指标的影响。方法:选取2011年4月²013年9月痤疮患者91例,分为对照组45例(采用异维A酸胶囊治疗)与观察组46例(采用4%5-氨基酮戊酸光动力疗法治疗),将两组患者治疗8周后的效果进行对比。结果:观察组患者治疗总有效率明显高于对照组(P<0.05),具有统计学意义。观察组患者皮肤油脂检测值明显优于对照组(P<0.05),具有统计学意义。两组患者角质层含水量、p H值检测值无明显差异(P>0.05),无统计学意义。结论:将4%5-氨基酮戊酸光动力疗法应用于痤疮患者治疗中,能够快速抑制皮损区炎症反应,控制皮肤组织损伤程度,减少或避免瘢痕形成,对提高治愈率及患者生活质量均有重要作用。     

4%5-氨基酮戊酸光动力疗法治疗痤疮疗效分析及相关指标影响

选取2014年2月~2015年2月100例痤疮患者,随机分为两组,试验组给予4%5-氨基酮戊酸光动力疗法治疗,对照组给予异维A酸胶囊治疗,对比两组患者效果治疗。试验组经4%5-氨基酮戊酸光动力疗法治疗,其治愈率、显效率以及总有效率明显优于异维A酸胶囊治疗的对照组(P0.05);试验组痤疮患者的皮肤油脂的检测值明显小于对照组(P0.05)。但两组痤疮患者在皮肤p H值、角质层含水量检测相比,并不具有明显的差异(P0.05)。痤疮患者接受4%5-氨基酮戊酸光动力疗法治疗的效果较好,可以提高患者的治疗有效率,减少瘢痕的形成,对改善患者的生活质量有着积极的意义。     

新型三阶段疗法对肛周尖锐湿疣患者血清IL-2、IFN-γ、IL-6细胞因子的影响

目的探讨新型三阶段疗法治疗肛周尖锐湿疣的临床疗效以及对血清白细胞介素-2(IL-2)、干扰素-γ(IFN-γ)、白细胞介素-6(IL-6)等细胞因子的影响。方法选取2015年2月~2016年1月本院收治的80例肛周尖锐湿疣患者。随机分为观察组和对照组。观察两组患者的临床治愈率、复发率、不良反应发生率和血清IL-2、IFN-γ以及IL-6变化情况40例。结果两组患者治疗1个月后,观察组治愈率为92.50%,对照组为77.5%,比较差异有统计学意义(P0.05)。不良反应率两组比较,差异无统计学意义(P0.05)。随访3个月后,观察组复发率为8.12%,对照组复发率为16.13%,比较差异有统计学意义(P0.05)。治疗结束时和治疗结束4周后两组患者血清IL-2、IFN-γ及IL-6的比较,差异有统计学意义(P0.05)。结论新型CO2激光疗法、5-氨基酮戊酸光动力疗法联合黄甘颗粒三阶段疗法可以提高肛周尖锐湿疣的治愈率,降低复发率,有着较好的治疗效果。     

护理干预在二氧化碳激光联合氨基酮戊酸光动力治疗尖锐湿疣的效果观察

目的:探讨护理干预在二氧化碳激光联合氨基酮戊酸光动力治疗尖锐湿疣中的临床效果。方法:选取我院2014年7月~2015年12月收治的100例尖锐湿疣患者作为研究对象,并随机等分为对照组和观察组,两组患者均实施二氧化碳激光联合氨基酮戊酸光动力治疗,对照组患者采用常规护理干预;观察组患者采用综合性护理干预,比较两组患者的护理效果及不良反应发生情况。结果:观察组患者的护理效果优于对照组,不良反应发生率少于对照组,差异均具有统计学意义(P0.05)。结论:综合性护理干预对二氧化碳激光联合氨基酮戊酸光动力治疗尖锐湿疣能有效缓解患者的疼痛感,促进水肿早期消退、创面早期痊愈,有效提高患者的生活质量。     

血清基质金属蛋白酶-3、趋化因子配体19水平与尖锐湿疣患者5α-氨基酮戊酸光动力疗法治疗后复发的相关性

目的 探讨尖锐湿疣患者5α-氨基酮戊酸光动力疗法治疗后复发与基质金属蛋白酶-3(matrixmetalloproteinase-3,MMP-3)、趋化因子配体19(chemokine C-C-Motif Ligand 19,CCL19)水平的相关性。方法 选取2021年1月至2022年6月在湖北省武汉市第一医院接受5α-氨基酮戊酸光动力疗法治疗的360例尖锐湿疣患者,根据3个月随访复发情况分为复发组40例和未复发组320例。采用酶联免疫吸附法对治疗前患者血清中MMP-3、CCL19水平进行检测;Spearman法分析血清MMP-3、CCL19水平与尖锐湿疣患者5α-氨基酮戊酸光动力疗法治疗后复发的相关性;对影响治疗后尖锐湿疣患者复发的因素进行logistic回归分析;受试者工作特征(receiver operator characteristic curve,ROC)曲线分析血清MMP-3、CCL19水平对5α-氨基酮戊酸光动力疗法治疗后复发的预测价值。结果 两组患者在人乳头瘤病毒感染状态上,差异有显著性(P<0.05);与未复发组相比,复发组尖锐湿疣患者血清MMP-3、CCL1...     

Determination of creatine kinase isoenzyme MB activity in serum using immunological inhibition of creatine kinase M subunit activity. Activity kinetics and diagnostic significance in myocardial infarction.

This is a new method for the determination of creatine kinase isoenzyme MB activity in serum. The method uses direct activity measurement of creatine kinase B subunit activity after blocking of CK-M subunit activity by inhibiting antibodies. The test takes no longer than 15 min. The method yields an intra-serial C.V. of 2.0-12.9%, and a C.V. from day to day of 5.5%. The detection limit is 3.4 U/l creatine kinase MB. In the 95 cases with proven myocardial infarction several types of creatine kinase MB activity kinetics could be determined. The percentage of creatine kinase MB of peak CK-total is 6-25%, with a mean of 11.1%. The amount of creatine kinase MB with respect to total CK activity after reinfarction is higher than the amount after initial infarction.     

Dissociable correlates of two classes of retrieval processing in prefrontal cortex

Although substantial evidence suggests that the prefrontal cortex (PFC) implements processes that are critical for accurate episodic memory judgments, the specific roles of different PFC subregions remain unclear. Here, we used event-related functional magnetic resonance imaging to distinguish between prefrontal activity related to operations that (1) influence processing of retrieval cues based on current task demands, or (2) are involved in monitoring the outputs of retrieval. Fourteen participants studied auditory words spoken by a male or female speaker and completed memory tests in which the stimuli were unstudied foil words and studied words spoken by either the same speaker at study, or the alternate speaker. On "general" test trials, participants were to determine whether each word was studied, regardless of the voice of the speaker, whereas on "specific" test trials, participants were to additionally distinguish between studied words that were spoken in the same voice or a different voice at study. Thus, on specific test trials, participants were explicitly required to attend to voice information in order to evaluate each test item. Anterior (right BA 10), dorsolateral prefrontal (right BA 46), and inferior frontal (bilateral BA 47/12) regions were more active during specific than during general trials. Activation in anterior and dorsolateral PFC was enhanced during specific test trials even in response to unstudied items, suggesting that activation in these regions was related to the differential processing of retrieval cues in the two tasks. In contrast, differences between specific and general test trials in inferior frontal regions (bilateral BA 47/12) were seen only for studied items, suggesting a role for these regions in post-retrieval monitoring processes. Results from this study are consistent with the idea that different PFC subregions implement distinct, but complementary processes that collectively support accurate episodic memory judgments.     

俯卧位通气对高海拔地区肺复张治疗无效急性呼吸窘迫综合征患者氧合的影响

目的 探讨俯卧位通气对高海拔地区肺复张术(RM)治疗无效急性呼吸窘迫综合征(ARDS)患者的治疗作用.方法 从海拔2260m的地区医院筛选RM治疗无效的41例ARDS患者[平均氧合指数( PaO2/FiO2)较RM前升高＜20％视为RM无效],依不同病因分为肺内源性ARDS组(ARDSp组)和肺外源性ARDS组(ARDSexp组),每组再按信封法随机分为俯卧位组和仰卧位组,即ARDSp俯卧位组(11例)、ARDSp仰卧位组(9例)、ARDSexp俯卧位组(10例)、ARDSexp仰卧位组(11例).在通气前及通气1、2、3、4h监测动脉血氧分压( PaO2)、PaO2/FiO2、静态顺应性(Cst)、气道阻力(Raw)的变化.结果 通气lh时,ARDSexp俯卧位组PaO2/FiO2( mm Hg,l mm Hg=0.133 kPa)即较通气前显著升高(157.4±40.6比129.3±48.7,P＜0.05),并随通气时间延长呈持续增高趋势,4h达峰值(219.1 ±41.1);且ARDSexp俯卧位组通气3h内PaO2/FiO2较其他3组显著增高,另3组间则差异无统计学意义.ARDSp俯卧位组、ARDSexp俯卧位组通气4h时PaO2/FiO2均较相应仰卧位组显著增高(208.8±39.7比127.4±47.1,219.1±41.1比124.9±50.8,均P＜0.05).4组通气前后Cst无显著改变,各组间差异也无统计学意义.ARDSp俯卧位组通气4h时Raw(cmH2O·L-1·s-1)较通气前显著降低(6.8±1.7比10.7±1.8,P＜0.05),且明显低于其他3组;其他3组各时间点Raw组内及组间比较差异均无统计学意义.结论 俯卧位通气作为ARDS机械通气重要策略之一,可以改善RM无效高原ARDS患者的氧合,为抢救患者赢得宝贵的时间.     

Digital imaging among medical facilities

The Department of Veterans Affairs (VA) in the USA operates a network of 172 medical centres which all utilize a hospital information system (HIS) which has been developed and is currently maintained by the VA. During the past several years, an image management and communication module has been developed, installed and clinically utilized at the Washington DC and Maryland VA Medical Centres. This image management and communication system, referred to as the decentralized hospital computer program (DHCP) imaging system, is fully integrated with a commercial picture archiving and communication system (PACS). The system is utilized to capture, archive, and display all images generated within the hospital including radiology, nuclear medicine, pathology, endoscopy, bronchoscopy, and dermatology, intraoperative photographs, ECG data, and a limited number of paper documents. The ultimate goal of the project is to have all patient text and image data available at any clinical workstation to any authorized user anywhere within the network of medical centres. Clinical requirements for an imaging workstation include ease of use, rapid and reliable access to the complete set of patient information, and images which are of acceptable quality to meet the requirements of the user and the subspecialty. Patient confidentiality and data security must be safeguarded at all times. Integration of the images with the remainder of the patient's database was found to be critical to the success of the project. The experience at the Washington and Maryland facilities suggests that an imaging system that is successfully integrated with a hospital information system can provide substantial clinical and economic benefits both within and among medical centres. Clinical acceptance and utilization of the system has been excellent, particularly in diagnostic radiology where DHCP Imaging has been interfaced to a commercial PAC system. Based upon this initial experience, the VA has begun to deploy the system throughout its large network of medical centres.     

Myocardial elastography at both high temporal and spatial resolution for the detection of infarcts

Myocardial elastography is a novel method for noninvasively assessing regional myocardial function, with the advantages of high spatial and temporal resolution and high signal-to-noise ratio (SNR). In this paper, in-vivo experiments were performed in anesthetized normal and infarcted mice (one day after left anterior descending coronary artery [LAD] ligation) using a high-resolution (30 MHz) ultrasound system (Vevo 770, VisualSonics Inc., Toronto, ON, Canada). Radiofrequency (RF) signals of the left ventricle (LV) in longitudinal (long-axis) view and the associated electrocardiogram (ECG) were simultaneously acquired. Using a retrospective ECG gating technique, 2-D full field-of-view RF frames were acquired at an extremely high frame rate (8 kHz) that resulted in high-quality incremental displacement and strain estimation of the myocardium. The incremental results were further accumulated to obtain the cumulative displacements and strains. Two-dimensional and M-mode displacement images and strain images (elastograms), as well as displacement and strain profiles as a function of time, were compared between normal and infarcted mice. Incremental results clearly depicted cardiac events including LV contraction, LV relaxation and isovolumetric phases in both normal and infarcted mice, and also evidently indicated reduced motion and deformation in the infarcted myocardium. The elastograms indicated that the infarcted regions underwent thinning during systole rather than thickening, as in the normal case. The cumulative elastograms were found to have higher elastographic SNR (SNR(e)) than the incremental elastograms (e.g., 10.6 vs. 4.7 in a normal myocardium, and 6.0 vs. 2.4 in an infarcted myocardium). Finally, preliminary statistical results from nine normal (m = 9) and seven infarcted (n = 7) mice indicated the capability of the cumulative strain in differentiating infracted from normal myocardia. In conclusion, myocardial elastography could provide regional strain information at simultaneously high temporal (>/=0.125 ms) and spatial ( approximately 55 microm) resolution as well as high precision ( approximately 0.05 microm displacement). This technique was thus capable of accurately characterizing normal myocardial function throughout an entire cardiac cycle, at the same high resolution, and detecting and localizing myocardial infarction in vivo.     

Clinical Pharmacokinetics of Morphine

Morphine, the most widely used mu-opioid analgesic for acute and chronic pain, is the standard against which new analgesics are measured. A thorough understanding of the pharmacokinetics of morphine is required in order to safely and effectively use this analgesic in a wide variety of patients with different levels of organ function. A MEDLINE search was conducted to identify literature published between 1966 and January 2002 relevant to the pharmacokinetics of morphine. These publications were reviewed and the literature summarized regarding unique and clinically important elements of morphine disposition relative to its parenteral administration (including intravenous, intramuscular, subcutaneous, epidural and intrathecal administration), absorption profile (immediate release, controlled release, and sublingual/buccal, and rectal administration), distribution, and its metabolism/ excretion. Special populations, including infants, elderly, and those with renal/liver failure, have a unique morphine pharmacokinetic profile that must be taken into account in order to maximize analgesic efficacy and reduce the risk of adverse events.