31例新生儿胎粪吸入综合征的临床护理探讨

目的:探讨胎粪吸入综合征的预防及临床护理措施,以减低其的发病率和病死率。方法:收集2011年1月至2012年10月31例新生儿胎粪吸入综合征的患儿进行回顾性分析、观察和护理。结果:新生儿胎粪吸入综合征的发病与围生期窒息息息相关。结论:新生儿胎粪吸人综合征及早预防、清理呼吸道分泌物及窒息抢救、正确治疗和护理极为重要。     

盐酸氨溴索治疗胎粪吸入综合征的疗效观察

目的 现察盐酸氨溴索治疗胎妻吸入综合征的疗效.方法 选择胎粪吸入综合征107例,随机分为对照组51例,治疗组56例,时照组行常规治疗,治疗组同时加用盐酸氨溴索治疗,观察两组患者临床症状改善和住院时间.结果 治疗组呼吸困难、发甜和肺部哆音好转时间及住院日优于对照组,盖异有显著统计学意义(P＜0.01),无药物不良反应.结论 胎粪吸入综合征在常规治疗同时加盐酸氨溴索治疗可提高临床疗效.     

新生儿胎粪吸入综合征22例临床分析

目的：胎粪吸入综合征是新生儿科临床重症，及时抢救、正确治疗才能提高治愈率。本文就我院收治的22例胎粪吸入综合征临床诊治结果进行回顾性总结。结论：基层医院治疗胎粪吸入综合征的综合措施中，特殊护理起到不可忽视的作用，应用酚妥拉明改善肺循环效果明显。     

氨茶碱辅助治疗新生儿胎粪吸入综合征临床效果观察

目的:观察氨茶碱在治疗新生儿胎粪吸入综合征中的临床疗效。方法:选取60例新生儿胎粪吸入综合征患儿为研究对象,随机分为两组,对照组28例,观察组32例,对照组行常规治疗,观察组在常规治疗的基础上加用氨茶碱辅助治疗。结果:观察组32例患儿治愈率为75.0%,总有效率为93.8%,显著高于对照组的治愈率50.0%、总有效率75.0%,差异均有统计学意义(P<0.05)。结论:氨茶碱辅助治疗新生儿胎粪吸入综合征疗效显著。     

肺表面活性物质治疗重症胎粪吸入综合征患儿的疗效分析

目的:探讨肺表面活性物质用于治疗重症胎粪吸入综合征患儿的疗效。方法:选择重症胎粪吸入综合征患儿76例,分为活性物质组和普通组。活性物质组采用呼吸机通气及肺表面活性物质治疗,普通组采用呼吸机通气常规疗法。观测治疗后血气分析指标,评价肺氧合功能。结果:活性物质组治疗10 h、20 h、30 h氧合指数、动脉/肺泡氧分压比值均优于普通组(P<0.05)。结论:肺表面活性物质治疗重症胎粪吸入综合征患儿,可有效改善血气分析指标,提高患儿肺氧合功能。     

雾化吸入治疗胎粪吸入综合征49例疗效观察

目的:探讨雾化吸入治疗胎粪吸入综合征的临床疗效。方法98例患儿随机分为治疗组和对照组,每组49例,两组均给予常规治疗,治疗组加雾化吸入治疗。结果:治疗组治愈率51.0%(25/49),明显高于对照组的32.7%(16/49)(P<0.05)。讨论雾化吸入治疗胎粪吸入综合征疗效确切,方法简便,副作用小,是常规综合疗法外的一种有效方法。     

氨溴索治疗新生儿胎粪吸入综合征的临床疗效分析

目的探讨氨溴索治疗新生儿胎粪吸入综合征的临床疗效。方法采样82例新生儿胎粪吸入综合征患儿均分为两组进行分析,即对照组采用常规治疗,而试验组在常规治疗的基础上,再予以氨溴索治疗。结果治疗后,试验组总显效率为95.12%,与对照组的75.61%相比,存在临床差异性(P0.05)。结论氨溴索治疗新生儿胎粪吸入综合征的临床疗效确切,值得推广。     

羊水胎粪污染与新生儿胎粪吸入综合征的观察护理

本文通过对732例羊水胎粪污染的新生儿进行分析,发现羊水胎粪污染与母亲的高危妊娠有关,其中主要以脐带异常为主(53.14%),羊水胎粪污染越严重,胎心图异常越明显,新生儿胎粪吸入综合征的发生率越高,Ⅲ度羊水粪染胎粪吸入综合征的发生率7.51%(P<0.01),Ⅱ度羊水粪染胎粪吸入综合征的发生率1.24%。本文认为,严重羊水胎粪污染是引起胎粪吸入综合征的主要原因,应加强孕产妇产前和产时的监测,及时发现羊水粪染,给予处理,并做好粪染新生儿的护理,减少胎粪吸入综合征的发生,提高新生儿的生存质量。     

121例新生儿气管冲洗治疗临床分析

目的 探讨气管冲洗治疗在新生儿复苏中的重要作用.方法 回顾性分析2009年1月~2011年7月本院121例气管冲洗治疗的病例资料.结果 气管冲洗治疗可减轻新生儿窒息并发症,防止胎粪吸入综合征,减少吸入性肺炎的发生.结论 羊水Ⅲ度胎粪污染,出生活力差的新生儿实施气管冲洗治疗能有效减轻窒息并发症,降低吸入性肺炎、胎粪吸入综合征的发生率,是值得推广的方法.     

沐舒坦治疗新生儿胎粪吸入综合征74例

目的探讨沐舒坦治疗新生儿胎粪吸入综合征的疗效。方法将74例新生儿胎粪吸入综合征患儿随机分为两组，治疗组在常规治疗的基础上加用沐舒坦，对照组仅给予传统的常规治疗。结果治疗组的临床症状、体征缓解时间明显缩短，预后较好，临床结果明显优于对照组，差异有统计学意义（P〈0．05）。结论沐舒坦可有效治疗新生儿胎粪吸入综合征，值得临床推广。     

二肽基肽酶Ⅳ抑制剂的药理作用及其机制研究

近些年来,二肽基肽酶Ⅳ（dipeptidyl peptidase IV,DPP-IV）抑制剂在治疗2型糖尿病的药物中异军突起,DPP-IV是一种2型多功能跨膜细胞表面糖基化蛋白,在临床治疗和临床试验中,发现了很多DPP-IV抑制剂潜在的药理作用。通过对国内外相关文献的检索,对DPP-IV抑制剂包括降糖、保护心脏、抗炎等药理作用进行了综述。     

Update on treatments of diabetic macular edema

Objective To review the update research progress about the treatment of diabetic macular edema and to give helpful guidelines in the treatment of diabetic macular edema based on available evidence to date.
Data sources A literature search of all English articles was performed on the online electronic PubMed database dated 1984 to 2009. The keywords searched included： macular edema, therapy, laser coagulation, intravitreal triamcinolone acetonide, vascular endothelial growth factor inhibitor, protein kinase C inhibitor and Pars plana vitrectomy. After finding relevant articles within these search limits, a manual search was conducted through the references from these articles.
Study selection Original articles and critical reviews were reviewed and selected to address the stated purpose.
Results To date, demonstrated means to reduce the risk of vision loss from diabetic macular edema include focal/grid laser photocoagulation and improved metabolic control. Emerging pharmacologic therapies （intravitreal triamcinolone acetonide, vascular endothelial growth factor inhibitors and protein kinase C beta-isoform inhibitors） and Pars plana vitrectomy have shown early promise in the treatment of diabetic macular edema. Conclusions As there has been extensive development in multiple treatments of diabetic macular edema, choice of the most suitable treatment for specific patients becomes important.
Combination therapy of laser, pharmacological and surqical treatment modalities mav offer an alternative to treatment of diabetic macular edema.     

Advances in the study of Alzheimer''''s disease

INTRODUCTION Alzheimer’sdisease(AD)isaneurodegenerativedisordercharacterizedbycerebraldepositsofβamyloidpeptidesandneurofibrillarytangles(NFT)whicharesurroundedbyinflammatorycells.ADisthe fourthlargestcausesofdeathforpeopleover65earsof age.Thediseaseisthecommonestformofdementia affectingolderpeopleandaccountsfor60%65%cases whereasvasculardementiaandmixeddementiaaccount for15%20%ofthecaseseach[1].Therehasbeen substantialprogressinthetherapeuticapproachtoADin thepastfewyears.Thisreview…     

新生儿胎粪吸入综合征的治疗进展

胎粪吸入综合征(MAS)是一种严重危害新生儿健康的疾病。近年来,随着科学技术的发展,诊疗技术不断提高,在治疗手段上也有所创新,给新生儿MAS的治疗带来了新策略,进一步提高了MAS的救治成功率。该文就MAS的治疗进展予以综述,探讨早期处理,包括产前处理和出生时处理,对新生儿MAS的防治作用,阐述药物治疗,如应用盐酸氨溴索雾化吸入或进行支气管肺泡灌洗、气管内注入肺表面活性物质、抗炎与抗氧化治疗、抗生素治疗以及一氧化氮吸入治疗等,对MAS发生、发展的影响,重点探讨MAS新生儿发生呼吸衰竭时机械通气治疗的临床应用。     

Psychopharmacological treatments in persons with dual diagnosis of psychiatric disorders and developmental disabilities

People with developmental disabilities are at considerable risk for the development of comorbid psychiatric conditions. Psychopharmacological treatments may have a crucial role in a multidisciplinary and multimodal approach to the management of psychopathology in this population. Psychiatric illnesses that are particularly amenable include mood disorders, anxiety disorders, schizophrenia, and attention deficit hyperactivity disorders (ADHDs) and antidepressants, mood stabilisers, anxiolytics, antipsychotics, and stimulants should be considered, respectively. ADHD may also respond to alpha(2)-agonists. Psychotropic agents such as beta-antagonists can target aggressive, self injurious, and stereotypical behaviours and opioid antagonists may be helpful in treating self injurious behaviour and stereotypy. Selective serotonin reuptake inhibitors, newer anticonvulsants, and atypical neuroleptics are preferred when treating psychiatric disorders among people with developmental disabilities. This paper will review the major studies of pharmacological treatment of mental illness in individuals with developmental disabilities.     

Usefulness of radial extracorporeal shock wave therapy for the spasticity of the subscapularis in patients with stroke: a pilot study

Background There are not many studies about treatment of shoulder spasticity. Although botulinum toxin injection has been reported to be effective for shoulder spasticity, the effectiveness was judged by pain and limited motion change, but not the spasticity itself. Shoulder spasticity is considered to play an important role in hemiplegic frozen shoulder. However, the subscapularis muscle, unlike the pectoralis major muscle, is located deep beneath scapula, where conventional injection is difficult to perform. As extracorporeal shock wave therapy （ESWT） has been reported to be effective for spasticity relief, and we thought spasticity of subscapularis muscle located deep beneath the scapula would be a good candidate for ESWT treatment. This study was to evaluate the beneficial effects of radial ESWT （rESWT） on spastic subscapularis muscle in stroke patients. Methods This is an uncontrolled, prospective, unicenter, clinical pilot study. Stroke patients （n=57; mean age 55.4 years） with spastic shoulders were recruited between June 2011 and February 2012 at the University Rehabilitation Hospital. rESWT was administered to each patient every two or three days for two weeks （five total treatments）. Evaluation consisted of 11 measurements for each patient; at the start of each of the five treatments and once per week during the following six weeks. Spasticity was measured at external rotator muscles of the shoulder using the modified Ashworth scale （MAS）, and passive range of motion （ROM） of the shoulder in external rotation was recorded. Pain was measured using a visual analogue scale （VAS） during passive ROM of the shoulder in external rotation, and was additionally recorded for patients who preserved cognitive and communicative ability （Pain group）. Results Reduction in MAS and VAS and improvement of ROM during and after rESWT treatments were prominent compared to baseline. The reduction in MAS and VAS and improvement of ROM continued four weeks after the last treatment and the effects of the treatment decreased afterward. Conclusion rESWT will be able to provide stroke patients with an effective and safe procedure for the reduction of spasticity and pain as well as for the improvement of ROM of spastic shoulders.     

Treatment for morbid obesity

There is no single unifying theory to explain the aetiology of obesity but several environmental factors, such as decreased physical activity and increased fat intake may contribute to its development in genetically predisposed individuals. Dietary and pharmacological treatments of morbid obesity have been proven to be unsuccessful. Modern surgical treatments have been shown to be effective in achieving significant weight loss with consequent reduction in morbidity. Despite the fact that surgical treatment of morbid obesity is the only therapeutic form that has stood the test of time, it still remains a crisis-driven form of therapy in the UK. It is probable that a better understanding of the aetiology and physiology of obesity may lead to the development of an effective pharmacological treatment of obesity in the future. However, until then, surgical treatment of morbid obesity should be considered as an effective and efficient way of treatment in selected cases.


     

肠促胰岛素类似物和DPP-Ⅳ抑制剂在2型糖尿病治疗中的作用

肠促胰岛素类似物(incretin mimetics)是一类具有多种抗高血糖作用的新型降糖药物,它模拟胰升糖素样肽(GLP)-1的作用;二肽基肽酶(DPP-Ⅳ)抑制剂抑制GLP-1的降解。这两类药物的作用机制为:增加葡萄糖依赖的胰岛素分泌;抑制不适当的胰高血糖素分泌增多;增强胰岛素敏感性;减缓胃的排空;和抑制食欲。研究显示,肠促胰岛素类似物和DPP-Ⅳ抑制剂还具有促进胰岛β细胞新生的作用,可能会成为未来2型糖尿病(T2DM)治疗领域的新药。目前,几种肠促胰岛素类似物和DPP-Ⅳ抑制剂正在进行T2DM治疗的末期临床试验。     

微种植钉联合横腭杆支抗对安氏Ⅱ类高角患者磨牙垂直向、牙弓宽度及后牙颊倾度的影响

  目的  比较微螺钉种植体支抗系统(MAS)联合横腭杆支抗(TPA)对安氏Ⅱ类高角患者的治疗效果。  方法  选取2014年6月—2015年6月邢台医学高等专科学校第二附属医院收治的安氏Ⅱ类高角患者40例,根据随机数字表法分为MAS组和MAS联合TPA组,每组各20例。采用X线头颅定位侧位片测量矫治前后磨牙垂直向距离,使用电子游标卡尺测量矫治前后的石膏模型上下颌牙弓横向宽度,对2组患者矫治前后采用锥形束CT(CBCT)测量分析第一磨牙颊倾度。比较2组患者磨牙垂直向距离、牙弓宽度以及后牙颊倾度的变化情况。  结果  经矫治后MAS联合TPA组的磨牙垂直向距离(L6-MP、LI-MP、U6M-SV、U6-PP和UI-PP)和MAS组(均P>0.05),牙弓宽度各指标(U33、U55、U66、L33、L55、L66)和MAS组比较差异有统计学意义(均P < 0.05)。MAS联合TPA组的磨牙旋转角度、磨牙颊向移动距显著高于MAS组[(2.23±0.45)°vs. (1.06±0.24)°; (1.23±0.08)mm vs. (0.15±0.01)mm],但磨牙位移显著低于MAS组[(3.13±0.66)mm vs. (5.21±0.82)mm,均P＜0.05]。  结论  MAS联合TPA可有效降低磨牙垂直向的变化,促进牙弓宽度的增加,改善颊倾度,其对于安氏Ⅱ类高角患者的矫治效果显著优于MAS,值得临床推广。      

Treating adults with acute stress disorder and post-traumatic stress disorder in general practice: a clinical update

General practitioners have an important role to play in helping patients after exposure to severe psychological trauma. In the immediate aftermath of trauma, GPs should offer "psychological first aid", which includes monitoring of the patient's mental state, providing general emotional support and information, and encouraging the active use of social support networks, and self-care strategies. Drug treatments should be avoided as a preventive intervention after traumatic exposure; they may be used cautiously in cases of extreme distress that persists. Adults with acute stress disorder (ASD) and post-traumatic stress disorder (PTSD) should be provided with trauma-focused cognitive behaviour therapy (CBT). Eye movement desensitisation and reprocessing (EMDR) in addition to in-vivo exposure (confronting avoided situations, people or places in a graded and systematic manner) may also be provided for PTSD. Drug treatments should not normally replace trauma-focused psychological therapy as a first-line treatment for adults with PTSD. If medication is considered for treating PTSD in adults, selective serotonin reuptake inhibitor antidepressants are the first choice. Other new generation antidepressants and older tricyclic antidepressants should be considered as second-line pharmacological options. Monoamine oxidase inhibitors may be considered by mental health specialists for use in people with treatment-resistant symptoms.