复方异丙托溴铵与沙丁胺醇辅助治疗慢性阻塞性肺病疗效对比分析

目的：复方异丙托溴铵与其单方制剂沙丁胺醇雾化吸入在辅助治疗慢性阻塞性肺病急性加重期的疗效对比。方法：将50例确诊慢性阻塞性肺病急性加重期患者随机分为观察组和对照组各25例,均给予常规治疗的同时,观察组雾化吸入复方异丙托溴铵,对照组雾化吸入沙丁胺醇进行治疗。结果：两组有效率比较有统计学意义。结论：复方异丙托溴铵雾化吸入辅助治疗慢性阻塞性肺病急性加重期疗效优于其单方制剂沙丁胺醇。     

布地奈德联合复方异丙托溴铵治疗喘息性慢性支气管炎临床分析

目的探讨布地奈德联合复方异丙托溴铵治疗喘息性慢性支气管炎的临床效果。方法回顾性分析2015年1月至2016年1月沈阳242医院门诊收治的84例喘息性慢性支气管炎患者的临床资料。采取随机数字表法分成联合治疗组(n=42)和常规治疗组(n=42)。常规治疗组给予雾化吸入复方异丙托溴铵治疗;联合治疗组在常规治疗组用药的基础上联合应用布地奈德进行治疗,比较两组的总有效率、临床症状以及不良反应发生情况等。结果联合治疗组和常规治疗组的临床治疗总有效率分别为95.1%和83.3%,两组间比较,差异有统计学意义(P<0.05);治疗后,联合治疗组的临床症状、体征消失时间均要短于常规治疗组,差异有统计意义(P<0.05);两组患者均未出现严重不良反应。结论布地奈德联合复方异丙托溴铵治疗喘息性慢性支气管炎的临床效果显著,不良反应较少、安全性高。     

布地奈德福莫特罗联合异丙托溴铵对COPD急性加重期患者免疫功能和炎症因子的影响

目的 观察布地奈德福莫特罗联合异丙托溴铵对慢性阻塞性肺疾病(COPD)急性加重期患者免疫功能和炎症因子的影响。方法 选取新疆四七四医院呼吸内科2022年12月至2023年12月收治的80例COPD急性加重期患者,按照随机数字表法分为研究组和对照组,各40例,对照组采用异丙托溴铵治疗,研究组再联用布地奈德福莫特罗,比较两组方案的临床疗效。结果 研究组治疗总有效率、气道峰压(PIP)、每分钟通气量(MV)、肺部第1秒用力呼气容积(FEV1)、用力肺活量(FVC),以及CD3+、CD4+水平和运动耐量(6MWT)评分均高于对照组,且日排痰量和CD8+、白介素-6(IL-6)、降钙素原(PCT)、C反应蛋白(CRP)水平低于对照组(P<0.05)。结论 关于COPD急性加重期,布地奈德福莫特罗联合异丙托溴铵治疗效果较好,能够显著缓解患者气道功能,提高其肺功能和免疫功能,有助于改善临床症状和预后表现,治疗实用性较高。     

雾化吸入布地奈德混悬液治疗慢性阻塞性肺疾患急性加重期疗效分析

目的 分析雾化吸入布地奈德混悬液治疗慢性阻塞性肺疾患急性加重期的临床疗效.方法 选取收治的急性加重期的慢性阻塞性肺疾病患者68例,将其随机划分为实验组与对照组,每组各34例.对照组患者行常规综合性治疗,实验组患者则在常规治疗基础上雾化吸入布地奈德混悬液治疗.观察并比较两组患者的呼吸困难评分、肺功能、血气指标变化以及不良反应发生情况.结果 治疗后,所有患者的呼吸困难评分均、肺功能、血气指标均明显改善.经比较,实验组患者治疗后的呼吸困难评分及肺功能改善情况显著优于对照组,P<0.05,差异有统计学意义;所有患者治疗后的PaCO2均降低,PaO2均升高,实验组与对照组比较差异显著,且实验组患者治疗后的不良反应发生情况显著低于对照组,P<0.05,差异有统计学意义.结论 雾化吸入布地奈德混悬液治疗慢性阻塞性肺疾患急性加重期,能有效缓解患者的临床症状、改善其肺功能,且不良反应发生率低,临床疗效显著.     

异丙托溴铵联合乙酰半胱氨酸对慢性阻塞性肺疾病患者血浆与诱导痰巨噬细胞刺激蛋白表达及肺功能影响

目的探讨异丙托溴铵联合乙酰半胱氨酸对慢性阻塞性肺疾病(COPD)患者血浆和诱导痰巨噬细胞刺激蛋白(MSP)表达及肺功能的影响。方法选取兰州大学第二医院自2017年10月至2018年10月收治的62例COPD患者为研究对象。采用随机数字表法将其分为A、B两组,每组各31例。A组采用异丙托溴铵治疗,B组采用异丙托溴铵联合乙酰半胱氨酸治疗。分析并比较两组患者治疗前、后血浆及诱导痰中MSP表达水平、肺功能情况及临床疗效。结果 B组患者的治疗总有效率为87.1%(27/31),显著高于A组的71.0%(22/31),两组间比较,差异有统计学意义(P<0.05)。治疗后,两组患者血浆及诱导痰中MSP表达水平较治疗前均降低,且B组显著低于A组,两组间比较,差异有统计学意义(P<0.05)。治疗后,两组患者肺功能较治疗前显著改善,且B组改善情况显著优于A组,两组间比较,差异有统计学意义(P<0.05)。结论异丙托溴铵联合乙酰半胱氨酸治疗COPD患者,可有效改善患者的血浆及诱导痰中MSP表达水平及肺功能。     

布地奈德氧驱动雾化治疗COPD急性加重期的临床效果

目的 研究布地奈德氧驱动雾化治疗慢性阻塞性肺病(COPD)急性加重期的安全性与有效性.方法 入选2007年3月～2011年9月在呼吸内科诊疗的COPD急性加重期患者123例,随机分成3组,每组41例,分别为布地奈德氧驱动雾化治疗组(B组)、甲基强的松静脉治疗组(M组)以及常规治疗对照组(C组).比较治疗前后3组患者相关临床资料情况.结果 B组和M组治疗后的肺功能、血气情况及临床评分均较治疗前明显改善(P＜0.05);治疗后,B组和M组的肺功能、血气情况及临床评分也均较C组明显改善(P＜0.05).B组与C组的不良反应发生率无统计学差异(P＞0.05),而B组的不良反应发生率明显低于M组(P＜0.05).结论 布地奈德氧驱动雾化可以取代甲强龙静脉治疗COPD急性加重期患者,具有较好的安全性与有效性.     

两种方式吸入布地奈德联合异丙托溴铵治疗急性感染性喉炎效果比较

 目的 比较经空气压缩雾化吸入与超声雾化吸入布地奈德联合异丙托溴铵治疗急性感染性喉炎的临床疗效,以及对患者白细胞介素-4(interleukin-4)和免疫球蛋白E(immunoglobulin E,IgE)水平的影响。方法 选取2015-01至2016-06接受治疗的120例急性感染性喉炎患者作为研究对象,按照随机数字表法随机分为对照组60例和观察组60例。常规治疗基础上,所有患者均给予布地奈德联合异丙托溴铵雾化吸入治疗。对照组患者给予空气压缩雾化吸入治疗,观察组患者给予超声雾化吸入治疗。疗程结束后,比较对照组和观察组患者临床疗效、临床症状改善时间及血清IL-4、IgE水平。结果 临床疗效显示,观察组患者治疗总有效率明显高于对照组(95.0% vs 83.3%,P<0.05)。与对照组相比,观察组咳嗽、声音嘶哑、喉鸣等临床症状改善时间显著缩短[(3.3±0.8)d vs (4.2±1.0) d,(3.5±0.6)d vs (4.3±1.2) d,(6.4±0.9)d vs (7.9±1.4) d,P均＜0.05]。治疗后,与对照组相比,观察组患者血清IL-4、IgE水平明显降低[(7.24±1.83)ng/L vs (15.19±2.36) ng/L,(50.43±9.62)μg/L vs (82.25±10.45)μg/L,P均＜0.05]。结论 对于急性感染性喉炎,与空气压缩雾化吸入布地奈德联合异丙托溴铵治疗相比,超声雾化吸入治疗总有效率高,临床症状改善时间短,血清IL-4、IgE降低更明显,具有更显著优势。     

盐酸氨溴索与噻托溴铵联合治疗老年COPD的疗效探究

目的 探究盐酸氨溴索与噻托溴铵联合治疗老年慢性阻塞性肺疾病(COPD)的疗效.方法 选取2020年1月-2021年3月收治的老年COPD患者136例,采用随机数字表法分为研究组与对照组,对照组给予盐酸氨溴索口服,研究组给予盐酸氨溴索口服联合噻托溴铵氧驱雾化吸入,对比两组临床疗效、血气指标变化、肺功能指标变化及6 min...     

噻托溴铵联合布地奈德福莫特罗粉吸入剂治疗慢性阻塞性肺疾病急性加重期的临床疗效观察

目的:观察噻托溴铵联合布地奈德福莫特罗粉吸入剂治疗慢性阻塞性肺疾病急性加重期的临床治疗效果.方法:选择我院2014年2月～2017年2月收治的68例慢性阻塞性肺疾病急性加重期患者作为研究对象,根据随机数字法将68例患者分成两组,其中34例患者仅应用噻托溴铵治疗设作对照组,另外34例患者在对照组治疗基础上增加布地奈德福莫特罗治疗,比较两组治疗效果.结果:对比两组1秒用力呼气容积(FEV1),最大呼气流速(PEF)与FEV1预计百分比,观察组疗效优于对照组,两组对比差异有统计学意义(P＜0.05);对比两组生活质量评分,观察组优于对照组,两组对比差异有统计学意义(P＜0.05);两组用药后均未见明显的不良反应.结论:噻托溴铵联合布地奈德福莫特罗粉吸入剂治疗慢性阻塞性肺疾病急性加重期疗效理想,可以明显改善患者的肺功能和生活质量,值得推广应用.     

噻托溴铵对老年慢性呼吸道疾病加重预防作用

目的分析噻托溴铵对老年慢性呼吸道疾病加重的预防作用,探讨其临床应用价值。方法选取2012年5月至2015年5月解放军11医院收治的180例老年慢性呼吸道疾病患者为研究对象,随机分为噻托溴铵组及舒利迭组,每组90例。两组患者分别在常规治疗的基础上加用噻托溴铵与舒利迭,比较治疗前后肺功能变化及急性加重次数。结果治疗后,两组患者用力肺活量(FVC)、一秒用力呼气容积(FEV1)、FEV1/FVC、动脉血氧分压(Pa O2)、均显著上升,动脉血二氧化碳分压(Pa CO2)均显著下降,噻托溴铵组变化更为明显,两组比较,差异有统计学意义(P<0.05)。两组患者治疗后,IL-6、TNF-α均显著降低,噻托溴铵组降低更为明显,两组比较,差异有统计学意义(P<0.05)。噻托溴铵组临床总有效率为91.1%,舒利迭组为81.1%,两组临床总有效率比较,差异无统计学意义(P>0.05)。噻托溴铵组不良反应发生率为6.7%,舒利迭组不良反应发生率为7.8%,两组不良反应发生率比较,差异无统计学意义(P>0.05)。噻托溴铵组治疗期间急性加重次数(1.19±0.58)次,舒利迭组为(4.17±2.06)次,噻托溴铵组治疗期间急性加重次数显著低于舒利迭组,差异有统计学意义(P<0.05)。结论噻托溴铵能够明显改善老年慢性呼吸道疾病患者肺功能,降低其炎性因子水平,具有良好的临床疗效,安全可靠,对预防慢性呼吸道疾病的加重具有积极意义。     

Knee injury and Osteoarthritis Outcome Score (KOOS) - validation of a Swedish version

The Knee injury and Osteoarthritis Outcome Score (KOOS) is a self-administered instrument measuring outcome after knee injury at impairment, disability, and handicap level in five subscales. Reliability, validity, and responsiveness of a Swedish version was assessed in 142 patients who underwent arthroscopy because of injury to the menisci, anterior cruciate ligament, or cartilage of the knee. The clinimetric properties were found to be good and comparable to the American version of the KOOS. Comparison to the Short Form-36 and the Lysholm knee scoring scale revealed expected correlations and construct validity. Item by item, symptoms and functional limitations were compared between diagnostic groups. High responsiveness was found three months after arthroscopic partial meniscectomy for all subscales but Activities of Daily Living.     

The acutely limping child

Acute limping may be the result of multiple pathologies in children. The differential diagnosis varies based on the age of the child. Irrespective of age, the initial imaging work-up includes AP and frog leg radiographs of the pelvis and ultrasound; MRI may sometimes be helpful. In children less than 3 years, infections and trauma are most frequent. MRI is the imaging modality of choice when osteomyelitis is clinically suspected. Between the ages of 3 and 10 years, transient synovitis of the hip and Legg-Calvé-Perthes disease are main considerations but infection, inflammation and focal bony lesions are also considered. In children over 10 years, slipped capital femoral epiphysis also is considered.     

Do Balance Board Training Programs Reduce the Risk of Ankle Sprains in Athletes?

Introduction Ankle sprains are the most common musculo-skeletal injury that occurs in athletes,particularly in sports that require jumping and landing on one foot such as soccer,and basketball(1-4).These injuries often result in significant time loss from participation,long-term disability,and have a major impact on health care costs and resources(5-8).     

High Intensity Interval Training:New Insights

KEY POINTS ·High-intensity interval training(HIT)is characterized by repeated sessions of relatively brief，intermittent exercise.often performed with an“a11 out”effort or at an intensity close to that which elicits peak oxygen uptake(i.e.，≥90%of VO2 peak).     

Endovascular management of carotid-cavernous fistulas

Objective To investigate endovascular treatment of traumatic direct carotid-cavernous fistulas （CCF） and their complications such as pseudoaneurysms. Methods： Over a five-year period, 22 patients with traumatic direct CCFs were treated endovascularly in our institution. Thirteen patients were treated once with the result of CCF occluded, 8 twice and 1 three times. Treatment modalities included balloon occlusion of the CCF, sacrifice of the ipsilateral internal carotid artery with detachable balloon, coll embolization of the cavernous sinus and secondary pseudoaneurysms, and covered-stem management of the pseudoaneurysms. Results All the direct CCFs were successfully managed endovascularly. Four patients developed a pseudoaneurysm after the occlusion of the CCF with an incidence of pseudoaneurysm formation of 18.2% （4/22）. A total number of 8 patients experienced permanent occlusion of the ICA with a rate of ICA occlusion reaching 36.4% （8/22）. Followed up through telephone consultation from 6 months to 5 years, all did well with no recurrence of CCF symptoms and signs. Conclusion Traumatic direct CCFs can be successfully managed with endovascular means. The pseudoaneurysms secondary to the occlusion of the CCFs can be occluded with stent-assisted coiling and implantation of covered stents.     

Developmental validation of the PowerPlex(®) ESI 16 and PowerPlex(®) ESI 17 Systems: STR multiplexes for the new European standard

In response to the ENFSI and EDNAP groups’ call for new STR multiplexes for Europe, Promega^® developed a suite of four new DNA profiling kits. This paper describes the developmental validation study performed on the PowerPlex^® ESI 16 (European Standard Investigator 16) and the PowerPlex^® ESI 17 Systems. The PowerPlex^® ESI 16 System combines the 11 loci compatible with the UK National DNA Database^®, contained within the AmpFlSTR^® SGM Plus^® PCR Amplification Kit, with five additional loci: D2S441, D10S1248, D22S1045, D1S1656 and D12S391. The multiplex was designed to reduce the amplicon size of the loci found in the AmpFlSTR^® SGM Plus^® kit. This design facilitates increased robustness and amplification success for the loci used in the national DNA databases created in many countries, when analyzing degraded DNA samples. The PowerPlex^® ESI 17 System amplifies the same loci as the PowerPlex^® ESI 16 System, but with the addition of a primer pair for the SE33 locus. Tests were designed to address the developmental validation guidelines issued by the Scientific Working Group on DNA Analysis Methods (SWGDAM), and those of the DNA Advisory Board (DAB). Samples processed include DNA mixtures, PCR reactions spiked with inhibitors, a sensitivity series, and 306 United Kingdom donor samples to determine concordance with data generated with the AmpFlSTR^® SGM Plus^® kit. Allele frequencies from 242 white Caucasian samples collected in the United Kingdom are also presented. The PowerPlex^® ESI 16 and ESI 17 Systems are robust and sensitive tools, suitable for the analysis of forensic DNA samples. Full profiles were routinely observed with 62.5 pg of a fully heterozygous single source DNA template. This high level of sensitivity was found to impact on mixture analyses, where 54–86% of unique minor contributor alleles were routinely observed in a 1:19 mixture ratio. Improved sensitivity combined with the robustness afforded by smaller amplicons has substantially improved the quantity of data obtained from degraded samples, and the improved chemistry confers exceptional tolerance to high levels of laboratory prepared inhibitors.     

Bronchial stump fistula :treatment with covered retrievable hinged metallic stents-preliminary clinical experience

Objective To evaluate the preliminaily clinical efficacy and retrievability of a retrievable hinged covered metallic stent in the treatment of the bronchial stump fistula （BSF）. Methods Between April 2003 and March 2005, 8 patients with bronchial stump fistula after pneumonectomy or lobectomy were treated with two types （A and B） of retrievable hinged covered metallic stents. Type A stent was placed in 6 patients and type B in 2 under fluoroscopic guidance. The stent was removed with a retrieval set when BSF was healed or complications occurred. Results Stent placement in the bronchial tree was technically successful in all patients, without procedure-related complications. Immediate closure of the BSF was achieved in all patients after the procedure. Stents were removed from all patients but one. Removal of the stents was difficult in two patients due to tissue hyperplasia. Patients were followed up for 6 - 21 months. Placement of the stents remained stable in all patients except one due to severe cough. Permanent closure of BSF was achieved in 7 （87.5%） of 8 patients. Conclusion Use of a retrievable hinged covered expandable metallic stent is a simple, safe, and effective procedure for closure of the BSF. Retrieval of the stent seems to be feasible. （J Intervent Radiol, 2007, 16： 253-257）     

Prevalence and severity of hip and groin pain in sub‐elite male football: a cross‐sectional cohort study of 695 players

The purpose of this study was twofold: (a) to investigate the prevalence of hip and groin pain in sub‐elite male adult football in Denmark and (b) to explore the association between prevalence and duration of hip and groin pain in the previous season with the Copenhagen Hip and Groin Outcome Score (HAGOS) in the beginning of the new season. In total 695 respondents from 40 teams (Division 1–4) were included. Players completed in the beginning of the new season (July–Sept 2011) a self‐reported paper questionnaire on hip and/or groin pain during the previous season and HAGOS. In total 49% (95% CI: 45–52%) reported hip and/or groin pain during the previous season. Of these, 31% (95% CI: 26–36%) reported pain for >6 weeks. Players with the longest duration of pain during the previous season had the lowest HAGOS scores, when assessed at the beginning of the new season, P < 0.001. This study documents that half of sub‐elite male adult football players report pain in the hip and/or groin during a football season. The football players with the longest duration of pain in previous season displayed the lowest HAGOS scores in the beginning of the new season.