戈舍瑞林联合腹腔镜手术治疗子宫内膜异位症致不孕症的疗效

目的:观察戈舍瑞林联合腹腔镜手术治疗子宫内膜异位症(EMT)致不孕症的疗效。方法:选取EMT致不孕症患者86例,按照随机数字表法分为对照组和观察组各43例。对照组行腹腔镜手术治疗,观察组在对照组基础上联合戈舍瑞林治疗。比较两组临床疗效、症状积分变化、不良反应发生情况,以及随访1年后两组妊娠及复发情况。结果:观察组总有效率(93.02%)明显高于对照组(74.42%),差异有统计学意义(P<0.05),治疗后观察组痛经、月经不调、性交痛、周期性膀胱刺激症状、周期性直肠刺激症状积分均高于对照组,差异有统计学意义(P<0.05);两组不良反应发生率相比,差异无统计学意义;治疗后随访1年,观察组复发率(4.65%)低于对照组25.58%,妊娠率(41.86%)高于对照组(20.93%),差异有统计学意义(P<0.05)。结论:戈舍瑞林联合腹腔镜手术治疗子宫内膜异位症致不孕症的疗效优于单纯腹腔镜手术治疗。     

腹腔镜手术联合戈舍瑞林治疗子宫内膜异位症合并不孕症的临床研究

目的：探讨腹腔镜手术联合戈舍瑞林治疗子宫内膜异位症合并不育症的临床疗效。方法：回顾性分析2009年4月-2012年4月间腹腔镜手术后接受戈舍瑞林治疗的39例子宫内膜异位症合并不孕症患者（治疗组）和接受米非司酮治疗的30例患者（对照组）的临床资料。结果：所有手术均获成功;治疗组与对照组总有效率分别为87．18％和63．33％,二者比较,有统计学差异（χ2=21．24,P〈0．01）;治疗组的复发率（10．26％）显著低于对照组（36．67％,χ2=5．22,P〈0．05）,治疗组的受孕率（58．97％）显著高于对照组（26．67％）,差异有统计学意义（χ2=7．15,P〈0．01）。结论：腹腔镜手术联合戈舍瑞林治疗子宫内膜异位症合并不孕症疗效确切,可以降低复发率、提高受孕率,是子宫内膜异位症患者助孕治疗的重要选择。     

戈舍瑞林联合腹腔镜治疗卵巢型子宫内膜异位症的疗效与安全性

目的:观察戈舍瑞林联合腹腔镜手术治疗卵巢型子宫内膜异位症的临床效果及安全性。方法:将68例卵巢型子宫内膜异位症患者分为2组,每组34例,分别接受腹腔镜手术治疗(对照组)及腹腔镜手术联合戈舍瑞林治疗(观察组),对比两组患者疗效差异。结果:观察组患者治疗总有效率明显高于对照组,差异存在统计学意义(P<0.05)。观察组患者随访期间不良反应发生率及复发率与对照组相比均明显降低,差异存在统计学意义(P<0.05)。观察组患者治疗后排卵恢复正常时间、月经恢复正常时间与对照组相比降低,半年内妊娠率与对照组相比明显升高,差异存在统计学意义(P<0.05)。结论:戈舍瑞林联合腹腔镜手术治疗卵巢型子宫内膜异位症效果显著,能快速有效地改善患者临床症状,安全性高,值得推广。     

腹腔镜手术联合戈舍瑞林皮下注射治疗中重度子宫内膜异位症的临床研究

目的:探讨腹腔镜手术联合戈舍瑞林皮下注射治疗中重度子宫内膜异位症患者的临床疗效及安全性.方法:选取2018年1月—2020年6月期间在无锡市人民医院接受治疗的中重度子宫内膜异位症患者60例,随机分为观察组和对照组,每组各30例;对照组给予腹腔镜手术治疗处理,观察组在对照组的基础上联合使用戈舍瑞林皮下注射治疗,对比两组疗效、性激素水平及预后.结果:治疗后观察组患者复发率(3.33％)低于对照组;妊娠率(53.33％)、症状缓解率(93.33％)较高于对照组,差异均有统计学意义(P<0.05);治疗后两组患者促卵泡生成素(FSH)、黄体生成素(LH)、雌激素(E2)以及血清CA125均有不同程度的改善,但治疗后观察组激素水平指标FSH(5.58±1.39)、E2(59.22±8.58)、LH(2.33±0.31)明显低于对照组,差异均有统计学意义(P<0.05);治疗后观察组血清CA125(25.21±5.22)明显低于对照组,差异有统计学意义(P<0.05).结论:腹腔镜手术联合戈舍瑞林皮下注射治疗中重度子宫内膜异位症,能降低患者复发率以及血清CA125水平,改善患者体内激素分泌状况,能有效缓解患者临床症状,值得临床推广应用.     

醋酸亮丙瑞林联合米非司酮对子宫内膜异位症的疗效观察

目的:观察醋酸亮丙瑞林联合米非司酮对子宫内膜异位症的疗效。方法:择取114例子宫内膜异位症患者纳入研究,就诊序号为单者设为观察组,就诊序号为双者设为对照组。对照组口服米非司酮治疗,观察组患者在此前提下皮下注射醋酸亮丙瑞林。对两组患者的性激素、炎症因子、疗效和不良反应进行比较。结果:治疗后,观察组的卵泡刺激素(FSH)、促黄体生成素(LH)、雌二醇(E_2)、肿瘤坏死因子-α(TNF-α)、白细胞介素-6(IL-6)和白细胞介素-8(IL-8)水平均小于对照组(P<0.01);观察组的治疗有效率达到96.49%,远高于对照组的80.70%(P<0.01);观察组的不良反应发生率为17.54%,与对照组的14.04%比较,差异无统计学意义(P>0.05)。结论:醋酸亮丙瑞林联合米非司酮能够显著减少子宫内膜异位症患者的性激素与炎症因子,增强疗效,且安全性好。     

坤泰胶囊联合醋酸亮丙瑞林对子宫内膜异位症患者血清性激素的影响

目的探究坤泰胶囊联合醋酸亮丙瑞林对子宫内膜异位症患者血清性激素的影响。方法选择2018年4月至2019年8月河南省人口和计划生育科学技术研究院附属医院收治的子宫内膜异位症患者78例,根据随机数表法将其分为两组,各39例。对照组使用醋酸亮丙瑞林治疗,观察组在对照组基础上使用坤泰胶囊行治疗,两组患者均治疗2个月。治疗后,比较两组患者卵泡刺激素(FSH)、雌二醇(E_2)、黄体生成素(LH)水平及临床疗效。结果治疗后,两组FSH、E_2、LH水平均低于治疗前,且观察组低于对照组,差异有统计学意义(均P<0.05);治疗后,观察组总有效率(94.87%)高于对照组(76.92%),差异有统计学意义(P<0.05)。结论坤泰胶囊联合醋酸亮丙瑞林治疗子宫内膜异位症效果良好,可降低患者性激素水平。     

阿拉瑞林对SD大鼠正位与异位子宫内膜雌孕激素受体的影响

【目的】观察阿拉瑞林对子宫内膜异位症大鼠异位病灶的抑制作用 ,研究其对正位与异位子宫内膜雌激素受体(ER)、孕激素受体 (PR)的影响。【方法】 2 7只采用外科诱导法建立的子宫内膜异位症大鼠随机分成模型对照组和阿拉瑞林(alarelin)治疗组 ,模型组在同等条件下观察 4周 ,阿拉瑞林组以alarelin 30 μg(kg·d) -1皮下注射 4周 ;治疗结束后 ,用链霉素抗生物素蛋白 过氧化物酶连接法 (SP)行正位与异位内膜ER、PR测定。【结果】阿拉瑞林组大鼠正位和异位子宫内膜生长活动受抑制 ,异位病灶体积较治疗前明显缩小 (P <0 0 1) ,异位内膜抑制率为 (6 8± 44 ) %;正位子宫内膜的ER较模型对照组明显下降 (P <0 0 5 ) ;正位子宫内膜上皮细胞的ER与异位内膜抑制率呈一定的负相关 (r =- 0 4 0 7,P <0 0 5 )。而对异位子宫内膜的ER、正位与异位子宫内膜PR的影响无显著性差异。【结论】阿拉瑞林对子宫内膜异位症大鼠有显著的治疗作用 ,其对正位子宫内膜的抑制作用可能通过ER介导 ,而对异位子宫内膜的抑制作用与异位内膜局部总的ER、PR可能无直接关系 ;检测正位子宫内膜上皮细胞的ER水平对阿拉瑞林的疗效有一定的预测作用。     

子宫内膜异位症术后使用戈舍瑞林治疗的疗效与不良反应的护理

目的:探讨子宫内膜异位症术后使用戈舍瑞林治疗的疗效与不良反应的护理。方法:采用回顾性分析法,选取子宫内膜异位患者122例,随机将其分为观察组61例(手术治疗联合戈舍瑞林辅助治疗)和对照组61例(单纯手术治疗),观察两组的治疗效果。结果:观察组61例,显效34例,有效22例,无效5例,总有效率为91.8%;对照组61例,显效22例,有效11例,无效28例,总有效率为65.6%。两组差异有统计学意义(P<0.05)。结论:子宫内膜异位症术后辅以戈舍瑞林治疗,可使子宫内残存的内膜异位萎缩,退化,从而降低了复发率,提高了治愈率,疗效明显优于单纯的手术治疗,值得临床推广。     

子宫内膜异位症伴不孕患者术后治疗妊娠情况341例分析

目的探讨腹腔镜联合药物治疗子宫内膜异位症合并不孕的临床价值。方法选择2005～2009年本院收治的子宫内膜异位症合并不孕患者341例,随机分为三组,给予不同的方法治疗,比较各组的临床疗效。结果 A、B组与对照组的Ⅰ、Ⅱ期子宫内膜异位症合并不孕患者的术后治疗结果相比,均P0.05。A组Ⅲ、Ⅳ期子宫内膜异位症合并不孕患者的术后治疗结果与B组、对照组相比,具有统计学显著性差异(χ2=13.31、12.84,均P0.05)。结论腹腔镜联合醋酸曲普瑞林是治疗Ⅲ、Ⅳ期的子宫内膜异位症合并不孕症的最佳方案。     

戈舍瑞林联合妇科千金胶囊对子宫内膜异位症术后血流动力学及雌激素水平的影响

目的分析戈舍瑞林联合妇科千金胶囊对子宫内膜异位症术后血流动力学及雌激素水平的影响。 方法150例子宫内膜异位症患者随机均分为对照组(戈舍瑞林治疗)和联合组(戈舍瑞林联合妇科千金胶囊治疗)。比较治疗前后两组患者血流动力学及雌激素水平的变化。 结果联合组治疗总有效率高于对照组(P＜0.05)。与治疗前比较,治疗后两组中医症候积分、子宫动脉左侧和右侧阻力指数、搏动指数、血清黄体生成素、促卵泡激素、雌二醇水平均降低,子宫动脉最大血流速度升高(P＜0.05);且联合组较对照组改善更为明显(P＜0.05)。 结论戈舍瑞林联合妇科千金胶囊治疗子宫内膜异位症术后患者安全有效,且改善其血流动力学及雌激素水平。     

APPLICATION OF LORNOXICAM TO PATIENT-CONTROLLED ANALGESIA IN PATIENTS UNDERGOING ABDOMINAL SURGERIES

FOR anesthesiologis s ,treatingpostoperativepainhas alwaysbeen a problem.Althoughopioidshave been provedtobe effective,theirsideeffectscouldnotbeignored.With thedevelopmentofscienceand pharmacology,many drugs with aspectsof satisfactoryanalgesicefficacyand couldbe welltoleratedby patientshave been developed.And lornoxicamisone of them, which isa non-steroidalanti-inflammatorydrug (NSAID ), with analgesic, anti-infl-ammatory,andantipyreticproperties.Itseliminationhalf-time(3 to 5 hours) isle…     

Value of D-Dimers in patients with acute aortic dissection

Objective: To evaluatel the value of D-dimers in patients with acute aortic dissection (AAD). Methods: This study consisted of 16 patients with AAD and 27 non-AAD patients. Serum D-dimets were measured by Sta-Liatest D-DI immunoturbidimetric assay. Results: D-dimer level was higher (P ＜ 0.001) in patients with AAD(7.91 ± 5.52 μg/ml) than that in non- AAD group(1.57±1.24 μg/ml). D-dimer was positive (＞0.4 μg/ml) in all patients with AAD and in 10 control group patients (37%). Among patients with acute AAD, D-dimers tended to be higher in Stanford A than in Stanford B (8.67 ± 4.31 μg/ml vs. 3.24±1.27 μg/ml, P ＜0.01). D-dimer values tended to be higher in more extended disease(3.84 ± 1.65 μg/ml, 8.57 ± 3.58 μg/ml and 11.87 ± 5.69 μg/ml in thoracic aorta, thoracic and abdominal aorta, thoracic and abdominal aorta and iliacal arteries, respectively, P ＜ 0.05 for both 8.57 ± 3.58 and 11.87 ± 5.69 vs. 3.84 ± 1.65 ). Including the control group into the analysis, we found a sensitivity of 100%, a negative predictive value of 100%, and a specificity of 66% and a positive predictive value of 64% for D-dimer in diagnosis of AAD in our patients with suspected AAD. Conclusion: D-dimer was elevated in patients with AAD. A negative D-dimer test result could be useful in excluding AAD.     

Research of combined liver-kidney transplantation model in rats

Objective： To set up a simple and reliable rat model of combined liver-kidney transplantation. Methods： SD rats served as both donors and recipients. 4℃ sodium lactate Ringer＇s was infused from portal veins to donated livers,and from abdominal aorta to donated kidneys, respectively. Anastomosis of the portal vein and the inferior vena cava （IVC） inferior to the right kidney between the graft and the recipient was performed by a double cuff method, then the superior hepatic vena cava with suture. A patch of donated renal artery was anastomosed to the recipient abdominal aorta. The urethra and bile duct were reconstructed with a simple inside bracket. Results： Among 65 cases of combined liver-kidney transplantation, the success rate in the late 40 cases was 77.5%. The function of the grafted liver and kidney remained normal. Conclusion： This rat model of combined liver-kidney transplantation can be established in common laboratory conditions with high success rate and meet the needs of renal transplantation experiment.     

BLOOD PRESSURE CHANGE WITH AGE IN SALT-SENSITIVE TEENAGERS

Objective To observe blood pressure change with age in salt-sensitive teenagers whose salt sensitivity were determined by repeated testing.Methods Salt sensitivity was determined through intravenous infusion of normal saline combined with volume-depletion by oral diuretic furosemide in 55 teenagers. After five years, salt sensitivity was re-examined and subject blood pressure was followed up. Blood pressure changes in salt-sensitive teenagers were compared to that of non-salt sensitive teenagers over five years.Results After 5 years, the repetition rate of salt sensitivity determined by intravenous saline loading is 92.7%. In teenagers with salt sensitivity on the baseline, both the systolic blood pressure increments and increment rates were much higher than non-salt sensitive teenagers (12.7±12.1 mmHg vs. 2.8±5.2 mmHg, P＜ 0.01; 12.2%± 12.0% vs. 2.5% ±4.4%, P＜ 0.001,respectively). There was a similar trend for diastolic blood pressure (8.4 ± 6.4 mmHg vs. 3.7 ± 6.4 mmHg, P = 0.052; 13.2% ±10.6 % vs. 6.8%± 10.1%, P = 0.053, respectively).Conclusions Salt sensitivity determined by intravenous saline loading showed good reproducibility. Blood pressure increments with age were much higher in salt-sensitive teenagers than non-salt sensitive teenagers, especially in terms of systolic blood pressure.     

Acupuncture Combined with Spinal Tui Na for Treatment of Primary Dysmenorrhea in 30 Cases

Objective: To observe the therapeutic effects in acupunture treatment of primary dysmenorrhea combined with spinal Tui Na, and study its mechanism. Methods: Thirty cases of the treatment group were treated by acupuncture combined with spinal Tui Na, and thirty cases in the control group were treated by routine acupuncture. Results: The total effective rate was 93.3% in the treatment group, and 73.3% in the control group, with a significant difference between the two groups (P<0.05). Conclusions: Acupuncture combined with spinal Tui Na has good prospects for treatment of primary dysmenorrhea.     

Luo Lingjie's Experience in Treating Chronic Nephropathy

In treating chronic nephropathy,Luo Lingjie,a chief physician,pays attention to regulating the balance between yin and yang,treating infection if present,and removing pathogenic factors.He prescribes gentle drugs and uses carefully strongly warming-tonifying ones,emphasizes the importance of persuading the patient to persist in treatment with medication and nurse one's health for recuperation,and is good at combined use of TCM and western medicine therapy and brings the merits of various therapies into full play,with obvious theraoeutic effects.     

Dr.Zhang Ren's Experience in the Acupuncture Treatment of Different Diseases with the Same Therapeutic Principle

Dr.Zhang Ren,the chief physician,is the chairman of Shanghai Acupuncture and Moxibustion Association.Having been engaged in medicine for about 40 years,he is experienced in treating various intractable diseases.In his long years of clinical practice,he advocates taking the TCM differentiation as the basis to seek for the acupuncture method for treatment of modern intractable diseases.The author of this essay had the fortune to follow Dr.Zhang in study.The following is a summary of Dr.Zhang's experience in the acupuncture treatment for different intractable diseases with the same therapeutic principle.     

安心颗粒对急诊经皮冠状动脉介入术后生活质量影响的研究

目的：评价使用安心颗粒对急诊经皮冠状动脉介入术（PPCI）术后生活质量的影响.方法：将160例接受PPCI的急性ST段抬高型心肌梗死患者随机分为安心颗粒组（术前顿服安心颗粒8.8g,术后安心颗粒4.4 g/次,每日2次）和对照组（仅接受基础药物治疗）.所有患者均服用阿司匹林、氯吡格雷和阿托伐他汀.分别在入院时、出院前1d、出院后180 d时,应用心肌梗死多维度量表（MIDAS）、中文版SF-36评价量表对患者生活质量评分.并观察术后30 d以内的出血并发症、血小板减少症发生情况.结果：入院时和出院前1d,两组患者的心肌梗死MIDAS、SF-36量表评分比较无差异（P＞0.05）;出院后180 d时,与对照组比较,安心颗粒组MIDAS、SF-36评分明显减低（P＜0.05）;组内与入院时比较,两组出院前1d、出院后180 d时,MIDAS、SF-36评分均降低（P＜0.05）.两组患者在随访期间均无大量出血、少量出血、重度和极重度血小板减少症发生,安心颗粒组有4例、对照组有7例发生不明显出血（P＞0.05）.两组发生轻度血小板减少症的患者数比较无差异（P＞0.05）.结论：PPCI使用安心颗粒,能改善急性ST段抬高型心肌梗死患者的生活质量,且不增加出血风险.     

猪肺磷脂注射液联合经鼻持续气道正压通气对呼吸衰竭早产儿的临床疗效及肌酸激酶同工酶活性的影响

目的 探讨猪肺磷脂注射液联合经鼻持续气道正压通气(NCPAP)对呼吸衰竭早产儿的临床疗效及肌酸激酶同工酶活性(CK-MB)的影响.方法 选取呼吸衰竭早产儿80例,分为观察组和对照组各40例.对照组采用NCPAP给氧治疗,观察组给予NCPAP给氧联合猪肺磷脂气管内给药.观察两组患儿治疗前及治疗12h、24 h后PaO2、PaCO2、血氧饱和度(SaO2)、pH的变化情况,检测治疗前及治疗5d后血清CK-MB水平;评估两组患儿的临床治疗效果.结果 两组患儿PaO2、PaCO2、SaO2、pH比较,差异均有统计学意义(P＜0.05),其中观察组治疗后的PaO2、SaO2、pH均高于对照组,PaCO2则低于对照组.两组的PaO2、SaO2、pH均随观察时间延长而升高(P＜0.05),PaCO2均随观察时间的延长而降低(P＜0.05).观察组治疗有效率为87.5％,显著高于对照组的70.0％ (P ＜0.05).治疗5d后两组患儿血清CK-MB水平均较前降低(P＜0.05),且观察组明显低于对照组(P＜0.05).结论 猪肺磷脂注射液气管内给药联合NCPAP可以显著降低呼吸衰竭早产儿CK-MB的含量,提高治疗有效率,起到很好的呼吸循环支持作用.