联合用药治疗女性生殖道支原体感染82例临床分析

目的 探讨生殖道支原体感染的有效治疗方法。方法 把152例病人随机分为观察组82例和对照 组70例,观察组给予强力霉素口服和阴道局部应用阿希米联合用药治疗,对照组仅给予强力霉素口服治疗。结 果 观察组总有效率为91.46％;对照组总有效率为78.57％。两组比较差异有显著性(P<0.05)。而白带增多、外阴 瘙痒等临床症状的消失率观察组(94.7％)亦显著高于对照组(75％),P<0.05。结论 强力霉素与阴道局部应用阿 希米联合用药治疗生殖道支原体感染是安全、有效的。     

心脏瓣膜手术后早期住院死亡相关危险因素分析

目的探讨影响心脏瓣膜手术后早期住院死亡相关危险因素。方法 2001年1月—2010年11月,618例心脏瓣膜疾病患者在我科行手术治疗,其中男339例,女279例,年龄10-74（44.01±13.95）岁;风湿性心脏病387例,非风湿性心脏病231例;以手术后早期住院死亡为研究终点,采用单因素及多因素logistic回归方法分析术后早期死亡的危险因素。结果心脏瓣膜术后早期住院死亡率6.2%（38/618）,死亡原因依次为低心排综合征,室性心律失常,多器官功能衰竭。单因素分析显示,年龄≥65岁（P=0.000）、心功能Ⅳ级（P=0.000）、肺动脉高压≥60 mmHg（P=0.024）、体外循环时间≥3 h（P=0.000）、主动脉阻断时间≥2 h（P=0.000）、术后出现并发症（P=0.011）、输血量≥2 000 ml（P=0.000）是瓣膜手术后早期死亡的危险因素。多因素Logistic回归分析示年龄≥65岁（P=0.042）、心功能Ⅳ级（P=0.019）、体外循环时间≥3 h（P=0.000）、术后出现并发症（P=0.000）、输血量≥2 000 ml（P=0.000）是瓣膜手术后早期死亡的独立危险因素。结论重视心脏瓣膜术后早期死亡的独立危险因素处理,缩短体外循环时间,减少并发症,对降低瓣膜手术的死亡率具有重要的临床意义。     

川芎嗪与噻氯匹啶联合治疗缺血性脑血管病的临床研究

目的　观察川芎嗪与噻氯匹啶联合治疗缺血性脑血管病的临床疗效。方法　本组 76例病人随机分为 3组 ,川芎嗪加噻氯匹啶 32例为治疗组 ;对照组 1 :单用噻氯匹啶 2 0例 ;对照组 2 :单用川芎嗪 2 4例。 1个月为 1个疗程。结果　治疗组总有效率为 96 .85 % ,优于对照组 1及对照组 2 (70 % ,87.5 % ) ;1年后复发率 9% ,对照组分别为 1 3.6 %和 1 1 .3%。结论　川芎嗪加噻氯匹啶治疗缺血性脑血管病优于单用川芎嗪或噻氯匹啶的疗效。     

弥漫性肺疾病395例临床分析

目的回顾性分析弥漫性肺疾病(DLD)患者的诊治情况,以提高临床医师对DLD的认识和诊治水平。方法回顾性分析1990年1月1日至2003年12月31日上海同济大学附属肺科医院收治的395例DLD住院患者的临床、影像学和病理等资料。结果本组395例DLD患者涉及的病种包括寻常型间质性肺炎(UIP)、非特异性间质性肺炎(NSIP)、脱屑型间质性肺炎(DIP)、呼吸性细支气管炎伴间质性肺病(RBILD)等10余种类型。其中,男190例,女205例,男女比例为0.93,女性稍多。以男性占优势的疾病主要包括UIP(男女比例为1.87)、弥漫性泛细支气管炎(DPB,男女比例为1.50)和RBILD(男女比例为1.33),以女性居多的病种主要包括隐原性机化性肺炎(COP,男女比例为0.25)、NSIP(男女比例为0.29)、结节病(男女比例为O.36)和胶原血管系统疾病(男女比例为0.24)等。随年龄增长DLD患病人数增加,>60岁者占36.2%。UIP以>50岁人群为主,占83.7%。1998年以后的6年收治的病例明显增加,占14年总病例数的85.3%(337/395例),活检例数占14年间的90.2%(92/102例)。有明确职业史者142例,占35.9%,其中农民占42.3%。吸烟者137例,占34.7%,吸烟率>40%的病种有肺泡细胞癌(72.7%)、DPB(60.0%)、RBILD(57.1%)和UIP(48.8%)。102例有活检资料的患者中,糖皮质激素治疗有效率为76.5%。不同病种的转归差别很大,DIP、COP、RBILD、DPB和结节病等的治疗有效率均达100.0%,NSIP为84.2%,UIP仅为40.0%。结论DLD患病率呈上升趋势,其发病的性别和年龄分布因不同病种而异。除UIP外,其他病种对糖皮质激素治疗的反应良好。DLD的病理活检率尚有待提高。     

阳萎的诊断程序和病因分类探讨(附100例分析)

本文报告1987—1989年间对阳萎诊断程序和病因分类的探讨,提出4步诊断程序和原5步程序作了比较。在100例阳萎病因中分为六类,心理性阳萎占65％,其次为血管性阳萎古24％,其它种阳萎合占11％。结合资料对诊断程序和病因加以讨论。     

Surgical management of thyroid diseases--a study on 78 cases

A total of 78 cases with thyroid diseases were treated surgically in the Department of ENTD, Mymensingh Medical College Hospital during the period from 2000-2001. The different types of surgery were done according to the diagnosis being presented here. Out of 78 cases, 60 (76.9%) were female and 18 (23.1%) were male having female to male ratio of 3.3:1. The highest number, 47 cases (60.3%) belongs to 21-40 year age group. The study revealed the incidence of thyroid diseases as follows: 53 (67.9%) Benign cold single nodular goitre. 17(21.8%) Benign cold multinodular goitre and 08 (10.3%) Papillary carcinoma of thyroid. Regarding surgical management 40 (51.3%) patients underwent hemithyroidectomy. Lobectomy were done for 13 (16.7%), subtotal thyroidectomy for 15 (19.2%), total thyroidectomy for 5 (6.4%) patients and total thyroidectomy with functional neck dissection were performed for 5 (6.4%) patients. The study showed that females were the mostly affected group having benign single cold nodular goitre who were treated surgically by hemithyroidectomy.     

Effectiveness of in vitro fertilization with intracytoplasmic sperm injection for severe male infertility

BACKGROUND: In its 1993 report the Canadian Royal Commission on New Reproductive Technologies challenged the effectiveness of in vitro fertilization for severe male infertility. To address the Commission's concern, the authors compared the relative effectiveness of in vitro fertilization combined with intracytoplasmic sperm injection for severe male infertility and conventional in vitro fertilization for complete tubal occlusion in women. METHODS: This historical cohort study was done at the PROCREA Fertility Centre, a private tertiary human reproduction centre in Montreal. Three groups of infertile couples were compared: 122 couples with severe male infertility treated by in vitro fertilization with intracytoplasmic injection of fresh sperm from ejaculate (group 1); 27 couples with obstructive azoospermia treated by in vitro fertilization with intracytoplasmic injection of epididymal sperm (collected by microepididymal or percutaneous epididymal sperm aspiration) (group 2); and 98 couples with tubal factor infertility (bilateral tubal occlusion) treated with conventional in vitro fertilization (with sperm from ejaculate) (group 3). The main outcomes measured were rates of fertilization, pregnancy, clinical pregnancy and implantation. RESULTS: Pregnancy rates per started cycle were 35%, 40% and 34% for groups 1, 2 and 3 respectively. When prognostic factors were controlled for, none of the outcome measures differed significantly between the 3 groups. INTERPRETATION: In vitro fertilization with intracytoplasmic injection of sperm from the ejaculate or the epididymis is as effective for treating severe male infertility as conventional in vitro fertilization is for treating complete occlusion of the fallopian tubes in women.     

睾酮对慢性心力衰竭雄性大鼠左心功能的影响

目的:观察生理剂量睾酮(Testosterone,T)替代治疗对心力衰竭雄鼠左心功能的影响。方法:健康雄性SD大鼠120只,随机分为假术组(sham组,n=15),模型组(n=105)。模型组行冠脉结扎术,术后6周模型组存活44只,随机分为治疗组(CHF+TU,n=22)、心衰对照组(CHF,n=22),治疗组给予十一酸睾酮(testosterone undecanonate TU)5 mg/kg/次,1次/2周深部肌肉注射。心衰对照组给等容积的灭菌花生油。给药前、睾酮治疗12周后分别行超声学检查以评价心功能。结果:心力衰竭大鼠T水平与Sham组比较明显降低(179.3±89.81 ng/dl vs.475.28±161.37 ng/dl,P<0.05),TU治疗12周后CHF+TU组大鼠左室射血分数(EF)与CHF组比较明显改善(36.1±9.3%vs.33.2±7.5%,P<0.05)。结论:雄性慢性心力衰竭大鼠T水平明显降低,生理剂量的T替代治疗可以改善心衰大鼠左心功能。     

溴隐亭治疗男性泌乳素腺瘤及对患者性功能影响的评价

目的 探讨溴隐亭对男性泌乳素腺瘤患者的治疗效果及性功能的影响。 方法 分析及随访29例男性泌乳素腺瘤患者采用溴隐亭治疗后不同时间内分泌学、影像学检测的变化,并采用国际勃起功能指数-5(IIEF-5)对患者在药物治疗前、后的性功能进行评估。 结果 男性泌乳素腺瘤患者临床表现以性功能障碍、头痛、视力障碍多见。溴隐亭治疗6个月后,患者临床症状改善明显;血清泌乳素(PRL)水平明显下降(P<0.05),睾酮(T)水平有所升高(P<0.05),总体PRL水平正常化率为82.8%;疗效评价全部患者均有不同程度缓解,药物治疗总体有效率达100%;按照IIEF-5评估,患者性功能障碍均有不同程度改善。 结论 溴隐亭能改善患者临床症状,使内分泌功能趋于正常,更重要的是明显改善患者的性功能障碍状况。     

胰蛋白酶原激活肽和白细胞介素-6在实验性急性胰腺炎中的意义

目的 探讨血浆胰蛋白酶原激活肽(TAP)和血清白细胞介素-6(IL-6)作为早期预测实验性急性胰腺炎病情严重程度指标的可行性.方法 雄性SD大鼠90只,随机分成5组.分别是3%牛磺胆酸钠逆行胆胰管注射组、5%牛磺胆酸钠逆行胆胰管注射组、3%牛磺胆酸钠逆行胆胰管注射后0.5h经股静脉注入乌司他丁组、0.9%生理盐水逆行胆...