培哚普利联合舒洛地特治疗老年早期糖尿病肾病疗效观察

目的观察培哚普利联合舒洛地特治疗老年早期糖尿病肾病的临床疗效。方法选择糖尿病肾病Ⅳ期患者65例,随机分为对照组和治疗组。对照组在常规治疗的基础上加用培哚普利,治疗组在对照组的基础上增加舒洛地特,8w后测定两组病人空腹血糖（FBG）、24h尿蛋白定量（UAE）、血清胱抑素C（Cystatin C）、甘油三酯（TG）、纤维蛋白原（FIB）的变化。结果治疗组与对照组比较血清胱抑素C、24h尿蛋白定量都有所下降,治疗组比对照组下降更为明显（P〈0.05）;而甘油三酯、纤维蛋白原只在治疗组有所下降,明显低于对照组（P〈0.05或P〈0.01）。结论舒洛地特联合培哚普利治疗可通过有效改善老年早期糖尿病肾病而达到延缓肾功能衰竭进展的目的 。     

不稳定型心绞痛调脂治疗对血浆C反应蛋白及纤维蛋白原水平的影响

 目的 观察不稳定型心绞痛(UAP)患者调脂治疗前后,血浆C反应蛋白(CRP)及纤维蛋白原(FIB)的水平变化。方法 选择UAP患者67例,随机分为两组,治疗组(n=35)给予辛伐他汀和常规治疗,对照组(n=32)仅给予常规治疗,分别测定两组患者治疗前后的血浆CRP水平、FIB水平。结果 (1)治疗6周后,治疗组血浆CRP水平、FIB水平均明显低于对照组,分别为(6.81±3.97)mg／L对(9.73±4.86)mg／L,P＜0.01和(2.86±0.98)mg／L对(4.15±1.03)mg／L,P＜0.01;(2)治疗组血浆CRP水平、FIB水平的降低与胆固醇(TC)水平的降低不相关。结论 UAP调脂治疗具有抗血管内皮炎症反应的作用,并独立于降脂之外。     

冠心病患者血浆纤维蛋白原与hs—CRP及血脂检测的临床意义

目的探讨血浆纤维蛋白原（FIB）与超敏C反应蛋白（hs—CRP）、血脂在冠心病诊疗中的价值。方法回顾性分析我院收治的98例冠心病患者与60例正常人群的临床资料,比较两组中血浆FIB、hs—CRP以及血脂水平的差异．以及3者与冠心病严重程度的关系。结果冠心病组中LDL—C水平均高于正常组,差异有统计学意义（P〈0．05）。冠心病组的急性心肌梗死（AMI）与不稳定性心绞痛（UAP）的FIB、hs—CRP水平均高于正常组,差异有统计学意义（P〈O．05）,稳定性心绞痛（SAP）与正常组差异无统计学意义（P〉O．05）。与正常组相比较,血管病变支数越多,FIB、hs—CRP、LDL—C的水平越高,差异有统计学意义（P〈0．05）。结论通过检测FIB、hs—CRP能够判断疾病严重程度．对诊断及预后判断有重要价值。     

瑞舒伐他汀钙治疗急性脑梗死的临床疗效观察

目的：探讨瑞舒伐他汀钙对急性脑梗死治疗的临床疗效。方法将78例急性脑梗死患者随机分为实验组和对照组,各39例。实验组患者在采用抗血小板聚集、扩张血管、甘露醇脱水降颅压等常规治疗基础上加用瑞舒伐他汀钙治疗,对照组则按照常规治疗。比较两组患者治疗前后血沉（ESR）、C反应蛋白（CRP）、纤维蛋白原（FIB）等炎症指标及血脂（TG、TC、LDL－C、HDL－C）水平变化,评价瑞舒伐他汀钙的临床疗效。结果两组患者的ESR、hs－CRP水平均随治疗时间逐渐下降,且实验组下降程度更明显,实验组水平明显低于对照组,差异具统计学意义（ P＜0.05）;两组患者FIB在第3天两组都表现轻度升高,后表现为逐渐下降,实验组下降趋势显著于对照组,实验组FIB水平明显低于对照组,差异具统计学意义（ P＜0.05）;治疗后HDL－C两组水平无明显差异（ P＞0.05）,两组TG、TC、LDL－C水平均随着时间逐渐下降,且实验组下降程度大于对照组,实验组水平显著低于对照组,差异具有统计学意义（P＜0.05）,可见实验组治疗效果显著优于对照组。结论瑞舒伐他汀钙显著降低脑梗死患者TG、TC、LDL－C水平、减轻炎症、抑制粥样斑块形成及稳定粥样斑块,降低脑卒中风险及病死率,疗效肯定,值得临床推广应用。     

C反应蛋白浓度与冠状动脉狭窄关系的探讨

 目的探讨冠心病(CHD)患者血浆C反应蛋白(CRP)的浓度与冠状动脉狭窄之间的关系.方法测定经选择性冠状动脉造影(CAG)证实为CHD患者和CAG结果正常者的血浆CRP浓度,分析CRP与冠脉狭窄间的关系.结果(1)CRP 浓度在单支冠脉病变组、双支冠脉病变组及3支冠脉病变组依次增高,均明显高于对照组(P＜0.05或P＜0.01);(2)CRP浓度与冠脉狭窄程度相关(r=0.55,P＜0.05);(3)CRP浓度在对照组、稳定性心绞痛组、不稳定性心绞痛组依次增高,稳定性心绞痛组及不稳定性心绞痛组均明显高于对照组(P＜0.05,P＜0.01).结论CRP浓度可作为临床评价冠脉狭窄程度的一个指标.     

丹红注射液加拜阿司匹林对心绞痛微循环的影响观察

目的：探讨丹红注射液加拜阿司匹林对不稳定型心绞痛（UA）微循环的影响。方法：将UA 140例随机分为观察组75例和对照组65例。对照组采用常规治疗;观察组在常规治疗基础上,加用丹红注射液和拜阿司匹林,2周为一疗程。比较两组治疗前后心绞痛发作次数、心电图、血脂、血液流变学、血清超敏C反应蛋白、凝血象活性、药物过敏等指标的变化情况。结果：观察组在改善心绞痛症状及心电图、降低纤维蛋白原浓度及血脂等方面的作用均显著优于对照组（P〈0.05）。结论：丹红注射液加拜阿司匹林可改善UA的微循环。     

芪参益气滴丸治疗冠心病心绞痛临床观察

目的观察芪参益气滴丸治疗冠心病心绞痛的临床疗效。方法选择冠心病心绞痛患者80例．随机分成治疗组和对照组各40例。芪参益气滴丸治疗组40例，西药对照组40例。治疗4周为1疗程。观察心绞痛症状及心电图ST段的变化。结果治疗组患者的心绞痛缓解总有效率及减少心绞痛发作频率、缩短发作持续时间方面，均优于对照组（P〈0．05）；心电图改善，治疗组亦显著优于对照组（P〈0．01）。结论芪参益气滴丸治疗冠心病心绞痛疗效确切。     

曲美他嗪联合阿托伐他汀治疗不稳定型心绞痛的临床疗效分析

目的探讨曲美他嗪联合阿托伐他汀治疗不稳定型心绞痛的临床疗效。方法选取海军总医院2011年1月-2012年6月不稳定型心绞痛患者122例,随机分为两组,61例患者行常规治疗为对照组,61例患者同时给予曲美他嗪、阿托伐他汀治疗为观察组,随访6个月,比较两组患者的临床指征、临床疗效、并发症情况、再住院情况。结果治疗后,观察组与对照组总胆固醇（TC）、甘油三酯（TG）、低密度脂蛋白胆固醇（LDL—C）、C反应蛋白（CRP）均显著降低,观察组与对照组高密度脂蛋白胆固醇（HDL—C）显著升高。观察组TC、TG、LDL—C、CRP均明显低于对照组,观察组HDL—C均明显高于对照组,观察组心绞痛总有效率95．1％、心电图总有效率83．6％,均明显高于对照组的80．3％、60．7％,观察组再住院率明显低于对照组,差异均有统计学意义（P〈0．05）。观察组并发症发生率高于对照组,差异无统计学意义（P〉0．05）。曲美他嗪联合阿托伐他汀治疗与硝酸盐、卢受体阻滞剂、钙拮抗剂等用药治疗存在明显正相关性。结论曲美他嗪联合阿托伐他汀治疗不稳定型心绞痛的临床疗效显著,可明显改善患者的临床指标和临床病症,降低再住院率,值得临床推广使用。     

丹参酮ⅡA对糖尿病维持性血透伴缺血性心脏病患者的疗效观察

目的探讨丹参酮ⅡA磺酸钠对糖尿病维持性血液透析（MHD）伴缺血性心脏病（IHD）患者的疗效。方法将40例MHD伴IHD患者随机分成2组。治疗组20例,给予生理盐水250 ml＋丹参酮ⅡA磺酸钠注射液20 mg,3次/w,于每次透析结束后静脉输入;对照组给予口服复方丹参滴丸10粒/次,3/d。两组疗程均为6个月。分别记录两组患者治疗前后的血脂、血液流变学、超氧化物歧化酶（SOD）、丙二醛（MDA）、心肌耗氧量、纤维蛋白原（FIB）、心电图及有无心绞痛症状。结果与对照组治疗后相比,治疗组治疗后心肌耗氧量、MDA、FIB、全血黏度高切和低切、血浆黏度、红细胞聚集指数显著下降（P〈0.05或P〈0.01）,心电图ST段、SOD显著升高（P〈0.05）。结论丹参酮ⅡA磺酸钠降低血液黏度,改善心肌缺氧,明显减轻维持性血液透析患者的心肌缺血。     

硝酸甘油联合丹参川芎嗪治疗心绞痛的有效性和安全性分析

目的探讨硝酸甘油联合丹参川芎嗪治疗心绞痛的有效性及安全性。方法将72例心绞痛患者随机均分为实验组和对照组,对照组采用硝酸甘油治疗,实验组采用丹参川芎嗪联合硝酸甘油治疗,比较两组的心电图改善情况与临床疗效、治疗前后心绞痛持续时间、发作次数及不良反应发生率。结果两组心电图疗效及临床疗效总有效率比较均有显著性差异（P〈0．05）;相比于对照组,实验组治疗后心绞痛持续时间及发作次数明显缩短,比较有显著性差异（P〈0．05）;实验组不良反应发生率为5．56％;对照组为16．67％,两组不良反应发生率比较有显著性差异（P〈0．05）。结论采用硝酸甘油联合丹参川芎嗪治疗心绞痛具有很好的疗效,其安全性高。     

Optimization of the system of medical service of students of Cadet Schools of the Ministry of Defense of the Russian Federation

One of the factors of the successful military career guidance Cadet schools students is preserving and promoting their health. Medical support of children and adolescents aged 10-17 years should include the full range of medical and preventive measures defined for this group. The state of providing outpatient care for pupils at the Cadet School in St. Petersburg was studied. These results show that full medical care in accordance with the standards can be based only on children's health clinics. It is important that the organization of medical support pupils cadet schools should be cooperate with civilian health care.     

带状疱疹83例误诊原因分析

带状疱疹是由水痘—带状疱疾病毒引起的皮肤科常见疾病。其主要的病理损害,一是受累神经的严重炎症性浸润,继而导致受侵犯神经节内神经细胞变性、坏死;二是皮肤的水泡。迅速抑制神经节和相应的感觉神经纤维的充血、水肿和坏死,防止粘连形成,达到迅速镇痛、改善皮损,缩短病程及防止后遗症的发生是治疗的关键。因而,尽早明确诊断,     

Estimation of accumulated dose of radiation by method of ESR-spectrometry of dental enamel of mammals

ESR-spectrometry was used to investigate radiation-induced paramagnetic centers in enamel of mammals: carnivores (polar bear and fox), ungulates (reindeer, European bison, moose), and man. Values at half the microwave power saturation of the radiation signal, P_1/2, evaluated at room temperature, was found to range from 16 to 26 mW for animals and man. A new approach to discrimination of the radiation induced signal from the total ESR spectrum of reindeer enamel is proposed. ‘Dose-response’ dependencies of enamel of different species mammals were measured within the dose range from 0.48 up to 10.08 Gy. Estimations of ‘radiosensitivity’ enamel of carnivores and ungulates showed good agreement with radiosensitivity enamel of man by ESR method.     

Analysis of the results of the international comparison of activity measurements of a solution of Fe

The results of an international comparison of activity measurements of a solution of ⁵⁵Fe organized by the BIPM in 2005 are reported and analysed. This exercise, which follows the procedures of the CIPM mutual recognition arrangement to update older comparisons, is a renewal of the comparison organized by the BIPM that took place in 1978. A EUROMET comparison was organized in 1996 specifically to compare activity measurements of a ⁵⁵Fe solution by means of liquid-scintillation techniques. Results of these three comparisons are presented and discussed in this paper.

The radionuclide solution was provided by the NPL, which also distributed the samples to the participants. The activity of the ampoules was measured by 16 laboratories using 12 methods producing 25 results. Some general considerations on uncertainty assessments pertaining to the different techniques used are drawn. The outcome of four different estimators is compared from which the presence of at least one outlier can be confirmed. Further measurements should be made to try to reduce the discrepancy between the results. To date the outcome of the present comparison does not show an improvement to that of the 1996 comparison.     

Evaluation of the results of various technics of non-surgical therapy of varicocele

A new method of non-surgical treatment of varicocele syndrome is described: it consists in sclerotherapy of spermatic vein by trans-femoral percutaneous catheterization with balloon-catheters. In 8 cases venous thrombosis has been induced by direct electric clotting. The techniques and a 6 months follow-up are discussed. It is pointed out that this procedure should be considered as the method of choice for tubular lesions and sub-fertility prophylaxis in young people and in childhood.     

延迟性脾破裂误漏诊原因分析

目的探讨延迟性脾破裂误漏诊原因和预防措施.方法回顾性分析总结12例延迟性脾破裂中的诊断和误漏诊的经验与教训.结果本组延迟性脾破裂的误漏诊5例(41.66%).对多发伤与脾破裂并存可能认识不足,外伤史轻微或伤员隐瞒外伤史,缺乏腹痛-缓解-突然再腹痛的典型病史,缺乏“对冲性脾破裂”力学分析和整体化诊断思路等为其误漏诊的主要原因.结论详细的外伤史和全面系统检查,重视腹以外多发伤掩盖腹内脏器伤及延迟性脾破裂可能.确立外伤-腹内脏器伤-脾破裂整体化诊断思路.不间断地辅以B超检查脾形态学变化和腹内有无积液,腹腔穿刺确定有无血腹、X线胸腹部检查观察左侧胸肋角和膈肌运动情况、必要时CT检查以尽早发现脾包膜下血肿,降低延迟性脾破裂误漏诊率.