丹参预防脊柱外科术后脊髓缺血再灌注损伤的疗效观察

Objective To investigate the effect of salvia mihiorrhiza on spinal cord ischemia reperfusion injury after surgical treatment in patients with cervical canal stenosis. Methods Retrospective analysis of 64 cases had cervical canal stenosis in the last 5 years in our hospital. Sixty-four cases were randomly divided into the salvia mihiorrhiza group(31 cases)and the control group(33 cases). The therapeutic effect was assessed using JOA grade system. Results In the salvia mihiorrhiza group,the JOA average score was 8. 8 ±2. 6 before surgical treatment, after two weeks of surgical treatment it was 13. 7 ± 2. 4. The JOA improvement ratio was (61. 5 ± 2. 9) % . In the control group,the JOA average score was 9. 1 ±2. 2 before surgical treatment,after two weeks of surgical treatment it was 13. 4 ± 2. 3. The JOA improvement ratio was (60. 5 ± 2.2)% .The JOA improvement ratio in the salvia mihiorrhiza group was significantly higher than that in the control group (P < 0. 05) . Conclusions Salvia mihiorrhiza has protective effect on spinal cord ischemia reperfusion injury.     

椎管扩大成形术对脊髓型颈椎病肢体功能障碍的改善

Background:The treatment of cervical spondylopathy have two ways,front and posterior decompression operation.But the operation by front route only apply in the cases of 1～ 2 segments of vertebral canal,and the operation by posterior route can cause the compression of posterior spinal cord and lead to dysfunction of limbs more worse.The plastic operation of enlarging vertebra canal can relieve the pressure of spinal cord and avoid re- stenosis of vertebral canal.     

咳嗽训练促进颈脊髓损伤伴不全瘫患者排痰

【 abstract 】 objective To explore the effects of cough training on intercostals muscles strength and sputum excretion ability in acute cervical spinal cord injury patients with incomplete paralysis. Methods 127 acute cervical spinal cord injury with incomplete paralysis cases treated in changzheng hospital from January 2012 to December 2015 were admitted into study. They had been divided into experimental group and control group randomly by the method of throwing a coin.Experimental group started cough training from 1 d postoperative and the control group only treated by routine sputum nursing measures.The effect of sputum excretion ability, intercostals muscles strength and the rate of sputum suction,lung infection and atelectasis had been compared 8 days after surgery.Results The sputum excretion ability and intercostals muscles strength of the experimental group were significantly better than the control group 8 days after surgery.The rate of sputum suction,lung infection and atelectasis in experimental group was significantly lower than the control group.There were no complications of early cervical fixation turning up in both groups.Conclusion The cough training can strengthen intercostals muscles of CSCI patients with incomplete paralysis, promote their sputum excretion ability .Futhermore ,It can reduce the rate of sputum suction and the incidence of respiratory complications such as lung infection, atelectasis.     

宫颈癌手术患者心理干预35例临床对比性分析

Objective To discuss the effect of psychological intervention on the patients of cervical cancer. Methods Take 35 patients of cervical cancer in psychological intervention group at random, at the same time, take the other 36 cases as control group. Evaluate condition of anxiety (SAS) and depression (ADS) before and after operation. Evaluate the time of getting out of bed and satisfaction of sex lives after operation. Results There were no significance in SAS, SDS before operation. The scores of SAS、SDS in psychological intervention group were significant lower than thcee in control group after operation. The time of getting out of bed in psychologi-cal intervention group was significant less than that in control group, and the satisfaction of sex lives after opera-tion was significant higher. Conclusions Psychological intervention on patients before and after cervical cancer plays an important role in physical and mental recovering of patient and rebuilding beautiful life.     

妥洛特罗贴剂治疗轻中度婴幼儿支气管哮喘临床观察

Objective To evaluate the therapeutic effect of tulobuterol tape on mild or moderate bronchial asthma in children less than three years old . Methods Sixty-two children with mild or moderate asthma were randomized to receive either tulobuterol tape(treatment group) or procaterol hydrochloride tablet(control group) on the basis of inhaled fluticasone propionate for 2 weeks. Symptom scores of asthma, frequencies of episode of wheeze, doses of inhaled ventolin as rescue drug and the incidence of adverse reactions were recorded. Results In the treatment group,the symptom scores during daytime in the treatment group were (2. 2 ±0. 9)/week and (0. 9 ±0. 5)/week after 1 and 2 weeks of treatment, respectively, which were significantly lower than that in the control group(3.4 ± 1. 1)/week and (1. 3 ± 0. 6)/week after 1 and 2 weeks of treatment, respectively) (P < 0. 05). The symptom scores during night in the treatment group was significantly lower than that in the control group after one week of treatment (1. 8 ± 0. 7) /week v. s. (3. 3 ± 0. 9) /week, P < 0. 05). The frequencies of episode of wheeze was significantly different between the two groups (2. 3 ±1.2 and 3. 6 ± 1.3 in the treatment and control groups, respectively (P < 0.05) .The doses of inhaled ventolin in the treatment group (2. 6 ±0.9 spray/week) was significantly lower than that in the control group (3.7 ± 0. 8) spray/week) (P < 0. 05). The incidence of adverse reactions in the treatment group was significantly lower than that in the control group (3. 12% v. s. 23. 33% ,x2 = 3. 89,P<0.05). Conclusions Tulobuterol tape is a safe and effective medication for the treatment of mild or moderate bronchial asthma in children less than three years old.     

妥洛特罗贴剂治疗轻中度婴幼儿支气管哮喘临床观察

Objective To evaluate the therapeutic effect of tulobuterol tape on mild or moderate bronchial asthma in children less than three years old . Methods Sixty-two children with mild or moderate asthma were randomized to receive either tulobuterol tape(treatment group) or procaterol hydrochloride tablet(control group) on the basis of inhaled fluticasone propionate for 2 weeks. Symptom scores of asthma, frequencies of episode of wheeze, doses of inhaled ventolin as rescue drug and the incidence of adverse reactions were recorded. Results In the treatment group,the symptom scores during daytime in the treatment group were (2. 2 ±0. 9)/week and (0. 9 ±0. 5)/week after 1 and 2 weeks of treatment, respectively, which were significantly lower than that in the control group(3.4 ± 1. 1)/week and (1. 3 ± 0. 6)/week after 1 and 2 weeks of treatment, respectively) (P < 0. 05). The symptom scores during night in the treatment group was significantly lower than that in the control group after one week of treatment (1. 8 ± 0. 7) /week v. s. (3. 3 ± 0. 9) /week, P < 0. 05). The frequencies of episode of wheeze was significantly different between the two groups (2. 3 ±1.2 and 3. 6 ± 1.3 in the treatment and control groups, respectively (P < 0.05) .The doses of inhaled ventolin in the treatment group (2. 6 ±0.9 spray/week) was significantly lower than that in the control group (3.7 ± 0. 8) spray/week) (P < 0. 05). The incidence of adverse reactions in the treatment group was significantly lower than that in the control group (3. 12% v. s. 23. 33% ,x2 = 3. 89,P<0.05). Conclusions Tulobuterol tape is a safe and effective medication for the treatment of mild or moderate bronchial asthma in children less than three years old.     

Traction combined with manual therapy on 70 cases of cervical spondylopathy

Background:Traction of cervical vertebrae is an effective method in treatment of cervical spondlopathy.Manual therapy can correct dysfunction,has the effects of function exercises and has an active significance to the rehabilitation of mixed cervical spondylopathy.Combination of these two methods could enhance therapeutic effects and do good to functional recovery.Objective:To observe effects of traction combined with nanual therapy on mixed cervical spondylopathy.Subjects:70 cases of mixed cervical spondylopathy from January 2000 to January 2001 were investigated including 49 males and 21 females,aged 21-48(mean:34.8)years old with disease course 1 week t 6 months.All cases were treated by non-operative therapy.Among these patients,numbness of upper limbs,22 cases,pain at neck,shoulder,back,40 cases.Pressure measurement by compression of neck was positive in 10 cases,brachial plexus pulling test was positive in 5 cases and lowering head test was positive in 11 cases.X-ray and CT examination showed abnormal curvature,hypertrophy of front and back edges of vertebrae,narrow intervertebral fossa in 51 cases,protrusion of intervertebral disc in 35 cases,prolapse in 25 cases,calcification of posterior langitudinal ligament in 48 cases.All cases were randomly divided into treatment group(n=36) and control group(n=34).there was comparability between two groups at age,sex,disease condition.brae:Traction began with 6 kg and 1 kg was increased every day.Maximal weight to male was 17 kg and female was 15 kg.Intermittent traction was wadopted,relaxing for 5 seconds after 5 seconds of traction.(2)Manual therapy:relaxing neck,pulling neck,lifting neck.Corresponding acupoints were compressed with thumb along brachial nerve.If the acupoint were selected correctly and “De qi” was felt,the patient,might feel comfortable after manual therapy.In the end.rolling and rotating manipulation,beating were adopted at neck,back and relaxing manipulation was adopted to upper libs 2 weeks was 1 therapeutic course.Simple manual therapy was adopted in control group.Main evaluation indexes:Marked:Clinical symptons disappeared,nedk could move freely and function recovered;Effective:Clinical symptoms disappeared basically and neck could take basic movement freely;Ineffective:no obvious alternation after treatment.Result:Marked:33 cases(92%)in treatment and 29 cases (85%)in control group;Effective:3 cases(8%)in treatment group and 4 cases(12%)in control group,Inefective:0 case in treatment group and 1 case(3%)in control group.Therapeutic effect in treatment group were superior to that in control group.Conclusion:Traction of cervical vertoebrae combined with manual therapy had an obvious effect on mixed cervical spondylopathy in relieving spasm of neck muscle and restoring of articular tunction.     

Effect of internal fixation and other methods alleviating low back pain caused by isthmic spondylolisthesis

AIM:To explore the long-term therapeutic effects of surgical treatment for isthmic spondylolisthesis.METHODS:42 cases of isthmic spondylolisthesis were analyzed retrospectively among which 13 cases underwent simple lumbar interlaminar bone implant and 29 cases underwent transpedicular fixation combined with bone implantation.Assessment was made according to JOA standards before and after treatment.RESULTS:At a 3 years of follow-up assessment,the functional outcome in transpedicular fixation assessed by JOA was excellent and good in 79.3% as compared with the group without fixation in which the excellent and good result was 76.9%.The level of pain and functional disability were similar in the two groups,but fusion rate in the group with transpedicular fixation was higher than that in group without it.CONCLUSION:Surgical treatment for isthmic spondylolisthesis imprves function and relieves pain.     

维拉帕米二甲双胍联合用药对高血压合并Ⅱ型糖尿病患者降压及降糖作用临床观察

Objective To observe blood pressure lowering effect and the blood glucose lowering effect on the combination of Verapamil and Metformin therapy for hypertensive patients with type 2 diabetes mellitus (diabetes mellitus, DM). Methods 129 cases of hypertension in patients with type 2 DM were divided into two groups, Verapamil treatment group, 98 cases in the control group 31 cases. (1) Verapamil treatment groups: Verapamil hydrochloride sustained-release capsules 180 mg/d, Metformin 750 ～ 1500 mg/d,Valsartan 80 ～ 160 mg/d, A Division horses Lin 100 mg/d, (2) control group, Valsartan 80 ～ 160 mg/d, Verapamil hydrochloride sustained-release capsules 180 mg/d, Aspirin 100 mg/d. (3) Blood pressure observation: Subjects in patients as early as 7: 00 and 22: 00 evening, measured two times a day and record systolic blood pressure blood pressure decreased significantly compared with those before treatment,4,6 weeks after the blood pressure weeks treatment their difference was significant (P<0.01), but the blood pressure has not dropped to normal ment review TC, TG, LDL decreased significantly after treatment, the difference was significant (P<0.05),HDL increased after treatment of (2.73±0.17), after treatment there was significant difference between improved (P<0.05), Verapamil treatment group was significantly better than the control group. Conclusion The combination of Verapamil and Metformin therapy for hypertensive patients with type 2 diabetes mellitus (DM) patients has good blood pressure lowering effect and blood glucose lowering effect.     

急性前壁心肌梗死伴心力衰竭患者急诊经皮冠状动脉介入治疗围手术期应用重组人B型钠尿肽的心肾保护效应

Objective To evaluate the protective effect of recombinant human B-type natriuretic peptide (rhBNP) on cardiac and renal functions in heart failure (HF) patients as a result of acute anterior myocardial infarction (AAMI) in peri-operative period of primary percutaneous coronary intervention (pPCI).Methods One hundred and twenty-six patients with AAMI-HF were enrolled into this study.All patients undertaken pPCI were randomly assigned to the rhBNP group (n=62) or the control group(n=64).rhBNP or nitroglycerin was intravenously administered on the basis of conventional treatment from first day of admission to 24 hours after pPCI in both groups.Heart rate (HR), systolic blood pressure (SBP), B-type natriuretic peptide (BNP), estimated lomerular filtration rate (eGFR) and heart function were observed.All patients were followed up for 30 days for the observation of main adverse cardiac events (MACE).Results The HR was significantly decreased compared with that at admission in rhBNP group, but such condition was not found in the control group.The SBP was reduced obviously in both groups.The plasma level of BNP, left ventricular ejection fraction (LVEF) and left ventricular end-diastolic dimension (LVEDD) were improved significantly at different time points compared with those before administration in both groups.The improvement of above parameters in rhBNP group was more significant than that in the control group[BNP (ng/L) 30 hours after pPCI: 303.5±128.4 vs.354.0± 133.6, 14 days after pPCI:157.8±78.6 vs.201.1±91.7; LVEF 1dayafter pPCI: 0.420±0.052 vs.0.378±0.055, 14 days after pPCI:0.444±0.050 vs.0.393±0.055, 30 days after pPCI: 0.469±0.053 vs.0.413±0.052; LVEDD (mm) 1 day after pPCI: 53.5±4.4 vs.57.6±4.4, 14 days after pPCI: 49.6±5.1 vs.53.4±4.6, 30 days after pPCI: 46.5±4.4 vs.50.2±4.8, P＜0.05 or P＜0.01].The eGFR was reduced obviously 1 day after pPCI than that at admission in both groups, and eGFR recovered to baseline 3 days after pPCI.The level of eGFR was significantly increased 7 days and 14 days after pPCI than that at admission, but there was no difference between rhBNP group and control group.The incidence of contrast-induced nephropathy showed a lowering tendency in the rhBNP group than that in the control group[19.4% (12/62) vs.29.7% (19/64),P=0.178].The incidence of ventricular arrhythmias was obviously lowered 7 days after pPCI in the rhBNP group than that in the control group[48.4% (30/62) vs.75.0% (48/64), P＜0.01].The rate of MACE was lower in rhBNP group than that in control group in 30 days[12.9% (8/62) vs.26.6% (17/64), P＜0.05].Conclusion Administration of rhBNP can effectively improve the heart function in AAMI-HF patients undergoing pPCI, and it lowered the incidence of MACE in 30 days, without influence on renal function, and it can reduce the incidence of contrast-induced nephropathy.