更昔洛韦眼用凝胶联合干扰素治疗单纯疱疹病毒性角膜炎80例临床疗效分析

目的分析更昔洛韦眼用凝胶联合干扰素治疗单纯疱疹病毒性角膜炎的临床疗效。方法选取80例单纯疱疹病毒性角膜炎患者并分为观察组和对照组,给予观察组更昔洛韦眼用凝胶联合干扰素治疗,对照组单纯使用更昔洛韦眼用凝胶治疗,对比两组临床治疗效果。结果观察组的总有效率明显优于对照组,且复发率明显低于对照组;两组患者在视力方面治疗前后差异均较大,且治疗后观察组的视力平均值明显高于对照组,P0.05。结论更昔洛韦眼用凝胶联合干扰素治疗单纯疱疹病毒性角膜炎临床疗效显著。     

更昔洛韦眼用凝胶和阿昔洛韦滴眼液治疗病毒性角膜炎的效果对比及对血清相关指标的影响

目的对比更昔洛韦眼用凝胶和阿昔洛韦滴眼液治疗病毒性角膜炎的效果,并分析对血清相关指标的影响。方法选取我院2013年3月至2015年5月收治的病毒性角膜炎患者152例,随机分为观察组和对照组,各76例。对照组采用阿昔洛韦滴眼液,观察组采用更昔洛韦眼用凝胶。比较两组患者的临床效果及血清相关指标。结果观察组的临床总有效率为96.05%,显著高于对照组的81.58%,差异具有统计学意义(P<0.05);治疗3天、一周、两周后,两组的NO、GSH-Px、Zn值均依次增大,MDA和EGF值均依次减小,观察组的变化幅度优于对照组(P<0.05)。结论更昔洛韦眼用凝胶治疗病毒性角膜炎的疗效优于阿昔洛韦滴眼液,且对血清相关指标的影响更明显。     

更昔洛韦联合人血免疫球蛋白治疗急性病毒性脑炎的疗效观察

目的:探讨观察更昔洛韦联合人血免疫球蛋白治疗急性病毒性脑炎的疗效及分析对比.方法:挑选40例急性病毒性脑炎患者并根据患者治疗方法分为两组,对照组给予更昔洛韦治疗,研究组给予更昔洛韦联合人血免疫球蛋白治疗;观察并比较两组疗效.结果:研究组的治疗总有效率(95.00％)明显高于对照组(70.00％),P<0.05;而对照组的发热、昏迷及抽搐消失时间均长于研究组,P<0.05.结论:急性病毒性脑炎应用更昔洛韦联合人血免疫球蛋白治疗疗效优于单一使用更昔洛韦治疗,可以提高患者的临床疗效,使患者的发热、昏迷及抽搐时间减少,值得临床推广应用.     

更昔洛韦联合丙种球蛋白治疗病毒性脑炎的疗效观察

目的：观察更昔洛韦联合丙种球蛋白治疗病毒性脑炎的临床疗效。方法：将120例病毒性脑炎患者随机分为治疗组和对照组各60例,治疗组在降颅内压、降温、止痉、补液、补充电解质、保护胃黏膜及支持治疗基础上,应用更昔洛韦及大剂量静注丙种球蛋白治疗;对照组在降颅内压、降温、止痉、补液、补充电解质、保护胃黏膜及支持治疗基础上,应用更昔洛韦治疗。结果：治疗组发热、头痛、呕吐、精神行为异常等临床症状缓解时间与对照组比较,差异有统计学意义（P〈0.05）。结论：更昔洛韦联合丙种球蛋白治疗病毒性脑炎的临床疗效优于单用更昔洛韦。     

氟米龙滴眼液联合更昔洛韦眼用凝胶对单纯疱疹病毒性角膜炎病人的影响

目的:观察氟米龙滴眼液联合更昔洛韦眼用凝胶对单纯疱疹病毒性角膜炎(HSK)患者视力恢复及角膜愈合的影响。方法 :选取90例我院收治的HSK患者(2018-05～2019-04),按照治疗方案不同分组,每组45例(45只眼)。对照组采用更昔洛韦眼用凝胶治疗,观察组采用0.02%氟米龙滴眼液联合更昔洛韦眼用凝胶治疗。比较两组疗效、角膜愈合时间、治疗前后疼痛程度(VAS评分)及裸眼视力(UCVA)。结果 :观察组总有效率(95.56%)较对照组(82.22%)高(P0.05);观察组角膜愈合时间较对照组短(P0.05);治疗后观察组VAS评分较对照组低,UCVA较对照组高(P0.05)。结论 :氟米龙眼液联合更昔洛韦眼用凝胶治疗HSK疗效确切,可有效缓解疼痛,促进角膜愈合,改善患者视力水平。     

更昔洛韦联合卡介菌多糖核酸治疗带状疱疹疗效观察

目的 探讨更昔洛韦联合卡介菌多糖核酸治疗带状疱疹的临床疗效.方法 将86例带状疱疹患者按随机数字表法分为观察组和对照组,每组43例.对照组单纯应用更昔洛韦治疗;观察组在此基础上联合应用卡介菌多糖核酸治疗,观察并比较两组疗效、修复皮肤损害(止疱、结痂)时间和疼痛缓解时间、后遗神经痛发生率和不良反应情况.结果 两组患者均顺利完成治疗,没有因为无法耐受药物而退出者.观察组止疱、结痂和疼痛缓解时间均较对照组明显缩短,差异有统计学意义(P＜0.05);后遗神经痛发生率明显低于对照组,差异有统计学意义(P＜0.05);治疗14 d后观察组有效率为90.7%(39/43),与对照组的74.4%(32/43)比较差异有统计学意义(P＜0.05);两组均无严重不良反应发生.结论 更昔洛韦联合卡介菌多糖核酸治疗带状疱疹疗效确切,安全可行.     

更昔洛韦眼用凝胶在单纯疱疹病毒性角膜炎中应用的效果观察

目的 观察更昔洛韦眼用凝胶在单纯疱疹病毒性角膜炎中的临床应用效果.方法 选择我院2010年1月至2012年2月诊断和治疗的单纯疱疹病毒性角膜炎患者87例作为研究对象,按照随机数字表法分为对照组和观察组.其中对照组42例,给予口服阿昔洛韦、重组人干扰素α-2b滴眼液及阿昔洛韦滴眼液交替滴眼,结膜下注射利巴韦林治疗;观察组45例加用更昔洛韦眼用凝胶点眼治疗;比较两组的临床应用效果.结果 观察组的总有效率为97.8％,对照组为81.0％,两组比较,前者明显高于后者,且有显著性差异(X2=4.9409,P＜0.05);观察组的不良反应发生率为4.4％,对照组为7.1％,组间无显著性差异(X2=0.0063,P＞0.05).结论 更昔洛韦眼用凝胶在单纯疱疹病毒性角膜炎中的临床应用效果满意,且安全性可靠,是首选的药物治疗方案之一.     

健脾祛湿解毒汤联合更昔洛韦对带状疱疹病毒感染患者BDNF、MITOL的影响

目的 探究健脾祛湿解毒汤联合更昔洛韦对带状疱疹病毒感染患者脑源性神经营养因子(BDNF)、线粒体泛素连接酶(MITOL)的影响。方法 选择2019年3月-2020年6月医院收治的164例带状疱疹病毒感染患者为研究对象,依照随机余数分组方法分为更昔洛韦组81例、联合健脾祛湿解毒汤组83例。更昔洛韦组采用更昔洛韦治疗,联合健脾祛湿解毒汤组采用更昔洛韦联合健脾祛湿解毒汤治疗。对比白细胞介素(IL)-2、IL-10、IL-6、β-内啡肽、BDNF、MITOL、止痛、结痂、脱痂、证候积分以及临床疗效水平变化情况。结果 联合健脾祛湿解毒汤组止痛、结痂、脱痂时间短于更昔洛韦组(P<0.05);治疗后联合健脾祛湿解毒汤组IL-10、IL-6、证候积分低于更昔洛韦组(P<0.05);治疗后联合健脾祛湿解毒汤组IL-2、MITOL、BDNF、β-内啡肽高于更昔洛韦组(P<0.05);联合健脾祛湿解毒汤组治疗有效率为96.39%,高于更昔洛韦组86.42%(P<0.05)。结论 健脾祛湿解毒汤联合更昔洛韦可以改善IL-10、IL-6、IL-2、BDNF、β-内啡肽、MITOL水平,有效缩短止痛、结痂、脱痂时间,降低中医证候积分,可应用于临床。     

更昔洛韦治疗小儿病毒性脑炎38例疗效观察

目的观察更昔洛韦治疗小儿病毒性脑炎的临床疗效。方法将68例病毒性脑炎患儿随机分为2组,治疗组38例应用更昔洛韦,对照组30例应用病毒唑,7~10 d为一疗程。结果2组患儿的临床疗效治疗组和对照组总有效率分别为92%和83%,2组比较差异有统计学意义(P<0.05)。治疗组发热、头痛、呕吐、抽搐、意识障碍、等消失时间均较对照组明显缩短(P<001)。结论更昔洛韦治疗小儿病毒性脑炎疗效较好,毒副作用少,值得临床推广应用。     

炎琥宁联合更昔洛韦对单纯疱疹病毒性角膜炎患者血清和泪液中抗氧化指标的影响

目的探讨炎琥宁联合更昔洛韦对单纯疱疹病毒性角膜炎患者血清和泪液中抗氧化指标的影响,为临床合理用药提供新思路。方法以医院2015年4月至2017年9月收治的单纯疱疹病毒性角膜炎经药物治疗的102例患者为研究对象,随机数字法将其分为对照组(48例)和实验组(54例)。对照组单纯采用更昔洛韦眼用凝胶治疗,实验组在此基础上增加炎琥宁注射液治疗。比较两组治疗前后泪液、血清抗氧化指标、症状评分变化和不良反应情况。结果实验组在治疗后血清氧化指标IFN-γ(3.42±0.51)μg/L、LPO(2.49±0.54)nmol/L、MDA(3.56±0.68)nmol/ml、TAC(5.44±1.43)U/ml、NO(60.45±4.16)μmol/L、GSH-Px(37.43±3.58)mg/ml均显著低于对照组,SOD(186.19±10.68)U/ml显著高于对照组(P0.05);泪液氧化指标呈现与血清氧化指标相同的变化。治疗后实验组症状积分视觉疲劳(0.45±0.16)分、流泪(0.56±0.28)分、干涩感(0.43±0.08)分、异物感(0.42±0.21)分、眼痛(0.49±0.14)分、烧灼感(0.69±0.18)分、畏光(0.44±0.13)分、总分(3.48±0.43)分,均显著低于对照组(P0.05);实验组不良反应率(20.37%)和对照组(18.75%)无显著性差异(P0.05)。结论炎琥宁联合更昔洛韦适用于单纯疱疹病毒性角膜炎的临床治疗,能够有效恢复患者泪液、血清抗氧化指标表达水平,促进症状恢复,安全性好。     

有性才会有健康

性是基本的人权。根据我国著名的性学家史成礼教授的研究,性有“三大功能”:生育功能、享乐功能和健康功能。     

Communicating with people with dementia

It can be very difficult to communicate with people with dementia. Each case requires its own unique handling. Not every scenario is covered, as many times your own judgment is what will work, best according to the circumstances. These can change from dawn to evening and from day to day. Never assume things will be the way they were the last time you communicated. Be on your guard. Be adaptable. The article will help get you started to think of your own ways to communicate.     

Working with patients with physical disabilities

Medical practices need to make a number of adaptations to ensure that their facilities and staff are accessible to patients and other office visitors with physical disabilities. This article describes 10 specific strategies for preparing your medical practice for patients with disabilities, both inside and outside your office. It describes minimum standards for office doorways, sidewalk inclines, ramps, reception areas, and other adaptations medical offices need to make. The article also describes specific do and don't advice for communicating with patients with physical disabilities. It suggests strategies for preparing written materials for disabled patients, for communicating verbally, and for providing healthcare education. Finally, it suggests an appropriate role for medical practice staff in the delivery of healthcare services to patients with physical disabilities.     

经方汗证治验

临床上汗证病情复杂,分自汗、盗汗、黄汗和但头汗出,治疗汗证方药诸多,有益气固表、养阴清热和清热除湿等方法,疗效不一。受恩师刘健主任教导和《伤寒论》《金匮要略》病脉证并治启发,以脉证并治、方证对应思想,浅谈桂枝加附子汤、黄芪芍药苦酒汤、柴胡桂枝干姜汤和三物黄芩汤治疗汗证的经验,为经方治疗汗证提供新思路。     

Coping with Children with ADHD: Coping Styles of Mothers with Children with ADHD or Challenging Behaviours

Parents of children with Attention Deficit Hyperactivity Disorder (ADHD) can experience significant levels of stress in their parenting roles, however, little is known about the specific coping strategies used by these parents. This pilot study Investigated the coping strategies used by mothers of children with ADHD. A 34 item questionnaire was developed to identify maternal coping strategies. A cohort of 38 mothers of children with ADHD and a control group of 30 mothers of children without ADHD or any other disability/illness completed the questionnaire. Factor analysis of responses produced three factors: Aggressive/Confrontive Coping, Rational Coping, and Indirect Coping. These factors are similar to coping dimensions proposed by Folkman and Lazarus. Comparisons between the two groups of mothers revealed that mothers of children with ADHD used significantly more Indirect Coping.     

Problems with measuring satisfaction with social care

The measurement of customer satisfaction has become widespread in both healthcare and social care services, and is informative for performance monitoring and service development. Satisfaction with social care services is routinely measured with a single question on overall satisfaction with care, comprising part of the Adult Social Care Survey. The measurement of satisfaction has been problematised, and existing satisfaction measures are known to be under‐theorised. In this article, the process of making an evaluation of satisfaction with social care services is first informed by a literature review of the theoretical background, and second examined through qualitative interviews conducted in 2012–2013 with 82 service users and family carers in Hampshire, Portsmouth and Southampton. Participants in this study were from white British and South Asian backgrounds, and the influence of ethnicity in the process of satisfaction evaluation is discussed. The findings show that the majority of participants selected a positive satisfaction rating even though both positive and negative experiences with services were described in their narratives. It is recommended that surveys provide opportunity for service users and family carers to elaborate on their satisfaction ratings. This addition will provide more scope for services to review their strengths and weaknesses.     

Ending clinical relationships with people with schizophrenia

The potential for the social worker-client relationship to contribute to therapeutic outcomes is not always apparent with clients who have schizophrenia. Their cognitive impairments often make it difficult for these clients to regulate interpersonal boundaries and for social workers to connect with them. Clinical practice is enhanced, however, by recognizing that severely impaired clients have the capacity and desire for relationships with service providers and others. The manner in which the clinical relationship ends is important for maintaining clinical gains and determining whether the client will risk investing in future relationships. The purpose of this article has been to sensitize social workers to the delicate nature of managing the endings of those relationships.