新生儿窒息224例分析

新生儿窒息２２４例分析长沙市妇幼保健院（４１０００７）李建军李爱林新生儿窒息是新生儿死亡及伤残的主要原因之一。为进一步探讨其防治措施，将我院近３年收治的２２４例病历资料做一回顾性分析。１资料和方法从１９９４年１月至１９９６年１２月我院共分娩２９９８例...     

Effects of Hedan Tablet(荷丹片)on Lipid Profile,Proprotein Convertase Subtilisin/Kexin Type 9 and High-Density Lipoprotein Subfractions in Patients with Hyperlipidemia:A Primary Study

Objective: To investigate the effects of Hedan Tablet(荷丹片) on serum lipid profile, proprotein convertase subtilisin/kexin type 9(PSCK9) and high-density lipoprotein(HDL) subfractions in patients with hyperlipidemia. Methods: Thirty-seven patients with hyperlipidemia were randomized to treatment with Hedan Tablet 4.38 g/day as Hedan group(18 cases) or placebo(19 cases) as control group for 8 weeks. The lipid profile, PCSK9 and HDL subfractions were determined at day 0 and week 8 in both groups respectively. Results: Hedan treatment for 8 weeks mildly decreased serum low-density lipoprotein cholesterol(LDL-C) levels, while no changes were found in total cholesterol(TC), triglycerides(TG) and PCSK9 concentrations. Furthermore, Hedan treatment increased the concentration of large high-density lipoprotein cholesterol(HDL-C) and the percentage of large HDL subfraction, while decreased the concentration of small HDL-C and the percentage of small HDL subfraction without changing serum HDL-C levels in patients with hyperlipidemia. Conclusion: Hedan treatment of 4.38 g per day for 8 weeks could confer a favorable effects on serum LDL-C concentration as well as HDL subfractions.     

Short-andLong-Term Effects of Xuezhikang(血脂康),An Extract of Cholestin,on Serum Proprotein Convertase Subtilisin/Kexin Type 9 Levels

Objective:To investigate the short- and long-term effects of Xuezhikang(血脂康,XZK),an extract of Cholestin,on proprotein convertase subtilisin/kexin type 9(PCSK9) level.Methods:Thirty rats were randomly divided into three groups and were given saline,XZK 1,200 mg/kg or lovastatin 10 mg/kg respectively by daily gavage for 3 days(n=10 for each).Sixteen patients without previous iipid-lowering drug treatment for dyslipidemia received XZK 1,200 mg daily for 8 weeks.Fasting blood samples and liver tissue were collected at day 3 for rats,while the blood samples were obtained at baseline and week 8 from patients.The serum PCSK9 and lipid profile were measured.The expression of hepatic low density lipoprotein(LDL) receptor and sterol regulatory element binding protein 2(SREBP-2) were measured by real time-PCR.Results:PCSK9 levels in rats were significantly increased in the XZK and lovastatin groups(P=0.002,P=0.003 vs.control) at day 3,while no significant differences were found in the levels of lipid parameters.PCSK9 levels in patients increased by34%(P=0.006 vs.baseline) accompanied by total cholesterol and LDL-cholesterol decreased by 22%and 28%(P=0.001,P=0.002 vs.baseline).The hepatic mRNA levels of LDL-receptor and SREBP-2 were significantly increased in the XZK and lovastatin groups.Conclusion:XZK has significant impact on PCSK9 in a short- and long-term manner in both rats and humans.Moreover,the data indicated that as lovastatin,XZK increased PCSK9 levels through SREBP-2 pathway.     

单侧双通道内镜与经通道显微镜减压技术治疗腰椎管狭窄症疗效比较

目的 评价单侧双通道脊柱内镜技术和经通道显微镜双侧减压技术治疗腰椎管狭窄症的临床疗效.方法 回顾性分析65例单节段腰椎管狭窄症患者的资料.行单侧双通道脊柱内镜技术治疗的患者为34例,行经通道显微镜双侧减压技术治疗的患者为31例.比较两组患者手术时间、术后下地活动时间及住院天数.根据术前、术后1月、3月及末次随访时疼痛视觉模拟评分(visual analogue scale,VAS)、Oswestry功能障碍指数(oswestry disability index,ODI)及改良MacNab标准评价临床疗效.结果 所有患者均顺利完成手术且获得有效随访,随访时间6～12个月.两组患者术后1月、3月及末次随访时VAS、ODI评分随时间推移逐渐降低,且较术前均得到明显改善(P<0.05),但两组组间比较无明显差异(P>0.05).末次随访时根据改良MacNab标准,单侧双通道脊柱内镜技术组优良率94.1％,经通道显微镜双侧减压技术组优良率90.3％,两种术式临床疗效无明显差异.单侧双通道脊柱内镜技术组手术时间、术后下地活动时间及住院天数均小于经通道显微镜双侧减压技术组,差异有统计学意义(P<0.05).结论 单侧双通道脊柱内镜技术具有视野清晰、操作灵活、适应症广泛、学习曲线低等优点,用于治疗腰椎管狭窄症可取得良好临床效果.     

后内侧入路在胫骨远端后pilon骨折治疗中的应用北大核心CSCD

目的探讨后内侧人路治疗后pilon骨折的临床疗效。方法对2009年3月至2013年11月采用经后内侧入路结合防滑钢板治疗的18例后pilon骨折合并踝关节不稳的患者资料进行回顾性分析,男12例,女6例;年龄15～65岁,平均42岁。均合并外踝骨折,6例合并内踝前丘骨折;受伤至手术时间2～15d,平均7d。结果所有患者术后获10～19个月（平均15个月）随访,骨折均愈合,愈合时间11—16周（平均13周）。术后1例患者出现切口浅表感染,经非手术治疗后愈合,无螺钉松动、断裂及内固定失效等并发症,无骨折不愈合及畸形愈合等并发症发生。临床疗效根据美国足踝外科协会评分进行评估：优15例,良2例,可1例。结论应用后内侧入路结合防滑钢板治疗后pilon骨折安全、可靠,可以取得满意的临床效果。     

手法整复老年腰椎小关节错缝

<正>腰椎小关节错缝,俗称为"闪腰",主要是在姿势不当或用力过猛时腰部活动受损致腰椎小关节关系紊乱,临床表现为腰痛,活动不利,强迫体位,深呼吸,咳嗽时疼痛加剧等。如不及时治疗或治疗失当,经久不愈给患者带来长期痛苦,产生慢性腰痛;由于老年患者腰椎骨质疏松,骨质增生,腰椎侧弯,给整     

获得性血管性血友病2例报告及文献复习

目的：探讨获得性血管性血友病的发病机制、诊断及治疗。方法：报道2例获得性血管性血友病并进行文献复习。结果和结论：获得性血管性血友病常伴发于血液肿瘤、免疫疾病、实体肿瘤等。大多数病人表现为自发性出血。治疗策略包括：治疗相关疾病，输注新鲜冰冻血浆或冷沉淀，静脉大剂量丙种球蛋白治疗等。     

间歇性变异性预激综合征1例

患者女 ,2 4岁 ,因反复阵发性心悸、胸闷就诊。平素健康 ,外院作心电图诊断为室性心动过速。入院后多次描记心电图均正常 ,行食管电生理检查 ,S1S1刺激间歇呈现左束支阻滞的QRS波群。静脉滴注异丙肾上腺素后 ,S1S1刺激诱发宽QRS波群的心动过速 (图 1a) ,频率 2 0 6次 /min ,呈左束支阻滞图。患者即出现头晕、心慌、胸闷、面色苍白 ,血压由 12 0 /90mmHg(1mmHg=0 .133kPa)降至 90 /6 0mmHg ,怀疑为室性心动过速 ,立即给予 10 0mg利多卡因静脉推注后心动过速即终止。遂以阵发性宽QRS心动过速待查 ,室性心动过速待排收治。该患者进行了 …     

全程康复治疗质量管理实践

全程康复治疗管理是对病人在康复治疗过程中康复质量的全面管理。中国康复研究中心在总结过去经验的基础上，针对康复治疗存在的主要问题，采取预先控制、环节检查、终末质量评定的全程康复治疗质量管理模式，取得了较好的效果。１影响康复医疗质量的主要问题１．１康复评...     

电刺激小脑治疗血管性痴呆的临床观察

脑循环功能治疗仪是一种新型电刺激治疗设备，通过体表电极无创伤引入小脑顶核区，可用于缺血性脑血管病的治疗，疗效满意，现报道如下。