逍遥散加味联合红金消结片对气滞血瘀型乳腺增生患者乳房超声指标及血管生成因子水平的影响

目的 探讨逍遥散加味联合红金消结片对气滞血瘀型乳腺增生患者乳房超声指标及血管生成因子水平的影响.方法 选取2019年11月至2020年12月我院接收的86例气滞血瘀型乳腺增生患者为研究对象,根据治疗方案将其分为对照组与观察组,各43例.对照组给予红金消结片治疗,观察组在对照组基础上加施逍遥散加味治疗.比较两组患者的临床...     

套索回归模型在中医临床研究数据的统计应用与R语言实践

目的：构建简洁且易于解释的模型,为同类研究提高模型预测的准确率提供参考。方法：从国家自然科学基金项目在研课题(81673904)中选取200例肺纤维化合并心力衰竭患者心力衰竭分级与其可能的相关因素,运用套索回归从患者的“性别”“年龄”“体质量指数”“收缩压”“舒张压”“血清总胆固醇”“空腹血糖”“舌质颜色”“舌苔颜色”“中医体质”等自变量中筛选特征变量,构建回归模型以探讨其与心力衰竭严重程度之间的关系。结果：剔除高维数据中的混杂因素,筛选特征变量,模型中包含6个特征变量,体质量指数=0.006 357 091,收缩压=0.219 695 622,血清总胆固醇=0.229 324 833,舌色红=0.004 216 705,苔色薄白=-0.825 660 057,苔色黄厚=0.356 499 153。肺纤维化合并心力衰竭出现严重心力衰竭的概率为P=-33.632+0.006×BMI+0.220×SBP+0.229×TC+0.004×是否红舌-0.826×是否薄白苔+0.356×是否黄厚苔。结论：得到的模型可用以解释严重心力衰竭发病的相关因素并推广到总体中进行预测。套索回归模型适用于中医临...     

甲状腺的淋巴流向

在５０例新鲜童尸上，用普鲁士兰氯仿溶液向甲状腺实质内注射后，观察该器官的淋巴液向，甲状腺的淋巴管从器官内器官表面形成淋巴管网。自淋巴管网发出的淋巴管向外侧、向上、向下走行，注入颈内静脉淋巴结，喉前淋巴结，气管旁淋巴结和气管前淋巴结。     

离子色谱法测定血清锂离子候选参考方法的建立及性能评估

目的：以离子色谱法为基础,建立血清总锂离子测定的候选参考方法并评价其性能。方法采用一种简单的样本前处理方法,用新鲜患者血清样本、IFCC-RELA 样本等对方法的精密度进行评估;用加标回收实验评价方法的准确性。结果锂离子标准曲线线性方程为：Y ＝0．8171X -0．0013,r^2＝0．99995,方法的检出限为6μg/L;测量血清样本的不精密度（CV）小于1．0％;样本的加标回收率在99％～101％之间。结论成功建立了血清锂候选参考方法,可用于血清锂离子项目的量值溯源和标准化,为血清锂常规检测系统向参考方法/参考物质溯源提供了有效途径。     

经伤椎椎弓根植骨和单纯后外侧植骨治疗胸腰椎骨折的疗效对比研究

目的 比较经伤椎椎弓根行椎体内植骨与单纯后外侧植骨两种方法 在椎弓根内固定系统复位固定治疗胸腰椎骨折疗效方面的差异.方法 对2004 年7 月至2007 年7 月沧州市中心医院采用椎弓根内固定系统复位固定治疗的186 例胸腰椎骨折患者的临床资料进行回顾性分析,其中经伤椎椎弓根椎体内植骨（经椎弓根植骨组）100 例,单纯后外侧植骨（单纯植骨组）86 例.对两组患者术后椎体压缩率、临床症状改善情况、并发症等方面进行比较.结果 两组患者均获随访.经椎弓根植骨组随访时间24～30 个月,平均随访时间28.4 个月;单纯植骨组随访时间24～38 个月,平均随访时间28.0 个月.经椎弓根植骨组患者术前、术后即刻和术后18 个月随访时的椎体压缩率分别为（38.2 ± 16.1）%、（2.4 ± 1.7）%和（3.7 ± 1.6）%,3 个时相点比较,差异有统计学意义（P ＜0.05）;单纯植骨组患者术前、术后即刻和术后18 个月随访时的椎体压缩率分别为（37.3 ± 13.8）%、（9.8± 5.3）%和（18.4 ± 8.7）%,3 个时相点比较,差异有统计学意义（P ＜0.05）.两组患者术前椎体压缩率比较,差异无统计学意义（P ＞0.05）;经椎弓根植骨组患者在术后即刻、术后随访18 个月时椎体压缩率均小于单纯植骨组（P ＜0.05）.两组术前有神经症状的患者术后腰部疼痛均明显缓解.术后18 个月随访时经椎弓根植骨组未出现断钉、断棒或松动;单纯植骨组有2 例出现内固定断裂.同期的CT扫描显示,经椎弓根植骨组椎体内植骨未吸收,填充确实,有4 例伤椎椎弓根破裂增粗,但未出现明显根性症状;单纯植骨组均可见椎体内空洞.结论 经伤椎椎弓根行椎体内植骨结合椎弓根内固定治疗胸腰椎骨折可即时恢复并长期维持椎体高度,降低内固定松动、断裂等并发症的发生率,临床效果理想.     

An allele of serum amyloid A1 associated with amyloidosis in both Japanese and Caucasians.

Serum amyloid A1 (SAA1), one of the two isotypes of acute phase SAA, is the predominant precursor to amyloid A (AA) protein, the chief constituent of fibrillar deposits in reactive (AA) amyloidosis. Prolonged hyperexpression of SAA protein accompanying chronic inflammation is critical to, but seems not to be sufficient for, the development of AA amyloidosis. Several previous studies have investigated the possibility of linkage between SAA1 exon 3 polymorphisms and susceptibility to amyloidosis. While the SAA1.1 allele was found to have a negative association with amylodosis in Japanese subjects, it showed a positive association in Caucasians. Moriguchi and colleagues recently showed that a single nucleotide polymorphism (SNP) at position -13 in the SAA1 5' flanking region was more strongly associated with amyloidosis than was the exon 3 polymorphism. To test whether this SNP may be an amyloidogenic factor common to Japanese and Caucasians, we have analyzed the SAA1 gene in amyloid and non-amyloid patients of both ethnic groups for the presence of T or C at position -13 and for exon 3 polymorphisms (SAA1.1, 1.3 or 1.5). The frequency of the -13T allele was 0.708 and 0.521 in Japanese rheumatoid arthritis patients with and patients without AA amyloidosis, respectively, and 0.536 and 0.196 in American Caucasian patients with AA amyloidosis and control subjects, respectively. In Caucasians, the -13T allele had a stronger association with amyloidosis than did the SAA1.1 allele. These findings suggest that -13T is a genetic background for AA amyloidosis in both Japanese and Caucasians and the difference in prevalence of AA amyloidosis in the two ethnic groups may be due, at least in part, to a difference in the frequency of the -13T SAA1 allele.     

临沂市放射诊疗资源配置现况调查

目的 了解临沂市放射诊疗资源配置现状,为卫生行政部门进一步优化资源配置提供数据支撑.方法 对全市所有开展放射诊疗的医院进行普查,用SPSS软件对数据进行统计分析.结果 临沂市共有放射诊疗机构305家,放射诊疗设备943台,市民平均每万人拥有放射诊疗设备0.89台,每家机构拥有放射诊疗设备平均数市区是县区的1.48倍.全...     

沈英森教授治疗杂病验案举隅

本文选用白疕、嗳气和口疮三份病案,通过分析其病因病机.详细阐明沈英森教授临证中运用中医药治疗杂病的特色和经验.     

沙利度胺联合LD-Arac治疗高危骨髓增生异常综合征27例

目的观察沙利度胺及小剂量阿糖胞苷(LD-Arac)治疗高危骨髓增生异常综合征的疗效,研究高危MDS的治疗方法。方法对27例高危骨髓增生异常综合征患者,应用LD-Arac10～15mg/m2,每12h1次皮下注射,15～21天1疗程,间隔10～15天重复。沙利度胺100mg·d-1,早、晚2次口服,无严重副作用者每周递增50mg·d-1,最大剂量300mg·d-1。结果完全缓解12例(44%),部分缓解6例(22%),3例进步,6例无效,总有效率66%。9例(33%)在治疗中转化为急性白血病。结论LD-Arac和沙利度胺治疗高危MDS确有明显疗效,无严重骨髓抑制,无感染及出血,明显改善高危MDS病人的预后。     

Reoperative CABG using left thoracotomy: a tailored strategy

BACKGROUND: Reoperative coronary artery bypass grafting (CABG) through a left thoracotomy is a challenging operation with no one dominant approach. We developed a tailored strategy for this difficult group of patients, integrating the currently available newer technologies for each patient indication. METHODS: Between October 1991 and October 1999, 50 consecutive patients underwent reoperative CABG through a left thoracotomy. Age was 65 +/- 9 years, 40 (80%) were men, and preoperative ejection fraction was 40 +/- 13. In 36 patients (72%) the left internal mammary artery had been placed to the left anterior descending coronary artery during the primary CABG and in 25 of 36 patients (70%) this left internal mammary artery-left anterior descending coronary artery graft was patent. The mean duration from previous CABG was 8.0 +/- 4.8 years. Three approaches were used: (1) conventional cardiopulmonary bypass using fibrillatory or circulatory arrest (n = 33, 66%); (2) Heartport endoaortic balloon occlusion (n = 4, 8%); and (3) off-pump beating heart techniques (n = 13, 26%). RESULTS: The off-pump CABG technique was used in the majority of recent patients and 1 (7.7%) had to be converted to cardiopulmonary bypass due to hemodynamic instability. When cardiopulmonary bypass was used its duration was 122 +/- 59 minutes and mean temperature on bypass was 24 degrees +/- 6 degrees C. In the 4 patients in whom the Heartport system was used, the median endoaortic occlusion duration was 49 minutes. Patients received an average of 1.4 grafts/patient. In 60 of 70 patients (89%) distal anastomoses were performed to an anterolateral coronary target. There were 3 of 50 (6%) operative deaths, 2 in the conventional group and 1 in the endoaortic balloon occlusion group. The mean length of stay in the 47 survivors was 7.8 +/- 3.9 days (median, 7 days). CONCLUSIONS: Reoperative CABG by left thoracotomy remains a challenging operation. Several techniques, including off-pump CABG, conventional cardiopulmonary bypass, circulatory arrest, and endoaortic balloon occlusion, should be in the surgeon's armamentarium to allow a tailored approach for each operation based on patient indications.