中药聪脑汤治疗老年性痴呆的临床研究

目的:比较聪脑汤和双益平(石衫碱甲)片剂治疗老年性痴呆(阿尔茨海默病,Alzheimerdisease,AD)的疗效。方法:35例AD病人随机分为2组,聪脑汤组20例,双益平组15例;分别给予聪脑汤50ml,口服,日3次和双益平片剂0.15mg,口服,日2次,两组疗程均为8w。结果:与治疗前相比,两组长谷川痴呆量表(HDS-R)积分均有显著性改善(P<0.05),聪脑汤组和双益平组总有效率分别为75%和73.4%,两组比较差异无显著性。结论:聪脑汤对AD临床症状有一定改善作用。     

Fahrunsicherheit durch Drogen und Medikamente

Zusammenfassung Medikamente – insbesondere solche mit zentralnervöser Wirkung – können einerseits die Fahrsicherheit einschränken, andererseits kann durch eine Arzneimitteltherapie eine krankheitsbedingt eingeschränkte Fahrsicherheit gebessert bzw. eine Fahreignung wiederhergestellt werden. Für die verschiedenen verkehrsmedizinisch bedeutsamen Arzneimittelgruppen werden im Folgenden die relevanten Leistungseinbußen dargestellt. Die dem Arzt im Zusammenhang mit einer Arzneimitteltherapie obliegenden umfangreichen Beratungs- und Hinweispflichten für seinen Patienten werden ebenfalls vorgestellt.     

重组合异种骨临床疗效观察

重组合异种骨（ＲＨＢ）骨形成蛋白（ＢＭＤ）与去除抗原特性后的异种松质骨的复合物，是近年来医学研究的一个新成果。既具有ＢＭＰ的高度诱导成骨作用，又具有松质骨的支架作用，十分便于临床使用、填充骨缺损。作者等应用ＲＨＢ治疗１６例骨缺损及骨不连，证实它是一种高效的成骨诱导物质，诱导生骨作用肯定，无明显副作用，临床使用方便，较自体骨移植愈合时间快，避免了取自体髂骨的痛苦。作者等认为，本生物制品颇值得大力推广应用。     

Acute biliary-vascular fistula following needle aspiration of the liver

A patient with cavernous transformation of the portal vein and a suspected hepatic mass lesion underwent an ultrasound-guided aspiration of the liver with a skinny needle. Two days later he became acutely ill. Bilirubin level peaked at 1375 mumol/L (80.4 mg/dL), and alkaline phosphatase level was 2290 IU/mL. There was no evidence of biliary obstruction. A biliary-vascular fistula was diagnosed by endoscopic retrograde cholangiography, and nasobiliary drainage was placed, leading to resolution of the symptoms and jaundice. A pressure gradient between the biliary tree and a venous collateral probably led to flow of bile into a blood vessel. Nasobiliary drainage should be considered as a potential therapy for acute biliary-vascular fistula.     

钻颅碎吸治疗急性期高血压性脑出血疗效观察

目的总结钻颅碎吸治疗高血压性脑出血的疗效。方法利用配对方法与保守治疗病人进行对比。碎吸组反复穿刺血肿,调整血压。对照组采取降颅压,营养脑细胞等内科治疗。结果碎吸组病死率15.6%,对照组病死率27%,两组相比P<0.05,CT观察发现,碎吸治疗可加速血肿的吸收。半年后随访结果表明,碎吸治疗可降低致残率。结论钻颅碎吸术可作为治疗部分高血压性脑出血病人的理想选择。     

Application of glow curve analysis methods to improve TLD-100 dose reassessment performance.

This paper presents a method of improving the TLD-100 dose reassessment performance. This method consists of applying numerical analysis techniques for evaluating the TLD-100 phototransferred thermoluminescence (PTTL) glow curve. From this analysis, a simple procedure for estimating the ultraviolet background components usually present in phototransferred thermoluminescence (TL) signals has been established. This procedure has been implemented in a computer program which performs the automatic evaluation of the glow curves and extracts the dose information contained in the PTTL curves. The use of this computer-aided evaluational method has enabled the extension of the working range of estimated absorbed dose down to 0.2-0.5 mGy with very adequate operational quality for doses even below the conventionally admitted lower reestimation limit (approximately 2 mGy). Because TL readout is a destructive process, the ability to reestimate doses can be important in any kind of dosimetric activity, such as operational dosimetry programs. The other commonly used dosimeter, film, uses a nondestructive readout and, therefore, presents some advantages over TLD when dose reassessment is necessary. With the reported improvements in the TLD-100 dose reassessment performance, the full range of absorbed doses covered by film dosimetry can now be reliably reassessed using TLD-100 dosimeters.     

可控性丝线留置术治疗体表难治性海绵状静脉畸形的实验及临床研究

目的研究可控性丝线的致栓效果及其治疗体表难治性海绵状静脉畸形的初步疗效。方法将丝线一端留置于不同管腔大小的静脉内,另一端挂于血管壁埋于皮下,实现其可控性,用经过不同处置的丝线,分别留置于兔耳缘静脉、股静脉,观察其引起血管栓塞的效果。选择致栓效果较好的丝线组,用于临床治疗难治性体表海绵状静脉畸形的患者。结果几种经不同处置的丝线,均能不同程度地起到闭塞血管的作用,对于管腔稍大,血流较快的静脉(兔股静脉),浸泡丝裂霉素并打结的丝线组,致栓效果最好;临床初步应用证实,可控性丝线治疗体表难治性静脉畸形,安全有效。结论可控性丝线静脉内留置术,是一种安全、有效、损伤小、操作简便的治疗体表难治性海绵状静脉畸形的新方法。     

SEOM clinical guidelines for the treatment of follicular non-Hodgkin’s lymphoma

Follicular lymphoma (FL) is the second most common subtype of non-Hodgkin’s lymphoma (NHL) in the Western world. FL constitutes the most frequent indolent lymphoma, well characterized by its clinical presentation related to nodal involvement and its morphologic and biologic features. It is often managed as an incurable disease. However, several active therapeutic approaches from the ‘wait and watch” strategy to the allogeneic transplantation are available for management of patients with FL and clearly have changed the natural history of this disease, achieving a long-term disease-free survival. Therapeutic decision is mostly conditioned by patient’s characteristics, stage, histological grade, tumor burden, and risk-predicting factors. This article try to summarizes the diagnosis and treatment of this heterogeneous group of patients.