大剂量阿托伐他汀预防对比剂肾病

Objective To compare the efficacy of high and low dose atorvastatin on preventing contrast induced nephropathy (CIN) in patients underwent diagnostic and therapeutic coronary intervention. Methods All patients received atorvastatin 10 mg/d on the basis of hydrated therapy (n =100) and high dose group received additional atorvastatin 80 nag at 12 to 24 hours before procedure (n =50). Scr, Ccr, blood β2-M, urine NAG/Cr, and urine osmolality before and after the procedure were compared between the groups. Results Baseline demographic characteristics and nephropathy risk factors were similar between groups. Cer was significantly reduced while blood β2-M and uric NAG/Cr were significantly increased in low dose group (all P ＜ 0.05) . Blood β2-M in the high dose group was significantly lower than that in the low dose group at day 1 [(2.35±0.52) mg/L vs. (2.67±0.64) mg/L, P =0.008], day 3[(2.49±0.55)mg/L vs. (2.80±0.64) mg/L,P =0.011] and day 5[(2.29±0.53) mg/L vs. (2.56±0.66) nag/L, P = 0.026] post-procedure respectively; urine NAG/Cr in the high dose group was also significantly lower than that in the low dose group at day 1 [(1.19±0.30) U/mmol vs. (1.46±0.34) U/mmol, P ＜ 0.001], day 3 [(1.30±0.30) U/mmol vs. (1.59±0.33) U/mmol, P ＜ 0.001], and day 5 [(1.10±0.30) U/mmol vs. (1.34±0.35) U/mmol, P = 0.001] post-procedure respectively;Cer in the high dose group was significantly higher than that in the low dose group at day 1 [(73.69±20.99) mL/min vs. (65.19±18.72) mL/min,P =0.035], day 3[(64.04±15.82) ml/min vs. (56.79±14.50)ml/min,P =0.019] post-procedure respectively. Conclusion High dose atorvastatin use before angiography is superior than low dose atorvastatin on attenuating contrast induced renal dysfunction.     

密闭式吸痰在新生儿机械通气中的应用及对患儿血气指标的影响

目的分析密闭式吸痰在新生儿机械通气中的应用及对患儿血气指标的影响。方法选取2016年2月-2017年2月在天津市中心妇产科医院NICU病房接受机械通气治疗的80例新生儿为研究对象,依据随机数表法分为研究组和对照组,每组各40例。对照组患儿采用开放式吸痰方式,研究组患儿采用密闭式吸痰方式。观察并对比治疗前、后两组患儿的动脉血气(PaO_2、PaCO_2)指标、并发症发生情况及痰液喷溅情况。结果治疗前,两组患者的动脉血气指标(PaO_2、PaCO_2)检测水平比较,差异无统计学意义(P0.05);吸痰治疗20 min后,两组患儿PaO_2水平升高,PaCO_2降低,差异有统计学意义(P0.05)。治疗后,研究组患儿并发症总发生率和痰液啧溅率低于对照组,差异有统计学意义(P0.05)。结论新生儿机械通气中采用密闭式吸痰方式,能彻底切断接触性传播及空气传播途径,可有效稳定患儿动脉血气指标,降低呼吸机相关性肺炎(VAP)等并发症的发生率,值得临床推广。     

大剂量阿托伐他汀预防对比剂肾病

Objective To compare the efficacy of high and low dose atorvastatin on preventing contrast induced nephropathy (CIN) in patients underwent diagnostic and therapeutic coronary intervention. Methods All patients received atorvastatin 10 mg/d on the basis of hydrated therapy (n =100) and high dose group received additional atorvastatin 80 nag at 12 to 24 hours before procedure (n =50). Scr, Ccr, blood β2-M, urine NAG/Cr, and urine osmolality before and after the procedure were compared between the groups. Results Baseline demographic characteristics and nephropathy risk factors were similar between groups. Cer was significantly reduced while blood β2-M and uric NAG/Cr were significantly increased in low dose group (all P ＜ 0.05) . Blood β2-M in the high dose group was significantly lower than that in the low dose group at day 1 [(2.35±0.52) mg/L vs. (2.67±0.64) mg/L, P =0.008], day 3[(2.49±0.55)mg/L vs. (2.80±0.64) mg/L,P =0.011] and day 5[(2.29±0.53) mg/L vs. (2.56±0.66) nag/L, P = 0.026] post-procedure respectively; urine NAG/Cr in the high dose group was also significantly lower than that in the low dose group at day 1 [(1.19±0.30) U/mmol vs. (1.46±0.34) U/mmol, P ＜ 0.001], day 3 [(1.30±0.30) U/mmol vs. (1.59±0.33) U/mmol, P ＜ 0.001], and day 5 [(1.10±0.30) U/mmol vs. (1.34±0.35) U/mmol, P = 0.001] post-procedure respectively;Cer in the high dose group was significantly higher than that in the low dose group at day 1 [(73.69±20.99) mL/min vs. (65.19±18.72) mL/min,P =0.035], day 3[(64.04±15.82) ml/min vs. (56.79±14.50)ml/min,P =0.019] post-procedure respectively. Conclusion High dose atorvastatin use before angiography is superior than low dose atorvastatin on attenuating contrast induced renal dysfunction.     

透析液温度在血液透析中影响血压的观察

目的探讨不同温度的透析液在血液透析中对血压产生的影响。方法鸡西市人民医院2007年1月至2008年7月透析室33例透析患者,采用相同透析液,在不同的透析液温度下,观察不同温度对血压的影响。结果当透析液温度高于体温时,高血压的发生率减少。当透析液温度低于体温时,低血压的发生率减少。结论通过透析液温度的调节可以有效的减少和预防透析并发症。     

浅谈永久性血管通路的建立与护理

目的 讨论永久性血管通路的建立与护理.方法 为需要血液透析的患者建立并护理永久性血管通路.结论 严格执行正确的穿刺技术,切忌反复定点穿刺.嘱患者定时锻炼内瘘侧手臂,使血管扩张.严格执行无菌操作,防止医源性感染;提高穿刺水平,避免发生血肿,如血肿处发生感染,可用碘酒、乙醇消毒.     

大剂量阿托伐他汀预防对比剂肾病

Objective To compare the efficacy of high and low dose atorvastatin on preventing contrast induced nephropathy (CIN) in patients underwent diagnostic and therapeutic coronary intervention. Methods All patients received atorvastatin 10 mg/d on the basis of hydrated therapy (n =100) and high dose group received additional atorvastatin 80 nag at 12 to 24 hours before procedure (n =50). Scr, Ccr, blood β2-M, urine NAG/Cr, and urine osmolality before and after the procedure were compared between the groups. Results Baseline demographic characteristics and nephropathy risk factors were similar between groups. Cer was significantly reduced while blood β2-M and uric NAG/Cr were significantly increased in low dose group (all P ＜ 0.05) . Blood β2-M in the high dose group was significantly lower than that in the low dose group at day 1 [(2.35±0.52) mg/L vs. (2.67±0.64) mg/L, P =0.008], day 3[(2.49±0.55)mg/L vs. (2.80±0.64) mg/L,P =0.011] and day 5[(2.29±0.53) mg/L vs. (2.56±0.66) nag/L, P = 0.026] post-procedure respectively; urine NAG/Cr in the high dose group was also significantly lower than that in the low dose group at day 1 [(1.19±0.30) U/mmol vs. (1.46±0.34) U/mmol, P ＜ 0.001], day 3 [(1.30±0.30) U/mmol vs. (1.59±0.33) U/mmol, P ＜ 0.001], and day 5 [(1.10±0.30) U/mmol vs. (1.34±0.35) U/mmol, P = 0.001] post-procedure respectively;Cer in the high dose group was significantly higher than that in the low dose group at day 1 [(73.69±20.99) mL/min vs. (65.19±18.72) mL/min,P =0.035], day 3[(64.04±15.82) ml/min vs. (56.79±14.50)ml/min,P =0.019] post-procedure respectively. Conclusion High dose atorvastatin use before angiography is superior than low dose atorvastatin on attenuating contrast induced renal dysfunction.     

利湿定眩汤治疗耳眩晕76例

<正> 自1983年我们用自拟利湿定眩汤治疗痰湿中阻型耳眩晕效果满意,现总结报告如下。1 临床资料76例中,男31例,女45例。其中15～20岁者2例,21～30岁者13例,31～40岁者24例,41～50岁者32例,51～60岁者5例。病史最长者18年,最短者2年。     

2010年《医学教育探索》载文、作者、引文分析

目的通过分析《医学教育探索》载文、作者、引文统计情况,探索该刊的特点和规律,为今后的办刊提供参考依据。方法运用文献计量学的统计方法,以该刊2010年刊载的615篇论文为研究对象,从载文、作者、和引文3个方面进行统计分析,具体指标包括载文量、基金项目、栏目设置、合著情况、作者分布、引文量、引文类型、引文语种,并进行比较分析。结果2010年该刊载文615篇,共1728页,篇均页数2．18,篇密度0．36篇／页;以教学改革和临床教学为主要栏目,分别占载文量的19．51％、16．75％。作者总数2084人,无作者和独著论文87篇,合著论文528篇,合著率85．85％,合作度3．39人／篇。引文4331条,篇均引文数7．04条,引文率为99．51％。结论该刊信息量大、栏目丰富、重点突出,在全国影响力大,但是引文量稍低,且外文文献引用偏少。     

舌咽神经痛非手术治疗7例报告

舌咽神经痛临床较少见。自1979年9月至1982年4月,笔者采用非手术疗法治疗舌咽神经痛7例,现报告如下。一、发病情况本组男4例,女3例;年龄除1例为40岁外,余皆在50～60岁之间。其中右侧发病4例,左侧3例;发病至就诊时间最短3天,     

临沂中医外科名医——汤坤标

临沂中医外科名医——汤坤标汤坤标（１９３７～），福建龙岩人，１９６３年毕业于上海中医学院医疗系本科。现任临沂市中医医院副院长、主任中医师，临沂市中医药学会名誉理事长，１９９５年４月被山东省卫生厅、人事厅确定为名老中医药专家学术经验继承工作指导老师。从...