药学监护对终末期肾病血液透析伴高血压患者降压效果观察

目的:临床药师通过药学监护建立与血液透析患者的联系,与医师共同选择个体化降压治疗方案,降低患者的高血压,提高血液透析患者的生命质量。方法:选取我院符合纳入标准的血液透析伴高血压患者,随机分为药学监护组(20例)与非药学监护组(21例)。结果:治疗3个月后,药学监护组患者收缩压158mmHg下降至139mmHg,舒张压95mmHg下降至84mmHg,非药学监护组患者收缩压155mmHg下降至152mmHg,舒张压96mmHg下降至93mmHg,药学监护组与非药学监护组比较差异有统计学意义(P<0.05)。结论:通过药学监护,临床药师参与终末期肾病血液透析伴高血压患者个体化降压治疗,可促进医疗质量的提高。     

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??OBJECTIVE To select the optimum extracting procedure for Kangdu Mixture by the application of L9(3⁴). METHODS Orthogonal design was used to observe and study the effects of the factors of water volume,extracting times and extracting time on kangdu Mixture,the chlorogenic Acid and yield of dry extract was determined by high performance liquid chromatography,the synthetic weighted mark method was used to evaluate the extraction process. RESULTS The optimum water extraction is as follows: 10 times of water, extracting twice by relux,2 hours for each time. CONCLUSION The process choosed in this experiment is practicable and can be applied for preparation of Kangdu Mixture,the optimal process is simple and high precision.     

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??OBJECTIVE To analyze the polymorphs of carbamazepin tablets by laser confocal micro-Raman spectrometer and establish the identification test model. METHODS Reference Raman spectra of the four crystal forms of carbamazepin were established; then the polymorphs of the carbamazepin tablets from different manufacturers were analyzed,and an identification test model was established to distinguish the unknown samples. RESULTS According to the results of the cluster analysis,the four batches of carbamazepin tablets from domestic manufacturers belonged to crystal form??. A qualitative model was created by choosing the first derivative and vector normalization method to process the spectra,using the factorization method to calculate,and selecting the 200-500, 650-850, 1 000-1 100, 1 500-1 700 cm^-1 regions to compare. This model was verified to have high sensitivity, specificity, precisicion, negative prediction ability, and detection efficiency. CONCLUSION The laser confocal micro-Raman spectrometer canbe used to analyze the polymorphs of carbamazepin tablets and the qualitative identification is rapid and accurate.     

某基层医院161例药品不良反应监测报告分析

目的分析本院药品不良反应发生情况,促进临床合理用药。方法回顾性调查本院2006~2009年各科室呈报的161例药品不良反应报告,按照患者年龄、性别、药品的种类、给药途径、不良反应涉及系统、临床症状等进行分析;并采用国家ADR监测中心制订的药品不良反应因果关系评估方法,对ADR因果关系进行初评。结果 161例药品不良反应报告中,抗感染药物占49.69%,91.41%为静脉给药,临床表现主要为皮肤及其附件损害(65.31%),严重程度多为一般;因果关系评价肯定9例,很可能24例,可能128例。结论本院应加大对抗感染药管理力度,减少不必要的静脉用药,以减少药物不良反应的发生。     

射干麻黄汤加减治疗儿童急性喘息性支气管肺炎42例疗效观察

目的观察射干麻黄汤加减中西医结合治疗儿童急性喘息性支气管肺炎的疗效。方法将82例急性喘息性支气管肺炎患者随机分为治疗组42例和对照组42例。对照组采用西医常规治疗,治疗组在西医常规治疗基础上加用射干麻黄汤。结果 2组痊愈率均为100%,2组痊愈率比较,差异无显著性意义(P>0.05)。但喘鸣音、湿啰音、干啰音消失平均时间、治愈天数,2组比较,治疗组均短于对照组,经统计学处理,差异有非常显著性意义(P<0.01)。结论配合射干麻黄汤可提高儿童急性喘息性支气管肺炎疗效。     

浅谈老年患者术中护理

目的：加强老年患者术中护理,提高工作效率和手术质量。方法：选择我院2009年至2010年老年手术患者1086例,通过术前评估、加强术中护理、术后转送等环节进行分析。结果：通过正确评估,加强心理沟通和护理,提高老年患者配合手术的主动性。结论：重视老年患者的术中护理,可以提高生命质量。     

徒手压迫法治疗冠状动脉介入术后股动脉假性动脉瘤的临床分析

目的探讨冠状动脉介入术后并发股动脉假性动脉瘤的原因、临床表现、徒手压迫法的疗效。方法回顾分析1999年3月2012年4月在中国人民解放军第309医院干部病房住院的冠状动脉介入术后并发股动脉假性动脉瘤16例患者临床资料。结果16例股动脉假性动脉瘤用徒手压迫法治疗均1次性成功,成功率100％,均未出现并发症。结论冠状动脉介入术后并发股动脉假性动脉瘤与多种因素有关,早发现,早诊断,及时予徒手压迫法安全有效。     

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??Gastrointestinal??GI?? endoscopy plays an indispensable role in the diagnosis and management of various pediatric GI disorders. Complications during the operation of digestive endoscopy are unavoidable. The incidence of complications of diagnostic endoscopy in children is very low??but the incidence of complications is obviously increased in recent years??because of the development of endoscopic treatment in children. Following strict operation indications and contraindications of GI endoscopy??standardized operation process??and skilled pediatric endoscopists are the key to reducing complications. Early identification and timely management of complications after endoscopy is essential to ensuring the safety of children and maintaining harmonious doctor-patient relationship.     

VR+CTA对脊柱变形患者的诊断及临床价值研究

目的探讨脊柱变形的VR+CTA影像学特征及临床价值。方法回顾性分析2013年1月-2015年11月经我治疗的38份脊柱变形患者的VR+CTA影像学资料及临床资料病例。结果通过VR+CTA检查显示,脊柱侧弯、旋转病例降主动脉经上胸段椎体(T5-7)前缘迂曲绕行至椎体右前方,并于L2椎体前缘向左前方走行;椎体破坏(结核)伴有侧弯的病例具有下胸段椎体内骨质破坏、增生、椎体变形等征象,动脉经上胸段椎体凹入后凸椎体,向下方椎体延行。脊柱变形患者血管充盈良好,壁无钙化斑,管腔形态正常,未见狭窄、扩张及充盈缺损。38例患者进行VR+CTA检查后,均能对脊柱情况及周围伴行脏器进行清晰显示,包括脊柱变形的位置和血管的走向。结论VR+CTA影像学特征能有效诊断脊柱变形部位、程度及与周围结构的关系,有利于患者选择恰当的临床治疗方案和预后评估,值得临床进一步推广和应用。     

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??Abstract??Objective??To detect the changes of the plasma homocysteine??p-Hcy????high-sensitivity C-reactive protein??hs-CRP????1actic dehydrogenase??LDH?? and tumor specific growth factor??TSGF?? determination in patients with acute lymphocytic leukemia??ALL?? and its clinical significance. Methods??p-Hcy??enzymatic cycling assay????hs-CRP??turbidimetry respectively????LDH??automatic analyzer?? and TSGF ??with biochemistry??before treatment and after remission were measured between ALL children and normal children in Department of Pediatrics??Zhengzhou university's First Hospital from Jan. 2009 to Jul. 2010. Results??Before chemotherapy and after complete remission??p-Hcy??hs-CRP??TSGF and LDH levels in the ALL-CR patients were significantly higher than those in the controls??P < 0.01?? .The level of p-Hcy??hs-CRP??TSGF and LDH after complete remission was lower than that before treatment??P < 0.05??.The level of p-Hcy??hs-CRP??TSGF and LDH after cancer recurrence was higher than that of normal children and after complete remission of ALL-CR children??P < 0.05??.p-Hcy level was significantly correlated with LDH??TSGF and hs-CRP level before chemotherapy of ALL-CR children??P < 0.01??. Conclusion??p-Hcy??hs-CRP??TSGF and LDH can be used as a reference marker in diagnosis??monitoring patients’condition and prognosis evaluation in acute lymphocytic leukemia of children.