复方青黛胶囊联合窄谱UVB治疗玫瑰糠疹43例疗效观察

2005年1月至2007年10月,本科采用口服复方青黛胶囊(陕西天宁制药公司)联合窄谱中波紫外线(narrow-band ultraviolet-B,NB-UVB)治疗玫瑰糠疹取得满意效果,现报道如下.     

急性冠脉综合征患者经替格瑞洛治疗后血栓弹力图的变化

目的研究急性冠脉综合征(ACS)患者经替格瑞洛治疗前后血栓弹力图(TEG)的变化特点。方法 89例ACS患者给予替格瑞洛抗血小板治疗1周前后,抽血查血栓弹力图,比较其前后变化特点。结果替格瑞洛治疗后1周较治疗前TEG指标均有所改善,主要表现为R、K值升高,MA值、α角和G值、CI减小,但差异均无统计学意义(P>0.05)。但AA途径、ADP受体途径的抑制率均有所升高,且与治疗前相比差异有统计学意义(P<0.01)。结论替格瑞洛是一种很有前景的抗血小板药物,可以适应ACS及介入术后患者个体化治疗的需要,使血小板抑制率达标,最终使更多患者获益。     

人转铁蛋白-阿霉素结合物对耐阿霉素K562细胞的体外杀伤作用

目的 探讨阿霉素（ＡＤＭ）与人转铁蛋白（Ｔｆ）结合物对耐阿霉素Ｋ５６２细胞株的体外杀伤作用。方法 采用葡聚糖（ＤＥＸ）Ｔ－１０作为中介体、联接Ｔｆ与ＡＤＭ制备结合物Ｔｆ－ＡＤＭ,用ＭＴＴ法比较结合物对耐ＡＤＭ及ＡＤＭ敏感的Ｋ５６２细胞的体外杀伤作用强度。结果 结合物对耐ＡＤＭ的Ｋ５６２细胞株７２ｈ培养、ＭＴＴ法测定结合物对耐ＡＤＭ的Ｋ５６２细胞ＩＣ５０为４．９μｍｏｌ,游离ＡＤＭ的ＩＣ５０〉１７．２４μｍｏｌ,Ｔｆ对这两种细胞都没有体外杀伤作用。结论 结合物Ｔｆ－ＡＤＭ可提高ＡＤＭ对耐ＡＤＭ的Ｋ５６２细胞株的杀伤作用,此作用与Ｔｆ无明显关系。     

复方氟米松软膏治疗108例神经性皮炎患者的临床疗效和安全性评价

目的 观察复方氟米松软膏治疗神经性皮炎的临床疗效和安全性.方法 采用多中心、随机、阳性药物平行对照的方法,将108例神经性皮炎患者随机分为治疗组(60例)与对照组(48例),分别给予复方氟米松软膏和糠酸莫米松软膏,治疗3周后比较疗效.结果 治疗组总有效率为86.66%,对照组有效率为81.25%,两组治疗效果相当.治疗组起效时间2～3 d,对照组起效时间3～5 d,治疗组起效更快.两组均未发生不良反应.结论 复方氟米松软膏治疗神经性皮炎起效迅速、有效,安全性好.     

慢性荨麻疹患者变应原检测及自体血清试验临床分析

目的:探讨慢性荨麻疹患者变应原检测和自体血清皮肤试验的临床意义。方法:皮肤点刺试验(SPT)检测30种变应原皮试液(包括吸入性和食物性),以生理盐水作阴性对照,以组胺作阳性对照,注射于前臂屈侧,20-30分钟后观察结果。自体血清试验(ASST)以自体血清注射于一侧前臂,另一侧注射生理盐水作阴性对照,30分钟后观察结果。结果:787例慢性荨麻疹患者中SPT有550例阳性(69.89%),6种以上变应原阳性332例(42.19%),吸入组阳性516例(65.57%)明显高于食物组309例(39.26%);ASST阳性为244例(31.00%),SPT阴性组ASST阳性率明显高于SPT阳性组。结论:SPT可以帮助我们寻找引起慢性荨麻疹的相关变应原。ASST阳性表明患者血清中存在自身抗体,可以作为自身免疫性荨麻疹的筛选试验。     

老年患者术后持续静脉镇痛的临床应用

目的　通过观察不同年龄组术后静脉持续注射等量的同一镇痛配方的镇痛、镇静效果 ,探讨术后持续静脉镇痛应用于老年人的可能性、安全性。方法　不同年龄组腹部择期手术 14 5例 ,在硬膜外麻醉末次给药 30- 4 0分钟时行静脉镇痛 ,组Ⅰ -组Ⅲ分别为≤ 4 5岁 ,4 5 - 6 5岁 ,≥ 6 5岁 ,全镇痛配方负荷量 10ml后开启镇痛微量泵。组Ⅳ年龄≥ 6 5岁 ,直接开启镇痛微量泵。观察术前各组病人合并症及镇痛期间镇痛、镇静程度和并发症。镇痛配方为吗啡 0 .2mg/ml和氟哌利多 0 .1mg/ml混合液。结果　组Ⅲ、组Ⅳ术前合并症明显多于组Ⅰ、组Ⅱ ,组Ⅲ、组Ⅳ镇痛、镇静效果明显强于组Ⅰ、组Ⅱ ,组Ⅲ在术后半小时MAP明显低于其它组及术前 ,但各组并发症无明显差别。结论　对≥ 6 5岁的老年人 ,在硬膜外麻醉末次给药 30 - 4 0分钟时 ,直接开启静脉镇痛微量泵进行术后镇痛更安全有效     

早早孕快速诊断微量酶免疫测定试剂盒研制完成

我室研制了一种微量酶免疫测定试剂盒,大大降低了成本。可制成小型包装,便于家庭、个人使用。试剂盒以本研究室发明的微量免疫测定塑料珠为固相,反应体系仅10μl。其测定方法如下:将抗hCG抗体包被的塑料小珠(0.8mm×1.0mm)装上一金属柄(以便手工操作),     

无缝连接一体化急救护理模式在高热惊厥患儿护理中的应用

目的：探讨无缝连接一体化急救护理模式在高热惊厥患儿护理中的应用效果。方法：选取2018年10月1日～2019年3月1日进行急救治疗的80例高热惊厥患儿,采用信封法随机分为观察组和对照组各40例,对照组给予常规急救护理,观察组在对照组基础上联合无缝连接一体化急救护理;比较两组家属满意度,患儿护理情况、并发症及不良事件发生率。结果：观察组家属对疾病认知、急救知识、降温方式知晓情况均高于对照组(P<0.05,P<0.01);护理后,观察组患儿体温、退热时间、惊厥消退时间、住院时间及护理满意度均优于对照组(P<0.05);观察组并发症及不良事件发生率低于对照组(P<0.05)。结论：在高热惊厥患儿护理中应用无缝连接一体化急救护理模式,可提高家属对疾病的认知情况和配合护理工作,缩短患儿退热时间及惊厥时间,改善患儿临床症状,降低并发症发生率,从而提高家属满意度。     

快速骨髓腔穿刺输液在创伤性休克患者院前急救中的应用

目的探讨快速骨髓腔穿刺输液在创伤性休克患者院前急救中的应用。方法选取2016年1月至2017年12月院前急救中遇到的创伤性休克患者60例,并按输液方式的不同等分为常规静脉输液组和骨髓腔穿刺输液组。观察两组患者建立有效输液通道的时间、输液速度、血压回升所需时间、抢救有效率及并发症发生率。结果快速骨髓腔穿刺输液组建立有效输液通道所用时间明显短于常规静脉输液组,差异有统计学意义(P0.05);快速骨髓腔穿刺输液组并发症发生率低于常规静脉输液组,但差异无统计学意义(P0.05);快速骨髓腔穿刺输液组抢救有效率明显高于常规静脉输液组,差异有统计学意义(P0.05)。结论创伤性休克患者在院前急救中采用快速骨髓腔穿刺输液可有效缩短静脉通道建立时间,提高抢救有效率,临床应用效果较优。     

99Tc-亚甲基二膦酸盐对胶原诱导性关节炎大鼠滑膜及软骨凋亡相关因子的影响

Objective Collagen induced arthritis (CIA) rats is an animal model of human rheuma-toid arthritis (RA). It is widely used in research of the pathogenesis and the therapeutic targets of RA. This paper was to investigate the therapeutic action of 99Tc-methylene diphosphonic acid (MDP) on CIA rats and its effects on the expression of apoptosis associated factor bcl-2 and bax in synoviocytes and articular chon-drocytes. Methods CIA rat models were carried out by subcutaneous injection with bovine collagen Ⅱ and incomplete Freud's adjuvant. Rats were divided into four groups: control group, CIA model group (the CIA rats were infused with physiological saline via tail vein daily), 99Tc-MDP group (the C1A rats were injected with 99Tc-Mi)P 0.04 μg 99Tc/kg via tail vein daily) and methotrexate (MTX) group (the CIA rats were in-jected with MTX 1 mg/kg via tail vein weekly). The signs of arthritis were evaluated by arthritis index (AI) scores. Immunohistochemistry was performed to detect the expression of bcl-2 and bax in synoviocytes and articular chondrocytes. SPSS 13.0 was used for data analysis. Results (1) The signs of arthritis, AI scores and pathological changes of arthrosynovitis in CIA rats were significantly improved by 99Tc-MDP orMTX. (2) The expression of bcl-2 and box in the synoviocytes of CIA model group [(39.30 ± 0.53) %, (27.37 ±2.45)%] was significantly increased compared with control group [(7.56 ± 1. 18)% , (6.14 ± 1.71) % ; q = 46.27, 24.57, all P < 0.001]. In the synovioeytes of 99Tc-M DP group and MTX group, the level of bcl-2 was remarkably decreased [(30.24 ± 2.09) %, (27.25 ± 3.33) %] compared with CIA model group (q = 13.20, 17.56, all P <0.001), while the level of bax was slightly increased and the ratio of bcl-2/bax was significantly decreased. (3)The expression level of bcl-2 and bax in the articular chondro-cytes of CIA model group [(20.20 ± 2.78) %, (36.40 ± 1.67) %] was significantly higher than control group [(9.91±4.09)%, (6.71 ±3.50)%; q=10.51, 37.01, allP<0.001]. Compared with CIA model group, the expression level of bcl-2 in articular chondrocytes of 99Tc-MDP group [(26. 58 ± 2. 52) %] and MTX group [(27.06 ± 1.92) %] was remarksbly increased [(24.26 ± 2.75) %, (23.53 ± 0.74) % ; q = 6.53, 7.01, all P < 0.001]. And the expression level of bax was significantly decread (q = 15.12, 16.04, all P <0. 001) and the ratio of bcl-2/bax was significantly increased. Conclusions The ab-normal expression of apoptosis associated factor bcl-2 and bax in synoviocytes and articular chondrocytes was closely related to the occurrence and progression of signs in CIA rats. 99Tc-MDP could improve the signs of arthritis, meanwhile regulate the expression of bcl-2 and bax in synoviocytes and articular ehondrocytes, suggesting that one of the therapeutic mechanisms of 99Tc-MDP might be related to stimulated synoviocytes apoptosis and reduced articular chondrocytes apoptosis.