左旋氧氟沙星与氧氟沙星治疗细菌性感染疗效比较

左旋氧氟沙星(levofloxacin)是氧氟沙星的左旋异构体,其体外抗菌活性是氧氟沙星的2倍,药物动力学特性与氧氟沙星相似,不良反应较氧氟沙星小。我们采用随机对照试验对其与氧氟沙星治疗细菌性感染的疗效进行比较。114例细菌感染患者随机分为试验组57例(男性23例,女性34例,年龄55.5±10.3a),轻度至中度感染用为盐酸左旋氧氟沙星100mg/次、1次/日静脉滴注,重度感染用100mg/次、2次/日静脉滴注,疗程5～7d。对照组57例(男性:23例,女性34例,年龄55.1±9.8a),轻度至中度感染用氧氟沙星200mg/次、1次/日静脉滴注,重度感染用200mg/次、2次/日静脉滴注,疗程5～7d。结果:试验组总有效率87.72％,细菌率87.62％,不     

药物性肝损害

<正> 概论 药物与肝脏的关系颇为密切,主要因药物进入人体后,必须通过肝脏内3个步骤:(1)肝细胞摄取药物;(2)药物在肝内代谢;(3)药物在胆道系统中排泄.其中以肝脏内药物代谢时,肝脏微粒体内混合功能氧化酶(细胞色素P_(450))所起的影响最大,它可使药物的药理作用降低或缩短,但亦可在脂溶性化合物转变为水溶性化合物时,产生对肝脏有高度反应性的有毒代谢产物.     

发热咳嗽喘息进行性加量

患儿，女，11岁。因发热2个月，咳嗽1个月，喘息进行性加重12d急诊入院。2个月前出现发热，体漫38.3℃左右，伴阵发性胸骨后疼痛。当地按“肺炎”治疗，体温稍降。1个月前出现阵发性刺激性干咏，予阿齐霉素，阿米卡星霉素5d无效。     

nm23蛋白检测对食管鳞癌淋巴结转移的预测价值

采用免疫组织化学方法检测８５例食管鳞癌ｎｍ２３蛋白表达。结果３４例（４０％）呈ｎｍ２３阴性。ｎｍ２３阴性表达与肿瘤的浸润深度、淋巴结转移和ＴＮＭ分期有关（Ｐ＝０．０１,Ｐ＝０．００１和Ｐ＝０．００１）,ｎｍ２３低表达表达者相经,淋巴结转移的风险比例（ＯＲ值）为７２．１８７。因此认为,对原发瘤或活检组织ｎｍ２３的免疫组化检测有可能成为评价食管鳞癌肿瘤分期及淋巴结转移的一个有价值的预测指标。     

三种细胞因子对肺纤维化中纤维母细胞转分化的作用

目的观察大鼠肺纤维化形成过程中TGF-β1、PDGF-AA、PDGF-BB与肌纤维母细胞的标志物α-SMA在不同时间的表达量,探索细胞因子在纤维母细胞转分化为肌纤维母细胞过程中的作用及与肺纤维化程度的关系。方法气管内注射博莱霉素制备大鼠肺纤维化模型,分别在第7、14、28天处死大鼠取肺组织,应用HE和免疫组化方法观察大鼠肺纤维化程度和四个指标表达的动态变化。结果造模后纤维母细胞表达α-SMA在第7天最明显,以后渐降。TGF-β1在第7天表达明显增强,第14天最强,第28天明显降低。纤维母细胞和肺泡巨噬细胞表达PDGF-AA在第7天最强,以后渐降。PDGF-BB在纤维母细胞的表达与PDGF-AA相似,在肺泡巨噬细胞则第14天最强。结论Fb自分泌TGF-β1、PDGF-AA、PDGF-BB在其转分化中发挥主要作用。AM是PDGF、TGF-β1的重要来源,在肺泡炎和纤维化持续中发挥重要作用。     

手法复位石膏固定治疗小儿肱骨髁上骨折

目的应用石膏托外固定治疗肱骨髁上骨折的疗效观察。方法肱骨髁上骨折58例，全部采用手法复位、石膏托外固定。结果随访时间5～20个月，平均9个月，全部达到骨性愈合，神经损伤亦自行恢复。结论对肱骨髁上骨折，应用手法复位、石膏托外固定，手法操作简单，创伤小，并发症少，固定可靠，骨折愈合快，功能恢复好，且可免除手术痛苦，治疗费用低，是一种较为理想的治疗方法。     

发热 咳嗽 喘息进行性加重

患儿,女,11岁。因发热2个月、咳嗽1个月、喘息进行性加重12d急诊入院。2个月前出现发热,体温38.3℃左右,伴阵发性胸骨后疼痛。当地按“肺炎”治疗,体温稍降。1个月前出现阵发性刺激性干咳,予阿齐霉素、阿米卡星霉素5d无效。PPD( ),拟诊肺结核。予链霉素等治疗12d,无改善。12     

4D-CTA联合CTP在缺血性脑卒中的应用

目的探讨动态四维CT血管造影(four-dimensional CT angiography,4DCTA)联合全脑灌注成像(CTperfusion imaging,CTP)对缺血性脑卒中的诊断价值。方法对42例临床怀疑缺血性脑卒中患者进行全脑灌注成像和常规头颅CTA检查,通过灌注原始数据重建获得4DCTA,对图像质量、血管狭窄程度及灌注参数等进行分析。结果 4D-CTA与常规CTA的图像质量评分分别为(2.67±0.48)和(2.81±0.39),差异无统计学意义(P0.05)。4D-CTA与常规CTA诊断血管狭窄或闭塞结果一致,35例患者存在不同程度的狭窄或闭塞。4D-CTA显示侧支循环较常规CTA多2例,而且重度狭窄及闭塞患者侧支循环显示率明显高于轻、中度狭窄患者。CTP发现34例患者灌注异常,8例灌注正常。CTA责任血管狭窄者CTP阳性率(71.43%)明显高于无责任血管狭窄者(9.52%)。结论 4D-CTA联合CTP不仅可用于动态观察全脑血流状态,还能清晰显示脑血管的异常变化,可以替代常规头颅CTA检查,为临床提供更加丰富的影像学信息。     

自适应光学技术原理及临床应用价值

自适应光学技术是一种利用光电子器件实时测量波前动态误差,用快速的电子系统进行计算和控制,用能动器件进行实时的波前校正,使光学系统具有自动适应外界条件变化,保持良好工作状态能力的新技术[1]。临床上自适应光学系     

生长抑素和生长激素联用对兔重症急性胰腺炎肠黏膜屏障损伤的保护作用

Objective To investigate the protective effect of somatostatin (SS)combined with growth hormone (GH) in treatment of intestinal mucosal barrier injury in rabbits with severe acute pancreatitis (SAP), as well as its clinical significance. Methods Seventy-two rabbits were equally assigned into model group (SAP group), SS treated group (SS group) and SS combined with GH treated group (SS + GH group). SAP models were induced by retro-injection of 5% sodium taurocholate into the pancreatic duct. After modeling, all rabbits were given 5 % glucose saline daily.The rabbits in SS group and SS+GH group were continuously Given SS (3.5μg·kg-1·h-1)for 48 hours. Besides, the rabbits in SS+GH group were subcutaneously injected with 0.15 IU/kg of GH at the 1st and the 24th hours after modeling. The levels of serum amylase, serum tumor necrosis factor-α (TNF-α) and plasma diamine oxidase were measured at the 6th, 12th, 24th and 48th hours after modeling. The pathological changes of pancreatic tissue and ileal mucosa were observed. Survival rate was calculated. Data were analyzed using SPSS 16.0 software. The univariate analysis was used to compare the difference among groups. Results In SS+GH group, the levels of serum TNF-α and plasma diamine oxidase were (2. 43 ± 0. 14) pg/ml and (4. 61 ± 0. 45) U/L at the 24th hour respectively, and were (2.08±0.23) pg/ml and (3.75±0.47) U/L at the 48th hour, respectively,which were lower than those in SAP group and SS group [(2.80 0.30) pg/ml and (8.74 ± 1.77)U/L, respectively, at the 24th hour; (2. 45±0.12) pg/ml and (5. 02±0.95) U/L, respectively, at the 48th hour)]with significant difference (P＜0.05). The inflammation in pancreas and ileal mucosa was alleviated, and the integrity of bowel mucosa was improved. Survival rate of SS+GH group was significantly higher than SAP group and SS group. There was no significant difference in level of serum amylase between SS+GH group and SS group. Conclusion The combination of SS with GH may enhance the function of intestinal mucosa barrier and improve the prognosis of SAP in rabbits.