辽吉冰凉花总甙对心功能影响的实验研究

辽吉冰凉花总甙(APAW)1.0mg/kg iv,能使麻醉家兔正常心脏的P-dP/dt环体面积(LO),LV-dP/dt_max,Vpm及LVSP比药前增大,HR减慢。APAW和冰凉花(AAR)及毒毛旋花子甙K(SK)一样,能明显改善衰竭兔心的心功能。静脉恒速输入0.5 mg/ml APAW,25min后,心衰家兔的LVSP,LV—dP/dt max,LO均明显回升,LVEDP降低,t-dP/dt max缩短。三种强心甙的最大强心效力无显著性差异。但APAW的治疗宽度和治疗指数均较AAR和SK为大,而AAR和SK间则无显著性差异。     

颈动脉炎引起双眼视神经萎缩1例

大动脉炎是一种比较少见的慢性血管病,多见于青年女性,因颈动脉炎引起双侧视神经萎缩较为罕见。患者党××女20岁学生双眼视力逐渐下降10个月。近2个月头晕、嗜睡、间歇性左颞部麻木及四肢发冷发麻。双眼视力指数/眼前,双眼瞳孔等大,约3mm,直接间接对光反射迟钝。双眼屈光间质正常,双眼视乳头边界整齐,颞侧色苍白,黄斑区     

欧洲癌症研究与治疗组织风险评分表在非肌层浸润性膀胱尿路上皮癌中的临床应用初探

Objective To evaluate the feasibility of European Organization for Research and Treatment of Cancer (EORTC) risk tables in non-muscle invasive bladder cancer in Chinese patients.Methods A retrospective analysis was performed on the data from 185 patients with non-muscle invaaive urothelial bladder cancer from January 2003 to February 2009. Among the 185 patients, 128 patients were stage Ta compared with 57 patients who were stage T1. There were 87, 53 and 45 patients with grade G1, G2 and G3 respectively. Transurethral resection of the bladder tumor was performed on all the patients and all the patients received routine post-operative intravesical instillation. A telephone interview follow-up was conducted on all the patients, and the average follow-up period was 36 months. EORTC risk tables were used to calculate risk scores for recurrence and progression for each patient. The recurrence and progression rates of different risk groups were recorded and compared with the estimated rates by EORTC risk table. Statistical analysis was used for comparison. ResultsTotal 1-year recurrence rate and progression rate for these patients were 25.9% and 3.8% respectively. According to calculated values of the patients, the 1-year recurrence rates of Group 0, Group 1-4, Group 5-9, Group 10-17 were 10.4%(5/48), 21. 5%(14/65), 35. 2% (19/54), 55.6%(10/18), respectively. The 1-year progression rates of Group 0, Group 2-6, Group 7-13, Group 14-23 were 0% (0/43), 1.5% (1/67), 6. 7% (4/60), 13. 3% (2/15). There was no significant difference between the real rates and estimated rates of the EORTC risk tables (P＞0. 05). However,the 1-year recurrence and progression rates between the low risk group, the medium risk group and the high risk group showed significant differences respectively (P ＜ 0. 05 ). Conclusions The EORTC risk tables are feasible to evaluate the recurrence and progression risk of non-muscle invasive bladder cancer in the present cohort. Nevertheless, the long term value and feasibility need more research to confirm.     

欧洲癌症研究与治疗组织风险评分表在非肌层浸润性膀胱尿路上皮癌中的临床应用初探

目的 评价欧洲癌症研究与治疗组织风险评分表(European Organization for Research and Treatment of Cancer risk tables,EORTC风险评分表)用于非肌层浸润性膀胱尿路上皮癌患者预后评估的可行性.方法 回顾性分析2003年1月至2009年2月收治的185例非肌层浸润性膀胱尿路上皮癌患者临床资料,其中Ta128例、T1 57例;G1 87例、G253例、G345例;肿瘤数目为单发、2～7个、≥8个者分别120、36、29例;肿瘤直径＜3 cm者131例、≥3 cm者54例;伴发原位癌者6例.185例均行经尿道膀胱肿瘤电切术,术后均行常规膀胱灌注化疗.采用电话随访方式,随访6～77个月,平均36个月.应用EORTC风险评分表进行预后风险评分,计算各评分组患者的1年复发率和进展率,并与EORTC评分表的预计值进行比较.结果 185例中1年内复发48例(25.9%),1年内出现肿瘤进展者7例(3.8%).根据患者实际情况计算,0、1～4、5～9、10～17分4组患者1年实际复发率分别为10.4%(5/48)、21.5%(14/65)、35.2%(19/54)、55.6%(10/18);0、2～6、7～13、14～23分患者1年实际进展率分别为0(0/43)、1.5%(1/67)、6.7%(4/60)、13.3%(2/15).经x2检验,结果与评分表的预计值差异无统计学意义(P＞0.05);而低危、中危、高危3组患者1年复发率及进展率差异有统计学意义(P＜0.05).结论 EORTC风险评分表可用于非肌层浸润性膀胱尿路上皮癌术后复发和进展风险的短期预测,对长期预测的应用及广泛人群的适用性尚待进一步验证.

Abstract：

Objective To evaluate the feasibility of European Organization for Research and Treatment of Cancer (EORTC) risk tables in non-muscle invasive bladder cancer in Chinese patients.Methods A retrospective analysis was performed on the data from 185 patients with non-muscle invaaive urothelial bladder cancer from January 2003 to February 2009. Among the 185 patients, 128 patients were stage Ta compared with 57 patients who were stage T1. There were 87, 53 and 45 patients with grade G1, G2 and G3 respectively. Transurethral resection of the bladder tumor was performed on all the patients and all the patients received routine post-operative intravesical instillation. A telephone interview follow-up was conducted on all the patients, and the average follow-up period was 36 months. EORTC risk tables were used to calculate risk scores for recurrence and progression for each patient. The recurrence and progression rates of different risk groups were recorded and compared with the estimated rates by EORTC risk table. Statistical analysis was used for comparison. ResultsTotal 1-year recurrence rate and progression rate for these patients were 25.9% and 3.8% respectively. According to calculated values of the patients, the 1-year recurrence rates of Group 0, Group 1-4, Group 5-9, Group 10-17 were 10.4%(5/48), 21. 5%(14/65), 35. 2% (19/54), 55.6%(10/18), respectively. The 1-year progression rates of Group 0, Group 2-6, Group 7-13, Group 14-23 were 0% (0/43), 1.5% (1/67), 6. 7% (4/60), 13. 3% (2/15). There was no significant difference between the real rates and estimated rates of the EORTC risk tables (P＞0. 05). However,the 1-year recurrence and progression rates between the low risk group, the medium risk group and the high risk group showed significant differences respectively (P ＜ 0. 05 ). Conclusions The EORTC risk tables are feasible to evaluate the recurrence and progression risk of non-muscle invasive bladder cancer in the present cohort. Nevertheless, the long term value and feasibility need more research to confirm.     

中国序贯疗法与三联疗法治疗幽门螺杆菌感染荟萃分析

目的:系统评价中国序贯疗法与三联疗法治疗幽门螺杆菌(H pylon)感染的疗效及不良反应的差异.方法:利用中文数据库,根据纳入标准入选中国序贯疗法与三联疗法根除H pylori的随机对照临床试验.提取患者的基本资料、研究质量、Hpylori根除率和不良反应发生率等相关数据.比较序贯疗法和7日或10日三联疗法的Hpylori根除率和不良反应发生率,计算相对危险度(Relative risk,RR)和95%CI.运用漏斗图评价出版偏倚.结果:纳入了9项随机对照研究.共835例患者.序贯疗法、7日及1 0日三联疗法的总H pylori根除率分别为92.0%、73.7%和84.5%(P=0.002).序贯疗法分别与7日或10日三联疗法比较.RR分别为1.23(95%CI:1.14-1.33)和1.12(95%CI:1.02-1.23).不良反应发生率无明显差异.结论:中国根除Hpylon使用序贯疗法明显优于7日和10日三联疗法,不良反应发生率无差异.     

莫沙必利治疗精神病人胃肠功能障碍的疗效观察

目的探讨莫沙必利在精神病患者胃肠功能障碍方面的疗效。方法将112例精神病患者随机分为两组:莫沙必利组:在给予原发病的治疗基础上加用莫沙必利5 mg,tid,对照组:仅给予原发病的治疗。观察两组精神病患者出现胃肠功能障碍的发生率,并进行对比分析。结果莫沙必利组与对照组胃肠功能障碍发生率比较差异均有高度显著性(P<0.05)。莫沙必利组出现便秘的概率明显低于对照组。结论莫沙必利在预防精神病患者胃肠功能障碍方面疗效肯定,有助于减少并发症的发生,尤其是精神病腹部手术后的患者。     

职业防护在呼吸科医务人员中应用的意义分析

目的对职业防护在呼吸科医务人员中应用进行统计和分析。方法对该院2011年10月—2012年10月呼吸科医务人员进行防护措施培训、宣教,共培训呼吸科医务人员66人,同时对2010年10月—2011年10月时呼吸科医务人员67人的情况进行对比分析。结果通过问卷调查结果显示,开展防护措施后呼吸科医务人员对环境防护知识的掌握、正确洗手率、佩戴防护口罩率和防针刺的几率显著高于开展培训前,差异有统计学意义(P<0.05)。开展培训后医务人员发生院内感染的几率显著高于开展培训后,差异有统计学意义(P<0.05)。结论对呼吸科医务人员采用职业防护措施培训,能有效的提高医务人员对环境防护知识的掌握、提高医务人员正确洗手率,佩戴防护口罩率,显著提高防针刺和疫苗接种率,增加了自我防护意识,对传染性疾病科室应进行广泛开展。     

中枢神经系统白血病脑脊液LDH水平与诊断及疗效关系的研究

目的了解中枢神经系统白血病脑脊液乳酸脱氢酶（LDH）与诊断及疗效之间的关系。并分析其临床意义。方法将例中枢神经系统白血病患者（CNS-L）。脑脊液（CSF）乳酸脱氢酶（LDH）与健康成人CSF中LDH对比。并对中枢神经系统白血病治疗前后脑脊液LDH水平进行对比分析和临床研究。结果中枢神经系统白血病组脑脊液中的LDH水平均较健康成人高,两者比较具有显著性差异（P〈0．001）;并且CNSL患者经治疗后病情缓解。CSF中LDH下降。与治疗前相比差异有显著性（P〈0．001）;未缓解的患者,CSF中LDH与治疗前比较差异无显著性（P〉0.05）。结论测量脑脊液乳酸脱氢酶对中枢神经系统白血病的早期诊断及动态检测CSF中LDH可作为CNSL治疗疗效判定的指标。     

急性胰腺炎少见病因分析

目的分析近4年来急性胰腺炎的少见病因组成及发病特点,旨在提高对少见因素所致急性胰腺炎的认识。方法回顾性分析我院2006年1月～2010年2月共436例急性胰腺炎患者的病例资料,统计除胆源性疾病、酒精性等常见原因外的少见原因引起的急性胰腺炎病例共79例,对其病因进行分析。结果特发性急性胰腺炎是少见病因胰腺炎的主要构成部分（62．03％）,高甘油三酯血症（13．92％）、手术（7．59％）在少见病因中所占比例也较高,其它病因少见,但仍有发生。结论急性胰腺炎的少见病因比例虽然少,但病种多样,临床上应注意寻找其可能病因,对因治疗。