同步间歇正压通气联合新型经鼻持续气道正压通气治疗新生儿肺出血14例

目的探讨同步间歇正压通气+呼吸末正压(IPPV+PEEP)治疗新生儿肺出血的疗效。方法对14例肺出血患儿进行IPPV+PEEP,观察上机后的临床表现,动脉血气变化及并发症的发生。结果12例实施同步IPPV+PEEP青紫立刻减轻或消失(85%),12h内肺出血完全停止3例(21%),24h内肺出血停止7例(50%),12h内动脉血氧分压由(42.5±6.95)mmHg升高至(84.9±7.85)mmHg,动脉二氧化碳分压由(53.92±12.4)mmHg降低至(41.64±10.25)mmHg,血氧饱和度由(55.7±12.75)%升高至(89.45±7.65)%。8/14例(57%)肺出血患儿被治愈,死亡6/14例(43%)。结论同步IPPV+PEEP联合NCPAP治疗新生儿肺出血有良好疗效,值得临床推广。     

老年冠心病患者低钾的临床观察

目的总结老年冠心病患者低钾的临床观察,提出预防措施。方法观察156例老年冠心病患者低钾的发生原因,临床表现,实验室资料,治疗转归等因素,进行分析总结。结果老年冠心病患者发生低钾有其自身发病特点,病因复杂,阳性症状少,治疗困难,恢复时间长,预后差。结论老年冠心病患者因其生理、病理特点较易发生低钾,且多发病隐蔽,表现不典型,容易漏诊,故要仔细观察病情,一旦发现要及时给予综合治疗。     

纤维蛋白在软骨组织工程中的应用

纤维蛋白是纤维蛋白原经激活后形成的聚合物凝胶，作为软骨组织工程研究的载体材料，在相关的生物学和物理特性上具有其一定的优势。对纤维蛋白在软骨组织工程中应用的现状和发展方向进行综述。     

三阶段心理护理在MRI增强扫描护理中的体会

目的 对比研究三阶段心理护理对MR增强扫描患者顺利完成榆查的价值.方法 一般护理组和心理护理组各126例,分别观察两组在造影检查过程中不良反应出现的情况,并分别计数.结果 心理护理组的不良后果发生率低于一般护理组,X2检验P＜0.05,差异有显著性.结论 运用三阶段心理护理能有效地降低MR增强扫描中出现的不良后果,具有良好的临床应用价值.     

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目的　探讨腹腔镜食道裂孔疝修补术的可行性及安全性。方法　回顾性分析 2 0 0 1年 3月至 2 0 0 3年12月天津南开医院行腹腔镜食道裂孔疝修补术 11例病人的临床资料。结果　 10例行裂孔疝修补后同时行胃底折叠术 ,其中 7例行Nissen胃底折叠术 ,3例行Toupet胃底折叠术 ,1例仅行裂孔修补术。术后症状完全缓解。食道下段压力由 (8 6± 2 4 )mmHg(1mmHg =0 133kPa)提高到 (18 2 0± 3 4 3)mmHg(P <0 0 1) ,2 4hpH值监测评分由 5 3 4± 39 7降低到 8 0 4± 2 12 (P <0 0 1) ,较手术前有明显改善 ,并达到正常范围。无手术并发症 ,无中转开腹及死亡病例。结论　对于食道裂孔疝 ,腹腔镜食道裂孔疝修补术是一种安全、有效的治疗方法     

重症急性胰腺炎大鼠血清高迁移率族蛋白-1水平的时相变化及意义

目的 观察重症急性胰腺炎(SAP)大鼠血清肿瘤坏死因子α(TNF-α)、白细胞介素19(IL-19)和高迁移率族蛋白-1(HMGBl)水平的时相变化，探讨HMGBl在SAP病程中的意义。方法采用胰管逆行灌注5％牛磺胆酸钠的方法复制大鼠SAP模型。随机分为正常对照组(N组，n=8)、假手术组(Sham组，n=8)和重症急性胰腺炎组(SAP组，n=80)。用酶联免疫吸附试验(ELISA)检测各组动物血清TNF-α、IL-1β。用Westernblot法检测血清HMGBl水平。结果 SAP组大鼠血清TNF-α和IL-1β在建模后迅速升高，约在4～6h达高峰，之后迅速下降，在建模12h即降至接近正常水平，一直维持至24和48h。SAP组大鼠血清HMGB1水平在建模后12h开始有明显升高，至24和48h仍维持在较高水平。结论 HMGB1可能作为晚期炎症因子参与了SAP的全身炎症反应。     

中西医结合治疗慢性盆腔炎100例疗效观察

目的:采用中西医结合治疗慢性盆腔炎,减少复发,提高治愈率。方法:对我院门诊患者100例采用胎盘组织液肌注,金钢藤胶囊口服,并用我院自制中药妇炎肠疗液灌肠。结果:临床显效40例,有效56例,无效4例,总有效率96％。结论:中西医结合治疗慢性盆腔炎疗效满意,是目前治疗慢性盆腔炎的最好方法。     

人工心脏瓣膜置换术后PT-INR测定监测口服抗凝药的研究

人工心脏瓣膜置换术后患者口服抗凝治疗不当所致的出血与栓塞占远期并发症的首位。血浆凝血酶原时间（PT）是对人工心脏瓣膜置换术后患者口服抗凝药监测简便、敏感、快速、实用的实验室首选指标，其报告方式的标准化对临床医生有着非常重要的指导意义，国际标准化比率（PT-INR）作为一个较好的监测抗凝药物水平的表示方法，已被WHO推荐使用，但对于人工心脏瓣膜置换术后患者口服抗凝药治疗时PT-INR值的允许范围各地报告不一，为此，我们对我院收治的行人工心脏瓣膜置换术后患者口服华法令治疗时PT监测的情况进行了总结和研究，以探讨适合本地区人工心脏瓣膜置换术后患者口服抗凝药治疗监测中PT-INR的允许范围，为临床合理用药提供安全可靠的实验室监测指标。现报告如下。     

Avoidance therapy in reactive dye-induced occupational asthma: long-term follow-up.

BACKGROUND: Previous studies reported that early diagnosis and avoidance therapy are the most important factors for prevention of permanent lung impairment; however, few studies have evaluated the long-term prognosis of reactive dye-induced occupational asthma (RD-OA). OBJECTIVE: To evaluate the long-term outcomes of RD-OA. METHODS: Methacholine airway hyperresponsiveness (AHR) and lung functions were evaluated and compared in 26 patients with RD-OA at the time of diagnosis and after complete avoidance of the causative agents. Patients with continued (n = 13) or remitted (n = 6) AHR were further monitored for up to a mean +/- SD of 8.7 +/- 1.8 years. RESULTS: The AHR resolved in 10 (38%) of 26 patients a mean +/- SD of 2.2 +/- 1.3 years after complete avoidance of RDs; however, prebronchodilator forced expiratory volume in 1 second (FEV1) values were not different. Levels of IgE specific to the RD-human serum albumin complex were markedly decreased at first follow-up in 5 RD-atopic patients from whom paired serum samples were compared (P = .02). The AHR disappeared in an additional 5 patients and improved in 4 by the second follow-up. The FEV1 values also improved compared with diagnosis and first follow-up levels. Favorable prognosis was associated with early diagnosis of RD-OA and complete avoidance of the causative agent. No association was found with smoking history, latent periods, the presence of RD specific IgE, baseline provocation concentration that caused a decrease in FEV1 of 20%, or FEV1. CONCLUSIONS: Early diagnosis and avoidance therapy are the most important prognostic factors in RD-OA. The AHR and lung function of patients with RD-OA can sometimes be recovered steadily and slowly through avoidance measures.     

A six-week, parallel, randomized, double-blind study comparing the efficacy and safety of the 0.5% timolol/2.0% MK-507 combination b.i.d. to the concomitant administration of 0.5% timolol b.i.d. and 2.0% MK-507 b.i.d.

This was a 6-week, parallel, randomized, double-blind study comparing the efficacy and safety of the 0.5% timolol/2.0% MK-507 combination b.i.d. to the concomitant administration of 0.5% timolol b.i.d. and 2.0% MK-507 b.i.d. Patients with ocular hypertension or open-angle glaucoma from 21 to 85 years of age were enrolled in this study. Each of them should have intraocular pressure (IOP) of 20 mmHg or more in the study eye after they completed the wash-out period. The patients enrolled were randomly assigned to either combination (0.5% timolol/2.0% MK-507 b.i.d. and placebo b.i.d.) or concomitant (0.5% timolol b.i.d. and 2.0% MK-507 b.i.d.) treatment. During the study, no systemic or topical medication affecting IOP other than test drugs were allowed. A total of 20 randomized patients were included in the intention-to-treat population for analysis of data. The ten were assigned to the combination treatment and others were assigned to the concomitant treatment. There was no statistically significant difference between the two study treatments in terms of gender distribution, average age, and average IOP at the trough and the peak before starting the test medications. Mean reduction of the IOP from baseline to the final visit at the trough was 5.04 mmHg in the combination treatment and was 2.73 mmHg in the concomitant treatment. Mean reduction of the IOP at the peak was 2.19 mmHg in the combination treatment and was 2.53 mmHg in the concomitant treatment. There were no statistically significant differences in the above analyses between the two treatments. Safety evaluation was carried out, and number of adverse events in each treatment group did not differ substantially. Ocular signs and symptoms were evaluated in each visit, and all of the between-treatment values were not different significantly, either. Laboratory tests were performed, and showed no significant differences between pre- and post-treatment periods. None of these was found to be clinically serious, either. We concluded that the 0.5% timolol/2.0% MK-507 combination b.i.d. is equivalent in the efficacy of lowering IOP as well as safety compared to the concomitant administration of 0.5% timolol b.i.d. and 2.0% MK-507 b.i.d. in patients with ocular hypertension or open-angle glaucoma.