中重度宫腔粘连宫腔镜电切术后联合不同剂量戊酸雌二醇、地屈孕酮序贯治疗的价值

目的 探讨中重度宫腔粘连患者宫腔镜电切术后联合不同剂量雌激素、孕激素序贯人工周期治疗的临床价值。方法 选择2018年8月至2020年3月我院收治的108例中重度宫腔粘连患者作为研究对象,按照随机数字表法分为大剂量组和小剂量组,每组54例。所有患者均行宫腔镜下粘连电切分离术,术后放置宫内节育环,配合戊酸雌二醇、地屈孕酮序贯人工周期治疗12周。大剂量组序贯治疗中戊酸雌二醇剂量为9 mg/d,小剂量组为3 mg/d。比较两组患者治疗前的一般资料及治疗前后不同时间的内膜厚度、月经持续时间、月经量评分、宫腔粘连评分、不良反应发生情况、粘连复发情况及血清血小板源性生长因子(PDGF)、转化生长因子-β(TGF-β)、基质金属蛋白酶组织抑制因子-1(TIMP-1)的水平变化,并统计末次随访时两组的妊娠情况。结果 治疗前两组患者的一般资料、内膜厚度、月经持续时间、月经量评分、宫腔粘连评分、PDGF、TGF-β及TIMP-1水平比较均无显著性差异(P>0.05)。序贯治疗后不同时间大剂量组的内膜厚度均显著高于小剂量组(P<0.05),月经持续时间、月经量评分显著高于小剂量组,宫腔粘连评分显著...     

普米克令舒雾化吸入治疗小儿口咽部烫伤 4 例

目的：观察普米克令舒雾化吸入治疗小儿口咽部烫伤的效果。方法回顾性分析4例使用普米克令舒雾化吸入治疗口咽部烫伤患儿的临床资料,观察治疗后患儿肿胀、气促等症状有无改善及是否行气管切开术。结果3例患儿症状得到改善,但早期出现血氧改变的患儿仍需行气管切开术。结论普米克令舒雾化吸入可以改善小儿口咽部烫伤患儿的临床症状,但对早期出现血氧改变的患儿,气管切开术仍难以避免。     

慢性乙型肝炎患者外周血CD4~+IL-17A~+IFN-γ~+T细胞的变化及临床意义

目的研究CD4+IL-17A+IFN-γ+T细胞在慢性乙型肝炎患者中的作用及意义。方法采用流式细胞术检测40例慢性HBV感染患者和15例健康志愿者外周血CD4+IL-17A+IFN-γ+T细胞数量,同时采用ELISA法检测血清IL-17A和IFN-γ含量。结果慢性HBV感染重型患者(CSHB)外周血中CD4+IL-17A+IFN-γ+T细胞含量和血清IL-17A含量最高,与慢性HBV感染轻、中度患者(CHB-LM)和慢性HBV感染无症状携带者(AsC)及健康志愿者(HV)比较差异有统计学意义(P均0.05)。CSHB和CHB-LM患者血清IFN-γ含量均明显低于AsC组和HV组,差异有统计学意义(P均0.05),AsC组和HV组患者IFN-γ含量差异无统计学意义(P0.05)。Pearson相关性分析显示,慢性HBV轻、中度患者及慢性HBV重型患者血清IL-17A水平与CD4+IL-17A+IFN-γ+T细胞含量呈正相关(P均0.05)。慢性HBV无症状携带者,慢性HBV轻、中度患者和慢性HBV重型患者血清IFN-γ含与血清IL-17A含量及外周血CD4+IL-17A+IFN-γ+T细胞含量均无明显相关性(P均0.05)。结论CD4+IL-17A+IFN-γ+T细胞在慢性乙型病毒性肝炎不同疾病阶段存在差异,可能在HBV发生、发展过程中发挥重要作用。     

皮瓣与肌皮瓣移植在治疗深度烧伤中的应用

目的：探讨多种类型皮瓣在深度烧伤创面上应用。方法：观察皮瓣下感染,出血和皮瓣动静脉危象及其所修复部位的功能,分析皮瓣应用的种类,时机。结果：本组61例（76例次）,所用15种皮瓣全部成活率为84．21％（64／76）,术后皮瓣下感染8例,出血3例,发生动脉危象10例,皮瓣成活率为60％（6／10）,发生静脉危象4例,全部成活率为0,晚期病例修复后73．21％功能要进行重建。结论：皮瓣与肌皮瓣修复深度伤面具有较好的疗效。皮瓣修复晚期功能部位创面,多数病例功能恢复差。     

强化精氨酸肠内营养对烧伤患者营养状况和细胞免疫的影响

Objective To investigate the effects of arginine enriched enteral nutrition (EN) on nu-tritional status and cellular immunity of severely burned patients. Methods Randomized, single blind, parallel and positive control investigation was employed in the study. Thirty severely burned patients were di-vided into enteral immune nutrition (EIN) group and EN group. Sixteen patients in EIN group received en-teral nutrition enriched with arginine, while the other 14 patients in EN group received standard enteral nu-trition. Nutritional support was continued for 14 days. Gastrointestinal reaction of patients in 2 groups was observed. Fasting venous blood was drawn from patients of both groups before receiving nutrition treatment and on the morning of 7th, 14th day of treatment. Level of serum protein, hepatic function parameters, renal function parameters, fasting-blood glucose, and subpopulations of T lymphocytes in peripheral blood were determined. Results (1) Incidence of gastrointestinal side effect in EIN group (25.0%) was close to that of EN group (21.4% , P>0.05). (2) Compared with pre-treatment days, levels of prealbumin and transferrin in serum of patients in 2 groups on 7th and 14th post-treatment days were significantly increased (P<0.05 or P<0.01), but there was no significant difference between 2 groups. The level of total serum protein on 14th day of treatment of patients was significantly increased in both groups, and that of EIN group (66±7 g/L)was significantly higher compared with that in EN group (64 ± 11 g/L, P<0.05). The level of serum albumin (29±5, 32±5 g/L, respectively) of patients in EIN group on 7th and 14th day of treat-ment were significantly higher than that (26±4 g/L, P <0.05) in pre-treatment days, however there was no significant difference in EN group. (3) There was no significant difference in respect of hepatic function, renal function, and fasting-blood glucose between pre-treatment and post-treatment periods in both groups (P>0.05). (4) The ratio of CD4+ , CD8+ on 14th day of treatment in EIN group was close to that of pre-treatment level. In EN group, cell percentage of CD4+ significantly decreased, while that of CD8+ significantly increased (P<0.05), and CD4+ was significantly higher [(56±8) %] in EIN group than that in EN group [(55±12) % , P <0.05]. In both groups, cell percentage of CD3+ was significantly higher than that in pre-treatment days (P<0.05), while there was no obvious change in CD4+/CD8+. Conclusions Arginine enriched enteral nutrition can effectively improve nutritional status and cellular immune function of burn patients.     

强化精氨酸肠内营养对烧伤患者营养状况和细胞免疫的影响

Objective To investigate the effects of arginine enriched enteral nutrition (EN) on nu-tritional status and cellular immunity of severely burned patients. Methods Randomized, single blind, parallel and positive control investigation was employed in the study. Thirty severely burned patients were di-vided into enteral immune nutrition (EIN) group and EN group. Sixteen patients in EIN group received en-teral nutrition enriched with arginine, while the other 14 patients in EN group received standard enteral nu-trition. Nutritional support was continued for 14 days. Gastrointestinal reaction of patients in 2 groups was observed. Fasting venous blood was drawn from patients of both groups before receiving nutrition treatment and on the morning of 7th, 14th day of treatment. Level of serum protein, hepatic function parameters, renal function parameters, fasting-blood glucose, and subpopulations of T lymphocytes in peripheral blood were determined. Results (1) Incidence of gastrointestinal side effect in EIN group (25.0%) was close to that of EN group (21.4% , P>0.05). (2) Compared with pre-treatment days, levels of prealbumin and transferrin in serum of patients in 2 groups on 7th and 14th post-treatment days were significantly increased (P<0.05 or P<0.01), but there was no significant difference between 2 groups. The level of total serum protein on 14th day of treatment of patients was significantly increased in both groups, and that of EIN group (66±7 g/L)was significantly higher compared with that in EN group (64 ± 11 g/L, P<0.05). The level of serum albumin (29±5, 32±5 g/L, respectively) of patients in EIN group on 7th and 14th day of treat-ment were significantly higher than that (26±4 g/L, P <0.05) in pre-treatment days, however there was no significant difference in EN group. (3) There was no significant difference in respect of hepatic function, renal function, and fasting-blood glucose between pre-treatment and post-treatment periods in both groups (P>0.05). (4) The ratio of CD4+ , CD8+ on 14th day of treatment in EIN group was close to that of pre-treatment level. In EN group, cell percentage of CD4+ significantly decreased, while that of CD8+ significantly increased (P<0.05), and CD4+ was significantly higher [(56±8) %] in EIN group than that in EN group [(55±12) % , P <0.05]. In both groups, cell percentage of CD3+ was significantly higher than that in pre-treatment days (P<0.05), while there was no obvious change in CD4+/CD8+. Conclusions Arginine enriched enteral nutrition can effectively improve nutritional status and cellular immune function of burn patients.     

强化精氨酸肠内营养对烧伤患者营养状况和细胞免疫的影响

Objective To investigate the effects of arginine enriched enteral nutrition (EN) on nu-tritional status and cellular immunity of severely burned patients. Methods Randomized, single blind, parallel and positive control investigation was employed in the study. Thirty severely burned patients were di-vided into enteral immune nutrition (EIN) group and EN group. Sixteen patients in EIN group received en-teral nutrition enriched with arginine, while the other 14 patients in EN group received standard enteral nu-trition. Nutritional support was continued for 14 days. Gastrointestinal reaction of patients in 2 groups was observed. Fasting venous blood was drawn from patients of both groups before receiving nutrition treatment and on the morning of 7th, 14th day of treatment. Level of serum protein, hepatic function parameters, renal function parameters, fasting-blood glucose, and subpopulations of T lymphocytes in peripheral blood were determined. Results (1) Incidence of gastrointestinal side effect in EIN group (25.0%) was close to that of EN group (21.4% , P>0.05). (2) Compared with pre-treatment days, levels of prealbumin and transferrin in serum of patients in 2 groups on 7th and 14th post-treatment days were significantly increased (P<0.05 or P<0.01), but there was no significant difference between 2 groups. The level of total serum protein on 14th day of treatment of patients was significantly increased in both groups, and that of EIN group (66±7 g/L)was significantly higher compared with that in EN group (64 ± 11 g/L, P<0.05). The level of serum albumin (29±5, 32±5 g/L, respectively) of patients in EIN group on 7th and 14th day of treat-ment were significantly higher than that (26±4 g/L, P <0.05) in pre-treatment days, however there was no significant difference in EN group. (3) There was no significant difference in respect of hepatic function, renal function, and fasting-blood glucose between pre-treatment and post-treatment periods in both groups (P>0.05). (4) The ratio of CD4+ , CD8+ on 14th day of treatment in EIN group was close to that of pre-treatment level. In EN group, cell percentage of CD4+ significantly decreased, while that of CD8+ significantly increased (P<0.05), and CD4+ was significantly higher [(56±8) %] in EIN group than that in EN group [(55±12) % , P <0.05]. In both groups, cell percentage of CD3+ was significantly higher than that in pre-treatment days (P<0.05), while there was no obvious change in CD4+/CD8+. Conclusions Arginine enriched enteral nutrition can effectively improve nutritional status and cellular immune function of burn patients.     

疏肝健脾利水方辅助治疗肝硬化腹水疗效及对肝肾功能的影响

目的观察常规西医疗法联合疏肝健脾利水方治疗肝硬化腹水的临床疗效及对患者肝肾功能的影响。方法将80例确诊肝硬化腹水患者随机分为治疗组与对照组各40例,2组患者均给予常规西医治疗方案,治疗组在此基础上加用自拟疏肝健脾利水方治疗,治疗8周后比较2组患者临床疗效,观察肝肾功能指标变化情况。结果治疗8周后,治疗组总有效率明显高于对照组(P0.05),2组患者血清谷丙转氨酶(ALT)、天冬氨酸氨基转移酶(AST)水平均较治疗前明显降低(P均0.05),白蛋白(ALB)水平均较治疗前明显升高(P均0.05),且治疗组较对照组降低或升高更明显(P均0.05);治疗后对照组血肌酐(Cr)、尿素氮(BUN)水平均较治疗前无明显改善(P均0.05),治疗组Cr、BUN水平均较治疗前及对照组明显降低(P均0.05)。结论疏肝健脾利水方辅助治疗肝硬化腹水可有效改善患者临床症状及肝肾功能,值得推广应用。     

驱臭粉治疗腋臭

处方:枯矾3份,轻粉1份。制法:将两药研末,越细越好,混合均匀,装瓶备用。用法:每逢出汗时,将药粉涂于腋窝处,揉搽片刻,每日可揉搽数次。不出汗时,每日早晚各搽1次。20天为1疗程,间隔3～5天。疗效:共观察34例腋臭者,重度10例,中度13     

钩端螺旋体病的血清学诊断

钩端螺旋体病是一种世界范围的人畜共患病,血清学试验是其重要的诊断方法之一,聚合酶链反应的应用加速了其分子水平的研究。为适应广大发展中国家的国情,一些简便、快速、价廉的血清学诊断方法应运而生,或在原有基础上加以改进。本文就目前开展的钩端螺旋体病血清学诊断方法作了综述。