直肠癌Miles术会阴创口处理方法的改进

背景与目的：直肠癌Miles术会阴创口的处理主要有纱布填塞敞开引流和一期缝合两种方法,其中纱布填塞敞开引流法有较多缺点.本研究探讨会阴创口敞开引流的改进方法的特点.方法：89例直肠癌患者,随机分为填塞组44例,改进组45例,填塞组和改进组分别采用纱布填塞敞开引流法和先缝后敞法处理会阴创口.结果：填塞组和改进组的换药次数分别为7.39±0.14和3.42±0.07;换药费用分别为（372±7）元和（171±4）元;创口愈合时间分别为（64.6±1.3）d和（54.8±1.1）d.两组相比较差异均有显著性（P＜0.01）.结论：采用先缝后敞法可缩短会阴创口愈合时间,是一种安全、简便、经济的处理方法.     

薏苡仁对扁平疣患者T淋巴细胞的影响

目的 观察薏苡仁对扁平疣患者皮损中T淋巴细胞的影响,初步探讨薏苡仁治疗扁平疣的可能作用机制.方法 收集扁平疣患者20例,经知情同意后予薏苡仁治疗,以薏苡仁粉30 g调糊口服,2次/d,同时外敷疣体,1次/晚,连续应用至疣体脱落或60 d止.采用免疫组织化学法对扁平疣患者治疗前后皮损中CD4+、CD8+T淋巴细胞水平进行检测,并与10例正常皮肤进行对照.结果 扁平疣患者治疗前较正常对照组CD4+/CD8+比值明显降低,差异有统计学意义(t=2.295,P<0.05);扁平疣患者治疗后较治疗前CD4+/CD8+比值明显升高,差异有统计学意义(t=2.121,P<0.05).结论 薏苡仁可能通过调节扁平疣患者皮损中T淋巴细胞的水平,从而增强机体免疫功能.     

通补法治疗冠心病国内RCT文献质量评价

目的 探讨通补法治疗冠心病(Coronary atherosclerotic heart disease,CHD)的疗效和安全性。方法 对中国知网全文数据库(China national knowledge infrastructure,CNKI)、中国生物医学文献数据库(Chinese biomedical literature database,CBM)、维普中文科技期刊全文数据库(VIP chinese scitech journal full-text database,VIP)和万方数据库建库至2021年2月文献进行检索。收集通补法治疗CHD随机对照试验(Randomized controlled trial,RCT),根据临床试验报告标准声明(2010版)(Consolidated standards of reporting trials,CONSORT)条目进行RCT文献质量评价,限定中文检索词为通阳、活络、补气、益气、冠心病、胸痹、胸痛、心痛。并总结纳入研究文献中结局指标的报告情况。结果纳入9篇RCT文献,包括849例CHD患者,文献发表的时间从2007年至2020年...     

基于“久卧伤气”探讨从气机防治急重症患者胃肠功能障碍

急重症患者在病程进展期间常常新发或合并急性胃肠功能障碍(AGD),导致原发病加重、延长住院时间从而增加医疗经济负担。因此类患者常常被动卧床改变了生理规律,结合“久卧伤气”理论,考虑可从调理气机论治预防及治疗急重症患者AGD的发生发展。笔者在临床治疗中从调理气机出发防治急重症患者AGD取得良好效果。     

中药带线棉栓对宫颈人类乳头状瘤病毒感染转阴的作用

目的 探讨中药带线棉栓对宫颈人类乳头状瘤病毒(human papillomavirus,HPV)感染转阴的干预作用.方法 将60例宫颈HPV感染的患者按治疗方法分为2组,治疗组(n=30)用中药带线棉栓(以鸦胆子、紫草、薏苡仁为主要成分)每次1枚宫颈用药,对照组(n=30)用奥平栓每次1粒(6万U·粒-1)宫颈用药,2组均隔天1次,7次为一疗程,每个月经周期用药一疗程,共三疗程.分别于疗程全部结束第1、3、6次月经干净后检测HPV的感染情况.结果 治疗后,治疗组和对照组第1-3次复查时HPV感染转阴率分别为56.7％、60.0％,66.7％、66.7％,73.7％、66.7％,2组比较差异均无统计学意义(均P＞0.05).结论 中药带线棉栓和奥平栓对宫颈HPV感染转阴的疗效相当.     

Synergistic Protection of Danhong Injection (丹红注射液) and Ischemic Postconditioning on Myocardial Reperfusion Injury in Minipigs

Objective: To explore the synergistic protection of Danhong Injection (丹红注射液,DHI) and ischemic postconditioning on myocardial reperfusion injury in minipigs.Methods: Acute myocardial infarction model was made by balloon occlusion in left anterior descending coronary artery (LAD) of minipigs,and then postconditioning was simulated through inflation/deflation of the angioplasty balloon.Minipigs were divided into four groups: the sham operation group (SH group),the ischemia/reperfusion group (I/R group),the ischemic postconditioning group (POC group) and DHI combined with ischemic postconditioning group (PAD group,DHI 20 mL through ear vein),six in each group.After 24-h continuous observation,myocardial infarction size was assessed by triphenyltetrazolium staining (TTC).Morphological changes of ischemic myocardium were observed by light microscopy,and cardiomyocyte ultrastructure was studied with electron microscopy.The superoxide dismutase (SOD) and malondialdehyde (MDA) activity in heart homogenates were measured by a biochemical method.Results: The myocardial infarction size was smaller in the POC group than in the I/R group (0.26±0.02 vs.0.37±0.09,P0.05),and the PAD group (0.14±0.08) displayed a significantly reduced infarction size relative to the I/R group (P0.01) and POC group (P0.05).The damage of myocardial tissue was severe in the I/R group shown by light and electron microscopy: myocardial fibers disorder,sarcoplasmic dissolution,myofilament fracture,mitochondria swelling and even vacuolization formation and a large number of inflammatory cell infiltrations.Compared with the I/R group,reduction of reperfusion injury in the PAD group included more orderly arranged myocardial fibers,less infiltration of inflammatory cells and maintenance of mitochondrial integrity.Compared with the I/R group,the damage of myocardial tissue in the POC group was improved,but not as significant as that in the PAD group.SOD levels in the POC group and the PAD group were significantly higher than those in the I/R group (96.96±13.43,112.25±22.75 vs.76.32±10.63,P0.05),and MDA was significantly lower in the POC group and the PAD group compared to the I/R group (1.27±0.19,1.09±0.21 vs.1.47±0.16,P0.05).Conclusion: DHI and ischemic postconditioning show a synergistic cardioprotection on myocardial reperfusion injury in minipigs.     

子宫内膜异位症引起不孕的诊治进展

<正>1 EMT与不孕的关系子宫内膜异位症(endometriosis,EMT)是妇科常见疾病,其发病率在一般人群中为1%~7%,且与不孕症密切相关,EMT患者中不孕症的发病率占30%~50%,而不孕症的患者中EMT占30%~58%[1]。现代医学对于轻微的EMT合并不孕症的治疗至今没有统一,多采用期待疗法。但期待疗法只能缓解临床症状,不能提高其妊娠率,目前研究[2]认为腹腔镜手术是EMT合并不孕患者的首选,而更多还原     

原发性下腔静脉平滑肌肉瘤超声造影表现1例

患者女,56岁.因体检发现腹膜后肿块入院,无心悸、面色苍白、出汗、恶心、呕吐、恐惧焦虑、乏力等症状.查体:一般状况好,心肺未见明显异常.腹平软,双侧肋脊角对称,双侧肾区无压痛、叩击痛,右侧上腹部可触及一界限不清的肿块,活动度差.     

针灸、HCG联合克罗米芬及补肾活血中药对排卵障碍性不孕临床干预的对比

目的：探讨针灸、HCG联合克罗米芬及补肾活血中药对排卵障碍性不孕临床疗效。方法将2012年3月-3013年12月在我院门诊就诊的患者按就诊顺序随机分为观察组和对照组,两组基础治疗：两组均在月经周期或激素撤退性出血第5d开始口服克罗米芬50mg/d,共5d,同时服用补肾活血中药,10-15d,一般至排卵后。同时于月经第11d开始监测卵泡,隔天监测一次,观察组于卵泡16mm时加用针刺关元、中极、子宫、三阴交、阴陵泉,3-5d,或直至排卵。对照组监测卵泡18mm-25mm时,肌注hcg10000U,48h后监测是否排卵。两组均治疗3个月经周期,观察6个月经周期。结果⑴观察组、对照组排卵率,P〈0.05,其中前3个治疗周期排卵率,P〉0.05,后3个观察周期排卵率,P〈0.05。⑵两组内膜厚度（每个周期中测得的最厚内膜）比较：观察组、对照组6个周期中第一、第二个周期两组内膜厚度比较,P〉0.05,第（3、4、5、6）周期两组内膜厚度比较,P〈0.05。⑶观察组、对照组6个周期累计妊娠例数,P〈0.05,其中前3个治疗周期累计妊娠例数P〈0.05,后3个观察周期累计妊娠例数,P〈0.01。