彩色多普勒超声诊断下肢深静脉血栓形成后综合征

目的:评估彩色多普勒超声对下肢深静脉血栓形成后综合征的诊断价值。方法:采用高频彩色多普勒超声对134例下肢深静脉血栓形成后综合征进行治疗前后观察对比,观察下肢静脉的血管内径、内膜厚度、光滑度、血管压缩性、管腔内回声、静脉瓣功能、侧支循环、血流速度等指标。结果:134例中107例临床治愈,27例病情好转,超声检查显示管壁回缩正常,内膜光滑,血管压缩性恢复良好,侧支循环建立,静脉瓣功能不全有所改善。结论:高频彩色多普勒超声对下肢深静脉血栓形成后综合征的治疗诊断及评估有着重要临床价值。     

脑脊液白蛋白和免疫球蛋白IgG检测在儿童病毒性脑炎诊治中的应用

目的：探讨病毒性脑炎患儿脑脊液白蛋白比值（QAlb)、IgG和IgG指数变化与疾病严重程度的相关性。方法研究对象分病毒性脑炎组和对照组,病毒性脑炎组按临床特点分为轻症病毒性脑炎组和重症病毒性脑炎组,采用免疫散射比浊法测定血清和脑脊液的白蛋白、IgG,计算QAlb和IgG指数,判断病毒性脑炎患儿血脑屏障功能状态及免疫球蛋白鞘内合成情况与临床严重程度的关系。结果病毒性脑炎组的QAlb高于对照组;重症病毒性脑炎组的QAlb较轻症病毒性脑炎组和对照组增高,差异有统计学意义（P<0.05）。重症病毒性脑炎组脑脊液IgG、IgG指数比轻症病毒性脑炎组和对照组增高,差异有统计学意义（P<0.05）。结论重症病毒性脑炎组患儿的血脑屏障功能损害程度、鞘内IgG合成情况与临床病情严重程度相关。检测脑脊液和血清中白蛋白、IgG,计算QAlb和IgG指数能反映病毒性脑炎患儿血脑屏障功能状态及IgG鞘内合成情况,为判断病毒性脑炎临床病情的严重程度提供相关依据。     

α受体激动剂盐酸米多君治疗女性压力性尿失禁的临床研究

目的　评价盐酸米多君 (管通 )治疗女性压力性尿失禁的有效性和安全性。　方法　采用多中心、随机、双盲、安慰剂平行对照方法对 136例女性压力性尿失禁患者进行管通与安慰剂的对比研究。试验组 6 8例 ,服管通 2 .5mg/次 ,3次 /d ,疗程 4周 ;对照组 6 8例 ,以安慰剂替代管通。 　结果　完成试验 12 9例 ,,管通组 (6 6例 )平均尿失禁量减少 9.9g ,安慰剂组 (6 3例 )减少 3.1g ;管通组尿失禁等级评分减少 1.0 2分 ,安慰剂组减少 0 .35分 ;管通组的客观有效率和主观有效率分别为 6 6 .7%和 80 .3% ,安慰剂组分别为 31.7%和 33.3% ,两组比较 ,差异均有显著性意义 (P均 <0 .0 0 1)。管通组患者副作用发生率 15 .0 % ,安慰剂组 17.1% ,两组间差异无显著性意义 (P >0 .0 5 )。　结论　盐酸米多君治疗女性压力性尿失禁疗效明显 ,优于安慰剂 ,安全性和耐受性与安慰剂相似。     

舍尼通~和抗生素联合用药治疗慢性非细菌性前列腺炎临床研究

目的:评价舍尼通与抗生素联合用药治疗慢性非细菌性前列腺炎的有效性及耐受性。方法:采用双盲、平行对照、多中心临床试验研究方法,通过Stam ey试验、前列腺按摩液(EPS)常规及美国国立卫生院慢性前列腺炎症状评分(NIH-CPSI),筛选出160例慢性非细菌性前列腺炎患者,随机分为试验组(80例,脱落1例)和对照组(80例)。试验组前4周合用舍尼通和左氧氟沙星,后4周单用舍尼通,服用剂量为舍尼通2次/d,1片/次,左氧氟沙星2次/d,0.1 g/次;对照组方法同上,仅将舍尼通换为安慰剂。所有患者均行入组前、治疗第4周和第8周随访并行NIH-CPSI评分、EPS等检查及药物不良反应的评估。结果:治疗后4周和8周,试验组疼痛评分降低分别为3.34±2.45,4.33±3.13,排尿评分降低分别为2.22±1.79,2.77±2.04;对照组疼痛评分降低分别为2.28±2.42,3.30±3.29,排尿评分降低分别为1.24±1.67,1.83±2.25。两组治疗前后的自身对比均差异有显著性(P<0.01),生活质量影响评分差异也有显著性(P<0.05)。组间比较,试验组较对照组第4周和第8周疼痛和排尿评分差异均有显著性(P<0.01或P<0.05)。两组治疗前后白细胞、卵磷脂小体差异无显著性(P>0.05),对药物的耐受性差异无显著性(P>0.05),无严重不良反应事件发生。结论:舍尼通与抗生素联合用药方案能更有效地缓解慢性非细菌性前列腺炎患者的疼痛不适症状和排尿症状,耐受性好,值得在临床上推广应用。     

雄激素剥夺条件下阻断自噬增加LNCaP细胞凋亡

目的 探讨雄激素剥夺条件下阻断自噬后LNCaP细胞凋亡变化与半胱天冬酶(caspase)激活的关系.方法 应用激光共聚焦显微镜、RT-PCR方法观察雄激素剥夺致细胞自噬增加后,利用DAPI染色观察细胞凋亡变化及药物抑制caspase后对凋亡的影响.结果 ①雄激素去除后LNCaP细胞自噬体增加,标准培养基(CM)培养下LNCaP细胞自噬体数量为1.90分;无血清培养基(SF)中细胞自噬体数量增高为2.64分;加入双氧睾酮(SFA组)后细胞自噬体下降至1.85分(P<0.01).CM中LNCaP细胞LC3 mRNA表达率为23%,血清饥饿12 h后,LC3表达量上调至100%,而SFA组LC3 mRNA表达量为86%;血清饥饿24 h后,SF组LC3 mRNA表达量为62%,SFA组为35%.②SF组和SFA组LNCaP细胞基础凋亡率分别为(3.19±1.09)0A和(3.01±0.33)%,加入3-甲基腺嘌呤(3-MA)阻断自噬24 h后,SF组凋亡率为(10.90±2.91)%,SFA组为(4.63±1.69)%.SF+3-MA组中加入Z-VAD-FMK后,细胞凋亡减至(1.16±0.52)%.组间差异有统计学意义(P<0.01).结论 剥夺雄激素后LNCaP细胞中自噬明显增加,阻断自噬后凋亡发生率增加.     

Diastolic Function Study with Conventional and Pulsed Tissue Doppler Echocardiography Imaging in Acromegalic Patients

Acromegaly is associated with myocardial hypertrophy and it can progress to diastolic and systolic dysfunction. Purpose: To evaluate diastolic function in acromegalic patients through conventional echocardiography (CD) and tissue Doppler imaging (TDI). Methods: Seventeen acromegalic patients were submitted to CD and TDI, and early (E) and atriogenic (A) transmitral flow were evaluated in mitral, septal, and tricuspid regions. Results: In comparison with controls the means of conventional (1.06), septal (1.01), and tricuspid (0.98) E/A ratio were significantly lower in acromegalic patients. E/A ratio <1.0 was demonstrated in 41% and 49% of acromegalics by DC and TDI, respectively, with no statistical difference among the two methods. An inverse linear correlation was shown between mitral E/A ratio and acromegalic age (r =−0.7). Conclusion: In this study, DC and TDI were equally effective in demonstrating diastolic dysfunction, a common finding in acromegalic patients.     

无张力疝修补术治疗腹股沟嵌顿疝85例分析

目的探讨无张力疝修补术治疗腹股沟嵌顿疝的临床效果。方法对83例腹股沟嵌顿疝患者选择性施行无张力疝修补术，分析其术后效果。结果83例患者中围手术期死亡2例，伤口感染1例，其余恢复良好．平均住院时间5．1d。结论应用无张力疝修补术治疗腹股沟嵌顿疝安全可靠，效果较为满意。     

全玻璃体切割治疗玻璃体积血疗效分析

目的 探索全玻璃体切割在玻璃体积血中的应用.方法 回顾51只眼手术病例,视网膜静脉阻塞23只眼,糖尿病视网膜病变9只眼,视网膜静脉周围炎2只眼,视网膜孔源性玻璃体积2只眼.眼外伤性玻璃体积血15只眼.采用睫状体平坦部三通闭合式全玻璃体切割术,并通过巩膜压陷结合高斜镜切割基底部玻璃体.结果 术后随诊5～12月,51只眼视力均有不同程度提高,其中视力在4.5者19只眼、4.6～5.0者9只眼4.0～4.4者19只眼、指数4只眼.结论 对玻璃体积血患者掌握好适应证及手术时机,行全玻璃体切割切实有效的减少玻璃体积血残留所致的并发症提高手术效果.     

Qualification needs of the nursing team for care provided to HIV and AIDS patients

This study discourses about the especific training needs of the nursing teams of the Centers of Reference of Sexual Transmissible Diseases (STD) and Aids from the STD/Aids Program of the Health Secretary of the Township of S?o Paulo for the assistance of clients with HIV and Aids. From a total of 671 nursing workers, 453 answered the questionnaire. They identified the following training needs: contents related to standard precautions, preparation and administration of specific drugs and other general nursing care to HIV + clients.     

Helical computed tomography characteristics of splenic and hepatic trauma in children subjected to nonoperative treatment

The purpose of this study was to present the radiological characteristics of abdominal computed tomography (CT) in the follow-up of splenic and hepatic injury in children. Children (n=24) less than 13 years old who had suffered blunt abdominal trauma and were diagnosed with splenic and hepatic injury by CT scan prospectively were enlisted in the study. The CT was performed immediately after the injury was suspected, and 7 and 60 days after the trauma. The clinical course of the patients was observed (red blood transfusion requirement, associated abdominal injuries, and hospital stay). The splenic and hepatic injuries varied from grade II to grade IV of the American Association for the Surgery of Trauma. The CT showed a reduction in the volume of the injury 60 days after the trauma. In this article the radiological findings will be shown and correlated with the clinical course of the patients. This study shows that CT is advantageous for detecting and grading splenic and hepatic injuries. These injuries can be managed nonoperatively in hospitals where CT is available for the evaluation of pediatric patients. Electronic Publication