多西他赛加奈达铂和顺铂加氟尿嘧啶方案诱导化疗局部晚期鼻咽癌的前瞻性研究

目的 比较多西他赛联合奈达铂(DN)方案和顺铂联合氟尿嘧啶(PF)方案诱导化疗治疗局部晚期鼻咽癌的近期疗效和不良反应.方法 86例局部中晚期鼻咽癌患者随机分为DN组(44例)和PF组(42例),两组患者均给予根治性放疗,诱导化疗PF组采用PF方案,DN组采用DN方案,诱导化疗第二疗程后十天内开始放疗.结果 不良反应:DN组在骨髓抑制反应、胃肠道反应、脉管炎、黏膜炎方面均小于PF组,其中胃肠道反应、脉管炎、黏膜炎方面差异有显著性沪＜ 0.05); DN组脱发较PF组明显,差异有显著性(P＜0.05).疗效:诱导化疗后短期显效率DN组(51.1％)明显优于PF组(29.3％)(P＜ 0.05);一年总生存率(OS)均为100％;无病生存率(PFS)DN组97.7％,PF组92.9％,差异无显著性(P＜0.05).结论 DN方案诱导化疗治疗局部中晚期鼻咽癌患者,不良反应小,短期疗效明显,近期有效率与PF方案相似,更有优势,值得临床推广.     

生脉注射液治疗小儿病毒性心肌炎疗效观察与护理

目的观察生脉注射液治疗病毒性心肌炎的疗效。方法西药（＋）生脉注射液（治疗组）与单纯两药治疗（对照组）进行疗效观察。结果西药＋生脉注射液治疗效果明显优于单纯西药治疗。结论生脉注射液对病毒性心肌炎治疗效果显著：     

血管内皮生长因子和内皮抑素在恶性心包积液中的鉴别诊断价值

<正>心包积液是心血管疾病常见的临床表现之一,或为某种全身疾病的局部表现。引起心包积液的病因众多,病因的正确诊断直接影响患者的治疗效果及预后,寻求新的检测指标对于鉴别诊断心包积液病因有着重要的临床意义。本研究对64例恶性心包积液和36例良性心包积液患者的     

从肝论治糖尿病视网膜病变

糖尿病视网膜病变一直困扰着人类的健康。本文介绍了肝与糖尿病视网膜病变的关系,论述了如何从肝论治糖尿病视网膜病变,分析得出从肝论治可收到良好疗效,为糖尿病视网膜病变的治疗提供了新的道路。     

人羊膜间充质干细胞移植减轻体外循环再灌注肺损伤

BACKGROUND: In recent years, mesenchymal stem cells exhibit a good prospect in organ or tissue repair and therefore, and therefore, cell transplantation based on mesenchymal stem cell plasticity can promote cell regeneration and functional recovery from lung injury after cardiopulmonary bypass. OBJECTIVE: To investigate the effects of human amnion-derived mesenchymal stem cells (hAMSCs) transplantation on ischemia-reperfusion-induced acute lung injury in dogs after cardiopulmonary bypassand its mechanism for regulating inflammatory cytokines. METHODS: Eighteen adult healthy mongrel dogs were randomly divided into three groups (n=6 per group): black group (cardiopulmonary bypass with 1 mL physiological saline injection via the femoral vein without blocking the aorta), control group (cardiopulmonary bypass with blocking the aorta for 1 hour and then opening the aorta for 15 minutes plus 1 mL physiological saline injection via the femoral vein), experiment group (cardiopulmonary bypass with blocking the aorta for 1 hour and then opening the aorta for 15 minutes plus femoral vein injection of 1 mL physiological saline containing 2×107 hAMSCs). Arterial blood samples of 2 mL were taken to calculate oxygenation index and respiratory index before cardiopulmonary bypass (T1), 15 minutes (T2), 1 hour (T3), 2 hours (T4), 3 hours (T5) after opening the aorta. 8 mL intravenous blood samples were taken to detect the serum tumor necrosis factor α, matrix metalloproteinase-9, interleukin-8 and interleukin-10 by ELISA. Meanwhile, western blot assay was used to detect the expression of nuclear factor-κB in lung tissues, and histopathological changes of lung tissues observed under optical microscope. RESULTS AND CONCLUSION: Compared with the control group, the oxygenation index was significantly increased in the experimental group at 2 and 3 hours after transplantation, and the respiratory index was remarkably decreased at 1, 2, 3 hours after transplantation. Compared with the control group, the levels of tumor necrosis factor α, matrix metalloproteinase-9 and interleukin-8 were significantly decreased in the experimental group, but the level of interleukin-10 was increased in the experimental group. Compared with the blank group, the expression of nuclear factor-κB was significantly strengthened in the control group at 3 hours after opening the aorta, but it was decreased significantly after intravenous injection of hAMSCs. After opening the aorta, the pathological changes in the experimental group were remarkably milder than those in the control group, and a small amount of red blood cells and neutrophils exuded, with telangiectasia, and congestion, were found in the experimental group. These findings indicate that hAMSCs transplantation can mitigate ischemia-reperfusion- induced acute lung injury after cardiopulmonary bypass by adjusting the level of nuclear factor-κB in lung tissues and release of tumor necrosis factor α, matrix metalloproteinase-9, interleukin-8 and interleukin-10.      

膝关节部复杂骨折30例远期疗效分析

从1987年1月～1992年11月收治30例膝关节部复杂骨折。手术治疗后经1～5年10个月随访,效果满意,现报告如下。 临床资料 一、一般资料本组男26例,女4例。闭合骨折27例,开放骨折3例;粉碎性骨折18例,单纯内髁骨折8例,单纯外髁骨折4例。 二、治疗方法手术复位,自制蟹钳式骨折把持固定器暂时维持固定。粉碎性18例中8例因压缩骨缺损严重,应用L—梯形自动加压钢板加松质骨螺钉、皮质骨螺钉同时植腓骨插入髓腔和大块髂骨组成三角桁架结构;10例无骨缺损和骨压缩,应用L—梯形自动加压钢板加松质骨螺钉、皮质骨螺钉固定,未植骨。单纯内     

单纯股外侧肌闭合性断裂一例报告

<正> 单纯股外侧肌腹闭合性断裂比较罕见,我院骨科收治一例,治疗效果良好,现报告如下。 病例报告 患者曹××,男性,17岁,学生。住院号A3430号。入院10天前骑自行车摔倒在两米深沟内,当时因疼痛不敢站立约五分钟。2小时后大腿外侧肿胀,出现淤血斑后因肿胀严重,不能伸膝行走,来我院就诊,按股四头肌断裂收容入院。 入院后检查查:左大腿软组织肿胀,腘窝处皮下可见淤血斑,膝关节肿胀、屈曲160度,活动受限,浮髌试验阴性,髌骨上缘向前倾。大腿中段前外侧,皮肤凹陷并压痛。直腿抬高不能,股四头肌力M_1,     

创伤性膝关节脱位的治疗(附22例报告)

<正> 创伤性膝关节脱位虽不多见,但损伤严重,处理不当往往会造成终身残废,我院自1959年10月至1980年5月,21年间共收治22例,现将我们治疗中的体会报告如下。     

氢吗啡酮对硬膜外阻滞分娩镇痛时布比卡因最低有效浓度的影响

目的：通过建立临床模型研究氢吗啡酮对硬膜外分娩镇痛时布比卡因最低有效镇痛浓度（MLAC）的影响,以探讨第一产程硬膜外镇痛过程中与氢吗啡酮配伍的布比卡因的浓度和剂量。方法选择单胎足月临产妇64例,ASAⅠ～Ⅱ级,均进入第一产程活跃期,分为两组：布比卡因对照组和布比卡因-氢吗啡酮组,每组30例。所有患者于 L3～4间隙行硬膜外穿刺置管,以10 mL／min 的速度分别给予15 mL 布比卡因注射液和含有200μg 氢吗啡酮注射液的布比卡因注射液。根据双盲、序贯的方法,以 VAPS 作为镇痛标准进行布比卡因适宜浓度的研究。结果 4例临产妇退出研究,余每组30例进入分析。两组布比卡因的MLAC 值分别为布比卡因对照组0．103％（95％ CI ：0．094％～0．113％）;布比卡因-氢吗啡酮组0．044％（95％CI ：0．034％～0．053％）,差异有统计学意义（P ＜0．05）。两组间 Bromage 评分,患者心率（HR）、血压（BP）、胎心（FHR）、宫缩强度、不良反应的发生情况差异均无统计学意义（P ＞0．05）。结论该研究显示硬膜外腔复合使用氢吗啡酮能显著降低布比卡因的 MLAC,氢吗啡酮能安全地应用于硬膜外分娩镇痛。     

剖宫产腰硬联合麻醉不同穿刺点麻醉效果的比较

目的:探讨剖宫产腰硬联合麻醉(CSEA)不同穿刺点的麻醉效果.方法:选择ASA I级产妇80例,在CSEA下行剖宫产术,按照腰椎(L)间隙穿刺点的不同分为两组(Ⅰ组:L2～3:Ⅱ组:L3～4).比较两组需要调整手术床位的例数、需要硬膜外用药的例数、术中自述呼吸困难发生率、术中低血压发生率和手术开始时的麻醉平面.同时观察术中恶心呕吐、寒颤及腹部牵拉不适等不良反应的发生情况.结果:Ⅰ组产妇术中自述呼吸困难发生率、术中低血压发生率、恶心呕吐的发生率、麻醉平面明显高于Ⅱ组产妇(P<0.01).需要调整手术床位的例数、硬膜外用药的例数Ⅱ组明显高于Ⅰ组(P<0.01).两组寒颤、腹部牵拉不适的发生率无统计学差异.两组新生儿1 min、5 min Apgar评分均在8分以上.结论:在CSEA剖宫产手术中,选择L3～4穿刺.通过调整麻醉平面使麻醉过程维持平稳,效果理想,不良反应少.