胰岛素治疗新进展

糖尿病是一种以糖代谢紊乱为主要表现的内分泌代谢疾病.它是由于胰岛素分泌绝对和相对不足,导致糖代谢的紊乱,使血糖过高,出现糖尿.主要表现为多饮、多食、多尿、消瘦等症状.胰岛素(insulin , INS) 是治疗糖尿病的一种多肽类药物.     

经下腔静脉放置冠状静脉窦电极导管对操作者放射剂量影响的研究

Objective To evaluate and compare the dosages of operator-incurred-radiation during the implantation of coronary sinus (CS) catheter between the approaches through inferior vena cava (IVC) with the steerable catheter and through supra vena cava (SVC) with the fixed curve catheter. Methods Two hundred and two patients were divided into two groups according to the different approaches of CS catheter insertion. IVC group (n = 122) :a deca-polar catheter with steerable curve was placed into CS through the femoral vein and the IVC. SVC group (n =80) :a fixed curve deca-polar catheter was inserted into CS through the jugular vein and the SVC. There was no obvious difference in gender, age, and echocardiogram between the two groups. All procedures were performed by the same three operators. The exposure time of each case and the dosage of operator-incurred-radiation during the procedure were measured. Results The catheters were positioned successfully inl20 patients in the IVC group and in all patients in the SVC group. The 2 failured in the IVC group were also failed in by attempting through SVC with fixed curve catheter. There was no significant difference in the exposure time between IVC group and SVC group[( 105 ± 12)s and ( 108 ± 19)s,P =0. 925]. The per sec operator-incurred-radiation was 0. 25 × 10-2 uGy/s in WC group and 1.38 × 10 -2 uGy/s in SVC group. This lead to significant decrease in the dosage of operator-incurred-radiation in IVC group[(0. 30 ± 0. 04) uGy vs ( 1.49 ±0. 27) uGy,P ＜ 0. 001]. No cardiac or vascular complication was observed in both groups. Conclusions Insertion of coronary sinus catheter through IVC with the steerable catheter is associated with significantly less radiation than that through SVC with the fixed curve catheter without increasing time of the procedure.     

系统性红斑狼疮患者左室肥厚发生率及其相关因素分析

目的探讨系统性红斑狼疮(systemic lupus erythematosus,SLE)患者左室肥厚(left ventricular hypertrophy,LVH)发生率及其相关因素。方法初诊SLE患者92例,女性84例,男性8例,平均年龄35.8±8.3岁,应用彩超测定心脏各参数,计算左室质量指数(LVMI),判断有无LVH,并比较阳性组(LVH+)和阴性组(LVH-)有关参数。结果92例初诊SLE患者中,39例(42.39%)存在LVH;LVMI与平均动脉压(MABP)、C反应蛋白(CRP)成正相关(P<0.01和P<0.05),与Hb负相关(P<0.01),r值分别为3.164、2.303和-2.848。结论部分SLE患者早期可出现LVH,MABP、Hb和CRP是SLE伴LVH的危险因素,宜及早干预相关危险因素,以减轻或逆转SLE患者的LVH,减少心血管事件。     

重组TRAIL蛋白对胰腺癌细胞SW1990增殖、凋亡的影响及吉西他滨的干预作用

目的 探讨重组肿瘤坏死因子相关凋亡诱导配体(TRAIL)蛋白的抗胰腺癌作用及吉西他滨的干预作用.方法 分别采用不同浓度TRAIL 和(或)吉西他滨处理人胰腺癌细胞株SW1990并分为TRAIL组、吉西他们滨组、联合组.采用MTT法检测各组生长抑制率(IR),流式细胞仪检测细胞凋亡率,Heochst 33342染色法检测凋亡细胞形态,Western blot检测凋亡相关蛋白Smac/DIABLO、Caspase-3表达.结果 TRAIL组、吉西他滨组及联合组均出现细胞增殖抑制和凋亡;联合组IR、凋亡率及凋亡相关蛋白表达均显著高于其他两组(P＜0.05).结论 TRAIL可通过调节细胞凋亡相关蛋白表达抑制SW1990细胞增殖及诱导凋亡;其与吉西他滨联用可为胰腺癌的靶向治疗提供新思路.     

穿心莲制剂引起急性肾毒性的文献回顾性分析

目的：调查穿心莲制剂致急性肾毒性的临床特征和发生原因,为预防该不良反应的发生提供参考。方法：检索中国期刊全文数据库、中国生物医学文摘数据库及维普中文科技期刊文献数据库,收集国内文献报道的穿心莲制剂引起急性肾毒性病例,从患者一般情况、用法用量、联合用药情况、急性肾毒性发生时间及临床病理特点等方面进行回顾分析。结果：共检索穿心莲相关制剂致急性肾毒性文献15篇,病例共27例,其中注射剂26例、片剂1例。用药后不良反应发生时间最短0.5h,最长96h,患者Scr、BUN值均升高。全部患者经治疗后痊愈。结论：穿心莲制剂可因一次性高浓度静脉给药、配伍禁忌等引起急性肾毒性,临床用药前应了解个人及家族疾病史,严格控制剂量与联合用药,密切监测患者肾功能。     

护理人员在合理使用抗生素中的作用

合理使用抗生素越来越成为临床工作中十分重要的问题,当前随着抗生素新品种不断开发成功,其临床上的应用日益广泛,但是,这无疑给人类健康带来新的危机,由于抗生素使用不当,细菌常会产生耐药性造成临床治疗中的困难,抗生性微生物死灰复燃的趋势,甚至出现抗生素的浪费和滥用现象,医护工作者直接接触感染患者,对指导和使用抗生素起着非常重要的作用。     

序贯疗法与标准三联疗法在幽门螺杆菌根除中的效果观察

序贯疗法在我国应用尚未广泛,且临床资料不多,缺乏多中心大样本试验,我们应用10d序贯疗法根除幽门螺杆菌取得较好效果。     

胸腔闭式引流术中存在的问题及处理和预防

胸腔闭式引流术是胸外科发展的基础之一,它的成败影响着胸部疾病的诊治效果。为此,笔者根据遇到的问题和经验教训,报告如下,供同道参考。     

Libsys 5.0典藏模块在解放军医学图书馆新书典藏中的应用

介绍了Libsys 5.0典藏模块的各项功能,分析了Libsys 5.0典藏模块在我馆新书典藏中的应用。     

手部全功能被动运动康复仪设计

基于持续被动运动康复原理和需求,设计了一种由柔顺曲柄机构、单片机（下位机）、通用计算机（上位机）和角度伺服电机（舵机）组成的可编程,功能完备,使用安全方便,并能进行医疗数据统计和分析的手部全功能被动运动康复仪。介绍了该康复仪的机械系统、电控系统、通信及数据处理技术。其性能超过国内外同类产品,满足此类医疗手段提出的各类要求,是一种理想的手部被动运动康复仪。