活血通便汤内服合大黄粉神阙穴外敷治疗单纯性胸腰椎压缩性骨折后腹胀便秘临床疗效观察

目的:观察活血通便汤内服合大黄粉神阙穴外敷对单纯性胸腰椎压缩性骨折后腹胀便秘患者胃肠功能恢复的影响,旨在为临床治疗提供参考依据。方法:选取我院2015年4月～2017年6月期间收治的92例单纯性胸腰椎压缩性骨折后腹胀便秘患者,将患者按随机数字表法分为对照组及观察组(每组46例),对照组采用口服枸橼酸莫沙必利胶囊治疗,观察组采用活血通便汤内服合大黄粉神阙穴外敷治疗。观察并比较两组患者临床疗效、肛门排气情况、便秘评分、康复情况及不良反应。结果:治疗后观察组临床总有效率明显高于对照组[(86. 96%) vs (60. 87%)],差异有统计学意义(P0. 05);治疗后观察组肛门排气总正常率明显高于对照组[(65. 22%) vs (34. 78%)],差异有统计学意义(P0. 05);治疗前两组患者便秘评分比较无明显差异(P0. 05);治疗后两组患者便秘评分均较治疗前明显降低,且观察组低于对照组,差异均具有统计学意义(P0. 05);治疗后观察组肠鸣音次数明显多于对照组,而首次排便时间明显少于对照组(P0. 05);两组患者治疗期间未出现明显不良反应。结论:活血通便汤内服合大黄粉神阙穴外敷治疗单纯性胸腰椎压缩性骨折后腹胀便秘临床疗效明确,能有效提高患者肛门排气正常率、降低便秘评分、减少肠鸣音次数并缩短首次排便时间,安全性高,值得临床推广应用。     

2008年山东省地方性水源性高碘病区成人颈动脉粥样硬化调查

Objective To survey the prevalence rates of adult carotid atherosclerosis in water-sourceoriginated high iodine area in Shandong province in 2008 and discuss the relationship between water-sourceoriginated high iodine and carotid atherosclerosis occurrence. Methods Yuncheng county was chosen as observation area which included Dachenlou, Weigai, Liuyi and Ershilipu villages. Juye county was chosen as control that included Zhangxi, Bihainan, Xiaguan and Qiji villages. Two hundred and ninety-nine participants aged over 40 from water-source-originated high iodine areas and 323 residents aged over 40 from normal iodine areas were investigated.Portable-type B mode color Doppler was performed to examine the carotid artery of all participants. The adult carotid atherosclerosis was diagnosed and graded through the ultrasonograms. Results The prevalence rates of adult carotid atherosclerosis in the 4 water-source-originated high iodine villages of Dachenlou, Weigai, Liuyi and Ershilipu were 47.1% (33/70) ,62.2% (51/82) ,67.5% (52/77) and 58.6% (41/70), respectively and the prevalence rates of adult carotid atherosclerosis in the 4 normal iodine villages of Zhangxi, Bihainan, Xiaguan and Qiji were 40.7%(35/86),40.8% (31/76),38.2% (34/89) and 37.5% (27/72), respectively. The prevalence rates of adult carotid atherosclerosis standardized by age in the 4 high iodine villages and the 4 normal iodine villages were 45.81% ,58.18% ,61.63%,55.34% and 34.66%,36.25%,43.01% ,41.30%, respectively. The prevalence rates were higher in high iodine villages than that in control villages(T = 26, P ＜ 0.05 ). There were 136 people scored "0", 120 people scored "1 -3",43 people scored "4 - 7", and total 299 people. There were 201 people scored "0", 87 people scored "1 - 3", 35 people scored "4 - 7", and total 323 people. The expected prevalence rates and severity of adult carotid atherosclerosis was significantly different between high iodine area and normal iodine area (x2 = 17.54,18.42, all P ＜ 0.01).Conclusion The prevalence rate and severity of adult atherosclerosis in water-source-originatod high iodine area is higher than that in normal iodine area.     

2008年山东省地方性水源性高碘病区成人颈动脉粥样硬化调查

目的 调查2008年山东省地方性水源性高碘病区成人颈动脉粥样硬化患病情况,探讨水源性高碘与颈动脉粥样硬化发生的关系.方法选择山东省郓城县和巨野县作为高碘病区和对照区,以郓城县的大陈楼村、魏垓村、刘一村和二十里铺村为高碘病村,以巨野县的章西村、毕海南村、夏官屯和祁集村为对照村.利用彩超对40岁以上的高碘病区居民299人和对照区居民323人进行颈动脉粥样硬化检查、诊断和记分.结果大陈楼村、魏垓村、刘一村和二十里铺村4个高碘病村成人颈动脉粥样硬化检出率分别为47.1%(33/70)、62.2%(51/82)、67.5%(52/77)和58.6%(41/70);章西村、毕海南村、夏官屯和祁集村4个对照村成人颈动脉粥样硬化检出率分别为40.7%(35/86)、40.8%(31/76)、38.2%(34/89)和37.5%(27/72).高碘病村和对照村成人颈动脉粥样硬化检出率按年龄标准化后分别为45.81%、58.18%、61.63%、55.34%和34.66%、36.25%、43.01%、41.30%,高碘病村的检出率高于对照村(T=26,P＜0.05).高碘病区299人中,检出阳性163人、阴性136人,0分136人、1～3分120人、4～7分43人;对照区323人中,检出阳性122人、阴性201人,0分201人、1～3分87人、4～7分35人.高碘病区与对照区成人颈动脉粥样硬化阳性检出情况及病变严重程度比较,差异有统计学意义(x2值分别为17.54、18.42,P均＜0.01).结论高碘病区成人动脉粥样硬化检出率增高、病变严重程度增大.

Abstract：

Objective To survey the prevalence rates of adult carotid atherosclerosis in water-sourceoriginated high iodine area in Shandong province in 2008 and discuss the relationship between water-sourceoriginated high iodine and carotid atherosclerosis occurrence. Methods Yuncheng county was chosen as observation area which included Dachenlou, Weigai, Liuyi and Ershilipu villages. Juye county was chosen as control that included Zhangxi, Bihainan, Xiaguan and Qiji villages. Two hundred and ninety-nine participants aged over 40 from water-source-originated high iodine areas and 323 residents aged over 40 from normal iodine areas were investigated.Portable-type B mode color Doppler was performed to examine the carotid artery of all participants. The adult carotid atherosclerosis was diagnosed and graded through the ultrasonograms. Results The prevalence rates of adult carotid atherosclerosis in the 4 water-source-originated high iodine villages of Dachenlou, Weigai, Liuyi and Ershilipu were 47.1% (33/70) ,62.2% (51/82) ,67.5% (52/77) and 58.6% (41/70), respectively and the prevalence rates of adult carotid atherosclerosis in the 4 normal iodine villages of Zhangxi, Bihainan, Xiaguan and Qiji were 40.7%(35/86),40.8% (31/76),38.2% (34/89) and 37.5% (27/72), respectively. The prevalence rates of adult carotid atherosclerosis standardized by age in the 4 high iodine villages and the 4 normal iodine villages were 45.81% ,58.18% ,61.63%,55.34% and 34.66%,36.25%,43.01% ,41.30%, respectively. The prevalence rates were higher in high iodine villages than that in control villages(T = 26, P ＜ 0.05 ). There were 136 people scored "0", 120 people scored "1 -3",43 people scored "4 - 7", and total 299 people. There were 201 people scored "0", 87 people scored "1 - 3", 35 people scored "4 - 7", and total 323 people. The expected prevalence rates and severity of adult carotid atherosclerosis was significantly different between high iodine area and normal iodine area (x2 = 17.54,18.42, all P ＜ 0.01).Conclusion The prevalence rate and severity of adult atherosclerosis in water-source-originatod high iodine area is higher than that in normal iodine area.     

依达拉奉联合银杏叶注射液治疗急性脑梗死疗效观察

目的观察依达拉奉联合银杏叶注射液治疗对急性脑梗死患者的疗效。方法将126例急性脑梗死患者随机分为治疗组63例和对照组63例,治疗组采用依达拉奉联合银杏叶注射液静脉滴注治疗,对照组采用银杏叶注射液治疗,2周为1个疗程,观察两组间的疗效差别。结果两组患者疗效间的差别有显著意义(P0.05);两组患者治疗前后2周神经功能缺损评分差别均有显著意义(P0.05)。结论依达拉奉联合银杏叶注射液治疗急性脑梗死效果较单用银杏叶注射液效果明显。     

α-玉米赤霉醇对肿瘤坏死因子α诱导的人内皮细胞活性氧产生及其激活信号通路的影响

目的 探讨α-玉米赤霉醇对肿瘤坏死因子α(TNF-α)刺激的人脐静脉内皮细胞中活性氧(ROS)产生及其对激活信号通路的影响.方法 用小分子RNA干扰(siRNA)技术消除人脐静脉内皮细胞的NADPH氧化酶p47phox亚基;用分子探针2,7-DCF测定细胞内ROS的产生量;用RT-PCR测定p47phoxmRNA的表达以及用细胞免疫组化方法测定p47phox蛋白的表达;用Western印迹测定ERK<,2>及核因子(NF)-кB、应激蛋白(SP-1)和活化因子蛋白的表达.结果 TNF-α刺激使细胞内ROS的产生量较对照组高155.4%;α-玉米赤霉醇预处理能够剂量依赖地抑制TNF-α对ROS的诱导效应.TNF-α作用细胞24 h后,p47phox的mRNA表达水平较对照组高212.8%,蛋白的表达也明显高;α-玉米赤霉醇预处理使TNF-α诱导的p47phox mRNA表达水平低63.0%,蛋白表达水平也明显下降.p47phox的siRNA完全阻断TNF-α诱导ROS的产生.α-玉米赤霉醇预处理和p47phox的siRNA均阻断TNF-α对细胞外信号调控激酶的激活和转录因子SP-1的核转位,明显地抑制了NF-кB的核转位.结论 α-玉米赤霉醇能够抑制内皮细胞中TNF-α诱导的ROS的产生及由ROS激活的信号转导通路,主要机制是通过抑制NADPH氧化酶p47phox亚基的表达.     

超声诊断门静脉海绵样变性58例分析

目的：分析门静脉海绵样变性的成因及声像图特征;方法：通过超声扣查58例门静脉海绵样变性患者的声像图表现,分析不同成因的声像图特征;结果：58例中57．0％（33／58）为肝癌门静脉内有癌栓而形成海绵样变性;20．7％（12／58）为肝硬化引起;19．0％（11／58）为门静脉周围脏器晚期肿瘤引起;0．05％（3／58）为先天性的。结论：门静脉海绵性变性的存在清楚的提示有门静脉高压的形成,超声对其的检出具有较高的临床意义,为临床治疗提供了依据。     

浅谈腹腔镜胰十二指肠切除术的安全性和适应症的选择

正腹腔镜手术由于创伤小,恢复快、解剖精细、出血少等诸多优点,已广泛应用于胆囊切除、胃肠道甚至肝脏手术中,并显示了良好的临床效果。而胰腺解剖位置深,周围结构复杂,切除困难,术后并发症多,因此腹腔镜胰腺手术远落后于其它领域。近年来,随着腹腔镜技术水平的提高和设备的完善,腹腔镜胰腺手术得到了长足的进步,其中包括最为复杂、最具挑战性的腹腔镜胰十二指肠切除术(Laparoscopic Pancreaticoduodenectomy,LPD)。     

留置导尿危重症患者真菌性尿路感染分析

目的了解危重症患者并发真菌性尿路感染的易患因素并探讨防治对策。方法回顾性分析432例我院ICU留置导尿患者的临床资料,重点分析其中42例并发尿路真菌感染患者的临床资料。结果医院内真菌性尿路感染与患者年龄、留置导尿时间、抗生素应用时间有关。结论为减少危重患者并发尿路真菌感染可能性,应尽量缩短留置导尿时间及合理应用抗生素、尽量缩短广谱抗生素的使用时间。