耐信、氧氟沙星、痢特灵三联治疗幽门螺杆菌感染疗效观察

目的观察耐信、氧氟沙星、痢特灵三联疗法根除幽门螺杆菌(H.pylori)感染疗效。方法87例H.py-lori感染患者随机分成治疗组42例,予耐信40 mg 2次/d,氧氟沙星0.3 g 2次/d,痢特灵0.1 g 2次/d,疗程1周。对照组45例,予枸橼酸雷尼替丁铋胶囊1片2次/d,克拉霉素0.25 g 2次/d,阿莫西林1.0 g 2次/d,疗程1周,疗程结束后4周复查。结果治疗组根除率83%,对照组根除率69%(P<0.05);治疗组不良反应发生率5%,对照组不良反应发生率7%(P>0.05)。结论耐信、氧氟沙星、痢特灵三联疗法为安全可靠方案。     

耐多药结核病的判定和处理对策

当前,结核病疫情在全球范围出现回升的局面,其中耐多药结核病(MDR-TB)的流行尤其引人关注,1977年WHO/IUATLD在35个国家进行耐药检测,1/3国家原发耐多药结核病在2%以上,获得性耐药为13%.2000年根据64个国家耐药检测和72个国家预测资料MDR-TB新病例已达27.3万例.据WHO估计20亿感染者中,约有5000万人感染耐药菌株,其中2/3的结核病人有发生MDR-TB的危险[1].2006年WHO估算MDR-TB患者全球总数已达100万.每年还在以30万至60万的速度递增.     

Influence of moderate hypothermia on cerebral oxygenation in pigs with intracranial hypertension

BACKGROUND: Moderate hypothermia is one of the effective therapeutic methods for head injury in recent years, there are many mechanisms of moderate hypothermia for brain protection, and its influence on cerebral oxygenation is also one of them. OBJECTIVE: To observe the influence of moderate hypothermia on cerebral oxygenation of animals with acute intracranial hypertension, and further investigate the protective mechanism of moderate hypothermia. DESIGN: A randomized controlled trial. SETTING: Department of Neurosurgery, Renji Hospital affiliated to the Medical College of Shanghai Jiao Tong University. MATERIALS: Twenty healthy little pigs, either male or female, weighing 4.5–5.5 kg, were used. Neurotrend-typed multiparameter monitoring system (Diametrics Company, British); CMA/100 micro-injection pump (Carnegie Company, Sweden). METHODS: The experiment was conducted in the Changzheng Hospital affiliated to the Second Military Medical University of Chinese PLA in November, 2001. The pigs were randomized into two groups: the normothermia group (control group, n =10) and moderate hypothermia group (n =10). ① Bilateral femoral arteries were separated, one was connected to pressometer for monitoring mean arterial pressure (MEP), and the other for analysis of blood gases [including peripheral blood pH value, arterial partial pressure of carbon dioxide (PaCO2), arterial partial pressure of carbon dioxide (PaCO2), HCO3–]. ② Rectal temperature was monitored with mercurial thermometer. ③ Intracranial pressure was monitored using Camino optic ICP probe placed in the subdural space. ④ Neurotrend multiparameter monitoring sensor was inserted into the white matter for about 4 cm to determine cerebral perfusion pressure (CPP, CPP=MAP(ICP), brain tissue partial oxygen pressure (PO2), partial pressure of carbon dioxide (PCO2), HCO3– and brain temperature. The rectal temperature of animals in the moderate hypothermia group was lowered to 34 ℃ using ice bags, and the body temperature was maintained at 33–35 ℃ for 2 hours. The changes of the parameters were observed continuously, and the pigs in the normothermia group were not treated with cooling. MAIN OUTCOME MEASURES: ① MAP, ICP, rectal temperature, CCP; Indexes of cerebral oxygenation detected with Neurotrend-typed multiparameter monitoring system; ② Results of blood gases analysis in the moderate hypothermia group. RESULTS: All the 20 pigs were involved in the analysis of results. ① MAP, ICP, rectal temperature, CCP and indexes of cerebral oxygenation: In the moderate hypothermia group, the ICP after cooling was obviously lower than that before cooling [(3.31±1.19), (5.33±0.95) kPa, P < 0.05], CCP was higher, brain tissue PCO2 [(12.03±1.73), (10.59±2.01) kPa, P < 0.05], and brain tissue pH value was higher [(7.03±1.63), (9.40±1.30) kPa, P < 0.05], whereas the brain temperature was decreased as compared with that before cooling [(34.9±0.3), (37.2±0.2) ℃, P < 0.05]. ② Results of blood gases analysis in the moderate hypothermia group: There were no significant differences in the parameters of peripheral arterial blood gases analysis before and after cooling in the moderate hypothermia group (P > 0.05) CONCLUSION: Moderate hypothermia will not impair the cerebral oxygenation, and it can reduce brain tissue CO2 and decrease brain tissue acidosis.     

微创拔甲治疗拇趾侧方慢性甲沟炎

目的 讨论微创拔甲治疗拇趾侧方慢性甲沟炎的疗效.方法 2006年1月至2008年4月门诊治疗92例拇趾侧方慢性甲沟炎患者,均采用微创拔甲的方法.结果 所有患者均在短期内痊愈.结论 微创拔甲治疗拇趾侧方慢性甲沟炎创伤小、恢复快,值得推广.     

二甲双胍治疗2型糖尿病36例疗效观察

目的 探讨二甲双胍对2型糖尿病的疗效.方法 采取平行双盲随机对照法,两组病例随机分为二甲双胍治疗组和苯乙双胍治疗组,疗程3个月.于治疗后第1、2、3月末分别测定空腹血糖,并于治疗结束后复查肝肾功能.结果 两种药均有降低血糖作用,但二甲双胍降糖作用优于苯乙双胍,差异有显著性意义.结论 二甲双胍对2型糖尿病疗效显著且安全可靠.     

人发中铜的分析研究

发样用HN03-HCO04加热消化，然后用BAO分光光度法直接测微量铜，T（4-TAP）P法测痕量铜。方法的准确度用不同方法对照分析的结果比对，所得结果准确可靠，应用BAO法测定人发、粉尘和尿铜，弄清了发铜的含量水平，铜污染的来源及其迁移，从而为微量铜与健康的研究，环境污染防治以及发铜的标准参照测试提供科学依据。     

急性重型肝炎患者血清甲胎球蛋白测定的意义分析

目的 了解血清甲胎球蛋白测定在急性重型肝炎患者药物治疗疗效、预后判断中的意义，为临床治疗、预后判断提供依据。方法 36例急性重型肝炎患者在入院当天对其进行血清甲胎球蛋白测定，按照血清甲胎球蛋白的浓度对这36例患者进行分组，而后观察治疗30天后的患者肝功能恢复情况。结果 初次血清甲胎球蛋白测定浓度大于200μg／L组患者肝功能好转率明显高于100—200μg／L组及100μg／L以下组。结论 血清甲胎球蛋白测定对急性重型肝炎临床治疗疗效及预后有重要的指导意义，可作为临床重型肝炎患者治疗效果和预后判断的指标。重型肝炎患者血清甲胎球蛋白含量高，则其治疗后肝功能逆转率高，预后好；患者血清甲胎球蛋白含量低，则其治疗后肝功能逆转率低，预后差。