软肝化纤丸治疗慢性乙型肝炎合并早期肝硬化40例临床分析

目的探讨软肝化纤丸治疗慢性乙型肝炎（CHB）合并早期肝硬化患者的临床疗效。方法将慢性乙型肝炎合并早期肝硬化患者81例随机分为治疗组（40例）与对照组（41例）。治疗组给予软肝化纤丸治疗；对照组用鳖甲软肝片、利加隆（水飞蓟素胶囊），疗程3个月。观察治疗前后肝功（ALT、AST、ALB、TBiL）和肝纤维化（HA、IV-C、LN）等指标的变化情况。结果疗程结束后，治疗组患脾大、门静脉增宽、肝纤维化指标明显好转，与对照组比较差异有显著性（P〈0．05或P〈0．01）。结论软肝化纤丸治疗慢性乙型肝炎合并早期肝硬化疗效优于鳖甲软肝片，利加隆。     

放射治疗65例早期鼻咽癌的预后因素分析

目的:分析影响放疗后早期鼻咽癌预后的因素。方法:单纯放疗48例,新辅助化疗 放疗17例。放疗采用常规双耳前野及面颈联合野放疗技术。化疗采用放疗前给予PDD 50mg静滴连用2 d,5-Fu 750mg静滴连用4~5 d,化疗结束后即行放疗。采用KapLan-Meier及Cox回归方法进行统计分析。结果:全组1、3、5年生存率为96.92%、86.15%、71.15%。5年局控率为78.5%,远地转移率为26.2%。外周血红蛋白低于110 g/l者,5年生存率明显低于血红蛋白高于110 g/l者(P<0.05)。疗终肿瘤残留者,5年生存率亦明显低于肿瘤消退者(P<0.05)。Ⅱ期患者行新辅助化疗者,5年生存率和单纯放疗者无明显差异。结论:(1)血红蛋白水平低者,生存率差。(2)疗终肿瘤残留者,生存率差。(3)Ⅱ期患者行新辅助化疗并没改善生存率。     

中药治疗ABO母婴血型不合溶血病至高胆红素血症临床疗效观察

目的 探讨早期简便有效治疗ABO母婴血型不合性高胆红素血症(ABO HDN With HUCB)的新方法,方法自1997年6月～2006年1月期间在本院分娩并因黄疸确诊为ABO HDN With HUCB 病例,随机选取92例,生后24小时内发现黄疸单纯口服中药茵桅黄口服液为A组(n=46).≥24～72小时发现黄疸为B组(n=46),A组,B组口服同样药物并按常规方法光疗,静脉输白蛋白,同时两组均在最初发现黄疸时取股静脉血,之后用经皮测黄疸仪监测胆红素峰值A组于＞72小时降至＜12.9mgldl.B组降至＜9mgldl为治愈.结果 2组相比有3种显著差异1、总胆红素峰值A组104.68±17.3umoi/l,B组16.27±52.28umoi/l,p＜0.001.2、喂养方式,A组全部母乳喂养,并在母婴同室,B组全部在NZCU由护士用配方奶喂养.3、平均住院天数,A组5.33±0.62天,B组10.39±2.92天,p＜0.001.结论 中药茵桅黄口服液对治疗在分娩后24小时内发现的ABO HDN With HUCB的疗效是可信的.     

白血病关节炎三例分析并文献复习

目的提高对白血病关节炎的认识并与其他类型的关节炎进行鉴别。方法对我院收治的3例白血病关节炎病例进行分析和总结,同时结合文献复习与国内外的相关文献进行比较。结果白血病关节炎具有不同于一般关节炎的一些临床特征,包括关节疼痛重、肿胀轻,但偶有大量关节积液;常伴乳酸脱氢酶显著增高;非甾体抗炎药效差,但化疗有效。结论白血病关节炎需要统一诊断标准,以便引起风湿病专科和血液病专科医师的重视,从而使白血病关节炎成为某些白血病早期诊断的重要线索,使白血病得到早期诊断及治疗。     

厚朴排气合剂治疗早期肠麻痹的临床研究

目的评价厚朴排气合剂治疗腹部非胃肠吻合术后早期肠麻痹(气滞证)的有效性及安全性.方法采用随机对照多中心临床试验的方法,试验组术后6 h口服厚朴排气合剂50 mL,4 h后再服厚朴排气合剂50 mL;对照组术后6 h口服西沙比利片10 mg,4 h后再服西沙比利片10 mg.疗程24 h.试验组327例,对照组108例.结果中医症状疗效比较:试验组94.80%,对照组87.96%.试验组明显优于对照组(P＜0.05).临床疗效:试验组94.19%,对照组83.33%.试验组明显优于对照组(P＜0.05).结论厚朴排气合剂治疗腹部非胃肠吻合术后早期肠麻痹疗效显著,未见明显不良反应.     

小剂量阿司匹林治疗早发型子痫前期的疗效及对母婴结局的影响

【摘要】 目的 探讨小剂量阿司匹林治疗早发型子痫前期的疗效及对母婴结局的影响。方法 选取2016年1月~2018年1月期间我院收治的94例早发型子痫前期患者,分为对照组（常规治疗组）和观察组（阿司匹林抗凝组）,每组各47例。对照组予以常规治疗,观察组在常规治疗基础上予以小剂量阿司匹林治疗。观察并记录两组患者疗程结束后的临床总有效率、凝血功能指标［血浆凝血酶原时间（PT）、活化部分凝血活酶时间（APTT）、凝血酶时间（TT）、纤维蛋白原（Fib）］、不良妊娠结局（肝肾功能异常、子痫、早产、剖宫产、产后出血）的发生率、围生儿结局［新生儿体质量、1min新生儿评分（Apgar）］以及治疗期间血小板计数异常、胃肠道症状等不良反应发生情况。结果 疗程结束后,观察组治疗总有效率明显高于对照组（P＜0.05）;观察组患者PT、APTT、TT均较对照组更长（P＜0.05）,血清Fbg水平则明显更低（P＜0.05）;两组剖宫产率、产后出血率差异无统计学意义（P＞0.05）;观察组肝肾功能损害、子痫、早产发生率均低于对照组（P＜0.05）;观察组新生儿体质量、1min Apgar评分均高于对照组（P＜0.05）;两组治疗期间均未出现血小板计数异常或明显的胃肠道症状(P＞0.05)。结论 小剂量阿司匹林用于治疗早发型子痫前期是安全有效的,可保护患者肝肾功能,减少并发症,改善母婴结局。     

Diagnóstico y seguimiento de los pacientes con hipotiroidismo congénito diagnosticados por cribado neonatal

The screening program of congenital hypothyroidism (CH) is probably one of the best achievements in paediatrics. Thyroid hormones are essential for brain development and brain maturation that continue through the neonatal period. Hypothyroidism that begins in the first months of life causes irreversible damage to the central nervous system, and is one of the most frequent and preventable causes of mental retardation. As children with congenital hypothyroidism are born with a normal appearance, analytical studies are required to immediately start the appropriate therapy.This article analyses the aims, diagnostic procedures, tests required, aetiology, and differential diagnosis in this disorder. Especially relevant is to perform frequent monitoring to ensure dose adjustments of L-Thyroxine therapy, avoiding infra- or supra-dosing that negatively affects neurosensory functions. Re-evaluation of the aetiology permanent vs transient hypothyroidism is always recommended after 3 years of chronological age.The relevance of this screening program should be widely discussed in paediatrics. The main objective is to avoid cerebral damage in these patients, and has been highly successful and economically beneficial.Other aspects are required to optimise patient outcomes, to perform all the controls according to the recommendations and to include, in the near future, the diagnosis of central hypothyroidism. Implementation of this program is necessary to progress in accordance with current scientific knowledge.     

Promontofixation par cœlioscopie : évaluation de la morbidité précoce par une méthode standardisée

ObjectiveAdverse event reporting for laparoscopic promontofixation is highly variable and non-standardized in the literature. The aim of this study was to better characterize early postoperative complications of laparoscopic promontofixation for genital prolapse using a standardized reporting methodology.Patients and methodsA retrospective study was conducted on 174 women with genital prolapse undergoing laparoscopic promontofixation from January 2008 to January 2013. Complications arising during the first month after surgery were reviewed according to the Clavien and Dindo classification.ResultsAt least one postoperative adverse event was reported in 57 out of 174 (33 %) women, grade 1 in 22 patients (13 %), grade 2 in 31 patients (18 %) and grade 3 in 4 patients (2 %). No patient experienced a grade 4 or 5 complication. Fifty-three out of 57 (93 %) complications were grade 1 or 2. The most frequently reported adverse event (n = 24; 14 %) was constipation (grade 2).Discussion and conclusionLaparoscopic promontofixation is a safe procedure with almost exclusively benign (grade 1 or 2) early complications. The hypothesis of induction or increasing constipation by this type of genital prolapse surgery should be further evaluated.     

炎症因子用于早期预测妊娠期糖尿病的研究进展

妊娠期糖尿病(gestational diabetes mellitus,GDM)是指在妊娠期发生或首次发现的不同程度的糖耐量异常或糖尿病,对母亲及胎儿的危害很大,早期发现其危险因子,并进行早期诊断和干预,来预防、减少GDM及其并发症的发生值得关注和研究。炎症因子在GDM发生中的作用一直是研究的热点之一,本文将综述用炎症因子指标对GDM进行早期预测的研究进展。     

Effects of the proximal home environment on language and behavioral outcomes in children prenatally exposed to cocaine

Proximal environmental variables illustrate aspects of the environment that are experienced directly and specifically by the child. The current study examined the associations between three proximal environmental variables: (1) quality of the home environment, (2) regularity of family routines and (3) frequency of parenting daily hassles and cognitive, language and behavioral outcomes in 36‐month‐old children who were prenatally exposed to cocaine and participating in an early intervention program. The quality of the home environment predicted expressive language and internalizing behavior problems, while daily hassles and family routines only predicted internalizing behavior problems. The results suggest that interventions aimed at changing proximal environmental variables may have positive implications for children who are at‐risk for developmental delay.