川芎嗪及复方丹参注射液辅助治疗妊娠高血压综合征60例临床分析

目的比较川芎嗪注射液及复方丹参注射液在辅助治疗妊娠高血压综合征(PIH)中的作用,探讨两药在改善微循环及胎儿宫内缺氧方面的差异,进一步指导临床用药。方法选取2001年6月~2002年6月在我院住院治疗的60例PIH患者,平均分为2组,在有效镇静、解痉、降压、低流量吸氧等治疗的基础上,分别给予静脉滴注川芎嗪注射液及复方丹参注射液治疗1个疗程。结果川芎嗪组抑制纤溶、改善微循环的效果显著;复方丹参组主要降低血液粘稠度、降低胆固醇及血酯。结论川芎嗪及复方丹参对PIH有肯定的治疗作用,由于两药的临床作用不同,需有针对性用药。     

韩树人教授谈“哮喘专主于风”

哮喘为临床的常见病、多发病,历来为医家所重视。韩树人教授在研究继承传统理论的基础上形成了自己的学术观点,提出了“哮喘专主于风”的理论。详细分析了临证时的分型特点,阐明哮喘发作程度有轻重之分,证型有寒热之别,缓解时肺脾肾各有所虚,但辨证总须与“风”紧密联系,抓住这一中心环节进行遣方用药,为临床工作提供了新的思路。      

影响异位妊娠保守治疗效果的相关因素

目的探讨影响异位妊娠保守治疗效果的相关因素。方法选取2006年1月～2011年1月本站应用药物保守治疗的异位妊娠患者120例。结果影响异位妊娠药物治疗成功率的因素为血13-HCG和B超硅示盆腔包块大小（P〈O．05）。而停经天数、B超子宫内膜厚度及盆腔积液量并不影响异位妊娠药物治疗效果（P〉0．05）。结论血B—HCG水平、B超包块直径与异位妊娠保守治疗的成功率关系密切,临床医生应予以重视。     

低频脉冲电磁场治疗骨质疏松症患者的疗效观察

目的 观察低频脉冲电磁场对原发性骨质疏松症的疗效.方法 用低频脉冲电磁场治疗30例骨质疏松症患者,观察患者骨痛的缓解情况、血清骨钙素、β-Ⅰ型胶原羧基前肽水平、骨密度变化情况.结果 患者骨痛缓解率达到57.7%,治疗前后血清骨钙素、β-Ⅰ型胶原羧基前肽水平、骨密度均有显著性差异.结论 低频脉冲电磁场能有效缓解骨质疏松患者的骨痛症状,提高骨密度,是治疗原发性骨质疏松症的有效方法之一.     

急性胰腺炎血流动力学变化及多巴胺治疗

作者观察了胰管内注射胰蛋白酶和胆汁所致犬急性胰腺炎(AP)时血流动力学变化及多巴胺对 AP 的治疗作用。治疗组在制 AP 模型后10min 开始静脉持续3h 滴注多巴胺,持续3h,每小时0.6mg/kg。AP 组的胰腺血流量(PBF)在制 AP 后迅速下降,全身血流动力学也发生了明显改变。多巴胺治疗可增加 PBF,改善全身血流动力学,降低 AP 犬的死亡率和减轻胰腺炎程度。提示多巴胺可通过改善 AP 早期的胰血供,有效地阻止水肿性胰腺炎向出血坏死性胰腺炎发展。     

Chidamide stacked in magnetic polypyrrole nano-composites counter thermotolerance and metastasis for visualized cancer photothermal therapy

Photothermal therapy (PTT) has become one of the most promising therapies in cancer treatment as its noninvasiveness, high selectivity, and favorable compliance in clinic. However, tumor thermotolerance and distal metastasis reduce its efficacy, becoming the bottleneck of applying PTT in clinic. In this study, a chidamide-loaded magnetic polypyrrole nanocomposite (CMPP) has been fabricated as a visualized cancer photothermal agent (PTA) to counter tumor thermotolerance and metastasis. The efficacy of CMPP was characterized by in vitro and in vivo assays. As a result, this kind of magnetic polypyrrole nanocomposites were black spherical nanoparticles, possessing a favorable photothermal effect and the suitable particle size of 176.97 ± 1.45 nm with a chidamide loading rate of 12.92 ± 0.45%. Besides, comparing with PTT, CMPP exhibited significantly higher cytotoxicity and cellular apoptosis rate in two tumor cell lines (B16-F10 and HepG2). In vivo study, the mice showed obvious near-infrared (NIR) and magnetic resonance imaging (MRI) dual-modal imaging at tumor sites and sentinel lymph nodes (SLNs); on the other hand, magnetic targeting guided CMPP achieved a cure level on melanoma-bearing mice through preventing metastasis and thermotolerance. Overall, with high loading efficiency of chidamide and strong magnetic targeting to tumor sites and SLNs, CMPP could significantly raise efficiency of PTT by targeting tumor thermotolerance and metastasis, and this strategy may be exploited therapeutically to upgrade PTT with MPP as one of appropriate carriers for histone deacetylase inhibitors (HDACis).     

老年人重症急性胰腺炎的临床特点

目的：总结老年重症急性胰腺炎的临床特点及治疗经验。方法：回顾性分析26例老年重症急性胰腺炎的临床资料,并与同期收治的56例非老年重症急性胰腺炎患者作比较。结果：胆源性和特发性胰腺炎是老年患者最常见病因;老年患者住院时间长,APACHEⅡ评分以及合并症和并发症的发生率均高于非老年患者,老年患者更易出现器官衰竭。结论：老年重症急性胰腺炎患者早期症状不典型,合并症比较多,病情复杂,宜早期积极预防和治疗并发症。     

Clinical characteristics of patients with chronic eosinophilic pneumonia in a Chinese tertiary‐care hospital: A 6‐year retrospective study

IntroductionChronic eosinophilic pneumonia (CEP) is a rare disease with unknown etiology. Due to lack of specificity of CEP symptoms, clinicians are not experienced in establishing its diagnosis.ObjectivesTo summarize the clinical data of CEP patients to improve the understanding of CEP and reduce misdiagnosis.MethodsData of patients pathologically diagnosed with CEP in the PLA General Hospital between May 2013 and May 2019 were collected, and clinical manifestations, imaging characteristics, pathological features, and treatment were retrospectively analyzed.ResultsTwenty patients, including 6 males and 14 females, were diagnosed with CEP. The average age was 47.0 ± 10.2 years. The main clinical manifestations were cough and dyspnea. The average duration of CEP was 15.5 ± 11.5 months. The average proportion of eosinophils in the peripheral blood was 18.9 ± 17.8%, and the average proportion of eosinophils in the bronchoalveolar lavage fluid was 41.5 ± 19.4%. The main imaging features were patchy shadows and consolidation shadows. The most common manifestations on bronchoscopic examination were congestion and edema of the bronchial mucosa. Two patients had granular protrusions of the endotracheal membrane. Histological examination indicated infiltration of numerous eosinophils. All patients improved after prednisone therapy.ConclusionCEP onset is insidious, and clinical manifestations lack specificity. Typical imaging features are peripheral and subpleural distribution of lung infiltrates. Some patients have a normal proportion of eosinophils in the peripheral blood, but most have an increased number of eosinophils in the BALF, which contributes to CEP diagnosis. A biopsy is necessary when differential diagnosis is difficult. A systemic glucocorticoid is effective.     

空回肠间质瘤13例诊治分析

目的　探讨空回肠间质瘤的诊断和治疗经验。方法　对我院 1993年 10月～ 2 0 0 4年 1月收治的有完整资料的 13例空回肠间质瘤病例进行回顾性分析 ,本组患者均经术后病理和免疫组化证实。结果　本组患者主要临床表现为消化道出血、腹痛。发病至确诊时间 2个月至 7年。剖腹探查确诊 7例 ,腹腔镜腹腔探查确诊 4例 ,术前确诊的仅 2例。随访 2个月至 9年 ,除 1例死于其它疾患外 ,余 12例均健在 ,无空回肠间质瘤复发病例发现。结论　小肠间质瘤预后甚好 ,但本病缺乏特征性的临床表现及有效的诊断手段 ,易致长期延误诊治 ;对长期不明原因的消化道出血患者 ,及早行剖腹探查或腹腔镜腹腔探查是避免小肠间质瘤长期延误诊治 ,改善患者预后的关键     

中国结直肠癌肝转移诊断和综合治疗指南（2018版）

正第一部分诊疗指南肝脏是结直肠癌血行转移最主要的靶器官,结直肠癌肝转移(colorectal cancer liver metastases)是结直肠癌治疗的重点和难点之一。15%～25%的结直肠癌病人在确诊时即合并肝转移,另有15%～25%的病人将在结直肠癌根治术后发生肝转移,其中绝大多数(80%～90%)的肝转移灶初始无法获得根治性切除。结直肠癌肝转移也是结直肠