晶氧和碳酸氢钠改善第二产程母血酸碱平衡

对９９ 例经阴道分娩的产妇于第二产程开始时给予鼻导管吸氧,静脉滴注碳酸氢钠、过氧化氢碳酸酰胺（ 晶氧） ,于第二产程始末两次采母桡动脉血行血气分析。结果显示：晶氧碳酸氢钠联用组（ Ⅰ组）于第二产程结束时其ｐＨ,ＢＥ,ＰＯ２ 及Ｏ２ｓａｔ均显著高于对照组（ Ⅲ组）（ Ｐ ＜ ０ ．０５ 和＜ ０ ．０１） ,而ＰＯ２ 及Ｏ２ｓａｔ则无统计学差异;Ⅰ组与Ⅱ组ｐＨ,ＰＯ２ 及Ｏ２ｓａｔ 值于第二产程末较开始时显著升高（ Ｐ ＜ ０ ．０５ 和＜ ０ ．０１） ,ＢＥ 在该产程始末无统计学差异;Ⅲ组上述４ 指标明显下降（ Ｐ ＜ ０ ．０５ 和＜ ０ ．０１） 。各组间及组内比较ＰＣＯ２ 均无明显变化。提示第二产程中常规给予纠酸,吸氧内给氧能有效地改善产妇过度消耗所致的酸中毒和缺氧倾向。     

Patients' and doctors' perception of long-term morbidity in patients with testicular cancer clinical stage I

Patient-based questionnaires were designed with the aim to identify and rank long-term somatic and psychosocial morbidity in patients with low-stage testicular cancer. A further intention was to compare patients' assessments with experienced doctors' general opinion on quality of life items in cured testicular cancer patients. In pilot study I, 103 tumour-free patients ranked items of physical and psychosocial morbidity after having had various kinds of treatment. Though the ranking procedure appeared to cause some difficulties amongst the patients and subsequently was abandoned, the results indicated considerable differences between the patients' and doctors' evaluations. In pilot study II patients were asked to score the different items. The questionnaire of pilot study II was completed by 107 patients from the Norwegian Radium Hospital (NRH) and 99 relapse-free patients from the Royal Marsden Hospital (RMH) with testicular cancer stage I at least 1 year after infradiaphragmatic radiotherapy (n = 94) or adjuvant chemotherapy (2 cycles,n=26), or patients who had been followed on the surveillance program (n = 86). A total of 93 doctors completed a similar questionnaire, thereby expressing their general opinion on long-term morbidity in comparable testicular cancer patients as seen during routine clinical follow-up. Both the irradiated patients and those on the surveillance program reported slight degrees of Raynaud-like phenomena, neurotoxicity and ototoxicity, most probably representing background morbidity in an age-matched general male population. Doctors tended to underestimate their patients' somatic morbidity, but often overestimated the degree of psychological distress, in particular in patients on the surveillance program. Significant differences between RMH and NRH patients with regard to sexual problems and to leisure time activity may be explained by cultural differences in the two countries. The items presented in the questionnaire used identify important issues for patients cured of testicular cancer which may be used in future multicentre trans-cultural studies assessing these patients' quality of life. This will provide sufficient data for psychometric testing and, together with the findings from patients' free comments, support the final design of a testicular cancer quality of life module.     

论中药饮片的使用期

目的：研究中药饮片的使用期。方法：采用梯度升温法得到符合化学动力学的变化规律。结果：说明橘皮的成分会随着存放时间发生变化。结论：中药饮片应有合理的使用期，以更好的保证临床用药的效果。     

头针对超早期局部脑缺血大鼠的影响

目的观察头针治疗超早期脑梗死的效果并探讨作用机理。方法用 SD 大鼠制做动脉血栓性大脑中动脉局灶性脑梗死动物模型,术后2h 分别予通脑活络针刺法及尿激酶溶栓法治疗,并设模型组与假手术组。各组分别于栓塞后6h、3天及7天测量神经功能损害积分、脑梗死容积百分比、脑组织含水量、脑组织一氧化氮(NO)含量、总超氧化物歧化酶(SOD)活力及丙二醛(MDA)含量。结果术后经针刺或溶栓治疗3天及7天大鼠神经功能损害评分、脑梗死容积百分比、脑组织含水率较模型组显著减少,7天时针刺组与溶栓组神经功能损害评分、脑梗死容积百分比、脑组织含水率的比较差异无显著性。栓塞后针刺组各时间点脑组织总 SOD 活力明显高于模型组(P<0.05),而 MDA 含量明显低于模型组(P<0.05)。结论超早期通脑活络针刺法治疗急性脑梗死有明显疗效。减少氧自由基的产生、直接对神经元起到保护作用可能是其作用机理之一。     

化痰通络汤治疗缺血性中风恢复期风痰瘀阻证29例的临床观察

目的 观察化痰通络汤对缺血性中风恢复期风痰瘀阻证的临床疗效.方法 将57例缺血性中风恢复期风痰瘀阻证患者随机分为两组,治疗组29例采用化痰通络汤治疗,对照组28例采用消栓通络胶囊治疗,治疗8周后评价临床疗效.结果 两组患者治疗后神经功能缺损评分均得到明显改善(P<0.01),且治疗组优于对照组(P<0.05):治疗组的临床疗效及显效率优于对照组(P<0.05).结论 化痰通络汤治疗缺血性中风恢复期风痰瘀阻证有效.     

迭代二步法估算维拉帕米的群体药动学参数

目的 :为临床合理应用维拉帕米提供依据。方法 :53例高血压患者口服维拉帕米片 ,采用荧光分光光度法测定血浆中维拉帕米浓度 ,用迭代二步法估算维拉帕米的群体药动学参数 ,并与传统二步法的结果比较。结果 :迭代二步法估算维拉帕米的CL为(189 3±59 3)ml/(h·kg) ,Vd 为 (1 420±0 231)L/kg ,T1/2 为 (5 74±1 90)h ,与传统二步法拟合的结果基本一致。结论 :迭代二步法能较好地估算出维拉帕米的群体及个体药动学参数 ,可用于预测血药浓度及优化个体给药方案。     

Embryo developmental stage at transfer influences outcome of treatment with intracytoplasmic sperm injection

Purpose: Our purpose was to determine if embryo cell stage at the time of intrauterine transfer correlates with pregnancy rate in patients treated with intracytoplasmic sperm injection (ICSI). Methods: We conducted a retrospective analysis of 455 embryo transfer cycles following ICSI and 304 conventional in vitro fertilization (IVF) and embryo transfer cycles in women aged 40 years or less. Abstracted information included grading of the embryo cell stage and quality at the time of transfer. Results: The overall ICSI pregnancy rate was 30.8%, while that of conventional IVF was 29.3%. However, the ICSI pregnancy rate fell to 9.3% for embryo transfers taking place at the two-cell stage but increased to 35.8% when at least one embryo had more than two cells, and this difference was statistically significant (P≤0.0001). The pregnancy rate following conventional IVF was 22.0% when only two-cell embryos were transferred and 32.0% when at least one of the embryos had more than two cells, but this difference in pregnancy rates was not significant (P>0.05). Conclusions: The stage of embryo development at transfer appears to exert a powerful influence on the successful establishment of pregnancy after ICSI.     

抗癌宝口服液治疗中晚期恶性肿瘤103例临床观察

目的：观察中药抗癌宝口服液治疗中晚期恶性肿瘤临床效果。方法：１０３例患者随机分为抗癌宝观察组与化疗对照组，对两组疗效作比较。结果：观察组患者免疫功能，近期有效率（ＣＲ＋ＰＲ），生存质量，１、２、３年生存期及中位生存时间，癌胚抗原下降水平，明显高于对照组，且有显著性差异。结论：抗癌宝具有抑制肿瘤生长，延长生存时间，提高生存质量之效。     

世界中西医结合大会在京召开──交流中西医结合在理论、临床、教育及政策管理方面经验

世界中西医结合大会在京召开──交流中西医结合在理论、临床、教育及政策管理方面经验人民日报北京１０月２７日讯世界中西医结合大会今天在北京国际会议中心开幕。大会以“继承、发扬、结合、创新”为主题，交流重点是中西医结合在理论、临床、教育及政策管理等各方面的...     

Outcome of combination chemotherapy in extensive stage small-cell lung cancer: Any treatment related progress?

During the past two decades many different treatment regimens of combination chemotherapy have been applied in extensive stage small-cell lung cancer (SCLC). This study was carried out to identify whether these modifications have resulted in an improved overall survival for extensive stage during the past two decades. In total, 1111 patients with extensive stage SCLC were included in six consecutive randomised trials in our setting from 1973 until 1992. Of these, 526 patients treated in the early period (1973–1981) were compared with 585 patients treated in the late period (1981–1992) with respect to pretreatment prognostic factors, staging, treatment and outcome. No change in the distribution of prognostic factors was detected and the frequency of patients with extensive stage was equal in the two periods, and no difference in overall response rates and survival was observed (P=0.49). Median survival in the two periods was 208 days and 215 days, respectively. No stage migration or treatment-related improved outcome was observed in extensive disease. We suggest restricting aggressive treatment to patients with favorable prognosis and long-term survival as a realistic aim.