内外合治治疗老年性阴道炎50例临床观察

运用短柏地黄丸加味配合中药外洗治疗老年性阴道炎５０例（治疗组）,同时用西药治疗３９例（对照组）。结果,治疗组总有效率（９２％）明显高于对照组（７４．４％）。两组比较有显著性差异（Ｐ〈０．０１）。提示知柏地黄丸加味配合中药外洗能提高卵巢功能,增强雌激素水平,增强局部抵抗能力,对治疗老年必阴道炎有明显疗效。     

CT引导臭氧消融术治疗腰椎间盘突出（附2500例报告）

目的：探讨臭氧消融术治疗腰椎间盘突出临床应用价值。方法：2500例腰椎间盘突出患者在CT引导下,根据病变分型及特殊解剖位置,采用侧后方入路或正后方入路,利用日本产19～21GPTE穿刺针,穿刺至病变椎间盘或突出物内,注入适量臭氧,再行CT扫描,观察髓核消融状况。结果：总有效率92．1％。术前VAS评分为6．7±1．6,术后1周平均为3．6±2,术后3月平均为4．1±2。髓核融解术前与术后1周和3个月VAS评分有统计学意义（P〈0．05）,术后1周与3个月差异无统计学意义（P〉0．05）。结论：臭氧消融术治疗腰椎间盘突出疗效显著、微创、安全、简单,具有较好的临床应用价值。     

Hepatitis B x antigen (HBx) is an important therapeutic target in the pathogenesis of hepatocellular carcinoma

Hepatitis B virus (HBV) is a human pathogen that has infected an estimated two billion people worldwide. Despite the availability of highly efficacious vaccines, universal screening of the blood supply for virus, and potent direct acting anti-viral drugs, there are more than 250 million carriers of HBV who are at risk for the sequential development of hepatitis, fibrosis, cirrhosis and hepatocellular carcinoma (HCC). More than 800,000 deaths per year are attributed to chronic hepatitis B. Many different therapeutic approaches have been developed to block virus replication, and although effective, none are curative. These treatments have little or no impact upon the portions of integrated HBV DNA, which often encode the virus regulatory protein, HBx. Although given little attention, HBx is an important therapeutic target because it contributes importantly to (a) HBV replication, (b) in protecting infected cells from immune mediated destruction during chronic infection, and (c) in the development of HCC. Thus, the development of therapies targeting HBx, combined with other established therapies, will provide a functional cure that will target virus replication and further reduce or eliminate both the morbidity and mortality associated with chronic liver disease and HCC. Simultaneous targeting of all these characteristics underscores the importance of developing therapies against HBx.     

Treatment of intrahepatic arteriovenous fistula in hepatocellular carcinoma with N-butyl-2-cyanoacrylate

Primary hepatocellular carcinoma (HCC) continues to be one of the most common malignancies with an incidence of approximately one million cases per year and a dismal prognosis; some authors have reported a median survival of 1 ～ 2 months after diagnosis. Although surgery remains the only hope for cure, few patients are candidates[1,2].     

163例老年创伤的临床分析

目的:总结163例老年创伤与救治的经验。方法:回顾性分析2003年1月至2005年12月我院急诊科救治163例60岁以上创伤人员的致病原因和救治方法。结果:致伤原因:163例老年创伤患者跌伤73例,交通事故42例,其他(坠落、砸伤、烧伤、中毒、他人暴力等)48例。122例治愈,20例好转,21例死亡,死亡率12.8%。死亡原因:感染性休克7例,重度颅脑损伤8例,多器官功能衰竭6例。结论:老年人的创伤发生率呈增加趋势,跌伤是老年人的创伤的第一位原因,对老年性创伤性病人应采取积极的救治,预防感染,保护重要脏器功能,防治MODS的发生,是提高治愈率的关键。     

角膜溃疡穿孔的临床治疗

目的:探讨角膜溃疡穿孔的不同临床治疗方法及其疗效评价。方法:收集我院1993-01/2003-06角膜溃疡穿孔病例49例(49眼),进行回顾性分析,对不同病变所采用的不同治疗方法进行比较、评价各种治疗方法的疗效。结果:49例患者中有16例经单纯药物治疗治愈,其中6例患者视力获得不同程度的提高;33例单纯药物治疗效果不佳患者经手术治疗治愈,其中22例穿透性角膜移植患者中有17例患者视力不同程度提高。单纯药物治疗遗留粘连性角膜白斑13例,单纯性角膜白斑3例,结膜瓣掩盖术后遗留粘连性角膜白斑3例。术后继发青光眼2例。角膜移植患者术后有6例发生角膜移植排斥反应。无溃疡复发。结论:药物治疗是有效的方法之一;穿透性角膜移植术是最佳的手术治疗方法。     

联合手术治疗真性小眼球继发青光眼及脉络膜渗漏

目的:探讨真性小眼球继发青光眼及脉络膜渗漏的手术方法和疗效.方法:7例(14眼)诊断为真性小眼球继发青光眼及脉络膜渗漏患者行三联手术(小梁切除术 白内障超声乳化 人工晶状体植入术)或四联手术(巩膜板层切除术 深层部分巩膜切除 小梁切除术 白内障超声乳化 人工晶状体植入术)治疗真性小眼球继发青光眼及脉络膜渗漏.结果:术后矫正视力提高者12眼,术后眼压稳定在10～20 mmHg,脉络膜渗漏者术后1 wk复位.结论:三联手术及四联手术治疗真性小眼球继发青光眼及脉络膜渗漏效果良好.     

光固化树脂桩核修复磨牙残冠的应用研究

目的:探讨光固化树脂作为制作桩核材料在修复磨牙残冠中运用的可行性.方法:选择磨牙残冠共68例,用光固化树脂作桩核联合金属全冠修复,所有病例随访2年,结果:68例患牙经随访后,有64例修复成功,结论:运用光固化树脂制作桩核具有操作简单,固位良好,保留牙体,缩短疗程等优点,值得临床推广.     

精氨酸治疗肾小球疾病时肾小管功能损害的临床观察

目的 :观察精氨酸治疗肾小球疾病时肾小管功能损害的临床效果。方法 :用精氨酸 10 g静滴 ,每天一次 ,治疗有肾小管功能损害的患者 75例 ,其中慢性肾功能不全氮质血症期患者 2 1例。治疗前查血pH值 ,如 pH <7.35 ,予 5 %NaHCO312 5～ 2 5 0ml静滴或口服碳酸氢钠片直至 pH≥ 7.35方用。比较治疗前后尿α1 MG、β2 MG、简化毛氏试验和肾功能。结果 :尿α1 MG治疗前为 43.3± 10 .5mg/L ,治疗后为 16 .3± 6 .6mg/L(P <0 .0 1) ,差异显著 ,尿 β2 MG治疗前 2 2 .7± 9.1mg/L ,治疗后 4.3± 1.4mg/L(P <0 .0 1) ,差异显著。简化莫氏试验结果明显改善 ,慢性肾功能不全患者血Bun治疗前 13 .3± 5 .7mmol/L ,治疗后 8.6± 3 .2mg/L ,血Cr治疗前 2 76± 31μmol/L ,治疗后 177± 2 5 μmol/L ,并异显著 (P <0 .0 1)。结论 :精氨酸可显著改善小管重吸收功能和肾小球滤过功能 ,对于慢性肾功能不全患者而言 ,亦是有效的治疗方法。     

Between caring and curing

Summary Care and cure have been described as different kinds of ethical approaches to clinical situations. Female concerns in nursing care have been contrasted with masculine, cure orientated physician's attitudes. Ethics in such different voices may have sociologic determinants, but they do not represent intrinsic distinctions. Medicine has shown a divergent development, on the one hand stressing cure in a deterministic and instrumental way, on the other hand being aware that disease is as much a pathographic as a biographic, care‐requiring existential situation. Disease is a breakdown of the living organism, to be cured by therapeutic efforts, but it is also the distressing failure of the lived body, requiring concern and care. Based on Lévinas’ ethics of encounter, it is suggested that any interpersonal relatedness is based on concern for the other, being grounded on an essentially ethical interaction. The clinical encounter is a paradigm of such ethics‐based relationships, which necessarily builds on awareness of the other qua other, and is concerned with fulfilling the therapeutic mandate. Caring for the other means doing one's best to help her/him, so that care and cure are inextricably interwoven, although care is the more fundamental form of human relatedness. Thus, neither gender nor professional tasks can allow for a caring attitude to develop without curing concerns, just as trying to cure without caring is unthinkable.