舒血宁注射液治疗急性脑梗死60例疗效观察

目的 观察银杏叶提取物舒血宁注射液对急性脑梗死的疗效和安全性。方法 将120例急性脑梗死患者随机分为治疗组和对照组,治疗组60例给予舒血宁注射液20ml加入NS500ml静滴,qd,15d;对照组60例给予复方丹参注射液30ml加入NS500ml静滴,qd,15d。其余常规治疗相同。结果 治疗组神经功能缺损评分减少明显优于对照组（P〈0．01）,其血液流变学指标较对照组有显著性差异（P〈0．05）。结论 舒血宁治疗急性脑梗死安全有效。     

伽玛刀治疗垂体微腺瘤的远期分析

目的 分析伽玛刀治疗垂体微腺瘤的远期疗效.方法 回顾性分析Leksell伽玛刀治疗的109例垂体微腺瘤.结果 影像学肿瘤消失、缩小、无变化和增大分别为45例、37例、22例和5例;血液激素完全恢复39例,部分恢复23例,无明显变化15例,继续增高14例.33例垂体功能低下的患者,治疗后28例恢复正常;8例目前存在垂体激素水平低下,但只有1例与本次治疗有明确关系,5例无自诉症状,需要激素替代治疗有3例.症状完全消失或明显改善62.6%,稍改善或无变化31.3%,继续恶化6.1%.结论 伽玛刀治疗效果肯定,创伤小,治疗风险低,可以作为治疗垂体微腺瘤的主要方法之一.     

精神分裂症精神残疾影响因素的研究进展

精神残疾指各类精神障碍持续一年以上未痊愈,存在认知、情感和行为障碍,影响日常生活和社会参与的状态［1］。精神分裂症是引发精神残疾的主要原因,83％的精神分裂症患者最终会出现精神残疾［2］。有研究证实,精神分裂症患者在前驱期已经表现出明显的社会功能缺陷,缺陷程度随着病程进展不断加重,最终出现严重的精神残疾［3］。患者不同程度的精神残疾和治疗费用给家庭和社会带来沉重的心理和经济负担。因此,积极探索精神分裂症患者的精神残疾的影响因素已成为研究热点。现就目前国内外精神分裂症精神残疾影响因素的研究进行归纳总结,将影响因素加以提炼,分为保护性和危险性因素,以期为强化保护性因素、降低危险性因素,改善患者的社会功能,延缓精神残疾提供新的视角。     

rt-PA 动脉溶栓联合机械取栓治疗急性脑栓塞的临床疗效研究

目的：观察 rt-PA 动脉溶栓联合机械取栓治疗急性脑栓塞的临床疗效。方法回顾性分析 rt-PA 动脉溶栓联合机械取栓治疗的10例急性脑栓塞病例,采用 NIHSS 评分评估患者治疗前及治疗24 h 后的神经功能缺损程度,3月后采用改良 Rankin 量表（mRS）评估患者预后。结果治疗24 h 后患者 NIHSS 评分显著低于治疗前（P 〈0.01）,3月后 mRS 0~2分为90%。结论rt-PA 动脉溶栓联合机械取栓是治疗急性脑栓塞的一种有效方法。     

急诊静脉应用胺碘酮治疗快速心律失常的临床疗效和安全性

目的探究急诊时静脉注射胺碘酮治疗快速心律失常的临床治疗效果和安全性。方法选取2010年10月至2012年10月在本院接受治疗的快速心律失常患者50例,静脉注射胺碘酮治疗。记录治疗后患者显效、有效和无效的例数,以及出现不良反应的例数,然后计算有效率和不良反应的出现率。结果治疗之后,有40例显效,8例有效,2例无效,总有效率为96%,3例出现了不良反应,分别为2例静脉炎和1例窦性心动过缓。结论对快速心律失常的患者,可以静脉注射胺碘酮进行治疗,有效率高,不良反应的发生率低,值得在临床上推广。     

循证护理对预防脑卒中患者肺部感染的临床研究

目的探讨循证护理在预防脑卒中患者住院期间肺部感染的可行性和临床疗效。方法回顾性分析我院收治的脑卒中患者206例,随机分为103例实验组和103例对照组,对照组患者予以常规院内基础护理,实验组患者予以循证护理干预,包括心理护理、肺部护理及营养支持等措施。对比两组患者经护理后的感染发生率及护理效果。结果实验组患者感染率为11.65%,经过规范对症治疗后11例患者痊愈,仅1例患者因脑卒中症状严重,卧床时间较长,感染部位较多,导致治疗效果不显著,感染治愈率为91.66%。对照组患者感染率为22.33%,显著高于实验组感染率,对照组感染患者治愈率为13.04%,显著低于实验组。实验组、对照组患者护理总有效率分别为99.03%、88.35%,差异见χ2=13.26,P<0.05。结论循证护理工作可提高患者身体质量和治疗效果,显著降低脑卒中患者院内肺部感染发生率,缩短患者住院时间,改善患者预后生活质量。     

Improved glycemic control with weight loss and a low risk of hypoglycemia with insulin detemir: insights from the Italian cohort of the PREDICTIVE study after 6-month observation in type 2 diabetic subjects

Objective: PREDICTIVE (Predictable Results and Experience in Diabetes through Intensification and Control to Target: an International Variability Evaluation) is a large, multinational, open-label, prospective, observational study addressed to assess the efficacy and safety of insulin detemir in clinical practice. This paper reports 26 weeks of follow-up data, from 1298 type 2 diabetes patients from Italy.

Research design and methods: In this observational study, the primary end point was the incidence of serious adverse drug reactions (SADRs), including major hypoglycemia. Secondary end points were: hemoglobin A1c (HbA1c), mean self-monitored fasting glucose, within-patient fasting glucose variability and body weight change.

Results: Insulin detemir significantly improved glycemic control, with a decrease in mean HbA1c, fasting glucose and within-patient fasting glucose variability. Interestingly, the improvements in glycemic control occurred in association with a small, but significant reduction in weight. The safety results of this study showed that 26 weeks of treatment with insulin detemir was associated with a very low rate of SADRs (only 14 events), which mainly consisted of hypoglycemia (78%, of which 42% were major hypoglycemia).

Conclusions: Insulin detemir improves glycemic control, with low risk of hypoglycemia, no weight gain and an excellent safety profile; these data support the overall findings of PREDICTIVE.     

Third International Conference on Shape Memory and Superelastic Technologies

Summary. More than 10 years after its clinical introduction, extracorporeal shock wave lithotripsy (ESWL) has proved to be the safest treatment modality for more than 90% of urinary stones. Absolute contraindications are untreated coagulopathy, urinary tract infection and pregnancy. After careful preparation, even patients with severe coagulopathy (haemophiliacs A/B, thrombocytopenia) can be treated successfully by ESWL. Shock wave lithotripsy for an increasing amount of small symptomatic renal calculi resulted in a stone-free rate of 50% and a complaint-free rate of 52%. A 50% chance of success justifies initial ESWL treatment for stones in caliceal diverticula. A stone-free rate of 70% was reported for stone-bearing horseshoe kidneys, but the recurrence rate was 29%. Therefore, percutaneous stone removal may become necessary in such cases.

The utilization of indwelling stents has contributed to the extension of indication for ESWL monotherapy, even for staghorn calculi, as acute morbidity is reduced. Double-J stents, however, do not improve the stone-free rate and special attention should be paid to double-J morbidity. Depending on stone localization, post-ESWL long-term stone-free rates are 58–84% with a recurrence rate of 6–11 % and despite persisting fragments, the infection rate is low.

The main features of third generation lithotripters are a combined localization system allowing interdisciplinary shock wave lithotripsy, a wide energy range of the shock wave source resulting in an efficacy similar to that of the Dornier HM3 and integration of the shock wave source and fluoroscopy unit in an endoscopic treatment table for multifunctional use. Finally, a modified version of the Clayman-Preminger efficacy quotient for clinical comparison of different lithotripters, is outlined.