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21.
谷氨酰胺在危重病患者中的应用 总被引:3,自引:0,他引:3
目的探讨危重病患者中早期经静脉应用谷氨酰胺(glutamine,Gl)的临床价值。方法42例患者随机分成两组(对照组和Gln组),Gln组进行Gln治疗(100mL/d,共7d)。治疗前后检测患者体质量、白蛋白、谷胱甘肽(GSH)、握力的变化和肠功能不全的发生率。结果体质量两组治疗前后比较差异无显著性(P〉0.05)。白蛋白、握力和GSH Gl治疗后非常显著高于治疗前(P〈0.01);白蛋白对照组治疗后较治疗前显著增高(P〈0.05),但握力和GSH治疗前后均无显著变化(P〉0.05);肠功能不全的发生率Gln组为4.8%,显著低于对照组(28.6%,P〈0.05)。结论在危重病患者疾病早期通过静脉途径外源性地补充Gln,有效改善了患者的营养状况;使患者血浆中的GSH水平增高,加强了机体的抗氧化能力;减少了患者肠功能不全的发生率。 相似文献
22.
董频 《山东医大基础医学院学报》2006,(4)
目的:运用软硬腭前移的手术方法扩大鼻咽下口,改善因鼻咽部狭小致阻塞性睡眠呼吸暂停综合征患者的呼吸暂停症状。方法:手术切除硬腭后份使其缩短、悬雍垂软腭成形并将软腭拉向前,扩大鼻咽下口。结果:患者术后自觉症状及客观评价疗效满意。结论:软硬腭前移鼻咽下口扩大显著改善鼻咽下口狭小导致的阻塞性睡眠呼吸暂停患者的症状。 相似文献
23.
Akira Sawaki Nobumasa Mizuno Kuniyuki Takahashi Tsuneya Nakamura Masahiro Tajika Hiroki Kawai Toshifumi Isaka Hiroshi Imaoka Yasuyuki Okamoto Masatoshi Aoki Hiroyuki Inoue Ahmed AS Salem Yasushi Yatabe Kenji Yamao 《Digestive endoscopy》2006,18(1):40-44
Background: Gastrointestinal stromal tumors (GIST) are one of the most common mesenchymal tumors of the gastrointestinal tract. GIST are defined by positive immunohistochemical staining for KIT or CD34 and thus are generally diagnosed after surgery. Because small GIST are rarely diagnosed before surgery, the clinical course of these small tumors is not clear. The aim of the present study was to follow changes in size and configuration of small GIST that were pathologically confirmed using endoscopic ultrasonography‐guided fine‐needle aspiration biopsy (EUS‐FNAB). Methods: Between July 1997 and December 2003, 16 tumors in 16 patients (10 men and 6 women) with an immunohistochemical diagnosis of GIST were regularly followed in our hospital. The median patient age when EUS‐FNAB was performed was 62 years (range 26–82 years) and the median follow‐up period was 4.9 years (range 0.5–9.6 years). Results: Fourteen tumors showed no remarkable changes in size and shape during follow up compared with the initial diagnosis. Two tumors enlarged: one tumor approximately doubled its diameter in 8 years and the other tumor increased from 1.8 cm at diagnosis to up to 10 cm after only 2 years. Doubling time of the latter tumor was calculated as 3.1 months. Conclusions: We conclude that EUS‐FNAB might be a good modality for final diagnosis of GIST without surgery, and that GIST without rapid growth on follow up can be endoscopically followed. 相似文献
24.
YOSHINORI MORITA NOBUO AOYAMA DAISUKE SHIRASAKA MASATERU FUKUDA MASATO KASUGA 《Digestive endoscopy》2003,15(Z1):S12-S14
In Kobe University Hospital, a new method for endoscopic mucosal resection (EMR) using insulated‐tip electrosurgical knife (IT‐EMR) for early gastric cancer (EGC) was introduced from November 2001. To achieve an effective and safe IT‐EMR procedure, we use a high‐frequency surgical unit for cutting and coagulation (ERBOTOM ICC 200) with automatically controlled cutting mode (ENDOCUT). In this study, we show not only our results of IT‐EMR for EGC in comparison with those of the conventional strip biopsy method, but also the optimal conditions for the apparatus of a high‐frequency surgical unit to prevent complications such as bleeding and perforation. 相似文献
25.
Clinical decisions are often made with incomplete information, yet patient care decisions are made every day. Patients vary clinically, uncertainty exists in diagnostic and prognostic information, and many preventive and treatment alternatives have not been formally assessed for their effectiveness. Because scientific information will never answer all clinical questions, clinical decisions are partially based on probabilistic information.
This paper describes how to apply clinical decision making to diagnosing and managing dental caries and periodontal diseases. By using explicit information to quantify probabilities and outcomes, clinical decision making analyzes decisions made under uncertain conditions and the uncertain impact of clinical information.
Clinical decision making incorporates concepts for preventing, diagnosing and treating dental caries and periodontal diseases: risk assessment, evidence-based dentistry, and multiple oral health outcomes. This information can serve as a tool for clinicians to augment clinical judgment and expertise. 相似文献
This paper describes how to apply clinical decision making to diagnosing and managing dental caries and periodontal diseases. By using explicit information to quantify probabilities and outcomes, clinical decision making analyzes decisions made under uncertain conditions and the uncertain impact of clinical information.
Clinical decision making incorporates concepts for preventing, diagnosing and treating dental caries and periodontal diseases: risk assessment, evidence-based dentistry, and multiple oral health outcomes. This information can serve as a tool for clinicians to augment clinical judgment and expertise. 相似文献
26.
Keiichiro Kume Masahiro Yamasaki Ichiro Yoshikawa Makoto Otsuki 《Digestive endoscopy》2006,18(3):218-220
Background: Although bleeding is an unavoidable complication of endoscopic submucosal dissection (ESD), endoscopic hemostasis using an insulation‐tipped electrosurgical knife (IT) knife is impossible because an insulator is mounted at the tip of the knife. We have developed a new type of hood which could perform both coagulation and irrigation simultaneously. Methods: Our new device was fabricated by drilling a side hole in the cap portion of a conventional transparent hood followed by attaching a machined papillotomy knife to the exterior surface of the hole. Results: Our new hood was useful for hemorrhage during ESD using IT knife. Conclusions: With this method, endoscopic hemostasis using IT knife is easy, as hemostatic procedure can be performed under irrigation and coagulation using conventional endoscopy. 相似文献
27.
P Avalos-Peralta† A Herrera† JJ Ríos-Martín‡ AM Pérez-Bernal† D Moreno-Ramírez† F Camacho† 《Journal of the European Academy of Dermatology and Venereology》2006,20(1):79-83
We report the case of a patient with a 13-year history of pemphigus vulgaris (PV) treated with immunosuppressive agents, prednisone and mycophenolate mofetil who had developed lesions of Kaposi's sarcoma (KS) on a sole plaque of PV that had been previously treated with intralesional injections of steroids. The lesions were surgically removed and polymerase chain reaction (PCR) demonstrated human herpesvirus-8 (HHV-8) DNA. There were neither recurrences nor later dissemination of KS following gradual decrease of the immunosuppressive therapy. We suggest that the treatment with intralesional steroids may have influenced the local reactivation of a latent infection of the virus, determining the appearance of this localized KS. 相似文献
28.
目的 :探讨玻璃体切割术前 F- ERG与术后视力的关系。方法 :对 5 0例行玻璃体切割手术的患者进行术前 F- ERG的测定 ,术后 2周对其视力进行测定 ,利用 SPSS软件包进行统计学处理。结果 :术前 F- ERG的 a波振幅与术后视力呈正相关 ;术前 F- ERG的 b波振幅与术后视力呈正相关 ;E值 ( E=La+ Lb/Aa+ Ab)与术后视力呈负相关 ;E小于等于 3.0者与 E大于 3.0组术后视力差异有显著性 ( P<0 .0 0 5 )。结论 :玻璃体切割术前进行正确的 F- ERG分析 ,有助于玻璃体切割术后视力的预测。 相似文献
29.
A. Al Tahan S. Arora A. Alzeer F. Al Tahan T. Malabarey A. Daif 《European journal of neurology》1997,4(1):52-58
The diagnosis of acute disseminated encephalomyelitis (ADEM) is frequently missed or delayed with consequent delay in instituting therapy in the crucial phase of the illness. The role of MRI in the diagnosis of ADEM is well established, however, the value of its early utilization of treatment on the outcome of patients has not been adequately stressed. Three patients with ADEM are described. Delay in the diagnosis of the first was associated with severe sequelae, while in the other two early diagnosis and institution of corticosteroid therapy which was facilitated by MRI, was associated with a better outcome. MRI should be carried out early once the diagosis of ADEM is entertained. 相似文献
30.
Role of intracortical mechanisms in the late part of the silent period to transcranial stimulation of the human motor cortex 总被引:3,自引:0,他引:3
J.P. Brasil-Neto A. Cammarota J. Valls-Solé A. Pascual-Leone M. Hallett L. G. Cohen 《Acta neurologica Scandinavica》1995,92(5):383-386
Transcranial magnetic stimulation (TMS) and transcranial electrical stimulation (TES) of the human motor cortex produce a silent period (SP) following motor evoked potentials (MEPs). The early part of the SP can be explained by decreased alpha motor neuron excitability, whereas the late part is presumably due to suprasegmental mechanisms. In order to determine the level of the suprasegmental contribution to the generation of SPs, we recorded excitatory and inhibitory responses to TMS, TES, and percutaneous electrical brainstem stimulation (PBS) in the voluntarily activated first dorsal interosseous muscle of the hand. Stimulus intensities were set so that PBS and TES induced MEPs with areas equal to or larger than those of MEPs obtained with TMS. This procedure revealed that SPs were 49% and 83% shorter with TES and PBS, respectively, than with TMS. As TMS is more effective than TES or PBS in activating cortical interneurons, these findings support the idea that a significant component of the SP arises from intracortical mechanisms. 相似文献