利福昔明对比环丙沙星治疗急性肠炎临床研究

目的　研究利福昔明对比环丙沙星治疗急性肠炎的有效性和安全性。　方法　采用随机对照方法 ,共治疗 5 1例急性肠炎。利福昔明治疗 2 5例 ,环丙沙星 2 6例 ,用药时间方法相同。观察治疗前后临床症状、大便性状、大便次数、便常规、血常规、尿常规及肝肾功能 ,以了解其疗效及不良反应情况。　结果　利福昔明组 (治疗组 )与环丙沙星组 (对照组 )相比 ,显效率分别为 92 .0 %和 80 .8% ,总有效率分别为 92 .0 %和 96 .2 % ,止泻时间治疗组 2 8.6 7± 15 .92h ,对照组 36 .12± 2 0 .70h ,均未见明显毒副作用。以上各项指标及两组在治疗过程中大便次数变化、大便常规复常率经统计学处理均无显著性差异 (P >0 0 5 )。　结论　利福昔明可用于治疗急性肠炎 ,与环丙沙星比较 ,疗效相仿 ,但耐受性好 ,口服不吸收 ,故值得推广     

中风毒邪论与神经保护治疗的研究

中风毒邪论是一种与传统中医中风病理有所不同的理论 ,在中风毒邪论指导下形成解毒通络方是较为理想的神经保护剂 ,可解决目前神经保护治疗的主要障碍 ,有望成为提高中医治疗中风急性期疗效的关键     

Bereavement therapy with adolescents: facilitating a process of spiritual growth

TOPIC: Bereavement therapy as a catalyst for spiritual growth. PURPOSE: This study aims to review the literature and reflect on the bereavement therapy undertaken with two adolescents who had been bereaved during childhood. SOURCES: Research articles and books identified through a combination of electronic and manual searches. CONCLUSIONS: It would appear that grief therapy could facilitate spiritual growth in such circumstances. Further in-depth studies are required to identify how typical or atypical this experience is, and to contribute to the evidence base for working with bereaved children and adolescents.     

急性大血管闭塞性轻型卒中血管内治疗的疗效及安全性观察

目的 观察急性大血管闭塞性轻型卒中患者血管内治疗的疗效及安全性。
方法 回顾性分析2018年1月-2019年5月行血管内治疗的急性大血管闭塞性轻型卒中（NIHSS评分
≤5分）患者的临床资料。观察术后血管成功再通率（mTICI≥2b级）、围手术期并发症、90 d良好预后率
（mRS评分≤2分）等。
结果 共纳入13例患者，平均年龄58.7±14.5岁，男性11例（84.6%）。术后血管成功再通率100%；围
手术期并发症2例，假性动脉瘤1例、无症状性颅内出血1例；90 d良好预后率100%。
结论 急性大血管闭塞性轻型卒中行血管内治疗可能是安全、有效的。     

Extacorporeal shock wave therapy unsuccessful for chronic medial epicondylitis

Medial epicondylitis is a chronic noninflammatory condition resulting from mechanical injury. Despite many treatment options, including rest, medications, physiotherapy and operative interventions, the results are too often poor; thus new treatment options are sought. We treated 4 men with chronic epicondylitis (5 affected joints) with extracorporeal shock wave therapy after failed attempts of other treatments. The patients’ complaints were graded with the Nirschl scoring system prior to and six months after therapy. The treatment consisted of three sessions, at 20-day intervals, of 3000 pulses of ultrasonic shock waves from a Piezolith 3000 unit (energy dosage was gradually increased to reach step 10 equaling 0.9 mJ/mm²). At the 6-month follow-up, no patient was pain free. Three cases had slightly lower Nirschl scores than prior to the procedure but the patients rated this difference as insignificant; two cases were unchanged. No complications were observed but all patients rated the procedure as very unpleasant. The well recognized biologic effects of ultrasonographic waves (heat generation, oscillations, cavitation, etc.) that result in functional and structural changes of cellular membranes with sonochemical reactions (acceleration of normal metabolism, oxygenation and reduction in water solutions, polymer degradation, etc.), even if present in our cases, did not result in a noticeable decrease of symptoms, even though we used high energy and more impulses per session. Significant variations in methodology make inconclusive the results of numerous reports on the use of extracorporeal shock waves in epicondylar degenerative problems, although ineffectiveness of such therapy is the conclusion of a review by Haake and colleagues.     

Le Fort型骨折的CT表现和分型

目的探讨Le Fort型骨折的CT表现及其分型。方法对62例Le Fort型骨折患者进行薄层螺旋CT扫描和三维重组分析。结果在62例中，Le FortⅠ型10例，Ⅱ型9例，Ⅲ型8例，复合型35例（其中Ⅰ＋Ⅱ型18例，I＋Ⅱ＋Ⅲ型7例，Ⅱ＋Ⅲ型10例）；55例同时伴发颌面部其他骨折。Le Fort型骨折在二维CT上表现为颌面部多发且杂乱的骨折，虽然在发现细小和深部结构的骨折方面优于三维CT成像，但难以作出Le Fort型骨折的诊断；三维CT成像能清晰立体地显示Le Fort型骨折的整体形状及走向，并可明确作出分型。结论三维CT成像是Le Fort型骨折最有效的诊断方法，对临床制定治疗方案具有指导意义，但是对细小骨折诊断不如二维CT。     

外加磁场对半乳糖化白蛋白磁性阿霉素纳米粒在大鼠体内分布影响的研究

目的观察半乳糖化白蛋白磁性阿霉素纳米粒(ADR-GHMN)在正常肝脏中的靶向性,并观察ADR-GHMN在全身各脏器的分布特征及外加磁场对其分布的影响.方法大鼠正中开腹,肝动脉插管并固定,肝动脉注射125I-ADR-GHMN(相当于阿霉素0.5 mg/kg),左外叶加磁场,磁场应用30 min,移去磁场后,动物立即处死;对照组:肝动脉注射ADR-GHMN,左外叶不加磁场,30min后,移去磁场后,动物立即处死,立即取靶区肝、非靶区肝、肾、心、肺、小肠、脾及周围血作γ计数.肝组织作病理切片.结果注入的纳米粒75～85%分布于肝脏,其它脏器极少.病理切片显示磁区小动脉见大量纳米粒存在,对照组及非磁区肝中纳米粒很少见.结论ADR-GHMN在正常肝组织中有明显的磁靶向性;在磁场作用下,ADR-GHMN主要分布于肝脏,其它脏器含量很少;试验组肾、心、肺、小肠、脾及外周血于对照组的放射活性比较明显降低,表明磁性物质的存在使这些脏器的相对药物暴露明显减少.     

Targeted Thrombolytic Therapy

Venous and arterial thrombosis are closely related to many severe diseases, especially to cardiovascular and cerebrovasular disorders. Thrombolytic therapy has been proven to be an effective method to treat such disease, which decreased the mortality and morbidity greatly.     

阿米替林合并认知疗法治疗精神分裂症后抑郁的对照研究

目的　评价阿米替林合并认知疗法对精神分裂症后抑郁的治疗效果。方法　将符合CCMD 3诊断标准的 86例精神分裂症后抑郁患者随机分为治疗组和对照组 ,治疗组给予阿米替林合并认知治疗 ,对照组织给予阿米替林治疗 ,疗程 12周。采用汉密尔顿抑郁量表 (HAMD)、简明精神病量表(BPRS)、阴性症状量表 (SANS)评定临床疗效 ,采用副反应量表 (TESS)评定副反应。结果　在治疗的 4、8、12周末 ,HAMD评分治疗组优于对照组 ,显效率分别为 83 95 %和 6 1 90 % (u =5 .83,P <0 0 5 )。结论　阿米替林与认知治疗组结合治疗精神分裂症后抑郁疗效好于单用阿米替林治疗。     

Simulation model of renal replacement therapy: predicting future demand in England.

BACKGROUND: The demand for renal replacement therapy (RRT) in England has risen steadily, although from a lower base than many other developed countries. Predicting the future demand for RRT and the impact of factors such as the acceptance rate, transplant supply and patient survival, is required in order to inform the planning of such services. METHODS: A discrete event simulation model estimates the future demand for RRT in England in 2010 for a range of scenarios. The model uses current prevalence and current and projected future acceptance rates, survival rates and the transitions between modalities to predict future patient numbers. National population and mortality data, published literature and data from the UK Renal Registry and UK Transplant, are used to estimate unmet need for RRT, the impact of changing demography and incidence of Type 2 diabetes, patient haemodialysis (HD) survival and transplant supply. RESULTS: By 2010 the predicted prevalence will have increased from about 30,000 in 2000 to between 42 and 51,000 (900-1000 p.m.p.), an average annual growth of 4.5-6%. Changing transplant supply has a small effect on overall numbers but changes the proportion of patients with functioning graft by up to 8%. Even with an optimistic increase in transplant supply (11% p.a. for 5 years), numbers on HD will continue to rise substantially, especially in the elderly. The factors most influencing future patient numbers are the acceptance rate and dialysis survival. CONCLUSION: This model predicts a substantial growth in the RRT population to 2010 to a rate approaching 1000 p.m.p., particularly in the elderly and those on HD, with a steady state not being reached for at least 25 years.