复方氯己定含漱预防腭裂整复创面感染的效果观察

目的探讨复方氯己定含漱液对腭裂整复创面感染的影响。方法分别用复方氯己定含漱液 (观察组 )和复方硼砂漱口液 (对照组 )对腭裂整复术后病人进行含漱 ,观察两组病人整复术后创面愈合率、平均住院时间。结果创面愈合时间观察组为 (8 5± 1 0 )d ,对照组 (14 0± 1 0 )d ;创面糜烂和愈合不良的发生率观察组为 0 ,对照组为 12 5 % ;平均住院时间分别为 (9 5± 2 0 )d和 (11 5± 3 0 )d ,观察组明显优于对照组 (P <0 0 5或P <0 0 1)。结论用复方氯己定含漱液漱口可有效降低腭裂整复创面感染率。     

低流量七氟烷吸入麻醉时不同二氧化碳吸收剂环路中化合物A浓度的比较及其对患者肝肾功能的影响

Objective To investigate the influence of different carbon dioxide (CO2) absorbents (Dr(a)gersorb 800 plus , Sodasorb,Sodasorb LF) on the production of compound A during low-flow sevoflurane anesthesia.Methods Twenty-seven ASA Ⅰ or Ⅱ patients aged 20-64 years were randomly assigned to three groups according to different CO2 absorbents: Dr(a)gersorb 800 plus' group (group D, n = 10), Sodasorb group (group S, n = 10) and Sodasorb LF group (group LF, n = 7). Anesthesia was maintained with low-flow (500 ml/min) sevoflurane inhalation (with the end-tidal sevoflurane concentration of approximately 2% ). At 2 h after low-flow sevoflurane anesthesia, gas samples were taken from the expiratory limb of the circuit. Compound A was detected by gas chromatography. Serum alanine transaminase (ALT), aspartate aminotransferase (AST), bilirubin (BR), urea nitrogen (BUN) and creatinine (Cr) levels were measured before (T0 ) and 24 h after operation (T1).Results The three groups were comparable with respect to age, body weight and height. After 2 h of low-flow sevoflurane anesthesia, compound A concentrations in the expiratory limb of the circuit were 11.6 ± 5.8 (group D), 2.1 ± 1.9 (group S)and ＜ 0.1 ppm (group LF), respectively. There were no significant changes in the serum ALT, AST, BR, BUN and Cr levels at 24 h after operation as compared with the preoperative baseline values in the three groups.Conclusion After 2 h of low-flow (500 ml/min) sevoflurane anesthesia, compound A concentrations within the circuit with different CO2 absorbents ( Dr(a)gersorb 800 plus' , Sodasorb, Sodasorb LF) are less than 50 ppm, with the lowest in Sodasorb LF.However, they have no significant effects on hepatic or renal function.     

Effects of laser irradiation on the spinal cord for the regeneration of crushed peripheral nerve in rats

BACKGROUND AND OBJECTIVE: The purpose of the present study was to examine the recovery of the crushed sciatic nerve of rats after low-power laser irradiation applied to the corresponding segments of the spinal cord. STUDY DESIGN/MATERIALS AND METHODS: After a crush injury to the sciatic nerve in rats, low-power laser irradiation was applied transcutaneously to corresponding segments of the spinal cord immediately after closing the wound by using 16 mW, 632 nm He-Ne laser. The laser treatment was repeated 30 minutes daily for 21 consecutive days. RESULTS: The electrophysiologic activity of the injured nerves (compound muscle action potentials--CMAPs) was found to be approximately 90% of the normal precrush value and remained so for up to a long period of time. In the control nonirradiated group, electrophysiologic activity dropped to 20% of the normal precrush value at day 21 and showed the first signs of slow recovery 30 days after surgery. The two groups were found to be significantly different during follow-up period (P < 0.001). CONCLUSION: This study suggests that low-power laser irradiation applied directly to the spinal cord can improve recovery of the corresponding insured peripheral nerve.     

替硝唑泡腾片联合雌激素软膏治疗老年阴道炎疗效观察

目的：：探讨替硝唑泡腾片联合雌激素软膏治疗老年阴道炎的临床疗效。方法：80例老年阴道炎患者随机均分为观察组和对照组,对照组仅给予替硝唑泡腾片治疗,观察组在对照组的基础上采用雌激素软膏治疗,比较两组患者的临床疗效、相关症状的变化、不良反应和复发率。结果：治疗后,观察组的总有效率、阴道健康评分、阴道脱落成熟指数明显高于对照组,阴道炎症评分、复发率明显低于对照组,组间比较差异具有统计学意义（P＜0.05）;两组不良反应发生率比较,差异无统计学意义(P＞0.05)。结论：替硝唑泡腾片联合雌激素软膏能够提高老年阴道炎的治疗效果,改善阴道健康状况,降低复发率。     

枸橼酸莫沙必利联合埃索美拉唑治疗胃食管反流病临床疗效分析

目的：探讨枸橼酸莫沙必利联合埃索美拉唑治疗胃食管反流病临床效果差异。方法整群选取2014年1-12月在该院住院时采用埃索美拉唑联合枸橼酸莫沙必利分散片治疗的76例胃食管反流病患者作为联合组,同时选取单用埃索美拉唑镁肠溶片治疗的56例胃食管反流患者作为单用组,并比较两组患者临床治疗效果和临床症状改善情况。结果治疗8周后,联合组患者临床治疗总有效率为94.74%,单用组患者临床治疗总有效率为71.43%,两组比较差异具有统计学意义(P<0.05);与单用组比较,联合组患者治疗8周后其症状积分明显降低,两组比较差异具有统计学意义(P<0.05)。结论枸橼酸莫沙必利分散片联合埃索美拉唑镁肠溶片能明显提高胃食管反流性疾病的临床治疗效果以及改善其临床症状。     

依那普利叶酸片对H型高血压左室肥厚患者心血管事件及心功能指标的影响

目的：研究依那普利叶酸片对H型高血压左室肥厚患者心血管事件及心功能指标的影响。方法选取2012年9月至2013年9月收入我院的H型高血压左室肥厚患者100例为研究对象,分为治疗组和对照组,每组各50例。对照组口服依那普利,治疗组口服依那普利叶酸片,2组均治疗12个月。治疗前后检测患者血浆同型半胱氨酸（ Hcy）水平、心功能及左室射血分数、主要心血管事件发生率及不良反应发生情况。结果治疗前,2组患者收缩压（ SBP ）、舒张压（ DBP ）差异无统计学意义（P＞0．05）,治疗后,2组SBP、DBP均显著降低（P＜0．05）,且治疗组降压效果更加明显。治疗前,2组患者血浆Hcy水平比较未见统计学差异（P＞0．05）,治疗后,2组血浆Hcy水平均显著降低（P＜0．05）,且治疗组降低更加明显。治疗后,治疗组和对照组患者E／A值,分别由0．65±0．09和0．64±0．13上升到0．93±0．14和0．77±0．12,治疗前后,2组E／A值比较差异均有统计学意义（P＜0．05）;治疗后,与对照组相比,治疗组患者E／A值显著升高,2组相比差异具有统计学意义（P＜0.05）。治疗后,治疗组和对照组的左室射血分数（ LVEF）值分别由64．64±1．19和65．11±1．47上升到69．43±1．40和66．95±1．38,治疗前后2组LVEF差异具有统计学意义（P＜0．05）;治疗后,与对照组相比,治疗组LVEF值显著升高,2组相比差异具有统计学意义（P＜0．05）。患者随访时间2～12个月,平均随访时间（7．53±3．74）个月。随访过程中,对照组出现7例主要心血管事件,其中4例脑卒中,2例心肌梗死,1例心血管病死亡,无主要心血管事件生存率为86．0％。治疗组共发生3例主要心血管事件,其中2例脑卒中,1例心肌梗死,无主要心血管事件生存率为94．0％。与对照组比较,治疗组无主要心血管事件生存率显著提高,2组相比差异具有统计学意义（P＜0．05）。结论依那普利叶酸片降压及降低血浆Hcy、逆转左室肥厚作用更强,心血管事件发生率更低,其疗效显著强于依那普利,有效保护心脏。     

中药复方防治脑梗死机制研究进展

脑梗死是临床常见性、多发性脑血管病,现代医学多以超早期溶栓、神经细胞保护、介入和外科手术等治疗为主,虽然近期疗效显著,但无法避免的副作用及严格的治疗准入条件使其临床应用大受限制。中医学整体审察、辨证论治的诊疗观以及复方多靶点、多环节、多途径、网络整合调节的治疗特点,在脑梗死防治方面有着不可或缺的优势。基于此,本文拟从抗氧自由基损伤、抑制凋亡基因激活、促进血管内皮生长及神经再生等方面系统综述中药复方治疗脑梗死的作用原理,以期为中医药防治缺血性脑血管疾病提供部分科学循证依据。     

妇科千金片对盆腔炎大鼠TLR2/4-NF-κB信号通路影响的研究

目的：观察妇科千金片对盆腔炎大鼠子宫 Toll 样受体2（ TLR2）、Toll 样受体4（ TLR4）、核转录因子 kappaB （ NF-κB ） mRNA 表达的影响,探讨妇科千金片调控 TLR2/4-NF-κB 信号通路对盆腔炎大鼠的抗炎机制。方法通过子宫注射混合菌液建立盆腔炎大鼠模型,将60只雌性 SD 大鼠随机分为5组,每组12只,即：空白组、假手术组、模型组、妇科千金片组、罗红霉素组,分别予以相应药物干预,运用免疫组化检测子宫组织中 TLR2、TLR4、NF-κB 的灰度值;运用实时荧光定量 PCR 检测子宫组织中 TLR2、TLR4、NF-κB 的 mRNA 表达变化。结果与空白组、假手术组比较,模型组的 TLR2、TLR4、NF-κB 灰度值显著降低（ P＜0.01）, TLR2、TLR4、NF-κBmRNA 的表达均显著升高（ P＜0.01）,表明模型成功;与模型组比较,妇科千金片组、罗红霉素组 TLR2、TLR4、NF-κB 灰度值均显著升高（ P＜0.01）, TLR2、TLR4、NF-κBmRNA 均显著降低（ P＜0.01）。结论妇科千金片对盆腔炎大鼠抗炎的作用机制,可能是通过调控 TLR2/4-NF-κB 炎性介质变化信号通路的传导而实现的。     

尼可地尔片对冠心病心绞痛患者血栓前状态及血管内皮功能的影响

目的探讨尼可地尔片对冠心病心绞痛患者血栓前状态及血管内皮功能的影响。方法随机双盲法将100例冠心病心绞痛患者分为对照组与观察组,各50例,对照组采取常规治疗,观察组在对照组基础上口服尼可地尔片,比较两组临床疗效、不良反应、治疗前后血栓前状态(Fbg、D-D、PAI-1、v WF、t-PA)及血管内皮功能(ET-1、FMD、NO)指标。结果观察组治疗总有效率92.0%,显著高于对照组的76.0%(P0.05)。两组治疗后Fbg、D-D、t PAI-1、v WF、t-PA、ET-1、FMD、NO比较差异均有统计学意义(P0.05)。两组患者均无明显不良反应发生。结论尼可地尔片治疗冠心病心绞痛安全有效,能明显改善机体凝血纤溶系统及血管内皮功能。     

塞来昔布联合正清风痛宁片对类风湿关节炎的疗效分析

目的:探讨塞来昔布联合正清风痛宁片对类风湿关节炎患者外周淋巴细胞的影响及疗效。方法:类风湿关节炎患者122例,随机分为两组:对照组57例,单用塞来昔布治疗;观察组65例,塞来昔布联合正清风痛宁片治疗,疗程4周。比较两组患者治疗前后IL-1、IL-6、TNF-α水平及类风湿因子(RF);肿胀疼痛关节数、VAS疼痛评分及疗效。结果:(1)总有效率观察组高于对照组(66.15%vs.52.63%,P<0.05);(2)治疗后观察组RF、IL-6、TNF-α水平均低于对照组[(19.27±3.81)vs.(36.64±4.11)]U/m L、[(10.34±1.64)vs.(14.37±3.21)]ng/L、[(8.54±2.47)vs.(12.58±1.69)]μg/L,均P<0.05;(3)治疗后观察组与对照组比较,肿胀疼痛关节数差异有统计学意义(P<0.05),但VAS疼痛评分比较差异无统计学意义(P>0.05)。结论:塞来昔布联合正清风痛宁片治疗类风湿关节炎,能够显著改善患者症状,缓解疼痛,减轻炎症反应,其疗效优于单用塞来昔布治疗。