帕米膦酸二钠(博宁)联合153Sm-EDTMP治疗骨转移癌疗效分析

目的　观察帕米膦酸二钠联合153Sm -EDTMP治疗骨转移癌的疗效、毒副作用并探讨其临床意义。方法　随机入组 71例骨转移癌患者 ,分别给予帕米膦酸二钠、153Sm -EDTMP以及帕米膦酸二钠联合153Sm -EDTMP治疗 ,对照并观察止痛效果及毒性。结果　帕米膦酸二钠、153Sm -EDTMP以及帕米膦酸二钠联合153Sm -EDTMP组的止痛有效率分别为 67%、67%和 88 5 % ,P >0 .0 5 ,提示全组差异无显著性 ,但以 χ2 分割法检验则联合组与其它单用组之间的差异有显著性 (P <0 .0 5 ) ,而毒副反应无显著性差异。结论　帕米膦酸二钠联合153Sm -EDTMP治疗骨转移癌所致疼痛有更好的疗效     

葛根素治疗颈性眩晕临床观察

以葛根素加半夏白术天麻汤治疗颈性眩晕45例，为治疗组；以西北灵加半夏白术天麻汤治疗42例，为对照组。通过两组临床疗效观察：治疗组显效27例，有效16例，无效2例，有效率为96．0％；对照组显效8例，有效24例，无效10例，有效率为77．0％，对比有显著性差异（P＜0．01）。     

黄春林教授治疗老年慢性肾功能衰竭经验介绍

介绍黄春林教授运用中医药治疗老年慢性肾功能衰竭的经验。黄教授认为脾肾亏虚、湿浊瘀阻是本病的基本病理因素，虚实并见则是本病的发病特点，及早诊断是有效治疗本病的前提。并阐述了中药肾衰康方在治疗本病中的作用机制及大黄的使用技巧。     

Partial venous thrombosis of the pancreatic allografts after simultaneous pancreas-kidney transplantation

Despite new advances in transplantation, complete venous thrombosis (VT) of the pancreas after simultaneous pancreas kidney (SPK) transplantation usually results in graft loss. Data are limited regarding the outcome and treatment of partial VT of the pancreas allograft. From July 1994 to December 1999, 126 patients with IDDM/end-stage renal disease underwent SPK with systemic bladder drainage at the University of Miami. We retrospectively reviewed our experience regarding the outcome and treatment options of partial VT of the pancreas allografts. From July 1994 to April 1997, partial VT was not seen in the first 66 SPK patients induced with anti-CD3 rnAb and oral or intravenous (i.v.) tacrolimus (TAC) in the operating room. From May 1997 to June 1999, 14 (29%) out of 48 patients had VT. These cases were identified following the i.v. use of TAC with anti-IL-2R antibody-induction therapy (7/15) or without (7/33). Partial thrombosis of the splenic vein (PTSV) was documented in 10 patients, 2 had complete thrombosis of the splenic vein (CTSV), 1 had partial thrombosis of the superior mesenteric vein (PTSMV), and 1 patient had PTSV and PTSMV. These were identified incidentally during routine color Doppler ultrasonography (CDU). None of these SPK recipients demonstrates a change in clinical parameters. The first 8 patients were systemically heparinized, followed by oral anticoagulation, except 1 patient with CTSV. He progressed to complete thrombosis of the pancreas allograft and was treated with percutaneous thrombectomy and urokinase infusion, followed by heparinization and oral anticoagulation. One patient required exploration for bleeding. In an attempt to reduce the morbidity of heparinization, we treated the next 6 patients with PTSV with aspirin followed by serial CDU. All 14 patients had preservation of the endocrine and exocrine pancreatic functions. CDU showed resolution with recanalization of the thrombosed vein(s). From July 1999 to December 1999, 12 SPK recipients were administered TAC orally with or without induction therapy with anti-IL-2R antibody. So far, in this group, VT has not been identified. In summary, a total of 14 out of 126 patients (11%) had isolated VT with a mean follow-up of 36.4 months. Based on our experience, we suggest that extensive VT after pancreas transplantation, including splenic and superior mesenteric VT, be treated with heparin and subsequent oral anticoagulation for 3 months. For more limited, partial splenic VT, aspirin may be sufficient. Follow-up CDU is critical for a successful outcome. The i.v. use of TAC appears to be a risk factor for the increased incidence of VT. Currently, using IL-2rmAb as induction, TAC is started orally on postoperative days 3 or 4 and aspirin on postoperative day 2.     

痛风汤剂益肾养肝合剂治疗痛风性肾病33例临床观察

目的: 探讨痛风汤剂与益肾养肝合剂同用治疗痛风性肾病的临床疗效.方法: 将痛风性肾病患者58例分为两组,治疗组33例予痛风汤剂加益肾养肝合剂治疗,对照组25例只予痛风汤剂治疗.观察两组治疗前后血尿酸,肾功能,血、尿β2-微球蛋白指标的变化.结果: 治疗组在改善临床症状、肾功能,降低血尿酸、尿β2-微球蛋白(β2-MG)方面均优于对照组.结论: 对痛风性肾病患者的治疗,痛风汤剂与益肾养肝合剂同用扶正祛邪的治疗方法较好,能够改善肾小管功能.     

盐酸乌拉地尔缓释胶囊的制备及体外释放度研究

目的:研制盐酸乌拉地尔缓释胶囊.方法:采用4因素3水平等水平正交试验L9(34)对处方进行筛选和优化,确定最佳处方及制备工艺.体外释放度的测定采用转篮法,以pH 6.8的磷酸盐缓冲液900mL为溶剂,转速50r·min-1,UV法定量测定波长269nm.结果:体外释放度研究结果表明,盐酸乌拉地尔缓释胶囊与对照品的释药特性相似,均符合Higuchi模型动力学释药过程.结论:本法研制的盐酸乌拉地尔缓释胶囊处方合理、工艺可行,体现了缓释制剂的特点.     

休克期削痂加复合植皮治疗大面积深度烧伤

目的　探讨休克期削痂加复合植皮治疗大面积深度烧伤的可行性。方法　对 15例烧伤面积(70 5± 19 2 ) %、深Ⅱ～Ⅲ度面积平均 (5 0 1± 2 0 5 ) %的患者采用休克期削痂加复合植皮 ,第一次手术时间是伤后 2 4～ 4 8h ,一次削痂面积约 (30 6± 9 3) % ,以神态、尿量、心率和中心静脉压 (centrevainpressure,CVP)为主要监护指标。结果　术中术后各监护指标在正常范围。治疗组病例全部治愈出院 ,与条件相似 16例休克期后削痂植皮患者对比 ,创面愈合天数缩短 12d左右。结论　休克期削痂加复合植皮治疗大面积深度烧伤是可行的。     

X线和内镜在贲门失弛缓症诊断中的价值

目的 :比较X线和内镜在贲门失弛缓症诊断中的价值及二者应用优选问题。方法 :对28例贲门失弛缓症患者作X线和内镜检查 ,对照分析。结果 :X线诊断符合率为92 9 % ,而内镜为64 3% ,x2=4.9,P<0 05。结论 :X线和内镜均适用贲门失弛缓症的诊断 ,X线较内镜符合率更高     

去粗取精去伪存真——宋立人教授谈本草文献研究

中医文献学是中医药学发展的先导,本草文献研究是中医文献研究中的一个最薄弱环节,这与我国历史悠久、地域广阔、各地药物使用情况不同有关。中药品种混乱、同名异物、真伪互用等现象的存在,不但影响了用药规范和药物的临床疗效,更严重地阻碍了中医药事业的发展,因此本草文献研究实乃当务之争。综合性本草的研究当以《证类本草》为起点,专题性本草可分食疗、炮制、民间药物、中药药性、中药药理、临床应用等类加以研究。在本草     

酒炙丹参对小鼠耳廓微循环的影响

探讨酒炙对丹参活血祛瘀作用的影响。用肾上腺素造成小鼠血瘀模型后,再注射药物,以观察小鼠微血管动、静脉管径和血流速度的变化。结果表明,造模后微血管管径明显收缩变小,血流速度变慢,给予丹参不同炮制品后,有显著缓解作用,酒炙较生品丹参作用稍强。结论：酒炙有增强丹参活血祛瘀作用。