我院实行大处方限制措施前后抗生素应用情况分析

目的控制大处方用药，促进抗生素合理应用。方法采用金额排序和回顾性调查法，统计、分析我院在实施大处方限制措施前后临床各病区应用抗生素情况，探讨行政干预对控制抗生素滥用、促进合理用药、减轻患者经济负担的办法。结果能有效地控制抗生素的滥用。结论通过医院管理层面的行政干预措施，能有效地控制抗生素的滥用，使抗生素的应用进入良性轨道。     

催奶灵治疗产后缺乳162例

<正> 近年来,强调母乳喂养已成为国策,为保证这一措施的落实,特研制催奶灵冲剂,经临床验证效果良好。 1临床资料及处方 1.1.病例情况:本组临床观察产后乳母共162例,年龄21—25岁,85例;26—32岁,77例。产后无奶(时间5天)120例,奶少者42例。 1.2用药情况:催奶灵冲剂,每次5克,每日3次口服。产后开始服药情况为:5天—,78例,占48.15％;10天—,37例占22.84％,15天—,34例占20.99％;20天—11例占6.29％;25天—2例占1.23％。 1.3处方及制法:王不留行、黄芪、当归、穿山甲等药适量。先将黄芪和当归煎煮三次合并滤液并浓缩成浸膏。王不留行炒至爆花后研成细粉。穿山甲制成细粉,然后将上述药物混合,加糖适量制成冲剂即     

药物不良反应报告分析

随着药品不良反应(ADR)监察制度在我国的开展和深入,越来越多的人由关心药品的疗效,而逐渐开始转向关注药品的不良反应、关注有ADR给人们带来的危害.该项工作也开始越来越引起人们的注意,有关ADR的报道也逐渐增多.本文对本院近几年收集的58份报表进行回顾性分析,具体分析如下:     

Prognostic significance of bcl-2, bax,and p53 expression in diffuse large B-cell lymphoma

Diffuse large B-cell lymphoma (DLCL) exhibits heterogeneous clinical features and varies markedly in response to treatment and prognosis. Because apoptosis-related proteins may play an important role in predicting the prognosis of DLCL, the current study investigated the prognostic significance of a high level of bcl-2, bax, and p53 expression in relation to clinical characteristics in patients with DLCL. Paraffin-embedded specimens from 94 patients with de novo DLCL were analyzed immunohistochemically for bcl-2, bax, and p53 gene expression. Cases with a positive immunohistological stain in more than 50% of the tumor cells were considered to have DLCL-positive expression. Patients were treated optimally, i.e., with radiotherapy including brief cycles of CHOP or CHOP-like regimens for patients with stage 1-2A diseases and with at least 6 cycles of CHOP or CHOP-like regimens for stage 2B-4 diseases. The responses to therapy and survival were then analyzed in 94 uniformly staged patients. bcl-2 expression was identified in 24 patients (26.4%), bax expression in 35 patients (37.6 %), and p53 expression in 21 patients (22.6%). bax expression proved to be a statistically significant prognostic factor in predicting the overall survival (OS) (P = 0.0015) and disease-free survival (DFS) (P = 0.0052), regardless of other clinical factors or immunohistological results. There was no significant difference in the OS (P = 0.0682) or DFS (P = 0.088) between the bcl-2-positive (n = 24) and bcl-2-negative (n = 67) groups. However, bcl-2 expression was found to be unfavorably associated with the OS (P = 0.0054) in a confined group with low (n = 51) or low intermediate (n = 22) IPI scores. The expression of p53 exhibited no statistical correlation with the OS or DFS. A multivariate analysis revealed that IPI score, bulky mass, and bax expression were all significantly associated with the DFS or OS. bax and bcl-2 should be considered as independent biologic prognostic parameters in DLCL, thereby aiding in the identification of patient risk groups. As such, bcl-2-positive patients with a low or low intermediate IPI score, or without a high level of bax expression could be candidates for more intensive therapy or alternative therapeutic approaches.     

Prevalence of neuropathic pain among black African patients suffering from common low back pain

To study the prevalence and semiotic characteristics of neuropathic pain in the common low back pain to the Black African subject. This was a prospective cross-sectional survey carried on from April 1 2009 to August 31 2009 in consultations of rheumatology, neurology, and neurosurgery at the University Hospital Yalgado Ouédraogo in Ouagadougou (Burkina Faso). All patients with a low back pain or a common lomboradiculalgie were included. DN4 questionnaire was used for the diagnosis of neuropathic pain. One hundred and seven patients have been recruited during the study period; Sixty-four (59.80%) were female (sex ratio M/F: 0.67). The average age was 34.11?±?13.46?years of age with extremes of 20 and 79. The average duration of disease was 48.53?months with extremes of 10?days and 50?years. Eighty-seven patients (81.31%) had a disease duration, which was 3?months longer. Sixty-six patients (61.70%) had a predominant lomboradiculalgie; among the remaining 41, low back pain predominated. Average intensity of pain was 62.81?±?22.43 (on a scale of 100). A sign of Lasèque was present in the 41 (38.30%) patients. Fifty-three (49.5%) patients had a neuropathic pain. The prevalence of neuropathy signs according to the DN4 questionnaire was as follows: burning (n?=?37; 34.58%), painful cold (n?=?13; 12.15%), electric shocks (n?=?31; 38.97%), pins and needles (n?=?34; 31.77%), tingling (n?=?35; 32.71%), numbness (n?=?45; 42.05%), itching (n?=?18; 16.82%), touch hypoesthesia (n?=?35; 32.71%), pinprick (n?=?33; 30.84%), and tactile allodynia (n?=?21; 19.62%). Among the studied variables, the presence of a radiculalgy was statistically associated with neuropathic pain. The lomboradiculalgie of the Black African subject associates neuropathic pain observed in half of patients. Treatment must therefore always take account of this association. However, further studies are needed before any definitive conclusion.     

肩峰下撞击综合征应用1.5T磁共振成像检查诊断的价值分析

目的:探讨使用1.5T核磁共振在肩峰下撞击综合征(SIS)检查诊断中的应用价值,为当前的疾病诊断工作提供参考意见。方法:选取2019年1月至2020年12月期间在我院确诊的62例SIS患者作为研究的对象,均给予患者核磁共振、多层螺旋CT进行检查,比较两种检查方式的检出率。结果:磁共振总检出率高于CT检查,有统计学意义(P<0.05)。其中,在Ⅰ型、Ⅲ型的检查中,两种检查方式的检出率差异不明显,无统计学意义(P>0.05);在Ⅱ型检查中,磁共振成像MRI检出率高于MSCT检查,有统计学意义(P<0.05)。CT检查发现,有15例患者观察到肩峰下间隙狭窄、有9例观察到肱二头肌及冈上肌肌腱出现不同程度的钙化、有28例患者观察到肩峰下及肩锁关节部位出现不同程度的骨质增生。磁共振检查发现,22例患者肩峰下滑囊观察到增厚、积液的情况,18例患者观察到肩袖出现不同程度损伤,17例患者观察到关节盂唇存在不同程度的撕裂、损伤,24例患者显示Ⅱ型肩峰,36例患者可观察到肩关节囊内存在积液。结论:SIS应用1.5T磁共振成像检查诊断检出率高,特别是能够清晰地反应患者肌肉组织损伤及病变,有利...     

急性有机磷农药中毒合并呼吸衰竭35例临床分析

目的探讨急性有机磷农药中毒（AOPP）合并呼吸衰竭的因素及有效抢救措施。方法35例AOPP合并呼吸衰竭患者给予彻底清除毒物,尽早应用长托宁、氯解鳞定,积极应用机械通气进行呼吸支持治疗,观察AOPP合并呼吸衰竭的抢救率及死亡率。结果抢救成功率80%,死亡率20%。结论早期识别和及时有效的综合抢救治疗是提高抢救成功的关键。     

A painful pulsatile abdominal mass in a young man with elevated blood pressures: an unusual presentation of phaeochromocytoma

We report an unusual presentation of phaeochromocytoma in a young man with a painful, pulsatile abdominal mass and elevated blood pressures. This led to a delay in diagnosis and resulted in the administration of triggers of catecholamine release, possibly causing a catecholamine surge. This caused the development of catecholamine-induced cardiomyopathy and multiple organ failure, requiring inotropic and ventilatory support, intra-aortic balloon pump and dialysis. Fortunately, his condition reversed with supportive treatment and alpha-adrenergic blockade. This illustrates the importance of having a high index of suspicion of phaeochromocytoma, especially in young patients with elevated blood pressures.     

Brain function in the vegetative state

Positron emission tomography (PET) techniques represent a useful tool to better understand the residual brain function in vegetative state patients. It has been shown that overall cerebral metabolic rates for glucose are massively reduced in this condition. However, the recovery of consciousness from vegetative state is not always associated with substantial changes in global metabolism. This finding led us to hypothesize that some vegetative patients are unconscious not just because of a global loss of neuronal function, but rather due to an altered activity in some critical brain regions and to the abolished functional connections between them. We used voxel-based Statistical Parametric Mapping (SPM) approaches to characterize the functional neuroanatomy of the vegetative state. The most dysfunctional brain regions were bilateral frontal and parieto-temporal associative cortices. Despite the metabolic impairment, external stimulation still induced a significant neuronal activation (i.e., change in blood flow) in vegetative patients as shown by both auditory click stimuli and noxious somatosensory stimuli. However, this activation was limited to primary cortices and dissociated from higher-order associative cortices, thought to be necessary for conscious perception. Finally, we demonstrated that vegetative patients have impaired functional connections between distant cortical areas and between the thalami and the cortex and, more importantly, that recovery of consciousness is paralleled by a restoration of this cortico-thalamo-cortical interaction.