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1.
Four clinical trials of porcine islet transplantation have been reported, and there are verbal reports that clinical trials on much larger scales are continuing in centers in China and Russia. The four reported trials are briefly reviewed and, in the light of the present status of experimental islet xenotransplantation, consideration is given to whether such trials are currently justified. The Ethics Committee of the International Xenotransplantation Association has (1) emphasized the need for encouraging studies in non-human primates before clinical trials should be undertaken, (2) mandatory monitoring for the transfer of porcine microorganisms, and (3) careful regulation and oversight by recognized bodies. Other aspects of the topic, such as the need for informed consent, are briefly discussed. We conclude that, at the present time, more data documenting convincing efficacy, focused on clinically applicable immunosuppressive regimens, are needed to justify the initiation of closely monitored clinical trials. A clinical trial may then be justified even though the potential risk to the patients, and possibly for society, will not be zero. 相似文献
2.
In this study we consider the process of the clinical encounter, and present exemplars of how assumptions of both clinicians and their patients can shift or transform in the course of a diagnostic interview. We examine the process as it is recalled, and further elaborated, in post-diagnostic interviews as part of a collaborative inquiry during reflections with clinicians and patients in the northeastern United States. Rather than treating assumptions by patients and providers as a fixed attribute of an individual, we treat them as occurring between people within a particular social context, the diagnostic interview. We explore the diagnostic interview as a landscape in which assumptions occur (and can shift), navigate the features of this landscape, and suggest that our examination can best be achieved by the systematic comparison of views of the multiple actors in an experience-near manner. We describe what might be gained by this shift in assumptions and how it can make visible what is at stake for clinician and patient in their local moral worlds—for patients, acknowledgment of social suffering, for clinicians how assumptions are a barrier to engagement with minority patients. It is crucial for clinicians to develop this capacity for reflection when navigating the interactions with patients from different cultures, to recognize and transform assumptions, to notice ‘surprises’, and to elicit what really matters to patients in their care. 相似文献
3.
目的:探讨子宫内膜萎缩疗法治疗青春期功血(DUB)的止血效果。方法:将362例平均分为观察组(采用炔诺酮、戊酸雌二醇联合疗法止血)和对照组(单用炔诺酮子宫内膜萎缩疗法止血),两组各181例,比较两组的止血效果。结果:观察组和对照组止血有效率分别为96.13%(174/181)和92.27%(167/181),两组比较差异无统计学意义(踟105);观察组和对照组控制出血时间分别为(28.69±14.87)h和(29.72±15.34)h,两组比较差异无统计学意义(踟.05)。观察组和对照组的完全止血时间分别为(32.80±19.10)h和(47.30±18.60)h,两组比较差异有统计学意义(/9〈0.05)。观察组和对照组的住院天数平均为(6.10±2.80)d和(6.9±2.60)d,观察组住院时间短于对照组(P〈0.01)。结论:炔诺酮止血疗法和炔诺酮、戊酸雌二醇联合疗法治疗青春期功血效果均较好,但炔诺酮、戊酸雌二醇联合疗法治疗效果更佳。 相似文献
4.
Summary UK health policy requires child and adolescent mental health service providers to demonstrate that their services are effective.
The FOCUS project has been developed to improve the availability and accessibility of research evidence and innovation, to
support purchasers in the effective commissioning of services and to help providers base service provision on evidence of
effectiveness and develop methods of evaluation. 相似文献
5.
目的探讨心力衰竭并发心律失常的发病规律及治疗方法。方法回顾性分析了93例慢性心力衰竭病人的临床资料,包括临床特点、诊断治疗方法以及预后。结果心律失常发生率为60.2%,以室性早搏发生率最高32.1%,其次是房性早搏26.8%,心房纤颤21.4%,其他19.7%,经治疗有效71例,总有效率76.3%。结论纠正心功能不全是治疗的关键,应根据具体情况选择性地应用抗心律失常药。 相似文献
6.
目的 :探讨单纯疱疹性角膜炎是中西医联合用药的治疗方法。方法 :本组 10 0例 ( 10 6只眼 )单纯疱疹性角膜炎患者应用抗病毒药物联合清热解毒中药的疗效观察。结果 :本组病例治疗后总有效率 82 .0 8%。结论 :中西医联合治疗措施是我们对单纯疱疹性角膜炎治疗的一项新的探讨。 相似文献
7.
P. Bertram K. -H. Treutner G. Winkeltau H. -J. Booß G. Staatz Prof. Dr. V. Schumpelick 《Langenbeck's archives of surgery / Deutsche Gesellschaft fur Chirurgie》1993,378(4):249-254
Zusammenfassung Die Pneumatosis cystoides intestinii (PCI), das Auftreten submuköser oder subseröser, gasgefüllter Zysten in der Wand des Gastrointestinaltrakts, tritt als seltene Erkrankung ohne eindeutige Geschlechtspräferenz vorwiegend in der 3. bis 5. Lebensdekade auf. Atiopathogenetisch werden unterschiedliche Faktoren diskutiert, am wahrscheinlichsten ist eine bakterielle Ursache (Clostridium perfringens) in Verbindung mit einer minimalen Unterbrechung der Mukosaintegrität. Eine pathognomonische Symptomatik gibt es nicht, das klinische Bild reicht von asymptomatischen Zufallsbefunden bis zur Hämatochezie. Die Diagnose wird durch den Nachweis der Gaseinschlüsse mittels Abdomenübersichtsaufnahme und Kolonkontrasteinlauf gestellt. Als Behandlungsmethoden für symptomatische Patienten stehen Sauerstofftherapie, Antibiotikagabe (Metronidazol) und in schweren Fällen die Resektion des betroffenen Darmabschnitts zur Verfügung.
Pneumatosis cystoides intestinalis (PCI), a condition involving submucosal or subserosal gas-containing cysts of the wall of the gastrointestinal tract, is a rare entity. It is mostly diagnosed between the third and fifth decades of life without a clear sexual predominance. Different aetiopathogenetic factors are under discussion, the most probable being a bacteriologic cause (Clostridium perfringens) in combination with minimal leaks in mucosal barrier. There are no pathognomonic symptoms; the clinical picture ranges from incidental findings to haematochezia. Diagnosis is based on plain abdominal film and X-ray following barium enema. Methods of treatment in symptomatic cases are oxygen and antibiotic (metronidazole) therapies and, in severe cases, resection of the diseased part of the intestine.相似文献
8.
环丙沙星与氧氟沙星注射液治疗细菌性感染的疗效观察 总被引:3,自引:0,他引:3
以乳酸环丙沙星(CPLX)注射液和氧氟沙星(OFLX)注射液随机分组治疗各种细菌性感染40例及42例,并以注射用头孢噻肟钠(CTX)治疗49例作对照。三组平均年龄、体重、疗程及病情程度相比无显著性差异,具可比性。病种分布以消化道感染最多,共81例,占总数的61.8%。三组131例病人细菌阳性率为94.7%。一疗程CPLX组、OFLX组、CTX组治愈率分别为87.2%、83.3%、71.4%,有效率 相似文献
9.
Clinical Evaluation of a New Type of Centrifugal Pump 总被引:2,自引:0,他引:2
J. Ninomiya T. Shoji S. Tanaka M. Ikeshita M. Ochi S. Yamauchi T. Yajima H. Yamauchi T. Sugimotox T. Aizawa 《Artificial organs》1994,18(9):702-705
Abstract: The major problems with existing centrifugal pumps are leakage, mechanical trauma, and thrombus formation. In consideration of these problems, a new compact centrifugal pump system was developed. The purpose of this study was to evaluate the new centrifugal pump system clinically. Ten patients underwent open heart surgery with a centrifugal pump or a roller pump. During surgery, hemodynamic and hematological data were obtained. A pulsatile assist device in the pump circuit was used in patients with severe heart disease. There was neither operative death nor hospital mortality, and there was no difference with regard to hemodynamic data between the two groups. The centrifugal pump group, however, had significantly lower hemolysis, especially during prolonged cardiopulmonary bypass. This centrifugal pump could also create sufficient pulsatile flow with a pulsatile assist device. Postoperative macroscopic and microscopic findings demonstrated the smooth surface of the pump without thrombus formation. This centrifugal pump system might be useful for prolonged cardiopulmonary bypass. 相似文献
10.
通瘀注射液盆腔给药法治疗外在型子宫内膜异位症的临床研究 总被引:2,自引:0,他引:2
目的 运用通瘀注射液在非直视下经输卵管盆腔给药对子宫内膜异位症 (EEMs)的治疗作用 ,探讨活血化瘀法对EEMs的作用机理及此给药法的优势。方法 将临床治疗的EEMs患者 60例随机分为治疗组 (通瘀注射液组 )和对照组 (丹那唑组 ) ,疗程各为 3个月。用药前后测定下列指标 :临床症状与体征、内分泌激素、血液流变学、癌抗原 12 5 (CA12 5)和子宫内膜抗体 (EMAb)的阳性率变化。结果 治疗组的临床症状与体征、血液粘滞度和红细胞压积、CA12 5和EMAb的阳性率均降低 ,卵泡刺激素 (FSH)、黄体生成素 (LH)、雌二醇 (E2 )和孕激素 (P)的含量均受到调节 ,与对照组相比 ,差异有显著性。而治疗组对内分泌的调节能力弱于对照组 ,但作用柔和、均衡。结论 通瘀注射液对EEMs的作用是通过清除月经时异位内膜的瘀血、水肿、改善微循环及组织供氧、调节免疫功能和内分泌紊乱而实现的 ,与丹那唑相比其副作用小、并以治本为主。盆腔给药法则可使药物直达病灶 ,见效快 相似文献