38例急性血源性骨髓炎临床治疗体会

目的总结急性血源性骨髓炎的临床治疗经验。方法对38例急性血源性骨髓炎早期即采用大剂量青霉素或第Ⅱ代头孢菌素,待细菌培养结果酌情调整抗生素。同时给予间歇输血浆、退热等支持对症处理。结果本组治愈33例（86.84%）,好转4例（10.53%）,1例（2.63%）转为慢性骨髓炎。结论急性血源性骨髓炎起病急,临床早期诊断,及时治疗,尽快控制感染,是改善其预后的关键。     

灌洗引流在治疗儿童急性血源性骨髓炎中的应用分析

目的:探讨持续灌洗引流在治疗儿童急性血源性骨髓炎中的应用价值。方法:对持续灌洗引流治疗的26例急性血源性骨髓炎患儿的临床资料进行回顾性分析。结果:26例痊愈出院。无转为慢性骨髓炎病例和死亡病例。随访0.5~4年无复发。结论:持续灌洗引流治疗儿童急性血源性骨髓炎可获得满意疗效。     

新型灌洗泵用于急性血源性骨髓炎的疗效分析

目的 探讨新型灌洗泵在急性血源性骨髓炎治疗中的应用效果.方法 将40例急性血源性骨髓炎患者分为对照组及观察组,每组20例.对照组采用传统灌洗引流,观察组应用自制灌洗泵灌洗引流,比较两组患者的临床治疗效果及其治愈时间.结果 观察组患者治疗总有效率为100.00％,明显高于对照组(80.00％),两组比较差异有统计学意义(P＜0.05);观察组治愈时间为(10.13±8.03)d,明显短于对照组(18.14±5.43)d,两组比较差异有统计学意义(P＜0.05).结论 新型灌洗泵用于治疗急性血源性骨髓炎比传统灌洗负压引流疗效更确切.     

妇康口服液治疗慢性盆腔炎的临床疗效观察附:120例病例报告

目的探讨妇康口服液对盆腔炎的有效性及安全性.方法随机对照分组.试验组124例(急性盆腔炎34例,慢性盆腔炎90例),予妇康口服液10ml tid,疗程分别为2周和4周;对照组64例(急性34例,慢性30例),分别予青霉素、庆大霉素、甲硝唑 iv,每日1次,金鸡冲剂 1包 tid ,疗程同治疗组.观察指标包括疗效性指标及安全性指标.结果妇康口服液治疗急性盆腔炎显效率88.24%,与对照组比较疗效相似(P＞0.05);治疗慢性盆腔炎显效率73.33%,对照组46.67%,两组比较差异有统计学意义(P＜0.01).结论妇康口服液治疗盆腔炎疗效确切,对慢性盆腔炎的疗效优于对照组.治疗期间,该药未发现不良反应,说明该药使用安全.     

急性血源性骨髓炎30例临床分析

目的:探讨急性血源性骨髓炎治疗方法及其临床效果。方法:选择30例急性血源性骨髓炎患者作为观察组,给予改良手术进行治疗,以同期收治的30例患者作为对照组,给予传统手术进行治疗,观察对比两组患者临床治疗效果。结果:观察组患者总有效率明显高于对照组,差异有统计学意义(P<0.05)。结论:给予急性血源性骨髓炎患者改良手术进行治疗,能够有效提高手术治疗效果,帮助患者尽快恢复健康。     

穴位自血与肌注自血疗法应用于慢性荨麻疹的临床疗效比较

目的观察穴位自血与臀部肌肉自血疗法同时联合复方甘草酸苷片、地氯雷他定片治疗慢性荨麻疹的临床疗效和安全性。方法将90例患者随机分为3组,治疗组穴位自血1次/周,共8周,联合口服复方甘草酸苷及地氯雷他定,共4周;对照1组臀部肌肉自血疗法,1次/周,共8周,联合口服复方甘草酸苷及地氯雷他定,共4周;对照2组口服复方甘草酸苷及地氯雷他定,共4周。于疗程4周后及8周结束时、停止治疗3月后分别评价疗效。结果治疗4周后,治疗组与对照1、2组有效率差异无统计学意义(P0.05);治疗8周后,治疗组与对照1组有效率差异无统计学意义(P0.05),与对照2组有统计学意义(P0.05);停药3个月后,治疗组与2个对照组有效率差异均有统计学意义(P0.05);各组均未见明显副作用。结论穴位自血疗法联合复方甘草酸苷、地氯雷他定治疗慢性荨麻疹安全有效。     

青霉素联合复方氨泰素片治疗急性点滴型银屑病临床观察

目的 观察青霉素和复方氨泰素片联合治疗急性点滴型银屑病的疗效.方法 治疗组给予注射用青霉素钠针20万/kg.分两次静滴.最大不超过800万/d,疗程两周:复方氨泰素片5粒3次/d口服,疗程一个月.对照组口服复方氨泰素片5粒3次/d,疗程一个月. 结果 两组有效率比较差异有显著性(P＜0.05). 结论 青霉素联合复方氨泰素片治疗急性点滴型银屑病有较好疗效.     

中药清肺饮颗粒联合氯洁霉素凝胶治疗寻常痤疮临床研究

目的 评价清肺饮颗粒联合氯洁霉素凝胶治疗寻常痤疮的有效性、安全性及复发率.方法将195例患者随机分成3组,治疗组给予清肺饮颗粒内服和氯洁霉素凝胶外用;两组对照组分别给予氯洁霉素凝胶外用和清肺饮颗粒内服,3组疗程均为2周,疗程结束后按疗效标准判定疗效.结果 治疗2周后,治疗组有效率90.77%,复发率16.95%;对照Ⅰ组有效率67.69%,复发率52.27%;对照Ⅱ组有效率55.38%,复发率36.11%.结论中药清肺饮颗粒联合氯洁霉素凝胶治疗寻常痤疮效果明显,复发率低,病人依从性好,值得临床推广使用.     

雾化吸入青霉素治疗扁桃体炎的疗效观察及护理

目的:应用超声雾化器分别吸入两种抗菌素(青霉素、庆大霉素,加等量地塞米松),减轻呼吸道黏膜水肿,控制呼吸道感染,消除扁桃体炎性反应。观察两种药物治疗效果,并采取恰当的护理措施。方法:随机抽取同等数量的病例分为两组进行吸入观察比较,一组为青霉素组,一组为庆大霉素组。结果:使用青霉素组疗效明显高于庆大霉素组。结论:超声雾化吸入青霉素加地塞米松治疗扁桃体炎疗效好,值得推广。     

小儿急性血源性骨髓炎早期診断及治疗(附40例分析)

急性血源性骨髓炎,在小儿最常见。由于抗菌素的广泛应用,近年来产生耐药菌株较多,特別是金黄色葡萄球菌为甚。临床病象及发病过程也较复杂,X线照片上也有异常表现。因此,早期确诊有一定的困难,往往延误治疗。早期诊断与早期治疗,对本病的预后极重要,所以这不能不引起我们的重视。兹对我院小儿急性血源性骨髓炎40例,予以分析和讨论。     

APPLICATION OF LORNOXICAM TO PATIENT-CONTROLLED ANALGESIA IN PATIENTS UNDERGOING ABDOMINAL SURGERIES

FOR anesthesiologis s ,treatingpostoperativepainhas alwaysbeen a problem.Althoughopioidshave been provedtobe effective,theirsideeffectscouldnotbeignored.With thedevelopmentofscienceand pharmacology,many drugs with aspectsof satisfactoryanalgesicefficacyand couldbe welltoleratedby patientshave been developed.And lornoxicamisone of them, which isa non-steroidalanti-inflammatorydrug (NSAID ), with analgesic, anti-infl-ammatory,andantipyreticproperties.Itseliminationhalf-time(3 to 5 hours) isle…     

Value of D-Dimers in patients with acute aortic dissection

Objective: To evaluatel the value of D-dimers in patients with acute aortic dissection (AAD). Methods: This study consisted of 16 patients with AAD and 27 non-AAD patients. Serum D-dimets were measured by Sta-Liatest D-DI immunoturbidimetric assay. Results: D-dimer level was higher (P ＜ 0.001) in patients with AAD(7.91 ± 5.52 μg/ml) than that in non- AAD group(1.57±1.24 μg/ml). D-dimer was positive (＞0.4 μg/ml) in all patients with AAD and in 10 control group patients (37%). Among patients with acute AAD, D-dimers tended to be higher in Stanford A than in Stanford B (8.67 ± 4.31 μg/ml vs. 3.24±1.27 μg/ml, P ＜0.01). D-dimer values tended to be higher in more extended disease(3.84 ± 1.65 μg/ml, 8.57 ± 3.58 μg/ml and 11.87 ± 5.69 μg/ml in thoracic aorta, thoracic and abdominal aorta, thoracic and abdominal aorta and iliacal arteries, respectively, P ＜ 0.05 for both 8.57 ± 3.58 and 11.87 ± 5.69 vs. 3.84 ± 1.65 ). Including the control group into the analysis, we found a sensitivity of 100%, a negative predictive value of 100%, and a specificity of 66% and a positive predictive value of 64% for D-dimer in diagnosis of AAD in our patients with suspected AAD. Conclusion: D-dimer was elevated in patients with AAD. A negative D-dimer test result could be useful in excluding AAD.     

Research of combined liver-kidney transplantation model in rats

Objective： To set up a simple and reliable rat model of combined liver-kidney transplantation. Methods： SD rats served as both donors and recipients. 4℃ sodium lactate Ringer＇s was infused from portal veins to donated livers,and from abdominal aorta to donated kidneys, respectively. Anastomosis of the portal vein and the inferior vena cava （IVC） inferior to the right kidney between the graft and the recipient was performed by a double cuff method, then the superior hepatic vena cava with suture. A patch of donated renal artery was anastomosed to the recipient abdominal aorta. The urethra and bile duct were reconstructed with a simple inside bracket. Results： Among 65 cases of combined liver-kidney transplantation, the success rate in the late 40 cases was 77.5%. The function of the grafted liver and kidney remained normal. Conclusion： This rat model of combined liver-kidney transplantation can be established in common laboratory conditions with high success rate and meet the needs of renal transplantation experiment.     

BLOOD PRESSURE CHANGE WITH AGE IN SALT-SENSITIVE TEENAGERS

Objective To observe blood pressure change with age in salt-sensitive teenagers whose salt sensitivity were determined by repeated testing.Methods Salt sensitivity was determined through intravenous infusion of normal saline combined with volume-depletion by oral diuretic furosemide in 55 teenagers. After five years, salt sensitivity was re-examined and subject blood pressure was followed up. Blood pressure changes in salt-sensitive teenagers were compared to that of non-salt sensitive teenagers over five years.Results After 5 years, the repetition rate of salt sensitivity determined by intravenous saline loading is 92.7%. In teenagers with salt sensitivity on the baseline, both the systolic blood pressure increments and increment rates were much higher than non-salt sensitive teenagers (12.7±12.1 mmHg vs. 2.8±5.2 mmHg, P＜ 0.01; 12.2%± 12.0% vs. 2.5% ±4.4%, P＜ 0.001,respectively). There was a similar trend for diastolic blood pressure (8.4 ± 6.4 mmHg vs. 3.7 ± 6.4 mmHg, P = 0.052; 13.2% ±10.6 % vs. 6.8%± 10.1%, P = 0.053, respectively).Conclusions Salt sensitivity determined by intravenous saline loading showed good reproducibility. Blood pressure increments with age were much higher in salt-sensitive teenagers than non-salt sensitive teenagers, especially in terms of systolic blood pressure.     

Acupuncture Combined with Spinal Tui Na for Treatment of Primary Dysmenorrhea in 30 Cases

Objective: To observe the therapeutic effects in acupunture treatment of primary dysmenorrhea combined with spinal Tui Na, and study its mechanism. Methods: Thirty cases of the treatment group were treated by acupuncture combined with spinal Tui Na, and thirty cases in the control group were treated by routine acupuncture. Results: The total effective rate was 93.3% in the treatment group, and 73.3% in the control group, with a significant difference between the two groups (P<0.05). Conclusions: Acupuncture combined with spinal Tui Na has good prospects for treatment of primary dysmenorrhea.     

Luo Lingjie's Experience in Treating Chronic Nephropathy

In treating chronic nephropathy,Luo Lingjie,a chief physician,pays attention to regulating the balance between yin and yang,treating infection if present,and removing pathogenic factors.He prescribes gentle drugs and uses carefully strongly warming-tonifying ones,emphasizes the importance of persuading the patient to persist in treatment with medication and nurse one's health for recuperation,and is good at combined use of TCM and western medicine therapy and brings the merits of various therapies into full play,with obvious theraoeutic effects.     

Dr.Zhang Ren's Experience in the Acupuncture Treatment of Different Diseases with the Same Therapeutic Principle

Dr.Zhang Ren,the chief physician,is the chairman of Shanghai Acupuncture and Moxibustion Association.Having been engaged in medicine for about 40 years,he is experienced in treating various intractable diseases.In his long years of clinical practice,he advocates taking the TCM differentiation as the basis to seek for the acupuncture method for treatment of modern intractable diseases.The author of this essay had the fortune to follow Dr.Zhang in study.The following is a summary of Dr.Zhang's experience in the acupuncture treatment for different intractable diseases with the same therapeutic principle.     

安心颗粒对急诊经皮冠状动脉介入术后生活质量影响的研究

目的：评价使用安心颗粒对急诊经皮冠状动脉介入术（PPCI）术后生活质量的影响.方法：将160例接受PPCI的急性ST段抬高型心肌梗死患者随机分为安心颗粒组（术前顿服安心颗粒8.8g,术后安心颗粒4.4 g/次,每日2次）和对照组（仅接受基础药物治疗）.所有患者均服用阿司匹林、氯吡格雷和阿托伐他汀.分别在入院时、出院前1d、出院后180 d时,应用心肌梗死多维度量表（MIDAS）、中文版SF-36评价量表对患者生活质量评分.并观察术后30 d以内的出血并发症、血小板减少症发生情况.结果：入院时和出院前1d,两组患者的心肌梗死MIDAS、SF-36量表评分比较无差异（P＞0.05）;出院后180 d时,与对照组比较,安心颗粒组MIDAS、SF-36评分明显减低（P＜0.05）;组内与入院时比较,两组出院前1d、出院后180 d时,MIDAS、SF-36评分均降低（P＜0.05）.两组患者在随访期间均无大量出血、少量出血、重度和极重度血小板减少症发生,安心颗粒组有4例、对照组有7例发生不明显出血（P＞0.05）.两组发生轻度血小板减少症的患者数比较无差异（P＞0.05）.结论：PPCI使用安心颗粒,能改善急性ST段抬高型心肌梗死患者的生活质量,且不增加出血风险.     

猪肺磷脂注射液联合经鼻持续气道正压通气对呼吸衰竭早产儿的临床疗效及肌酸激酶同工酶活性的影响

目的 探讨猪肺磷脂注射液联合经鼻持续气道正压通气(NCPAP)对呼吸衰竭早产儿的临床疗效及肌酸激酶同工酶活性(CK-MB)的影响.方法 选取呼吸衰竭早产儿80例,分为观察组和对照组各40例.对照组采用NCPAP给氧治疗,观察组给予NCPAP给氧联合猪肺磷脂气管内给药.观察两组患儿治疗前及治疗12h、24 h后PaO2、PaCO2、血氧饱和度(SaO2)、pH的变化情况,检测治疗前及治疗5d后血清CK-MB水平;评估两组患儿的临床治疗效果.结果 两组患儿PaO2、PaCO2、SaO2、pH比较,差异均有统计学意义(P＜0.05),其中观察组治疗后的PaO2、SaO2、pH均高于对照组,PaCO2则低于对照组.两组的PaO2、SaO2、pH均随观察时间延长而升高(P＜0.05),PaCO2均随观察时间的延长而降低(P＜0.05).观察组治疗有效率为87.5％,显著高于对照组的70.0％ (P ＜0.05).治疗5d后两组患儿血清CK-MB水平均较前降低(P＜0.05),且观察组明显低于对照组(P＜0.05).结论 猪肺磷脂注射液气管内给药联合NCPAP可以显著降低呼吸衰竭早产儿CK-MB的含量,提高治疗有效率,起到很好的呼吸循环支持作用.