天麻素联合丁咯地尔注射液治疗椎-基底动脉供血不足性眩晕的临床观察

目的观察天麻素联合丁咯地尔治疗椎-基底动脉供血不足(IBV)的临床疗效。方法治疗组50例采用天麻素联合丁咯地尔注射液治疗,对照组50例采用天麻素联合舒血宁注射液治疗,治疗7 d后观察两组的临床疗效、血流动力学及脑血流速度的变化。结果治疗组总有效率92%,对照组总有效率76%。两组治疗后症状、血流动力学变化、脑血流速度均有改善,但治疗组的疗效、血流动力学、脑血流速度改善更为明显,两组相比差异有统计学意义(P<0.05)。结论天麻素联合丁咯地尔治疗IBV能更好的扩张脑血管,增加脑血流量,降低血液黏稠度,改善椎-基底动脉供血不足及临床症状。     

丹参川芎嗪注射液联合双氯芬酸纳治疗急性痛风性关节炎疗效及安全性研究

目的探讨丹参川芎嗪注射液联合双氯芬酸纳治疗急性痛风性关节炎的临床疗效与安全性。方法选择2014年9月至2016年5月就诊的急性痛风性关节炎患者30例,给予丹参川芎嗪注射液联合双氯芬酸纳治疗:丹参川芎嗪注射液10 ml与0.9%氯化钠溶液250 ml静脉滴注,1次/d;双氯芬酸纳75 mg口服,2次/d。治疗3 d后评价其疗效。结果本组患者30例,痊愈60.0%(18/30),显效26.7%(8/30),有效13.3%(4/30),无效0例,总有效率100.0%。治疗后,患者关节疼痛与肿胀评分较治疗前明显改善,差异有统计学意义(P<0.05)。所有患者均未出现明显不良反应。结论丹参川芎嗪联合双氯芬酸纳治疗急性痛风性关节炎疗效显著,且起效快、不良反应少。     

盐酸川芎嗪治疗椎基底动脉供血不足的疗效观察

目的:观察盐酸川芎嗪注射液治疗椎基底动脉供血不足的临床疗效和对脑血流的影响。方法:将120例椎基底动脉供血不足的患者随机分为治疗组60例和对照组60例,治疗组在综合治疗的基础上应用盐酸川芎嗪注射液120ml+5%葡萄糖注射液250ml静脉滴注,每日1次,对照组应用复方丹参注射液20ml+5%葡萄糖注射液250ml静脉滴注,每日1次,(糖尿病患者用生理盐水),14d为一个疗程。结果:治疗组总有效率95.1%,对照组总有效率75%,两组比较差异有统计学意义(P<0.05)。结论:盐酸川芎嗪注射液治疗椎基底动脉供血不足的疗效明显优于复方丹参注射液,且无严重不良反应,是一种疗效满意,且又安全的药物,值得临床推广应用。     

丹参川芎嗪注射液对股骨骨折保守治疗患者凝血功能及D-二聚体的影响

目的观察丹参川芎嗪对股骨骨折保守治疗患者凝血功能及D-二聚体的影响,初步探讨丹参川芎嗪预防深静脉血栓的作用机制。方法将52例符合纳入标准患者随机分为对照组和治疗组各26例,两组均给予常规基础治疗,治疗组从受伤第1天开始使用丹参川芎嗪注射液静脉滴注,第14天结束;同时,应用低分子肝素钙皮下注射。对照组仅应用低分子肝素钙皮下注射。观察两组患者凝血功能及D-二聚体的变化。结果治疗组患者血浆凝血酶原时间、血浆活化部分凝血活酶时间、纤维蛋白以及D-二聚体较治疗前有明显改善,差异有统计学意义(P<0.05)。治疗组治疗后在凝血功能指标改善方面,与对照组比较,差异无统计学意义(P>0.05),但D-二聚体下降明显,差异有统计学意义(P<0.05)。结论丹参川芎嗪注射液可改善股骨骨折保守治疗患者的血液高凝状态,具有抗血栓和降低D-二聚体作用,可能为丹参川芎嗪注射液预防股骨骨折保守治疗深静脉血栓作用机制之一。     

马来酸桂哌齐特联合丹参川芎嗪注射液治疗脑梗死的疗效

 目的 通过观察治疗前后患者血清中白介素-18、可溶性细胞间黏附分子-1、胰岛素样生长因子-1的变化,探讨马来酸桂哌齐特(克林澳)联合丹参川芎嗪注射液治疗脑梗死患者的疗效。方法 选择2015-09至2018-12在医院诊治的脑梗死患者135例,根据治疗方法不同分为对照组(n=65)与联合组(n=70)。对照组给予克林澳治疗,联合组在对照组治疗的基础上联合丹参川芎嗪注射液治疗,两组均治疗观察3个月,记录与检测患者血清IL-18、sICAM-1、IGF-1的变化。结果 所有患者均顺利完成治疗,治疗期间无严重不良反应发生。联合组的总有效率97.1%,高于对照组的86.2%(P＜0.05)。两组治疗后的MoCA评分、颅脑椎动脉与基底动脉血流速度都高于治疗前,联合组评分为(27.38±1.49)分,高于对照组的(22.88±2.69)分。两组治疗后的血清IL-18、sICAM-1、IGF-1水平均低于治疗前,联合组也低于对照组(P＜0.05)。结论 克林澳联合丹参川芎嗪注射液治疗脑梗死能抑制血清IL-18、sICAM-1、IGF-1的表达,改善脑血流状况,提高患者的认知功能与总体治疗效果。     

丹参注射液联合米非司酮治疗子宫肌瘤的临床效果

目的 探讨丹参注射液联合米非司酮治疗子宫肌瘤的临床价值.方法 将2012年2月～2020年9月收治子宫肌瘤患者120例,根据治疗方法将其分为两组,对照组采用米非司酮片治疗;在此基础上观察组联合采用丹参注射液静脉注射,比较治疗前后两组患者月经情况及疗效.结果 观察组患者治疗总有效率高于对照组(P＜0.05).治疗后观察组胰岛素样生长因子结合蛋白-3和半胱氨酸蛋白酶-3显着高于对照组,子宫肌瘤体积和子宫体积明显低于对照组,月经量和月经周期优于对照组(P＜0.05).结论 丹参注射液联合米非司酮能缩减肌瘤体积,改善子宫肌瘤患者临床症状和月经情况.     

多巴胺、酚妥拉明、川芎嗪联合治疗肺原性心脏病心力衰竭40例临床观察

目的：观察多巴胺、酚妥拉明、川芎嗪注射液联合治疗肺心病心衰的临床疗效。方法：将患者70例随机分为治疗组（40例）与对照组（30例）,两组均采用抗感染、解痉平喘、强心利尿等常规处理,治疗组予川芎嗪联合参麦注射液静滴。结果：治疗组症状缓解及心功能改善程度均优于对照组。结论：多巴胺、酚妥拉明、川芎嗪注射液联合治疗对肺心病心衰有良好的治疗作用。     

血栓通注射液治疗短暂性脑缺血发作的疗效观察

目的:观察血栓通注射液治疗短暂性脑缺血发作(TIA)的临床疗效.方法:将92例确诊为TIA的患者随机分为治疗组和对照组,每组46例,两组均给予常规治疗,治疗组在此基础上加用血栓通注射液静滴,对照组加用复方丹参注射液静滴,均连用2周为一疗程.结果:治疗组的总有效率为84.78%,显著高于对照组的60.87%(P<0.01).在治疗后,两组血液流变学各项指标均较治疗前显著改善(P<0.05),但治疗组较对照组改善更明显(P<0.05).结论:血栓通注射液能有效改善TIA患者临床症状和血液流变学指标,值得临床推广应用.     

慢性乙型肝炎重用丹参注射液对血液流变性和凝血功能的影响

目的　观察慢性乙型肝炎患者重用丹参注射液治疗对血液流变性和凝血功能的影响。方法　将 254例慢性乙型肝炎患者随机分为治疗组 133例重用丹参静滴,对照组 121例常规中药煎剂口服,同时设健康人组 108例。观察治疗前后各组的血液流变性及凝血功能指标的变化。结果　治疗组重用丹参注射液治疗后,血液流变性和凝血功能指标均较治疗前有显著差异 (P<0. 05 ),并且接近健康人组;对照组治疗后各项指标均无明显改善 (P>0. 05 )。结论　血液流变性和凝血指标的改变可为临床慢性乙型肝炎患者重用丹参注射液治疗后的疗效判断提供有力依据。     

银杏叶注射液治疗急性脑梗死46例临床观察

目的　观察银杏叶注射液治疗急性脑梗死的临床疗效。方法　 88例急性脑梗死患者随机分为银杏叶组 ( 4 6例 )和对照组 ( 4 2例 ) ,分别给予银杏叶注射液静滴和复方丹参静滴。治疗前后均对患者进行神经功能缺损评价及血液流变学的监测。结果　银杏叶组在临床神经功能缺损及血液流变学均较对照组明显改善 ,银杏叶组总有效率达 84.78%,对照组总有效率 61.90 %,两者差异显著 (P <0 .0 5 )。结论　银杏叶注射液是治疗急性脑梗死的安全、有效药物。     

Dealing with cancer--conversations with radiotherapy patients

Thirty in-patients treated by radiotherapy were questioned in qualitative interviews about the information they had received from the physicians and their way to deal with the disease and the physicians. Furthermore 18 persons out of this group were accompanied continuously. The confidential relationships between the patients and the author of the study brought about spontaneous conversations showing some new aspects of the way to experience disease and therapy. Despite a poor prognosis and an initially insufficient information, the patients formulated their questions openly. Generally they desired a clearer communication. They criticized above all the lack of information and attention from the physicians. A need for confidence, frankness, and the conveyance of a justified hope was expressed. The physician's stress and resulting lack of time was complained of. During the time of accompanying which lasted several weeks, it became evident that information means a way to deal with the disease to which the patient can make his individual contribution. The majority of questions as well as emotional reactions as fear or depression came from those patients who seemed to be quiet persons.     

Radiochemotherapy with temozolomide for patients with glioblastoma

Background

The objective of this retrospective analysis was to assess long-term outcome and prognostic factors of unselected patients treated for glioblastoma (GB) at a single center with surgery, standard radiotherapy (RT), and concomitant temozolomide (TMZ). From 1999?C2005, the institutional protocol included surgery and RT with TMZ. From 2005 on, adjuvant TMZ was routinely added.

Patients and Methods

Between April 1999 and September 2009, 181 patients with GB were treated with RT (60 Gy in 30 fractions) and concomitant TMZ (75 mg/m²/day throughout RT). Biopsy only had been performed in 53 patients (29.3%), 128 patients (70.7%) had undergone resection, which was complete based on postoperative MRI in 51 patients (28.2%). Adjuvant TMZ was applied in 67 of 181 patients (37%).

Results

Median overall survival (OS) and progression-free survival (PFS) were 15.0 (95% CI, 13.1?C16.8) and 7.2 months (95% CI, 5.9?C8.5), respectively. After complete resection, partial/subtotal resection and biopsy, median OS was 23.20, 14.75, and 7.89 months (p < 0.001), respectively. In multivariate Cox proportional hazards regression models, extent of resection (p < 0.0001), Karnofsky??s performance score (p < 0.0001) and adjuvant TMZ (p = 0.001) were significant independent prognostic factors for OS. RT with concomitant TMZ was well tolerated in the majority of patients and could be completed as scheduled in 146 patients (80.7%), while 11 patients (6.1%) discontinued RT. Another 35 patients (19.3%) interrupted concomitant chemotherapy.

Conclusion

RT with concomitant TMZ is a feasible regimen with acceptable toxicity in routine practice. Our data are compatible with a beneficial effect of adjuvant TMZ on OS and PFS.     

湿润烧伤膏与手术联合治疗褥疮的护理

目的 :减少溃疡期褥疮的术前准备时间 ,缩短褥疮的总病程。方法 :将 1996年 5月至 2 0 0 2年 5月收住院的 4 2例溃疡期褥疮病人按随机原则分为 2组 ,2 1例术前用湿润烧伤膏纱换药处理 ,为A组 (试验组 ) ;2 1例用庆大霉素紫草油纱布换药处理 ,为B组 (对照组 )。 2组病例的年龄、性别、发病原因、病灶部位、病灶范围等经统计学处理 ,无显著性差别 ,有可比性。两组病人均换药至创面新鲜行皮瓣转移手术 ;比较两组平均术前换药时间 ,及换药 +手术的总住院日。术前术后两组患者均运用护理程序施行整体护理。结果 :A组术前平均换药时间为 8 4 9± 2 2 3天 ,B组为 15 6 0± 6 70天 ;A组平均治愈时间为 2 0 5 0± 4 81天 ,B组为 35 31± 7 70天。结论 :湿润烧伤膏换药与庆大霉素紫草油纱布换药比较 ,前者可明显缩短褥疮手术的术前准备时间及病人的总住院天数。     

Bronchogenic carcinoma: staging with MR compared with staging with CT and surgery

Thirty-three patients suspected of having bronchogenic carcinoma were studied prospectively using magnetic resonance (MR). In this group, 30 underwent examination with computed tomography (CT), 15 underwent thoracotomy, six had mediastinal biopsy procedures performed, and eight underwent bronchoscopy. MR studies, which included transaxial spin-echo imaging (TR, 0.5 and 2.0 sec; TE, 28 and 56 msec) of all patients and sagittal or coronal imaging of 18, were performed without knowledge of CT findings, using only plain radiographs as a guide. CT and MR studies were interpreted separately. CT and MR provided comparable information regarding the presence and size of mediastinal lymph nodes. MR better discriminated mediastinal nodes from vascular structures. However, in two of 11 patients who had multiple mediastinal lymph nodes that were normal in size at CT examination and surgery, MR suggested a confluent abnormal mass, probably because of its poorer spatial resolution. MR was superior to CT in showing enlarged hilar lymph nodes, but CT was better for demonstrating bronchial abnormalities. In three of four patients who had a proved hilar mass with distal obstructive pneumonia, MR (TR, 2.0 sec) helped distinguish between the mass and collapsed lung.     

臭氧治疗船员下肢损伤89例

2006年10月至2007年4月,我科采用引进的德国赫尔曼Medozon型臭氧发生装置系统产生的臭氧治疗船员下肢损伤89例,疗效满意.现报告如下.     

Tumor Burden Assessment with Positron Emission Tomography with

Objective: In patients with advanced cancer, total tumor burden affects the likelihood of tumor response and has important implications for prognosis. The aim of this study was to select the optimum 2-[F-18]fluoro-2-deoxy-D-glucose-positron emission tomography (FDG PET) tumor uptake parameter to accurately measure tumor burden in advanced metastatic renal cell cancer, in comparison with volumes measured with computed tomography (CT), as a reference test.Materials and Methods: Six patients with metastatic renal cell carcinoma measurable on CT were studied. CT and FDG PET scans were carried out on all patients within 4 weeks prior to their entry into a phase I-II radioimmunotherapy trial. CT-based evaluation of disease extent (tumor volume) and 4 PET-based measurements (standardized uptake value[SUVmax], SUVav, volume, and total lesion glycolysis [TLG]) were performed independently by a radiologist (VN) and a nuclear medicine physician (TA). The degree of correlation between conventional (CT) extent of disease and parameters describing tumor concentration of FDG was then determined.Results: Fifty-seven CT-measurable metastatic lesions in lung, abdomen, and scalp were evaluated in 6 patients. There was a high correlation between CT and FDG PET volume estimates for lesions greater than 5 cm(3) in size. However, a PET-derived parameter that embodies both FDG uptake and lesion size, the TLG, correlated better with CT-derived tumor volume than did FDG PET volume alone.Conclusion: Using CT volume as a gold standard, the optimal PET-based estimate of total tumor burden in patients with metastatic renal cancer is the sum over all lesions of the total lesion glycolysis.     

MEBO药纱门诊治疗烧(烫)伤71例的体会

作者报道用MEBO药纱敷盖门诊治疗烧（烫）伤71例，均获治愈。经随访1年，深Ⅱ度创面疤痕发生率为15％（3／20），浅Ⅲ度创面疤痕发生率为38．9％（7／18）。     

多虑平、雷尼替丁治疗消化性溃疡81例临床观察

1995年 1月～ 1 998年 2月 ,我们采用多虑平、雷尼替丁治疗消化性溃疡 (ＰＵ) ,并与雷尼替丁为对照组进行治疗观察 ,疗效满意 ,现总结报告如下。1　临床资料1 1　一般资料　本组 81例ＰＵ均因上腹痛、返酸、腹胀及食欲不振等症状 ,经胃镜诊断为溃疡活动期患者。病程 2个月～ 5ａ,平均 1 7ａ。伴有焦虑、抑郁及夜眠欠佳等症者59例。随机分为 2组 :治疗组 4 1例 ,男 3 8例 ,女 3例 ;年龄 1 8～ 3 6岁 ,平均 2 4岁。其中胃溃疡 1 1例 ,十二指肠球部溃疡 3 0例。对照组 4 0例 ,男 3 7例 ,女 3例 ;年龄 1 9～ 3 5岁 ,平均 2 4 5岁 ;胃溃疡 1 2…