还原型谷胱甘肽联合甘草酸二铵对腹部开放伤后海水浸泡犬肝功能损伤的治疗作用

Objective To investigate effect of reduced glutathione and diammonium glycyrrhizinate on the treatment of hepatic damage in experimental dogs following open abdominal injuries coupled with seawater immersion. Methods Twenty-four dogs with open abdominal injuries were randomly divided into 3 groups: the control group (given with simple observation after 1.5 h seawater immersion); the routine treatment group (given routine care and fluid transfusion after 1.5 h seawater immersion) ; the hepatic treatment group (given routine are, fluid transfusion and hepatic treatment as well, after 1.5 h seawater immersion). Each group consisted of 8 dogs. Blood samples were taken at different time points to measure total bilirubin (TB), alanine aminotransferase (ALT), aspartate aminotransferase (AST), lactate dehydrogenase (LDH), prothromin time (PT), endotoxin, tumor necrosis factor-α(TNF-α), interleukin-6 (IL-6), and pathological examination was also made at the same time. Results For the control group, contents of TB, ALT, AST and LDH increased significantly and survival time was less than 24 hours. Contents of TB, ALT, AST and LDH of the routine treatment group also increased significantly, but survival time of all the experimental animals was mere than 24 hours. Reduced glutathione and diammonium glycyrrhizinate could reduce the extent of lesion quite significantly 12～24 hours following open abdominal injuries. Conclusions Reduced glutathione and diammonium glycyrrhizinate seemed to have good effects on the treatment and prevention against hepatic damage induced by trauma coupled with seawater immersion. It could be used as a primary means for the treatment of such kind of hepatic damage.     

1例感染布鲁杆菌患者骨髓中见戒指细胞的报道

布鲁氏菌病是由布鲁杆菌引起的一种人畜共患性传染病。其临床症状为长期发热、多汗、乏力、关节痛及肝脾肿大等,临床表现多样。本病所累及的组织器官广泛,其中以单核-吞噬细胞系统的病变最为显著。其症状与多种疾病相似,易发生误诊。目前对本病血液系统的变化,特别是骨髓象特点尚缺乏系统分析。现对一例布鲁杆菌病患者的血常规、骨髓象及误诊情况报告如下。     

他克莫司联合激素治疗18例狼疮性肾炎的疗效分析

选择2008年6月-2012年10在我院就诊的LN患者36例，随机分对照组和试验组各18例。对照组采用环磷酰胺联合强的松治疗，试验组采用他克莫司联合强的松治疗。结果对照组总有效率为50%，试验组总有效率为83%，试验组总有效率显著高于对照组（P〈0.05）。对照组治疗期间出现反复腹泻3例，白细胞下降2例，并发感染1例，血糖升高1例，SCr升高2例，累积9例次。试验组出现反复腹泻1例，血糖升高1例，并发感染1例，SCr升高1例，累积4例次，无白细胞下降患者出现。试验组不良反应累积例次显著低于对照组（P〈0.05）。他克莫司联合激素治疗LN效果显著，毒副作用较传统方法小，值得进一步深入研究。     

重症胰腺炎患者早期肠内营养后炎性介质IL-8及TNF-α改变与预后关系

目的 探讨早期肠内营养对血清炎症介质(IL-8及TNF-α)的影响以及重症胰腺炎患者预后的关系.方法 52例患者随机均分为肠内营养组(EEN组,n=25) 和肠外营养组(TPN组,n=27), 两组患者入院确诊后除营养支持不同外,给予同样的抗生素、抑酸及抑制胰腺外分泌等处理.治疗前1天 、治疗后7天和14天检测血清IL-8和TNF-α水平,同时,观察血淀粉酶、血白细胞及预后变化.结果 EEN组治疗后第7天及第14天血清IL-8 和TNF-α水平较对照组显著降低(P<0.01).同时,血淀粉酶及白细胞总数EEN组较TPN组降低明显(P<0.01),患者感染并发症及上消化道出血以EEN组为低,但两组死亡率差异无显著性.结论 重症胰腺炎患者早期进行肠内营养可明显降低血中炎性介质的量,改善患者的临床预后,其机制可能与肠内营养维护肠道屏障功能、减少细菌移位、增强肠道及机体免疫功能有关.     

急救护理路径对抢救急性心肌梗死患者的效果

目的探讨急救护理路径在抢救急性心肌梗死患者中的效果。方法制订急性心肌梗死急救护理路径,对100例患者(观察组)按路径实施护理,并与实施传统急诊护理流程的100例(对照组)进行比较。结果观察组进-出急诊科时间、急诊-球囊扩张时间、住院时间明显短于对照组,观察组死亡率低于对照组,观察组的满意度明显高于对照组。结论采用急救护理路径抢救急性心肌梗死患者能够明显缩短进-出急诊科时间、急诊-球囊扩张时间、住院时间,降低死亡率,提高患者的满意度,提高抢救效率。     

闭合性骨折早期应用中药熏洗、外敷的疗效观察

目的:探讨早期应用中药熏洗、外敷治疗闭合性骨折的疗效.方法:120例四肢闭合性骨折随机分为观察组和对照组各60例.两组均常规复位和固定,口服独一味胶囊,3粒/次,3次/d,疗程4周.对照组采用局部物理治疗,疗程4周,观察组采用中药熏洗(1次/d,共7d)+中药外敷(1次/d,共4周).于治疗前及治疗后7d对疼痛、压痛、瘀斑、功能障碍及肿胀进行评价,观察不良反应及并发症.结果:观察组治疗后疼痛、压痛、瘀斑、功能障碍及肿胀评分均低于对照组(P＜0.01);观察组总有效率(100％)优于对照组(88.3％)(P＜0.05);观察组出现张力性水泡少于对照组(P＜0.05).结论:早期应用中药熏洗、外敷治疗闭合性骨折,能明显改善早期疼痛、肿胀及功能障碍,并能提高临床疗效,减少并发症.     

左旋肉碱抗疲劳实验研究

目的研究左旋肉碱抗疲劳的效果。方法将健康雄性昆明小鼠80只随机分入四个组：实验前肌糖原和肝糖原测定组、负重游泳组、血乳酸测定组、尿素氮测定组,每个实验各20只小鼠。每个组再随机分成对照组和实验组,每组10只。对照组每天以蒸馏水灌胃,实验组以600mg/kg左旋肉碱灌胃,连续6周后分别测定肝糖原、肌糖原、游泳时间、血乳酸、血清尿素氮含量等指标,观察左旋肉碱抗疲劳效果。结果左旋肉碱组小鼠游泳时间和运动前肌肝糖原含量较对照组明显增加（P〈0.05）,游泳30min和游泳60min的肌肝糖原消耗均较对照组明显减少（P〈0.05）,力竭游泳后肝糖原消耗较对照组显著减少（P〈0.05）,但肌糖原消耗与对照组比较差异无统计学意义（P〉0.05）;运动后左旋肉碱组乳酸增加较对照组明显降低（P〈0.05）,休息30mim后血乳酸含量较对照组降低,恢复率明显增加（P〈0.05）;运动结束休息60min后左旋肉碱组血清尿素氮增量与对照组比较差异无统计学意义（P〉0.05）,但休息120min后,左旋肉碱组血清尿素氮含量较对照组明显降低,恢复率显著增高（P〈0.05）。结论左旋肉碱具有抗疲劳作用,其抗疲劳作用机理主要与左旋肉碱增加肌肝糖原储备,减少运动后肌肝糖原消耗,抑制乳酸生成,加速乳酸和尿素氮清除有关。     

干预措施对海军某部官兵功能性便秘发病率的影响及疗效

目的采取干预措施降低海军功能性便秘(functional constipation,FC)的发病率,保障部队战斗力。方法2010-06至2010-12以整群随机抽样的方法调查海军某部官兵2925例。其中1452例为干预治疗组,1473例为对照组。调查问卷采用罗马Ⅲ标准流行病学调查问卷(RomeⅢ-MQ),并参照SF-36生活质量量表(HRQOL)进行生活质量评判。8周后分析FC发病率及大便次数、性状积分变化。结果海军某部官兵功能性便秘的发病率高达12.14%,显著高于国内普通人群的6.07%(P<0.01)。经干预治疗后治疗组的功能性便秘发病率及大便次数、性状积分明显降低(P<0.05)。结论科学合理的干预措施可显著降低海军某部官兵FC的患病率,对保障海军官兵的身心健康,增强部队的战斗力有重要意义。     

幽门螺杆菌与反流性食管炎发病关系的探讨

目的探讨幽门螺杆菌（Hp）与反流性食管炎（RE）发病的关系。方法回顾性分析2004年1月至2008年5月行胃镜检查患者的报告,将内镜下RE阳性286例患者作为研究组进行分级,选择同期行内镜检查的非RE慢性胃炎250例患者为对照组,统计2组Hp阳性率并进行比较。结果研究组Hp感染率为28．7％（82／286）,明显低于对照组的48．4％（121／250）（χ^2=21．01,P=0．00）。研究组中无论是否存在Hp感染均以轻度食管炎多见,而且其Hp感染率32．0％要高于重度食管炎17．2％,组间比较差异有统计学意义（χ^2=5．153,P〈0．05）。结论Hp在食管炎的发病过程中与消化性溃疡等疾病不同,并非主要致病因素。     

还原型谷胱甘肽联合甘草酸二铵对腹部开放伤后海水浸泡犬肝功能损伤的治疗作用

Objective To investigate effect of reduced glutathione and diammonium glycyrrhizinate on the treatment of hepatic damage in experimental dogs following open abdominal injuries coupled with seawater immersion. Methods Twenty-four dogs with open abdominal injuries were randomly divided into 3 groups: the control group (given with simple observation after 1.5 h seawater immersion); the routine treatment group (given routine care and fluid transfusion after 1.5 h seawater immersion) ; the hepatic treatment group (given routine are, fluid transfusion and hepatic treatment as well, after 1.5 h seawater immersion). Each group consisted of 8 dogs. Blood samples were taken at different time points to measure total bilirubin (TB), alanine aminotransferase (ALT), aspartate aminotransferase (AST), lactate dehydrogenase (LDH), prothromin time (PT), endotoxin, tumor necrosis factor-α(TNF-α), interleukin-6 (IL-6), and pathological examination was also made at the same time. Results For the control group, contents of TB, ALT, AST and LDH increased significantly and survival time was less than 24 hours. Contents of TB, ALT, AST and LDH of the routine treatment group also increased significantly, but survival time of all the experimental animals was mere than 24 hours. Reduced glutathione and diammonium glycyrrhizinate could reduce the extent of lesion quite significantly 12～24 hours following open abdominal injuries. Conclusions Reduced glutathione and diammonium glycyrrhizinate seemed to have good effects on the treatment and prevention against hepatic damage induced by trauma coupled with seawater immersion. It could be used as a primary means for the treatment of such kind of hepatic damage.