Avastin在增生性糖尿病性视网膜病变玻璃体切割手术中的临床应用

目的探讨Avastin在增生性糖尿病性视网膜病变（PDR）玻璃体切割手术中应用的临床效果。方法回顾分析31例（32眼）PDR患者,术前5～7d玻璃体腔内注射Avastin 0.1 mL/2.5 mg,行标准的三通道玻璃体切割手术,其中合并白内障的患者同时一期行超声乳化＋人工晶体植入术。结果术中发现术前活跃的新生血管膜明显消退,术中出血明显减少,且膜剥除难度明显降低。随访3个月,26例26眼（81.3%）矫正视力较术前明显提高,4例5眼（15.6%）无明显变化,1例1眼（3.1%）视力反而下降。无严重并发症。结论Avastin可以显著降低PDR玻璃体切割手术的难度,减少术中出血,缩短手术时间,改善患者视力。但其安全性和有效性需长期大样本的临床观察。     

UPLC法测定普济消毒饮配方颗粒中黄芩苷的含量

目的 采用超高效液相色谱法(UPLC)建立普济消毒饮配方颗粒中黄芩苷的含量测定方法. 方法运用UPLC法测定,色谱条件为ACQUITY UPLC BEH C18色谱柱,甲醇-0.2%磷酸溶液(40:60)为流动相,检测波长为315nm. 结果 黄芩苷在0.02630μg～0.52600μg范围内具有良好线性关系;平均加样回收率为100.76 %(RSD%=0.37%).结论 本方法简便、快速、准确可靠,重复性好.     

下咽癌手术后喉功能康复护理

下咽癌的发病率约占头颈部恶性肿瘤的2．5％,其主要治疗方法为手术治疗,包括保留喉功能和不保留喉功能两种术式。术后患者的吞咽功能、发音功能、呼吸功能等均受到不同程度的损伤,因此术后合理的康复治疗及护理较为重要。现将我科对74例下咽癌手术患者的喉功能康复护理作一回顾性分析,报道如下。     

逆行隔离灌注化疗可减轻对大鼠肝脏的毒性及药物的泄漏

Objective The retrograde isolated hepatic perfusion (RIHP) model was used to compare with the isolated hepatic perfusion (IHP) model in reducing the rate of normal hepatic tissue toxicity and peripheral drug leakage during chemotherapy in rat liver. Methods A total of 90 male Sprague-Dawley rats weighing 300-350 g were randomized into 3 groups with 30 rats in each. Group A: perfusion with Lactated Ringer'S Solution through arteria hepatica (RA) and portal vein (PV),the inferior vena cava was used as an outflow tract of perfusate. Group B: For isolated hepatic perfusion (IHP), Fluorouracil (5-FU) was added into the perfusate at a dose of 350mg/kg and introduced in to the liver through arteria hepatica, portal vein was perfused by Lactated Ringer'S Solution, and the inferior vena cava was used as an outflow tract of perfusate. Group C: by using retrograde isolated hepatic perfusion (RIHP), the solution which contains 350 mg/kg Fluorouracil (5-FU) was also introduced through arteria hepatica, the inferior vena cava was introduced with Lactated Ringer'S Solution;the portal vein was used as an outflow tract of the perfusate. On day 1, 3, 5 and 7 after the perfusion in all groups, blood serum ALT test and liver histopathology test were performed. The peripheral blood drug levels were measured with high performance liquid chromatographic(HPLC) system in group B and group C. Results The survival rate was 90%, 86.7% and 90% in group A, B and C,respectively. No statistically significant difference was observed in the survival rate among the 3groups. In all the three groups, serum ALT levels were the highest on the first day after IHP: (481.6±207.6)μmol/LingroupA;(1641. 6±658.0) μmol/LingroupBand( 913. 0±353. 5)μmol/Lin group C. Significant higher serum ALT levels were observed by comparing group B and C with A(P＜0. 05). Meanwhile, the serum ALT levels were significantly higher in group B than in group C (P＜0.05). The peaks of peripheral blood drug concentration during the perfusion were 131.2±29.4μg/ml in group B and 65.3±28. 4μg/ml in group C. Significant difference was observed (P＜0. 05). Liver biopsies of group A showed mild changes on the first day after IHP and returned to normal after 7 days. Group B showed severe changes on the first day after IHP and local necrosis still existed after 7 days. Group C showed moderate changes as compared with group B on the first day after IHP and also returned to normal after 7 days. Conclusion Retrograde isolated hepatic perfusion (RIHP) can reduce the liver toxicity compared to isolated hepatic perfusion (IHP). Hopefully, RIHP will be considered as a safer way in regional chemotherapy in liver cancer.     

石榴皮鞣质对糖尿病肾病大鼠血脂及肾功能的影响

目的 观察石榴皮鞣质对糖尿病大鼠血脂及肾功能的影响.方法 用链尿佐菌素复制糖尿病大鼠模型,观察石榴皮鞣质对其空腹血糖、血胆固醇、甘油三酯、尿素、尿蛋白的影响.结果 石榴皮鞣质治疗剂量组可降低大鼠血胆固醇、甘油三酯、肌酐、尿素、尿蛋白等,与模型组比较有显著性差异(P<0.05).以高剂量组最佳.结论 石榴皮鞣质可以降低实验性糖尿病肾病大鼠血胆固醇与甘油三酯水平,改善肾功能.     

小波分析技术在椎旁及腰大肌肿块超声诊断中的应用

目的使用photoshop计算机技术,观察研究肿块组织的纹理空间分布特征表现,以提高超声诊断能力。方法将超声获取的图像组织,再经photoshop技术的变换和变换后的小波系数与图像的局部特征的对应关系进行分析,即：行细节按列排序,列细节按行排序,对角线细节按Z排序。结果通过对椎旁及腰大肌肿块组织的图像测定和小波技术分析,提供了频谱数据及图像的纹理分析信息,获取了病灶区域与正常组织的纹理定量的数据描述。结论小波分析技术为临床诊断椎旁及腰大肌肿块提供了分辨和分析病灶性质、程度的可靠依据。     

新生儿颅内出血危险因素及预防措施研究

目的探讨新生儿颅内出血的类型及其可能的危险因素,研究预防措施。方法选择2004-2009年住院的180例颅内出血新生儿为病例组,同期住院的200例非颅内出血新生儿为对照组进行病例对照研究。单因素分析用卡方检验,多因素分析用多元Logistic回归分析。结果病例组中出血部位发生率由高到低依次为脑室周围-脑室内出血、蛛网膜下腔出血、脑实质出血、硬膜下出血、小脑出血。产程延长、产钳、低出生体重儿、过期产、巨大儿、母亲感染发热、母亲产前出血、脐带绕颈、胎儿宫内窘迫、胎盘老化、胎头吸引、胎位异常、臀位牵引、新生儿呼吸困难、新生儿低血糖、新生儿酸碱失衡、新生儿出血病、新生儿休克、新生儿血小板减少、新生儿窒息、早产儿均是新生儿颅内出血的相关危险因素。结论减少早产,提高产科质量,控制感染,预防出血,维持内环境稳定,可降低新生儿颅内出血的发生率。     

生长抑素联合奥美拉唑治疗肝硬化性消化道出血的临床疗效观察

目的探讨生长抑素联合奥美拉唑治疗肝硬化性消化道出血的临床效果。方法回顾性分析了2008年7月至2011年7月入住我院的120例肝硬化性消化道出血患者的临床资料,将其随机地均分为对照组与观察组两组,对照组(n=60)应用垂体后叶素进行治疗,观察组(n=60)应用生长抑素联合奥美拉唑进行治疗,对比二组的临床疗效。结果观察组治疗的总有效率为95.0%(57/60),对照组治疗的总有效率为73.3%(44/60),二组治疗的总有效率存在显著的统计学差异(P<0.05),两组患者在不良反应的发生率上差异无统计学意义(P>0.05)。结论生长抑素联合奥美拉唑治疗肝硬化性消化道出血疗效确切,安全性好,值得临床推广应用。     

肌钙蛋白Ⅰ升高在呼吸科ICU中的临床意义

目的对肌钙蛋白Ⅰ升高在呼吸科ICU的临床意义进行分析。方法对120例患者的血清肌钙蛋白Ⅰ水平进行检测,在回顾性分析的基础上,对患者的病情进行探究,掌握危重病患者肌钙蛋白Ⅰ与ICU住院时间、机械通气时间、病死率、心肌损伤等状况之间的关系。结果肌钙蛋白Ⅰ升高组与正常组相比,心律失常、缩血管药物使用、机械通气、病死率、ICU住院时间之间的差异具有统计学意义(P<0.05)。Logistic回归分析显示肌钙蛋白Ⅰ升高与病死率独立相关。结论肌钙蛋白Ⅰ水平升高表明危重病患者的功能失调、心肌损伤的发生率非常的高,作为心肌伤的特异性标志物,肌钙蛋白Ⅰ对于患者的预后和评价具有重要作用。     

超声引导介入治疗剖官产瘢痕妊娠的价值

剖宫产瘢痕妊娠(cesarean scar pregnancy,CSP)是指受精卵或胚胎着床于既往剖宫产切口瘢痕处,属于一种异位妊娠.CSP临床表现无特异性,多以停经后无痛性阴道流血为主,早期诊断困难,易漏诊.因其随孕周增加有胎盘植入、子宫破裂的风险,处理不当可导致难以控制的大出血、子宫切除,甚至危及患者生命.而超声对于CSP的诊断和处理都有其独特的优越性,本研究对78例CSP患者进行回顾性分析,旨在评价超声介入保守性治疗CSP的价值.