揿针埋针镇痛联合康复训练对膝关节骨性关节炎功能障碍的疗效影响

目的 观察揿针埋针镇痛治疗联合康复训练对膝关节骨性关节炎患者的膝关节疼痛以及功能障碍的疗效影响。 方法 采用随机数字表将2016年1—6月于杭州市第三人民医院就诊的40例膝关节骨性关节炎患者随机分为观察组和对照组,每组各20例。观察组给予埋针镇痛治疗联合常规康复训练,对照组单纯给予常规康复训练。2组患者分别于治疗前、初次治疗结束时、治疗1个月及随访3个月时采用西安大略和麦克马斯特骨关节炎指数(WOMAC)评定膝关节疼痛、僵硬和关节功能程度,分数记录时使用视觉模糊评分法(VAS);同时于治疗前、治疗1个月后采用普通量角器测量患者膝关节活动范围(ROM),并进行膝关节功能评定,然后作疗效评定。 结果 初次治疗结束时,观察组的WOMAC评分与治疗前比较,差异有统计学意义(P＜0.05),而对照组与治疗前比较差异无统计学意义(P＞0.05);通过1个月的治疗,2组患者WOMAC评分均较治疗前明显改善,同项目与治疗前比较,差异均有统计学意义(均P＜0.05);2组间WOMAC评分同项目比较,差异有统计学意义(P＜0.05),2组的总有效率,观察组为95%,对照组为70%。2组疗效比较,差异有统计学意义(P＜0.05);3个月后随访时,2组WOMAC评分较治疗1个月后时有所上升,与治疗前同项目比较,差异仍有统计学意义(P＜0.05),2组间WOMAC评分同项目比较,差异也有统计学意义(P＜0.05)。 结论 揿针埋针镇痛治疗联合康复训练能有效地改善膝关节炎疼痛以及功能障碍。      

中药熏蒸治疗糖尿病相关性干眼症的疗效观察

目的探讨中药熏蒸治疗糖尿病相关性干眼症的效果。方法选择2017年1月～2018年1月在我院诊断治疗的糖尿病相关性干眼症患者60例为研究对象,随机分为研究组与对照组,各30例。对照组采用人工泪液治疗治疗,研究组在此基础上加用中药熏蒸治疗。比较两组治疗后主观症状评分、角膜染色、泪膜破裂时间、泪液分泌量评分及两组临床疗效。结果两组治疗后角膜染色评分显著低于治疗前,膜破裂时间、泪液分泌量评分显著高于治疗前,差异有统计学意义(P0.05);治疗后,治疗组角膜染色评分显著低于对照组,膜破裂时间、泪液分泌量评分显著高于对照组,差异有统计学意义(P0.05)。两组治疗后主观症状得分均显著低于治疗前,差异有统计学意义(P0.05);治疗后研究组主观症状得分显著低于对照组,差异有统计学意义(P0.05)。研究组总有效率显著优于对照组,差异有统计学意义(P0.05)。结论中药熏蒸治疗糖尿病相关性干眼症能够显著改善患者症状,提高临床疗效。     

碱性成纤维细胞生长因子滴眼液联合人工泪液治疗老年干眼症的疗效观察

目的探讨碱性成纤维细胞生长因子滴眼液联合人工泪液治疗老年干眼症的临床疗效.方法 选取70例老年干眼症患者随机分为联合治疗组和对照组,每组各35例,对照组给予人工泪液滴眼2滴/次,4次/日;联合治疗组在使用人工泪液的同时加用碱性成纤维细胞生长因子滴眼液,2滴/次,4次/日.8周为1疗程.结果 治疗前联合治疗组和对照组患者眼部症状评分、Schirmer测定(Schirmer test I)、泪膜破裂时间测定(tear break up time, BUT)、角膜荧光染色评分结果比较,差异无统计学意义(P>0.05).治疗8周后,两组眼部症状评分、schirmer测定、BUT测定、角膜荧光染色评分相比较均较治疗前有所改善(P<0.05),且联合治疗组疗效优于对照组(P<0.05).结论 在常规使用人工泪液的基础上加用碱性成纤维细胞生长因子滴眼液治疗老年干眼症患者的疗效优于单用人工泪液替代治疗.     

普拉洛芬滴眼液治疗干眼症的临床疗效评价

目的 探讨普拉洛芬滴眼液治疗干眼症的临床疗效.方法 选择干眼症患者86例,43例患者采用普拉洛芬滴眼液治疗（A组）,另43例患者应用人工泪液治疗（B组）.两组点眼为4次/d,时间2周.两组进行干眼症状问卷、泪膜破裂时间、Schirmer Ⅰ试验、荧光素染色及疗效评价.结果 A组治疗后的干眼症状计分和荧光素染色评分低于B组（P＜0.05）;泪膜破裂时间高于B组（P＜0.05）.A组治疗效率95.3％,明显高于B组.结论 普拉洛芬滴眼液治疗干眼症效果良好,能有效缓解临床症状,有较好的临床价值.     

化裁密蒙花散超声雾化联合雷火灸熏眼治疗干眼症的临床观察

目的观察化裁密蒙花散超声雾化联合雷火灸熏眼治疗干眼症的临床疗效。方法将160例(160眼)干眼症患者随机分为(治疗A、B、C组,对照组)4组,每组40例。治疗A组采用化裁密蒙花散超声雾化治疗;治疗B组采用雷火灸熏眼治疗;治疗C组采用超声雾化联合雷火灸熏眼治疗;对照组采用人工泪液滴眼治疗。治疗4周后,统计疗效。分别记录治疗前后各组症状评分和泪液分泌实验、泪膜破裂时间,并进行统计分析。结果治疗A组(87.00%)、B组(84.00%)与对照组(82.00%)的有效率比较,差异无统计学意义(P>0.05);治疗C组总有效率为97.00%,和对照组比较差异有显著统计学意义(P<0.01)。治疗A组、B组、C组的显效率优于对照组;治疗A组、B组及对照组治疗后泪液分泌(SchirmerⅠ)试验和泪膜破裂时间(BUT)与治疗前比较差异有统计学意义(P<0.05);C组治疗后SchirmerⅠ试验和BUT与治疗前比较差异有统计学意义P<0.01,各组治疗后各检测指标优均于治疗前。结论化裁密蒙花散超声雾化联合雷火灸熏眼能明显改善干眼症患者的临床症状,改善SchirmerⅠ功能及泪膜破裂时间,疗效确切,且优于单用人工泪眼液;此两种方法联合治疗干眼症具有叠加效应。     

不同种类人工泪液治疗白内障患者术后干眼症的临床效果

目的:探讨不同种类人工泪液治疗白内障超声乳化联合人工晶体植入术后干眼症患者的临床效果。方法:选取白内障超声乳化联合人工晶体植入术后发生干眼症患者63例(82眼)为研究对象,根据使用的人工泪液种类不同分为对照组[33例(43眼)]和观察组[30例(39眼)]。对照组予常规药物治疗,观察组在对照组基础上予玻璃酸钠治疗,比较两组治疗前后泪液分泌试验结果,角膜染色评分,泪膜破裂时间及干眼症状评分。结果:观察组治疗后1周、2周、3周及1个月泪液分泌试验试纸浸湿长度及泪膜破裂时间均长于对照组,差异有统计学意义(P<0.05);观察组治疗后1周、2周、3周及1个月角膜染色评分、干眼症状评分均低于对照组,差异有统计学意义(P<0.05)。结论:玻璃酸钠治疗白内障超声乳化联合人工晶体植入术后干眼症临床疗效更佳,可有效缓患者解临床症状,改善相关临床指标水平。     

干眼症状与临床检查相关性的初步研究

目的 调查辽宁省庄河、大洼两地居民干眼症状的患病情况,分析干眼症状与临床检查的相关性.方法 对1 131例样本进行问卷调查,并监测他们的泪液分泌量(Schirmer I test)和泪膜破裂时间(BUT).结果 干眼症状与临床检查结果的检出率间存在着显著差异(χ~2=66.01,P＜0.05),性别和环境因素影响着干眼症状的发生;对1 131例样本按是否出现干眼症状及临床检查结果是否为阳性进行分组比较,各组在Schirmer I test和BUT上存在显著差异(Schirmer I test:F=502.75,P＜0.05;BUT:F=177.45,P＜0.05).结论 进一步明确干眼病程,在临床工作中提出"临床前期"概念,对于预防、诊断及治疗干眼症具有一定意义.     

人工泪液联合普拉洛芬治疗青光眼术后干眼症的疗效

目的:观察人工泪液联合普拉洛芬治疗青光眼术后干眼症的临床疗效。方法:选取我院收治的行青光眼术治疗后干眼症患者64例作为研究对象,选取时间为2016年6月~2017年6月,根据治疗方法分为对照组与观察组,每组32例,观察组患者应用人工泪液联合普拉洛芬治疗,对照组患者应用人工泪液治疗,对比观察两组患者治疗前与治疗4周后的临床治疗效果。结果:观察组与对照组患者治疗前感觉症状评分对比,无统计学意义,P0.05,经4周治疗后,观察组患者的症状评分优于对照组,组间比较差异存在统计学意义,P0.05,观察组患者与对照组患者在角膜荧光素染色评分与泪膜破裂时间两个方面对比,组间比较存在统计学差异,P0.05。结论:应用人工泪液联合普拉洛芬治疗青光眼术后干眼症的临床治疗效果显著,值得临床推广普及。     

中西医治疗2型糖尿病患者干眼症的临床研究

目的观察芪明颗粒、电脑多功能治疗仪及爱丽滴眼液治疗2型糖尿病患者干眼症的临床疗效。方法研究对象为临床确诊的2型糖尿病干眼症患者60例120只眼,其中30例接受芪明颗粒、电脑多功能治疗仪及爱丽滴眼液治疗(治疗组);另外30例接受常规治疗:采用爱丽滴眼液治疗(对照组),观察治疗前后患者泪液分泌量(Schirmer法)、泪膜破裂时间(BUT)及症状的变化。结果治疗后3个月,治疗组总有效率为85.00%(51/60),对照组为51.67%(31/60),差异有统计学意义(P<0.05)。治疗后两组BUT及泪液分泌量比较,差异有统计学意义(P<0.05),治疗组优于对照组。结论中西医治疗方案对干眼症的中远期治疗有着显著的疗效。     

穴位揿针埋针治疗妇科恶性肿瘤化疗相关性恶心呕吐的疗效观察

目的观察穴位揿针埋针治疗妇科恶性肿瘤化疗相关性恶心呕吐(CCINV)的临床疗效,评估其对患者生活质量的改善作用。方法选择2018年3月-2019年6月收治的妇科恶性肿瘤CCINV患者60例,随机分为对照组和研究组,每组30例,对照组患者应用昂丹司琼止吐,研究组同时应用穴位揿针埋针方法。治疗后评估患者呕吐、恶心临床疗效,评估患者呕吐恶心状况,并应用恶心呕吐生活功能量表(FLIE)评估患者生活质量。结果研究组治疗后总有效率高于对照组(P 0. 05),差异有统计学意义;研究组恶心呕吐评分、呕吐持续时间均低于对照组,研究组首次呕吐时间高于对照组(P 0. 05),差异具有统计学意义。研究组治疗第1周、第2周和结束用药第3天FLIE评分均高于对照组(P 0. 05),差异具有统计学意义。结论应用穴位揿针埋针治疗妇科恶性肿瘤CCINV患者,临床疗效显著,能够显著改善患者恶心呕吐状况,缩短呕吐时间,提高生活质量。     

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.