Heart-lung transplantation for end-stage heart disease with Eisenmenger＇s syndrome： report of two cases

From September 2006 to January 2007, 2 patients with end-staged heart and lung disease （congenital disease,Eisenmenger＇s syndrome, severe pulmonary artery hypertension and heart failure） underwent heart and lung transplantation （HLT） at the First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China.     

Discussion about the Prognoses of Wilson＇s Disease with Severe Cortex Structure Impairment--A Case Report of Wilson＇s Disease （WD） Treated by the Traditional Chinese Medicine and Western Medicine

Introduction： As we know, Wilson＇s disease（WD） patient with severe structure and function impairment will have a poor prognosis. We met an exceptional case and madea report, then discussed some viewpoints about prognosis of WD patients. Case report： A WD patient presenting with severe cortex structure and cerebral function impairment was followed up for 5 years, including his therapeutic regiment-the combined treatment of traditional Chinese medicine and western medicine, clinical manifestation, the 24-hr urine copper output and brain MRI. By effective copper-excluding therapy, his clinical manifestation went on worse I st year after diagnosis, and then was improved in the following years. The patient＇s symptoms almost complete recover 3 years afterward. During 5 years, the 24-hr urine copper excreted is tapered, but it was still higher than normal. The cerebral MR image of the patient was getting worse at 1^st year, then began to recover, and improved markedly 5 years after. Conclusion： For WD patients, treated with the traditional Chinese medicine and western medicine, even therapy start in serious conditions and in late adolescent, clinical manifestation may get striking improvement.     

Treatment of Reflux Laryngopharyngitis with Modified Banxia Xiexin Tang （Pinellia Decoction for Draining the Heart） ——A Report of 40 Cases

To evaluate the effect of modified Banxia Xiexin Tang （半夏泻心汤 Pinellia Decoction for Draining the Heart） in treatment of laryngopharyngitis caused by gastroesophageal reflux disease （GERD）. Methods： Forty patients in the treatment group were treated with modified Pinellia Decoction for Draining the Heart and 38 patients in the control group were treated with Jinsang Liyan Wan （金嗓利咽丸 Pills for a Good Voice by Relieving Sore-Throat）o The effects were evaluated by the improvement in symptoms and the parameters obtained in a grading system of gastroscopy and laryngoscopy. Results and Conclusion： The comparison of therapeutic effects on complication of laryngopharyngitis, GERD symptoms, and findings in gastroscope grading and laryngoscope （P〈0.05 or P〈0.01） demonstrated that the modified Pinellia Decoction for Draining the Heart was much more effective in treating laryngopahryngitis caused by gastroesophageal reflux.     

Chinese Herbal Medicine and Acupuncture Used for Rehabilitation of the Impaired Urinary System in Patients with Paraplegia——A Report of 52 Cases

Infection of the urinary system is frequently seen in the paraplegic patients with urinary complications,which is one of the main reasons for the late death in such cases. The effects of the therapeutic method adopted for the urinary rehabilitation are directly related to the life quality and survival time of thepara plegic patients. Since 1999-2002, the authors had applied Chinese herbal medicine combined with acupuncture for the urinary rehabilitation in 52 paraplegic patients, with quite good therapeutic results as reported in the following.     

Performance measures for management of chronic heart failure patients with acute coronary syndrome in China： results from the Bridging the Gap on Coronary Heart Disease Secondary Prevention in China （BRIG） Project

Background Chronic heart failure (CHF) is a severe clinical syndrome associated with high morbidity and mortality, and with high health care expenditures. No nationwide data are currently available regarding the quality of clinical management of CHF patients in China. The aim of this study was to assess the quality of care of CHF inpatients in China.

Methods The American College of Cardiology/American Heart Association Clinical Performance Measures for Adults with Chronic Heart Failure (Inpatient Measurement Set) with slight modifications was used to measure the performance status in 612 CHF patients with acute coronary syndrome (ACS) from 65 hospitals across all regions of China.

Results The implementation rates of guideline recommended strategies for CHF management were low. Only 57.5% of the CHF patients received complete discharge instructions, 53.6% of the patients received evaluation of left ventricular systolic function, 62.8% received an angiotensin-converting enzyme inhibitor/angiotensin receptor blocker at discharge, and 52.7% received a β-blocker at discharge, 56.3% of the smokers received smoking cessation counseling. The rate of warfarin utilization was only 9.7% in CHF patients with atrial fibrillation. Most patients (81.4%) did not receive all the first four treatments. There were marked differences in the quality of CHF management among patients with different characteristics.

Conclusions Performance measures provide a standardized method of assessing quality of care, and can thus highlight problems in disease management in clinical practice. The quality of care for CHF patients with ACS in China needs to be improved.

     

耳穴压贴联合呼吸减痛法对分娩结局的影响

目的：观察耳穴压贴联合呼吸减痛法对分娩结局的影响。方法：按标准纳入在我院住院的初产妇100例,随机分为实验组50例和对照组50例。实验组出现规律宫缩后予耳穴压贴联合呼吸减痛法进行护理干预,对照组按产程常规护理,不予其他干预。比较2组产妇各产程时间、阴道自然分娩率、剖宫产率等指标。结果：实验组总产程时间、阴道自然分娩率、剖宫产率等指标与对照组比较均有统计学意义。结论：耳穴压贴联合呼吸减痛法能促进产程进展,降低剖宫产率。     

充血性心力衰竭致胸腔积液125例临床分析

目的 对心衰引起的胸腔积液的临床特点及误诊的原因进行分析。方法 对125洌心衰引起的胸腔积液病人临床资料进行回顾性分析。结果 心衰引起的胸腔积液发生率分别占同期心衰病人与胸腔积液病人的38．3％和31．1％,误诊率为58．4％;心衰引起的胸腔积液以双侧多见,双侧者右侧量大,胸腔积液多为漏出液;抗心衰治疗效果良好。结论 减少误诊的关键是认识心衰引起的胸腔积液临床特点。     

平静呼吸状态下肺通气功能测试

目的：介绍用于平静呼吸时各项呼吸指标测试系统的设计。方法：系统太要由Fleisch流量换能器、压力换能器、放大器、A/D转换器和486微机组成，系统软件是用汇编语言对流量信号进行采样，用C语言计算各项指标[呼吸频率（RR）、潮气量（TV）、潮气峰值流量（PTEF）、吸气时间/总呼吸时间（TiTtot到达呼气峰流量时间/呼气时间（TPF）、到达静态呼气峰流量时的呼出气量/潮气量（VPF）、呼出75%潮气量时的呼气流量（PE25）、平静呼吸中期流量/静态吸气中期流量（MEF/MIF），静态流量-容量环]，结果：经测试，同一正常男子测试TV的相对误差为1%；Fleisch型流量换能器，在整个量程内（0-8L），非线性误差不大于2%。结论：肺量计与浮筒式肺量计比较具有阻力小，精度高的优点，临床适用范围大，易于临床推广使用。     

呼吸机治疗中呼气末正压在急性左心衰竭中的应用

呼吸机已经成为抢救重症急性左心功能衰竭(左心衰)的有效措施,通气模式多采用呼气末正压辅助治疗,作者综述了呼气末正压发生机制及背景、对重症急性左心衰竭患者病理生理上的影响,以及探讨利用无创心功能监测仪监测血流动力学参数,进而辅助对血流动力学不稳定患者选择最佳呼气末正压。     

心脏瓣膜病合并冠心病的外科治疗

目的探讨对心脏瓣膜病合并冠状动脉粥样硬化性心脏病(冠心病)患者行手术治疗的疗效。方法对21例心脏瓣膜病合并冠心病患者进行瓣膜置换或成形同期行冠状动脉旁路移植。结果术后早期死亡1例.其余20例患者术后随访6～38个月,均无心绞痛发作,心功能恢复,生活质量明显提高。结论对心脏瓣膜病合并冠心病患者选择瓣膜置换或成形同期进行冠脉血运重建,能够改善患者心功能,提高生活质量。     

主动呼吸控制结合光学体表监测在左侧乳腺癌深吸气屏气放疗呼吸训练中的应用

目的 探讨左侧乳腺癌深吸气屏气(Deep Inspiration Breath-Hold,DIBH)放疗中使用主动呼吸控制(Active Breathing Coordinator,ABC)下光学体表监测DIBH的可行性以及幅度变化范围,比较两种呼吸状态下剂量学差异.方法 15例左侧乳腺癌保乳术后拟行全乳放疗患者,使用...     

瑜伽呼吸法联合沉思冥想对分娩产程及结局的影响

目的 研究分析瑜伽呼吸法联合沉思冥想对产妇分娩产程及结局的影响. 方法 随机抽取2013年1月—2014年12月该院收治的210例分娩产妇作为研究对象,按照随机数字表法将其分为观察组和对照组各105例,比较两组产妇的产程时间、 疼痛耐受程度和分娩方式. 结果 观察组的自然分娩率93.3%要明显高于对照组的65.7%(P<0.05);观察组总产程时间(446.76±81.06)min较对照组(518.35±97.92)min更短(P<0.05);观察组疼痛程度I级31例要多于对照组11例,同时疼痛程度Ⅱ、Ⅲ级例数要少于对照组(P<0.05). 结论 瑜伽呼吸法联合沉思冥在分娩产妇中的应用能有效的缓解产妇疼痛,缩短产程和提高自然分娩率,具有高度的应用推广价值.     

两种新型的动态心率检测器

介绍两种动态心率检测器，它们能准确、可靠地检出在运动状态下的人体心率。电路采用两种检测技术，一接为ＱＲＳ波检测法，另一种为光电脉搏检测法。这两种心率检测器成功地应用于Ｖｏ２ｍａｘ的间接估测系统中。实验证明其结构简单、使用方便、操作安全、检测准确。     

农村老年慢性心力衰竭患者住院期间和出院后生活质量比较研究

目的：：了解农村老年慢性心力衰竭住院患者入院后和出院后一个月生活质量的差别。方法：对136例农村老年慢性心力衰竭住院患者进行一般情况调查,在入院后和出院后一个月分别采用明尼苏达州心力衰竭生活质量调查表。结果：农村老年慢性心力衰竭住院患者入院病情稳定后生活质量得分为(52.45±17.54)分,出院后一个月生活质量得分为(30.84±11.62)分。心功能分级与生活质量总分有显著相关性,心功能越差,生活质量越差。结论：农村老年慢性心力衰竭住院患者的生活质量低,有效治疗以及家庭和社会的帮助能提高其生活质量。