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通过呼吸调制缓解心衰症状
在以色列特拉维夫证券交易所上市的InterCure 医疗器械公司宣称,<欧洲心衰>杂志(European Journal of Heart Failure),一份欧洲心脏学会的同行评审医疗刊物,刊出了随机的72 个病人对照研究结果,该研究结果称,居家病人由雷帕特治疗仪(RESPeRATE)引导的呼吸调制可明显缓解老年病人的心衰症状.
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Objective: To evaluate the effectiveness, toxicity and prospective application of hepatic arterial infusion (HAI) with embolized Curcuma Aromatic oil (CAO) in treating primary liver cancer (PLC). Methods: In the treated group, 32 patients with PLC were treated by HAI with 1-3 ml embolized CAO and oral administration of Chinese herbal medicine. In the control group, 32 patients with PLC were treated with transcatheter artery chemoembolization (TACE). Results: In the treated group, one patient attained complete remission (CR) and 13 partial remission (PR), the total effective rate being 43.75%. The level of alpha fetal protein (AFP) turned to normal range in 7 cases and decreased in other 7. In the control group, 10 obtained PR and the total effective rate being 31.25%, AFP level turned to normal in 5 and decreased in 2. There was no statistical significance between the two groups. The incidences of post-embolism Sydrome, such as fever, abdominal pain and vomiting were similar between the two groups but no myelosuppression occurred in the treated group with significant difference as comparing with that in the control group (P<0.01). The mean survival time, median survival time, 1-, 2- and 3-year survival rate in the treated group were 11.5 months, 10 months, 37.5%, 13.3% and 6.9% respectively, while in the control group they were 7.25 months, 6 months, 15.6%, 3.2% and 0% respectively. Better result in mean survival time, median survival time and 1-year survival rate was found in the treated group than that of the control group (P<0.05). Conclusion:HAI with embolized CAO showed a similar good effect in treating PLC as that of TACE, but superior to TACE with longer survival time and milder myelosuppression.
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Objective: To study the effect and mechanism of Shuanghua aerosol (SHA) in treating infantile upper respiratory tract infection. Methods: In the clinical study, 276 patients were randomly divided into two groups. The treated group was treated with SHA and the control group was treated with Shuanghuanglian aerosol (SHLA, 双黄连气雾剂). In the experimental study, the effects of SHA on anti-inflammation and anti-virus were observed. Results: The clinical total effective rate of SHA was 99.03% and its cure rate 65.38%, while those of the SHLA were 94.11% and 44.12% respectively, significant difference was shown between the two groups (P<0.01). Experimental study showed that SHA could inhibit the xylol induced ear swelling and the egg white induced paw swelling in mice obviously, and inhibit the proliferation of influenza virus in rat's lung. Conclusion: SHA has obvious anti-inflammatory and anti-viral effect, and has good curative effect in treating infantile upper respiratory tract infection.
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Peptic ulcer is a common and frequently encountered disease. H2 receptor blocker and several other drugs have been used in treating peptic ulcer (PU) since many years ago, but there still remain a rather large number of intractable ulcer and recurrent ulcer. Recently the discovery of Helicobacter pylori (HP), as well as the relationship between HP and PU relapse was confirmed, but there still lacks of perfect therapeutic program for anti-HP infection(1). From June 1993 to August 1996, we used a pure TCM preparation Moluo Yangping granule (摩罗疡平冲剂, MYG) in treating 64 PU patients, and satisfactory results have been obtained. The report is as follows.METHODSPatient Selection According to the diagnostic standard of PU worked out by Ministry of Health in “Guiding Principles for Clinical Study of New Chinese Drugs”, 126 PU patients with typical symptoms and signs were enrolled, who were confirmed to have PU before treatment with biopsy sample performed urease quick diagnostic method under gastroscopy, and pathological special stain were microscopically examined to verify the HP infection. Basal acid output (BAO), maximal acid output (MAO), peak acid output (PAO) and the amount of parietal cells were measured in all the patients.
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术后早期应用肠内营养五例报告
目的总结术后早期(24~36小时)肠内营养应用的经验,疗效及并发症.方法总结三年来我院实施5例术后早期肠内营养的方法、疗效及并发症.结果5例术后早期肠内营养的病人疗效满意,病人营养状况改善,体重增加,原发病(2例高位肠痿,3例胰、十二指肠、脾等脏器损伤)均治愈.5例中仅一例出现恶心,予对症治疗后缓解,2例高位肠痿应用肠内营养4周痊愈出院.3例多发脏器损伤应用肠内营养7~10天,均于2周出院.无感染发生.结论本组资料显示,术后早期应用肠内营养,既能改善病人营养状况,又可保护肠粘膜屏障作用,是防止术后感染的方法之一.
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阿托伐他汀逆转动脉僵硬度多中心、开放临床研究
目的:探讨阿托伐他汀对心血管疾病患者动脉僵硬度的影响.方法:67例心血管疾病患者,其中男性28例,女性39例,平均年龄(62.42±9.41)岁(范围35~80岁).受检者3例为单纯高脂血症,3例为单纯糖尿病患者,5例为单纯冠心病患者,56例为高血压合并冠心病或糖尿病患者.观察服用阿托伐他汀10 mg治疗4周、12周和24周时血脂水平及动脉僵硬度的改善状况.动脉僵硬度的评价应用脉搏波速度测定系统(pulse wave velocity,PWV)和血压脉搏测量装置.颈动脉-股动脉PWV(C-F PWV)、颈动脉-桡动脉PWV(C-R PWV)和心-踝血管指数(cardio-ankle vascular index,CAVI)作为反映动脉僵硬度改变的指标.结果:阿托伐他汀治疗前与治疗后4周、12周、24周相比总胆固醇水平明显降低[分别为(5.12±1.18) mmol/L,(4.05±0.82) mmol/L,(4.18±0.80) mmol/L和(4.27±1.00) mmol/L,与基线相比,均为P<0.01];低密度脂蛋白胆固醇水平在治疗后显著下降[分别为(2.95±0.92) mmol/L,(2.11±0.64) mmol/L,(1.24±0.24) mmol/L,(1.28±0.29) mmol/L,与基线相比,均为P<0.01];高密度脂蛋白胆固醇水平在治疗12周后明显增加,并持续至24周[分别为(1.33±0.40) mmol/L,(1.24±0.29) mmol/L,(2.22±0.72) mmol/L,(2.31±0.83) mmol/L,与基线相比,均为P<0.01].C-F PWV治疗后显著下降[分别为(12.33±2.54) m/s,(11.43±2.46) m/s,(11.18±2.05) m/s,(11.14±1.77) m/s,与基线相比,均为P<0.01];C-R PWV治疗12周后明显降低并持续到24周[分别为(10.07±1.89) m/s,(9.71±1.39) m/s,(9.62±1.41) m/s,(9.52±1.33) m/s,与基线相比,均为P<0.01].CAVI在治疗前后无显著差异.结论:阿托伐他汀治疗可有效降低胆固醇水平,并对改善心血管疾病患者动脉僵硬度有益,对动脉结构的改变需更长期的治疗.
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基质金属蛋白酶-9和金属蛋白酶组织抑制因子-1与急性心梗后左室重构关系的临床研究
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科学性是脊髓损伤基础与临床研究的根本
脊髓损伤是可致患者终生残疾的灾难性损伤,完全性脊髓损伤至今无有效治愈方法.长期以来,各国学者对脊髓损伤后的病理与影像学改变、脊髓损伤后继发性损伤的防治、外科手术减压治疗、脊髓损伤部位的神经再生与重建、脊髓损伤后功能康复与重组等方面进行了大量基础与临床研究[1-4].近30年来有关脊髓损伤治疗的大量动物实验基础研究中,就有数以百计的治疗方法被"确定"有不同程度的治疗效果[5].但是如何准确评估临床前动物实验研究(pre-clinical research)结果的可信度及有效性(或"证据"等级);如何科学地选择某种治疗方法进行临床研究;如何科学设计临床研究并客观准确评估研究结果的有效性,以便能为渴求治疗的脊髓损伤患者提供安全有效的治疗,这些都是需要引起高度重视的问题.
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择期肝切除术后不留置常规胃肠减压的临床研究
肝切除术是目前治疗肝脏良恶性疾病的有效手段~([1,2]),传统观点认为,包括肝切除术在内的腹部手术后应常规行胃肠减压,以利于胃肠功能恢复~([3-5]),近国外的多项研究和系统评价结果提示的腹部手术后无需留置胃肠减压~([6-8]),国内关于此方面的研究报道较少,笔者对81例择期肝切除术病人进行随机对照研究,以评价肝切除术后不留置胃肠减压的安全性.
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直肠癌超低位吻合保肛术30例临床观察
近年来,低位直肠癌行各种保肛术发展较快,显著提高了患者术后生活质量,其远期效果与Milse手术类似,已得到公认.我科于2003年1月至2006年1月对低位直肠癌患者采用双吻合器行超低位吻合保肛术30例,现将临床疗效报告如下.
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对我国外科临床科研现状的感悟与思考
目前,我国外科临床研究存在着这样的情况:一方面,值得研究的临床难题不少;另一方面,许多临床医师对此认识不够或者根本不愿意做临床课题.为什么会出现这种局面呢?近,我带着这个问题一认真研读了新出版的几种国外著名胸心外科杂志,颇有感触与心得,于是提笔记录下来,希望能对从事外科临床工作的年轻医生有所启发和帮助.
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小儿气管、支气管异物胸部X线表现的临床研究
气管、支气管异物属于急重症,如果不及时诊断和手术,就有生命危险.尽管人们已开始应用MRI[1]、冠状位CT扫描[2]等技术探讨了其在诊断气管异物中的价值,但传统的胸部X线及透视下观察纵隔摆动的检查方法因诊断迅速、费用低廉,仍为诊断呼吸道异物首选辅助检查.我们分析了220例气管、支气管异物患儿胸部X线表现特点,并探讨其在确定气管、支气管异物位置和判断手术效果中的作用.
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体位性心动过速综合征的临床研究进展
早在1940年就提出了体位性心动过速的概念,但直到1993年体位性心动过速综合征(the postural tachycardia syndrome,POTS)的概念才由Schondorf和Low正式提出,并且继血管迷走性晕厥后成为近几年来功能性心血管疾病的研究热点~([1]).
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子宫肌瘤栓塞子宫动脉造影中双侧卵巢支显影的处理
目前认为子宫肌瘤的栓塞治疗是有效的治疗方法之一.但其安全件尤其对卵巢功能的影响,引起了妇产科和介入放射医师的关注[1-3].
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对比超声心动图临床应用及进展(上)
对比超声心动图是分子影像学的一个分支,它是通过静脉注入微泡和微泡造影剂,增强感兴趣区与背景超声信号的差别.经改进后研制成靶向造影剂,即通过主动或被动机制对特定类型的细胞或组织进行定位.
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对比超声心动图临床应用及进展(下)
心力衰竭心力衰竭是一类包含多种病理和临床问题的致残性疾病,可以根据心脏的解剖结构、功能或分子结构进行分类.目前通过分子或细胞特异性靶向成像技术使得临床诊治的终目标是进一步完善诊断、预测预后和评价疗效.
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Intracerebral hemorrhage(ICH)is one of the cerebrovascular disease which occurs frequently in China with the high rate of occurance,disability and death.Through the acupuncture in treating cerebral hemorrhage related literature study in recent 5 years,we found that acupuncture compared with the simple western medicine has certain advantages in the treatment of cerebral hemorrhage,the help of acupuncture treatment can improve the patients neurological function score and increase the effective rate.Through these datas research,we hope to provide references for further study.
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老年脑缺血实验研究与临床研究相关性的问题与思考
脑缺血是临床常见病,增龄在其发病中起重要作用[1],由于老年人存在机体衰老、潜在多重危险因素、应激调节减退、多器官受损、治疗预后差等限制了临床研究的开展,实验研究显得尤为重要.但目前存在着实验研究动物选取和模型制备是否合理,实验过程和临床特征能否一致,临床研究与实验研究结果能否互证等问题,直接影响了老年脑缺血实验研究与临床研究的相关性,制约了研究的突破.解决这些问题则是实验研究为临床研究提供依据和切入点,以及临床研究印证实验结果并为实验研究提出问题和提供信息的关键.
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胎盘早期剥离28例护理分析
目的:探究胎盘早期剥离的临床护理措施。方法:选取2012年10月-2014年9月我院收治的28例胎盘早期剥离患者为研究对象,将其随机分为对照组和观察组,每组14例患者,对照组采用常规性护理方法,观察组采用综合性护理措施,对两组护理效果进行比较分析。结果:在本次研究中,观察组出现不良反应的患者有1例,不良反应率为7.1%,对照组出现不良反应的患者有3例,不良反应率为21.4%,观察组的护理效果明显优于对照组,两组比较结果有明显的差异,具有统计学意义(p<0.05)。结论:胎盘早期剥离对患者的影响比较大,因此在临床研究中结合患者的病情给予综合性护理措施,综合性护理干预措施能减少临床不良反应,提升患者生活质量,值得临床推广应用。
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脑卒中后抑郁状态的相关因素分析
Objective To study the relative factors of concomitant depression after stroke.Methods Using Geriatric depression Scale(GDS) and SSS,we scored 121 storke cases who were treated from January 2001 to December 2001, in which 54 cases were concomitant with depression, assessed defect and promotion degree of nervous function, and observed relationship between number of lesion and onset of depression.Result Incidence of depression of cerebral hemarrhage patients was apparently higher than that of cerebral infarction patients (P< 0.05), there was no apparent difference in lesion location and concomitant depression (P >0.05), incidence of concomitant depression of stroke patients with multiple lesions was apparently higher than that of stroke patients with single lesion.Conclusion Concomitant depression of stroke patients is related to location, number of lesions and severity of stroke.