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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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Adrenocortical hormone (ACH) has antiinflammatory and antiallergic actions, changes stress state and controls the attack of some severe and obstinate diseases. The treatment of chronic diseases with ACH often leads to its dependence; especially oral administration of ACH for a long time is liable to inhibit the function of hypothalamus-pituitary-adrenocortical-thymic axis (HPAT), and results in the hypo-reservation of adrenal cortex. Hence, sudden ACH withdrawal or decrease often causes the disease recurrence, even adrenocortical crisis. Academician Shen Ziyin has a wealth of clinical experience in both the withdrawal and reduction of ACH and the keeping of therapeutical effectiveness to form his unique remedy in the application of drugs. Shen's rich experience is described as follows.
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Clinicopathological Conference(the48th case)Adult gland pituitary hypofunction in an elderly female patient
Case presentation A female patient(a retired worker),68 years old,who complained mainly of "repeated episodes of dizziness,fatigue,vomiting in 6 years,chest tightness,chest pain for 1 year",was admitted to Heart Center,Chaoyang Hospital,Capital Medical University on February 24,2010.The patient suffered from dizziness and fatigue with unknown cause 6 years ago.She ever experienced sudden syncope and loss of conscioueness during visiting Xuanwu Hospital,when she presented with blood pressure of 62/? mmHg and slower heart rate,then her consciousness recoverd spontaneously 1-2 minutes later with no treatment.The head CT and electrocardiogram(ECG)showed no significant abnormality,and she was discharged after symptomatic treatment.Since then,the patient presented with intermittent anorexia,dizziness,nausea,vomiting,non-visual rotation,which were not affected by different body positions.All these symptoms appeared more frequently in winter,lasted for several days,relieved without any treatment.One year ago,the patient began to suffer from chest tightness and chest pain at physical activities.Each attack lasted for 3-5minutes and relieved by rest.In Xuanwu Hospital,the diagnosis of "coronary heart disease,angina pectoris " was established.After oral administration of "Wan Shuang Li" and other meidcations,chest tightness and chest pain appeared accidentally.Ten days ago,the patient experienced dizziness and vomiting(stomach contents,4-5 times a day on average).No visual rotation or tinnitus was accompanied.Twenty-nine hours before admission,the patient suffered from chest distress and chest pain again after 100 meters walking,accompanied with shoulder dispersion and sweating;the symptoms relieved after resting for 3-5 minutes.For further treatment,the patient visited Heart Center,Chaoyang Hospital.ECG showed "sinus bradycardia",and she was admittied for "arrhythmia".Since the onset,the patient displayed low blood pressure,slow heart rate,Susceptibility to coldness,frailty,poor appetite and sleep,normal stool.The body mass decreased by about 5kg over the past decade.
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中药内服外用治疗勃起功能障碍(ED)50例临床观察
从2003年3月~2005年3月笔者采用中药内服外用治疗勃起功能障碍(ED)50例,治疗前后应用阴茎勃起角度值的对比进行疗效评估,疗效满意,报告如下.
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透明质酸连续口服后在血清和皮肤中的分布
透明质酸(玻璃酸,hyaluronic acid,HA)是由N-乙酰氨基葡糖和D-葡糖醛酸双糖单位以糖苷键交替连接而成的多糖,广泛存在于机体中,以皮肤、关节腔、眼、血管、心脏及脑中的含量较高.
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口服环丙沙星致血管神经性水肿一例
1 病例报告患者,女,60岁,过往因上呼吸道感染引发鼻窦炎服用环丙沙星,取得良好疗效.近日病情复发,遂自行服用盐酸环丙沙星片(广州白云山制药总厂,批号1090002),3次/d,0.5 g/次.第2天晚服药后,自觉双唇麻木似蚁爬感,轻微能耐受,未诉说,未采取治疗措施即睡下.次日晨起,双唇感觉正常,其他未有异样,遂继续服用,2 h后,双唇又现麻木感,较前日明显,继而双唇肿胀,遂向家中从事医疗工作者诉说,经分析认为系环丙沙星所致血管神经性水肿,停止服用环丙沙星,经顿服氯雷他定片(上海先灵葆雅制药有限公司,批号08ERXF1022)10 mg、地塞米松片(浙江仙琚制药股份有限公司,批号080624)0.75 mg,当日双唇麻木感消失.
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口服利君沙片致胃肠型过敏反应一例
1 病例资料患者,女,55岁.2006年9月20日上午在拔牙后给予利君沙0.375 g,3次,d,服药3次后出现中上腹部疼痛、恶心、呕吐,故停用利君沙,给予口服胃舒平片2片,3次/d,胃复安10 mg,肌注,症状暂时减轻.4 h后症状再次加重,给予吗丁啉10 mg,3次/d,症状无减轻.9月21日患者皮肤出现散在皮疹,仍感上腹痛、恶心,给予扑尔敏4mg,3次/d,服用扑尔敏后约0.5 h患者腹痛减轻,恶心、呕吐症状缓解,1 d后上腹部症状完全消失,皮疹消失.
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口服莫西沙星过敏后误诊一例
1 病程及用药患者,女,55岁,咳嗽,痰多不能睡眠,使用头孢噻肟、头孢呋辛、阿莫西林等治疗两周后效果不佳.于2009年3月6日10:00前往医院就诊,患者午餐后13:00给予氯雷他定片10 mg,口服,1次/d,无异常,15:00给予莫西沙星(拜复乐,德国拜尔公司,生产批号:115454)0.4 g,口服,1次/d,20 min后感觉胸闷气短,勉强耐受至第2天症状仍未好转,去医院复诊.
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持续质量改进在口服给药安全管理中的应用
内科干部病房的服务对象主要是老年病人,病人合并症多,需要应用的药物种类纷繁复杂、用药时间要求多样,如用药过多或剂量不当,加上老年人各器官功能逐步障碍、本身对药物的反应很容易发生药物毒性反应,甚至因药物反应而加重病情,或使健康受到威胁.基于这个原因,老年内科的用药安全一直是临床医护人员关注的问题.2009年10月-2010年10月我科采用持续质量改进的方法控制分发口服药中的护理缺陷,有效预防差错事故的发生,取得了良好的效果.现报告如下.
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综合应用中西药物预防术后肠粘连的实验研究
术后肠粘连和粘连性肠梗阻的发病率在小儿剖腹术中约占6%,且发病率逐年增高.因此,术后肠粘连的预防甚为重要.对术后肠粘连的预防,国外多应用皮质激素类或促进局部纤溶的药物,国内则广泛应用中药制剂.但文献报告多为单独用某种药物.
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临床药师查房英语
Clinical pharmacist:Good morning,how are you feeling today?药师:早上好,今天感觉怎么样?Patient:Not so good,I've been feeling like nausea and vomit since yesterday,just after finished my chemotherapy.患者:不太好,从昨天化疗完成后就一直恶心、想吐.Clinical pharmacist:Ok,let me check your medical order.Yes,the GP(Gemcitabine+Cisplatin) regimen performed yesterday is very good for NSCLC(Non-Small Cell Lung Cancer),but the Cisplatin in the regimen can cause severe nausea and vomit.And I find the doctor has given antiemetic for you: Tropisetron with intravenous injection and Metoclopramide for oral administration three times a day.Did you follow the advice?药师:好吧,让我看看你的医嘱.是的,你用的GP化疗方案确实对非小细胞肺癌有效,但是其中的顺铂也很容易引起恶心呕吐.而且医嘱上也给你开了止吐药了,有静脉给的托烷司琼,还有口服的甲氧氯普胺需要一天吃三次,你是按这种方法用药的吗?
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中药内服外敷治疗退变性腰椎管狭窄症36例
2004年5月~2008年5月,笔者用中药内服外敷治疗退变性腰椎管狭窄症效果良好,现介绍如下.1临床资料36例均经临床及影像学检查(腰椎X片、CT、磁共振等)确诊.男17例,女19例;年龄50~59岁6例,60~69岁16例,70~77岁14例;病程6月~9年,平均3.5年.