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加强对支气管哮喘和慢性阻塞性肺疾病本质及异同点的认识,提高治疗效果
本期发表了2篇有关支气管哮喘(简称哮喘)与慢性阻塞性肺疾病(COPD)相互关系及异同点的论文[1,2],读后颇有收益,这也是近期国内外关注的热点之一[3-7].的确,一部分COPD患者在临床症状、炎症反应、病理及病理生理改变方面与哮喘有诸多重叠和相似之处.
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进一步提升对心房颤动的治疗质量
心房颤动(房颤)发病率高,致残、致死率高早已引起医药学界高度关注,尤其是近30年来,有关对房颤的基础与临床的研究成果层出不穷,这些研究成果业已融入国内外指南/共识之中,对房颤规范化治疗产生巨大的推动作用.
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进一步提高结直肠癌疗效的思考
结直肠癌是常见的消化道肿瘤之一.根据目前对结直肠癌的认识,其发病因素中环境因素(特别是饮食因素)与遗传因素较为确定;癌前病变演变为结直肠癌的过程漫长;诊断亦不困难;早期治疗效果良好.
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精神医学中的生物统计学(6):对观察性研究治疗效果的估计
In randomized treatment studies the randomization of subjects to the different treatment conditions ensures that the treatment groups are comparable in their baseline characteristics-measured or unmeasured-so we can confidently attribute differences in treatment outcomes to the assigned treatments.In contrast,subjects in observational studies are not randomly assigned to the treatment groups so differences in treatment outcomes could be due to differences in baseline characteristics between the treatment groups.For example,if we wished to compare the outcome of high-intensity treatment for depression (i.e.,many visits in the prior 12 months) versus the outcome of low-intensity treatment for depression (i.e.,few visits in the prior 12 months) and included subjects from both primary care and specialty mental health clinics,any observed differences in the outcomes for low-intensity and high-intensity treatment could be due to differences in the proportions of subjects that were treated in the two types of clinics.When the treatments being compared (e.g.,low versus high intensity of care) and other factors that can affect the outcome (e.g.,type of clinic or patient characteristics) are associated with each other,there is confounding.
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E型沙眼衣原体临床株热休克蛋白60含量变化及传代衣原体培养与疗效的关系
目的 探讨E型标准株和细胞培养成功的沙眼衣原体E型临床株随着传代次数的增加其热休克蛋白60(HSP60)含量的改变.方法 经McCoy细胞培养法检测出的40例E型沙眼衣原体临床株,分为首次传代出现和未出现包涵体两组,通过RT-PCR方法检测1~4次传代的HSP60含量,x2检验其与对应患者疗效的关系.结果 经细胞培养成功的E型沙眼衣原体临床株传代未出现包涵体时其HSP60含量较出现包涵体时高(P<0.05).18例首次传代出现包涵体的标本1~4次传代HSP60/16SrRNA分别为0.38±0.06、0.39±0.03、0.38±0.04、0.39±0.03;12例2次传代出现包涵体的标本1~4次传代HSP60/16SrRNA分别为1.18±0.10、0.28±0.06、0.30±0.03、0.29±0.05;10例3次传代出现包涵体的标本1~4次传代HSP60/16SrRNA分别为1.20±0.04、1.20±0.04、0.28±0.04、0.28±0.05.患者疗效对1次传代是否出现包涵体有影响,20例治疗失败患者16例1次传代未出现包涵体,1个疗程治疗后转阴患者20例中14例在1次传代出现包涵体.结论 80%治疗失败患者1次传代未见包涵体,临床株传代培养未出现包涌体时沙眼衣原体可能处于持续感染状态,其CHSP60合成增加,临床采集的衣原体标本至少应进行3次盲传以避免漏检.
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美沙酮与丁丙诺啡联用治疗海洛因依赖的临床效果
Objective:To explore the effectiveness of methadone combined with buprenorphine on the alleviation of heroin withdrawal symptoms. Methods: One hundred and twenty patients with heroin dependence were randomly divided into two groups , namely the methadone combined buprenorphine treatment group (n=60)and the methadone alone treatment group (n=60). Rating scales were employed to assess the treatment outcomes. Results: Compared with patients in the methadone alone treatment group, patients in the combined treatment group reported fewer withdrawal symptoms, especially in first four days. They also subjectively considered the combined treatment as more acceptable. This effect was more pronounced in patients with relatively high levels of initial withdrawal symptoms. Conclusion: Methadone with buprenorphine was proved to be a favourable combination treatment in terms of reducing withdrawal symptoms, as well as improving the short-term detoxification success rate, especially in patients with severe heroin withdrawal symptoms.