丙戊酸镁缓释片合并奥氮平治疗病毒性脑炎所致精神障碍伴兴奋冲动行为对照研究

观察丙戊酸镁缓释片合并奥氮平治疗病毒性脑炎所致精神障碍伴兴奋冲动行为的疗效及安全性。将60例伴兴奋冲动行为病毒性脑炎所致精神障碍患者随机分为研究组（丙戊酸镁缓释片＋奥氮平）和对照组（氟哌定醇＋异丙嗪）。两组于治疗前及治疗第3天末、第1、2周末采用护士观察量表（NOSIE）、外显攻击行为量表（MOAS）及临床疗效总评量表（CGI）评估疗效,采用副反应量表评定药物不良反应及严重程度。两组NOSIE量表激惹因子分减分率在治疗前后比较,研究组显效率26．7％,有效率90．0％;对照组显效率30．O％,有效率86．7％,两组间总体疗效相当,差异无统计学意义（P〉0．05）;NOSIE量表激惹因子分及MOAS量表评分,研究组在治疗第2周末与治疗前比较差异有统计学意义（P〈0．05）,对照组在治疗第1周末与治疗前比较差异有统计学意义（P〈0．05）,治疗第2周末研究组与对照组比较差异均无统计学意义（P〉0．05）;TESS评分,治疗第3天末、第1、2周末较治疗前均降低,第1、2周末两组差异有统计学意义（P〈0．05）。氟哌定醇合并异丙嗪控制病毒性脑炎所致精神障碍伴兴奋冲动行为较丙戊酸镁缓释片合并奥氮平起效快,治疗2周后两者疗效相当,但丙戊酸镁缓释片合并奥氮平副作用小,安全性高。     

醒脑静注射液辅助治疗小儿病毒性脑炎38例的疗效观察

目的观察醒脑静注射液辅助治疗病毒性脑炎的疗效及安全性。方法病毒性脑炎75例随机分为治疗组38例,对照组37例。对照组按病情给予脱水、利尿等降颅压和激素、抗炎、抗病毒以及营养脑细胞等常规治疗;治疗组则在此基础上加用醒脑静0．4-0．6mL／（kg．d）,加入氯化钠100mL中静脉滴注,1次／d,疗程10d。结果经1个疗程治疗后,治疗组基本治愈率71．1％,对照组35．1％,两组疗效比较,差异有显著意义（P〈0．01）。治疗组临床症状或体征消失时间短于对照组,两组比较缓解消失率有明显差异（P〈0．05）。治疗过程中未发现不良反应。结论醒脑静注射液辅助治疗病毒性脑炎安全有效。     

静注丙种球蛋白和丽科伟治疗重症病毒性脑炎

目的 探讨静注丙种球蛋白和丽科伟联合治疗重症病毒性脑炎的疗效。方法将56例重症病毒性脑炎患儿随机分为治疗组和对照组，每组28例：治疗组在常规综合治疗基础上采用大剂量静注丙种球蛋白和丽科伟联合治疗，对照组采用常规综合治疗，另加用病毒唑抗病毒治疗；分别对两组的临床疗效及药物副作用进行观察。结果治疗组的临床疗效明显优于对照组（P〈0．05），两组基本无明显副作用。结论大剂量静注丙种球蛋白和丽科伟联合治疗重症病毒性脑炎安全，疗效好。     

清开灵治疗流行性乙型脑炎30疗效观察

流行性乙型脑炎是一种常见的传染病，抗病毒药如阿糖饱苷、金刚烷胺等治疗无效，多采用综合治疗。我院自1998—2000年采用清开灵静滴治疗流行性乙型脑炎30例。1 资料与方法1.1临床资料：所有病例均为住院病历。随机分为治疗组30例，平均年龄6.28±3.21岁；病程3.51±2.78天；中型8例，重型15例，极重型7例。对照组30例，平均年龄5.98±3.42岁；病程3.62±2.56天；中型9例，重型15型，极重型6例。两组病情、病程和年龄等方面经统计学处理差异显著（P＞0.05）。1.2 治疗方法：两组均常规应用激素、维生素、脱水剂及脑细胞活化剂，治疗组加用…     

应用米索前列醇与利凡诺中期妊娠引产的效果对比分析

将70例妊娠(16～24)周有引产指针的孕妇随机分成两组实验组30例，阴道置米索前例醇100μg;对照组40例，羊膜腔内注射利凡诺100mg，用药前后行宫颈Bishop评分，比较两组宫颈成熟度评分、引产有效率、产程长短、分娩情况及产后清宫率。结果表明末次用药12h内，实验组宫颈评分平均升高(3．6±1．09)分，明显高于对照组(平均升高(2．6±1．04)分)(P＜0．05);末次用药至正规宫缩时间，实验组为(9．25±4．56)h，较对照组为(36．42±5．67)h，前者比后者明显缩短(P＜0．01);总产程，实验组为(12．50±2．06)h，对照组为(42．56±5．42)h前者明显短于后者(P＜0．01)；产后清宫率，实验组为26．27％，较对照组为80％，前者比后者明显降低(P＜0．01)；引产有效率、产后出血、软产道损伤两组间无显著性差异(P＜0．05)。     

双黄连(冻干)粉针治疗病毒性脑炎34例观察

目的：观察双黄连（冻干）粉针治疗34例病毒性脑炎的临床效果。方法：在治疗相同的基础上，治疗组加用双黄连粉针60mg／kg．d^-1。加入10％GS或5％GS或者生理盐水500ml静脉点滴；对照组加用病毒唑针10mg／kg．d^-1加入5％GS或生理盐水250ml静脉点滴。结果：双黄连粉针治疗组总有效率为94．1％；而病毒唑针对照组总有效率且为53-3％。治疗组与对照组临床疗效结果比较P〈0．01，差异有非常显著性。结论：双黄连粉针是治疗病毒性脑炎较为理想的抗病毒药物。     

黄粉虫对血清总胆固醇及甘油二酯的作用

利用黄粉虫的幼虫含较多亚油酸成分，喂正常迪卡公鸡，并对它的血清总胆固醇及甘油三酯的作用进行研究．试验动物随机分成３组，Ｉ组为对照组，Ⅱ组为黄粉虫幼虫组，６ｇ／ｄ，Ⅲ组为复方亚油酸乙酯丸组，１丸（含亚油酸乙酯３００ｍｇ）／ｄ，实验期１８ｄ．结果表明，血清总胆固醇，Ⅱ组为（２．７３±０．２６）ｍｍｏｌ／Ｌ，Ⅲ组为（２．８３±０．３１）ｍｍｏｌ／Ｌ，均明显低于对照组（３．４０±０．６）ｍｍｏｌ／Ｌ，Ｐ＜０．０１）．血清甘油三酯，Ⅱ组为（０．４０±０．１３）ｍｍｏｌ／Ｌ，Ⅲ组为（０．３６±０．１１）ｍｍｏｌ／Ｌ，均明显低于对照组（（０．９±０．３）ｍｍｏｌ／Ｌ，Ｐ＜０．０１）．试验说明用黄粉虫的幼虫喂迪卡公鸡有显著降低血清总胆固醇和甘油三酯作用．     

半导体激光(650 nm,5 mW)血管内照射对人外周血淋巴细胞凋亡的影响

报道了用半导体激光进行血管内照射（ＩＬＩＢ）治疗１３例患者外周血淋巴细胞凋亡的影响．发现照射前ＰＣＤ为（５．４７±３．６５）％，第一次照射后为（７．１±３．１６）％，第五次照射后为（１６．７１±９．５）％．两者均有非常显著性差异（Ｐ＜０．０１）．     

体育系与普通系女生身体成份与PWC_(170)的测试分析

65名女大学生身体成份和PWC170的测试结果表明，体育专业女生与普通专业女生的体脂百分比无统计学差异（19．8％±4．05对18．8％±3．76，P＞0．05）。而在PWC170体育组高于普通组（458.4±139.21kg·m·min-1对379．88±113．01kg·m·min-1P＜0.05），但两组均低于国际标准（640kg·m·min-1），提示本校女生的体能在下降。     

紫癜灵治疗慢性原发性血小板减少性紫癜22例疗效观察

笔者自拟“紫癜灵”方．用益气养阴活血药物治疗慢性原发性血小板减少性紫癜患者２２例．总有效率为９０．９％．该组病例治疗后，血小板均数从（３．５±１４１）×１０９／Ｌ上升到（７３．３±２１．０）×１０９／Ｌ，治疗前后均数自身对照，经统计分析Ｐ＜０．０１，其差别有高度显著性．     

利多卡因凝胶治疗带状疱疹后神经痛临床疗效分析

目的探讨利多卡因凝胶治疗带状疱疹后神经痛的临床疗效.方法随机将86例带状疱疹后神经痛患者分为两组,对照组43例使用双氯芬酸凝胶治疗,治疗组43例使用利多卡因凝胶治疗,观察比较两组临床疗效.结果观察组治疗总有效率(93.02%)显著优于对照组(76.74%)(P0.05);治疗前,两组患者VAS评分无统计学意义(P0.05);治疗后1,2,4周观察组VAS评分(13.5±14.2),(18.5±17.1),(20.8±19.0)分,均显著优于对照组(6.8±12.5),(7.3±12.4),(8.2±14.3)分,差异具有统计学意义(P0.05).结论利多卡因凝胶治疗带状疱疹后神经痛,效果明显,值得进一步深入研究与临床推广使用.     

微创经皮椎弓根内固定术对胸腰椎骨折患者功能障碍指数、伤椎高度及疼痛程度的影响

目的 探讨经皮椎弓根内固定术(MIPPSO)对胸腰椎骨折患者功能障碍指数、伤椎高度以及疼痛程度的影响。方法 回顾性分析2018年10月-2020年10月期间我院进行微创经皮椎弓根内固定术治疗的45例胸腰椎骨折患者临床资料。观察记录所有手术患者创面愈合时间、手术时间、术中出血量。同时比较患者术前、术后的功能障碍指数(ODI)、疼痛程度(VAS)以及伤椎高度与Cobb角。结果 本次研究的45例患者胸腰椎手术均已完成。其中创面愈合时间为(7.34±1.23)d,手术时间为(83.98±6.22)min,术中出血量为(66.45±5.11)ml。术后6d与术后10个月,ODI、VAS评分均明显低于术前(P<0.05)。术后6d与术后10个月,患者伤椎前缘高度均明显高于术前(P<0.05),但Cobb角度明显均低于术前(P<0.05)。结论 胸腰椎骨折患者进行经皮椎弓根内固定术治疗,能够改善患者腰椎功能障碍,同时减少术中出血量,缩短手术时间,促进创面快速愈合,并有效减轻术后机体疼痛,值得临床应该与推广。     

RACK1基因在急性冠脉综合征行PCI术患者外周血中的表达及意义

选取在我院行PCI术的急性冠脉综合征患者66例,用实时荧光定量PCR法分别测定PCI术前及术后3个月时患者外周血单个核细胞中RACK1基因的表达。40名健康者作为对照组。测定结果是:(1)急性冠脉综合征组患者外周血单个核细胞中RACK1 mRNA表达水平明显高于对照组(17.56±4.98 vs 3.11±1.24,P0.05);(2)急性冠脉综合征患者行PCI术3月后,外周血单个核细胞中RACK1 mRNA表达水平较术前明显降低(10.84±3.71 vs 17.56±4.98,P0.05),但仍高于健康者(10.84±3.71 vs 3.11±1.24,P0.05)。RACK1在急性冠脉综合征患者外周血中表达上调,其表达水平可能和病情进展相关。     

中药止血散的止血作用初探

本实验选用ＮＩＨ小鼠，随机分成Ⅰ、Ⅱ、Ⅲ三组，用环磷酰胺建立小白鼠再生障碍性贫血动物模型．实验结果显示：出血时间Ⅰ（对照）组（１．５８±０．１５）ｍｉｎ，Ⅱ（环磷酰胺）组（５．２３±０．２７）ｍｉｎ，Ⅲ（环磷酰胺＋止血散）组（１．５７±０．１）ｍｉｎ；统计学处理表明Ⅱ与Ⅰ组间有差异（ｐ＜０．０５），Ⅱ与Ⅲ组间有差异（ｐ＜０．０５），Ⅰ与Ⅲ组间无差异（ｐ＞０．０５）；血块回缩分别为完全、不良、完全，血小板计数分别为４３０．２±３４．３６×１０￣９Ｌ￣（－１），２８４±１９．９６×１０￣９Ｌ￣（－１），４６５．４±２２．４８×１０￣９Ｌ￣（－１）．统计处理表明Ⅱ与Ⅰ组间和Ⅱ与Ⅲ组间存在显著性差异（ｐ＜０．０１），Ⅰ与Ⅲ组间无差异，本实验提示：中药制剂止血散能促进血小板的生成和血小板的释放，具有止血作用．     

Cardiac protective role of a novel erythrocyte-derived depressing factor on rats and its Ca^2＋ mechanism

The cardiac protective role of a novel erythro-cyte-derived depressing factor (EDDF) on spontaneous hy-pertensive rats (SHR), calcium overload (CaO) rats and Wistar rats and its mechanism was evaluated. Mean artery pressure (MAP), heart rate (HR) and LVdp/dtmax were measured by physiological recorder. The effect of EDDF on the Ca2+-ATPase activity in myocardial sarcoplasmic reticu-lum (SR) of CaO rats was determined by inorganic phos-phate assay. Calcium transport in myocytes was measured by 45Ca2+ radioactive isotope measurement. The phosphoryla-tion levels of extracellular signal-regulated protein kinases (ERK1/2) in myocardial tissue of SHR and CaO rats were measured by Western blot method. And the ultrastructures of cardiac muscle cells were observed with the transmission electron microscope. The results indicated that EDDF could significantly decrease MAP, HR and LVdp/dtmax in a dose dependent manner (P < 0.05). It seems that the mechanism might relate with activating the Ca2+-APTase, enhancing the uptake and release of Ca2+ from SR (P < 0.05), decreasing the phosphorylation levels of ERK1/2 of myocytes (P < 0.01) and lightening the ultrastructural lesion of cardiac muscle cells. In CaO rats, the Ca2+-ATPase activity decreased clearly com-pared to control (64.99 7.16 vs 94.48 7.68 nmol·min-1 ·mg-1 protein, P < 0.01), while EDDF (100 mg/mL) could significantly increase the activity (87.93 ?9.54 vs 64.99 ?7.16, P < 0.05, n = 7). Both uptake and release rate of Ca2+ (祄ol 45Ca2+/g protein/min) from myocardial SR of CaO rats re-markably decreased compared to control (32.40 ?2.70 and 15.46 ?1.49 vs 61.09 ?10.89 and 25.47 ?4.29, P < 0.05); EDDF (100 mg/mL) could significantly stimulate their activi-ties (50.48 6.76 and 21.76 2.75 vs 32.40 2.70 and 15.46 1.49, P < 0.05). EDDF could evidently down-regulate the phosphorylation of ERK1/2 in myocardial tissue from SHR and CaO rats (P < 0.01), lighten the ultrastructural lesion of cardiac muscle cells of SHR as well. It is concluded that EDDF seems to play protective roles on both structure and function of heart, which closely related with amelioration of Ca2+ transport and inhibition of Ca2+-MAP kinase pathway.     

慢性阻塞性肺疾病急性加重患者治疗后气道阻力变化特点

为探索慢性阻塞性肺疾病急性加重(AECOPD)患者经过治疗后气道阻力变化特点,通过选取2017年3月～2018年3月因AECOPD就诊病人共50例,其中男性患者39例,女性患者11例,平均年龄(68. 1±8. 7)岁,所有患者于第1天治疗前及门诊治疗后第7天均行常规肺功能(PFT)联合脉冲振荡肺功能(IOS)检查,比较治疗前后肺功能指标变化。结果表明AECOPD患者治疗后共振频率(Fres)、总气道阻力(R5)、中心气道阻力(R20)、外周气道阻力(R5-R20)、5 Hz时电抗(X5)、低频电抗面积(AX)均明显低于治疗前,R5-R20改善值与FEV1%pred负相关性最强(r=-0. 507,P 0. 05),R20改善值与基线PFT相关性无统计学意义(P 0. 05)。可见AECOPD患者经治疗后全气道阻力下降,其中外周气道阻力的变化指标R5-R20与基线PFT相关性最好,气流受限越重患者治疗后外周气道阻力改善越明显,以R5-R20作为慢阻肺急性加重治疗效果评价指标具有相对可靠的临床适用性。     

Immobilization of arsenic in soils by stabilized nanoscale zero-valent iron, iron sulfide (FeS), and magnetite (Fe3O4) particles

Arsenic is a widespread contaminant in soils and groundwater. While various iron-based materials have been studied for immobilizing arsenic in contaminated soils, the feasibility of stabilized iron-based nanoparticles has not been reported. This study investigates the effectiveness of using three types of starch-stabilized iron-based nanoparticles, including zero-valent iron (ZVI), iron sulfide (FeS), and magnetite (Fe₃O₄), for immobilization of arsenic in two representative As-contaminated soils (an orchard soil and a fire range soil). To test the effect of the nanoparticles on the arsenic leachability, As-contaminated soils were amended with the nanoparticles at various Fe/As molar ratios (5:1–100:1) and contact time (3 and 7 d). After three days’ treatments of a field-contaminated sandy soil, the PBET-based bioaccessibility of As decreased from an initial (71.3±3.1)% (mean±SD) to (30.9±3.2)% with ZVI, (37.6±1.2)% with FeS, and (29.8± 3.1)% with Fe₃O₄ at an Fe/As molar ratio of 100:1. The TCLP-based leachability of arsenic in a spiked fire range soil decreased from an initial (0.51±0.11)% to (0.24±0.03)%, (0.27±0.04)% and (0.17±0.04)% by ZVI, FeS, and Fe₃O₄ nanoparticles, respectively. The Fe₃O₄ nanoparticles appeared to be more effective (5% or more) than other nanoparticles for immobilizing arsenic. When the two soils were compared, the treatment is more effective on the orchard soil that has a lower iron content and higher initial leachability than on the range soil that already has a high iron content. These results suggest that these innocuous iron-based nanoparticles may serve as effective media for immobilization of As in iron-deficient soils, sediments or solid wastes.     

合并膀胱逼尿肌无力的前列腺增生患者激光治疗的临床观察

为探讨合并膀胱逼尿肌无力(detrusor underactivity,DU)的前列腺增生患者进行激光治疗的安全性及临床疗效.通过分析2017年1月—2019年11月完成的10例激光治疗的合并DU的前列腺增生患者资料:年龄58～88岁(平均74.00岁),其中长期留置尿管引流尿液1例,前列腺超声测得体积24.1～94.26 mL(平均46.7 mL).术前泌尿系彩超、直肠指诊、膀胱镜检查及尿动力检查明确前列腺增生诊断.尿动力学检查结果显示:最大逼尿肌压力(Pdet,max)为15～49.5 cm H2 O(平均35.3 cm H2O),膀胱收缩指数(bladder contractility index,BCI)为21～89,线性被动尿道阻力关系分级(linearized passive ure-thral resistance relation,linPURR)3例膀胱出口梗阻(bladder outlet obstruction,BOO),6例可疑膀胱出口梗阻,1例无膀胱出口梗阻,排除前列腺癌.观察术中出血情况、手术时间、并发症发生情况.观察术前术后国际前列腺症状评分(international pros-tate symptom score,IPSS)、生活质量评分(qaulity of life,QoL)、最大尿流率(maximum urinary flow rate,Qmax)及术后尿管留置时间.观察及随访术后排尿情况,有无尿潴留及再次置管并发症.结果表明:10例手术过程顺利,未发现严重脑梗、心梗、血栓、大量出血及周围器官组织损伤等严重并发症.手术时间40～130 min(平均70 min).术后留置导尿管时间4～12 d(平均5.4 d).术后Qmax由术前(4.4±0.6)mL/s增加至(13.9±5.7)mL/s(P<0.05),IPSS及QoL分别从(21.3±6.2)分和(5.1±1.1)分降到(10.8±4.1)分和(1.4±0.7)分,手术前后比较差异均有统计学意义(P<0.05).术后拔尿管后能自行排尿,随访3～6月无尿潴留及尿失禁发生.可见合并DU的前列腺增生患者并非手术治疗的绝对禁忌症,经尿道激光前列腺切除术治疗该类患者是一种安全、有效的微创治疗方法.     

Assessment of alternated cooling and heating treatment by US combined CEUS in the VX2 rabbit liver tumor model

Inoperable liver tumors are often treated by thermal ablation that destroys the tumor in situ and spares the adjacent hepatic tissue.Thermal–physical treatment has many advantages,but treatment by freezing or heating alone has some limitations.By taking the advantages and disadvantages of cryosurgery and thermotherapy into consideration,a new thermal technique that combines cryosurgery and radio frequency ablation has been proposed,thereby overcoming the disadvantages of each treatment strategy and improving therapeutic outcomes.This new approach remains to be systematically studied in the liver;therefore,this study was performed to estimate survival after alternated cooling and heating ablation therapy in a VX2 rabbit liver tumor model.Sixteen days after VX2 carcinoma implantation into the rabbit liver,tumors were treated with alternated cooling and heating ablation therapy.Rabbits were monitored for 6 months after treatment and assessed with ultrasound(US)and computed tomography at 1,7,14,and 30 days posttreatment.Untreated tumor-bearing animals served as the control group.Our results show that alternate freezing and heating ablation therapy resulted in a good recovery of VX2 rabbits.Compared with the control group,treated rabbits lived significantly longer(P\0.05),with 70%of treated animals surviving to 196 days posttreatment without metastasis or recurrence,while none of the controls did so.There was no local recurrence in the treatment group.All rabbits in the control group developed metastasis,while metastasis was only observed in 30% of treated rabbits.These results suggest that alternate cooling and heating ablation therapy can prolong the survival time of rabbits with VX2 liver tumors and is an effective method for tumor therapy.Furthermore,we also showed in this model that contrast enhanced US is a valid follow-up approach to assess treatment effectiveness.     

肥胖低通气综合征患者血清瘦素水平的变化及意义

为了研究血清瘦素在肥胖低通气综合征(OHS)患者体内的变化及其意义,通过酶联免疫吸附测定(ELISA)法测定了所有受试者的血清瘦素水平,选取OHS组23例、肥胖OSA组40例、非肥胖OSA组14例、单纯肥胖组6例和正常对照组10例。比较所有受试者的一般资料、血清瘦素水平和多导睡眠参数,分析肥胖各组的血气分析结果。对瘦素与其他参数进行相关性分析,并分析其对OHS的诊断预测。结果表明OHS组BMI、颈围明显高于其他组。OHS组血清瘦素水平高于其他各组,且各组之间均存在明显差异(P 0.05)。血清瘦素水平与BMI、颈围、腰围、臀围、Pa CO_2、动脉血HCO_3~-呈正相关,与Pa O_2呈负相关。BMI、颈围、腰围和血清瘦素水平对OHS具有诊断预测作用。可见OHS组血清瘦素水平较肥胖OSA组、单纯肥胖组明显升高,除了肥胖因素外,OHS本身也可成为血清瘦素水平升高的原因,血清瘦素水平的升高可以作为OHS的诊断预测指标之一。