自发性气胸140例的临床分析

自发性气胸是内科呼吸系统常见的急症之一,该病来势常急骤,若诊断处理及时、得当常可化险为夷,反之则会危及生命．我院自１９８３年３月－１９９７年３月期间收治１４０例病例,现就其病因、临床表现及诊断治疗作一初步分析．１一般资料１４０例均为住院病人,其中男性...     

自发性液气胸的早期诊断——附两例病例报告

目的 为探讨自发性液气胸的早期诊断.方法 采用临床病例回顾对比法进行.结果 两例均为年轻健康者,无外伤史,突然感觉胸闷、胸痛、进行性呼吸困难而求医.检查见患者呈急性病容,呼吸困难,纵隔及气管向健侧移位,肺部未闻及干湿性啰音,病侧呼吸音消失.血象检查为正常值,胸部摄片为液气胸.结论 此病发病较快,呈进行性,应早期进行X线检查,以求早期得以治疗.     

中心静脉导管在胸腔穿刺技术中的应用及护理

恶性胸腔积液是肿瘤内科常见的并发症之一,临床上需进行胸腔穿刺,多次引流以缓解患者胸腔压力,给予胸腔内药物灌注治疗。但原有胸腔穿刺技术需反复多次穿刺,既增加患者痛苦又增加了污染机会,穿刺针为金属硬针,易出现气胸、血气胸等并发症。我们将中心静脉导管应用于胸腔穿刺中,克服了原有技术的不足,具有独特的优越性。我科于2000年1月-2004年12月用该方法治疗138例恶性胸腔积液患者取得了满意的效果。1,临床资料及药物选择1.1,临床资料患者中男性86例,女性52例,年龄25-73岁,平均年龄53岁。均有病理学诊断,其中肺癌118例,乳腺癌4例,恶性淋巴…     

元极疗法对提高晚期癌症生存质量初探

采用养德、多炼元极功法、三元能量治疗（贯顶开天目、调理疾病）、药理治疗等元极疗法对晚期癌症患者进行治疗,以提高他们的生存质量。通过对１５９例晚期癌症患者提高生存质量的临床观察,经元极医学治疗后,有７１．０６％的晚期癌症患者ｋｐｓ评分提高,其中提高２０分以上者达３８．３６％。有７１．０％的晚期癌症患者生存质量评分提高,其中提高１０分以上者占５２．２０％。２０％左右的患者病情稳定,总有效率达９１％。     

儿童传染性单核细胞增多症的两种治疗方法的比较

目的：观察利巴韦林、更昔洛韦治疗儿童传染性单核细胞增多症（IM）（简称传单）的疗效对比。方法：70例传单患儿随机分为对照组和治疗组。两组患儿在常规治疗的基础上,对照组35例给予利巴韦林10mg／kg／d,治疗组35例给予更昔洛韦10mg／kg／d,均静脉滴注,疗程均为7～10天。结果：治疗组总有效率达94．29％,明显高于对照组68．57％,（P〈0．01）;治疗组热程、咽峡炎改善时间、淋巴结缩小时间、肝脾回缩时间、平均住院时间、变异淋巴细胞恢复至〈10％的时间均较对照组明显缩短（P〈0．01或P〈0．05）。结论：更昔洛韦治疗儿童传单较传统的利巴韦林疗效好,值得推广。     

外用盐酸氨基酮戊酸光动力疗法治疗尖锐湿疣多中心随机对照研究

目的观察外用盐酸氨基酮戊酸光动力疗法（ALA-PDT）治疗尖锐湿疣的安全性与疗效,方法随机、开放,CO2激光平行对照的多中心临床研究,分为ALA-PDT试验组和CO2激光对照组,疗程最多3周,末次治疗后第1周进行疗效评价,第4,8和12周观察复发率,治疗前及末次治疗后1周进行实验室检查,并观察不良反应,结果5个中心共入组尖锐湿疣患者453例,其中442例完成全部随访（试验组331例,对照组111例）,在末次治疗后1周,试验组和对照组疣体清除率分别为98.42％和100％（P〉0.05）,两组男性尿道口部位的疣体清除率分别为99.43％和100％（P〉0.05）,试验组治疗后总复发率（10.77％）较对照组（33.33％）显著降低（P〈0.0001）。其中男性尿道口部位的疣体复发率在试验组和对照组分别为10.53％和36.36％,差异亦有统计学意义（P〈0.0001）试验组及对照组均未发生系统不良反应,局部不良反应发生率在试验组为7.67％,主要为轻微糜烂;对照组53.57％,主要为溃疡、疼痛,其中瘢痕14例次,试验组不良反应发生率明显低于对照组,差异有统计学意义（P〈0.0001）结论外用ALA-PDT疗法治疗尖锐湿疣治愈率高,复发率低,安全性好,特别适用于男性尿道口尖锐湿疣的治疗。     

补阳还五汤联合空气波压力治疗仪治疗糖尿病高危足临床观察

目的：观察补阳还五汤联合空气波压力治疗仪治疗糖尿病高危足的临床疗效。方法：112例糖尿病足0级病变患者随机分为治疗组53例和对照组49例,均进行常规基础治疗,治疗组加用补阳还五汤联合空气波压力治疗仪治疗,对照组加用前列腺素E1治疗。4周后评价、总结疗效。结果：治疗组显效25例（47-2％）,良好14例（26．4％）,改善8例（15．1％）,无效6（11．3％）例,总有效率88．7％;对照组显效7例（14．3％）,良好10例（20．4％）,改善27例（55．1％）,无效5例（10．2％）,总有效率为89．8％。两组总有效率比较差异无显著性（P〉O．05）,但治疗组显效率高于对照组,差异有显著性（P〈0．05）。结论：补阳还五汤联合空气波压力治疗仪治疗糖尿病高危足疗效确切,适于临床推广应用。     

不同胸腔闭式引流术方案对创伤性(非开放型)气胸疗程比较

目的对比创伤性(非开放型)气胸患者在不同位置留置胸腔闭式引流术的差别,从而对今后创伤性(非开放型)气胸置管方案提供指导意义。方法对创伤性(非开放型)气胸患者分别经锁骨中线第2肋间、腋中线第6肋间行胸腔闭式引流术,对比两种术式并发血胸能否及时引流。结果 67例创伤性(非开放性)气胸中经锁骨中线第2肋间置管33例、经腋中线第6肋间置管34例,后者能及时有效引流(P0.01)。结论对外伤性(非开放型)气胸置管应首选腋中线第6肋间。     

高血压用药20问

据中国医师协会高血压专家委员会近日发布的数据显示,我国高血压患者达1.6亿。而与高血压患病率相对应的却是很多人并不知道自己是高血压病患者。调查显示：高血压患病知晓率低（仅占患病人数的30．2％）、治疗率低（25％）、控制率低（6％）。这与世界总体水平有着很大的差距：美国高血压控制率为34％、法国27％、意大利23％、苏格兰17．5％,与我国国情相似的印度有9％,而同是中华民族的台湾也有24％。     

中药胃安散根除幽门螺杆菌的临床研究

探讨幽门螺杆菌感染致慢性胃炎和消化性溃疡病的中医理论认识、病理机制和治疗原则,使之有效地指导临床实践,观察中药胃安散根除幽门螺杆菌的临床疗效,为治疗幽门螺杆菌感染致相关性病创立一个新的理论和方法。研究方法：将180例患者随机分组,其中对照组90例,以甲硝唑0．4g,日2次,阿莫西林1．0g,日3次,果胶铋100mg,每天4次,均饭前半小时温开水送服;治疗组90例,以自制中药胃安散6g,日三次,饭前半小时温开水送服。两组均以三周为疗程观察;两组分别于治疗后对中医症状疗效、内镜下观察胃粘膜改善、病理诊断改善、幽门螺杆菌根除率进行对比分析。研究结果：中药胃安散根除幽门螺杆菌的临床研究,治疗组中医症候治疗总有效率为95．56％,明显优于对照组的82．22％,具有显著性差异（P〈0．01）;治疗组中医单项症状疗效明显优于对照组,除胃脘痛疗效无差异外（P〉0．05）,其他症状疗效均有显著性差异,（P〈0．01）;治疗组与对照组中医症候积分比较,有显著性差异（P〈0．05）;治疗组与对照组单项症候积分比较,有显著性差异（P〈0.05）;;台疗组内镜疗效为84．44％,对照组为74．44％,两组比较有显著性差异,（P〈0．05）;两组病理疗效比较治疗组明显优于对照组,除萎缩无差异外（P〉0．05）,其他均有显著性差异（P〈0．01）;治疗组幽门螺杆菌清除率为84．44％,对照组为74．44％,两组比较有显著性差异,（P〈0．05）。研究结论：中药胃安散根除幽门螺杆菌的研究证明,中药胃安散对中医症侯的治疗疗效好,无明显的毒副作用和不良反应,并且价格便宜,治疗依从性好。为根除幽门螺杆菌和治疗幽门螺杆菌相关性胃病,创新的中医理论的认识观和实践观,确立了新的治疗原则,为根除幽门螺杆菌和治疗幽门螺杆菌相关性胃病开辟了新的途径。     

育龄妇女早期自然流产危险因素的Logistic回归分析

目的:调查育龄妇女早期自然流产的危险因素,降低和预防自然流产的发生。方法:采用病例对照研究,用单因素和多因素Logistic回归分析探讨早期自然流产的危险因素。结果:单因素分析显示,男女双方学历、男女双方年龄、胎次与早期自然流产相关;多因素Logistic回归分析显示,女方学历、规律的妇科检查、男方年龄与早期自然流产相关。结论:女方学历、男方年龄是引起育龄妇女早期自然流产的危险因素,规律的妇科检查可降低自然流产的发生。     

伤寒LPS-PHA快速诊断试剂盒的评价

本文对伤寒LPS-PHA诊断试剂盒进行现场应用评价.来自各医院和不同地区977份不同类型的血清标本作LPS-PHA检测的同时与Widal试验作比较,结果伤寒沙门氏菌血培养阳性46份血清标本前者检出率(86.96％)显著高于后者(67.39％),两者在统计学上有显著差异(X~2=4.999,P<0.025),95份Widal试验阳性血清LPS-PHA阳性率为97.89％,漏检2份系乙型副伤寒抗体阳性者.607份对照血清标本LPS-PHA的假阳性率1.48％,低于Widal试验(4.84％).伤寒LPS-PHA的敏感度和特异度(94.33％和98.52％)高于Widal试验(89. 36％和95.72％).其他5项评价指标(阳性和阴性预示值,粗一致性,调整一致性和约登指数)亦都较Widal试验好.因此,LPS-PHA诊断试剂盒能满足目前临床上早期快速诊断伤寒的要求.但不适用于追溯诊断和血清流行病学调查.     

SP100B Expression Indexed Hemorrhage in Mouse Models of Cerebral Hemorrhage

The aim of the present study was to investigate the expression of SP100B in mouse models with acute cerebral hemorrhage. Mouse models of cerebral hemorrhage were induced using injection of collagenase into the brain. The serum levels of SP100B were detected by ELISA. The expression of SP100B in the hippocampus and other brain tissue were detected by indirect immunofluorescence technique. The mean concentration of serum SP100B was significantly higher in hemorrhage group (0.85 μg/l) than in control group (0.20 μg/l) (P = 0.0017). More importantly, the mean value of serum SP100B in both moderate hemorrhage (0.96 μg/l) and severe hemorrhage (1.21 μg/l) had significantly higher compared to hyporrhea group (0.39 μg/l) (P = 0.0041 and P = 0.0009, respectively). The expression of SP100B also increased in the hippocampus with severe hemorrhage. Additionally, the expression of SP100B was high in the early stage of hemorrhage. SP100B expression was positively related to the severity of hemorrhage in mouse models of cerebral hemorrhage. Serum SP100B might be a noninvasive biomarker for cerebral hemorrhage.     

对企业中“强制自发性”型员工“过劳”的研究

针对企业中"强制自发性"型员工的"过劳"情况进行分析,得到该类型员工"过劳"人员所占比例近80%,且多为轻度、重度"过劳"。在与一般员工的比较分析中,得到领导支持、环境设施等因素对该类型员工的"过劳"形成起到有效的缓解作用。而岗位要求、工作监督和心理负荷等因素则会加剧"过劳"程度。     

Urinary iodine levels in three ecological zones of Bangladesh

Urinary iodine levels in children (5–11 years) and in adult males and females (15–44 years) of three ecological zones (hilly, flood-prone and plains) of Bangladesh were analyzed to determine the status of biochemical iodine deficiency in the country. Data indicated that a large majority of the population all over Bangladesh have biochemical iodine deficiency urinary iodine excretion (UIE) less than the accepted cut-off level of 10 μg/dl. Adults were deficient to comparable degrees, 31.3% severely iodine deficient. The flood-prone zone was less affected: 71.7% children had iodine deficiency and 25% were severely deficient. Adults of this zone were less affected than the children. Iodine deficiency was least severe in the plain zone: 59.8% children were biochemically iodine deficient and of them 23.4% had UIE less than 2.0 μg/dl. In the case of the adults of this zone, 60.8% were biochemically iodine deficient and 20.6% had severe iodine deficiency. The results indicate that Bangladesh as a whole is an iodine deficient region, with the hilly zone being the most severely affected. Children were slightly more affected than the adults, and females were more affected than the males.     

LP(a) phenotypes and levels in angiographically proven coronary heart disease patients and controls

Lipoprotein Lp(a) excess has been identified as a powerful predictor of premature atherosclerotic vascular diseases. To evaluate this in a North-Indian population, 130 CAD patients and 130 controls were analyzed. The size of the apo(a) phenotypic isoforms was inversely proportional to Lp(a) concentrations. The mean concentration of Lp(a) in the CAD patients was 42±34 mg/dl whereas in the normal subjects it was much lower, 27±27 mg/dl. 157 subjects out of the total 260 subjects showed plasma levels of >20mg/dl. The frequency of high Lp(a) levels was much higher in patients(73%) than controls (43%). These data suggest (1) that there is heterogeneity of the Lp(a) polymorphism, (2) Higher Lp(a) levels were found in patients than in the controls, (3) Patients showed 1.5 fold increase in Lp(a) levels as compared to the controls. We conclude that low molecular weight apo(a) isoforms are significantly associated with increased risk of CAD in the North-Indian population.     

Prevalence of insulin resistance in first degree relatives of type-2 diabetes mellitus patients: A prospective study in north Indian population

A total of 172 first degree relatives (FDRs) and 178 controls were included in this study. All the cases and controls were subjected to various anthropometric measurements, fasting and postprandial glucose estimation, fasting insulin measurement and fasting lipid profile. Results revealed the prevalence of Impaired Fasting Glucose (IFG) (cases 37% Vs controls 11.6%), Impaired Glucose Tolerance (IGT) (cases 34.3% Vs controls 11.2%) and diabetes (cases 11.05% controls 3.37%) was significantly higher in first degree relatives. Insulin resistance was measured using various methods, which included fasting plasma insulin (FPI), Homeostasis Model Assessment for Insulin Resistance (HOMA_IR), insulin sensitivity index (ISI) (Mffm/l). Prevalence of insulin resistance (Insulin Resistance) as observed comparing FPI and HOMA_IR in cases and controls was 43.6% and 11.24% (P=0.005) and 37.8% and 12.47% (P=0.000) respectively. Prevalence of IR (Insulin Resistance) observed in cases having Normal Glucose Tolerance (NGT), Impaired Fasting Glucose (IFG), Impaired Glucose Tolerance (IGT) and diabetes mellitus measuring FPI Vs HOMA_IR was 37.5% vs 30.2%, 45% vs 40%, 38.98% vs 37.28% and 36.84% vs 31.57% as accordingly. However, ISI (Mffm/l) was not found to be a promising index for IR due to its poor specificity. Though HOMA is taken as gold standard for measurement of IR globally, our study observed fasting plasma insulin representing high sensitivity (89.7%) and specificity (93.3%) as compared to HOMA. Thus FPI had emerged in this work as a simple and reliable test for diagnosing insulin resistance across the population susceptible to develop diabetes including FDRs.     

开采厚煤层时如何预防自燃发火

介绍了新兴煤矿才开采厚煤层时,为防止煤层自然发火所采取的改革巷道布置、加强通风管理、提高回采率、缩短热交换周期等措施。     

煤层自燃防治技术体系的建立与应用

根据特厚煤层综放开采工作面自燃特点,得出了特厚煤层综放开采工作面采空区煤层的自燃危险区域,并确定了"防控结合、重在预防"的防火指导原则,建立了以"预测预报技术、综合防控技术、特殊区域防火技术"相结合的煤层自燃综合防治技术体系,保障了工作面的安全生产。     

碳纤维增强型树脂基复合材料的生物安全性评价

目的评价碳纤维增强型树脂基复合材料(CFRP)的生物相容性,为其在口腔临床中的应用提供依据。方法本研究进行三种体内外试验,即短期全身毒性试验(经口途径),静脉注射急性全身毒性试验和溶血试验。结果实验一:对照组和试验组大鼠均未出现毒性反应,对照组和实验组的体重增长率和食物利用率无明显差异(P>0.05),肉眼观察动物重要脏器,均未出现病理变化;实验二:对照组和试验组小鼠均未出现毒性症状,试验组和对照组小鼠体重无明显差异(P>0.05);实验三:测的体外溶血率2%。结论碳纤维增强型树脂基复合材料对动物无全身毒性作用也无溶血作用。