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中国临床实用医学最新文献

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Study on the change of serum trace elements and BDNF, Hcy, Cor, neural function related factors of patients with depression before and after treatment with Olanzapine 抑郁症患者奥氮平治疗前后血清微量元素及BDNF、Hcy、Cor、神经功能相关因素变化的研究
Pub Date : 2014-01-25 DOI: 10.3760/CMA.J.ISSN.1673-8799.2014.01.012
Xue-ying Wang, Shi-chun Li
Objective To analyze and observe the serum trace elements and BDNF,Hcy,Cor,neural function related factors of patients with depression before and after treatment with olanzapine.Methods 64 patients with depression in our hospital from October 2011 to February 2013 were selected as research object,and they were randomly divided into control group 32 cases and observation group 32 cases,the control group were treated with only sertraline,the observation group were treated with olanzapine based on the treatment of control group,then the serum trace elements and BDNF,Hcy,Cor,neural function related factors of two groups before the treatment and at 3rd and 6th week after the treatment were compared.Results The serum Cu and Fe of observation group at 3rd and 6th week after the treatment were lower than those of control group,Zn and Mn were higher than those of control group,Hcy,Cor and neural function related factors were lower than those of control group,BDNF were higher than those of control group,all P<0.05,there were all significant differences.Conclusion The olanzapine can effectively adjust the serum trace elements and BDNF,Hcy,Cor,neural function related factors of patients with depression,and it shows a continuous improvement state. Key words: Depression;  Olanzapine;  Trace elements;  Brain-derived neurotrophic factor, BDNF;  Homocysteine,Hcy;  Cortisol,COR;  Neural function related factors;  Change
目的分析观察抑郁症患者奥氮平治疗前后血清微量元素及BDNF、Hcy、Cor、神经功能相关因素。方法选取我院2011年10月至2013年2月收治的64例抑郁症患者作为研究对象,将其随机分为对照组32例和观察组32例,对照组仅给予舍曲林治疗,观察组在对照组治疗的基础上给予奥氮平治疗,分别于治疗前和治疗后第3、6周测定两组患者血清微量元素及BDNF、Hcy、Cor、神经功能相关因子比较两种治疗方法。结果观察组患者治疗后第3、6周血清Cu、Fe低于对照组,Zn、Mn高于对照组,Hcy、Cor及神经功能相关因子低于对照组,BDNF高于对照组,均P<0.05,差异均有统计学意义。结论奥氮平能有效调节抑郁症患者血清微量元素及BDNF、Hcy、Cor、神经功能相关因子,并呈持续改善状态。关键词:抑郁症;奥氮平;微量元素;脑源性神经营养因子;同型半胱氨酸(Hcy);皮质醇,心脏;神经功能相关因素;改变
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引用次数: 0
Research of the motion compensation after single segmental cervical spine fusion surgery 单节段颈椎融合术后运动补偿的研究
Pub Date : 2014-01-25 DOI: 10.3760/CMA.J.ISSN.1673-8799.2014.01.006
Rui Zhang, B. Bai
Objective To know the motion compensation regulation of each segments after single segmental cervical spine fusion surgery.Methods With the help of 3D motion information collecting system,the movement angle of each segment was recorded before and after single segmental cervical spine fusion surgery.Results All the statistics are dealed with normalization,we got the statistics of the motion compensation regulation of each segments after single segmental cervical spine fusion surgery,range of motion of each segment increased diversely,especially the lower adjacent segment,with statistical significance(P<0.05).Conclusion Compensatory enhancement of the range of motion of adjacent segments is one of the important reasons lead to the degeneration. Key words: Cervical spine;  Fusion surgery;  Adjacent segment;  Motion compensation
目的了解单节段颈椎融合术后各节段的运动代偿规律。方法利用三维运动信息采集系统,记录单节段颈椎融合手术前后各节段的运动角度。结果对所有统计数据进行归一化处理,得到单节段颈椎融合术后各节段运动补偿调节的统计数据,各节段运动幅度有不同程度的增加,尤其是下邻节段,差异均有统计学意义(P<0.05)。结论相邻节段活动度代偿性增强是导致退变的重要原因之一。关键词:颈椎;融合手术;邻近节段;运动补偿
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引用次数: 0
Expression and clinical significance of PCNA and IRF2 in human pancreatic cancer PCNA和IRF2在人胰腺癌中的表达及临床意义
Pub Date : 2014-01-25 DOI: 10.3760/CMA.J.ISSN.1673-8799.2014.01.014
Zhenwei Hu, Jiansheng Liu
Objective To research the expression levels,clinical significance and the correlation of PCNA and IRF2 in human pancreatic cancer.Methods The expression levels of PCNA and IRF2 in 60 different cases of pancreatic cancer tissues and 30 different cases of para-pancreatic cancer tissues were investigated by Immunohistochemical SP staining and then analyzed through clinicopathological data.Results Immunohistochemical results:the positive expression rates of PCNA and IRF2 in pancreatic cancer tissues were 83.3% and 78.3% respectively,which were significantly higher than those in the adjacent pancreatic tissues,of which were 20.0% and 23.3% respectively.The differences were statistically significant (P<0.001).The factors of age,gender,tumor site of patients with pancreatic carcinoma were not statistically significant with the expression of PCNA (P>0.05),but other factors,such as the differentiation of pancreatic tissue,TNM stage and lymph node metastasis,were statistically significant (P<O.05).The factors of age,sex,tumor location and lymph node metastasis of pancreatic carcinoma patients were not statistically significant with the expression of PCNA (P>0.05),but the factors of differentiation of pancreatic tissue and TNM stage were statistically significant (P<0.05).Moreover,the expression of PCNA and IRF2 was positively correlated (γ =0.416,P=0.001).Conclusion The abnormal expression of PCNA and IRF2 is correlated with occurrence of pancreatic cancer and the cancer cell proliferation activity. Key words: Pancreatic Cancer;  PCNA;  IRF2;  Immunohistochemistry
目的探讨PCNA与IRF2在人胰腺癌组织中的表达水平、临床意义及相关性。方法采用免疫组化SP染色法检测60例不同类型胰腺癌组织和30例不同类型胰腺旁癌组织中PCNA和IRF2的表达水平,并结合临床病理资料进行分析。结果免疫组化结果:PCNA和IRF2在胰腺癌组织中的阳性表达率分别为83.3%和78.3%,显著高于癌旁胰腺组织的20.0%和23.3%。差异有统计学意义(P<0.001)。胰腺癌患者年龄、性别、肿瘤部位等因素对PCNA表达的影响无统计学意义(P< 0.05),而胰腺组织分化程度、TNM分期、淋巴结转移等因素对PCNA表达的影响有统计学意义(P< 0.05)。胰腺癌患者年龄、性别、肿瘤部位、淋巴结转移等因素与PCNA表达差异无统计学意义(P<0.05),而胰腺组织分化、TNM分期等因素与PCNA表达差异有统计学意义(P<0.05)。PCNA与IRF2表达呈正相关(γ =0.416,P=0.001)。结论PCNA和IRF2的异常表达与胰腺癌的发生及癌细胞的增殖活性有关。关键词:胰腺癌;PCNA;IRF2;免疫组织化学
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引用次数: 1
咪达唑仑、笑气在口腔治疗清醒镇静中对血压的影响 咪达唑仑、笑气在口腔治疗清醒镇静中对血压的影响
Pub Date : 2014-01-25 DOI: 10.3760/CMA.J.ISSN.1673-8799.2014.01.027
王久国, 王霞
目的 探讨高血压患者实施口腔治疗时应用咪达唑仑、笑气清醒镇静的治疗效果.方法 76例需拔牙的高血压患者随机分为咪唑安定组和笑气组,各38例.咪唑安定组采用小剂量咪达唑仑静脉注射加局部麻醉法拔牙;笑气组采用笑气吸入加局部麻醉法拔牙.记录两组患者镇静前、局麻前、拔牙中及拔牙后的收缩压(SBP)、舒张压(DBP)、心率(HR)和脉搏血氧饱和度(SpO2),并进行镇静程度(Ramsay评分)、疼痛程度(VAS评分)的观察.结果 咪唑安定镇静组血压低于笑气组(P<0.05),血氧饱和度、镇静程度、疼痛程度比较差异无统计学意义.结论 高血压患者拔牙时应用咪唑安定镇静较笑气镇静具有更直接稳定循环系统的作用。
目的 探讨高血压患者实施口腔治疗时应用咪达唑仑、笑气清醒镇静的治疗效果.方法 76例需拔牙的高血压患者随机分为咪唑安定组和笑气组,各38例.咪唑安定组采用小剂量咪达唑仑静脉注射加局部麻醉法拔牙;笑气组采用笑气吸入加局部麻醉法拔牙.记录两组患者镇静前、局麻前、拔牙中及拔牙后的收缩压(SBP)、舒张压(DBP)、心率(HR)和脉搏血氧饱和度(SpO2),并进行镇静程度(Ramsay评分)、疼痛程度(VAS评分)的观察.结果 咪唑安定镇静组血压低于笑气组(P<0.05),血氧饱和度、镇静程度、疼痛程度比较差异无统计学意义.结论 高血压患者拔牙时应用咪唑安定镇静较笑气镇静具有更直接稳定循环系统的作用。
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引用次数: 0
纳洛酮治疗老年慢性肺源性心脏病合并肺性脑病患者临床疗效和安全性观察 纳洛酮治疗老年慢性肺源性心脏病合并肺性脑病患者临床疗效和安全性观察
Pub Date : 2014-01-25 DOI: 10.3760/CMA.J.ISSN.1673-8799.2014.01.028
廖正寿, 唐云, 唐诚江, 罗小春, 张耀灵
目的 研究慢性肺源性心脏病合并肺性脑病的老年患者临床上应用纳洛酮进行治疗的临床效果,以及临床用药的安全性.方法 选择深圳市宝安区沙井人民医院2010年11月至2012年12月收治的160例慢性肺源性心脏病合并肺性脑病的老年患者,随机均分为两组,对照组患者进行持续低流量鼻导管吸氧,氧流量为1~3 L/min,给氧浓度为25%~35%,积极对抗感染,止咳化痰,保持酸碱及电解质平衡,解痉平喘以及营养支持等.治疗组患者在上述治疗的基础上给予纳洛酮进行治疗.结果 治疗组患者的总有效率为85%,对照组总有效率为60%,两组患者的临床疗效差异有统计学意义.治疗组患者的血pH值、PaO2、PaCO2指标值均优于对照组,两组差异有统计学意义(P<0.05).结论 对慢性肺源性心脏病合并肺性脑病的老年患者应用纳洛酮进行治疗,临床效果较为显著,能显著提高血PaO2、pH值,同时降低PaCO2,用药后患者未出现明显的不良反应,减少了患者恢复清醒的时间,值得在临床推广使用。
目的 研究慢性肺源性心脏病合并肺性脑病的老年患者临床上应用纳洛酮进行治疗的临床效果,以及临床用药的安全性.方法 选择深圳市宝安区沙井人民医院2010年11月至2012年12月收治的160例慢性肺源性心脏病合并肺性脑病的老年患者,随机均分为两组,对照组患者进行持续低流量鼻导管吸氧,氧流量为1~3 L/min,给氧浓度为25%~35%,积极对抗感染,止咳化痰,保持酸碱及电解质平衡,解痉平喘以及营养支持等.治疗组患者在上述治疗的基础上给予纳洛酮进行治疗.结果 治疗组患者的总有效率为85%,对照组总有效率为60%,两组患者的临床疗效差异有统计学意义.治疗组患者的血pH值、PaO2、PaCO2指标值均优于对照组,两组差异有统计学意义(P<0.05).结论 对慢性肺源性心脏病合并肺性脑病的老年患者应用纳洛酮进行治疗,临床效果较为显著,能显著提高血PaO2、pH值,同时降低PaCO2,用药后患者未出现明显的不良反应,减少了患者恢复清醒的时间,值得在临床推广使用。
{"title":"纳洛酮治疗老年慢性肺源性心脏病合并肺性脑病患者临床疗效和安全性观察","authors":"廖正寿, 唐云, 唐诚江, 罗小春, 张耀灵","doi":"10.3760/CMA.J.ISSN.1673-8799.2014.01.028","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1673-8799.2014.01.028","url":null,"abstract":"目的 研究慢性肺源性心脏病合并肺性脑病的老年患者临床上应用纳洛酮进行治疗的临床效果,以及临床用药的安全性.方法 选择深圳市宝安区沙井人民医院2010年11月至2012年12月收治的160例慢性肺源性心脏病合并肺性脑病的老年患者,随机均分为两组,对照组患者进行持续低流量鼻导管吸氧,氧流量为1~3 L/min,给氧浓度为25%~35%,积极对抗感染,止咳化痰,保持酸碱及电解质平衡,解痉平喘以及营养支持等.治疗组患者在上述治疗的基础上给予纳洛酮进行治疗.结果 治疗组患者的总有效率为85%,对照组总有效率为60%,两组患者的临床疗效差异有统计学意义.治疗组患者的血pH值、PaO2、PaCO2指标值均优于对照组,两组差异有统计学意义(P<0.05).结论 对慢性肺源性心脏病合并肺性脑病的老年患者应用纳洛酮进行治疗,临床效果较为显著,能显著提高血PaO2、pH值,同时降低PaCO2,用药后患者未出现明显的不良反应,减少了患者恢复清醒的时间,值得在临床推广使用。","PeriodicalId":64135,"journal":{"name":"中国临床实用医学","volume":"5 1","pages":"58-59"},"PeriodicalIF":0.0,"publicationDate":"2014-01-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"69973584","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
低位直肠癌保肛手术中直肠冲洗治疗对预后的影响 低位直肠癌保肛手术中直肠冲洗治疗对预后的影响
Pub Date : 2014-01-25 DOI: 10.3760/CMA.J.ISSN.1673-8799.2014.01.036
闫保功
目的 探讨低位直肠癌保肛手术中直肠冲洗治疗对预后的影响.方法 选取2010年3月至2012年3月平顶山市第一人民医院收治的98例低位直肠癌患者,将其随机分为对照组和观察组,对照组49例给予单纯保肛手术治疗,观察组49例在保肛手术治疗的基础上给予直肠冲洗治疗,对比两组患者复发率及近期生存率.结果 对两组患者进行为期3年的随访,两组患者1年和3年复发率及生存率差异有统计学意义(P<0.05).结论 低位直肠癌保肛手术中给予直肠冲洗可防止吻合时脱落细胞种植转移,能有效降低复发率,提高患者生存率,意义重大。
目的 探讨低位直肠癌保肛手术中直肠冲洗治疗对预后的影响.方法 选取2010年3月至2012年3月平顶山市第一人民医院收治的98例低位直肠癌患者,将其随机分为对照组和观察组,对照组49例给予单纯保肛手术治疗,观察组49例在保肛手术治疗的基础上给予直肠冲洗治疗,对比两组患者复发率及近期生存率.结果 对两组患者进行为期3年的随访,两组患者1年和3年复发率及生存率差异有统计学意义(P<0.05).结论 低位直肠癌保肛手术中给予直肠冲洗可防止吻合时脱落细胞种植转移,能有效降低复发率,提高患者生存率,意义重大。
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引用次数: 0
The relationship between children with Helicobacter pylori infection and gastroduodenal disease 儿童幽门螺杆菌感染与胃十二指肠疾病的关系
Pub Date : 2014-01-25 DOI: 10.3760/CMA.J.ISSN.1673-8799.2014.01.007
Zeng-bin Xu, Xianglian Li, Shenghua Wan
Objective To explore the relationship among different types of Helicobacter pylori (HP),the gastroduodenal disease type and the severity of gastric mucosal inflammation in childhood.Methods By western blot method to detect serum antibodies of CagA and VacA obtained from 112 patients infected by HP-related Chronic Gastritis (CG) and Peptic ulcer (PU).and observe the pathologic changes of gastric mucosa.Results In 112 cases,the CagA,VacA antibody detection rate was 82.14% and 82.14%,no significant difference (P>0.05).The detection rate of CagA,VacA antibodies in patients with chronic gastritis (CG) was 79.10% and 83.58%,and in patients with Peptic ulcer (PU) was 86.67% and 91.11%,The detection rate of CagA,VacA antibody in PU,CG had no obvious difference (P>0.05).Of 112 cases of children with Hp infection,I type HP accounted for 80.36%,Ⅱ type HP accounted for 11.61% and intermediate type accounted for 8.03%,No significant differences existed in the detection rate of these three types of HP in CG or PU (P>0.05); Among the 90 patients with Ⅰ type HP,92.22% of them caused severe gastric mucosal inflammation,7.78% of them got mild inflammation.23.08%of 13 patients with Ⅱ type HP and 55.56% of 9 patients with intermediate type HP got severe gastric mucosal inflammation,which showed that the differences are significant (P<0.01).Conclusion CagA and VaCA are closely related to the onset of CG and PU,but can not be used as the basis for judging the onset of CG and PU,when children infected with Ⅰ type HP,their gastric mucosa suffers the greatest damage,they should be treated actively. Key words: Helicobacter pylori,children;  Cytotoxin associated protein;  Vacuolating toxin protein;  Antibody;  Chronic Gastritis;  Ulcer
目的探讨儿童不同类型幽门螺杆菌(HP)与胃十二指肠疾病类型及胃黏膜炎症严重程度的关系。方法采用western blot法检测112例hp相关性慢性胃炎(CG)和消化性溃疡(PU)患者血清中CagA和VacA的抗体。观察胃黏膜病理变化。结果112例CagA、VacA抗体检出率分别为82.14%和82.14%,差异无统计学意义(P < 0.05)。慢性胃炎(CG)患者CagA、VacA抗体检出率分别为79.10%和83.58%,消化性溃疡(PU)患者CagA、VacA抗体检出率分别为86.67%和91.11%,两组患者CagA、VacA抗体检出率差异无统计学意义(P < 0.05)。112例儿童Hp感染中,I型Hp占80.36%,Ⅱ型Hp占11.61%,中间型Hp占8.03%,三种Hp在CG和PU的检出率差异无统计学意义(P < 0.05);90例Ⅰ型HP患者中,92.22%的患者出现重度胃黏膜炎症,7.78%的患者出现轻度炎症,13例Ⅱ型HP患者中有23.08%出现重度胃黏膜炎症,9例中度HP患者中有55.56%出现重度胃黏膜炎症,差异有统计学意义(P<0.01)。结论CagA和VaCA与CG和PU发病密切相关,但不能作为判断CG和PU发病的依据,当儿童感染Ⅰ型HP时,其胃黏膜损伤最大,应积极治疗。关键词:幽门螺杆菌;儿童;细胞毒素相关蛋白;液泡毒素蛋白;抗体;慢性胃炎;溃疡
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引用次数: 1
The repairing of the soft tissue defect in the eyebrow area with hatchet skin flap 短柄皮瓣修复眉区软组织缺损
Pub Date : 2014-01-25 DOI: 10.3760/CMA.J.ISSN.1673-8799.2014.01.017
Wei Feng, N. Luo, Tairan Li, Yiping Xiu, Xu Zhang, Qingyan Meng
Objective To found out a suitable method for the repairing of the eyebrow area soft tissue defect based on research and the clinical application of the ‘Hatchet Skin Flap’.Methods All 23 patients with eyebrow area soft tissue defect was included.The skin flap was designed along the longitudinal axle of the defect and with the curve of the ‘Hatchet Skin Flap’ parallel to the curve of the eyebrow.The scale of the width to the length of the flap should not less than 1:3.The flap was dissected and transferred to the defected area.The unnecessary skin in the tip area of the flap was dissected.The skin flap was sutured in different layer and without any tension in the sutured area.Results All 23 skin flaps was survived well and without any necrosis and blood supply disorder.The eyebrow was tot be influnced.After 6 months to 3 years follow up all of the skin flap with a satisfactory appearance.Conclusion Having the advantages as easy to design,no influence to the eyebrow,well-distributed tension and without obvious scar,the ‘Hatched Skin Flap’is suitable for the repairing of the soft tissue defect in the eyebrow area. Key words: Hatched skin flap;  Eyebrow area;  Soft tissue defect;  Repairing
目的通过对“短柄皮瓣”的研究和临床应用,寻找一种适合修复眉区软组织缺损的方法。方法对23例眉区软组织缺损患者进行回顾性分析。皮瓣沿缺损的纵轴方向设计,“小斧皮瓣”的曲线与眉毛的曲线平行。皮瓣宽度与长度的比例不应小于1:3。皮瓣被剥离并转移到缺损区域。切除皮瓣尖端区不需要的皮肤。皮瓣采用分层缝合,缝合区无张力。结果23例皮瓣全部成活,无坏死和血供障碍。眉毛不受影响。术后6个月至3年随访,皮瓣外观满意。结论“孵化皮瓣”具有设计简单、对眉部无影响、张力分布均匀、无明显瘢痕等优点,适用于眉区软组织缺损的修复。关键词:孵化皮瓣;眉毛区域;软组织缺损;修复
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引用次数: 0
脑钠肽灰色区域与急性呼吸困难的诊断进展 脑钠肽灰色区域与急性呼吸困难的诊断进展
Pub Date : 2014-01-25 DOI: 10.3760/CMA.J.ISSN.1673-8799.2014.01.041
姜凯莲, 别自东
人体中以B型脑钠肽(BNP)和N末端脑钠肽(NT-proBNP)研究最多,BNP的测定提高了急性呼吸困难的准确率,并且已经成为一个标准评估的一部分.PRIDE研究表明,NT-proBNP是最终诊断为急性心力衰竭患者呼吸困难[1]的最强预测指标.脑钠肽灰色区域的急性呼吸困难患者,最终诊断往往是轻中度心力衰竭,需要临床医师额外的关注及完善相关辅助检查,以利于早期诊断,避免误诊。
人体中以B型脑钠肽(BNP)和N末端脑钠肽(NT-proBNP)研究最多,BNP的测定提高了急性呼吸困难的准确率,并且已经成为一个标准评估的一部分.PRIDE研究表明,NT-proBNP是最终诊断为急性心力衰竭患者呼吸困难[1]的最强预测指标.脑钠肽灰色区域的急性呼吸困难患者,最终诊断往往是轻中度心力衰竭,需要临床医师额外的关注及完善相关辅助检查,以利于早期诊断,避免误诊。
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引用次数: 0
2013冠心病抗栓治疗进展 2013冠心病抗栓治疗进展
Pub Date : 2014-01-25 DOI: 10.3760/CMA.J.ISSN.1673-8799.2014.01.002
韩雅玲
血栓形成是冠状动脉粥样硬化及其并发症的重要因素,也是冠心病事件的始作俑者,抗栓治疗(抗凝、抗血小板治疗)是冠心病治疗的重要基石.实现冠心病抗栓优化治疗,是心血管医师努力的目标之一.一、抗血小板治疗:氯吡格雷仍有一席之地氯吡格雷合用阿司匹林的双联抗血小板方案,因可提高患者远期生存率和降低支架内血栓,已使众多冠心病患者获益.但是,在应用氯吡格雷的过程中发现,患者对氯吡格雷变异性反应较大。
血栓形成是冠状动脉粥样硬化及其并发症的重要因素,也是冠心病事件的始作俑者,抗栓治疗(抗凝、抗血小板治疗)是冠心病治疗的重要基石.实现冠心病抗栓优化治疗,是心血管医师努力的目标之一.一、抗血小板治疗:氯吡格雷仍有一席之地氯吡格雷合用阿司匹林的双联抗血小板方案,因可提高患者远期生存率和降低支架内血栓,已使众多冠心病患者获益.但是,在应用氯吡格雷的过程中发现,患者对氯吡格雷变异性反应较大。
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中国临床实用医学
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