阻塞性睡眠呼吸暂停综合征( obstructive sleep apnea syndrome, OSAS) 是一种常见的睡眠呼吸障碍性疾病, 在成人发生率为2% ～4% , 由于睡眠中反复发生上气道部分或完全阻塞而表现为夜间间断低氧和高碳酸血症、反复觉醒、睡眠结构紊乱, 临床上常引起心、脑、肾等多器官损害。越来越多的证据表明, OSAS并发高血压、冠心病、肺动脉高压、心力衰竭、中风的危险性增高, 是心脑血管疾病的独立危险因素。未经治疗的重度OSAS 患者5 年病死率高达11% ～13% , 而心脑血管并发症是主要死因。如果及时给予有效治疗, 在一定程度上可以预防并发症的发生, 甚至逆转心脑血管并发症的转归。
Objective To evaluate short-term effects of a single photodynamic therapy (PDT) treatment with visudyne (CIBA Vision Corp.) for choroidal neovascularization (CNV) in age-ralated macular degeneration (AMD). Methods Thirty cases (35 eyes) diagnosed as AMD patients with classic CNV were treated with PDT. The data of visual acuity testing, fluorescein angiography (FFA), indocyanine green angiography (ICGA) and optic coherence tomography （OCT) were used to evaluate the effects of a single treatment of PDT before and 1 week, 1 ,3 month after treatment. Results The visual acuity of 34 eyes were stable or improved in 3 months follow-up；and the visual acuity of 1 eye was decreased. Decrease or dispearance of fluorescein leakage from CNV was noted in 19 eyes. No serious complication occurred. Conclusion Single treatment of PDT for CNV in AMD can achieve short-term decrease or cessation of fluorescein leakage from CNV without loss of visual acuity. (Chin J Ocul Fundus Dis, 2002, 18: 171-174)
【摘要】 目的 观察经皮导管介入治疗急性肺栓塞的疗效。 方法 选择2003年1月-2009年6月收治的急性肺栓塞患者15例，采用经皮导管吸栓术、碎栓术及溶栓术治疗。溶栓术用局部灌注加即刻静脉注射尿激酶，总量100万U。溶栓后给予低分子肝素7~10 d，口服华法林3~6个月。观察临床症状、体征改善情况、并发症、平均肺动脉压（mPAP）与动脉血氧分压（PO2）的变化，以及肺动脉开通情况。 结果 12例肺动脉完全开通，3例部分开通，显效率89%，有效率100%。mPAP从（41.07±6.97） mm Hg降到（21.00±5.66） mm Hg，PO2从（46.26±9.30） mm Hg升到（79.49±8.04） mm Hg，治疗前后差异有统计学意义（Plt;0.05）。即刻临床症状明显改善，mPAP迅速降低11例。随访3~6个月，疗效持续，未见复发。 结论 介入治疗急性肺栓塞疗效显著，安全可行，对抢救危重患者、改善临床症状、维持血流动力学稳定有重要作用。【Abstract】 Objective To observe the clinical curative effect on acute pulmonary embolism(PE)via percutaneous catheter intervention. Methods Fifteen acute PE patients admitted from January 2003 to June 2009 were treated with percutaneous catheter drawing of thrombus, thrombectomy, and thrombolysis. Local infusion and immediate intra-venous injection of urokinase with 100 000 000 U in total were used for thrombolysis. Afterwards, the low molecular weight heparin was given for seven to ten days, and an oral intake of warfarin lasts for three to six months. Observe the clinical symptoms, improvement of physical signs, occurrence of complications, change of mean pulmonary arterial pressure (mPAP) and arterial partial pressure of oxygen (PO2), as well as the patency condition of pulmonary artery. Results Twelve of fifteer patients gained complete patency of pulmonary artery, and the other three patients gained partial patency, with an obvious effectiveness rate of 89% and an effectiveness rate of 100%. mPAP decreased from (41. 07±6. 97) mm Hg to (21. 00±5. 66) mm Hg, and PO2 elevated from (46. 26±9. 30) mm Hg to (79. 49±8. 04) mm Hg, showing a significant difference (Plt;0. 05) before and after the therapy. The immediate clinical symptoms exhibited a significant improvement. The pulmonary artery pressure of 11 patients dropped rapidly. During three to six months’ follow up, the therapeutic effects persisted and no recurrence was found. Conclusion The interventional treatment of acute PE demonstrates remarkable effectiveness, safety and feasibility, which plays an important role in the rescue of critical patients, improvement of clinical symptoms, and maintenance of hemodynamic stability.
目的：检测李斯特菌DNA对小鼠H22肝癌Bcl2基因表达的影响，探讨细菌DNA对肿瘤的抑制作用。方法：建立H22肝癌小鼠模型，从模型建立后的第一天开始，随机分组，分别给予李斯特菌DNA液（实验组）和生理盐水（对照组）。从癌组织中提取总RNA，设计目的基因引物和内参照GAPD引物。采用RT-PCR方法，分别检测实验组及对照组小鼠瘤体Bcl-2基因的表达，应用Bio-RAD凝胶成像系统及在Quantity One软件辅助下分析测定表达结果。结果：实验组小鼠瘤体Bcl-2表达低于对照组，经统计学处理，两者有显著性差异。结论：李斯特菌DNA对H-22肝癌小鼠肿瘤有抑制作用。
目的探讨经腹正中线入路2孔法腹腔镜胆囊切除术的可行性。 方法对笔者所在医院2009年5月至2013年3月期间收治的220例胆囊结石、胆囊炎患者行经腹正中线入路2孔法腹腔镜胆囊切除术，观察其手术时间、术后疼痛、并发症发生情况及恢复时间。 结果220例中成功施行经腹正中线入路2孔法腹腔镜胆囊切除术215例，成功率为97.73%，手术时间30～110 min，平均45 min。另5例因炎症严重、操作困难而改为3孔法完成腹腔镜胆囊切除术，并行腹腔引流。本组患者无中转开腹者，术后均未用镇痛剂，也无并发症发生；术后住院时间3～5 d，平均4 d。 结论经腹正中线入路2孔法腹腔镜胆囊切除术，具有切口更少、创伤更小、疼痛轻、康复快、美容效果更好、不增加设备投入等优点。
Objective To explore the intervention effect of music therapy on children with autism spectrum disorder. Methods The China National Knowledge Infrastructure, Wanfang, Chongqing VIP, PubMed, Embase, Cochrane Library were searched by computer to comprehensively collect randomized controlled trials on the intervention effect of music therapy on children with autism spectrum disorder. The search period was from the establishment of the database to December 31, 2022. RevMan 5.4 software was used for meta-analysis. Results Finally, 20 articles were included, including 913 cases in the music therapy group and 811 cases in the control group, with a total sample size of 1724 cases. The meta-analysis results showed that the overall treatment effect [standardized mean difference (SMD)=−0.95, 95% confidence interval (CI) (−1.12, −0.78)], the treatment effect of language [SMD=−0.71, 95%CI (−0.84, −0.57)], behavior [SMD=−0.65, 95%CI (−0.78, −0.52)], social interaction [SMD=−0.52, 95%CI (−0.63, −0.40)], cognition [SMD=1.37, 95%CI (1.00, 1.74)] and sensory perception [SMD=−0.89, 95%CI (−1.03, −0.74)] of the music therapy group were better than those of the control group (P<0.05). Conclusion The existing data show that music therapy applied to children with autism spectrum disorder can effectively improve their language, behavior, social interaction, cognition, and sensory perception, thereby having a positive impact on the overall treatment effect of children. However, due to the limitations of the number and quality of included studies, more high-quality studies are needed to verify.
Objective To investigate the risk factors for Carbapenem-resistant Klebsiella pneumoniae (CRKP) infections, and construct a clinical model for predicting the risk of CRKP infections. Methods A retrospective analysis was performed on Klebsiella pneumoniae infection patients hospitalized in the Third Hospital of Hebei Medical University from May 2020 to May 2021. The patients were divided into a CRKP group (117 cases) and a Carbapenem-sensitive Klebsiella pneumoniae (CSKP) group (191 cases). The predictors were screened by full subset regression using R software (version 4.3.1). The truncation values of continuous data were determined by Youden index. Nomogram and score table model for CRKP infections risk prediction was constructed based on binary logistic regression. The receiver operator characteristic (ROC) curve and area under curve (AUC) were used to evaluate the accuracy of models. Calibration curve and decision curve were used to evaluate the performance of models. Results308 patients with Klebsiella pneumoniae infections were included. A total of 8 predictors were selected by using full subset regression and truncation values were determined according to Youden index: intensive care unit (ICU) stay at time of infection>2 days, male, acute physiology and chronic health evaluation Ⅱ (APACHEⅡ) score>15 points, hospitalization stay at time of infection>10 days, any history of Gram-negative bacteria infection in the last 6 months, heart disease, lung infection, antibiotic exposure history in the last 6 months. The AUC of CRKP prediction risk curve model was 0.811 (95%CI 0.761 - 0.860). When the optimal cut-off value of the constructed CRKP prediction risk rating table was 6 points, the AUC was 0.723 (95%CI 0.672 - 0.774). The Bootstrap method was used for internal repeated sampling for 1000 times for verification. The model calibration curve and Hosmer-Lemeshow test (P=0.618) showed that these models have good calibration degree. The decision curve showed that these models have good clinical effectiveness. Conclusion The prediction model of CRKP infections based on the above 8 risk factors can be used as a risk prediction tool for clinical identification of CRKP infections.
Objective To evaluate the efficacy of adefovir monotherapy (ADF) versus adefovir-Matrine combination therapy (ADF+M) for chronic hepatitis B. Methods Such databases as The Cochrane Library, MEDLINE, PubMed, CBM, CNKI, WanFang and VIP Database were searched from the date of their establishment to July 2010, and the references of all included studies were also traced so as to identify randomized controlled trials (RCTs) of ADF versus ADF+M. Quality assessment and data extraction were conducted in accordance with the Cochrane Handbook 5.0.2 by two reviewers independently. Meta-analyses were conducted by using RevMan 5.0 software. Results A total of 24 RCTs involving 2 092 patients were included. The results of meta-analyses showed that at the end of the treatment for both six months and 12 months, respectively, the ADF+M group was superior to ADF group with a significant difference in both the HBeAg seroconversion rate as the primary outcome (six months: RR=2.05, 95%CI 1.53 to 2.74; 12 months: RR=2.13 95%CI 1.74 to 2.60) and the secondary outcome such as HBV-DNA negative conversion, HBeAg negative conversion, ALT normalization, HBV-DNA variation, complete response and HBsAg negative conversion, etc. Conclusion As the current evidence shows, ADF+M therapy is superior to ADF therapy for chronic hepatitis B. The significant difference can even be observed at the end of the treatment for six months. However, the results should be interpreted with caution because of the low quality of the included studies. High-quality, large-scale RCTs are needed to further prove the results.