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find Keyword "研究进展" 159 results
  • Acute exacerbation of chronic obstructive pulmonary disease:Update

    根据慢性阻塞性肺疾病全球创议(GOLD)的定义,慢性阻塞性肺疾病急性加重(AECOPD)是“在COPD的自然病程中发生的事件,气紧、咳嗽或/和咳痰等基础症状加重超出正常的日间变异的范围,急性发病,可能需要改变常规的治疗”[1]。AECOPD意味着对医疗卫生资源耗用的增加,如非预约的就医、使用药物增加,使用抗生素或口服皮质激素甚至住院,等等。仅仅依据是否占用卫生资源来定义AECOPD并不适当,这一点还要取决于医疗卫生资源的可获得性,同时有研究提示部分AECOPD可以是自限性的,特别是轻度急性加重。另一方面,占用医疗卫生资源的形式可以大致评估AECOPD的严重程度,如需要增加常规的吸人性药物常常意味着轻度AECOPD,需要短程口服抗生素或糖皮质激素意味着中度AECOPD,而需要住院者多为重度AECOPD。AECOPD是导致COPD患者健康状态降低乃至死亡的主要原因,也是耗用医疗卫生资源从而构成COPD疾病负担的主要部分,需要采用有力的干预措施以降低其发生率[2]。

    Release date:2016-08-30 11:37 Export PDF Favorites Scan
  • 吸入性肺炎的研究进展

    吸人性肺炎是指口咽部分泌物和胃内容物反流吸入至喉部和下呼吸道, 引起的多种肺部综合征, 吸入量较大时可引起急性化学性吸入性肺炎, 如果吸入量小且将咽部寄植菌带入肺内, 可导致细菌性吸入性肺炎, 常见于老年人、患有神经系统疾病或脑血管病的患者, 是导致老年人死亡的主要危险因素。其他吸入综合征包括气道阻塞、肺脓肿、外源性类脂质综合征、慢性间质性肺炎和偶发分枝杆菌性肺炎等。现将细菌性吸入性肺炎( 简称吸入性肺炎) 的研究进展综述如下。

    Release date:2016-08-30 11:53 Export PDF Favorites Scan
  • 耐碳青霉烯类鲍曼不动杆菌的耐药机制研究进展

    根据美国联邦感染监测系统( NNIS) 和中国院内感染病原菌耐药监测资料显示[ 1, 2] , 鲍曼不动杆菌( Acinetobacter baumannii) 在院内感染占第四位, 成为仅次于铜绿假单孢菌的非发酵菌。而随着广谱抗生素和免疫抑制剂的广泛使用,世界各地陆续出现了泛耐药或多重耐药鲍曼不动杆菌的报道。碳青霉烯类抗生素被认为是目前临床治疗鲍曼不动杆菌感染最有效的抗菌药物之一, 但近年来由于碳青霉烯类药物在医院中的大量使用, 碳青霉烯类耐药鲍曼不动杆菌( Carbapenem-resistance Acinetobacter baumannii, CRAB) 的比例也逐年增高。一旦细菌对碳青霉烯类抗生素耐药, 则意味着对其他抗生素都基本耐药, 往往让临床医生束手无策。因此, 如何治疗这类CRAB 感染已经成为一个临床难题, 探讨其耐药机制也迫在眉睫。

    Release date:2016-08-30 11:53 Export PDF Favorites Scan
  • The Research Progress of Mesenchymal Stem Cells in Acute Lung Injury/Acute Respiratory Stress Syndrome

    ARDS 是引起重症患者呼吸衰竭的主要原因, 尽管医疗技术有了很大的进步, 但对ARDS 的治疗只局限在器官支持层面, 其病死率仍高达40% [ 1] 。ARDS的主要病理改变为肺泡上皮细胞和毛细血管内皮细胞受损, 通透性增加, 富含蛋白质的液体渗出积聚于肺间质和肺泡。因此促进损伤肺毛细血管内皮细胞和肺泡上皮细胞的有效修复可能是ARDS治疗的关键所在。随着干细胞工程学的发展, 间充质干细胞( MSC) 作为一种理想的组织修复来源, 在ARDS 治疗中的应用受到越来越多的关注, 这可能为ARDS 的治疗开辟一条新的途径。

    Release date:2016-08-30 11:53 Export PDF Favorites Scan
  • Management of Asthma:Update 2009-2010

    目前哮喘的治疗已经取得了显著的进步, 大多数哮喘按全球哮喘防治创议( GINA) 推荐的治疗方案进行规范治疗都可以获得良好的临床控制, 但仍有部分中重度患者难以获得良好的临床控制, 所以仍有必要探索针对这一部分哮喘人群的更好的干预措施。

    Release date:2016-08-30 11:55 Export PDF Favorites Scan
  • 联合检测半乳甘露聚糖和(1→3)-β-D葡聚糖在诊治侵袭性曲霉菌感染中的研究进展

    近年随着广谱抗生素和免疫抑制剂的使用,侵袭性真菌感染(invasive fungal disease,IFD)的发病率逐年上升。其中侵袭性曲霉病(invasive aspergillosis,IA)在IFD中比例逐年增高。侵袭性曲霉菌感染在血液科和重症加强治疗病房(ICU)最为常见,其次为呼吸内科、感染科和免疫科,IA为免疫功能低下患者致死率高的主要原因,造血干细胞移植(HSCT)患者中IA的发病率为2%~26%,在血液病和造血干细胞移植患者中IA死亡率高达70.0%~90.0%。造成死亡率高的主要原因是在病程早期不能对IA进行可靠诊断,往往使患者延误治疗而死亡。因此,选择正确、合适的早期诊断方法对疾病的预后具有决定性意义。传统的诊断方法如影像学、真菌直接镜检、培养及组织病理学检查的敏感性不高,检出率低,难以用于早期诊断。因此,新的诊断方法对IA的治疗至关重要。血清学诊断方法是应用免疫和生化方法检测血清或其他体液中的真菌细胞壁和胞质成分,分为抗原和抗体检查两类。但由于IFD多继发于严重免疫受损患者,往往缺乏可检测到的抗体,或者抗体的产生变化较大,因此以检测真菌抗原为主。目前半乳甘露聚糖(GM)和(1→3)-β-D葡聚糖(BG)成为真菌检查中非常重要的两个抗原。

    Release date:2016-08-30 11:58 Export PDF Favorites Scan
  • 抗菌药物耐药机制和抗感染治疗研究进展

    目前临床应用的抗菌药物大部分是在1936~1968年间发现的,过去的40余年仅发现了3种具有新型抗菌作用机制的药物,即利奈唑胺、达托霉素和Mutilins。有限的抗菌药物资源和抗菌药物滥用使得细菌迅速获得耐药性,细菌对抗菌药物的耐药性已成为全球性问题,给抗感染治疗带来了严峻挑战,NDM-1耐药基因的出现更是雪上加霜。今年世界卫生日的主题为“抵御耐药性:今天不采取行动,明天就无药可用”,世界卫生组织号召所有主要利益相关方,包括决策者和计划者、公众和患者、行医者和处方者、药剂师和药物供应商以及制药业,采取行动并负起责任,抵御抗菌药物耐药性。近年来,抗菌药物耐药机制的研究揭示了新型耐药机制,同时,新药物、新的致病机制和治疗手段的发现为抵御耐药菌感染打下了坚实的理论基础。本文拟就这两方面内容做一综述。

    Release date:2016-08-30 11:58 Export PDF Favorites Scan
  • RESEARCH PROGRESS OF POSTEROLATERAL ROTATORY INSTABILITY OF THE ELBOW

    【Abstract】 Objective To review the progress in pathoanatomy, diagnosis, and treatment of posterolateral rotatory instability (PLRI) of the elbow. Methods Related literature concerning PLRI of the elbow was extensively reviewed, comprehensive analysis was done. Results The lateral collateral ligament complex (LCLC), radial head, capitellum, and coronoid process are important constraints to PLRI. Muscle groups that cross the lateral elbow are secondary constraints to PLRI. Clinical examination includes lateral pivot-shift test, lateral pivot-shift apprehension test, chair sign, active floor push-up sign, tabletop relocation test, and posterolateral rotatory drawer test. Radiology, arthroscopy, and ultrasound can help diagnosis of PLRI. Reconstruction of bony fixation or soft tissue fixation can be used for treatment of injured LCLC. Conclusion The primary constraints to PLRI is LCLC. Ultrasound imaging is accurate for identification and measurement of normal LCLC. Therefore, ultrasound may prove valuable in assessment of abnormal lateral ulnar collateral ligaments. Reconstruction of soft tissue fixation, which can avoid iatrogenic fracture, is a selective treatment method.

    Release date:2016-08-31 04:21 Export PDF Favorites Scan
  • PROGRESS OF LIPOSOMES AS ANTIBIOTIC CARRIERS

    Objective To reviewe the research progress of liposomes as antibiotic carriers. Methods Domestic and abroad literature concerning liposomes as antibiotic carriers was reviewed and analyzed thoroughly. Results Liposomes as antibiotic carriers can significantly improve drug distribution, enhance antibacterial activity, and reduce the side effects of antibiotics during treatment. But it also has some problems, such as poor physical and chemical stabilities and low encapsulation efficiency. Conclusion Liposomes as antibiotic carriers can reduce the drug toxicity, improve drug biodistribution, and pharmacokinetics, and bring the dawn to completely curing infections disease.

    Release date:2016-08-31 04:22 Export PDF Favorites Scan
  • PROGRESS IN DIAGNOSIS AND TREATMENT OF TARSAL COALITION

    Objective To review the progress in the diagnosis and treatment of tarsal coal ition. Methods Recent l iterature concerning the diagnosis and treatment of tarsal coal ition was reviewed. Results Tarsal coal ition is a bridge between the tarsal bones of the foot. The most common types are talocalcaneal and calcaneonavicular coal itions. Calcaneonavicular coal itions can be diagnosed with an oblique radiograph of the hindfoot. Most talocalcaneal coal itions require computer tomography for diagnostic confirmation. Magnetic resonance imaging may be useful for diagnoses of cartilaginous andfibrous coal ition. Casting is the usual initial treatment for the symptomatic individual. For patients with treatment failure and no degenerative changes, resection of the coal ition can be performed with good results. Isolated subtalar fusion may be performed for patients with failure of talocalcaneal resections. For patients undergoing failure of subtalar fusions and calcaneonavicular resection, tri ple arthrodesis may be performed. During minimally invasive operation, operation indications should be strictly controlled. Conclusion The diagnosis method of tarsal coal ition is clear. The cl inical manifestation combined with imaging examination can improve the diagnosis rate. The surgical indication of tarsal coal ition remains controversial, the randomized prospective studies are still required.

    Release date:2016-08-31 04:23 Export PDF Favorites Scan
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