目的：观察卡介菌多糖核酸联合润燥止痒胶囊治疗慢性荨麻疹的疗效。方法： 将2008年4月~2009年4月门诊就诊的86例慢性荨麻疹患者随机分成两组，治疗组44例采用卡介菌多糖核酸2 mL肌注，隔日1次，18次为1疗程；同时予口服润燥止痒胶囊4粒，3次/d，连续治疗36天；对照组42例单独口服润燥止痒胶囊，方法疗程同治疗组。结果： 治疗组有效率为90.91%,对照组为7143%。两组比较差异有显著性（Plt;005）。结论： 卡介菌多糖核酸联合润燥止痒胶囊治疗慢性荨麻疹疗效确切。
为预防应激性溃疡和消化道出血, 质子泵抑制剂( PPI) 、组胺H2 受体拮抗剂( H2 RA) 以及硫糖铝在ICU中的应用非常普遍。既往的研究认为以PPI 或H2RA 为代表的抑酸剂( ASD) 可致胃液pH 值增高, 为细菌在胃腔内定植创造了条件, 并进而增加医院获得性肺炎( HAP) , 尤其是呼吸机相关性肺炎( VAP) 发生的风险。我们通过文献复习发现,ASD 与VAP 的关联性迄今仍无明确的证据, 已有的临床研究结论互为矛盾; 另一方面, 既往研究多集中于硫糖铝与H2RA 的比较, 有关PPI 和H2RA 导致VAP 的风险比较研究仍然缺乏, PPI 是否比H2 RA 更易发生VAP 也缺乏研究可资证明。为此我们将有关内容综述如下, 以供同道参考。
Objective To investigate change of bispectral index(BIS) and hemodynamic index during induction and orotracheal intubation of sevoflurane anesthesia. Methods This study was a prospective before-after study in the same patients. A total of 30 ASA physical status I and II adult patients without airway abnormalities were enrolled to receive inhalation induction of anesthesia with 8% sevoflurane. Mean arterial pressure(MAP),heart rate(HR) and BIS were recorded before anesthesia(T1),when patients loss of consciousness(T2), before intubation (T3),at 1 min(T4) and 3 min(T5) after intubation. Results BIS at T1-T5 were 96.8±1.7,70.4±8.8,39.2±8.4,43.6±12.9 and 41.6±9.3 respectively, the measurements at T2-T5 were all markedly lower than at T1(Plt;0.05). HR at T3-T5 were all markedly higher than at T1(Plt;0.05). MAP at T2 and T3 were markedly lower than at T1, but at T4 was higher than at T1(Plt;0.05), and recovered to the level at T1 at T5(Pgt;0.05).BIS,HR and MAP at T4 were all significantly higher than T3(Plt;0.05). Conclusion Anesthesia induction with sevoflurane and small dose of succinylchoiline we used can provide adequate depth of general anesthesia,but can not prevent cardiovascular adverse reactions to intubation.
Objective To explore the distribution characteristics and prognostic risk factors of critically ill patients who has long-term hospitalization in intensive care unit ( ICU) . Methods A retrospective study was carried out to evaluate 119 critically ill patients from January 2003 to July 2009 by extracting data from computerized hospital information system. The patients were divided into a survival group and a non-survival group based on discharging outcomes. A binary logistic regression analysis wasintroduced to investigate potential risk factors of prognosis. Results Age, type of payment, entity of disease,and length of ICU stay were significantly different between the two groups ( P lt; 0. 05) in independent-Samples T test. Logistic regressions indicated that age, length of ICU stay and plasma infusion were independent predictors for worse outcome. Conclusions Age, length of ICU stay and plasma infusion may directly influence the prognosis of patients with prolonged stay in ICU. Intensive therapies should be emphasized for those patients at high risk.
Objective To investigate the effectiveness of meniscal allograft in treatment of discoid meniscus tear. Methods Between May 2005 and September 2009, 7 cases of discoid meniscus tear were treated with meniscal allograft. There were 2 males and 5 females with an average age of 22.6 years (range, 18-33 years). The locations were the left knee in 5cases and the right knee in 2 cases. The causes were sport trauma in 4 cases, impact injury in 2 cases, and no apparent reason in 1 case. Of them, 7 cases had joint tenderness gap, 2 cases had positive results in floating patella test, 7 cases had positive results in McMurray test, and 6 cases had positive results in squatting test. The range of knee motion was 0-60°. The disease duration ranged from 3 months to 17 years (median, 26 months). Results The number of the pins was 9-13 (mean, 11). The operative time ranged from 1.5 to 2.7 hours (mean, 1.7 hours). The postoperative fever time ranged from 31 to 57 hours (mean, 46.4 hours). Incisions healed by first intention in 6 cases; infection occurred in 1 case after operation and was cured after 18 days of local irrigation with antibiotic sal ine. Seven patients were followed up 21.6 months on average (range, 12-53 months). The range of knee motion was 0-125°. All patients had the negative results of floating patella test, McMurray test, and squatting test. MRI showed that there was a good heal ing between the transplanted meniscus and the surrounding synovium. The Japanese Orthopaedic Association (JOA) score was 80.71 ± 4.82 at 6 months after operation, showing significant difference (t=10.11, P=0.00) when compared with the score (41.71 ± 8.07) before operation. Conclusion Meniscal allograft in treatment of discoid meniscus tear is a rel iable and effective method, which can ease knee pain.
Objective To explore a new method of treating early avascular necrosis of femoral head (AVNFH). Methods Sixty-nine New Zealand adult rabbitswith a mean weight of 2.8 kg after AVNFH presenting were randomly divided into three groups. In group A, deproteinized bone(DPB) combined with the recombinant plasmid pcDNA3.1/vascular endothelial growth factor 165(VEGF165) was implanted in the drilled channel of the necrotic femoral head. In group B, only DPB was implanted. In group C, channel was drilled without DPB or plasmid implanted. Femoral head specimens were obtained 3 days, 1, 2, 4, 8 and 16 weeks after operation. The expression of VEGF165 was examined by RT-PCR, Western blot and immunohistochemical techniques. X-ray testedbone formation generally. Angiogenesis and repair of the femoral head were observed by histological and histomorphometric analysis. Results In group A, the expressions of VEGF165 mRNA and protein were detected 3 days postoperatively, reached apex 1 week and lasted more than 3 weeks after implantation. The ratios of IOD of collagen type Ⅰ were 0.29±0.11, 0.55±0.13 and 0.67±0.10 IOD/μm2 respectively at 2, 4 and 8 weeks postoperatively and the ratios of IOD of new capillary vessels were 0.33±0.10and 0.57±0.16 IOD/μm2 respectively at 2, 4 weeks postoperatively in group A, showing statistically significant difference (Plt;0.01) when compared with groups B and D. X-ray test indicated much bone callus formed early. Conclusion Transfection of the VEGF165 gene can enhance local angiogenesis at early stage andDPBVEGF165 compound can improve bone formation. Deproteinized bone combined with VEGF165 gene provides a potential method for therapy of osteonecrosis.
Objective To investigate the clinical applicationand curative effect of isoionic microtrauma arthroscope on treatment of knee arthropathy. Methods From May 2003 to November 2004, 52 cases of knee joint injury were cured by using isoionic microtrauma arthroscope, including 30 cases ofknee osteoarthritis, 10 cases of meniscus injury, 5 cases of kneecap dislocation, 5 cases of laxity of anterior cruciate ligation and 2 cases of rheumatoid arthritis. In accordance with Lysholm criterion for knee joint function, the scores were 35.5±4.9 before operation. Results All of these patients were followed up for 2-17 months. The scores of knee joint function was 86.4±5.3 after operation, and there was significant difference (Plt;0.001). Conclusion Isoionic microtrauma arthroscope is characterized by low-temperature hemoagglutination, crimpling,boiling, cutting and hemostasia, which makes kneejoint arthroscope operation easier-to-do, miner histological scathe and lighter side effect; so it is favourable for functional recovery and its curative effect is satisfactory.
Objective To investigate the relationship between velopharyngeal functions and factors such as age at operation , cleft type, performing procedure.Methods FFT technique and velopharyngeal X-ray examination were used to evaluate the velopharyngeal functions of 82 patients. The relatively important factors affecting velopharyngeal functions were searched out through regression analyse and pearson correlation. Results A significant positive correlation was confirmed between AAO(age at operation) and A1/A2(velopharyngeal incompetence), Plt;0.001. AAO also showed linear regression with A1/A2. Model was significant, Plt;0.001. Quotation: A1/A2(velopharyngeal incompetence)=0.005 852×AAO+0.961. Conclusion AAOwas an important affecting factor on velopharyngeal functions. The earlier the cleft is repaired, the more normal velopharyngeal functions will be obtained.
Objective To probe the clinical character,the histopathological classification and misdiagnoses of intraocular tumors. Methods The clinical and pathological data of 359 patients with intraocular tumor diagnosed clinically between 1980～2000 were retrospectively analyzed. Results There were 300 cases of malignant tumor and 23 cases of benign tumor respectively. Non-oncologic malady and benign tumor misdiagnosed as tumor or malignant tumor were 40 cases. The two leading malignant tumors were retinoblastoma and melanoma. Conclusion The clinical and pathological analysis of intraocular tumor is beneficial to the correct clinical diagnosis and treatment. (Chin J Ocul Fundus Dis,2002,18:28-30)
Objective To investigate the survivability of ret inal ganglion cells (RGC) after optic nerve crush with intraocular injection of schwann cells(SC) derived neurotrophic (SCNA) in vivo． Methods Schwann cells of 3～5 day newborn mice were cultured,conditioned media without serum was collected,ultraspeed centrifugalized,and frozen-dry.SD rats were divided into normal contrl,crush control,medium treatment and SCNA treatment groups,and 20 eyes in every group.RGC of adult rats were labelled with flu orogold.Seven days later,the optic nerve was intraorbitally crushed and SCNA was injected into the vitreous on the 5th,7th,21th and 28th day after crush,the number of RGC were counted respectively. Results The densities of RGC began to decrease on the 7th day after injury,the number of RGC was 70.2% and 40.5% of normal controls on the 14th and 28th day,respectively .In the group with SCNA injection,RGC densities decreased on the 7th day,but RGC densities were much higher then that of controls on the 14th,21th,and 28th day after injury (Plt;0.01). Conclusions SCNA administered intraocularly at the time of crush of optic nerve can protect RGC from injury and death of the cells. (Chin J Ocul Fundus Dis，2000，16：1-70)