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1.
目的探讨血循毒类毒蛇咬伤患者早期伤口切开对预后的影响。方法回顾性分析我院2011年3月~2014年3月诊治的血循毒类毒蛇咬伤患者223例的临床资料,总结并比较其临床特点及预后。结果本组患者轻度肿胀97例中,伤后12h内切开21例,未溃疡12例,Ⅰ°溃疡7例,Ⅱ°溃疡2例;晚期切开或未切开76例,未溃疡15例,Ⅰ°溃疡41例,Ⅱ°溃疡16例,Ⅲ°溃疡4例。中度肿胀患者85例中,伤后12h内切开32例,未溃疡8例,Ⅰ°溃疡21例,Ⅱ°溃疡2例,Ⅲ°溃疡1例;晚期切开或未切开53例,未溃疡6例,Ⅰ°溃疡16例,Ⅱ°溃疡24例,Ⅲ°溃疡7例。重度肿胀患者41例中,伤后12h内切开17例,Ⅰ°溃疡11例,Ⅱ°溃疡4例,Ⅲ°溃疡2例;晚期切开或未切开24例,Ⅰ°溃疡2例,Ⅱ°溃疡6例,Ⅲ°溃疡16例。在蛇伤后12h内切开的患者坏死溃疡的形成、肿胀程度的改善均明显优于晚期切开或未切开的患者,差异有显著统计学意义(P0.05)。结论随着患者凝血功能的改善,早期伤口切开对血循毒类毒蛇伤患者局部伤口状况有较好的改善作用。 相似文献
2.
目的:探讨重型肝炎患者发生低血糖的临床意义,为针对性的防护提供依据。方法:检测20例健康献血员、44例急性肝炎、51例慢性肝炎及30例重型肝炎患者的空腹血糖水平进行比较,患者在发生低血糖症状时检测其血糖水平。结果:重型肝炎组的空腹血糖水平明显低于正常对照组、急性肝炎组及慢性肝炎组,在病程中低血糖发生率明显高于急性肝炎及慢性肝炎患者组,重型肝炎死亡组在病程中低血糖发生率明显高于存活组。结论:重型肝炎患者常发生低血糖,早期识别低血糖征兆,合理饮食,做好健康宣教是预防的关键;检测空腹血糖对判断重型肝炎危重程度和评估预后有重要意义。 相似文献
3.
During the period of 1980-1996 the dispensary observation of 50 HIV-infected patients was carried out. The clinical forms of the infection were distributed among these patients as follows: asymptomatic forms in 18 patients, persisting generalized lymphadenopathy in 8 patients, pre-AIDS in 14 patients, AIDS in 10 patients. Secondary infections were registered at the pre-AIDS stage. Dermatoses, oropharyngeal candidiasis occurred most frequently: in 52% of the HIV-infected patients. Herpes virus infection was registered in 46% of the patients. At the stage of AIDS during the generalized herpes virus and cytomegalovirus infections were registered in 5 and 7 patients respectively. Generalized forms of combined infections (herpes virus + fungi) prevailed, which caused the death of 7 patients at the terminal stage of AIDS. 相似文献
4.
The pronounced forms of depression and the levels of neuro-psychical adaptation and subjective control (attitude to the disease) were studied in 27 patients with HIV infection. 14 patients were at stage A, 8 patients were at stage B and 5 patients were at stage C of the CDC classification (1994). Starting from the early stages of the disease, neuro-psychical adaptation disturbances were noted: at stage A 10 patients belonged to group 5 of health, at stage B 8 patients and at stage C 2 patients. Most of the patients (15) had a low level of subjective control, 12 patients exhibited a medium level, which should be taken into consideration in prescribing and carrying out curative and diagnostic procedures. 相似文献
5.
目的:探讨颈椎椎弓根螺钉内固定治疗外伤性颈椎骨折脱位的临床疗效。方法:回顾性分析2010年6月至2012年7月我院采用颈椎椎弓根内固定治疗颈椎骨折脱位28例。损伤部位:C16例,C22例,C3~43例,C43例,C54例,C5~65例,C63例,C6~72例。脱位程度:I度脱位20例,II度脱位5例,III度脱位1例,Ⅳ度脱位2例。ASIA分级:A级2例,B级1例,C级3例,D级4例,E级17例。全部病例术前均行x线、CT及MRI检查并根据其结果行个体化椎弓根钉置入。术前和术后按ASIA神经功能评估方法评价手术疗效。结果:28例均获得8~18个月随访,平均随访12个月,随访期内无一例死亡。其中置入螺钉140枚,有128枚位置正确,12枚存在不同程度偏差,无手术相关并发症,无神经损伤加重。ASIA分级:A级3例中的1例恢复至D级,2例恢复至B级,B级1例恢复至C级,C级3例中的1例恢复至D级,2例恢复至E级,D级4例恢复至E级,E级17例仍为E级。结论:颈椎椎弓根钉内固定是治疗外伤性颈椎骨折脱位安全有效。 相似文献
6.
Testicular responsiveness to long-term administration of hCG and hMG in patients with hypogonadotrophic hypogonadism 总被引:2,自引:0,他引:2
A Okuyama M Nakamura M Namiki T Aono K Matsumoto M Utsunomiya T Yoshioka H Itoh H Itatani S Mizutani 《Hormone research》1986,23(1):21-30
Steroidogenic responsiveness and amelioration of sperm number and motility following long-term intramuscular hCG and hMG administration were evaluated in 18 males with hypogonadotrophic hypogonadism (HH). The patients consisted of 13 patients with isolated gonadotrophin deficiency (IGD) and 5 patients hypophysectomized at an early or middle pubertal period. Basal serum levels of testosterone and 17 beta-estradiol were within prepubertal range in all patients before the treatment. Serum testosterone levels reached the normal adult male levels within 12-24 months of the treatment in only 2 of 7 younger patients and 1 of 6 older patients with IGD, whereas in all hypophysectomized patients serum levels of both testosterone and 17 beta-estradiol increased to the levels found in normal adult males within 6 months of the treatment. The mean peak levels of serum testosterone and 17 beta-estradiol, respectively, during the treatment were 2.1 +/- 0.8 (SD) ng/ml and 10.8 +/- 4.9 (SD) pg/ml in younger patients with IGD, 1.4 +/- 0.9 ng/ml and 9.7 +/- 5.1 pg/ml in older patients with IGD and 6.0 +/- 1.2 ng/ml and 34.2 +/- 14.8 pg/ml in hypophysectomized patients. Quantitative improvement in both sperm density and sperm motility were found in 4 of 7 younger patients, 1 of 6 older patients with IGD and all hypophysectomized patients, but only 3 of hypophysectomized patients (3 of 18 patients) could become fertile. 相似文献
7.
Six patients with varying degrees of acute cardiorespiratory failure were seen. All patients deteriorated noticeably when rapid atrial fibrillation developed. In all patients intravenous digitalis failed to slow the ventricular response, and in three patients misguided attempts at electrical cardioversion failed. Haemodynamic monitoring showed a normal or low pulmonary artery occlusion pressure in all patients. Controlled expansion of plasma volume was associated with an immediate slowing of the heart rate in all patients, and the heart rate in all patients returned to sinus rhythm within 30 minutes of transfusion. It is suggested that hypovolaemia in critically ill patients may contribute to the development of atrial fibrillation. 相似文献
8.
目的 目前对意识障碍(DOC)患者的分级评估仍是相关领域的重点和难点。因效性网络可以通过时间序列间的因果关系直观地反映信息传递方向,帮助人们更好地理解患者大脑不同区域之间的信息交互作用。本文结合脑电图和因效性网络探讨听觉刺激下无反应觉醒综合征(VS)患者与最低意识状态(MCS)患者的脑功能连通性差异。方法 共纳入23例DOC患者,采集并分析唤名刺激下的脑电信号,通过多元格兰杰因果方法构建脑功能网络,利用脑网络节点度、聚类系数、全局效率以及因果流向性等参量从脑区之间协同工作的角度对比研究听觉刺激下不同意识水平患者的网络特征。结果 唤名刺激下MCS患者的脑功能连通性强于VS患者,且呈现出因果流向差异,MCS与VS患者四个脑区的信息传递方向均不相同。结论 唤名听觉刺激下MCS患者的信息传递能力强于VS患者;与VS患者相比MCS患者为因果源的电极通道数增多,对其他脑区的信息输出增多。本研究可为DOC患者意识水平的分级评估提供一定的理论依据。 相似文献
9.
F. O. Finkelstein B. H. Forman N. J. Marieb J. Neely S. Santacroce 《The Yale journal of biology and medicine》1981,54(2):95-100
The present study describes our experience with CAPD in an unselected group of patients presenting with endstage renal failure. Twenty-three consecutive patients were offered CAPD, in-center, and home hemodialysis. Twenty-two patients selected CAPD, including 14 patients more than 60 years of age, four patients with diabetes, and one with multiple myeloma. CAPD training was performed in an out-of-hospital office facility. One patient returned to hemodialysis following the development of resistant Pseudomonas peritonitis, two patients died of a myocardial infarction, and one patient died with a GI bleed. The other 18 patients are doing well. Assessment of 17 patients maintained on therapy for four months or more revealed that the patients are less depressed, less organic, and have fewer physical symptoms than previously reported for a comparable group of patients maintained on hemodialysis for a similar period of time. In conclusion, CAPD can be successfully employed, at least for the initial months of therapy, to treat the vast majority of patients with endstage renal disease. CAPD training and follow-up care can be provided in an out-of-hospital office facility. 相似文献
10.
Among 100 consecutive patients who had removal or drainage of the gallbladder and exploration of the common bile duct for stones, there were no serious, immediate or late complications and there were no operative deaths. Ninety-six of the 100 patients had stones in the gallbladder, in the common duct, or in both, and 52 of these patients had one or more stones in the common duct.Ten patients died subsequently of unrelated causes. Six patients were lost to followup. Of the 84 patients whose present condition is known, 75 or 89 per cent have had a completely satisfactory result. Six more patients have minor residual symptoms, and for them the result has been classified as good. In three patients, the results were unsatisfactory. Cholangiograms taken before the removal of the T-tube showed residual stones in two patients. In each instance, the stone or stones have been subsequently passed and both patients are in excellent condition. 相似文献
11.
The results of treating trigeminal neuralgia with percutaneous retroganglionic glycerol rhizotomy in 319 patients from an overall series of 394 patients with 459 operations carried out over a period of 5 1/2 years are reported. Idiopathic trigeminal neuralgia was the diagnosis in 252 patients. 34 patients had trigeminal neuralgia associated with multiple sclerosis. The remaining 33 patients suffered from symptomatic trigeminal neuralgia or atypical facial pain. 230 patients (91.3%) with idiopathic trigeminal neuralgia and 30 patients (88.2%) with multiple sclerosis reported complete freedom from pain. In 12 patients (4.8%) of those with tic douloureux and in 1 patient (2.9%) with multiple sclerosis, pain was alleviated, and the patients required a reduced pharmacotherapy. 10 patients (3.9%) and 3 patients (8.8%) were considered to be treatment failures. The rate of recurrences within the first 2 years was 10.9 and 40.0%, respectively. In the long-term, the rate of recurrences in patients with tic douloureux was 36.9%. 144 patients (45.1%) noticed a hypesthesia. 132 patients (41.4%) had hypalgesia following the procedure, and there was a decrease of symptoms in the long-term observation in 20.0% of the patients. 59 patients (18.5%) developed dysesthesia postoperatively which regressed only to an inappreciable extent in the long-term course. In 16 patients (5.0%) exclusively with a preexisting organic lesion or who had received surgical pretreatment, there was a loss of corneal sensation. The investigation showed on the one hand the effectiveness of the method, but on the other hand also the possibility of marked sensory disorder in selected cases. 相似文献
12.
幽门螺杆菌感染与慢性口臭关系的初步研究 总被引:8,自引:0,他引:8
目的 调查主诉口臭患者的幽门螺杆菌(H.pylori)感染率和主诉消化不良的口臭发生率。方法 研究对象为125例主诉慢性口臭患者和212例主诉慢性消化不良患者。口臭以口气挥发性硫化物(VSC)检测与闻诊联合诊断,H.pylori感染以^14C-尿素呼气试验诊断。结果 125例主诉慢性口臭的患者有87例是真性口臭,其余38例为假性口臭,真性口臭患者的H.pylori感染率显著高于假性口臭(40.2%和13.2%,P〈0.01)。212例主诉慢性消化不良的患者发生口臭105例(49.5%)、感染H.pylori 94例(44.3%),H.pylori阳性患者的口臭发生率显著高于H.pylori阴性患者(57.5%和43.2%,P〈0.05)。无论何种主诉,大部分口臭患者属于VSC阳性(88.5%),但H.pylori阳性患者和H.pylor阴性患者口气VSC水平差异无显著性,VSC阳性口臭和VSC阴性口臭的H.pylori感染率差异也无显著性。结论 H.pylori感染可能与口臭的发生有一定关系,但口气VSC并非由H.pylori直接产生。 相似文献
13.
A H Salibian G R Allison I Rappaport M E Krugman B L McMicken T L Etchepare 《Plastic and reconstructive surgery》1990,85(4):513-24; discussion 525-6
Twelve patients with advanced carcinoma of the floor of the mouth and tongue were treated with total (five patients) or subtotal (seven patients) glossectomy, partial mandibulectomy, and immediate reconstruction with the microvascular composite groin flap. The osteomusculocutaneous groin flap was used in eleven patients, and the osteomuscular flap was used in one patient. The groin musculocutaneous or muscle flap was designed to resemble the shape of the tongue for dynamic food transport, improved swallowing, and acceptable speech. Eight of the 12 patients who survived more than 1 year were evaluated for speech and swallowing. Eight patients were able to speak intelligibly, six patients could tolerate a soft/pureed diet, and two patients were limited to fluids. Cinefluorographic swallow studies using semisolid contrast material showed voluntary active intraoral transport and propulsive pharyngeal emptying without aspiration in six patients with complete flap to palate contact; the remaining two patients were unable to move the intraoral contrast material effectively for swallowing because of poor palatal contact. 相似文献
14.
Zhongliang Ning Dong Chen Aiguo Liu Pingsheng Fan Qiaohong Duan Tengyue Zhang Gaofei Fan 《Cell biochemistry and biophysics》2014,68(1):195-200
The present study evaluated the efficacy of chemotherapy combined with targeted arterial infusion of verapamil in patients with advanced gastric cancer. Forty patients were enrolled. Targeted arterial infusion of verapamil was done once a month, 3–5 times per patient, along with chemotherapy. After 2 bouts of combined treatment, the efficacy was evaluated. Primary gastric tumor was confirmed in 38/40 patients, and unconfirmed in 2/40 patients due to adhesion of tumors to surrounding tissue. Combined treatment was administered in 38 patients with defined tumors. Complete response to the treatment was in 5/38 (13.1 %) patients, partial response in 27/38 (71.1 %) patients, stable disease in 4/38 (10.5 %) patients, and progressive disease in 2/38 (5.26 %) patients. The effective rate (i.e., complete + partial response) comprised 84.2 %. There were 31 patients with liver metastases; 10/31 (32.3 %) patients showed complete response, 16/31 (51.6 %) patients showed partial response, 3/31 (9.7 %) patients had stable disease, and 2/31 (6.5 %) patients had progressive disease. The effective rate in these patients was 83.8 %. Thirty-seven patients were followed up, and 27/37 (73.0 %) patients were alive for 6 months or longer, 19/37 (51.3 %) for 12 months, 8 (35.1 %) for 18 months, and 8/37 (21.6 %) for 24 months. In conclusion, in patients with advanced gastric cancer, chemotherapy is more effective when combined with targeted arterial infusion of verapamil, leading to extended patients’ survival and improved quality of life. 相似文献
15.
We explored the effects of the oral histone deacetylase (HDAC) inhibitor ITF2357 in patients with autoinflammatory syndrome. In this prospective open-label pilot study, eight patients were enrolled; one patient with tumor necrosis factor receptor-associated periodic syndrome (TRAPS), three patients with hyper-IgD and periodic fever syndrome (HIDS) and four patients with Schnitzler syndrome were closely followed during 90 d of ITF2357 treatment. Three patients with Schnitzler syndrome and one TRAPS patient experienced a partial remission. In four patients, there was no effect. In HIDS patients, there was a tendency toward a higher attack frequency and increasing attack severity. In two patients (one TRAPS and one HIDS), we observed a decrease of acute-phase response without signs of clinical improvement. One patient with Schnitzler syndrome showed a partial response despite an ongoing acute-phase response. In conclusion, ITF2357 monotherapy was able to induce partial response only in patients with Schnitzler syndrome and no response in patients with HIDS. 相似文献
16.
J Lumbroso M Schlumberger F Tenenbaum B Aubert J P Travagli C Parmentier 《Journal of nuclear biology and medicine (Turin, Italy : 1991)》1991,35(4):288-291
Twenty patients, 16 male and 4 female (aged 11-76 years), with metastatic pheochromocytoma were treated in our Institution between 1985 and 1990. Metastases occurred in all patients: at presentation in 11 patients, with a 10 to 30 month delay in 7 patients, and 9 and 28 years later respectively in 2 patients. Catecholamines hyperproduction was present in all patients. Metaiodobenzylguanidine (MIBG) uptake was found in 16 patients after a diagnostic dose and only after a therapeutic dose in 1 patient. Surgery was performed on primary tumor (18 patients) and on distant metastases (10 patients). 131I-MIBG therapy was performed in 11 patients, 9 of whom were evaluable. The cumulative activity ranged from 3.7 to 26.3 GBq (100 to 711 mCi) in 1 to 6 courses. We observed symptomatic improvement (5 patients) and partial tumor response in 2 patients, which lasted for 28 and 9 months respectively, terminating with a rapidly progressing disease involving the bone marrow. Stabilisation was observed in 3 patients. Moderate myelosuppression occurred in 4 patients. Fifteen patients died with a median survival of 16 months (range 3-60). Response to therapy was poor and further evaluation of the presently available therapeutic approaches is needed. 相似文献
17.
The monoclonal antibody-defined CAR-3 antigen is a serological marker associated with pancreatic carcinoma 总被引:1,自引:0,他引:1
M Prat E Medico P Piantino S Bretti F P Rossini P M Comoglio 《The International journal of biological markers》1988,3(1):29-35
The monoclonal antibody-defined CAR-3 antigen is a new carcinoma associated marker which is expressed on a mucin-like molecule. Serum concentrations of CAR-3 were assayed in 181 patients with carcinomas of different organs, 20 patients with non-carcinomatous malignancies, 123 patients with inflammatory diseases and 150 healthy controls. Serum levels of CAR-3 were significantly increased in 51% of the patients with pancreatic carcinomas, in 60% of patients with biliary tract carcinomas and in about 15% of the patients with carcinomas of the digestive apparatus. Sera from patients with breast carcinomas were negative, as well as sera from patients with melanomas or sarcomas. CAR-3 values in samples from patients with chronic pancreatitis were constantly negative, as were samples from healthy donors. Significant concentrations of CAR-3 were detected in 20% of the sera from patients with acute pancreatitis and in 15% of the sera from patients with cirrhosis. Because of its high specificity for pancreatic carcinomas compared to chronic pancreatitis, CAR-3 seems a promising marker for distinguishing between neoplastic and chronic inflammatory diseases of the pancreas, whose differential diagnosis is difficult. 相似文献
18.
Laktionov PP Tamkovich SN Rykova EY Bryzgunova OE Starikov AV Kuznetsova NP Sumarokov SV Kolomiets SA Sevostianova NV Vlassov VV 《Nucleosides, nucleotides & nucleic acids》2004,23(6-7):879-883
The concentration of extracellular DNA and RNA in blood plasma of healthy donors, trauma patients, patients with breast and lung cancer, nonmalignant breast tumors and nonmalignant lung diseases were estimated. Significant amounts of extracellular RNA were found in plasma of trauma patients. The concentration of DNA and RNA in plasma of trauma patients correlates with the extent of posttraumatic organ failure. Extracellular RNA was not found in the plasma of breast cancer patients and patients with nonmalignant breast tumors, whereas a very high concentration of extracellular RNA was found in patients with malignant and nonmalignant diseases of lung. 相似文献
19.
To examine whether psychological variables such as depression and non-specific physical symptoms (somatization) influence pain entity among acute and chronic TMD patients with one or more TMD diagnoses (muscle disorders, MD; disc displacements, DD; and arthralgia, arthritis, arthrosis, AAA). One hundred and fifty-four patients (37 male and 117 female; mean age, 39.0 +/- 14.5 years) with Research Diagnostic Criteria for Temporomandibular Disorders (RDC/ TMD) protocol were selected. Differences in mean depression and somatization scores between acute and chronic TMD patients, as well as TMD patients with one or multiple TMD diagnoses were compared by using the parametric T-test for independent samples. The majority of patients were acute TMD patients (81.8%), while the remaining 28 patients (18.2%) were chronic TMD patients. 62% of patients had only one TMD diagnosis (MD or DD or AAA), 31% of patients had two diagnoses (MD+DD, MD+AAA, DD+AAA) and, finally, 7% of patients had three diagnoses (MD+DD+AAA) according to the RDC/TMD protocol. According to the SCL-90 psychometric evaluation, 19.5% of patients presented a severe depression score (> 1.105), 27.3% of participants presented a severe somatization score with pain items included (> 1.000). The results of the t-test for independent samples showed statistically significant differences between acute and chronic TMD patients (p < 0.001), as well as between patients who were assigned one diagnosis (p = 0.019) and patients who had two or more diagnoses (p < 0.001); for mean levels of depression and somatization scores. Chronic TMD patients and patients with multiple TMD diagnoses had higher rates of depression and somatization in this study. These results could be used in a tailored strategy of TMD treatment. 相似文献
20.
IntroductionThe incidence of colorectal cancer in young patients is increasing. The goal of this study was to investigate whether clinicopathological features and survival differed between young, middle-aged and elderly patients.MethodsThe Czech National Cancer Registry was searched to identify all cases of colorectal cancer between 1982 and 2014. Three subgroups of patients were created: young patients, defined as being between 18 and 40 years of age, middle-aged patients, defined as being between 41 and 74 years of age, and elderly patients, defined as being over the age of 75 years.ResultsA total of 192,241 patients diagnosed with colorectal cancer between the years 1982 and 2014 were included in the study. Out of these, 3,287 patients (1.7%) were between 18 and 40 years of age, 134,139 patients (69.8%) were between 41 and 74 years of age and 54,815 patients (28.5%) were 75 years of age or older. The young patients had a higher incidence of mucinous adenocarcinoma and signet ring cell carcinoma, more advanced disease and more rectal tumours than elderly patients. Nonetheless, young patients received treatment more frequently and had better cancer-specific survival than the older patients.ConclusionThe better prognosis in young patients is presumably due to their better physiological reserve and lower incidence of comorbidities. Efforts should be made in younger patients to diagnose early and treat aggressively. 相似文献