下肢动脉硬化闭塞症介入治疗的临床疗效及其影响因素研究

目的:探索介入治疗下肢动脉硬化闭塞症(ASO)的临床疗效及其影响因素。方法:选择2012年10月至2013年8月我院收治的ASO患者96例,按照治疗方法将所有患者平均分成对照组和实验组,每组48例。对照组进行常规药物治疗,实验组在常规药物治疗基础上行介入手术。考察患者临床疗效及踝肱指数(ABI),并应用二元Logistic回归研究影响ASO复发的因素。结果:术后1个月、3个月、6个月、1年,随着时间的延长,ABI值呈下降趋势,且实验组患者的ABI值在各时间点均明显高于对照组,差异具有统计学意义(P0.05)。其中对照组患者有效率为31.25%,实验组患者有效率为87.50%,实验组有效率显著高于对照组,差异具有统计学意义(P0.05)。糖尿病和高胆固醇症可以单独影响ASO复发。结论:介入治疗ASO患者具有良好的疗效,显著提高患者的ABI,但术后需严格控制血糖和血脂。     

复合式与传统小梁切除术对青光眼患者眼压、生活质量及血清细胞因子的影响

目的:对比复合式与传统小梁切除术对青光眼患者眼压、生活质量及血清细胞因子的影响。方法:前瞻性选取2014年1月-2018年10月期间我院收治的青光眼患者80例,随机分为A组[n=38,传统小梁切除术]和B组[n=42,复合式小梁切除术],比较两组患者视力、眼压、生活质量、血清细胞因子及并发症发生情况。结果:两组患者术后1个月、术后3个月、术后6个月眼压呈不断下降趋势,且B组低于A组(P<0.05);B组术后3个月、术后6个月视力高于A组(P<0.05)。两组患者术后6个月生活质量量表(SF-36)各维度评分均升高,且B组高于A组(P<0.05)。两组患者术后1个月白介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)、血管内皮生成因子(VEGF)均降低,且B组低于A组(P<0.05);两组患者术后1个月色素上皮衍生因子(PEDF)升高,且B组高于A组(P<0.05)。B组并发症发生率低于A组(P<0.05)。结论:与传统小梁切除术相比,复合式小梁切除术在改善青光眼患者中的视力、眼压、生活质量、血清细胞因子方面效果显著,同时还可减少并发症发生率。     

心可舒片治疗冠心病患者PCI术后焦虑的疗效及对生活质量的影响

目的:探讨心可舒片治疗冠心病(CAD)患者经皮冠状动脉介入(PCI)术后焦虑的疗效及对生活质量的影响。方法:选择2015年1月~2017年1月我院心内科收治的68例行PCI术后合并焦虑的CAD患者并将其随机分为治疗组(n=34)、对照组(n=34)。对照组给予常规药物治疗,治疗组在此基础上给予心可舒片,4片/次,3次/d,治疗周期为3个月。比较两组患者治疗前后血液流变学指标、焦虑症状、生活质量的变化。结果:治疗3个月后,治疗组患者全血黏度、血浆黏度、红细胞压积及血小板聚集率均较治疗前显著下降,且均明显低于对照组(P0.05);治疗1个月后,两组HAMA评分均较治疗前明显减低(P0.05),而两组间比较差异无统计学意义(P0.05);治疗3个月后,治疗组HAMA评分明显低于对照组(P0.05);治疗1、3个月后,两组WHOQOL-BREF各维度评分均较治疗前明显升高(P0.05),且治疗组心理、社会关系维度评分显著高于对照组(P0.05)。结论:心可舒片可改善CAD患者PCI术后合并焦虑患者的血液流变学,缓解焦虑症状,提高患者的生活质量。     

不同剂量糖皮质激素治疗老年哮喘急性发作的对比研究

目的:探讨不同剂量吸入型糖皮质激素(ICS)治疗老年哮喘急性发作的疗效及安全性分析。方法:将108例老年哮喘急性发作患者随机分为A组(34例)、B组(38例)和C组(36例),分别吸入布地奈德200μg/d、400μg/d、800μg/d;治疗3个月后再随机分为低剂量组(200μg/d,n=)和高剂量组(400μg/d)进行维持治疗,并随访观察12个月。结果:治疗3个月后,三组的临床症状评分、肺功能较治疗前均有显著改善,差异有统计学意义(P<0.05);B组、C组治疗后的临床症状评分、肺功能及症状消失时间均显著优于A组,而B组、C组之间差异无统计学意义(P>0.05);A组和B组不良反应的发生率分别为5.9%,10.5%,显著低于C组30.6%,差异有统计学意义(P<0.05);维持治疗期间,低剂量组复发率为21.2%,高剂量组为20.4%,差异无统计学意义(P>0.05)。结论:老年哮喘急性发作患者给予ICS 400μg/d治疗剂量及200μg/d维持剂量即可取得较好的治疗效果,可减少不良反应,提高患者的耐受性。     

Cardiac shockwave therapy in patients with chronic refractory angina pectoris

Background

Cardiac shockwave therapy (CSWT) might improve symptoms and decrease ischaemia burden by stimulating collateral growth in chronic ischaemic myocardium. This prospective study was performed to evaluate the feasibility and safety of CSWT.

Methods

We included 33 patients (mean age 70?±?7 years, mean left ventricular ejection fraction 55?±?12?%) with end-stage coronary artery disease, chronic angina pectoris and reversible ischaemia on myocardial scintigraphy. CSWT was applied to the ischaemic zones (3–7 spots/session, 100 impulses/spot, 0.09 mJ/mm²) in an echocardiography-guided and ECG-triggered fashion. The protocol included a total of 9 treatment sessions (3 treatment sessions within 1 week at baseline, and after 1 and 2 months). Clinical assessment was performed using exercise testing, angina score (CCS class), nitrate use, myocardial scintigraphy, and cardiac magnetic resonance (CMR) 1 and 4 months after the last treatment session.

Results

One and 4 months after CSWT, sublingual nitrate use decreased from 10/week to 2/week (p?<?0.01) and the angina symptoms diminished from CCS class III to CCS class II (p?<?0.01). This clinical improvement was accompanied by an improved myocardial uptake on stress myocardial scintigraphy (54.2?±?7.7?% to 56.4?±?9.4?%, p?=?0.016) and by increased exercise tolerance at 4-month follow-up (from 7.4?±?2.8 to 8.8?±?3.6 min p?=?0.015). No clinically relevant side effects were observed.

Conclusion

CSWT improved symptoms and reduced ischaemia burden in patients with end-stage coronary artery disease without relevant side effects. The study provides a solid basis for a randomised multicentre trial to establish CSWT as a new treatment option in end-stage coronary artery disease.

     

人工颈椎间盘置换与颈前路减压植骨融合术治疗脊髓型颈椎病近期疗效的回顾性研究

摘要 目的：回顾性分析人工颈椎间盘置换（ADR）与颈前路减压植骨融合术（ACDF）治疗脊髓型颈椎病（CSM）的近期疗效。方法：回顾性选取2016年7月~2018年12月期间我院收治的CSM患者120例,上述患者根据手术方式的不同分为A组（n=58,ACDF治疗）和B组（n=62,ADR治疗）,比较两组患者疗效、围术期指标、生活质量简表（SF-12）评分、日本矫形外科协会（JOA）评分、颈椎活动度及并发症发生情况。结果：B组术后12个月的优良率为74.19%（46/62）,高于A组的53.45%（31/58）（P<0.05）。两组患者术后6个月、术后12个月躯体健康评分、精神健康评分均较术前升高,且B组高于A组（P<0.05）。B组术后1个月、术后3个月、术后6个月、术后12个月JOA评分和颈椎活动度均高于A组（P<0.05）。B组住院时间、术后颈托固定时间、术后恢复工作时间均短于A组（P<0.05）。两组术后并发症发生率比较差异无统计学意义（P>0.05）。结论：与ACDF治疗相比,ADR治疗CSM的近期疗效显著,可有效改善患者脊椎功能及生活质量,且安全性较好,临床应用价值较高。     

胸腔镜局麻下治疗结核性胸膜粘连及包裹

目的:研究胸腔镜局麻下治疗结核性胸膜粘连及包裹的方法及临床效果。方法:以我院自2014年3月23日-2016年3月23日收治的68例结核性胸膜炎粘连包裹患者为研究对象,采用随机数表法分成两组。观察组接受胸腔镜局麻下粘连分离术治疗,对照组采取常规穿胸水引流术治疗,比较两组临床效果。结果:观察组总有效率(94.12%)高于对照组总有效率(85.29%),组间差异显著(P0.05)。观察组患者治疗后6个月BORG评分低于治疗后1个月,差异有统计学意义(P0.05)。观察组患者治疗后1、3、6个月BORG评分均显著低于对照组(P0.05)。接受治疗后3、6个月,对照组患者BORG评分均低于治疗后1个月,差异均有统计学意义(P0.05)。观察组患者治疗后6个月FVC水平高于治疗后3个月(P0.05)。相较于对照组,观察组患者治疗后1、3、6个月FVC水平明显更高(P0.05)。结论:胸腔镜局麻下治疗结核性胸膜粘连及包裹效果十分显著,可明显改善患者肺功能和临床症状,对患者有利。     

MIS-TLIF与TLIF治疗单节段腰椎退行性疾病近期疗效的对比分析

摘要 目的：对比分析微创经椎间孔入路腰椎椎间融合术（MIS-TLIF）与传统经椎间孔腰椎椎体间融合术（TLIF）治疗单节段腰椎退行性疾病近期疗效。方法：回顾性选取我院2018年4月-2020年12月收治的72例单节段腰椎退行性疾病患者的临床资料,根据手术方式分为A组（n=36,给予TLIF治疗）,B组（n=36,给予MIS-TLIF治疗）。对比两组患者手术指标（手术时间、术中出血量、切口长度）;对比两组患者手术前和手术后1个月、手术后6个月疼痛程度和腰椎功能;对比两组患者椎间融合率。结果：相比于A组,B组手术时间更长,切口长度更短,术中出血量更少（P＜0.05）;相比于A组,B组手术后1个月、手术后6个月视觉模拟评分法（VAS）评分均更低（P＜0.05）;相比于A组,B组手术后1个月、手术后6个月日本骨科协会（JOA）评分均更高（P＜0.05）。B组椎间融合率为97.22%（35/36）与A组的88.89%（32/36）比较差异无统计学意义（P＞0.05）。结论：与TLIF治疗相比,采用MIS-TLIF治疗单节段腰椎退行性疾病患者,手术时间更长,但对于患者疼痛的缓解和腰椎功能的改善更为明显。     

The effects of leflunomide on clinical parameters and serum levels of IL-6, IL-10, MMP-1 and MMP-3 in patients with resistant rheumatoid arthritis

OBJECTIVE: The purpose of this open pilot study was to assess possible mechanisms of the effects of leflunomide by studying the influence of the drug on the serum levels of MMP-1, MMP-3, IL-10, IL-6 and their possible correlation with clinical disease parameters. PATIENTS AND METHODS: Thirty patients with long standing active rheumatoid arthritis were enrolled in this study. All patients failed at least 5 DMARDs in the past and were on stable treatment for at least 3 months before starting the protocol. The patients received a loading dose of 100 mg for 3 days followed by 20 mg/day thereafter and followed up monthly for 6 months. Disease activity was assessed at baseline, 2 weeks, and every month of therapy thereafter using the following variables: tender joint count, swollen joint count, morning stiffness duration, pain, tiredness, physician's and patient's global assessment, using VAS, ESR and CRP. Clinical effects of the treatment regimen were calculated using the American College of Rheumatology (ACR) criteria for clinical response. Adverse events were recorded. Serum levels of MMP-1, MMP-3, IL-10 and IL-6 were measured before and 3 months after starting the protocol. RESULTS: Except for tiredness, a statistically significant improvement in all clinical and laboratory parameters of disease activity was reached after 3 months. At this time point the ACR-20 response rate was 46.2%. The levels of MMP-1, MMP-3, IL-6 and IL-10 decreased significantly after 3 months. A statistically significant correlation between serum levels of MMP-1, IL-10 and IL-6 and clinical and laboratory parameters was also shown. After 6 months, 16 out of 30 patients withdrew from the study [adverse events (35.4%), lack of efficacy (9.7%), and low compliance (6.4%)]. CONCLUSIONS: Leflunomide was clinically efficacious in this group of long standing resistant RA in an open study "real life" design. These results comply with those reported in previous clinical trials. Serum MMP-1, MMP-3, IL-10 and IL-6 levels decreased significantly. Despite high withdrawal rate, no serious adverse effects were recorded.     

甲亢低骨量患者131I治疗后干预治疗效果的评价

目的:研究甲亢低骨量患者131I治疗后干预治疗的效果。方法:对100例甲亢低骨量患者,随机分为两组:A组50例,131I治疗后口服钙尔奇D及罗盖全治疗;B组50例,131I治疗后骨质自然恢复。另设C组50例为正常对照组。于131I治疗前、治疗后3、6及12个月测定A、B两组骨密度(BMD),观察其骨质变化并评价治疗效果。结果:(1)A组随治疗时间延长BMD逐渐升高,具有一定的规律性,腰椎(L2-4)骨密度3个月提高明显(t=-2.111,P=0.04)且12个月时达到与C组无统计学差异(t=-2.290,P=0.202)。(2)B组3个月时腰椎BMD有所降低,12个月时升高明显(股骨颈t=-2.327,P=0.043;腰椎(L2-4)t=-2.798,P=0.000)。(3)6个月时两组腰椎骨密度改善幅度出现统计学差异(t=-2.416,P=0.018),12个月时差异显著(t=-3.259,P=0.002)。结论:131I联合钙尔奇D与罗盖全治疗甲亢低骨量患者,其恢复时间及疗效均用131I治疗,能有效防止骨量的进一步下降及减少骨质疏松症的发生。     

超声乳化联合不同术式对青光眼合并白内障患者视力、血流动力学及生活质量的影响

目的:探讨超声乳化联合不同术式对青光眼合并白内障患者视力、血流动力学及生活质量的影响。方法:回顾性分析2015年1月～2019年8月期间我院收治的青光眼合并白内障患者56例(66眼)的临床资料,根据手术方式的不同分为A组(n=27,超声乳化联合小梁切除术)和B组(n=29,超声乳化联合房角分离手术),比较两组患者视力、眼压、血流动力学及生活质量情况,统计两组并发症发生情况。结果:两组术后1个月、术后3个月、术后6个月视功能指数量表(VF-14)评分呈升高趋势,且B组高于A组(P0.05)。两组患者术后1个月、3个月、6个月视力呈先升高后降低,且术后1个月、3个月、6个月均高于术前(P0.05),B组术后3个月、术后6个月视力均高于A组(P0.05);两组患者术后1个月～术后6个月眼压均呈不断下降趋势,且B组低于A组(P0.05)。两组术后6个月舒张末期流速(EDV)、收缩期峰值流速(PSV)均升高,且B组高于A组(P0.05);阻力指数(RI)均降低,且B组低于A组(P0.05)。两组并发症发生率比较差异无统计学意义(P0.05)。结论:与超声乳化联合小梁切除术相比,超声乳化联合房角分离手术治疗青光眼合并白内障患者,在改善患者视力、眼压、血流动力学及生活质量方面效果较佳,且不增加并发症发生率。     

恩替卡韦对CHB患者外周血T淋巴细胞PD-1水平及

摘要：目的 探讨恩替卡韦对慢性乙型肝炎（CHB）患者外周血T淋巴细胞程序性死亡受体1（PD-1）水平及肝功能的影响。方法 将128例CHB患者随机分为观察组及对照组各64例,对照组患者给予拉米夫定治疗,观察组在对照组基础上给予恩替卡韦治疗。分别于治疗前、治疗后1个月、3个月、6个月、12个月抽取静脉血5 mL,采用荧光定量PCR检测患者血清HBV DNA载量,流式细胞术检测T淋巴细胞PD-1表达水平,全自动化生化分析仪测定患者血清谷草转氨酶（ALT）水平。结果 两组组患者治疗1个月、3个月、6个月、12个月HBV DNA载量、ALT水平、CD4+T细胞PD-1、CD8+ T细胞PD-1水平均低于治疗前（P<0.05）。观察组治疗后1个月、3个月、6个月、12个月HBV DNA载量、ALT水平、CD4+ T细胞PD-1、CD8+ T细胞PD-1水平低于对照组（P<0.05）。结论 恩替卡韦能有效抑制CHB患者外周血CD4+、CD8+ T细胞表面PD-1表达水平,进而抑制HBV DNA复制,改善患者肝功能。     

Surgical treatment of migraine headaches by corrugator muscle resection

The authors, a plastic surgeon (Dirnberger) and a neurologist (Becker), conducted this study after reading the article by of Bahman Guyuron et al. in the August 2000 issue of Plastic and Reconstructive Surgery (106: 429, 2000). Sixty patients were operated on between June of 2001 and June of 2002; postoperative follow-up ranged between 6 and 18 months. Patients' charts were reviewed to confirm the diagnosis of migraine headache according to the criteria of the International Headache Society. Sixty patients (13 men and 47 women) from Austria and four neighboring countries took part in the study. The patients were divided into three groups, based on the severity of their migraines: group A comprised patients with up to 4 days of migraine per month; group B included patients with 5 to 14 days of migraine per month; and group C was composed of patients with more than 15 days of headache per month ("permanent headache") or evidence of drug abuse and drug-related headaches. The effectiveness of the operation was evaluated using the following factors: percentage reduction of headache days; percentage reduction of drugs; percentage reduction of side effects, severity of headaches, and response to drugs; and patient grade of personal satisfaction, using a scale from 1 to 5 [1 = excellent (total elimination of migraine headache) to 5 = insufficient or no improvement]. From the entire group of 60 patients, 17 (28.3 percent) reported a total relief from migraine, 24 (40 percent) reported an essential improvement, and 19 (31.7 percent) reported minimal or no change. Patients with a rather mild form of migraine headache had a much better chance (almost 90 percent in group A and 75 percent in group B) to experience an improvement or total elimination of migraine than those patients (n = 27) from group C with severe migraine, "permanent headaches," and drug-induced headaches. Contrary to the reports by Guyuron, 11 patients who had a very favorable response immediately and in the first weeks after the operation experienced a gradual return of their headaches to preoperative intensity after about 4 postoperative weeks. After 3 months, the results in all patients could be declared permanent. All side effects, such as paraesthesia in the frontal region, disappeared in all patients within 3 to 9 months.     

不同粘度骨水泥椎体成形术对骨质疏松椎体压缩性骨折的临床疗效及生活质量的影响

目的:比较不同粘度骨水泥椎体成形术(PVP)治疗骨质疏松椎体压缩性骨折(OVCF)的临床疗效及生活质量的影响。方法:回顾性分析于2016年8月至2018年2月期间我院收治的104例OVCF患者的临床资料。将患者按数字表法分为对照组(n=52)和研究组(n=52),两组患者均给予PVP治疗,对照组选用低粘度骨水泥,研究组选用高粘度骨水泥。比较两组患者术前、术后1周、术后1个月、术后3个月、术后6个月及术后12个月的Oswestry功能障碍指数(ODI)评分、疼痛视觉模拟量表(VAS)评分、健康状况调查问卷(SF-36)评分以及Cobb角,记录两组并发症发生情况。结果:研究组患者手术时间长于对照组(P<0.05),而两组患者骨水泥注入量、住院时间比较差异无统计学意义(P>0.05)。两组患者术后1周、1个月、3个月、6个月、12个月ODI评分、VAS评分、Cobb角均较术前降低(P<0.05);两组患者术后1个月、3个月、6个月、12个月ODI评分、VAS评分、Cobb角均较术后1周降低(P<0.05);研究组术后1周、1个月、3个月、6个月、12个月ODI评分、VAS评分、Cobb角低于对照组(P<0.05)。两组患者术后1周、1个月、3个月、6个月、12个月SF-36评分均升高,且研究组高于对照组(P<0.05)。两组并发症发生率比较无统计学差异(P>0.05)。结论:高粘度骨水泥应用于PVP治疗OVCF患者疗效确切,可有效减轻患者疼痛状况,改善生活质量,促进患者恢复。     

局部注药联合口服康复新液辅助治疗颈淋巴结结核疗效观察

目的:探讨局部注射药物联合口服康复新液辅助治疗颈淋巴结结核的临床疗效及安全性。方法:按照随机数字表法将2010年1月-2014年1月我院收治的140例颈淋巴结结核患者分为对照组(n=70)和观察组(n=70),对照组口服异烟肼、利福平、乙胺丁醇、吡嗪酰胺及肌注链霉素进行全身抗结核治疗,观察组在对照组的基础上局部注射异烟肼、链霉素粉联合口服康复新液治疗。比较两组患者治疗后1个月、3个月及6个月症状缓解率,淋巴结吸收率,治疗后3个月复发率及不良反应发生率。结果:观察组治疗后1个月、3个月及6个月的症状缓解率、淋巴结吸收率均高于对照组(P0.05)。治疗后3个月,观察组复发率为2.86%,显著低于对照组的11.43%(P0.05)。观察组恶心、局部反应、白细胞减少及肝功能损害发生率均低于对照组(P0.05)。结论:局部注射抗结核药物联合口服康复新液辅助治疗颈淋巴结结核可提高患者的症状缓解率和淋巴结吸收率,且安全性高,有重要的临床推广价值。     

Timed Rise from Floor as a Predictor of Disease Progression in Duchenne Muscular Dystrophy: An Observational Study

Background

The role of timed items, and more specifically, of the time to rise from the floor, has been reported as an early prognostic factor for disease progression and loss of ambulation. The aim of our study was to investigate the possible effect of the time to rise from the floor test on the changes observed on the 6MWT over 12 months in a cohort of ambulant Duchenne boys.

Subjects and methods

A total of 487 12-month data points were collected from 215 ambulant Duchenne boys. The age ranged between 5.0 and 20.0 years (mean 8.48 ±2.48 DS).

Results

The results of the time to rise from the floor at baseline ranged from 1.2 to 29.4 seconds in the boys who could perform the test. 49 patients were unable to perform the test at baseline and 87 at 12 month The 6MWT values ranged from 82 to 567 meters at baseline. 3 patients lost the ability to perform the 6mwt at 12 months. The correlation between time to rise from the floor and 6MWT at baseline was high (r = 0.6, p<0.01).

Conclusions

Both time to rise from the floor and baseline 6MWT were relevant for predicting 6MWT changes in the group above the age of 7 years, with no interaction between the two measures, as the impact of time to rise from the floor on 6MWT change was similar in the patients below and above 350 m. Our results suggest that, time to rise from the floor can be considered an additional important prognostic factor of 12 month changes on the 6MWT and, more generally, of disease progression.     

血液灌流联合血液透析对慢性肾衰竭患者炎症因子及Hcy、PTH、beta2-MG的影响

目的：探索血液灌流（HP）联合血液透析（HD）对慢性肾衰竭（Chronic renal failure, CRF）患者炎症因子及同型半胱氨酸 （Hcy）、甲状腺旁素（PTH）、beta2- 微球蛋白(beta2-MG)的影响。方法：选择自2012 年10 月至2014 年9 月我院收治的98 例CRF 患 者,按照随机数表法将患者分成HD 组和HP 联合HD组（HP+HD组）,每组49 例,两组采用相应疗法治疗。由专业的医师对所有 患者治疗前及治疗后1 个月、2 个月、3 个月血清中的炎性因子（IL-1beta、IL-6、IL-8、CRP、TNF-alpha及PCT）及Hcy、PTH、beta2-MG 水平 进行检测并统计分析。结果：与治疗前相比,两组患者治疗后1 个月、2 个月、3 个月血清中的炎症因子及Hcy、PTH、beta2-MG水平 均不同程度下降,而HP+HD组患者在各个时间点血清中的炎症因子及Hcy、PTH、beta2-MG水平均明显低于HD组,且差异均具有 统计学意义（P<0.05）。结论：HP 联合HD较单独使用HD 治疗CRF患者具有更好的疗效,可以明显降低患者体内的炎症因子及 Hcy、PTH、beta2-MG 水平,对于临床上治疗CRF具有重要的指导意义。     

CysC检测在阿托伐他汀治疗早期CRS中的意义

目的:观察血清胱抑素C(Cystatin C,Cys C)在阿托伐他汀治疗早期心肾综合征中的变化,探讨Cys C在阿托伐他汀治疗早期心肾综合征中的临床意义。方法:选择90例慢性心功能不全引起的早期心肾综合征患者,随机分为常规治疗组(A组)、阿托伐他汀20 mg组(B组)以及阿托伐他汀40 mg组(C组)各30例。常规治疗组给予常规抗心力衰竭药物治疗,阿托伐他汀组在常规抗心衰药物治疗基础上分别加用阿托伐他汀20 mg/d或者阿托伐他汀40 mg/d口服。分别测定其治疗3个月前后Scr、GFR、Cys C水平并进行组间比较。结果:治疗3个月后,A组、B组Scr及GFR分别与治疗前比较差异无显著性(P0.05),C组Scr及GFR与治疗前比较差异有显著性(P0.05);治疗3个月后,A组Cys C与治疗前比较差异无显著性(P0.05),B组、C组Cys C与治疗前比较差异有显著性(P0.01)。结论:在阿托伐他汀治疗早期心肾综合征疗效观察中,Cys C较Scr更能敏感反应早期肾功能变化情况。     

Safety and tolerability of elubaquine (bulaquine, CDRI 80/53) for treatment of Plasmidium vivax malaria in Thailand

We conducted a study to compare the safety and tolerability of anti-relapse drugs elubaquine and primaquine against Plasmodium vivax malaria. After standard therapy with chloroquine, 30 mg/kg given over 3 days, 141 patients with P. vivax infection were randomized to receive primaquine or elubaquine. The 2 treatment regimens were primaquine 30 mg once daily for 7 days (group A, n = 71), and elubaquine 25 mg once daily for 7 days (group B, n = 70). All patients cleared parasitemia within 7 days after chloroquine treatment. Among patients treated with primaquine, one patient relapsed on day 26; no relapse occurred with elubaquine treatement. Both drugs were well tolerated. Adverse effects occurred only in patients with G6PD deficiency who were treated with primaquine (group A, n = 4), whose mean hematocrit fell significantly on days 7, 8 and 9 (P = 0.015, 0.027, and 0.048, respectively). No significant change in hematocrit was observed in patients with G6PD deficiency who were treated with elubaquine (group B, n = 3) or in patients with normal G6PD. In conclusion, elubaquine, as anti-relapse therapy for P. vivax malaria, was as safe and well tolerated as primaquine and did not cause clinically significant hemolysis.     

显微内窥镜椎间盘切除术(MED)治疗腰椎间盘突出症的特点及易出现的并发症研究

摘要 目的：探讨与研究显微内窥镜椎间盘切除术(microendoscopic discectomy,MED)治疗腰椎间盘突出症的特点及易出现的并发症情况。方法：2017年1月到2020年2月选择在空军第九八六医院诊治的椎间盘突出症患者72例,根据治疗方法把患者分为MED组与对照组,各36例,MED组给予MED手术治疗,对照组给予开放手术治疗,记录两组术后并发症发生情况。结果：MED组术后6个月的优良率为97.2 %,显著高于对照组的77.8 %(P<0.05)。两组术后1个月、术后6个月的日本骨科协会(Japanese orthopaedic association,JOA)评分高于术前,MED组高于对照组(P<0.05)。两组术后1个月、术后6个月的视觉模拟评分法(visual analogue scale,VAS)评分低于术前,MED组低于对照组(P<0.05)。MED组术后6个月的髓核组织残留、神经根损伤、硬脊膜破裂、脑脊液漏等并发症发生率为5.6 %,显著低于对照组的33.3 %(P<0.05)。结论：MED治疗腰椎间盘突出症能改善患者的腰椎功能,缓解患者疼痛,提高总体治疗优良率,减少术后并发症的发生。