挑灸治疗颈性眩晕的临床观察研究

目的:观察挑灸治疗颈性眩晕的临床疗效,探讨挑灸治疗颈性眩晕的临床机理.方法:选取35例颈性眩晕患者,全部采用挑灸治疗.一个疗程后,观察治疗前后临床症状及体征评分、经颅多普勒超声(TCD)指标和三维多层螺旋CT血管成像 (3D-MSCTA)结果的变化.结果:挑灸治疗后患者的临床症状及体征评分有很大提高,与治疗前比较,有显著性差异(P﹤0.01);治疗后患者左右椎动脉(VA)和基底动脉(VB)的收缩峰期血流速度(Vs),舒张末期血流速度(Vd)及平均血流速度(Vm)均显著上升;阻力指数(PI)和博动指数(RI)值均显著下降,与治疗前比较,均有显著性差异(P﹤0.01).治疗前后患者的3D-MSCTA结果分析比较,椎-基底动脉与毗邻骨性结构的关系上没有明显的改变.结论:挑灸治疗颈性眩晕能明显改善椎-基底动脉供血,缓解或消除临床眩晕等症状.     

常规药物联合丹红注射液治疗冠心病不稳定型心绞痛临床观察

目的:观察在西药治疗基础上加用丹红注射液治疗冠心病心绞痛的临床疗效.方法:58例冠心病心绞痛患者随即分为对照组和治疗组,治疗组服用丹红注射液静脉滴注和西药,对照组单纯应用西药,疗程均为15天,观察临床症状和心电图变化.结果:治疗组临床症状改善总有效率为93.3%;心电图改善总有效率为86.6%,均显著优于对照组(P<0.05).结论:在常规药物基础上加用丹红注射液治疗冠心病不稳定型心绞痛有较好的疗效.     

胞磷胆碱、脉络宁、丹红注射液治疗急性脑梗死56例

目的:观察胞磷胆碱、脉络宁、丹红注射液治疗急性脑梗死的临床疗效.方法:将112例急性脑梗死病例随机分为治疗组(56例)和对照组(56例),治疗组采用脉络宁、丹红注射液、胞磷胆碱分别加入葡萄糖液中静滴,连用2个疗程;对照组采用丹红注射液加入低分子右旋糖酐中静滴,脑蛋白水解物加入0.9%氯化钠注射液中静滴,连用2个疗程.结果:治疗组总有效率为83.9%,对照组总有效率为53.6%,两组有显著的差异(P＜0.05%).结论:胞磷胆碱、脉络宁、丹红注射液联用治疗急性脑梗死临床疗效好,病死率低.     

天麻钩藤饮治疗椎基底动脉供血不足的疗效观察

椎-基底动脉供血不足(vertebrobasilarinsuffi-ciencyVBI)是由于各种病因引起的椎基底动脉狭窄或闭塞而导致脑干、小脑或枕叶皮层的缺血.椎基底动脉供血不足是临床常见病症.这种病症的发生多是因为动脉硬化或颈椎间盘突出、肥大压迫血管,影响了血液循环,最终导致椎基底动脉供血不足.它多发生在伏案工作时间长的人身上,如教师、编辑等,由于长期伏案工作,很少运动,引起脑血管弹性减退、颈椎疾病,50岁以上的中老年人多发,现在随着电脑走进千家万户,许多年轻人因长时间伏案工作,加上饮食结构不科学,高脂肪高蛋白摄入过多,致使"椎基底动脉供血不足"病症患者年轻化了.椎基底动脉供血不足的症状:病人可出现眩晕,恶心呕吐,步行不稳,肢体震颤,或视力模糊,或眼睛颤动,语言不利.舌暗淡,舌苔白腻或黄腻,脉搏沉弦,或弦滑无力.     

梅花针治疗偏头痛的临床疗效观察

目的 观察梅花针治疗偏头痛的临床疗效及经颅多普勒血流速度的改变.方法 采用随机分组法将74例偏头痛患者随机分为2组,治疗组口服尼莫地平40mg,每日3次,结合梅花针刺法;对照组仅口服尼莫地平,30天为1个疗程.结果 治疗组较对照组头痛程度明显减轻(p<0.01),MCA、ACA、PCA、VA、CA的平均血流速度(Vm)明显减慢(p<0.01).结论 梅花针治疗改善偏头痛及患者血流速度优于对照组.     

参附注射液静脉滴注治疗CHF病症90例疗效观察

目的:探讨参附注射液治疗CHF病症的临床疗效.方法:随机将90例老年心力衰竭患者分为治疗组和对照组.对照组给予常规治疗,治疗组在常规治疗基础上加用参附注射液,判定疗效.结果:治疗组的左心室舒张末期内径、左室射血分数及E/A值均较治疗前明显改善,各项指标较对照组均显示出了优势,差异具有统计学意义(P<0.O1～0.05).结论:参附注射液无明显副作用,是一种安全、有效、低毒副作用小的中药制剂,是良好的临床治疗心衰药物,在常规抗心衰药物治疗基础上加用参附注射液,疗效确切,值得在临床推广应用.     

诺和灵30R治疗2型糖尿病46例疗效分析

目的:观察分析诺和灵30R治疗2型糖尿病临床有效性和安全性.方法:选择2009年1月～2010年10月收治于我院的92例2型糖尿病患者为研究对象,随机将其分为对照组和观察者,对照组采用常规口服降糖药治疗,观察组采用诺和灵30R治疗,一月后比较两组临床疗效.结果:观察组患者的空腹血糖、餐后2 h血糖,糖化血清蛋白,甘油三酯,血胆固醇等指标均明显优于对照组(P＜0.05).结论:诺和灵30R治疗2型糖尿病患者是安全且有效的,具有较好的临床疗效,值得临床推广应用.     

人血白蛋白治疗老年人不明原因性高血压探讨

目的:探讨人血白蛋白治疗老年人不明原因性高血压的临床疗效.方法:将我院2009年12月至2010年6月收治的60例老年不明原因性高血压高血压的患者随机分为观察组40例和对照组20例,对照组采用降压、降脂及生活干预等治疗,观察组在对照组的基础上采用人血白蛋白静脉滴注治疗,比较两组患者的治疗效果.结果:观察组的平均动脉压的改善效果显著高于对照组,P<0.05.且观察组的总有效率为92.5%(37/40)显著高于对照组的总有效率80.0%(16/20),P<0.05.结论:人血白蛋白治疗老年人不明原因性高血压疗效确切.     

曲美他嗪治疗糖尿病合并冠心病120例临床分析

目的:探讨曲美他嗪治疗糖尿病合并冠心病的临床疗效.方法:选取糖尿病伴冠心病患者240例,随机分成观察组和对照组,对照组患者采用常规冠心病药物治疗,观察组患者在常规治疗基础上加用曲美他嗪进行治疗,经过一个疗程的治疗后,分析两组患者的治疗效果.结果:曲美他嗪组疗效较常规治疗组疗效好,差异显著,有统计学意义.结论:曲美他嗪的疗效机制较适合糖尿病合并冠心病患者的治疗,即能有效改善心肌缺血的状况,同时对糖尿病本身也有改善作用,值得临床推广应用.     

黄芪注射液对脓毒症患者心肌损伤干预作用的观察

目的:观察黄芪注射液治疗脓毒症患者心肌损伤的临床疗效.方法:将63例心肌损伤的脓毒血症患者随机分为2组,对照组30例,给予常规治疗,治疗组在33例在常规治疗的基础上家用黄芪注射液静脉滴注,观察2组临床疗效.结果:治疗组的总有率为81.82%,对照组为66.67%,治疗组的临床总有效率优于对照组(P＜0.05).结论:黄芪注射液用于脓毒症患者心肌损伤疗效显著.     

Phaeochromocytoma with myocarditis managed with alpha-methyl-p-tyrosine

A case of bilateral phaeochromocytoma with catecholamine-induced myocarditis is described. The two operations needed allowed comparison of the use of alpha-methyl-p-tyrosine alone and in conjunction with adrenergic blocks in the management of the patient. The combination of both drugs was particularly successful in the relief of symptoms and reduction of catecholamine metabolism as monitored by 4-hydroxy-3-methoxymandelic acid (HMMA) excretion. As myocarditis is a potentially fatal complication, further investigation of the combined use of alpha-methyl-p-tyrosine and adrenergic blocking drugs is suggested in the pre-operative management of patients with phaeochromocytoma.     

Factors related with compliance with tuberculosis chemoprophylaxis

OBJECTIVES: To determine therapeutic tolerance and compliance level with antituberculous chemoprophylaxis. PATIENTS AND METHODS: 587 patients were proposed for antituberculous chemoprophylaxis with isoniazid from January 1995 to June 1996 in Murcia (Spain). RESULTS: 3.6% of the patients gave up treatment because of hepatic intolerance and 73% completed the prophylaxis. Non-compliance related factors were: social risk factors (odds ratio [OR] = 9.31), previous history of allergies (OR = 2.87), previous personal history of tuberculosis-related events (OR = 0.49) and interaction between sex and age. CONCLUSIONS: Support and intervention measures directed to risk groups of a social origin deem to be needed. Control measures and information provided to middle-aged males, with particular emphasis to the first weeks of prophylaxis, should also be implemented.     

Communication with parents of children with cancer

The authors summarize the results of recent work evidencing the existence of latent merozoites during the course of the erythrocytic cycle of the rodent Plasmodia. These merozoites, unlike the majority of merozoites released at schizogony, do not penetrate immediately into the erythrocytes and remain latent for a variable length of time. The merozoites of each of the species or subspecies show marked peculiarities which are responsible for the characteristics of their cycle. The presence of latent merozoites free in the blood, the asynchronous development, and the resistance to chloroquine, are three closely related factors. Knowing that the merozoite is so far drug resistant, and that latent merozoites can maintain the infection for any length of time, it appears important to take into account these purely biological data, when studying the drug resistance of the human falciparum malaria.     

Surgical outcome in patients with epilepsy with occult vascular malformations treated with lesionectomy

PURPOSE: This retrospective study reports the long-term surgical outcome of patients with medically refractory epilepsy and vascular malformations who were treated with lesionectomy. A detailed analysis of surgical failures had been performed in an attempt to define predictors of surgical success and failure. METHODS: Fifteen patients with medically intractable epilepsy and angiographically occult vascular malformations (AOVMs) were treated surgically with lesionectomy at Duke University Medical Center. Lesionectomy consisted of removal of the AOVM and surrounding hemosiderin-stained brain only, without the use of electrocorticography (ECoG) to guide resection. RESULTS: Eleven (73%) patients are seizure free after lesionectomy. Three showed no significant improvement, and one patient died, presumably after a seizure. Age of onset, duration of seizures, age at resection, and gender did not affect outcome. All patients with neocortical AOVMs in whom EEG findings correlated with the site of the lesion were seizure free after lesional resection. Treatment failures were associated with the presence of multiple intracranial lesions, poorly localized or diffuse EEG findings, discordant positron emission tomography (PET) imaging, or with a lesion in close proximity to the limbic system. CONCLUSIONS: Lesionectomy, with removal of surrounding hemosiderin-stained brain, can be considered the procedure of choice in carefully selected patients with epilepsy with occult vascular malformations.     

Patients with malignant meningitis presenting with neuropsychiatric manifestations

BACKGROUND: Malignant meningitis is often thought of as a late event in the course of cancer. At one time, it was thought to be rare, but it has been recognized more frequently in recent times. Clinical suspicion of malignant meningitis is prompted by neurologic symptoms and signs in patients at risk for this oncologic complication. Neuropsychiatric symptoms previously were not considered as presenting symptoms of malignant meningitis. METHODS: Three patients with cancer with no neurologic symptoms were examined for malignant meningitis based on neuropsychiatric symptoms. Cerebrospinal fluid was examined for malignant cells to confirm the diagnosis of malignant meningitis. RESULTS: The clinical presentation of malignant meningitis for three patients was neuropsychiatric. None of the patients had delirium during their initial presentation. CONCLUSIONS: It is important that clinicians recognize that psychiatric symptoms without neurologic findings may indicate malignant meningitis and that malignant meningitis needs to be included in the differential diagnosis of neuropsychiatric disorders in patients with cancer.     

Patient satisfaction with time spent with their physician

AIMS: The aim of the study was to compare the effects of meloxicam and piroxicam on the gastroduodenal mucosa in healthy adults. METHODS: Forty-four healthy volunteers were given a 28 day course of either meloxicam 15 mg, piroxicam 20 mg or placebo. Damage to the oesophageal, gastric and duodenal mucosa was assessed, mucosal blood flow (MBF) measured at endoscopy and biopsies taken for prostaglandin content and microscopic assessment of damage before NSAID administration and during days 1, 7 and 28 of continued intake. RESULTS: Maximal macroscopic gastric mucosal damage (median grade+IQR) occurred within 24 h of piroxicam administration, the damage score increasing from 0 to 2.5 (0-3) (P=0.02) at day 1 before falling to 2.0 (0-2) at day 7 and 0 (0-1) at day 28 with resolution of damage observed in six out of the seven subjects who sustained acute injury. No significant macroscopic gastric damage occurred in either of the two other groups although some minor damage was observed in seven subjects taking placebo and five taking meloxicam. There was a trend towards piroxicam causing more acute gastric damage than meloxicam (P=0.06). Baseline antral, body and duodenal MBF were similar in all three groups. No significant changes occurred in any of the groups on any of the visits. There were also no changes in gastric mucosal prostaglandin content in any group. CONCLUSIONS: These observations suggest that meloxicam causes little acute damage to the upper gastrointestinal tract and piroxicam causes some acute gastric injury but such damage resolves in most subjects by 28 days.