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 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.
ObjectiveTo analyze the prognostic factors of patients with bacterial bloodstream infection sepsis and to identify independent risk factors related to death, so as to potentially develop one predictive model for clinical practice. Method A non-intervention retrospective study was carried out. The relative data of adult sepsis patients with positive bacterial blood culture (including central venous catheter tip culture) within 48 hours after admission were collected from the electronic medical database of the First Affiliated Hospital of Dalian Medical University from January 1, 2018 to December 31, 2019, including demographic characters, vital signs, laboratory data, etc. The patients were divided into a survival group and a death group according to in-hospital outcome. The risk factors were analyzed and the prediction model was established by means of multi-factor logistics regression. The discriminatory ability of the model was shown by area under the receiver operating characteristic curve (AUC). The visualization of the predictive model was drawn by nomogram and the model was also verified by internal validation methods with R language. Results A total of 1189 patients were retrieved, and 563 qualified patients were included in the study, including 398 in the survival group and 165 in the death group. Except gender and pathogen type, other indicators yielded statistical differences in single factor comparison between the survival group and the death group. Independent risk factors included in the logistic regression prediction model were: age [P=0.000, 95% confidence interval (CI) 0.949 - 0.982], heart rate (P=0.000, 95%CI 0.966 - 0.987), platelet count (P=0.009, 95%CI 1.001 - 1.006), fibrinogen (P=0.036, 95%CI 1.010 - 1.325), serum potassium ion (P=0.005, 95%CI 0.426 - 0.861), serum chloride ion (P=0.054, 95%CI 0.939 - 1.001), aspartate aminotransferase (P=0.03, 95%CI 0.996 - 1.000), serum globulin (P=0.025, 95%CI 1.006 - 1.086), and mean arterial pressure (P=0.250, 95%CI 0.995 - 1.021). The AUC of the prediction model was 0.779 (95%CI 0.737 - 0.821). The prediction efficiency of the total score of the model's nomogram was good in the 210 - 320 interval, and mean absolute error was 0.011, mean squared error was 0.00018. Conclusions The basic vital signs within 48 h admitting into hospital, as well those homeostasis disordering index indicated by coagulation, liver and renal dysfunction are highly correlated with the prognosis of septic patients with bacterial bloodstream infection. Early warning should be set in order to achieve early detection and rescue patients’ lives.
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 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.
ObjectiveTo summarize the application of image texture analysis in the diagnosis and treatment of gastric cancer.MethodsReviewed the literatures on the application of image texture analysis related methods in the diagnosis and treatment of gastric cancer, and summarized the value of texture analysis in the diagnosis and treatment of gastric cancer in terms of diagnosis, staging, curative effect evaluation, and prognosis prediction.ResultsImage texture analysis had been widely used in diagnosis, staging, curative effect evaluation, prognosis prediction of gastric cancer, and other related diagnosis and treatment applications.ConclusionsImage texture analysis is an important part of the diagnosis and treatment of gastric cancer, which has a good development prospect.
【摘要】 目的 观察腹腔镜手术联合孕三烯酮治疗子宫内膜异位症合并不孕的疗效及不同评分系统对妊娠结局的预测价值。 方法 回顾性分析2004年1月-2006年12月收治的97例子宫内膜异位症合并不孕患者的临床病理资料，统计其术后妊娠率及活产率。 结果 术后1年内与1~2年的妊娠率与活产率比较，差异均无统计学意义（Pgt;0.05）。根据美国生育协会1985年修订的子宫内膜异位症分期标准（r-AFS）进行分期，各期患者术后妊娠率差异无统计学意义（Pgt;0.05）；但随着分期升高，活产率逐渐下降（Plt;0.05）。子宫内膜异位症生育指数（EFI）评分越高，其妊娠率和活产率也越高（Plt;0.05）。 结论 子宫内膜异位症患者腹腔镜手术后联用孕三烯酮可能会提高远期妊娠率。r-AFS分期对妊娠结局的预测有一定局限性，而EFI具有较好的预测性。【Abstract】 Objective To evaluate the therapeutic effectiveness of laparoscopic surgery combined with gestrinone treatment in the infertile women with endometriosis (EM), and the value of different score systems to predict gestational outcome. Methods We retrospectively analyzed the clinical data of 97 infertile women with EM who were treated in our hospital from January 2004 to December 2006, and collected their pregnancy rate (PR) and live birth rate (LBR) after operation. Results There was no significant difference of PR and LBR within the 1st year and between the 1st and the 2nd year (Pgt;0.05). There was no significant difference of PR among women of various stages of EM based on the 1985 edition of risk stratification for patients with EM put forward by American Fertility Society (r-AFS) (Pgt;0.05), but the LBR decreased with the raising of the stages (Plt;0.05). The endometriosis fertility index (EFI) was positively correlated with PR and LBR (Plt;0.05). Conclusion Laparoscopic surgery combined with gestrinone may increase the long-term pregnancy rate of women with EM. R-AFS classification is limited in predicting the gestational outcome of women with EM, while EFI achieves a better result.
Objective To evaluate the current situation of the design of the randomized controlled trials (RCTs) in Clinical Anesthesiology, Chinese Journal of Anesthesiology and Chinese Journal of Pain Medicine from 1999 to September in 2003. Method The clinical therapeutic studies in the three journals from 1999 to September of 2003 were hand searched over page by page to identify strictly the randomized controlled trials according to Chinese Cochrane Center hand search guideline. Results 412, 378 and 142 papers of the three journals were published, among which, there were 237, 221 and 68 papers of RCT. Conclusions Although the quality of RCT in the three journals has been increased significantly year by year, but there still exist some problems. The quality of RCT papers needs more improvement to guarantee RCT to be more precise as it demands.
Objective To investigate the curve correlation between ventilation pressure and tidal volume in assisted mechanical ventilation with facemask during anesthesia induction. Methods Between January and August 2015, 120 patients, American Society of Anesthesiology Ⅰ-Ⅱ, undergoing selective gynecological surgery were randomly divided into four groups: groups P5, P10, P15 and P20, with 30 patients in each group. Mask ventilation pressure for the four groups were respectively 5, 10, 15 and 20 cm H2O (1 cm H2O=0.098 kPa). Patients were ventilated by preset ventilation pressure and frequency based on different groups after loss of consciousness. Mean ventilation volume (mean value of three tidal volumes) and end-tidal carbon dioxide pressure (PetCO2) were recorded for analysis. Results There was no significant difference among the four groups in patient’s general condition (P>0.05). The tidal volume of assisted mechanical ventilation increased with ventilation pressure degrees, and the differences among the four groups were significant (P<0.05). After curve regression analysis, tidal volume and ventilation pressure showed a positive linear correlation when ventilation pressure was set at 5-20 cm H2O, and the correlation equation was: tidal volume = 33.612×ventilation pressure-53.155. PetCO2 in P5 group was lower than those in the other three groups (P<0.05), while there were no significant differences among groups P10, P15 and P20 (P>0.05). Conclusion When ventilation pressure is set at 5-20 cm H2O in assisted mechanical ventilation with facemask during anesthesia induction, tidal volume and ventilation pressure show a positive linear correlation.