高频喷射通气治疗急性有机磷农药中毒中间综合征的临床研究

目的 观察高频喷射通气对急性有机磷农药中毒中间综合征的治疗效果。方法 随机将 115例有机磷农药中毒伴中间综合征患者分为A、B两组 ,A组 5 8例进行高频喷射通气 ,B组 5 7例进行间歇正压通气和间歇指令性通气 ,进行治疗前后的疗效比较。结果 A组治疗后动脉血气明显改善 ,其死亡率 3.4 % ,低血压发生率 1.7% ,肺部感染发生率 1.7% ,明显低于B组 (P <0 .0 1)。结论 对有机磷农药中毒伴中间综合征患者行高频喷射通气治疗 ,通气频率快 ,气道压、胸内压低 ,对循环干扰小 ,优于间歇正压通气。

急性有机磷农药中毒并中间综合征的机械通气治疗及心理护理

目的总结急性有机磷中毒并发中间综合征的治疗和护理经验。方法对急性有机磷中毒并发中间综合征34例患者施行机械通气,并予以心理护理。结果34例患者中有30例痊愈。结论急性有机磷中毒并发中间综合征的机械通气治疗配合心理护理是较好的方法。

急性有机磷中毒致中间综合征42例

急性有机磷中毒（AOPP）患者经积极治疗后可能会出现中间肌无力综合征（IMS），这是急性有机磷农药中毒除引起急性胆碱危象和迟发性周围神经病外，还可引起一组以肌无力为突出表现的综合征。因其处于急性中毒症状缓解后和迟发性神经病变发生前，约在急性中毒后24～96h突然发生死亡，1987年enanayake和Karalliedde命名为中间综合征。

中间葡萄膜炎的临床特征与治疗

目的 观察中间葡萄膜炎的临床表现、并发症和治疗效果。方法回顾分析36例中间葡萄膜炎患者66只眼的临床表现、荧光素眼底血管造影（FFA）特征、治疗效果和预后。患者中男21例，女15例，年龄8～70岁，平均年龄34．8岁。双眼30例，单眼6例。结果主要临床表现为玻璃体混浊，周边部视网膜血管病变，视盘水肿，黄斑水肿和后囊下白内障。FFA表现为周边部视网膜血管炎性病变，视盘强荧光，黄斑囊样水肿和视网膜静脉染色。经治疗后，31例患者60只眼视力提高，占90．9％；4例5只眼视力稳定，占7．6％；1例1只眼视力下降，占1．5％。导致视力损害的主要并发症有黄斑囊样水肿、后囊下白内障和玻璃体积血。结论中间葡萄膜炎是一种较常见的双眼慢性进行性眼内炎症，主要累及前部玻璃体、睫状体扁平部和周边部视网膜血管，早期发现和及时治疗可防止发生永久性视力损害。

眼底荧光血管造影在中间葡萄膜炎治疗中的作用

目的探讨眼底荧光血管造影在中间葡萄膜炎治疗中的价值。方法回顾性分析24例31只眼中间葡萄膜炎的临床表现,玻璃体混浊程度、FFA影像结果,结合玻璃体混浊程度和FFA影像结果制定治疗方案并随访。结果有临床表现的24例31只眼FFA影像均有不同程度的视盘高荧光、和(或)周边视网膜血管壁着染、血管渗漏。11只无临床表现的对侧眼,FFA也发现周边视网膜血管壁着染、血管渗漏。玻璃体严重混浊且视网膜血管壁着染、血管渗漏的患者必须使用糖皮质激素和/或免疫抑制剂才能抑制炎症,随访中FFA显示周边视网膜血管壁着染、血管渗漏明显消退的患者长时间维持低剂量糖皮质激素和/或免疫抑制剂可减少炎症复发。结论FFA有助于识别隐匿性中间葡萄膜炎,以制定正确治疗方案和避免过早停药,减少炎症复发。

CLINICAL OBSERVATION ON THE THERAPEUTIC EFFECT OF ACUPUNCTURE PLUS ATOMIZED HERBAL MEDICINE IN THE TREATMENT OF LUMBAR INTERVERTEBRAL DISC PROTRUSION

Objective To observe the therapeutic effect of acupuncture combined with atomized herbal medicine in the treatment of protrusion of lumbar intervertebral disc. Methods A total of 211 patients with lumbar intervertebral disc protrusion were randomized into two groups, with 106 cases being in trealment group and 105 in control group. The treatment was given once everyday, 12 days as one course of treatment. After two courses of treatment, the results were analyzed. Results The curative rate was 97.1% in the treatment group and 81.0% in the control group. Conclusion Acupuncture together with herbal medicine for the protrusion of lumbar intervetebral disc was better in effect than acupuncture only.

COMMENTS ON THE THERAPEUTIC TIMETABLE OF ISCHEMIC APOPLEXY AND SUPER-EARLY INTERVENTION OF ACUPUNCTURE

According to the pathological process of ischemic apoplexy, which involves its onset and development, this paper expounds the great significance of adopting various active and effective measures within the therapeutic timetable for favorable prognosis and improvement of apoplexy. The author’s viewpoints differ from the conventional thinking towards the management of apoplexy, stressing super early intervention with acupuncture.

CLINICAL OBSERVATION ON TREATMENT OF 80 CASES OF PROLAPSE OF LUMBAR INTERVERTEBRAL DISC BY COMBINATION OF ACUPUNCTURE AND MEDICINE

cases of prolapse of lumbar intervetebral disc were randomly divided into treatment and control groups. 80 cases in treatment group were treated with combination of acupuncture, oral administration of Chinese medicinal herbs, traction, point injection and intravenous drip of energy dehydration mixture; 70 cases in control group were managed by combination of acupuncture, oral administration of herbal medicines, traction, acupoint injection (without energy dehydration mixture). The results showed that the curative rate and the total effective rate of the treatment group were 91.25% and 98.75% separately, while those of the control group 62.86% and 92.86% respectively. Comparison of the curative rate between the 2 groups showed a remarkable significance (P<0.01). The observation demonstrated that combined treatment of prolapse of lumbar intervertebral disc with traditional Chinese and Western medicine is an effective approach.

Gemcitabine and Docetaxel as a Second-Line Treatment in Advanced Soft Tissue Sarcomas

OBJECTIVE Promising anti-tumor activity in patients with metastatic or unresectable soft tissue sarcomas has been reported with gemcitabine and/or docetaxel. METHODS Forty patients with advanced soft tissue sarcomas refractory to first-line chemotherapy treatment were enrolled. They received combination of gemcitabine at dose of 900 mg/m2 on days 1 and 8 and docetaxel at dose of 100 mg/m2 on day 8, and had this regimen repeated every 3 weeks. If the patients had received the pelvic irradiation in advance, gemcitabine dose was reduced to 675 mg/m2 on days 1 and 8 and docetaxel to 75 mg/m2 on day 8, and had it repeated every 3 weeks. RESULTS Gemcitabine/docetaxel combination was well tolerated by the patients with an overall response of 20%. After median follow-up of 15 months, a median overall survival time was 12 months （95% CI 7.042-16.958） and a median progression free survival time was 6 months （95% CI 5.445-6.545）. The most common hematologic toxicity was neutropenia （47.5%） while mucositis was the most common nonhematologic toxicity （45%）. The 1- and 2- year survival rates were 50% and 15%, respectively. CONCLUSION This regimen of gemcitabine/docetaxel combination as second-line treatment for the patients with advanced soft tissue sarcomas is effective with acceptable toxicities. These results should be evaluated in a large phase III trial.

Study on timing and dosage of acupuncture in stroke treatment

Objective： To summarize the timing-efficacy relationship and the dosage–efficacy relationship of acupuncture in stroke treatment. Method： Literature research was conducted for quantitative clinical studies of acupuncture in stroke treatment, with the entry point on the timing factor and dosage factor. A hierarchical analysis was performed on observing the time–efficacy relationship and the dosage–efficacy relationship before, during and after acupuncture. Results： Though the retrieved studies differ especially in such timing factors as needle retaining time, acupuncture interval and course, they share an agreement in the acupuncture intervention time point, acupuncture timing, specificity of acupoints and acupuncture manipulation. Conclusion： The optimal stimulation is the core of the research on the timing-efficacy relationship and the dosage–efficacy relationship of acupuncture and also the key to the clinical efficacy.

Observations on After-Effect Duration of Kidney-Nourishing and Marrow-Replenishing Therapy on 58 Cases of Mediterranean Anemia

To observe the after-effect duration of kidney-nourishing and marrow-replenishing therapy on Mediterranean anemia. Methods： To observe the kidney-nourishing and marrow-replenishing therapy on 58 cases of Mediterranean anemia and the influence of various relative factors on the after-effect duration. Results： The after-effect duration on 58 cases varied from 3-6 months, about 4 months on average, and was not influenced by sex, clinical types, genetic types, types of Mediterranean anemia and other factors. Conclusion： Kidney-nourishing and marrow-replenishing therapy used to treat Mediterranean anemia can not only produce good therapeutic effect during treatment but also keep after effect lasting for about 4 months, indicating that the therapy used to treat Mediterranean anemia has good clinical after effect.

Duration of viral shedding of Influenza A(H1N1) virus infection treated with oseltamivir and/or Traditional Chinese Medicine in China:A retrospective analysis

OBJECTIVE:H1N1 was a new and potentially serious infectious disease,in human,the severity of influenza can vary from mild to severe,thus to find an effective and safety way to control the influenza pandemic is of crucial importance.This retrospective study describes the duration of viral shedding in H1N1 patients that were hospitalized and treated in China.METHODS:Clinical data were collected from May to July,2009 in China for 963 patients with influenza A(H1N1) virus infection.Patients were treated based on the guidelines issued by the Chinese Ministry of Health.The primary outcome was duration of viral shedding and statistical comparisons were performed.RESULTS:In the patients with body temperature greater than 38.0℃,there were no differences in virus shedding duration among the patients taking oseltamivir within two days,patients undergoing Traditional Chinese Medicine(TCM) therapy or those receiving no drug therapy.In patients with body temperature 338.1℃,TCM therapy reduced the viral shedding duration(P<0.05,vs.oseltamivir therapy).Furthermore,taking oseltamivir two days after onset of symptoms might prolong the virus shedding duration(P<0.05,vs.taking oseltamivir less than 2 days of onset).CONCLUSION:TCM therapy is effective for reducing the length of virus shedding in patients with body temperature 338.0℃.Oseltamivir used for reducing virus shedding duration should be taken within two days of onset.

Short Needling and Herniation of Lumbar Intervertebral Disc： A Report of 100 Cases

Altogether 100 cases of lumbar intervertebral disc herniation were treated by needling major points including Yaotu （Extra point）, Yinlingquan （SP 9） and Zusanli （ST 36） with heat-reinforcing manipulation, adjunct points including Weizhong （BL 40） and Sugu （BL 65） in the case of pain radiating to the Bladder Meridian or Yanglingquan （GB 34） and Zulinqi （GB 41） in the case of pain radiating to the Gallbladder Meridian with even reinforcing and reducing manipulation. The result showed that 49 cases got recovery, 37 cases got marked effect, 11 cases got certain effect, 3 cases got no effect and the total effective rate was 97.0%.

From solar terms to medical terms(PartⅡ):Some implications for traditional Chinese Medicine

In the traditional Chinese Medicine(TCM), the timing of performing the treatment during the year is always an important factor for maximizing its effectiveness. Based on over half a century of observational and reanalysis data, a modified calendric system, named the Twenty-four Medical Terms(24-MTs), has been established for China's Mainland following a systematic calibration and geographical adjustment of the classic Twenty-four Solar Terms(24-STs). In view of "adapting the human body to the changing universe", a core philosophy of the TCM, this improved medical calendar is expected to make a significant contribution to the development of precise Chinese Medicine in the big data era. Specifically, two maps of localized timings for the so-called Triple-Fu(TF) and Triple-Jiu(TF) defined using a joint heat index of air temperature and relative humidity are created as an alternative to the two nationwide unified timings representing the warmest and coldest periods of the year. These location-specific medical calendars, with a maximum regional time shift of one week for TJ and a systematic advancing of 3.6–28.2 days for TF in China's Mainland, are thought to be clinically useful for carrying out precise TCM such as"treating winter deceases in summer". In addition, similar maps of localized timings for peak spring and peak autumn defined as the days of fastest warming and cooling around the years are generated for China's Mainland, so as to provide a helpful guidance for practicing season(ST/MT) related and geographically dependent precise health care in the context of "born in spring, grow in summer, harvest in autumn, and preserve in winter", which is a key ideology in the TCM.