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中国实用医刊杂志   部级期刊

主管单位:中华人民共和国卫生部

主办单位:中华医学会河南分会

影响因子:0.8

ISSN:1674-4756CN:11-5689/R

    基本信息:

  • 下单时间:1个月内
  • 发行周期:半月刊
  • 曾用名:中原医刊
  • 发行地:河南
  • 创刊:1972
  • 类别:医学类
  • 出版社:中国实用医刊
  • 语言:中文
  • 价格:¥408.00
  • 起订时间:2020年01月
  • 邮编:450003
  • 库存:199
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中国实用医刊 2010年第02期杂志 文档列表

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凝血酶敏感蛋白-1对人肝癌细胞株HCCLM3凋亡的作用

作者:范正军 邢玉广 薛建锋 Zheng-jun Yu-guang Jian-feng
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立体定向放疗联合EP方案化疗治疗高龄局限期小细胞肺癌23例

作者:段玉龙 刘擎国 范向辉 何洪涛 赵诚 解洪泉 丁朝鹏 Yu-long Qing-guo Xiang-hui Hong-tao Hong-quan Zhao-peng

摘要:目的 探讨立体定向放疗(SRT)联合EP方案化疗治疗高龄局限期小细胞肺癌的临床意义.方法 23例高龄局限期小细胞肺癌立体定向放疗联合EP方案化疗,SRT处方剂量50~60 Gy,中位剂量56 Gy.EP方案化疗:顺铂(DDP)20 mg/d,依托泊昔(VP-16)100 mg/d,均第1~5天静脉滴注,3周为1个周期,化疗2~4个周期.结果 局部控制率(CR+PR)为82.5%,1、2年生存率分别为61.8%、29.0%,中位生存期为13.1个月,局部复发率19%,远处转移率为43%.结论 立体定向放疗联合EP方案化疗治疗高龄局限期小细胞肺癌疗效较好,不良反应可以耐受. Abstract: Objective To evaluate of stereotactic radiotherapy(SRT) combined with chemotherapy in etoposide -cisplatin for elderly limited-stage small-cell lung cancerr(LD-SCLC). Methods Twenty three cases of elderly patients with LD-SCLC were treated by SRT(prescription dose was 56 -72 Gy, with a median of 60.8 Gy) and chemotherapy (EP: cisplatin 20 mg d1-5, E: etoposide 100 mg d 1-5, three weeks for a cycle. For two to four cycles). Results The local control rate (CR + PR) was 82.5%, the 1,2 year survival rates was 67.8% and 29.0% respectively,with a median survival time 13.1 months. The frequencies was 19%, and distant metastasis was 43%. Conclusions The SRT combined with chemotherapy with etoposide-cisplatin for elderly limited-stage small-cell lung cancer could be more effectively, and the elderly patients could tolerate the side effects.

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自主呼吸试验在机械通气患者撤机中的应用效果

作者:张宪芬 徐远 李琨 祁艳 Xian-fen

摘要:目的 将自主呼吸试验(SBT)与同步间歇指令通气(SIMV)逐步撤机法的机械通气患者进行比较,以寻找最佳撤机方式.方法 将126例机械通气患者随机分为SBT组和对照组,观察两组患者的平均机械通气时间、入住ICU时间、呼吸机相关肺炎(VAP)发生率、48 h内再插管率,应用SPSS13.0软件进行统计学分析.结果 SBT组与对照组平均机械通气时间分别为(3.9±1.9)d和(5.6±2.2)d,平均入住ICU时间分别为(5.5±2.4)d和(7.4±3.0)d,VAP发生率分别为11.3%和26.6%,48 h内再插管率分别为9.7%和10.9%.结论 SBT撤机方式比SIMV逐步撤机法具有机械通气时间短、住ICU时间短,VAP发生率低的优点,而48 h内再插管率差异无统计学意义,体现了SBT应用于撤机过程中的优越性. Abstract: Objective To find a reasonable weaning way through comparing mechanical ventilation patients treated by spontaneous breathing trials(SBT)with those treated by SIMV gradual weaning. Methods One hundred and twenty six mechanical ventilation patients were divided into SBT group and control group (SIMV group) ,then the average duration of mechanical ventilation,the average time in ICU,the ventilator associated pneumonia(VAP)rate as well as the re -intubation rate within 48 hours were recorded,and finally SPSS 13. 0 was used to make statistical analysis. Results The average mechanical ventilation duration of SBT group and control group were (3.9 ± 1.9) days and (5. 6 ± 2. 2) days respectively, the average time in ICU were (5. 5 ±2. 4) days and (7. 4 ±3. 0) days respectively,the VAP rate was 11.3% and 26. 6 % respectively and the re-intubation rate within 48 hours was 9. 7% and 10. 9% respectively. Conclusions SBT weaning is superior to SIMV gradual weaning in short duration of mechanical ventilation,short time in ICU and low VAP rate. And there is no statistically significant difference in the re -intubation rate within 48 hours.

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高频震荡通气在重症胎粪吸入综合征中的应用

作者:孙慧清 Hui-qing
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福州地区儿童微量元素检测结果分析

作者:高丽钦 俞娃娜 吴文红 张惠平 Li-qin Wa-na Wen-hong Hui-ping

摘要:目的 了解儿童体内铁、钙、锌、铜、镁、铅6种微量元素失衡情况及其年龄分布特点,为早期预防和综合治疗提供依据.方法 使用AA-700型原子吸收光谱仪检测福州地区732例儿童静脉血中铁、钙、锌、铜、镁、铅的含量.结果 732例中,缺钙164例,占22.40%;缺锌158例,占21.04%;缺铁136例,占18.58%;高铅血症272例,占37.16%.缺钙、缺锌、缺铁及高铅血症的发生与年龄及饮食结构有关.结论 福州地区儿童存在一定程度的钙、锌、铁微量元素缺乏,且一定比例儿童血铅水平偏高.建议定期对儿童进行各种血微量元素检测,按照需要调整儿童饮食结构. Abstract: Objective To investigate blood contents of 6 trace elements,including Fe, Ca, Zn, Cu,Mg and Pb,children in Fuzhou area,and understand the level of trace elements as well as the distribution of age, so as to provide basis for prevention and cure at the early stage. Methods Blood contents of Fe, Ca,Zn,Cu,Mg and Pb of 732 cases of children in Fuzhou region were detected by using the AA-700 atomic absorption spectrometer. Results In 732 cases, 164 cases of calcium deficiency,accounting for 22. 40%, 158 cases of zinc deficiency, accounting for 21.04%, 136 cases of iron deficiency,accounting for 18. 58% ,272 cases of high blood lead levels ,accounting for 37. 16%. Calcium deficiency, zinc deficiency, iron deficiency and high blood lead levels are related to age and diet. Conclusions There exist the lack of Ca,Zn and Fe to some degree,and a certain percentage of high blood lead levels of children in Fuzhou. It is recommended to detect various trace elements from blood of children regularly, and adjust the diet of children in accordance with need timely.

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低分子量肝素在胸部肿瘤合并高凝血状态病人围术期的临床应用

作者:宋清荣 周福有 耿明飞 李英 王卫杰 苏文中 李剑 Qing-rong Fu-you Ming-fei Wei-jie Wen-zhong

摘要:目的 使用低分子量肝素(LMWH)预防胸部肿瘤合并高凝血状态病人的围术期血栓性疾病的发生.方法 对2006年1月至2007年10月我科收治的合并高凝血状态的食管癌、贲门癌、肺癌病人,在围术期皮下注射低分子量肝素,每日1次,从术前3~5 d开始直至病人下床,观察术中出血量及术后胸液量,并统计血栓性疾病发生率.结果 该组病人围术期血栓性疾病发生率得到了明显控制.结论 低分子量肝素对预防胸部肿瘤合并高凝血状态病人的围术期血栓性疾病的发生有明显效果,安全可靠. Abstract: Objective To evaluate the efficacy of low molecular weight heparin for preventing thromboembolism disease in perioperative of thoracic tumor with blood hypercoagulabale state. Methods From January 2006 to October 2007, we diagnosed and treated 72 patients with lung cancer and carcinoma of esophagus and cardia. All the patients were treated with LMWH qd from the 3 -5 days before operation until ambulation after operation. To observe the postoperative total amount effusion and to statistic of incidence of thromboembolism disease. Results Incidence of thromboembolism disease decreased more significantly of this group than usual. Conclusions Application of LMWH for preventing thromboembolism disease in periopetive of thoracic tumor with blood hypercoagulabale state is an effective, safe and reliable treatment.

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侵入上矢状窦脑膜瘤36例临床研究

作者:李帅 宋来君 徐晨阳 Lai-jun Chen-yang

摘要:目的 提高对侵入上矢状窦脑膜瘤的手术治疗效果.方法 回顾性分析我院2004年1月至2009年6月间手术切除的36例侵入矢状窦脑膜瘤盘床表现、诊断方式和显微手术疗效.结果 按Simpson切除分级标准:Ⅰ级切除26例,占72.2%;Ⅱ级切除7例,占19.4%.脑膜瘤致上矢状窦完全闭塞,脑膜瘤并窦完全切除者11例.无手术死亡,术前症状及体征均有不同程度改善或消失.随访0.5~4.6年(平均2.3年),仅有1例术后3.8年复发,再次手术前窦已闭塞,将窦连同肿瘤一并切除.结论 脑膜瘤不全侵犯上矢状窦时,可将窦切开,在全切肿瘤的基础上,对静脉窦进行重建或修补保持窦的通畅.脑膜瘤致矢状窦完全阻塞的,可将受侵犯的窦段全切.采用显微神经外科技术保护重要结构,吻合重建血管是提高全切率,减少术后并发症,改善患者术后生存质量的重要因素. Abstract: Objective To improve the curative effect of microsurgery for meningiomas invading the superior sagittal sinus. Methods A retrospective analysis was performed in 36 patients with meningiomas invading the superior sagittal sinus who were treated in our department from January 2004 to June 2009, includingthe clinical presentations, the diagnostic methods and the effect of microsurgery treatment. Results According to Simpson classification of glioma resection, among the 36 patients, Grade Ⅰ resection was performed in 26 cases(72.2 %),Grade Ⅱ in 7 cases(19.4%),11 patients with meningiomas totally occluding the SSS had complete resection of the encased portion of the sinus. No patient died from the surgery, all the patients recovered well after the treatment. Following-up ranged from 0.5 to 4.6 years(mean 2.3year) in 36 patients showed that only one patient suffered a recurrence 3.8 years after the surgery. With total sinus occlusion when received reoperation. Conclusions If the sinus is partially invaded, it can be opened to obtain as complete a resection as possible and to reconstruct t

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抑癌基因WWOX在食管鳞状细胞癌中的表达及意义

作者:李晓芳 Xiao-fang
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雌激素对缺氧/复氧神经元高迁移率族蛋白B1及核因子-κB表达的影响

作者:周艳丽 滕军放 徐桂英 Yan-li Jun-fang Gui-ying 单位:郑州市第十人民医院内科 450052 郑州大学第一附属医院神经内科

摘要:目的 探讨雌激素对缺氧/复氧诱导新生大鼠皮质神经元损伤的保护作用及其机制.方法 将培养7 d的大鼠皮质神经元随机分为三组,A组为正常对照组,B组采用缺氧/复氧(H/R),C组采用雌激素(17βE2)预处理加H/R处理,各组在H/R后0、1、3、6、12、24 h各时间点,以TUNEL法比较各组凋亡细胞,免疫组化方法比较各组高迁移率族蛋白B1(HMGB1)、核因子-κB(NF-κB)表达.结果 ①B组凋亡神经元明显多于正常对照组(H/R后3~24 h),C组凋亡细胞数目显著少于B组,三组比较差异有统计学意义.②B组HMGB1、NF-κB的表达较正常对照组明显增加,C组HMGB1、NF-κB表达较B组明显减少.结论 雌激素可使H/R后神经元HMGB1、NF-κB表达降低,抑制神经元凋亡,提高其存活率,这可能是其脑保护作用的机制之一. Abstract: Objective To explore the protective effects of estrogen on injured neurons induced by H/R and the mechanisms of that. Methods The cortical neurons cultured for 7 days were randomly divided into group A (normal control group), group B (H/R alone), group C (pretreatment with Estrogen -17βE2 and H/R). Then the apoptotic neurons were count by TUNEL, and the expression of HMGB1,NF- κB was observed by immunocytochemical technique, on each time point after reoxygenation 0,1,3,6,12,24 h of each group. Results ①The number of apoptotic neurons in group B was more than that in control group after H/R 3-24 h, and was less in group C than in group B. ②Compared with group A, the expression of HMGB1 and NF-κB was higher in group B,and was lower in group C than in group B. Conclusions Estrogen could decrease the expression of HMGB1 and NF-κB to inhibit neuronal apoptosis after H/R, which may be one of the mechanisms in which estrogen exerts its neuro-protective effect.

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术中置药并术后胸腔灌注治疗Ⅲa期非小细胞肺癌的疗效观察

作者:宋静超 吉庆春 崔新征 董亚东 姜功前 陈占军 Jing-chao Qing-chun Xin-zheng Ya-dong Gong-qian Zhan-jun

摘要:目的 探讨Ⅲa期非小细胞肺癌的有效治疗方法.方法 将53例Ⅲa期非小细胞肺癌患者分为观察组(26例)和对照组(27例).观察组术中用吡柔比星(THP)10 mg、环磷酰胺(CTX)200 mg、卡铂(CBP)50 mg置入清扫淋巴结处,以及术后行胸腔灌注吡柔比星50 mg、环磷酰胺600 mg、卡铂水针300 mg、α-干扰素500万U.两组均于手术后第3周采用紫杉醇(PTX)+THP+CBP/顺铂(DDP)或吉西他滨(GEM)+CBP/DDP及PTX+奥沙利铂(L-OHP)或异长春花碱(NVB)+L-OHP等多种方案交替静脉联合化疗,4周为一疗程,共4-6个疗程.随访3年进行疗效比较.结果 观察组1、2、3年生存率分别为88.4%、76.9%和46.1%,对照组依次为77.8%、44.4%和33.3%.结论 Ⅲa期非小细胞肺癌手术并术中置药术后胸腔灌注,辅以早期联合静脉化疗,可提高患者生活质量及生存率. Abstract: Objective To investigate an effective approach for stage Ⅲ a non- small cell lung cancer. Methods The stage Ⅲ a non-small cell lung cancer were divided into observation group (26 cases) and control group(27 cases). The observation were set THP 10 mg, CTX 200 mg, CBP 50 mg on lymph during the operation and were given THP 50 mg, CTX 600 mg, CBP 300 mg, IFN-α thoracic infusion chemotherapy after surgery. All of two groups(53 cases)received alternate intravenous chemotherapy of PTX + THP + CBP/DDP or GEM + CBP/DDP or PTX + L-OHP or NVB + L-OHP regimens in 3weeks after surgery and repeat every 4 weeks. The patients had 4 to 6 therapeutic course. The follow-up survery was compared after the treatment between the two groups. Results 1,2,3 years survival rates were 88.4% ,76. 9% and 46.1% in the observation group as compared with 77.8% ,44.4% and 25.9% in the control grouup respectively. Conclusions Operation set chemicals in surgery and given thoracic infusion chemotherapy after surgery and combined chemotherapy is an effective way for treatment of stage Ⅲ a non -small cell lung cancer. It can improve the life quality and survival rates of the

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婴儿室间隔缺损合并肺动脉高压的早期外科治疗

作者:石磊 范太兵 李群 徐红亮 李斌 裴宇 杨玉奇 Tai-bing Hong-liang Yu-qi

摘要:目的 分析460例婴儿室间隔缺损合并肺动脉高压的手术结果,验证早期外科治疗的可行性及优越性.方法 2003年1月至2009年3月我科连续行体外循环心内直视术纠治室间隔缺损伴肺动脉高压患儿460例,其中小婴儿组(6个月以下)132例,大婴儿组(6个月以上)328例.结果 本组婴儿中死亡16例,病死率3.4%,小婴儿组与大婴儿组分别死亡6例(4.5%)和10例(3.0%).其余患儿并发症有低心排、肺炎、肺不张、心律失常、切口感染等,经过治疗后均痊愈.小婴儿组与大婴儿组手术时间、体外循环时间、术后呼吸机辅助时间、术后监护时间、术后住院时间及死亡率比较差异均无统计学意义.结论 婴儿室间隔缺损合并肺动脉高压早期行外科手术治疗安全、可靠,并发症少、痛死率低;可避免患儿反复发生肺炎以及发生器质性肺高压丧失治疗机会. Abstract: Objective To analyze the surgical outcome of 460 infants with VSD complicated with PH, to investigate the feasibility and advantage of early open-heart surgery. Methods Four hundred and sixty infants with VSD and PH underwent extracorporeal circulation open -heart surgery from Jan 2003 to Mar 2009 in our hospital. Among which, there were 132 little infants(younger than 6 months)and 328 big infants (older than 6 months). Results Sixteen of all patients died, and the overall in- hospital mortality was 3.4%. The mortality of little infants group and big infants group were 4.5% (6 cases died)and 3.0% (10 cases died)respectively. Other complications were low cardiac output, pneumonia, atelectasis, arrhythmia, wound infection and so on, and they were cured. There were no significant differences in operation time, extracorporeal circulation time, duration of postoperative respiratory machine assisted ventilation, postoperative monitoring duration, postoperative hospitalization duration and mortality rate between the two groups. Conclusions The effect of early cardiac surgical treatment on inf

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肺腺癌患者外周血及肿瘤浸润性淋巴细胞中Fas分子的表达及意义

作者:楚广民 马艳英 Guang-min Yan-ying
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胸水四项肿瘤标志物联检对恶性胸腔积液的诊断价值

作者:高延秋 王静 杨克艳 Yan-qiu Ke-yan 单位:河南电力医院内五科 郑州 450052 郑州大学第一附属医院呼吸内科
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不同药物诱导的全身麻醉在小儿白内障手术的临床观察

作者:唐祖恩 孙福德 吴文双 Zu-en Fu-de Wen-shuang
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高频超声对婴幼儿肥厚性幽门狭窄的诊断价值

作者:张芳 曲红培 张周龙 Hong-pei Zhou-long

摘要:目的 探讨高频超声对婴幼儿先天性肥厚性幽门狭窄(CHPS)的诊断特点及应用价值.方法 采用高频探头对18例疑为幽门狭窄的婴儿患者的幽门部的实时超声图像进行分析,所有患者均经手术病理证实.结果 高频超声可清晰地显示幽门的形态、幽门肌增厚的程度,幽门肌超声测量值与术中的测量值比较,差异无统计学意义(P>0.05).结论 实时超声是一种无损伤、安全、方便、可重复的诊断方法,可作为婴幼儿肥厚性幽门狭窄的首选检查方法,为临床提供充分的诊断依据,具有很高的临床应用价值. Abstract: Objective To investigate the characteristic imaging and diagnostic value of congenital hypertrophic pyloric stenosis by high -frequency ultrasonography. Methods Eighteen high -frequency ultrasonography performed for possible congenital hypertrophic pyloric stenosis were analyzed retrospectively. All of diagnosis were confirmed by operation. Results High-frequecy ultrasound could be shown pyloric modality and the sign of the hypertrophied pyloric muscle bulging into the gastric lumen. There was no significant difference between the thickness of pyloric muscle and the value found in surgery (P>0.05). Conclusions High -frequency ultrasonography is a simple and reliable method for the diagnosis of CHPS and should be the initial imaging procedure.