• 主题
高级搜索  >
历史搜索 清空历史
您现在的位置：首页> 中文期刊>医药卫生>内科学>疑难病杂志

疑难病杂志

疑难病杂志

CSTPCD

Chinese Journal of Difficult and Complicated Cases
《疑难病杂志》是目前国内惟一报道疑难病症的综合性医学学术期刊，由中华人民共和国卫生部主管，中国医师协会主办。本刊为“中国科技论文统计源期刊(中国科技核心期刊)”、“中国学术期刊综合评价数据库统计源期刊”、“中国生物医学核心 期刊” ，并被美国《化学文摘(CA)》、俄罗斯《文摘杂志（AJ）》、波兰《哥白尼索引(IC)》、“中国期刊全文数据库”、“中国生物医学文献数据库”、“中文生物医学期刊 文献数据库”、“中文科技期刊数据库” 等国内、外重要检索期刊和数据库收录。中国标准连续出版物号：CN 13-1316/R，ISSN 1671-6450。 本刊由著名医学家吴阶平院士担任名誉总编辑，吴咸中、陈可冀、王正国、王永炎、张运、李春岩、张伯礼、邱蔚六、郭应禄等院士担任顾问，吴以岭教授担任编委会总编辑，包括2位美籍专家在内的46名知名医学家担任编委。本刊贯彻“百花齐放、百家争鸣”的方针，开展开放式、多方位的学术交流，加速医学科技进步和发展；坚持“三个”结合，即理论与实践相结合、普及与提高相结合、现代医学与传统医学相结合，为创建具有中国特色的医学体系架桥铺路；坚持“创新”、“实用”的办刊宗旨，着力报道中医、西医、中西医结合在诊疗各种疑难病、罕少见病及各种难诊难治病症的新理论、新成果、新进展、新疗法、新药物、新经验，真正做到“引导潮流、荟萃精华、贴近临床、服务读者”。本辟有专家笔谈、论著、临床研究、络病论坛、罕少见病例、误诊误治分析、疑难病例（理）讨论、名医精粹、释疑解难、继续教育等特色栏目，本刊面向全国各级医疗、教育、研究机构的医学专业人员，是广大医务人员学术交流的园地和继续教育的良师益友。欢迎赐稿，欢迎征订。
更多
  • 发文量：7245
  • 被引量：4133
  • H指数：1
  • 开始收录时间：2002(1)
  • CNKI综合因子：1.336
  • 维普期刊影响因子： 2.37
  • 万方期刊影响因子：2.57
  • 创刊时间：2002
  • 国内刊号/CN：13-1316/R
    国际刊号/ISSN：1671-6450
  • 发行周期：月刊
    邮发代号：18-187
  • 主管单位：中华人民共和国卫生部
    主办单位：中国医师协会
疑难病杂志-联系信息
  • 主编：马智
  • 电话：0311-85901735
  • 邮箱：ynbzz@163.com
  • 地址：石家庄市天山大街238号
  • 邮编：050035
疑难病杂志-获奖情况
  • • 全国优秀中医药期刊
  • • 中国北方优秀期刊
  • • 河北省优秀期刊
  • • 国家卫生计生委首届优秀期刊
  • 收录汇总
  • 刊内文献检索
  • 投稿信息

刊期浏览

相关中文期刊

相关中文会议

相关外文期刊

相关外文会议

最新期刊

热门期刊

疑难病杂志 >2023年第11期

学科

年度

全选（0）
排序：
共4384条结果
  • 摘要：Objective To quantitative analyze peripheral circulating DNA and evaluate its potential clinical value on diagnosis of liver damage. Methods Circulating DNA level of patients with chronic hepatitis B were quantified with a novel duplex real time PCR assay. Results The level of circulating DNA in control group, mild, moderate and severe chronic hepatitis B was( 21 ± 9,29 ± 8,38 ± 8 and 81 ± 16 ) μg/L, respectively. As the condition of patients with chronic hepatitis B exacerbated, circulating DNA level increased gradually. Circulating DNA level of patients with severe chronic hepatitis B was significantly higher than that of control group( P ＜ 0.01 ). There was a positive relationship among circulating DNA level, alanine aminotransferase and aspartate aminotransferase( r= 0. 612 and 0. 632 respectively, P ＜ 0.01 ). Circulating DNA level of serum HBeAg positive group was significantly higher than that of serum HBeAg negative group( 68 μg/L ± 14 μg/L vs 23 μg/L ± 12 μg/L, P ＜ 0.05 ). Conclusion Circulating DNA level may reflect liver inflammation degree and may become a marker of liver inflammation activity.%目的 探讨外周循环DNA水平定量检测在诊断肝组织损伤中的价值.方法 纳入慢性乙型肝炎轻度、中度、重度患者及健康对照者各30例,采用双重荧光定量PCR法检测血浆中循环DNA的含量.结果 健康对照组,慢性乙型肝炎轻度、中度和重度患者外周循环DNA水平分别为(21±9、29±8、38±8和81±16 )μg/L,随着慢性乙型肝炎患者病情加重,外周循环DNA水平逐渐升高,慢性乙型肝炎重度患者外周循环DNA水平显著高于健康对照组(P＜0.01).慢性乙型肝炎患者外周循环DNA水平与ALT和AST呈显著正相关(r值分别为0.612和0.632,P值均<0.01).HBeAg阳性慢性乙型肝炎患者外周循环DNA显著高于HBeAg阴性组(68 μg/L±14 μg/L vs 23 μg/L±12 μg/L,P＜0.05).结论 外周循环DNA的含量可反映肝脏的炎性反应程度,有可能作为肝脏炎性反应活动程度的一项监测指标.
  • 摘要：@@ 例1.18岁,未婚,孕1产0.因停经4月余,阴道出血4 d入院.停经2个月外院超声示宫内早孕.4 d前阴道出血,超声示宫内孕(未见明显胎心胎动).于外院行钳刮不成功,改羊膜腔穿刺引产加口服米非司酮150 mg、米索前列醇600 μg均失败转来本院.
  • 摘要：@@ 例1.男,17岁,因反复发作性意识丧失、倒地8 d入院.入院8 d前出现口角抽动,10 s后意识丧失,是否有双眼瞪视、肢体抽搐不详.无舌咬伤及二便失禁.几秒钟后醒来,对发作时情况不能回忆.遂于外院就诊,就诊时突发手中物品落地,口角往左侧抽动,双眼瞪视,呼之不应,倒地,持续几秒钟醒来.后反复发作,每天发作2～3次.既往有进食生肉史.否认接触猫狗等动物.无冶游史.
  • 摘要：@@ 不稳定型心绞痛(UA)/非ST段抬高心肌梗死(NSTEMI)为急性冠脉综合征(ACS)的一个亚组,是指在一定临床环境(胸部不适或绞痛)下,心电图提示ST段压低或T波倒置,和(或)在无ST段抬高的情况下有关心肌坏死的生物标志物(如肌钙蛋白)阳性.UA 和NSTEMI是一个连续的、有着相似的病理生理基础及临床特征的疾病,随着循证医学的不断发展,UA/NSTEMI的治疗进展很快,但仍存在很大的不确定性,需不断校正.目前UA/NSTEMI患者的治疗方法有保守治疗、介入治疗(PCI)、外科手术(CABG)治疗等3种.
  • 摘要：@@ 嗜睡是脑梗死后常见的临床表现,它不仅不利于神经功能康复、提高生活质量,而且可加重高血压、糖尿病等脑梗死危险因素,增加脑梗死再发的可能性[1,2].临床常用的纳络酮等药物虽可促醒并可改善呼吸和血液循环功能[3],但对脑梗死后嗜睡的治疗效果却不理想.果糖二磷酸钠(FDP)在嗜睡中的应用罕见报道.本文通过分析2008年1月-2010年8月在我院神经内科住院部用FDP治疗的40例脑梗死后嗜睡患者的资料,以探讨治疗脑梗死后嗜睡的有效方法.
  • 摘要：@@ 肺栓塞(PE)是各种栓子阻塞肺动脉系统的一组疾病或临床综合征的总称.目前,因其高发病率、高病死率和低诊断率已成为全球医学界关注的疾病[1],且发病率有明显升高趋势,是一种极易被误诊的急危重症疾病,可见于各临床科室.
  • 摘要：@@ 宫颈妊娠是一种罕见的异位妊娠,其胚胎植入子宫颈内,早期临床表现无特异性,发病前不易诊断,常易误诊流产.清宫时易发生难以控制的大出血,处理不当或抢救不力,后果严重,可丧失生育功能或危及患者生命.为探讨宫颈妊娠的超声诊断和选择相应的有效治疗方法,现将本院收治的宫颈妊娠临床资料作回顾性分析,报道如下.
  • 摘要：@@ 随着人口趋于老龄化,心血管疾病逐渐成为威胁人们健康的主要杀手之一.缺血性心脏病、心肌梗死、心力衰竭、心肌病成为当今临床上常见病.人体心肌组织中干细胞数量有限,分化能力差,肌细胞坏死或凋亡后,难以满足心肌修复需要,进而出现心肌工作细胞数量减少、心室重构、心律失常等,最终出现心力衰竭.
  • 摘要：Objective To investigate the value of color Doppler ultrasound in assessing endometrial development and the effect and mechanism of low dose aspirin on endometrial development in ovulation induction.Methods 32 unexplained infertility women were randomly allocated into two groups: Aspirin group, 16 patients with low dose aspirin ( 75mg/d on menstrual cycle day 1 to 20 ) and clomiphene citrate ( 50mg/d on cycle days 5 to 9 ) in ovulation induction; CC group, other 16 patients only with clomiphene citrate ( 50mg/d on cycle days 5 to 9 ).In addition, 16 healthy women were enrolled as control group and were not received any hormnal treatment.Results Ratio of TXA2/PGI2 in the Aspirin group was significantly lower than that of the CC group and control group 1 d before ovulation( P ＜ 0.05 ), no significant difference was found among 3 groups 10 d after ovulation( P ＞ 0.05 ).1 d before ovulation the uterine blood RI was similar in Aspirin group and control group( P ＞ 0.05 ).but was lower than CC group( P ＜ 0.01 ), 10 d after ovulation, there was no difference among 3 groups ( P ＞ 0.05 ).The endometrial thickness in the Aspirin group was significantly thicker than that of the CC group 1 d before ovulation and 10 d after ovulation( P ＜ 0.01 ).Conclusion It is of great value to predict endometrial development by color Doppler ultrasound.Low dose aspirin therapy in ovulation induction combined with CC can promotes uterine perfusion and improve inadequate endometrial development.%目的 探讨超声预测子宫内膜发育的价值及小剂量阿司匹林在促排卵过程中对子宫内膜发育的影响及作用机理.方法 将不明原因的不孕妇女32例随机分为2组,阿司匹林(Aspirin)组(16例)于月经周期第1～20天给予小剂量阿司匹林(每天75 mg),周期第5～9天给予克罗米酚(50 mg);克罗米酚(CC)组(16例)仅在月经周期第5～9天用克罗米酚;同时选取具有分娩史正常妇女作为对照组(16例),不给予任何激素类药物.检查血浆栓素A2/前列环素2(TXA2/PGI2)和子宫血流阻力指数(RI)及内膜厚度.结果 排卵前1 d Aspirin组血浆TXA2/PGI2比值明显低于CC组和对照组(P<0.05),排卵后10 d 3组差异无统计学意义(P>0.05).排卵前1 d,Aspirin组子宫血流RI与对照组无差异(P>0.05),但明显低于CC组(P<0.01),排卵后10 d,3组差异无统计学意义(P>0.05).排卵前1 d及排卵后10 d,Aspirin组子宫内膜厚度均明显厚于CC组(P<0.01).结论 彩色多普勒超声对预测子宫内膜发育很有意义,小剂量阿司匹林可增加子宫血流量,使子宫内膜增厚,从而改善促排卵治疗时用克罗米酚所致的子宫内膜发育不良.
  • 摘要：目的 观察肌萎灵冻干粉对大鼠脊髓损伤后的神经保护作用,并研究其对谷氨酸诱导的原代神经细胞凋亡的影响.方法 以质量30 g静态压迫硬膜外脊髓10 min建立大鼠脊髓损伤模型,于术后第1天、7天、14天进行各实验组神经功能评价,并观察损伤处脊髓形态学改变;建立低浓度谷氨酸诱导原代神经细胞的兴奋性毒性损伤模型,MTT法检测细胞活力,流式细胞仪检测细胞凋亡率,Western检测Bcl-2、Bax蛋白表达变化.结果 (1)肌萎灵冻干粉可明显提高脊髓损伤大鼠各时间段的BBB评分,改善后肢运动功能,减轻脊髓神经元水肿.(2)肌萎灵冻干粉可增强谷氨酸损伤后的神经细胞活力,缓解神经细胞损伤.(3)肌萎灵冻干粉能显著减少谷氨酸诱导的神经细胞凋亡.(4)肌萎灵冻干粉可不同程度的上调Bcl-2蛋白表达,下调Bax蛋白表达.结论 肌萎灵冻干粉可促进脊髓损伤大鼠后肢运动功能恢复,增强神经细胞活力,抑制谷氨酸诱导的神经细胞凋亡,调节凋亡相关蛋白表达,具有一定的神经保护作用.%Objective To observe the protective effects of Jiweiling lyophilized powder ( JWLF ) on the neuron of spinal cord injury ( SCI ) rats, and the influence on primary neuron apoptosis induced by glutamate in vitro, also explore the molecular mechanism of JWLF on the motor neuron disease ( MND ). Methods The SCI model of rats were developed with static compressive pressure of 30 g on the spinal epidural for 10 min, the neuron function was evaluated at 1 d,7 d and 14 d after the surgery and the morphologic changes of the damaged spinal were determined. The primary cortical neuron was damaged by glutamate at low concentration, then measure the viability and the expression of Bcl-2,Bax with methods of MTT, flow cytometry and Western blot. Results ( 1 )JWLF could obviously improve BBB rating score on SCI rats at different time and release the edema of spinal neurons. ( 2 )JWLF could enhance neuron activity in rat which suffered from glutamate and alleviate neuronal injury. ( 3 )JWLF remarkably inhibited the neuron apoptosis induced by glutamate. ( 4 )JWLF could balance the expression of Bcl-2 and Bax of neuron. Conclusion JWLF could promote hind limb motor function of SCI rats through enhancing the neuron activity and restraining the neuron apoptosis.
  • 摘要：Objective To investigate the effect of β-elemene on the expression of VEGF and eIF4E in human salivary gland adenocarcinoma SACC-83 cell line cultured in vitro. Methods SACC-83 cell was refrigerated and cultured for 24 h and divided into 6 groups:control group,elmene 60 mg/L、80 mg/L、100 mg/L、120 mg/L,and cisplatin group. The expression level of eIF4E and VEGF in SACC-83 cell with different concentration of elemene was detected by immunocytochemistry. Results Elemene and cisplatin can restrain the growth of salivary gland adenocarcinoma SACC-83 cell and reduce its eIF4E and VEGF expression level obviously. Compared with control group,there was significent difference( P ＜0. 05, P ＜0. 01 ). Moreover, this effect correlates with time and concentration. The expression of eIF4E and VEGF protrin was lower in elemene 100 mg/L,120 mg/L group than cisplatin group( P ＜ 0. 05 ). Conclusion Elemene inhibit SACC-83 cell growth, and has the effect of down regulation protein expression of eIF4E and VEGF in human salivary gland adenocarcinoma SACC-83 cell, thus elemene prevents metastasis via lymphatic or blood vessels by reducing expression level of eIF4E and VEGF in salivary gland adenocarcinoma. This conclusion provides theoretic foundation and experimental evidence for tumor aimed therapy.%目的 探讨β-榄香烯对体外培养的人涎腺腺样囊性癌SACC-83细胞中真核细胞翻译启始因子(eIF4E)及血管内皮生长因子(VEGF)蛋白表达的影响.方法 将SACC-83细胞复苏培养24 h后分为6组:空白对照组,榄香烯60 mg/L、80 mg/L、100 mg/L、120 mg/L组,顺铂组,采用免疫细胞化学方法检测各组不同时点(12 h、24 h、48 h)SACC-83细胞中eIF4E和VEGF蛋白表达水平.结果 β-榄香烯各组和顺铂组各时点与对照组比较,均下调人涎腺腺样囊性癌SACC-83细胞中eIF4E及VEGF蛋白的表达水平(P<0.05,P<0.01),且均有时间、剂量依赖性.100 mg/L、120 mg/L榄香烯组对SACC-83细胞中eIF4E及VEGF蛋白下调水平低于顺铂组(P<0.05).结论 β-榄香烯通过抑制SACC-83 细胞的生长,遏制了肿瘤血管、淋巴管转移,为肿瘤靶向治疗提供了理论基础和实验依据.
  • 摘要：@@ 垂体或下丘脑的多种病损可累及垂体的内分泌功能,当垂体的全部或绝大部分被破坏后,可产生一系列的内分泌腺功能减退的表现,主要累及的腺体为性腺、甲状腺及肾上腺皮质,临床上称为垂体前叶功能减退症(hypopituitarism)[1].
  • 摘要：@@ 我院自2005年 12月- 2010年7 月对107例高血压脑出血患者实施CT扫描定位定向,局麻下锥颅置入软管抽吸引流血肿,术后根据引流血肿量,间断注入尿激酶促进血肿引流.穿刺准确度明显提高,成功引流血肿,并有效地控制继发性脑损伤,疗效较满意.现报告如下.
  • 摘要：目的 研究血液透析对急性重度酒精中毒患者血中乙醇浓度及预后的影响.方法 纳入55例急性重度酒精中毒患者,其中26例入院后行血液透析(透析组),29例入院后予纳洛酮治疗(对照组),用气相色谱法于血液透析前后测定血中乙醇浓度.结果 26例患者在血液透析后1 h内清醒者15例,1～3 h清醒者11例,透析组治疗后2 h血中乙醇浓度由(6075±1013)mg/L降为(29±16)mg/L,差异有统计学意义(P<0.01);对照组治疗后2 h由(5860±634)mg/L降至(4946±530)mg/L,差异无统计学意义(P>0.05).透析组平均清醒时间、生命体征平稳时间,平均住院时间均较对照组缩短,差异有统计学意义(P<0.01).结论 血液透析能有效地降低血液中的乙醇浓度,缩短清醒时间,减少并发症.
  • 摘要：Objective To compare the long term prognosis of different therapies for the treatment of stable coronary artery disease. Methods 317 stable coronary artery disease patients were divided into three groups:medical therapy group,percutaneous coronary intervention ( PCI ) group and coronary artery bypass grafting ( CABG ) group. Each group was further divided into two sub-groups, including single vessel stenosis and multi-vessel stenosis according to the number of coronary artery stenosis. The patients were followed up for average( 48 ± 8 ) months. The clinical endpoint including death, myocardial infarction, revascularization, readmission caused by acute coronary syndrome( ACS ) and release of angina pectoris. Results During the follow up, there were no significant differences between medical therapy group and PCI group no matter single or multiple vessel stenosis in angina pectoris releave rate, the endpoint of death, myocardial infarction and readmission because of ACS( P ＞ 0.05 ). In multiple vessel stenosis sub-group, CABG group had a significant higher rate in angina pectoris releave rate, lower rate in death and revascularization than that in medical therapy group and PCI group( P ＜ 0.01 or P ＜ 0.05 ); PCI group had a significant lower rate of revascularization than that in medical therapy group( P ＜ 0.05 ). Conclusion Medical therapy is the basic treatment of stable coronary disease. PCI in early stage may not improve long term prognosis in patients with stable coronary artery disease;CABG may had a better prognosis than PCI in multiple vessel stenosis.%目的 比较稳定型冠心病单纯药物治疗、经皮冠状动脉介入治疗(PCI)和冠状动脉旁路移植术(CABG)3种治疗方法的远期预后.方法 将317 例稳定型冠心病患者按治疗方法不同分为单纯药物治疗组、PCI 组和CABG 组,每组再按冠状动脉病变情况分为单支病变和多支病变2个亚组.平均随访(48±8)个月,随访内容包括全因死亡、心肌梗死、血管重建、因急性冠脉综合征(ACS)再入院以及心绞痛缓解情况.结果 无论单支病变或是多支病变,单纯药物治疗组心绞痛缓解率、全因死亡、心肌梗死、因ACS 再入院与PCI组比较差异均无统计学意义(P>0.05);对于多支病变患者,CABG组心绞痛缓解率高于药物治疗组和PCI组(P<0.05或P<0.01),全因死亡、血管重建率显著低于药物治疗组和PCI 组(P<0.01或P<0.05),PCI组血管重建率低于药物治疗组(P<0.05).结论 强化药物治疗是稳定型冠心病治疗的基础;早期PCI可能并不改善稳定型冠心病患者的远期预后;对于多支病变稳定型冠心病患者,CABG 预后可能优于PCI.
  • 摘要：目的 探讨非瓣膜性心房颤动与C-反应蛋白(CRP)、纤维蛋白原(FIB)的关系及阿司匹林、稳心颗粒对其水平的影响.方法 应用速率散射比浊法定量测定102例非瓣膜性心房颤动(房颤组)患者和76例健康对照者(对照组)血清CRP、FIB 的浓度并进行比较;房颤组分为阿司匹林组(常规组52例)和阿司匹林联用稳心颗粒组(联合组50例),药物治疗3周后再次测定血清CRP、FIB浓度.结果 房颤组患者的CRP、FIB浓度明显高于健康对照组(P<0.01);联合组和常规组治疗后CRP较治疗前均明显降低(P<0.05),且联合组CRP、FIB均较常规组降低显著(P<0.05).结论 CRP和FIB在非瓣膜性房颤患者明显升高,是发生血栓栓塞并发症的一个重要参考指标;阿司匹林联用稳心颗粒可明显降低血清CRP、FIB浓度.%Objective To observe the effect of aspirin and Wenxin granule on the level of plasma C-reactive protein ( CRP ) and fibrinogen ( FIB ) in patients with non-valvular atrial fibrillation. Methods We detected the plasma FIB and CRP in 102 cases with non-valvular atrial fibrillation( fibrillation group ) by method of rate nephelometry, and then compared those index with 76 cases ( control group ) of healthy person. A comparative study was carried out on the level of plasma FIB and CRP in patients with atrial fibrillation after 3 weeks treatment with aspirin( routine group, n = 52 ) and Wenxin granule combined with aspirin( combination group, n = 50 ). Results It showed that the level of plasma FIB and CRP in patients with non-valvular atrial fibrillation group was significantly higher than that in control group( P ＜ 0.01 );the level of CRP and FIB declined obviously in routine group and combination group( P ＜ 0.05 ), and Cower in combination group than routine group ( P ＜ 0.05 ). Conclusion CRP and FIB can be used as indicators for detecting of pre thrombosis in patients with atrial fibrillation . It can decrease the level of CRP and FIB with use of aspirin and Wenxin granule.
  • 摘要：目的 比较血液透析(HD)和腹膜透析(PD)改善肾性贫血患者的疗效.方法 选择尿毒症行透析治疗患者59例,其中行腹膜透析患者24例(PD组),行血液透析患者35例(HD组).2组开始治疗时未使用促红细胞生成素,在治疗1个月时均加用促红细胞生成素,治疗2个月时均加用左旋卡尼汀联合促红细胞生成素治疗,比较2组患者透析治疗前与开始透析治疗1个月、2个月、3个月后血红蛋白(Hb)值的变化.结果 透析治疗前PD组和HD组的Hb值无明显差异(P>0.05).透析治疗前后比较,PD组和HD组治疗1个月、2个月、3个月的Hb值均明显升高(P<0.05或P< 0.01),治疗3个月>治疗2个月>治疗1个月(P<0.05或P<0.01),且透析治疗1个月、2个月、3个月后PD组的Hb值均高于HD组,差异有统计学意义(P<0.05或P<0.01).结论 无论腹膜透析和血液透析均能改善贫血,但腹膜透析疗效更明显,促红细胞生成素可有效纠正尿毒症患者的肾性贫血,并且联合左旋卡尼汀治疗效果更明显.%Objective To compare the effects of hemodialysis ( HD ) and peritoneal dialysis ( PD ) on improving renal anemia. Methods A total of 59 uremia patients were divided into two groups: PD group ( 24 patients ) and HD group ( 35 patients ). At the beginning of the therapy, the patients were not treated with erythropoietin or levocarnitine. After a month of dialysis, both of the two groups were treated with erythropoietin intravenously. Then after two months all of the patients were administered with both erythropoietin and levocarnitine. The hemoglobin ( Hb ) of the two groups was evaluated at one month,two months and three months respectively. Results There was no difference between the PD group and the HD group before dialysis. The Hb level of the two groups were increased after one month, two months and three months therapy ( P ＜ 0.05, or P ＜ 0.01 ). And the Hb level of PD group was higher than that of HD group after dialysis for one month, two months and three months ( P ＜ 0.05, or P ＜ 0.01 ). Conclusion Both PD and HD can improve anemia. And the effect of PD is more significant than that of HD. Erythropoietin can correct anemia in dialysis patients ( including PD patients and HD patients ).But the combined therapy of erythropoietin and levocarnitine is more efficient.
  • 摘要：目的 了解肝硬化患者不同CTP分级及出现不同并发症时与小肠细菌过度生长(SIBO)的关系.方法 对68例肝硬化患者,均行葡萄糖氢呼气试验(GHBT)检测SIBO情况,按不同CTP分级、不同并发症分组统计,并设立健康对照组,对检测结果作对比分析.结果 (1)肝硬化患者SIBO与健康对照组比较差异有统计学意义(P<0.05);(2)CTP级A级、B级、C级患者SIBO阳性率及氢呼气浓度平均值呈渐进性增高,A级、B级与C级相比组间差异有统计学意义(P＜0.05);(3)不同并发症患者SIBO阳性率及氢呼气浓度不一,其中无并发症患者与上消化道出血患者、肝性脑病患者、自发性腹膜炎患者及多种并发症患者相比差异均有统计学意义(P＜0.05).结论 肝硬化患者往往合并有SIBO,其与CTP分级相关,而且与肝硬化出现的不同并发症密切相关.%Objective To investigate the situations of small intestinal bacterial overgrowth ( SIBO ) in patients with hepatic cirrhosis of different CTP, and the relationship between complication and SIBO.Methods Glucose hydrogen breath test ( GHBT ) was performed in 68 patients with hepatic cirrhosis and 20 health control subjects.Results ( 1 )A statistical difference in the positive rate of SIBO was fond between patients with hepatic cirrhosis and health control subjects( P ＜0.05 ).( 2 )The rate was risen gradually according to the classification of CTP A, B and C, statistical difference was found among patients with CTP A and C, B and C( P ＜ 0.05 ).( 3 )The rate of hemorrhage in upper digestive tract, hepatic encephalopathy and spontaneous peritonitis have statistical differences between patients with or without complications( P ＜ 0.05 ).Conclusion Patients with hepatic cirrhosis have a higher positive rate of SIBO, and the rate would rise when the score of CTP was increased, and the rate has close relationship with complications of hepatic cirrhosis.
  • 摘要：目的 探讨慢性心力衰竭患者氨基末端脑钠肽前体(NT-proBNP)水平和中医辨证分型之间的关系.方法 采用问卷调查和中医辨证的方法,对100例慢性心力衰竭患者进行中医辨证分型,同时测定NT-proBNP水平.计算每种中医证型的NT-proBNP平均值,并进行统计学分析.结果 慢性心力衰竭中医辨证为气虚血瘀证患者比例明显高于其他亚型(P＜0.05),且气虚血瘀证患者中冠心病所占比例最高,高于其他亚型(P＜0.05),气虚血瘀证患者NT-proBNP均值及心功能IV级者明显高于其他证型(P＜0.05).结论 慢性心力衰竭属气虚血瘀证患者心力衰竭程度较其他证型严重.
  • 摘要：@@ 先证者,女,29岁.于1992年8月开始出现视力下降,1995年开始出现走路不稳,蹬自行车费力,动作欠灵活,走路易摔倒,未予重视,症状进行性加重.1998年出现口齿不清,饮水呛咳,干重体力活时易心悸胸闷.四肢及头部不自主抖动.体格检查:神清,智力正常.
  • 摘要：目的 观察恩替卡韦治疗乙型肝炎肝硬化患者的疗效和安全性.方法 80例患者随机分为恩替卡韦组和拉米夫定组各40例,疗程48周,观察治疗不同时间点患者的病毒学、生物化学指标、凝血酶原活动度(PTA)及病毒耐药等变化情况.结果 2组患者 ALT、AST明显下降,白蛋白、总胆红素、PTA等指标均有所改善(P＜0.05),治疗后24、48周HBV-DNA水平下降值、HBV-DNA阴转率恩替卡韦组高于拉米夫定组(P＜0.05),恩替卡韦组耐药率0%.2组无不良反应.结论 恩替卡韦能快速有效抑制乙型肝炎肝硬化患者的病毒复制,使HBV-DNA水平下降,同时能够改善肝功能,且具有极低耐药率.
  • 摘要：@@ 手足口病(hand-foot-mouth disease,HFMD)是由多种肠道病毒引起的常见传染病,1957年新西兰首次报道,我国于1980年由上海首先报道本病[1],以后各地均有报道,近年来发病率呈急剧上升趋势.现就我院感染科自2008年7月-2010年7月诊治的1845例手足口病患者进行临床回顾性分析.
  • 摘要：Objective To observe and compare the effect of perindopril plus bisoprolol and perindopril on chronic congestive heart failure ( CHF ).Methods 75 cases of CHF were randomly divided into control group ( group A, 37 cases )and treatment group ( group B, 38 cases ).Heart rate, blood pressure, heart function, LVDd, LVEF, CO, SV, A/E rate and FS between the two groups on the time point of before and after the treatment were compared.Results The blood pressure had declined significantly after treatment in the two groups( P ＜ 0.01 ), the heart rate had declined significantly in group B compared with group A( P ＜ 0.01 ).The heart function was improved significantly after treatment in the two groups ( P ＜ 0.01 ),and the improvement in group B was more significant than that in group A ( P ＜0.01 ).The LVDd didn't show significant difference between the two groups at the time point of before and after treatment( P ＞ 0.05 ).The A/E rate significantly declined after treatment in the two groups( P ＜0.01 ),group B was better than that of group A( P ＜0.01 ).CO and SV significantly improved after treatment both in the two groups( P ＜ 0.01 ), but didn' t show significant difference( P ＞ 0.05 ) between the two groups.The LVEF significantly improved after treatment in the two groups( P ＜ 0.01 ), and group B was better than that of group A( P ＜ 0.05 ).Conclusion The treatment of combining perindopril and bisoprolol is more effective than only use perindopril in improving the prognosis of the patients with CHF.%目的 观察比较比索洛尔和培哚普利联合应用与单用培哚普利对慢性收缩性心力衰竭患者的疗效.方法 将75例慢性收缩性心力衰竭的患者随机分为培哚普利组(A组)37例和比索洛尔加培哚普利组(B组)38例,比较2组治疗前后心率、血压、心功能、左室舒张末内径(LVDd)、左室射血分数(LVEF)、心排出量(CO)、每搏量(SV)、A峰/E峰比值(A/E比值)、小轴缩短率 (FS).结果 2组患者治疗后血压、心率均下降(P＜0.01),B组心率较A组明显下降,差异有统计学意义(P＜0.01);心功能均明显改善(P<0.01),B组较A组改善更明显(P<0.01).A组、B组治疗前后LVDd无明显变化(P>0.05);A/E比值2组均明显下降(P均＜0.01),B组优于A组(P＜0.01);2组CO、SV均明显上升(P均<0.01),组间差异无统计学意义(P＞0.05);2组LVEF均明显上升(P均<0.01),B组优于A组(P＜0.05).结论 培哚普利联合比索洛尔更能改善慢性收缩性心力衰竭患者的预后.
  • 摘要：目的 探讨冠心病介入治疗发生造影剂肾病(CIN)的影响因素及预防措施.方法 回顾性分析2008年1月-2009年12月1700例行冠心病介入治疗的患者,分析CIN发生的危险因素以及预防性措施.结果 CIN总发生率为5.76%(98/1700).CIN组合并高血压病、糖尿病、原有肾功能不全病史比例明显高于非CIN组(P<0.05),而LVEF以及24 h水化量明显低于非CIN组(P<0.05).结论 冠心病介入术前应积极评估患者的危险因素,同时应用水化疗法预防,可以最大限度地改善及纠正危险因素,尽量避免CIN的发生.%Objective To investigate the influence factors and prevention of contrast-induced nephropathy ( CIN ) in patients who underwent coronary artery intervention.Methods 1700 patients who underwent PCI or coronary angiograph from January 2008 to December 2009 were enrolled in this study.Clinical characteristics, risk factors and preventive actions were investigated.Results Among the 1700 patients,98 patients ( 5.76％ ) developed CIN.Compared with the non CIN patients,the incidence of pre-existing renal dysfunction, hypertension, diabetes mellitus in CIN patients increased significantly ( P ＜0.05 ), the left ventricle ejective fraction and amount of hydration in 24 hours decreased significantly ( P ＜ 0.05 ).Conclusion Positive evaluating the risk factors and using hydration can effectively improve and correct risk factors and reduce the in cidence of CIN in patients who would undergo coronary interventional therapy.
  • 摘要：Objective To study the change of NO in plasma of patient with COPD and detect its relationship with TNF-α and hs-CRP.Methods Plasma of 30 patients in the acute exacerbation COPD ( AECOPD ), 30 patients in the stable COPD and 26 healthy control subjects were collected.The density of NO was assayed by means of nitrate reductase in plasma.The density of hs-CRP was assayed by means of latex agglutination test.The density of TNF-α was assayed by means of radioimmunoassay.Results The density of NO in plasma of AECOPD patients were lower than that in the stable COPD patients ( P ＜ 0.01 ).the density of TNF-α and hs-CRP in plasma of AECOPD patients were higher than that in stable COPD ( P ＜0.01 ).The density of NO in plasma of stable COPD patients were lower than that in the healthy control subjects( P ＜ 0.05 ).The density of TNF-α in plasma from COPD patients were higher than that in the healthy control subiects( P ＜ 0.05 ).Linear correlation analysis showed that the density of NO in plasma of AECOPD patients had negative association with TNF-α and hs-CRP( r = - 0.365, P= 0.047, r= - 0.450, P= 0.013 ).No correlation was found between NO and TNF-α, hs-CRP in stable COPD.Conclusion Both NO,TNF-α and hs-CRP were involved in airway inflammation and associated with the degree of inflammation in COPD patients.The lower the density of NO, the more severe of inflammatory response will be showed.NO plays an important role in inflammation of COPD.%目的 检测慢性阻塞性肺疾病(COPD)患者血清中一氧化氮(NO)的变化,并探讨NO与肿瘤坏死因子-α(TNF-α)、超敏C-反应蛋白(hs-CRP)的相关性.方法 采集COPD急性加重期、稳定期患者和健康者外周血血清,采用硝酸还原酶法检测血清中NO、速率散射比浊法检测血清hs-CRP和放射免疫法定量测定血清TNF-α浓度.结果 COPD急性加重期组NO水平明显低于稳定期组(P＜0.01),而TNF-α和hs-CRP显著高于稳定期组(P<0.01);COPD稳定期组NO水平明显低于对照组(P<0.05),TNF-α水平明显高于对照组(P<0.05),而hs-CRP水平在稳定期组和对照组之间比较差异无统计学意义(P＞0.05);COPD急性加重期NO与TNF-α、hs-CRP存在明显负相关性(r=-0.365,P=0.047,r=-0.450,P=0.013).COPD稳定期患者血清NO与TNF-α、hs-CRP之间无明显相关性(r=-0.148,P=0.434;r=-0.09,P=0.636).结论 NO、TNF-α、hs-CRP均参与了COPD气道炎性反应,并与COPD炎性损伤程度有关.此外,NO水平越低,炎性反应越剧烈,提示NO在炎性级联反应中起一定作用.
  • 摘要：目的 观察内关穴注射小剂量恩丹西酮、氟哌利多混合液超前镇吐用于腹腔镜手术的临床效果.方法 选择ASA I～II级拟行腹腔镜手术患者180例,按手术顺序将患者随机分为3组,每组60例.I组患者于术前20 min行恩-氟混合液(恩丹西酮 4 mg,氟哌利多2.5 mg,共3 ml)行双侧内关穴注射;II组患者于术前20 min静脉注射恩-氟混合液3 ml;III组患者术前20 min静脉注射0.9%氯化钠液3 ml.观察各组患者术后24 h恶心呕吐的发生次数与程度,并按评定标准予以评分.结果 I组恶心、呕吐发生率分别为20.0%、21.7%,低于II组46.7 %、45.0%,亦低于III组68.3%、63.3%,差异均有统计学意义(P＜0.01);3组患者均未发现明显嗜睡、焦虑及锥体外系反应等并发症.结论 针药结合超前镇吐用于腹腔镜手术,能阻断引起术后恶心呕吐的多个因素,临床效果确切,可减少或避免大剂量单一用药所导致的诸多并发症.%Objective To investigate the clinical effects of Neiguan point injection with small dose of ondansetron and droperidol mixed liquor for preemptive anti vomit in laparoscopic surgery. Methods 180 ASA Ⅰ ～ Ⅱ patients who were took laparoscopic surgery were randomly divided into 3 groups ( 60 cases in each group ) . Patients in group I were given an injection of ondansetron and droperidol mixed liquor( ondansetron 4 mg and droperidol 2.5 mg, total of 3 ml ) on bilateral Neiguan point 20 minutes before operation; Patients in group Ⅱ were given a vein shot of 3 ml ondansetron and droperidol mixed liquor while in group I injected with 3 ml of 0.9％ sodium chloride solution 20 minutes before operation. The frequency and degree of nausea and vomiting 24 hours after operation in each group were observed and scored according to evaluation standard. Results The incidence rate of nausea and vomiting was 20.0％ and 21.7％ in group I which has statistical different ( P ＜ 0.01 )compared with 46.7％ and 45.0％ in group Ⅱ and 68.3％ and 63.3％ in group Ⅲ. No complication such as obvious drowsiness, anxiety and extra-corticospinal tract reaction was found among the three groups. Conclusion Neiguan point injection with small dose of ondansetron and droperidol mixed liquor for preemptive anti vomit in laparoscopic surgepy can block many factors causing PONV, which can reduce or avoid many complications caused by large dose of single medication.
  • 摘要：Objective To evaluate the effects of ligustrazine on endostatin level in serum of spontaneous hypertensive rats( SHR ). Methods 20 spontaneous hypertensive rats with 20 weeks old were randomly divided into ligustrazine intervened group ( 10 rats ) and control group ( 10 rats ). 10 Wistar rats with 20 weeks old were used as normal control group. Rats in intervened group were intra-peritoneal injected with ligustrazine 20 mg· kg-1 · d -1 for 4 weeks. The rats in control group were intra-peritoneal injected with the amount of 0.9％ sodium chloride solution for 4 weeks. Endostatin level in serum was determined by ELISA method. Results Endostatin level in serum was( 57 ± 16 )ng/ml for ligustrazine intervened group,( 44 ± 3 )ng/ml for the control group,and( 59 ± 16 ) ng/ml for the normal control group. There were differences between the ligustrazine intervened group and the control group( P ＜ 0.05 ), but no differentce between the ligustrazine intervened group and the normal control group( P ＞ 0.05 ). Conclusion Ligustrazine could increase endostatin level in serum of spontaneous hypertensive rats, it may be one of the mechanisms against atherosclerosis.%目的 探讨川芎嗪对自发性高血压大鼠血清内皮抑素浓度的影响及其意义. 方法 20周龄的自发性高血压大鼠(SHR)随机分为川芎嗪干预组10只和对照组10只.20周龄的Wistar大鼠(WKY)10只作为正常对照组.川芎嗪干预组给予川芎嗪20 mg·kg-1·d-1腹腔注射,共4周,对照组和正常对照组给予等量生理盐水腹腔注射.应用双抗体夹心法(ELISA法)测定血清内皮抑素浓度. 结果血清内皮抑素浓度川芎嗪干预组(57±16)ng/ml,对照组(44±3)ng/ml,正常对照组(59±16)ng/ml.干预组与对照组比较差异有统计学意义(P<0.05);干预组与正常对照组比较差异无统计学意义(P>0.05).结论 川芎嗪能使自发性高血压大鼠血清内皮抑素浓度升高,这可能是川芎嗪抗动脉粥样硬化的机制之一.
  • 摘要：目的 评估神经传导速度(NCV)对糖尿病周围神经病变(DPN)的早期诊断价值,研究DPN的相关危险因素.方法 将133例2型糖尿病患者根据是否具有典型周围神经病变表现,分为症状组和无症状组,行NCV检查,并对2组患者的相关因素进行多因素分析.结果 症状组65例(48.87%),无症状组68例(51.13%),NCV总异常率69.17%,其中症状组异常率81.54%,无症状组异常率57.35%.症状组女性比例更高、病程更长(P<0.01),尿微量白蛋白(UmALB)更高(P<0.05).Logistic回归分析确定性别是DPN的独立危险因素(P<0.05,OR=2.485,95%CI:1.143～5.406).结论 神经传导速度检测是早期发现DPN的有效手段.女性可能是DPN的独立危险因素.
  • 摘要：@@ 患者,男,19岁,因腹痛、腹胀9 d入院.入院前9 d外出旅游后出现腹痛,为阵发性绞痛,以左上腹部明显,无放射痛,持续约数分钟至1 h,每日发作数次,伴有腹胀、恶心、呕吐,呕吐物为胃内容物,排便、排气减少,无发热,无皮肤、巩膜黄染.2 d前于外院行腹部彩色超声提示"腹腔积液",立位腹部X线平片提示"肠管积气合并气液平面",给予加替沙星抗炎治疗,症状无明显缓解.

    疑难病杂志的期刊信息

    • 创刊时间：2002
    • 地区：CN
    • 语言：中文
    • 热门主题：中国医师协会
    • 学科分类：

    疑难病杂志的获奖情况

    • • 全国优秀中医药期刊
    • • 中国北方优秀期刊
    • • 河北省优秀期刊
    • • 国家卫生计生委首届优秀期刊

    疑难病杂志的收录情况

    • • 化学文摘（网络版）
    • • 哥白尼索引
    • • 日本科学技术振兴机构数据库
    • • 中国科技核心期刊

    疑难病杂志的投稿信息

    • 投稿方式：在线投稿或邮箱投稿
    • 投稿须知：点击查看
    • 期刊官方网站：点击前往
    • 通讯地址：石家庄市天山大街238号
    • 邮编：050035
    • 联系电话：0311-85901735
    • 邮箱：ynbzz@163.com
    • 期刊栏目：卫生健康事业发展70年巡礼；论著临床；论著基础；荟萃分析；罕少见病例；综述
    免费订阅本刊

    客服邮箱：kefu@zhangqiaokeyan.com

    京公网安备：11010802029741号 ICP备案号：京ICP备15016152号-6 六维联合信息科技 (北京) 有限公司©版权所有 出版物经营许可证

    • 客服微信

    • 服务号