目的:探討腹膜透析相關性腹膜炎的治療。方法:回顧性分析的89例腹膜透析相關性腹膜炎患者,初期使用頭孢菌素和或氨基糖甙類抗生素治療,嚴重者使用頭孢唑林和頭孢他啶治療。結果:89例腹膜炎患者透析液培養陽性33例(37.1%),其中19例1～4d治愈(21.3%),56例4～14 d治愈(62.9%),復發11例(12.4%),2例因尿毒癥而全身衰竭死亡(2.2%)。結論:雖然腹膜透析相關性腹膜炎的發病率有降低趨勢,但其仍然是腹膜透析最常見并發癥之一,我們在強調對腹膜炎治療的同時,更要強調對腹膜炎的預防。
目的:探討單發腦轉移瘤的CT和MRI診斷價值。方法:回顧性分析37例經手術病理證實或臨床綜合診斷確診的單發腦轉移瘤的CT和MRI表現。結果:病灶位于幕上31例,分布于皮髓質交界區21例。囊實性22例,實性9例,囊性6例。不規則環形強化13例,結節形強化7例,囊實形強化15例,均勻強化2例。病灶直徑gt;1.0 cm時瘤周水腫常較明顯。結論:單發腦轉移瘤的CT、MRI表現具有一定的特征,增強掃描對診斷單發腦轉移瘤有重要價值。
目的:研究空蝶鞍綜合征(ESS)患者的X線、CT、MRI表現,探討三種診斷方法在ESS的診斷價值。材料與方法:32例ESS具有完整的X線、CT、MRI及臨床資料。結果:X線、CT、MRI均能發現蝶鞍擴大,X線不能分辨鞍內結構;CT可顯示垂體萎縮,識別75％的垂體柄,有少量偽影干擾,觀察細節受影響;MRI完全顯示鞍區解剖結構及信號變化。結果:MRI是ESS的最佳影像學診斷手段。
Objective To analyze acupuncture resources in the Cochrane Database of Systematic Reviews (CDSR). Methods We identified acupuncture literature from CDSR (2008 year) electronically. W analyzed this literature by research time date, author, study contents, and conCochrane Library usions.?Results?? ? We initially found 82 articles. Finally, we identified 67 systematic reviews. The number of acupuncture articles has increased all over the world with higher growth rate in China than overseas. The disease spectrum of acupuncture treatment increased widely, focusing on nervous system diseases and pain diseases. Eight articles (25.8%) definitely supported the efficacy of acupuncture. Twenty two articles (71%) considered the efficacy of acupuncture as uncertain owning to insufficient evidence. Just one article expressed that acupuncture treatment was ineffective according to current evidence.
Objective To evaluate the efficacy of acupuncture and moxibustion (acup-moxi) therapy for breech presentation. Methods We electronically searched The Cochrane Library (Issue 1, 2008), PubMed (1980 to Mar. 2008), MEDLINE (1966 to 2008), Ovid EBM Database (1991 to 2008), CBMdisc (1978 to Mar. 2008), VIP (1989 to Mar. 2008), CNKI (1979 to Mar. 2008), and WangFang Database (1983 to Mar. 2008), as well as handsearched seven traditional Chinese medicine journals to obtain randomized control trials (RCTs) about acup-moxi for breech presentation. Quality assessment was conducted according to the Cochrane Handbook for Systematic Reviews of Interventions 5.0.1. Meta-analyses were performed for the results of homogeneous studies using RevMan 5.0 software. Results Eight RCTs involving 1 341 patients met the inclusion criteria. Five trials were of relatively high quality and 3 were of low quality. The pooled analysis of six trials showed that acup-moxi was superior in cephalic presentation with RR=1.38, and 95%CI 1.20 to 1.58. Conclusion Acup-moxi can increase the successful rate of cephalic presentation in the treatment of breech presentation compared with no (routine care) or knee-chest position treatment.
Objective To investigate the efficacy of systemic immune inflammation index (SII) at admission and National Institutes of Health Stroke Scale (NIHSS) score immediately after thrombolysis on evaluating the short-term prognosis of neurological function in patients with acute ischemic stroke (AIS) receiving intravenous thrombolysis. Methods Patients with AIS treated with intravenous thrombolysis in the Second People’s Hospital of Chengdu between March 2022 and March 2023 were retrospectively analyzed. The basic data of the patients, NIHSS score at emergency admission, NIHSS score immediately after thrombolysis, modified Rankin Scale (mRS) score 3 months after discharge, and laboratory data at admission were collected, and SII at admission was calculated. According to the mRS score 3 months after discharge, the patients were divided into the good prognosis group (mRS≤2) and the poor prognosis group (mRS>2). Multivariate logistic regression analysis was used to screen out the factors affecting the prognosis of patients, and the receiver operating characteristic curve was drawn to analyze the evaluation effect of SII at admission and NIHSS score immediately after thrombolysis on the poor prognosis of neurological function of patients in the short term. Results A total of 213 patients were enrolled, and the prognosis was poor in 88 patients. Multivariate logistic regression analysis showed that age, onset-to-needle time, uric acid at admission, SII at admission, fasting blood glucose after admission, and NIHSS score immediately after thrombolysis were independent risk factors for poor prognosis in AIS patients (P<0.05). The area under the receiver operating characteristic curve (AUC) of SII at admission for predicting poor prognosis was 0.715, the sensitivity was 55.7%, and the specificity was 84.0%. The AUC of NIHSS score immediately after thrombolysis for predicting poor prognosis of patients was 0.866, the sensitivity was 87.5%, and the specificity was 72.8%. The AUC of SII at admission combined with NIHSS score immediately after thrombolysis for predicting poor prognosis of patients was 0.875, the sensitivity was 84.1%, the specificity was 77.6%, the positive predictive value was 72.5%, and the negative predictive value was 87.4%. SII at admission was positively correlated with NIHSS score at emergency admission, NIHSS score immediately after thrombolysis, and mRS score 3 months after discharge (P<0.05). Conclusion SII at admission can predict the short-term prognosis of neurological function of patients with AIS after thrombolysis therapy, and the combination of SII at admission and NIHSS score immediately after thrombolysis can improve the prediction efficiency.