1956年甲磺丁脲应用于临床,糖尿病治疗进入了有口服药的时代.随后,世界卫生组织统一了糖尿病的诊断标准和血糖控制的标准.我国糖尿病专家又提出了以"五驾马车"为内容的综合治疗糖尿病的方案,使糖尿病治疗进入了比较规范的轨道.但在目前的临床实践中,有关糖尿病的治疗方法仍然是五花八门,有很多患者甚至一些基层医生仍然没有掌握规范的治疗方法.下面就介绍一下经过优化选择、专家论证和实践证明的适合大多数糖尿病患者应用的规范疗法:

Pseudomonas aeruginosa is a conditional pathogen and the leading species isolated from hospitalacquired infections.With the increasing and unrational usage of antibiotics , the resistance of Pseudomonas aeruginosa to β -lactam antibiotics has gradually increased , and then the anti-infection therapy in hospitals becomes even more difficult.The resistance mechanism of Pseudomonas aeruginosato β -lactam antibiotics is complex , including natural and acquired drug-resistance.In this paper , the recent researches on mechanisms of resistance to β -lactam antibiotics and transmission of Pseudomonas aeruginosa are reviewed.

目的 探讨早期肠内营养对肝部分切除术后肝功能恢复的影响.方法 2011年8月-11月解放军第三0二医院肝胆外科一中心二科行肝部分切除手术的病人60例,其中行早期肠内营养(EEN组)30例,常规肠内营养组(REN组)30例.两组均于术后24h开始给予营养支持,共10d.其中EEN组给予早期肠内营养,REN组在肛门排气后给予肠内营养.观察术后4d、7d及术后11d病人一般情况、肝脏功能等指标的变化.结果 两组病人在平均住院时间的差异无统计学意义;但EEN组术后胃肠蠕动功能及肝功能恢复较快.结论 肝部分切除术后进行早期肠内营养是安全、有效、可行的营养支持方式.

目的 对心脏骤停急诊心肺复苏成功的相关因素进行分析探讨,为今后的临床抢救工作提供可靠的参考依据.方法 选取2010年1月～2012年12月本院收治的心脏骤停接受心肺复苏的患者82例,按照心肺复苏成功与否分成成功组和失败组,对比分析两组患者的相关资料,总结成功与失败因素.结果 成功组急救反应时间较失败组显著缩短(P < 0.05),成功组急救措施优于失败组(P < 0.05).结论 对心肺复苏工作给予重视,建立高效护理协助平台,配备优良先进设备,并注意其生物安全和卫生洁净度,从而提高心肺复苏成功率,改善患者预后.

Objective To observe the awakening effects of naloxone combination with Xingnaojing injection on the patients with acute carbon monoxide poisoning.Methods Totally 71 patients with acute carbon monoxide poisoning were divided into three groups at random: group A(n=25),group B(n=24) and group C(n=22).Group A was treated by naloxone combination with Xingnaojing injection,group B was treated by naloxone and group C was treated by Xingnaojing injection.The awakening time of the patients were compared.Results The awakening time of the patients in group A was(4.10±1.33)hours,which was significantly shorter than that of group B and group C(P<0.01).Conclusion The awakening effects of naloxone combination with Xingnaojing injection is superior to that of Xingnaojing injection or naloxone alone on the patients with acute carbon monoxide poisoning.

Objective To observe the effect to intracranial pressure by hyponome pressing the tune of hematoma post-operation in apoplexy.Methods Fifteen patients with intracranial hematoma in apoplexy were chose,placed hyponome in the tune after removal of intracerebral hemotomas and the probe of intracranial pressure monitor in the lateral ventricle.Dehydration therapy was arranged according to intracranial pressure recorded in operating and 3 days after operation.We rechecked CT at the first and third day after operation to get the message of rehaemorrhagia and encephaledema.Results We observed only one low-grade intracranial hypertension and the others kept normal during operation,4 cases low-grade and 1 cases middle-grade at the first day,5 cases low-grade and 2 cases middle-grade at the second day,6 cases low-grade,3 cases middle-grade and 1 cases high-grade at the third day.Conclusion There is slightly effect to intracranial pressure by hyponome pressing the tune of hematoma post-operation in apoplexy.

目的 探讨脑源性神经营养因子基因多态性(BDNF G196A)与海洛因依赖患者之间的相关性.方法 抽取120例海洛因依赖病人做研究,120例为健康体检者为对照.应用聚合酶链式反应(PCR)扩增技术对BDNF基因上的G196A基因多态性进行分型,运用SPAS10.0统计软件包进行数据分析.结果 120例海洛因依赖者BDNF G196A基因的基因型频率和等位基因频率与120例正常人群间比较无显著差异(P>0.05).结论 本研究尚未发现BDNF G196A基因多态性与海洛因依赖患者相关联.

鼻塞、流涕、打喷嚏……面对这些症状,你首先会想到什么?"感冒"估计是很多人的第一想法。其实,有很多疾病都会出现貌似感冒的症状,这就提醒我们要当心,不要把"假感冒"当"真感冒"

骨母细胞瘤是很少见的原发性骨肿瘤,好发于20～40岁的青壮年.四肢长骨及脊柱是常见好发部位.其发生率约占全部骨肿瘤的1%,占全部良性骨肿瘤的3.5%,有45%的骨母细胞瘤累及脊柱[1].

银杏又名白果,在宋代就被列为皇家贡品.从食用角度看,银杏果仁含有多种营养元素,如维生素C、核黄素、胡萝卜素、钙、磷、铁、钾、镁等矿物质及白果酚、银杏酸等成分. 根据现代医学研究,银杏具有通畅血管、改善大脑功能、延缓大脑衰老、增强记忆能力、治疗老年痴呆症和脑供血不足等功效.

Objective To investigate the value of simeticone in gastroscopy examination. Methods Two hundred and forty patients in our hospital were randomly divided into group A and B,group A were taken by simeticone,group B was the control group.The level of gastrointestinal air bubbles,cleanness and satisfaction of endoscopists during inspection were observed. Results The air bubbles in group A was significantly lower than that in group B,the difference was statistically significant(χ2=4.36;P0.05);the cleanness in group A was higher than that in group B,the difference was statistically significant(χ2=6.11;P0.05);the satisfaction of endoscopists in group A was higher than that in group B,the difference was statistically significant(χ2=4.85;P0.05). Conclusion Simeticone obtained obviously value in the gastroscopy examination.

白癜风和银屑病均为临床常见病,多为单发,两者同时发生在同一患者身上少见,笔者近期诊治1例,现报道如下. 临床资料 患者男,70岁.7年前发现双手背、双足背部、躯干等处皮肤发白,无自觉症状,逐渐增多扩大,当地医院诊断为白癜风,心理压力较大,采用多种方法治疗效果不佳,皮疹仍然发展,遂中断治疗,近2年来病情相对稳定.1年前感冒后半月左右发现左手背输液针眼处出现红色丘疹,皮疹在躯干四肢逐渐增多变大,于2009年1月来我院门诊诊治.患者既往体健,否认家族中有类似病史.

42岁的刘女士在一次单位例行体检时,胸部X线片发现右上肺有1厘米的小结节,CT扫描证实为"肺部孤立性结节"。虽经多科专家会诊,但结节的良恶性质难定,建议刘女士"手术切除或定期复查"。刘女士感觉这身体里好似埋了

Objective:To preliminarily evaluate the efficacy of hypofractionated 3 dimensional conformal radiotherapy(HFCRT) for locally advanced prostate cancer.Methods:This retrospective study includes 18 cases of locally advanced prostate cancer(phase T4).Nine cases received HFCRT alone,with 40-58Gy/8-16F/2.5-4 weeks,the others received conventional whole pelvic external beams irradiation with 36-40Gy/18-20F/3.5-4 weeks,followed by 3DCRT with 16-24Gy/4-5F/2-3 weeks.We evaluated the biological effective dose(BED),the state of tumors local control and clinical effect and side effect of radiotherapy for prostate cancer.Results:The average BED at prostate cancer was (125±9.8)Gy(α/β ratio 2.6Gy);8 tumors were complete response and 10 tumors were partial response;Most morbid symptoms were alleviated and none of patients experienced ≥degree Ⅲ toxicity (RGOT & EORTC criteria).Conclusion:HFCRT revealed a better effect for the locally advanced prostate cancer,maybe high fractionated dose is an important advantage.

我院自2007年12月至2008年12月共诊治局限于小腿部浸润肥厚性寻常型银屑病96例,分组采用积雪苷霜或雷公藤内酯软膏联合温泉浴和松馏油软膏治疗,对比观察疗效,现报道如下.

我国现有的保肝降酶药物难以数计,主要含有五味子丙素、水飞蓟素、甘草酸等化学成分.这些药物可以使血液中超标的转氨酶迅速降低,获得肝功检查一个重要项目的复常.但是对于乙肝患者来说,单纯的转氨酶复常只是解决了表面问题,对于疾病的实质没有帮助;大量使用"降酶药物"有可能掩盖病情,贻误抗病毒治疗时机.

现在各种媒体上的药物广告不少,虽然国家有关部门已开始对药品广告严格审查,但仍有挡不住"鬼子进庄"之势.君不见,只要您打开电视报刊,明星、名人喋喋不休地向您介绍药品,俊男靓女起劲地向您推荐药品,连老人孩子也言不由衷地称赞某种药品的功效,似乎他们所宣传的药品都能药到病除.于是,有人信以为真,照方抓药,结果是吃完广告药又想买"后悔药".

临床资料 患者女,42岁.因躯干、四肢出现淡褐色斑3年,于2006年7月15日来我科就诊.

1 病例介绍 患者女性,26岁,主诉阴道流液15小时入院.查体生命体征正常,心肺正常,不规律宫缩.无过敏史、无家族遗传史.诊断:妊娠38+5周,孕1产0枕位,胎膜早破入院.入院后考虑破水时间超过12小时给予抗生素治疗.做青霉素皮试(-),输液时护士未询问患者是否对碘伏过敏.

国际上公认的流感治疗药物主要有两种:1罗氏公司研发的磷酸奥司他韦胶囊(商品名达菲),2葛兰素史克公司研发的扎纳米韦吸入粉雾剂(商品名乐感清或瑞乐沙).扎那米韦(zanamivir)1991年由澳大利亚的von Itzstein等合成[1].