目的:探讨通里攻下法对急性呼吸窘迫综合征(ARDS)的疗效及可能的作用机制.方法:选择80例ARDS患者,随机分为对照组、观察组.对照组常规给予广谱抗生素抗感染、纠正电解质紊乱酸碱失衡、营养支持、机械通气等治疗;观察组在对照组治疗基础上,鼻饲小承气汤加减400 mL早晚分服,连续7 d.观察治疗前及7 d后的氧合指数(PaO2/FiO2)、APACHEⅡ评分、血小板(PLT)、活化部分凝血酶时间(APTT)变化,以及机械通气时间、ICU平均住院时间、多器官功能不全(MODS)发生率、28 d病死率.结果:两组治疗7 d后,PaO2/FiO2均较治疗前明显升高(对照组187.7±25.8,252.4±26.8;观察组186.5±29.6,312.3±19.8;P<0.05).两组治疗后较治疗前APACHEⅡ评分有差异(对照组23.8±3.1,18.8±1.7;观察组22.6±4.6,12.6±2.1;P<0.01).两组PLT、APTT治疗后比较无差异(P>0.05).对照组与观察组机械通气时间[(6.38±4.65)d vs(5.11±2.18)d]、ICU平均住院时间[(8.25±3.75)d vs(7.23±2.88)d]、MODS发生率(21%vs 11%)、28 d病死率(23%vs 15%)差异具有统计学意义(P<0.05).结论:与常规治疗相比,结合通里攻下法治疗能更快改善ARDS患者氧和水平,减少病死率,改善预后.

Objective To observe and analyze the clinical therapeutic effect of BiPAP on respiratory failure caused by severe asthma. Methods 52 cases with respiratory failure due to severe asthma admitted in our hospital from May 2013 to May 2014 were selected as the subjects and randomly divided into two groups, namely, group A(26 cases) and group B(26 cases). Patients in group B were treated by the conventional therapy, and those in group A were treated by bi-level positive airway pressure (BiPAP) venti-lation based on the conventional therapy. And the clinical efficacy of the two groups was observed and compared. Results After treatment, the heart rate, respiration, PaO2 and PaCO2 and other indicators of group A were much better than those before treatment with statistical significant differences (P<0.05); the heart rate, respiration, PaO2 and PaCO2 and other indicators of group B after treatment were better than those before treatment with statistically significant differences (P<0.05); after treatment, the levels of PaO2 and PaCO2 of group A were obviously better than those of group B, there were statistically significant differences between the two groups(P<0.05). Conclusion For respiratory failure caused by severe asthma, BiPAP ventilation has ideal treatment effect, so it is worthy of clinical application and promotion vigorously.

目的:研究对充血性心衰患者采取参附注射液联合常规疗法的临床疗效。方法:将70例充血性心衰患者随机分为治疗组和对照组各35例,对照组采取常规疗法,治疗组采取参附注射液联合常规疗法,并对两组疗效进行比较。结果:治疗组总有效率为94.3%,对照组77.1%,两组结果差异有可比性。结论:常规疗法联合参附注射液治疗充血性心力衰竭安全有效,值得推广应用。

Objective To investigate co-expression of hypoxia-inducible factor-1α(HIF-1α) and hepatocyte growth factor(HGF) and their association with lymphangiogenesis in non-small-cell lung cancer(NSCLC).Methods Applying the immunohistochemical technique,the lymphatic micro-vessel density(LMVD) and expressions of HIF-1α and HGF in 126 patients with NSCLC and 20 peri-cancerous normal lung tissue samples were determined.Relationships of expressions of HIF-1α and HGF with LMVD and clinicopathological factors were analyzed.Results Expression of HIF-1α was positively related to expression of HGF(R2=0.590,P<0.05).Expressions of HIF-1α and HGF in NSCLC tissues were significantly higher than in peri-cancerous normal lung tissues(17.5250±2.2869 vs 1.7650±0.7353,P<0.05).Higher LMVD was found in NSCLC samples with positive HIF-1α and HGF expressions than those with negative expressions(P<0.05).Expressions of HIF-1α and HGF were significantly associated with the TNM stage and lymph node metastasis(P<0.05),while they had no significant correlation with sex,age,tumor size,histological type and differentiation grade(P>0.05).Conclusion Co-expression of HIF-1α and HGF exists in NSCLC,moreover,over-expressions of HIF-1α and HGF can promote lymphangiogenesis and lymph node metastasis.