肺栓塞25例临床分析

肺动脉血栓栓塞(PE)是由内源性或外源性栓子堵塞肺动脉引起肺循环障碍的临床综合症。肺栓塞是一个常见病，但过去由于对本病的认识不足，其临床漏诊、误诊率很高。正确治疗者病死率仅8％，而治疗不当者病死率高达25—30％。如何提高对本病的认识，及时正确诊断及治疗。避免误诊是一个值得重视的问题，我院近3年来诊断治疗肺栓塞25例，现就诊断治疗情况介绍如下：     

20例浆细胞性乳腺炎的诊治体会

浆细胞性乳腺炎是乳腺导管扩张症病程中的一个阶段。本病由于炎性浸润及纤维组织增生而形成肿块，临床表现酷似乳腺癌，致使术前诊断十分因难，误诊率很高。我院1996年8月～2004年1月共收治本病20例，术前误诊10例。故本病虽不多见，但在与乳腺癌鉴别诊断上占重要位置。本文分析20例浆细胞性乳腺炎的临床表现，并对诊断及治疗进行讨论。     

主动脉窦瘤破裂的诊断与外科治疗（附35例报告）

主动脉窦瘤破裂的诊断与外科治疗（附３５例报告）天津胸科医院心外科李培军，姜　楠，左景珍，李庆和主动脉窦瘤破裂较少见，本病发病率东方人高于西方人，但在我国并非罕见，早期诊断并手术治疗可以治愈。阜外医院从１９５９年１０月～１９８８年１２月共收治１２８例，...     

成人急性会厌炎（附65例分析）

报告了我院１９８５年８月至１９９３年２月收治的６５例２６～６５岁的急性会厌炎，对其病因、症状、诊断及治疗作了简要的分析讨论，指出成人急性会厌炎的诊断并非困难，及时诊断，合理治疗，予后良好。但忽视早期正确诊断及处理，特别是对本病的抢救的准备工作忽视或认识不足，也会危及病人的生命。     

孤立性蝶窦病变的鼻内镜治疗

目的探讨孤立性垛窦病变的临床诊断和治疗。方法对12例孤立性蝶窦炎性病变的临床资料进行回顾性分析。结果12例随访半年-5年无复发，1倒术后1年奏口封闭再次手术。结论本病早期可无特殊表现。CT检查对早期诊断本病有较大价值，对手术有指导意义。鼻内窥镜手术对治疗本病有明显的优越性。     

反复溶血性肝豆状核变性患者的误诊分析

肝豆状核变性（HLD）属先天性遗传代谢病，目前少数患者能够用药物治疗，若能早期诊断、早期治疗，预后良好。但是，本病临床表现多样，极易误诊。文献报道误诊率达67%。如果晚期确诊则预后不佳。因此，早期诊断、早期治疗是改善本病预后的关键。我科近期收治1例，病史1年多，在外院多次洪诊。为提高对本病的认识，减少误诊，现报道如下。     

小儿巨大网膜囊肿7例的外科治疗

大网膜囊肿较为少见，诊断不易。我院1981年6月-2000年6月手术治疗小儿巨大网膜囊肿7例，现予报告，并就本病的诊断及治疗进行讨论。     

腹部术后并发ARDS临床研究

目的：探讨腹部术后并发症ARDS的早期诊断及治疗。方法：对1993年-2002年的22例术后并发ARDS的诊治进行回顾性分析。结果：22例中12例好转，7例死亡，3例自行出院。结论：PaCO2呈渐进性下降对本病诊断十分重要，急诊床边胸片亦有一定价值，呼吸支持原发病治疗，预防性治疗在本病的治疗中具有很重要的意义。     

肾嗜酸细胞瘤3例报告并文献复习

肾嗜酸细胞瘤较为少见，术前很难确诊，但本病又为良性病变。如能在术前或术中确诊则有可能避免过度治疗。我科于2004年11月至2005年4月收治3例，此前我院并无该病的诊断病例。现将相关临床资料及诊疗经过结合文献报告如下。以加深我们对。肾嗜酸细胞瘤的认识，提高对本病的诊治水平。     

小肠出血的诊断及病因分析

小肠出血在临床上并不常见，占消化道出血的3％～5％，本病常反复发作．但缺乏特异性，给诊断带来了困难。山西煤炭中心医院消化科自2006年5月至2007年6月对收治的18例小肠出血患者采用胶囊内镜及双气囊小肠镜等方法进行诊断，提高了诊断率，缩短了治疗时间。现报告如下。     

Value of D-Dimers in patients with acute aortic dissection

Objective: To evaluatel the value of D-dimers in patients with acute aortic dissection (AAD). Methods: This study consisted of 16 patients with AAD and 27 non-AAD patients. Serum D-dimets were measured by Sta-Liatest D-DI immunoturbidimetric assay. Results: D-dimer level was higher (P ＜ 0.001) in patients with AAD(7.91 ± 5.52 μg/ml) than that in non- AAD group(1.57±1.24 μg/ml). D-dimer was positive (＞0.4 μg/ml) in all patients with AAD and in 10 control group patients (37%). Among patients with acute AAD, D-dimers tended to be higher in Stanford A than in Stanford B (8.67 ± 4.31 μg/ml vs. 3.24±1.27 μg/ml, P ＜0.01). D-dimer values tended to be higher in more extended disease(3.84 ± 1.65 μg/ml, 8.57 ± 3.58 μg/ml and 11.87 ± 5.69 μg/ml in thoracic aorta, thoracic and abdominal aorta, thoracic and abdominal aorta and iliacal arteries, respectively, P ＜ 0.05 for both 8.57 ± 3.58 and 11.87 ± 5.69 vs. 3.84 ± 1.65 ). Including the control group into the analysis, we found a sensitivity of 100%, a negative predictive value of 100%, and a specificity of 66% and a positive predictive value of 64% for D-dimer in diagnosis of AAD in our patients with suspected AAD. Conclusion: D-dimer was elevated in patients with AAD. A negative D-dimer test result could be useful in excluding AAD.     

Research of combined liver-kidney transplantation model in rats

Objective： To set up a simple and reliable rat model of combined liver-kidney transplantation. Methods： SD rats served as both donors and recipients. 4℃ sodium lactate Ringer＇s was infused from portal veins to donated livers,and from abdominal aorta to donated kidneys, respectively. Anastomosis of the portal vein and the inferior vena cava （IVC） inferior to the right kidney between the graft and the recipient was performed by a double cuff method, then the superior hepatic vena cava with suture. A patch of donated renal artery was anastomosed to the recipient abdominal aorta. The urethra and bile duct were reconstructed with a simple inside bracket. Results： Among 65 cases of combined liver-kidney transplantation, the success rate in the late 40 cases was 77.5%. The function of the grafted liver and kidney remained normal. Conclusion： This rat model of combined liver-kidney transplantation can be established in common laboratory conditions with high success rate and meet the needs of renal transplantation experiment.     

APPLICATION OF LORNOXICAM TO PATIENT-CONTROLLED ANALGESIA IN PATIENTS UNDERGOING ABDOMINAL SURGERIES

FOR anesthesiologis s ,treatingpostoperativepainhas alwaysbeen a problem.Althoughopioidshave been provedtobe effective,theirsideeffectscouldnotbeignored.With thedevelopmentofscienceand pharmacology,many drugs with aspectsof satisfactoryanalgesicefficacyand couldbe welltoleratedby patientshave been developed.And lornoxicamisone of them, which isa non-steroidalanti-inflammatorydrug (NSAID ), with analgesic, anti-infl-ammatory,andantipyreticproperties.Itseliminationhalf-time(3 to 5 hours) isle…     

BLOOD PRESSURE CHANGE WITH AGE IN SALT-SENSITIVE TEENAGERS

Objective To observe blood pressure change with age in salt-sensitive teenagers whose salt sensitivity were determined by repeated testing.Methods Salt sensitivity was determined through intravenous infusion of normal saline combined with volume-depletion by oral diuretic furosemide in 55 teenagers. After five years, salt sensitivity was re-examined and subject blood pressure was followed up. Blood pressure changes in salt-sensitive teenagers were compared to that of non-salt sensitive teenagers over five years.Results After 5 years, the repetition rate of salt sensitivity determined by intravenous saline loading is 92.7%. In teenagers with salt sensitivity on the baseline, both the systolic blood pressure increments and increment rates were much higher than non-salt sensitive teenagers (12.7±12.1 mmHg vs. 2.8±5.2 mmHg, P＜ 0.01; 12.2%± 12.0% vs. 2.5% ±4.4%, P＜ 0.001,respectively). There was a similar trend for diastolic blood pressure (8.4 ± 6.4 mmHg vs. 3.7 ± 6.4 mmHg, P = 0.052; 13.2% ±10.6 % vs. 6.8%± 10.1%, P = 0.053, respectively).Conclusions Salt sensitivity determined by intravenous saline loading showed good reproducibility. Blood pressure increments with age were much higher in salt-sensitive teenagers than non-salt sensitive teenagers, especially in terms of systolic blood pressure.     

Development on Adjustable Calibration Marker for Shock Wave Focus

Shock wave lithotripsy （SWL） is a treatment of choice for upper urinary stones. However, this procedure is inappropriate for obese patients because the focus is often unable to reach the target owing to the limited focal distance in shock wave source. Although treating such patients in a blast path may increase the application length of shock wave source, it＇s difficult to find this path on the lithotripter monitor. For this reason, we invented an adjustable calibration marker in order to set an effective focus in the shock wave hath.     

Study on the TCM Pathogenesis of Angiopathic Complications of Type II Diabetes

Excess production of reactive oxygen species(ROS)of mitochondrion mediated by hyperglycemia is the common pathogenesis of angiopathic complications of diabetes.TCM holds that the damp from the dysfunction of spleen.kidney and liver is the causative factor of complications of diabetes.This is similar to the mechanism of Ros resulting in angiopathic complications of diabetes.When the angiopathic complications of type II diabetes mellitus(T2DM)are difierentiated as caused by turbid damp in TCM can be explained as ROS.Since the obstruction of pathogenic damp in channels and collaterals is said to be the main pathogenesis,the treating principle should be dissolving the damp to remove the obstruction.     

Leptin, Ghrelin and TNF-α before and after Hypo-caloric Traditional Chinese Diet and Auricular Acupuncture

INTRODUCTION Obesity is a complex emergent problem, which can be possibly solved not only by the diet but also by the life style and promotion of a constant physical exercise. 1, 2 No doubt careful attentions must be given to the nutritional condition of obese people, the dietary habits, the somatic build (i.e. distribution of fat mass) and the organic functions linked to formation of the fat mass. All the parameters should be constantly monitored before, during and after a diet treatment. 3, 4, 5     

Relationship between Dysglycemia and Carotid Atherosclerosis in Tibetan Population

People with dysglycemia are at high risk for atherosclerotic diseases. This study aims at investigating the atherosclerotic vascular damage in dysglycemia and its metabolic origin in Tibetan population.     

Acupuncture Combined with Spinal Tui Na for Treatment of Primary Dysmenorrhea in 30 Cases

Objective: To observe the therapeutic effects in acupunture treatment of primary dysmenorrhea combined with spinal Tui Na, and study its mechanism. Methods: Thirty cases of the treatment group were treated by acupuncture combined with spinal Tui Na, and thirty cases in the control group were treated by routine acupuncture. Results: The total effective rate was 93.3% in the treatment group, and 73.3% in the control group, with a significant difference between the two groups (P<0.05). Conclusions: Acupuncture combined with spinal Tui Na has good prospects for treatment of primary dysmenorrhea.     

Luo Lingjie's Experience in Treating Chronic Nephropathy

In treating chronic nephropathy,Luo Lingjie,a chief physician,pays attention to regulating the balance between yin and yang,treating infection if present,and removing pathogenic factors.He prescribes gentle drugs and uses carefully strongly warming-tonifying ones,emphasizes the importance of persuading the patient to persist in treatment with medication and nurse one's health for recuperation,and is good at combined use of TCM and western medicine therapy and brings the merits of various therapies into full play,with obvious theraoeutic effects.