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1.
汪铮  陈孝谦  张春美  李秀 《临床肺科杂志》2013,18(10):1932-1933
柴油误吸患者在呼吸内科较少见到.我科成功救治1例柴油吸入致外源性类脂性肺炎患者,现报告如下.  相似文献   

2.
<正>类脂性肺炎是肺对一些脂类物质的炎症反应,临床上并不常见,可根据脂类来源分为内源性及外源性类脂性肺炎。内源性主要是由骨折、肺癌、错构瘤、脂肪瘤等疾病所引起;外源性多由误吸汽油、柴油、石蜡油等矿物质油、植物油、动物油引起。为进一步学习类脂性肺炎的临床特点及诊治措施,现将我院收治的1例柴油吸入性肺炎患者进行临床分析。  相似文献   

3.
<正>外源性类脂性肺炎(exogenous lipoid pneumonia,ELP)是临床上一种少见的吸入性肺炎,其临床症状及影像学表现无特异性,易与多种肺部疾病(肺炎、肿瘤、结核、囊性纤维化等)相混淆,容易误诊~([1])。目前国内外相关报道较少,现通过我院收治的1例柴油吸入致外源性类脂性肺炎诊治经过,结合相关文献,加强对此疾病的进一步认识。  相似文献   

4.
正类脂性肺炎(lipoid pneumonia)或称脂质性肺炎是一种临床少见疾病,分为内源性类脂性肺炎(endogenous lipoid pneumonia)和外源性类脂性肺炎(exogenous lipoid pneumonia)。内源性类脂性肺炎又称胆固醇性肺炎(cholesterol pneumonia),主要是由骨折、肺癌、错构瘤、脂肪瘤、脂肪肉瘤等疾病所引起[1]。外源性类脂性肺炎多由误吸汽油、柴油、石蜡油、鱼肝油等矿物质油、植物油、动物脂油引  相似文献   

5.
氟康唑吸入治疗重症肝炎合并肺部真菌感染19例报告   总被引:1,自引:0,他引:1  
20 0 0~2 0 0 2年,我们应用氟康唑超声雾化吸入治疗重症肝炎合并肺部真菌感染19例,取得满意效果。现报告如下。临床资料:19例患者均符合1995年全国传染病与寄生虫病会议修订的重症肝炎的诊断标准,痰中查到白色念珠菌孢子菌丝生长。主要临床表现为咳嗽、低热、呼吸困难、咳白色粘胶样痰或血性痰,两肺可闻及湿罗音;X线表现为散在支气管肺炎。方法:全部患者在治疗重症肝炎基础上加用氟康唑6 0 mg,生理盐水2 0 ml,超声雾化吸入,每日1次,共用14天。治疗期间每周复查肝功能、痰涂片及痰培养。结果:治疗1周复查时11例痰中无真菌;其余8例治疗2周结…  相似文献   

6.
目的 提高甲状腺功能减退致类多肌炎样综合征的认识.方法 报道4例确诊为原发性甲状腺功能减退致类多肌炎样综合征的临床特点.结果 4例患者均为男性,开始均出现双下肢乏力和肌酸激酶明显增高等类多肌炎样表现,后检查确诊为原发性甲状腺功能减退,经过甲状腺激素补充治疗后类多肌炎样表现明显好转.结论 甲状腺功能减退可合并类多肌炎样综合征,临床上肌酸激酶增高时应注意筛杳甲状腺功能.  相似文献   

7.
脂质性肺炎是一种临床少见的疾病,包括外源性脂质性肺炎和内源性脂质性肺炎。外源性脂质性肺炎(exogenous lipoid pneumonia,ELP)是指油脂类物误吸入肺内所致的肺部急慢性炎性反应、局部肺纤维化或肉芽肿。因其临床症状及影像学表现缺乏特异性,容易误诊和漏诊。本文通过对病理确诊的外源性脂质性肺炎3例患者的临床资料的回顾性分析,提高临床医师对脂质性肺炎的认识。  相似文献   

8.
目的探讨麻疹肺炎合并急性呼吸窘迫综合征(ARDS)患儿吸入外源性一氧化氮(NO)治疗后呼吸功能变化。方法 12例麻疹肺炎合并ARDS患儿在进行药物治疗、机械通气的同时采用外源性NO吸入治疗,NO起始治疗体积分数为10×10-6,分别监测吸入前,吸入后0.5、6、12、24、48 h不同时间点的SaO2、PaO2、氧合指数;至某个时间点NO治疗效果不明显时,将体积分数降低50%,每2 h递减50%,直至停用。结果吸入NO后24 h内,SaO2、PaO2、氧合指数与吸入前比均明显升高(P〈0.05)。50 h吸入NO降体积分数低50%后与48 h相比,各指标显著降低(P〈0.05),52 h NO体积分数再减50%后与50 h相比,各指标无统计学差异(P〉0.05)。结论一定时间内吸入适宜浓度的外源性NO可有效改善麻疹肺炎合并ARDS患儿的气体交换功能。  相似文献   

9.
目的:探讨氨苯砜致传染性单核细胞增多症样综合征的认识及其临床意义。方法:对2例患者的临床资料、血液学及相关实验室检查进行分析并复习相关文献。结果:2例外周血白细胞计数中异型淋巴细胞分别为29%、36%,以DowneyⅠ型居多,例1骨髓涂片及淋巴结病理检查亦见此类细胞,例1嗜异性凝集试验与例2EBV-DNA检测结果均为阴性,结合临床病史即时作出了正确的诊断与治疗。结论:氨苯砜致传染性单核细胞增多症样综合征为一药物过敏反应,故采用以糖皮质激素为主的综合治疗,是使患者得以痊愈的关键。  相似文献   

10.
1990~1999年,我们应用莨菪浸膏片预防糖尿病周围神经病变30例,取得满意效果。现报告如下。一般资料:本组60例2型糖尿病患者均按WHO1980年拟定的标准诊断,均为初治者,无周围神经病变。随机分为两组,治疗组30例,男16例,女14例。两组年龄40~60岁。两组均连续观察9年。治疗:治疗组予以降糖药(剂量视血糖高低而定)、莨菪浸膏片(每日300mg,分3次口服)和维生素类。对照组予以降糖药及维生素类。结果:治疗组有10例阳性:(治疗期间出现肢体疼痛、麻木、虫爬、蚁走、灼热触电样感觉异觉或感觉减退,腱反射减弱或消失)肢痛4例,灼热感4例,蚁走感2例。…  相似文献   

11.
Relying on a certain degree of abstraction, we can propose that no particular distinction exists between animate or living matter and inanimate matter. While focusing attention on some specifics, the dividing line between the two can be drawn. The most apparent distinction is in the level of structural and functional organization with the dissimilar streams of ‘energy flow’ between the observed entity and the surrounding environment. In essence, living matter is created from inanimate matter which is organized to contain internal intense energy processes and maintain lower intensity energy exchange processes with the environment. Taking internal and external energy processes into account, we contend in this paper that living matter can be referred to as matter of dissipative structure, with this structure assumed to be a common quality of all living creatures and living matter in general. Interruption of internal energy conversion processes and terminating the controlled energy exchange with the environment leads to degeneration of dissipative structure and reduction of the same to inanimate matter, (gas, liquid and/or solid inanimate substances), and ultimately what can be called ‘death.’ This concept of what we call dissipative nature can be extended from living organisms to social groups of animals, to mankind. An analogy based on the organization of matter provides a basis for a functional model of living entities. The models relies on the parallels among the three central structures of any cell (nucleus, cytoplasm and outer membrane) and the human body (central organs, body fluids along with the connective tissues, and external skin integument). This three-part structural organization may be observed almost universally in nature. It can be observed from the atomic structure to the planetary and intergalactic organizations. This similarity is corroborated by the membrane theory applied to living organisms. According to the energy nature of living matter and the proposed functional model, the decreased integrity of a human body's external envelope membrane is a first cause of the structural degradation and aging of the entire organism. The aging process than progresses externally to internally, as in single cell organisms, suggesting that much of the efforts towards the restoration and maintenance of the mechanisms responsible for structural development should be focused accordingly, on the membrane, i.e., the skin. Numerous reports indicate that all parts of the human body, like: bones, blood with blood vessels, muscles, skin, and so on, have some ability for restoration. Therefore, actual revival of not only aging tissue of the human body's membrane, but the entire human body enclosed within, with all internal organs, might be expected. We assess several aging theories within the context of our model and provide suggestions on how to activate the body's own anti-aging mechanisms and increase longevity. This paper presents some analogies and some distinctions that exist between the living dissipative structure matter and inanimate matter, discusses the aging process and proposes certain aging reversal solutions.  相似文献   

12.
The immunoneuroendocrine role of melatonin   总被引:19,自引:0,他引:19  
Abstract: A tight, physiological link between the pineal gland and the immune system is emerging from a series of experimental studies. This link might reflect the evolutionary connection between self-recognition and reproduction. Pinealectomy or other experimental methods which inhibit melatonin synthesis and secretion induce a state of immunodepression which is counteracted by melatonin. In general, melatonin seems to have an immunoenhancing effect that is particularly apparent in immunodepressive states. The negative effect of acute stress or immunosuppressive pharmacological treatments on various immune parameters are counteracted by melatonin. It seems important to note that one of the main targets of melatonin is the thymus, i.e., the central organ of the immune system. The clinical use of melatonin as an immunotherapeutic agent seems promising in primary and secondary immunodeficiencies as well as in cancer immunotherapy. The immunoenhancing action of melatonin seems to be mediated by T-helper cell-derived opioid peptides as well as by lymphokines and, perhaps, by pituitary hormones. Melatonin-induced-immuno-opioids (MHO) and lymphokines imply the presence of specific binding sites or melatonin receptors on cells of the immune system. On the other hand, lymphokines such as -γ-interferon and interleukin-2 as well as thymic hormones can modulate the synthesis of melatonin in the pineal gland. The pineal gland might thus be viewed as the crux of a sophisticated immunoneuroendocrine network which functions as an unconscious, diffuse sensory organ.  相似文献   

13.
Abstract: The effect of swimming at night on rat pineal melatonin synthesis was compared with that of light exposure at night. Rats were forced to swim at 0030 hr (lights out at 2000 hr) and sacrificed by decapitation 15 and 30 min later, immediately after swimming. Other groups of animals were exposed to white light (650μW/cm2) for 15 and 30 min at same time. Swimming caused a rapid and highly significant drop in the melatonin content in the pineal gland; however, the activity of N-acetyltransferase (NAT), the supposed rate limiting enzyme in the melatonin production, was not changed. Despite the drop in pineal melatonin levels, serum concentrations of the indole remained elevated in the rats that swam. In contrast, melatonin levels in the pineal and serum of light exposed rats fell precipitously, accompanied by a significant suppression of NAT activity. Since we anticipated that the strenuous exercise associated with swimming may induce release of artrial natriuretic peptide (ANP) from the heart, which in turn could cause the release of pineal melatonin, in a second study we injected physiological saline intravenously to stretch the cardiac muscle and release ANP. Three milliliters of normal saline was injected during the day into the jugular vein of anesthetized rats that were pretreated with isoproterenol to stimulate pineal melatonin production. Animals were killed 15 min after the saline injection, and pineal NAT activity and pineal melatonin levels were measured. The saline injections caused no alteration in the elevated levels of either NAT or melatonin. These data suggest that the disparity in pineal NAT activity (which was high) and pineal melatonin (which was low), in animals swum at night, may not be caused by ANP which is released during strenuous exercise such as swimming.  相似文献   

14.
15.
Abstract: Herein we documented the response of pineal melatonin production to electrolytes known to be effective on pineal function in view of a possible circadian stage dependence. We studied the release of melatonin by perifused rat pineal glands at 2 different circadian stages corresponding to the middle of the light and dark periods, i.e., respectively, 7 and 19 HALO (Hours After Light Onset, L:D = 12:12). The initial efflux rates were, as expected, much higher in the perifusates of glands removed from rats sacrificed during the dark phase than of those removed during the light phase. After 3 hr of perifusion, melatonin release reached similar levels which were found constant up to the 8th hr of perifusion, whatever the circadian stage. Perifusion of the glands with physiological concentrations for the rat of calcium (5.2 mmol/1) and magnesium (1.34 mmol/1) resulted in a stimulatory effect on the pineal glands removed from rats sacrificed in the middle of the dark period (19 HALO), whereas no effects were observed on the pineal glands removed from rats sacrificed during the light (7 HALO). Lithium (0.28 and 0.55 mmol/1) was ineffective on melatonin release in pineal glands removed 7 and 19 HALO. Our results show differences in the initial efflux rates of melatonin and in the response of perifused pineal glands to calcium and magnesium according to the circadian stage.  相似文献   

16.
Abstract: Well-established circadian physiology supports the view that photoperiodic time measurement utilizes the coincidence between the presence of light and a photosensitive phase of a 'biological clock' to alter reproductive status—the so-called external coincidence model of seasonal breeding. In this review, we examine the mechanism whereby photoperiod interacts with presumed suprachiasmatic nuclei activity to allow endogenous melatonin to normally synchronize reproductive activity to the optimal time of year. The Romney Marsh sheep is particularly explored as an experimental model. It is suggested that the on/off activity of seasonal reproduction may be a robust mechanism able to be predictably manipulated by the judicious use of the light/dark cycle and exogenous melatonin, but firmly based on circadian principles.  相似文献   

17.
Microbiology of human immunodeficiency virus anorectal disease   总被引:3,自引:3,他引:0  
PURPOSE: Individuals who are seropositive for the human immunodeficiency virus are at high risk for opportunistic infection and anorectal disorders. Little prospective information is available regarding anorectal pathogens in these patients. METHODS: One hundred sixty-three HIV-seropositive patients presented to the colorectal clinic between 1989 and 1992. Forty-seven (29 percent) patients were thought to have an infectious process and were prospectively studied using a standardized multiculture protocol. RESULTS: Mean age was 33 (range, 19–59) years. All were male; high-risk behavior accounted for 87 percent of HIV transmissions. Presenting complaints included anorectal pain (79 percent), pus per anum (28 percent), and blood per anum (26 percent). Examination revealed perianal tenderness (60 percent), condyloma (38 percent), perianal ulcers (38 percent), and anal fissures (34 percent). Sixty-six sets of cultures were performed; 28 patients had one set, 15 had two sets, and 4 had three sets. Thirty-two of these 47 patients (68 percent) had positive cultures including herpes (50 percent), cytomegalovirus (25 percent),Neisseria gonorrhoeae (16 percent), chlamydia (16 percent), acidfast bacilli (2 percent), and others (9 percent). Six of 32 patients with positive cultures had more than one organism cultured. Sixteen (50 percent) patients with positive cultures were treated medically, 8 (25 percent) were treated surgically and 8 (25 percent) were treated with both modalities. Sixty-one procedures were performed on 17 patients for condylomata. Eighteen patients had 20 procedures for abscesses, 50 percent of whom had positive cultures for other than common bowel flora; all improved. Fourteen patients underwent 33 procedures for perianal fistulas.Mycobacterium fortuitum was cultured from one patient who required 13 procedures for abscesses and fistulas. Forty-five (96 percent) patients were followed for an average of 12.5 months ±2.9 SEM (range, 1–94 months). Symptoms were improved or resolved in 22 of 32 (69 percent) patients with positive cultures and in 11 of 13 (84 percent) with negative cultures. CONCLUSIONS: Specific pathogens may often be identified in human immunodeficiency virus-seropositive patients with anorectal disorders if aggressively sought. Although patients without specific pathogens identified may be expected to improve with planned empiric treatment, positive identification allows more directed therapy.  相似文献   

18.
Postural orthostatic tachycardia syndrome (POTS) is a badly known pathology because its diagnosis is not based on the conventional methods of investigation. The orthostatic test allows to make the diagnosis easily. The objective of this study is to determine cardiovascular autonomic reflexes of 70 patients having POTS. The tests of exploration of the autonomic nervous system practised are: deep breathing, hand grip, mental stress and orthostatic test. The analysis of orthostatic test showed that the increase of the cardiac frequency, relative to the state of “β” peripheral sympathetic hyperactivity occurred before the 2nd minute in 80% of patients. The POTS was considered “florid” in 43% of patients and had complicated of a rough and severe fall of systolic blood pressure inferior to 70 mmHg in four patients, after the fifth minute of the test. The analysis of the different tests had shown vagale hyperactivity in 63% of patients on deep breathing, in 93% of patients on hand grip and in 100% on orthostatic test. The “α” central sympathetic activity was increased in 76% of the cases and “β” central sympathetic activity was high in 83% of cases. The “α” peripheral hyperactivity was observed in 63% of patients on hand grip, and in 44% on orthostatic test. The analysis of cardiovascular autonomic reflexes on patients affected by POTS allowing the determination of their autonomic profile, will contribute probably to a better understanding of this pathology and to a better orientation of its care.  相似文献   

19.
Duodenal diverticula are a relatively common condition. They are asymptomatic, unless they become complicated, with perforation being the rarest but most severe complication. Surgical treatment is the most frequently performed approach. We report the case of a patient with a perforated duodenal diverticulum, which was diagnosed early and treated conservatively with antibiotics and percutaneous drainage of secondary retroperitoneal abscesses. We suggest this method could be an acceptable option for the management of similar cases, provided that the patient is in good general condition and without septic signs.  相似文献   

20.
Abstract: The abundance of gap junctions between rat pineal astrocytes formed by connexin43 (Cx43) was studied during development. Levels and distribution of Cx43 were measured by immunoblotting and indirect immunofluorescence, respectively. The amount of Cx43 in cells located within the gland was low until about the 7th postnatal day and increased to adult values between the 14th and 21st days postpartum. Although astrocytes, recognized by their vimentin immunoreactivity, were scarce before birth, they were abundant by the 7th postnatal day suggesting that the low levels of Cx43 found at this age corresponded to a low expression of this protein. Localization of the immunoreactivity to Cx43 and vimentin showed a close correlation, indicating that mature or immature pineal astrocytes form gap junctions made of Cx43. Since Cx43 levels attained their adult values at about the time the innervation and the functional state of the gland reached maturity (2–3 weeks after birth), it is proposed that astrocyte gap junctions are involved in the function of the adult rat pineal gland.  相似文献   

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