下腔静脉平滑肌肉瘤误诊一例

病例资料患者,女,60岁.胸闷、双下肢水肿1月余,活动后心慌10天.查体:一般情况好,体温、血压正常.肝肾区无叩痛,双下肢凹陷性水肿,持续性.实验室检查:白细胞19.0×109/l,红细胞4.55×1012/l,谷丙转氨酶227U/l,谷草转氨酶132U/l,尿常规(-),乙肝五项(-),类风湿因子(-),抗链"O"(-),C反应蛋白(-).     

胸内结节病8例误诊情况分析

结节病是一种临床较少见的原因未明的多系统肉芽肿性疾病,临床表现无特异性,确诊较困难,特别是肺结节病Ⅰ期常与中央型肺癌、肺门淋巴结结核、淋巴瘤、恶性肿瘤淋巴结转移等混淆,导致误诊误治.本文对8例确诊为肺结节病患者的诊断经过及临床资料进行总结分析如下.     

上消化道出血为首发症状的小脑出血（附3例报告）

上消化道出血为首发症状的小脑出血（附３例报告）袁静（附属第一院神经内科）孙荣（台安县恩良医院内科）马晓达（锦州市职业病防治所）小脑出血约占脑出血的１０～１５％，临床表现多以突发头痛、恶心、呕吐、眩晕、不能站立行走或步态不稳为首发症状［１］，但以上消化...     

二氯胺基酚诱发的染色体畸变及染毒时间对畸变率的影响研究

２，４－二氯胺基酚（ＤＣＡＰ）是８３—１除草剂在哺乳动物体内的主要代谢产物。本研究以三种染毒计划观察了ＤＣＡＰ诱发Ｖ７９细胞的染色体畸变。结果表明：ＤＣＡＰ是一种染色体损伤剂，诱发的畸变主要为染色单体断裂和交换；３ｈ染毒和染毒后培养１７ｈ诱发的染色体畸变率最高，２０ｈ染毒观察不到染色体畸变，说明以高浓度短期染毒对高细胞毒性化合物的细胞遗传毒性研究可能是较好的染毒方案。     

丽珠肠乐、参苓止泻汤合治婴幼儿腹泻

目的：探讨丽珠肠乐、参苓止泻汤治疗婴幼儿迁延性或慢性腹泻的疗效。方法：将62例患儿随机分为两组，均补液、维持水电解质及酸碱平衡。治疗组用丽珠肠乐、参苓止泻汤，对照组用蒙脱石。7d为1个疗程，观察两组疗效。结果：治疗组的显效率、有效率、总有效率明显优于对照组（P〈0．01）。结论：丽珠肠乐、参苓止泻汤合治婴幼儿迁延性或慢性腹泻疗效满意。     

Propofol and Sevoflurane in Subanesthetic Concentrations Act Preferentially on the Spinal Cord: Evidence from Multimodal Electrophysiological Assessment

Background: Animal experiments in recent years have shown that attenuation of motor responses by general anesthetics is mediated at least partly by spinal mechanisms. Less is known about the relative potency of anesthetic drugs in suppressing cortical and spinal electrophysiological responses in vivo in humans, particularly those, but not only those, connected with motor responses. Therefore, we studied the effects of sevoflurane and propofol in humans using multimodal electrophysiological assessment.

Methods: We studied nine healthy volunteers in two sessions during steady state sedation with 0.5, 1.0, and 1.5 [mu]g/l (targeted plasma concentration) propofol or 0.2 and 0.4 vol% (end-tidal) sevoflurane. Following a 15-min equilibration period, motor responses to transcranial magnetic stimulation and peripheral (H-reflex, F-wave) stimulation were recorded, while electroencephalography and auditory evoked responses were recorded in parallel.

Results: At concentrations corresponding to two thirds of C50 awake, motor responses to transcranial magnetic stimulation were reduced by approximately 50%, H-reflex amplitude was reduced by 22%, F-wave amplitude was reduced by 40%, and F-wave persistence was reduced by 25%. No significant differences between sevoflurane and propofol were found. At this concentration, the Bispectral Index was reduced by 7%, and the middle-latency auditory evoked responses were attenuated only mildly (Nb latency increased by 11%, amplitude PaNb did not change). In contrast, the postauricular reflex was suppressed by 77%.     

Oxygen Reverses Deficits of Cognitive Function and Memory and Increased Heart Rate Induced by Acute Severe Isovolemic Anemia

Background: Erythrocytes are transfused to improve oxygen delivery and prevent or treat inadequate oxygenation of tissues. Acute isovolemic anemia subtly slows human data processing and degrades memory, increases heart rate, and decreases self-assessed energy level. Erythrocyte transfusion is efficacious in reversing these effects of acute anemia. We tested the hypothesis that increasing arterial oxygen pressure (Pao2) to 350 mmHg or greater would supply sufficient oxygen to be equivalent to augmenting hemoglobin concentration by 2-3 g/dl and thus reverse the effects of acute anemia.

Methods: Thirty-one healthy volunteers, aged 28 +/- 4 yr (mean +/- SD), were tested with verbal memory and standard, computerized neuropsychologic tests before and twice after acute isovolemic reduction of their hemoglobin concentration to 5.7 +/- 0.3 g/dl. Two sets of tests were performed in randomized order at the lower hemoglobin concentration: with the volunteer breathing room air or oxygen. The subject and those administering the tests and recording the results were unaware which gas was administered. As an additional control for duration of the experiment, 10 of these volunteers also completed the same tests on a separate day, without alteration of hemoglobin concentration, at times of the day similar to those on the experimental day. Heart rate, mean arterial blood pressure, and self-assessed sense of energy were recorded at the time of each test.

Results: Reaction time for digit-symbol substitution test increased, delayed memory was degraded, mean arterial pressure and energy level decreased, and heart rate increased at a hemoglobin concentration of 5.7 g/dl (all P < 0.05). Increasing Pao2 to 406 +/- 47 mmHg reversed the digit-symbol substitution test result and the delayed memory changes to values not different from those at the baseline hemoglobin concentration of 12.7 +/- 1.0 g/dl, and decreased heart rate (P < 0.05). However, mean arterial pressure and energy level changes were not altered with increased Pao2 during acute anemia.     

常见传染病的发病趋势

为了探讨法定传染病发病谱的变化 ,以便为制订现阶段的传染病防制策略提供依据。作者将浙江省奉化市195 7～ 2 0 0 1年甲、乙类传染病疫情资料分析如下。1　材料与方法1.1　资料来源　①奉化市历年甲、乙类法定传染病订正年报和浙江省《疫情资料汇编》 ;②人口资料为奉化市统计局《统计年鉴》。1.2　分类方法　根据传染病的不同传播途径分为 :呼吸道传染病 (麻疹、百日咳、白喉、流脑、猩红热、肺结核 ) ,肠道传染病 (病毒性肝炎、伤寒副伤寒、痢疾、脊髓灰质炎 ) ,虫媒及自然疫源性传染病 (乙脑、疟疾、钩体病、狂犬病、出血热 )和血源及性…     

The Effects of Astragalus membranaceus and Tripterygium hypoglaucum on NK Activity in Systemic Lupus Erythematosus

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