以脑转移为首发症状的肺癌临床误诊分析

目的 探讨以脑转移为首发症状的肺癌临床特点及误诊原因。方法 结合33例患者的临床表现、影像学表现进行分析。结果 以脑转移为首发症状的肺癌易被误诊为脑血管病变或原发脑肿瘤。结论 对突发神经系统症状的患者应考虑到脑转移的可能，应完善检查，以免误诊。     

上颌骨掀翻入路行颅底手术的临床应用初探

目的：探讨采用经上颌骨翻转入路手术切除颅底肿瘤的方法及术后并发症。方法：采用经一侧上颌骨掀翻入路切除3例颅底肿瘤，其中鼻咽巨大纤维血管瘤l例；翼腭窝平滑肌肉瘤1例；鼻口咽部非霍奇金恶性淋巴瘤1例。结果：3例患者均无上颌骨坏死和面部畸形、无错位咬合、无面神经功能障碍和下睑外翻、无术侧面部感觉障碍和溢泪、无脑脊液漏及颅内外感染。但2例出现术侧分泌性中耳炎、有轻度张口受限。结论：经一侧上颌骨掀翻入路行颅底手术具有显露充分、肿瘤切除彻底、正常功能结构及外观影响小的优点。     

30例脑卒中偏瘫痉挛期患者综合康复治疗体会

2003年1月～2005年4月，我们对30例脑卒中偏瘫痉挛期患者采用综合康复治疗，疗效较好。现报告如下。     

纳络酮治疗急性有机磷农药中毒致重症中间综合征30例观察

2002年1月到2005年8月，我院ICU用纳络酮治疗急性有机磷农药中毒（AOPP）致重症中间综合征（IMS）30例，疗效显．现总结如下：     

农村低出生体重儿危险因素的病例对照研究

采用流行病学回顾性配对调查方法,对1992～1994年澄江县农村236名低出生体重儿和 236名正常出生体重儿进行了病例—对照研究,对 31个因素同时采用单因素的卡方检验和多因素的Logistic分析进行研究,结果表明3年农村低出生体重儿平均发生率为4.15％,经单因素分析两组在母亲文化程度、身高、体重、孕次、产次、第一次产检孕周、产检次数、分娩孕周、经济收入、高危因素、臀位、双胎、过期妊娠、怀孕期间情绪、怀孕期间饮食、早产史16个方面差异有显著性(P<0.05);经Logistic分析选出的低出生体重儿的主要危险因素为母亲文化程度、怀孕期间情绪、身高、体重、孕次、产次、双胎、臀位、分娩孕周、经济收入、第一次产检孕周、民族、年龄、地区、新生儿性别。     

维生素E在妇产科临床中的应用

维生素E是大家最为熟悉的抗氧化药物，至今已有70多年历史。目前已成为妇产科的常用药物。根据文献报道及本人临床实践，现将维生素E在妇产科临床应用及药物作用机理简介如下。1．治方不孕症维生素E是生物膜的保护剂、生物膜中含有磷脂成分，四胎中含有不饱和脂肪酸。维生素E缺乏时，不饱和脂肪酸在自由基作用下，可生成不饱和脂肪酸过氧化物，破坏生物膜结构和功能。因此在不孕症病人中应用维生素E，能促进子宫内膜的正常生长，给受精卵的着床建立良好环境；维生素E还可以提高微粒体上前蛋白的合成和线粒体氧化磷酸化作用，增加子宫肌营…     

环戊硫酮治疗干眼的临床疗效评价

Objective To investigate anethol trithione therapic efficiency on dry eye. Methods It was a prospective random double-blind controlled study. Eighty cases diagnosed dry eye in Ocular Surface Out-patient Clinic of Xiamen University Affiliated Xiamen Eye Center from 2006 to 2008 were divided into two groups: anethol trithione group and control group, 40 cases in each group. Every group was then divided into two subgroups: weak dry eye subgroup, middle and severe dry eye subgroup. All groups had been added with 0.05% refresh drops. All patients had been detected and evaluated by subjective symptoms of dry eye, visual acuity,corneal fluorescent staining(F1), break-up time(BUT) and Schirmer Ⅰ test (SⅠT) at pre-therapy and 3,7,28 d of post-therapy. All groups had been compared and analyzed by F test and sample mean difference (SMD) or median difference (MD) comparison between pre-therapy and post-therapy. Results Except of tear and red eye, the other subjective symptoms of dry eye, F1, BUT and SⅠT of weak dry eye subgroup of both groups had been improved at 7 d after therapy. Only those of middle and severe dry eye subgroup of anethol trithione group had been improved at 7 d after therapy compared with those of pre-therapy: SMD=0.96 (visual tiredness), 1.26 (dry and unsmooth sensation), 0.82 (foreign body sensation), 1.28 (burning sensation), 1.05 (photophobia), 1.48 ( pain ) ; MD=0.30 (visual acuity), 4.00 (F1) ,5.00 (BUT), 5.00 (SⅠT) [F=15.30 (visual tiredness), 15.68 (dry and unsmooth sensation ), 13.56 (foreign body sensation), 20. 91 ( burning sensation ), 18.90 (photophobia), 27.22 ( pain ), 10.54 (visual acuity), 188.21 (F1) ,261.76 (BUT) ,269.05 (SⅠT) ;P<0. 05]. Those of middle and severe dry eye subgroup of control group hadn't significantly been improved at 28 d after therapy: SMD=0.10 (visual tiredness) ,0.16 (dry and unsmooth sensation) ,0.09 (foreign body sensation) ,0.38 ( burning sensation ), 0.24(photophobia) ,0.36 (pain) ,0.23 (red eye) ; MD=0.10 (visual acuity) ,0.50(F1) ,0.50(BUT), 0.50(SⅠT) [F=1.76 (visual tiredness), 1.61 (dry and unsmooth sensation), 1.02 (foreign body sensation),2.39 (burning sensation), 2.42 (photophobia), 2.73 ( pain ), 2.55 ( red eye ), 1.46 ( visual acuity) ,2.35 (F1) ,2.90 (BUT) ,2.76 (SⅠT) ; P>0.05]. SⅠT of anethol trithione group had been improved more significantly after therapy (F=13.77, P<0.05). Conclusion Anethol trithione could significantly improve middle and severe dry eye patients' symptoms and signs whose lacrimal gland function survival and it has clinical application value.     

右侧房室旁路射频消融经验总结

除少数心外膜房室旁道(AP)外，目前右侧AP(RAP)的射频消融成功率，由于技术的熟练和Swartz鞘的使用，已明显提高，大组资料统计，其成功率为91．8％-93．6％，少数报道达100％，但手术时程仍较长和复发率较高15％左右。笔通过院内、外近400例RAP导管消融总结了一套自己的经验，对缩短RAP射频消融时程、提高成功率和减少复发有一定意义。     

3例有机磷杀虫药中毒之中间综合征报告

有机磷杀虫药通过抑制机体乙酰胆碱酯酶AchE引起乙酰胆碱(Ach)在体内蓄积，导致胆碱能神经受到持续性冲动使机体产生先兴奋后衰竭的毒蕈样、烟碱样及中枢神经系统症状。重度有机磷杀虫药中毒患者易发生中间综合征。