常规开胸与胸腔镜下治疗早期胸腺瘤的临床研究

目的比较常规开胸与胸腔镜下治疗早期胸腺瘤的临床效果,探讨胸腔镜下治疗早期胸腺瘤的可行性及优越性。方法回顾分析96例常规开胸（40例）和胸腔镜（56例）治疗的早期胸腺瘤患者,观察两种治疗方式的术后临床情况和并发症情况的差异。结果胸腔镜组与常规开胸组相比,手术时间、术后拔管时间和术后住院时间短,术中出血和术后胸腔积液引流量少,差异有统计学意义（P〈0.05）;胸腔镜组发生并发症的例数少于常规开胸组,差异有统计学意义（P〈0.05）;随访期间,胸腔镜组无复发和转移者,常规开胸组出现1例。结论胸腔镜较常规开胸治疗早期胸腺瘤具有明显优势。     

口服药物对增生性糖尿病视网膜病变术后康复效果的影响

目的：观察口服羟苯磺酸钙片联合依帕司他片,对增生性糖尿病视网膜病变(proliferative diabetic retinopathy,PDR)玻璃体切割手术后患者康复效果的影响。

方法：在PDR玻璃体切割手术后患者知情同意的情况下进行随机分组,分为术后药物干预组及对照组,术后2d; 3,6,9,12mo随访视力及眼底情况,并进行比较。

结果：药物干预组视力恢复及保持较好,且黄斑水肿消退情况明显优于对照组。

结论：PDR患者玻璃体切割手术后,积极口服保护视网膜的药物进行干预有利于视力的提高和眼底的康复。     

阿托伐他汀钙治疗老年心力衰竭合并阵发性房颤的临床观察

目的：观察阿托伐他汀钙治疗老年心力衰竭合并阵发性房颤的临床疗效及安全性。方法：将149例老年心力衰竭合并阵发性房颤患者随机分为对照组（73例）和治疗组（76例）。对照组患者给予常规治疗;治疗组患者在对照组治疗的基础上给予阿托伐他汀钙20mg,1次／晚。两组患者疗程均为1年。评价两组患者的临床疗效;观察两组患者治疗前后甘油三酯（TG）、胆固醇（TC）、心输出量（CO）、左心室射血分数（LVEF）及左心房内径的变化;观察两组患者房颤和缺血性事件的发生率及不良反应发生情况。结果：治疗组患者总有效率显著高于对照组,两组比较差异有统计学意义（P〈0．05）。治疗后,治疗组患者TG、TC和左心房内径均显著低于对照组,CO、LVEF显著高于对照组,两组比较差异均有统计学意义（P〈0．05）。治疗组患者阵发性房颤复发率、转为持续性或永久性房颤发生率、缺血性事件发生率均显著低于对照组,两组比较差异有统计学意义（P〈0．05）。治疗期间两组患者均未见明显不良反应发生。结论：阿托伐他汀钙治疗老年心力衰竭合并阵发性房颤具有较好的疗效,且安全性较好。     

Effects of alcohol restriction on ambulatory blood pressure,heart rate,and heart rate variability in Japanese men

We investigated the effects of alcohol restriction on ambulatory blood pressure (BP), heart rate, and heart rate variability in 33 Japanese male volunteers (37 ± 1 years, mean ± SE), who were all habitual drinkers. Subjects were told either to keep their usual drinking habits for 3 weeks (usual alcohol period), or to reduce alcohol intake by at least half of their usual drinking amount (reduced alcohol period). The ambulatory BP, heart rate, and electrocardiographic R-R intervals were measured during a 24-h period with a portable recorder on the last day of each period. A power spectral analysis of R-R intervals was performed to obtain the low-frequency (LF) and high-frequency (HF) components. The percentage of differences between adjacent normal R-R intervals >50 msec (pNN50) was also calculated. The amount of ethanol intake was significantly reduced from 70 ± 5 mL/day in the usual alcohol period to 19 ± 3 mL/day in the reduced alcohol period (P < .0001). The daytime systolic BP was significantly lower in the reduced alcohol period than in the usual alcohol period by 4 ± 1 mm Hg (P < .05). The daytime and nighttime heart rate was significantly lower in the reduced alcohol period than in the usual alcohol (P < .001 for each). The pNN50 and the HF component were significantly higher in the reduced alcohol period than in the usual alcohol period (P < .0001 for each). The LF/HF ratio was significantly lower in the reduced period than in the usual period (P < .01). These results demonstrate that 3-week alcohol restriction produced reductions in ambulatory systolic BP, heart rate, and the index of sympathovagal balance, and augmentations of parasympathetic indices of heart rate variability in Japanese male drinkers.     

不同取血方式对分离骨髓单核细胞浓度的影响

150例行髓芯减压加自体干细胞移植股骨头坏死患者按侧别分为单侧和双侧髂骨取血两组,按取血量再分为3个亚组（200、300和400ml组）,并于取髂骨血前、后行单核细胞记数。单侧髂骨取血200、300和400ml组分离后单核细胞记数分别为（3．11±1．42）×10^10／L、（2．62±1．31）×10^10／L和（2．13±0．91）×10^10／L,取血400ml组单核细胞记数显著低于取血200ml组（t=5．118,P〈0．01）;双侧髂骨取血200、300和400ml组分离后单核细胞计数分别为（4．51±2．21）×10^10／L、（3．89±2．06）×10^10／L和（2．98±1．39）×10^10/L,取血400ml组单核细胞记数显著低于取血200ml组（t=6．446,P〈0．01）;双侧髂骨取血200、300和400ml分离后单核细胞浓度明显高于单侧取血,且差异有统计学意义（t=3．119,P〈0．01;t=5．544,P〈0．01;t=2．207,P〈0．05）。提示髂骨取血所分离单核细胞浓度受不同取血方式影响：双侧高于单侧;随着取血剂量增加,分离单核细胞浓度降低。     

间歇充气加压联合低分子肝素预防下肢深静脉血栓形成的临床研究

下肢深静脉血栓(deep venous thrombosis,DVT)形成是股骨骨折最常见的并发症之一。在不进行干预条件下,老年股骨近端骨折病人术后DVT的发生率可高达61.3%[1]。DVT形成的基本要素是Virchow三联征:血流瘀滞、高     

肝前性门脉高压合并脾动脉盗血综合征的诊治

1一般资料患儿男性,12岁。因间断性呕血4年而入院。钡餐X线检查示食管胃底静脉重度曲张。血常规：WBC 0.78×109/L,RBC 2.72×1012/L,PLT 40.4×109/L,Hb 68 g/L。肝功能Child分级A级。术前CT动脉造影示脾动脉粗大,肝动脉分支纤细。CT静脉造影示脾静脉粗大,汇合进入门静脉左支发出的粗大脐旁静脉下行与右髂静脉交通,