妊娠合并自发性卵巢过度刺激综合征一例

卵巢过度刺激综合征是辅助生殖技术常见的并发症,通常在排卵后2周或2周以上发生。然而自发性卵巢过度刺激综合征极其罕见,一些病例报道表明,自发性卵巢过度刺激综合征的发生与卵泡刺激素受体突变、高人绒毛膜促性腺激素水平、高促甲状腺激素水平、促性腺激素垂体腺瘤等有关。现报告1例双胎妊娠合并自发性卵巢过度刺激综合征的病例,并进一步探讨自发性卵巢过度刺激综合征的可能病因、诊断和治疗原则。     

Consensus document on community-acquired pneumonia in children. SENP-SEPAR-SEIP

Community-acquired pneumonia (CAP) is a prevalent disease among children and is frequently associated with both diagnostic and therapeutic uncertainties. Consensus has been reached between SEPAR, SENP and SEIP, and their conclusions are as follows:Etiology depends mainly on age and other factors and no single analytical marker offers absolute diagnostic reliability.In the event of clinical suspicion of pneumonia in a healthy child, chest X-ray is not necessary. Chest ultrasound is increasingly implemented as a follow-up method, and even as a diagnostic method.The empirical antibiotic treatment of choice In typical forms of the disease is oral amoxicillin at a dose of 80 mg/kg/day for 7 days, while in atypical presentations in children older than 5 years, macrolides should be selected. In severe typical forms, the combination of 3rd generation cephalosporins and cloxacillin (or clindamycin or vancomycin) administered intravenously is recommended.If pleural drainage is required, ultrasound-guided insertion of a small catheter is recommended. Intrapleural administration of fibrinolytics (urokinase) reduces hospital stay compared to simple pleural drainage.In parapneumonic pleural effusion (PPE), antibiotic treatment combined with pleural drainage and fibrinolytics is associated with a similar hospital stay and complication rate as antibiotic treatment plus video-assisted thoracoscopy (VATS).Systematic pneumococcal conjugate vaccination is recommended in children under 5 years of age, as it reduces the incidence of CAP and hospitalization for this disease.     

Review of Budd-Chiari Syndrome

This study aims to report the Budd-Chiari syndrome clinical research status and progress that has occurred in over nearly 30 years in China, and emphasize the value of imaging in facilitating the diagnosis of Budd-Chiari syndrome based on more than 2500 cases. Findings on ultrasonography, computed tomography, magnetic resonance imaging, and digital subtraction angiography images are used to propose new Budd-Chiari syndrome types and subtypes. The new subtype classification presented here has important value for guiding interventional treatment. This study also proposes a new concept of anatomical and functional obstruction of hepatic vein that stresses the compensatory value of accessory hepatic vein and azygos vein and describes the risk of manipulation of the communication branch of inferior vena cava obstruction in interventional therapy.     

霉菌性鼻窦炎的CT特征性表现与其诊断价值

目的:分析霉菌性鼻窦炎的CT诊断和鉴别诊断价值。材料与方法:回归性分析2000年至2010年在我院诊治、有完整资料的2例霉菌性鼻窦炎,均行螺旋CT检查。结果:2例霉菌性鼻窦炎中,男女各1例,2例均为单侧上颌窦,年龄分别为31岁和61岁,病史2年至11年余。其特征性表现为2例均上颌窦窦腔充满较高密度、中央部斑片、棉絮状钙化,窦壁骨质未受侵袭,伴有狼疮性肾炎和类风湿性关节炎病史。结论:CT诊断和鉴别霉菌性鼻窦炎有一定的价值。     

先天性红细胞生成异常性贫血发病机制研究进展

先天性红细胞生成异常性贫血（CDA）是一组以骨髓红系无效造血、有独特的光学显微镜及电镜形态学改变为特征的先天性贫血性疾病.其临床表现主要为自出生或婴幼儿时期,即开始出现不同程度的贫血、黄疸及肝、脾大,并常继发胆石症和铁过载.近年,多数文献研究已对单一类型CDA或CDA Ⅰ、Ⅱ、Ⅲ型及变异型的临床特征,分子机制和诊断方法等进行概述.笔者主要从各型CDA发病机制中的相关致病基因、异常信号传导、细胞周期紊乱与膜的糖基化异常及基因型与表现型的关系等进行更深入的综述研究,旨在整体了解和掌握各型CDA,及探索各型CDA之间可能存在的联系.     

新世纪里胃癌的发病率能进一步降低吗？

胃癌是最常见的肿瘤之一。胃癌的发病率和死亡率在世界各国分布不均。胃癌的发生与幽门螺杆菌（Hp）感染、基因和环境因素有关。Hp感染是启动肠型胃腺癌发生的扳机。东亚和东欧地区胃癌的发病率较高，而非洲地区Hp感染率虽很高，但胃癌的发病率却很低。早期胃癌的5年生存率明显高于进展期胃癌。提高早期胃癌的诊断率对人类战胜胃癌至关重要。近年来胃癌发病率有下降趋势，随着人民生活水平的提高和科学技术的发展，新世纪胃癌的发病率可能会进一步降低。     

急性心肌梗死并发肺炎的病因及预后分析

目的 分析急性心肌梗死患者并发肺炎的病因及预后.方法 选取2011年1月～2013年10月本院102例急性心肌梗死患者,其中合并肺炎53例,以无肺炎的49例为对照组,对多种因素进行回顾性分析.结果 急性心肌梗死并发肺炎与年龄、绝对卧床≥7d、应用镇静剂≥5d、心功能异常等多种因素有关;好转率明显低于对照组.结论 急性心肌梗死并发肺炎诱因较多,积极预防、控制肺炎对治疗具有重要作用.