下肢外伤后肺动脉栓塞死亡1例

[案例]男性，33岁。因“多处刀砍伤，右尺神经离断伤，左髌骨开放性不完全性骨折，右肱二、三头肌离断伤”住当地市医院。伤后生命体征稳定，予清创缝合术、右尺神经吻合术，右上肢功能位、左下肢伸直位石膏托固定。住院28d，无明显诱因出现胸闷、右侧胸部疼痛，予吸氧及对症处理。全胸正位片示：双肺纹理增粗，右下肺动脉干增粗（2．1cm），心脏肺动脉段膨隆。治疗后胸痛及胸闷有好转。2d后突发呼吸、心跳骤停，抢救无效死亡。     

纹理分析技术应用于舌象研究的问题与对策

探讨了目前在舌诊纹理研究中需要解决的,如标准模板的制定,加强对正常舌象的研究,避免过度追求舌诊自动化等问题。分析和探讨了成立舌象标准制定专业组来研究制定异常典型舌象的标准模板以及从正常舌象的研究入手进行正常舌象纹理特征的获取与规范的相关问题。认为医生的舌诊评价与仪器的舌图评估应该相互参照,不主张以仪器评估替代医生诊断,采取临床医生参与的半定量评估方法可能是当前舌诊客观化的最佳模式。     

用于颅颌面种植外科的三维立体可视化系统

目的论文对在个人PC机上对颅颌面医学图像的可视化进行研究,开发出用于颅颌面种植外科的CT断层图像三维可视化系统。方法应用3D纹理映射的方法对颅颌面CT断层图像进行三维重建,并得到其XYZ方向上的切面图像。然后利用边缘检测的方法得到眼眶的位置,并在眼眶位置进行扇形切割,得到18幅扇形切割图像。结果该系统可以帮助医生进行手术前的骨质、骨量分析,设计种植手术的过程及模拟、预测手术的种植效果。结论建立的颅颌面种植外科三维可视化系统以其硬件配置合理、软件设计新颖、多维视角、便捷快速精确等为特色。具有较强的应用价值。     

美肤达人保湿补水终极计划

在尽情享受着秋高气爽的时节,没有太阳光的暴晒,把清凉的衣物叠整齐放入柜中。可是秋风、灰尘、面部肌肤晦暗且逐渐变得干燥,会让每个渴望水灵的佳人心生烦恼。爱美的美眉们是否已为娇嫩肌肤做好了换季的准备?     

人的指掌纹理分型补遗

人的指掌纹理分型补遗骆传祖（郧阳医学院生物学教研室十堰４４２０００）人类普遍存在的指掌纹理分型已有不少报道。本文只就几年来学生的皮纹实验报告补充一些“分型”和已有分型中的一些亚型，以期为应用者和研究者广泛而深入的探讨提供点滴参考，为方便，我们将指掌纹...     

Electroanatomical systems to guided circumferential pulmonary veins ablation for atrial fibrillation: initial experience from comparison between the Ensite/NavX and CARTO system

Background The circumferential pulmonary vein ablation (CPVA) has been proved effective for atrial fibrillation (AF) treatment and is becoming more widely accepted and practiced. This study aims to evaluate the characteristics of the CARTO and the Ensite/NavX system and draw a comparison between them on the aspects of procedural parameters and clinical effectiveness.Methods Seventy-five cases with paroxysmal or chronic symptomatic AF were randomly assigned to CPVA procedure guided by the Ensite/NavX system (group Ⅰ, n=40) and by the CARTO system (group Ⅱ, n=35). After successful transseptal procedure, the geometry of left atrium was created under the guidance of the two systems. Radiofrequency energy was applied to circumferentially ablate tissues out of pulmonary veins’ (PVs’) ostia. In cases with chronic AF, linear ablation was applied to modify the substrate of left atrium （LA）. The endpoint of the procedure was complete PVs isolation. Results Seventy-five cases underwent the procedure successfully. The total procedure and fluoroscopic durations in group Ⅱ were significantly shorter than in group Ⅰ ［(150±23) min and (18±17) min versus (170±34) min and (25±16) min, P=0.03 and 0.04, respectively］. There was no significant difference in the fluoroscopic and procedure durations for geometry creation between group Ⅰ and group Ⅱ ［(8±4) min and (16±11) min versus (5±4) min and (14±8) min, respectively］. The fluoroscopic durations for CPVA were (15±5) min in group Ⅰ versus (10±6) min in group Ⅱ (P=0.05), and the CPVA procedural durations were significantly shorter in group Ⅱ than in group Ⅰ ［(18±11) min versus (25±10) min, P=0.04］. AF was terminated by radio frequency delivery in 14 cases (35%) in group Ⅰ versus 5 cases (14%) in group Ⅱ (P=0.035). After CPVA complete PV isolation was attained in 26 cases (65%) in group Ⅰ versus 11 cases (31%) in group Ⅱ (P=0.004). During a mean follow-up of 7 months, 32 (80%) cases in group Ⅰ and 24 (69%) cases in group Ⅱ were arrhythmia-free (P=0.06). One case developed pericardium effusion and another one case was found to have intestinal artery thrombosis in group Ⅱ. One case had moderate hemothorax in group Ⅰ. All the complications were cured by proper treatment. No PV stenosis was observed. Conclusions The CPVA procedure for atrial fibrillation is effective and safe. Although there is difference between the CARTO and the Ensite/NavX system, the CPVA procedure guided by either of them yields similar clinical results.     

先天性白内障一家系17例

1临床资料先证者,男,5mo,主因“发现双眼瞳孔区白色反光2mo”来诊。眼部检查:视力不合作,眼压右:Tn,左:T双角膜透明,前房中深,虹膜纹理清,双瞳孔圆,直径3mm,双晶状体皮质混浊,眼底不入。诊断:双眼先天性白内障。治疗:入院后行双眼白内障超声乳化吸除+后囊环形撕开+前部玻璃体切除。先证者之母,女,32岁。左眼外斜20+a。眼部检查视力右眼1.0,左眼手动/30cm。眼压:右:15mmHg,左16mmHg。左眼外斜45°,眼球各方向运动不受限,右眼正常。双角膜透明,前房中深,虹膜纹理清,右眼瞳孔圆直径3mm,晶状体透明,眼底未见异常。左眼瞳孔圆直径4mm晶状体核性混浊,眼底不入。家系调查     

LASIK术后非结核分枝杆菌性角膜炎1例

0引言随着激光原位角膜磨镶术(LASIK)手术的广泛开展,LASIK术后并发症也在增加,术后感染性角膜炎的发病率为0.1%~0.2%,而真实的发病率可能远超过所报道过的病例[1]。我们在LASIK术后3d发现1例非典型性分枝杆菌性角膜炎,现报告如下。1病例报告患者,男,35岁,因双眼视物不清20a+于2008-03-16在外院行LASIK手术,术后常规使用糖皮质激素滴眼。术后第1d复查,裸视力右1.2,左1.0,无不适感,术后检查未发现异常;第3d双眼轻度畏光,流泪,右眼角膜未见异常,左眼视力明显下降,裂隙灯检查显示:角膜水肿,角膜瓣下有散在圆点状上皮下浸润,边界不清(图1);第4d,双眼畏光     

防己与马兜铃科三种"防己"的鉴别

《中国药典》2000年版一部收载了两种防己,一种为防己科植物粉防己,另一种为马兜铃科植物广防己.由于马兜铃科广防己含有马兜铃酸,有肾毒性,《中国药典》2005年版一部未收载广防己,仅收载了防己科植物粉防己一种.虽然《中国药典》2005年版已经执行近两年了,但是很多医疗单位仍在继续使用马兜铃科的广防己和同属多种植物的根及根茎作防己用.笔者现把马兜铃科常见的三种“防己“与防己科防己(《中国药典》2005年版一部收载的防己),进行对比鉴别,总结出正品防己与非正品防己的主要区别,以便正确鉴别防己真伪.……     

胸片检查,你了解吗

什么情况下需做胸部X线检查需要做胸部X线检查的疾病主要有以下几种:呼吸系统疾病如:支气管炎、肺炎、支气管哮喘、支气管扩张、气胸等;循环系统疾病如:心绞痛、急性肺水肿等。