320排探测器CT单心动周期扫描应用于心律不齐患者冠状动脉成像的可行性

目的 探讨uCT960+宽体探测器CT单心动周期在心律不齐患者行冠状动脉CT成像的可行性。方法 对接受冠状动脉CT成像检查的63例心律不齐患者和63例窦性心律患者的临床资料进行回顾性分析。采用五分法评估冠状动脉节段的图像质量。比较两组对比噪声比（CNR）、信噪比（SNR）、主动脉根部CT值、有效辐射剂量（ED）及冠状动脉图像质量评分。结果 两组性别，年龄无显著性差异（P≥0.05）;心律波动有统计学意义（P＜0.01）;所有患者图像均能满足诊断需要，两组患者的主观评分无显著差异（P≥0.05）;两组冠脉各段CT值、SNR、CNR无统计学差异（P≥0.05）;心律不齐组有效辐射剂量为窦性心律组的150%。结论 uCT960+宽体探测器CT对心律不齐患者行CCTA与窦性心律患者图像质量无差异，且辐射剂量保持在可接受水平。     

心肺运动试验中窦房结变时效应频率应答特性的初步探讨

采用最大症状限制性心肺运动试验的方法，依据运动过程中心率与机体作功和体内代谢强度的变化关系研究４０名正常人运动中窦房结变时效应的频率应答特性，探讨心率储备和影响最大心率的主要因素。结果显示：心率与作功呈直线相关（Ｙ＝７５＋０．４１Ｘ，ｒ＝０．９８６３，Ｐ＜０．００１）。运动中心率与代谢当量亦呈直线相关（Ｙ＝５２．３＋１１．０１Ｘ，ｒ＝０．９１５２，Ｐ＜０．００１）。影响最大心率的主要因素是氧耗量、二氧化碳量和每分通气量。运动过程中心率与运动负荷和代谢的线性关系反映了窦房结频率应答的特性，即代谢性频率应答。窦房结的这种特性可能是单传感器频率应答性起搏器不能完全符合生理需要的基本原因。     

Fluvastatin combined with benazepril may contribute to the favorable prognosis of patients with atrial fibrillation

The aim of this study was to observe the clinical efficacy of fluvastatin combined with benazepril in the treatment of patients with atrial fibrillation (AF). A total of 92 patients with AF were randomly assigned to the case group (n = 46), in which the patients were treated with fluvastatin (80 mg) plus benazepril (10 mg), or to the control group (n = 46), in which the patients were treated with fluvastatin (80 mg). The conversion rate of sinus rhythm was higher in the case group than in the control group (P < 0.05). The case group had more treatment-effective patients than the control group, with fewer treatment-ineffective patients (P < 0.05). The LVEDd, LVESd, LAD, and LVEF indexes in the case group were lower than in the control group after 6 months of treatment (all P < 0.05). Levels of hs-CRP were also lower in patients in the case group than in patients in the control group after 1 month of treatment (P < 0.05). After 12 months, renin and Ang II concentrations were lower in patients in the case group than in the control group (both P < 0.05). Significant differences in IL-6 and TNF-α expression were found between the two groups after 1 month, 6 months, and 12 months of treatment (all P < 0.05). Compared to patients in the control group, the levels of total cholesterol (TC), triglycerides, and LDL-C in the case group were lower after 6 and 12 months of treatment (all P < 0.05), while the HDL level was higher (P < 0.05). Treatment with fluvastatin combined with benazepril further increased the conversion rate of sinus rhythm and significantly improved the quality of life and prognosis of AF patients.     

内镜经鼻蝶术后垂体腺瘤患者腺垂体功能低下情况分析

[目的]检测垂体腺瘤患者内镜经鼻蝶术后相关激素水平变化,分析影响垂体功能低下的因素,指导其激素替代治疗.[方法]总结本院神经外科2008年至2013年内镜下经鼻蝶手术82例垂体腺瘤患者的临床资料及治疗方法,测定患者术前及术后d3甲状腺轴、肾上腺轴及性腺轴相关激素水平并进行比较.[结果]患者术后d3甲状腺轴及肾上腺轴激素水平较术前有所降低,发生腺垂体功能低下者共34例,占41.5%(34/82).高龄、术前存在垂体功能低下、无功能型、大型肿瘤患者术后发生垂体功能低下比例较高,其中微腺瘤发生率为16.7%(2/12),大腺瘤45.7%(32/70),45例无功能腺瘤发生腺垂体功能减低者16例,占35.5%.而术后腺垂体功能低下发生与患者性别无关.[结论]垂体腺瘤术后垂体相关各项激素水平较术前会有不同程度的下降;术前高龄、垂体功能低下、无功能性垂体腺瘤及肿瘤体积较大的患者,术后发生腺垂体功能低下可能性较高,合理的激素替代疗法有利于患者康复.     

Physiological regulation in cigarette exposed infants: an examination of potential moderators

The primary purpose of this study was to examine pathways from prenatal cigarette exposure to physiological regulation at 2 months of age. Specifically, we explored the possibility that any association between prenatal cigarette exposure and infant physiological regulation was moderated by fetal growth, prenatal or postnatal environmental tobacco smoke (ETS) exposure or maternal depressive symptomatology during pregnancy. We evaluated whether exposed infants who were also exposed to ETS after birth, were small for gestational age (SGA) or had mothers with higher depressive symptoms during pregnancy had the highest levels of physiological dysregulation. Respiratory sinus arrhythmia (RSA) was obtained from 234 (166 exposed and 68 nonexposed) infants during sleep. As expected, cigarette-exposed infants had significantly lower RSA than nonexposed infants. This association was not moderated by prenatal or postnatal ETS exposure, or maternal depressive symptomatology during pregnancy. However, small for gestational age status did moderate this association such that nonexposed infants who were not small for gestational age had a significantly higher RSA than nonexposed small for gestational age infants and exposed infants. These findings provide additional evidence that prenatal cigarette exposure is directly associated with dysregulation during infancy.     

鼻内镜鼻窦手术后患者治疗依从性的护理干预

目的 探讨护理干预对鼻内镜鼻窦手术后患者治疗依从性的方法和疗效,为临床护理提供指导.方法 总结分析本院于2010年1-6月收治入院的80例鼻内镜鼻窦手术后患者.采用随机抽取法分为2组,实验组40例,行综合护理干预.对照组40例,行普通护理干预.随访6个月～1年,对比2组患者护理后认知和行为变化,并统计依从性改变.结果 ...     

筛窦恶性黑色素瘤术后胃转移1例分析

目的恶性黑色素瘤临床较为罕见,而转移至胃的病例更为罕见。为探讨其病理特征提高临床诊断而避免误诊,报道1例筛窦恶性黑色素瘤术后胃转移。方法行CT检查提示右筛窦占位性病变,进一步检查,未见转移到其他组织,于外院手术切除,术后病理证实为右筛窦恶性黑色素瘤,术后进行化疗。结果于该院行胃镜检查,两处病灶分别取活检,病理及免疫组化均证实恶性黑色素瘤胃转移。结论恶性黑色素瘤根据其发生部位分为皮肤及黏膜恶性黑色素瘤两类,以皮肤的多见,而原发于筛窦者罕见。恶性黑色素瘤的胃转移多发生于胃底、胃体。     

稳心颗粒治疗窦性心动过缓合并室性早搏的临床观察

目的 观察稳心颗粒治疗窦性心动过缓合并室性早搏的疗效与安全性.方法 选择窦性心动过缓合并室性早搏患者60例,给予稳心颗粒9 g/次,3次/d口服,4周后复查心电图1次及24 h动态心电图(Holter).观察治疗前后室早次数、心率、临床症状改善情况及药物不良反应情况.结果 治疗后临床症状明显改善、早搏明显减少.结论稳心颗粒治疗窦性心动过缓合并室性早搏安全有效且无明显不良反应.     

胺碘酮对慢性阻塞性肺病急性加重并窦性心动过速的疗效分析

目的 探讨胺碘酮在慢性阻塞性肺病急性加重期(AECOPD)并窦性心动过速中的疗效.方法 AECOPD患者43例,经合理氧疗、抗感染、纠正酸碱失衡及电解质紊乱、解痉平喘、祛痰等综合基础治疗2 h后心率仍超过120次/min,心电图确诊窦性心动过速,以随机数字法分为治疗组(A组,23例)及对照组(B组,20例);监测患者使用胺碘酮或西地兰前,使用后24 h、72 h、7 d及14 d时的心率、呼吸次数、二氧化碳分压及血氧分压、血压及心电图,必要时调整用量或停药.结果 A组及B组所有患者均能按计划完成治疗,未出现严重的心率失常;A组予胺碘酮治疗后24 h、72 h、7 d及14 d时心率、呼吸次数均有改善,并具有统计学意义;血氧分压及血二氧化碳分压也有所改善但差异无统计学意义;B组予西地兰治疗后24 h及72 h心率、呼吸次数无显著性改善;而治疗后7 d及14 d心率、呼吸次数改善具有统计学意义;监测血氧分压及血二氧化碳分压逐步改善,但差异无统计学意义.结论 胺碘酮可安全有效地降低AECOPD窦性心动过速患者的心率及呼吸频率.