复方丹参注射液组接加门冬氨酸钾镁注射液出现接加组浑浊、沉淀现象

用5％葡萄糖250ml稀释复方丹参针水14ml(正常剂量)，接加5％葡萄糖液200ml稀释门冬氨酸钾镁针20ml～30ml，随即出现一次性输液吊袋中第二组液体变成灰黑色，有浑浊、沉淀，共2例，再用上述方法试验亦再次出现浑浊、沉淀现象。     

隐蔽型神经母细胞瘤的影像学定位诊断

对腹部不能触及肿块的小儿神经母细胞瘤（隐蔽型）于手术前进行超声、ＣＴ与磁共振检查，以确定原发肿瘤的部位。本组共７１例，均来自中国医科大学第二临床学院小儿内、外科与眼科，５岁以下者５７例。均做过超声检查，２２例曾做ＣＴ检查，２５例曾做磁共振检查。７１例...     

经皮气管切开术在ICU患者中的运用

目的:探讨经皮气管切开术(Percutaneous tracheostomy,PT)在ICU患者中的应用效果.方法:回顾性分析2006年3月至2008年10月我科开展的PT术90例,并与同期行传统气管切开术(Open tracheostomy,OT)的40例进行对照,观察两组术中一般情况及并发症情况.结果:PT组在手术时间、出血量、切口大小以及切口愈合时间方面明显优于OT组,差异具有统计学意义(P<0.05);OT组总的并发症发生率为25%,PT组总的并发症发生率为1.11%,差异有统计学意义(P<0.05).PT组的皮下气肿、切口溢痰、套管脱出的发生率均明显低于OT组,差异有统计学意义(P<0.05).结论:经皮气管切开术具有创伤小、并发症发生率低、手术操作简单等优点,值得临床广泛应用.     

留守老人、儿童、妊娠妇女的就医现状及对策

笔者就留守老人、儿童、妊娠妇女的就医现状及对策进行分析,根据现有医疗体制,尽可能方便地使留守老人、儿童、妊娠妇女疾病诊治提供快捷的通道,使其异地务工的家属更安心地工作,为家庭和谐、社会稳定创造更好的条件。     

急性有机磷农药中毒七例误诊分析

我院急诊科 1998年6月至1999年10月在收诊的急性有机磷农药中毒病人中,有7例发生误诊,后经追问病史,详细体查,结合查血胆碱脂酶活性而明确诊断,治愈出院,现将其误诊情况分析如下.     

布洛芬缓释片致阵发性手足搐搦

患者男,74岁,因"慢性支气管炎、肺气肿、肺心病、肺部感染,右心功能不全"住我科治疗.经抗感染、强心利尿、支持对症治疗,病情好转,但因患者腰椎骨质增生而致腰部疼痛,给予布洛芬缓释片(芬必得)300mg,qd口服.     

分析ICU危重患者抢救中常见并发症

ICU危重患者抢救过程中，每一个环节都至关重要，如果发现或处理不及时，就有可能影响到治疗和抢救，甚至危及生命。现将笔者在临床工作中遇到的除院内感染外的并发症总结如下。     

阿司匹林预处理对原代培养大鼠Ⅱ型肺泡上皮细胞抗氧化损伤的影响研究

目的 观察阿司匹林对原代培养大鼠Ⅱ型肺泡上皮细胞(AEC Ⅱ)的保护效应,并探讨其抗氧化损伤的机制.方法 将原代分离、纯化、培养的离体大鼠AEC Ⅱ分为5组.过氧化氢损伤(H2O2)组在培养40 h后加入0.5 mmol/L H2O2,建立细胞氧化损伤模型;生理盐水(NS)组则加入NS ;阿司匹林预处理1、2、3(A1～3)组在加入H2O2前给予阿司匹林50、100、200μmol/L预处理.3 h后观察细胞形态学变化和贴壁细胞计数;采用四甲基偶氮唑盐(MTT)比色法检测细胞存活率;采用免疫组化法和聚合酶链反应法检测NS组、A1～3组在培养20、40、60 h AEC Ⅱ中血红素氧合酶-1(HO-1)的蛋白及mRNA表达.结果 采用胰蛋白酶消化、免疫黏附法每只鼠可收获(2.0～2.5)×107个AEC Ⅱ,纯度和活性均＞90%.与NS组比较,H2O2组细胞间隙增宽,贴壁细胞数减少,细胞皱缩,细胞存活率(A值)明显下降(0.054 6±0.004 0比0.103 8±0.009 9,P＜0.01);与H2O2组比较,A1～3组贴壁细胞数增多,细胞形态较完整,无明显皱缩,细胞存活率(A值)明显增加(0.066 9±0.003 9、0.071 0±0.006 5、0.078 7±0.009 2比0.054 6±0.004 0,均P＜0.01).与NS组比较,A1～3组培养20、40、60 h时HO-1的蛋白及mRNA表达均明显增加,60 h时达峰值[蛋白(积分A值):1.59±0.12、1.60±0.09、1.61±0.08比1.25±0.11;mRNA(Ct值比值):24.31±1.74、30.45±2.53、32.63±3.74比22.99±1.95,均P＜0.05];但A1～3组间HO-1蛋白表达无明显差异.结论 阿司匹林通过上调HO-1表达对离体培养氧化损伤的大鼠AEC Ⅱ起保护效应;HO-1可能是其中重要的保护调节因子.

Abstract：

Objective To investigate the protective effect of aspirin on primary cultured type Ⅱ alveolar epithelial cell (AEC Ⅱ ), and the mechanism of its effect on anti-oxidation damage. Methods The original generation of adult rat AEC Ⅲ were cultured and purified. They were divided into normal saline (NS) group,hydrogen peroxide injury group (H2O2 group), and 1, 2, 3 aspirin pretreatment groups (Al -3 groups). In H2O2 group, 0. 5 mmol/L H2O2 was added to AEC Ⅱ after 40 hours of culture to reproduce a cell oxidative injury model. In NS group, only NS was added to AEC Ⅱ culture. To the A1 - 3 groups aspirin 50, 100 and 200 μmol/L were added respectively. Cell form, cell count and cell survival rate were observed at 3 hours after H2O2 was given. Immunohistochemical and polymerase chain reaction (PCR) methods were used for the determination of heme oxygenase-1 (HO-1) protein and HO-1 mRNA (20, 40, 60 hours of culture). Results With trypsin digestion and immune adherence method AEC Ⅱ could be harvested (2.0- 2. 5)× 107, and the purity and activity were both over 90%. Compared with NS group, gaps between cells were widened in H2O2 group, cell account was reduced, and the survival rate (A value) was reduced significantly (0. 054 6±0. 004 0 vs. 0. 103 8±0. 009 9, P＜0. 01). Compared with H2O2 group, in A1 - 3 groups the number of adherent cells was increased, cell morphology was intact, and no obvious cell shrinkage was found. Higher survival rate (A value) was found in A1 - 3 groups than that of H2O2 group (0. 066 9±0. 003 9, 0. 071 0±0. 006 5,0. 078 7±0. 009 2 vs. 0. 054 6±0. 004 0, all P＜0. 01). Compared with NS group, HO-1 protein and HO-1 mRNA expression in AEC Ⅱ after 20, 40 and 60 hours of culture reached peak level at 60 hours, and they were increased significantly in A1 - 3 groups [protein (A value) : 1.59±0. 12, 1.60±0. 09, 1.61±0. 08 vs.1.25±0. 11; mRNA (the ratio of Ct value: 24.31±1.74, 30. 45±2. 53, 32. 63±3. 74 vs. 22.99±1.95, all P＜0. 05]. There was no significant difference in HO-1 protein expression among A1 - 3 groups. Conclusion There are significant protective effects of aspirin against anti-oxidative damage in cultured AEC Ⅱ cell.As expression of HO-1 is increased in aspirin groups, it may be considered as a protective factor agninst anti-oxidative damage in AEC Ⅱ cell culture.     

差示聚合酶链式反应检测骨髓转移的神经母细胞瘤N－myc扩增及临床意义

测定骨髓转移神经母细胞瘤（ＮＢ）Ｎ－ｍｙｃ扩增情况及评价其与预后的关系。采用差示ＰＣＲ法检测１７例骨髓转移ＮＢ的Ｎ－ｍｙｃ拷贝数，并随访１年。结果，１２例（７０．５９％）证实有Ｎ－ｍｙｃ扩增。Ｎ－ｍｙｃ扩增与ＮＢ分期及患者预后均成显著相关（分别为Ｐ＜０．０５，Ｐ＜０．０１）。有Ｎ－ｍｙｃ扩增者预后差，且扩增倍数越高则预后越差。因此，Ｎ－ｍｙｃ扩增对于ＮＢ分期及预后评估均为有价值的指标，它可能与ｃ－ｍｙｃ协同调控ＮＢ的生物学特性。差示ＰＣＲ作为一种建立在内参照原理上的新方法可定量测定基因拷贝数，比Ｓｏｕｔｈｅｒｎ杂交更简便、快速、灵敏、精确，适于临床应用。尤值一提的是，该法需样品量很少，且无同位素沾染。     

急性磷化氢中毒七例临床分析

急性磷化氢中毒是吸入较高浓度磷化氢气体后引起的以神经系统、呼吸系统损害为主的全身性疾病。贵州省为全国黄磷生产重要基地之一，时有职业中毒发生。我院近期收治了7例急性磷化氢中毒患者，经抢救治疗全部痊愈出院，现将有关临床资料报告如下。