30例四氧化二氮群体吸入中毒急救分析

临床资料 本组30例青年男性患者,年龄19-58岁,平均32.4岁,均因吸入泄漏的四氧化二氮（N2O4）气体30-50 min后急诊入院。临床表现：所有患者均有胸闷、心悸、气急,头晕、恶心,流涕、咽痛,刺激性咳嗽、呼吸困难;咳棕黄色痰14例;烦躁不安、意识障碍1例。查体：血压80-160/50-90 mmHg;体温〉37.2℃者21例,其中体温〉38℃者10例;呼吸浅快、     

脂多糖致肺血管内巨噬细胞分泌功能的改变

目的 探讨肺血管内巨噬细胞(PIM)在感染性急性肺损伤(ALI)发病中的作用.方法 采用改良Morton法分离、培养猪PIM;用贴壁法获得黏附的PIM,培养于RPMI 1640培养基,予10 mg/L脂多糖(LPS)刺激.用鼠胸腺细胞增殖法测定白细胞介素-1β(IL-1β)活性,酶联免疫吸附法(ELISA)测定IL-6、IL-8含量.结果 LPS刺激后,PIM释放IL-1β、IL-6和IL-8均增多,峰值分别出现在刺激后的2 h[IL-1β活性(10 400±2 389)次/min]、4 h[IL-6含量(0.80±0.36)μg/L]和6 h[IL-8含量(4.94±1.19)μg/L],与刺激前[IL-1β活性(213±85)次/min,IL-6含量(0.27±0.12)μg/L,IL-8含量(1.84±0.53)μg/L]比较差异均有统计学意义(均P＜0.01).结论 LPS刺激后,PIM分泌多种细胞因子,其中IL-1β升高最早,提示其在ALI发病早期起重要作用;而IL-6、IL-8升高较晚,且持续时间较长,可能对ALI的病情进展起重要作用.细胞因子间的相互作用在ALI的发病中似乎更为重要.

Abstract：

Objective To investigate the role of pulmonary intravascular macrophages(PIMs)in the pathogenesis of acute lung injury(ALI)due to infection. Methods Porcine pulmonary blood vessels were flushed by modified Morton method, and PIMs were isolated and cultured. The adhered PIMs were collected with adhesion method and incubated in RPMI 1640 medium. They were challenged with lipopolysaccharide (LPS, 10 mg/L). The activity of interleukin-1β(IL-1β), and contents of IL-6 and IL-8 in the culture supernatant were measured by method of thymocyte proliferation and enzyme linked immunoadsorbent assay (ELISA). Results The released contents of IL-1β, IL-6 and IL-8 from PIMs were increased significantly compared with those before LPS challenge, and they peaked at 2 hours[IL-1β activity:(10 400±2 389)scintillant count/min], 4 hours[IL-6 content:(0. 80± 0. 36)μg/L], and 6 hours[IL-8 content:(4. 94± 1.19)μg/L]after LPS challenge, and the differences were significant compared with those before LPS challenge[IL-1β activity:(213±85)scintillant count/min, IL-6 content:(0. 27 ± 0. 12)μg/L, IL-8 content:(1.84±0.53)μg/L, all P＜0. 01]. Conclusion Among the cytokines released from PIMs after LPS challenge, the increase in IL-1β occurred earlier in comparison with that of IL-6 and IL-8, suggesting that the former might play an important role at the early stage of ALI; on the other hand, though the increase in IL-6 and IL-8 contents occurred later than that of IL-1β but it lasted for a longer duration,suggesting that they might be associated with the advancement of ALI. The results also suggested that interaction of these cytokines played a more important role in the pathogenesis of ALI.     

少量胸腔积液及胸膜粘连的普通放射征象分析

目的：加深对少量胸腔积液及肋膈角区胸膜粘连的平片、透视征象，提高普通放射诊断正确率。材料和方法：对50例经CT证实的影像学资料进行回顾性分析。结果：平片对此两者不可鉴别；结合透视可作出较正确的诊断。CT明确诊断。结论：影像学不可定性。     

先天性肩胛骨高位症1例

患者男,37岁。因雷管爆炸致全身多发皮肤金属伤入院,胸部X线示:右侧肩胛骨明显抬高,肩胛骨上端平颈6椎体上缘水平,肩胛骨与颈椎间可见骨性条形影,左侧肩胛骨未见明显异常。双侧胸部可见多发点状、不规则形高密度影。诊断:右侧肩胛骨高位伴“肩椎骨”形成;双侧胸部多发异物影,结合病史考虑为多发皮肤内金属影。讨论:先天性肩胛骨高位症又称肩胛骨下降不全,本病是肩胛骨在胚胎发育过程中,由于受到某种因素的影响,如宫内压增高,肩胛带肌肉发育不良,肩胛骨与脊柱之间有异常连接而发生下降障碍所至。单侧发病者多表现为双侧颈肩部不对称,患侧颈…     

脑颜面血管瘤病1例

瘸例男,12岁.主因反复抽搐,呈间歇性加重10余年来我院就诊,以往未做过任何相关影像学检查.查体:右侧颜面部可见紫红色血管痣.右眼略向前突出,右眼结膜血管扩张.     

脂多糖致肺血管内巨噬细胞释放TNFα-、IL-1β及IL-8的改变

目的探讨肺血管内巨噬细胞（PIM）在感染性急性肺损伤（ALI）发病中的作用。方法仿Morton法灌洗肺血管床,贴壁法分离猪PIM,培养于RPM I 1640培养基,予10 mg/L脂多糖（LPS）刺激,胸腺细胞增殖法测PIM培养上清白细胞介素-1β（IL-1β）活性,酶联免疫吸附试验（ELISA）法测肿瘤坏死因子-α（TNF-α）和白细胞介素-8（IL-8）含量。结果 LPS刺激后,PIM释放TNF-α、IL-1β和IL-8增多,峰值分别出现在刺激后的1、2和6 h。与刺激前相比,P〈0.01。结论 LPS刺激后,PIM分泌多种细胞因子,其中TNFα-、IL-1β升高最早,提示其在ALI发病早期起重要作用;而IL-8升高较晚,且后者持续时间较长,可能对ALI的病情进展起重要作用。细胞因子间的相互作用在ALI的发病中似乎更为重要。     

少量胸腔积液及胸膜粘连的普遍放射征象分析

目的:加深对少量胸腔积液及肋膈角区胸膜粘连的平片、透视征象,提高普遍放射诊断正确率。材料和方法:对50例经CT证实的影像学资料进行回顾性分析。结果:平片对此两者不可鉴别;结合透视可作出较正确的诊断;CT明确诊断。结论:影像学不可定性。     

蜂蜇伤过敏性休克2例

蜂蜇伤后可致局部皮肤红肿痒痛，甚至引起过敏性休克、多脏器功能衰竭，但引起迟缓相I型变态反应过敏性休克的报道甚少，现将我院2例蜂蜇伤致迟缓型I型变态反应过敏性休克患者的救治体会报道如下。     

基于“军卫一号”下的计算机耗材管理与故障报修系统设计与实现

目的：实现计算机类设备耗材管理和故障维修工作的数字化管理,规范工作流程,提升工作效率。方法：根据工作实际,设计耗材管理和设备维修的工作流程,在软件实现上,采用C／S结构,基于“军卫一号”下的oraclelOg数据库,使用PowerBuilder9．0开发。结果：该系统包含档案管理、耗材的库存管理、故障报修等功能,对加强医院计算机类设备档案管理、配件耗材库存管理、故障报修管理工作等有很大帮助。结论：基本上实现了计算机档案管理、耗材库存管理、故障报修管理工作的数字化管理。