新型冠状病毒肺炎（COVID-19）CT表现初步探讨

【摘要】目的：探讨新型冠状病毒肺炎（COVID-19）的CT表现。方法：搜集武汉大学中南医院2019年12月20日-2020年1月22日收治的33例确诊为COVID-19患者的病例资料（男13例,女20例）,对其CT表现进行分析。结果：33例COVID-19患者均进行胸部CT检查,30例累及双肺,25例弥漫分布,33例均见磨玻璃密度影,15例合并纤维条索影,23例伴小叶间隔增厚,11例见支气管充气征,22例见胸膜肥厚,3例见双侧少量胸腔积液,1例合并淋巴结肿大,2例呈“白肺”。早期胸部CT主要表现为肺内磨玻璃密度影,肺外带胸膜下分布常见,以多发为主,进展期可引起网格样改变呈“铺路石”征,重症期病灶弥漫分布,甚至呈“白肺”,胸腔积液及纵隔淋巴结肿大少见。结论：了解COVID-19的CT表现对早诊断、早治疗和疗效评估具有重要作用。     

一位改变了我一生的医生

##正##Fukushima老师让我重新认识了"医生"这个词,让我知道,在美国,医生无论多么高尚,无论收入多么高都要以服务的心态来对待每一个病人。Fukushima老师是我2003年在美国学习时的妇产科主任,他是指导我科研的老师。在我看来,他是一个称得上是我一生中的人生导师的人,一个足以让我记忆一辈子的人。     

模拟高住低练对大鼠外周血内皮祖细胞增殖能力的影响

目的:观察体外原代培养模拟高住低练后大鼠外周血内皮祖细胞的生长情况,探讨低氧与运动复合刺激对其增殖能力的影响。方法:选用健康雄性SD大鼠24只,随机分为4组:常氧居住组,低氧居住组,常氧训练组和高住低练组。低氧居住组采用递减氧浓度刺激,常氧训练组采用递增负荷跑台训练,高住低练组采用递减氧浓度刺激和递增负荷跑台训练,每周训练6天,为期8周。方案结束后12h提取大鼠外周血,采用密度梯度离心法分离外周血得到单个核细胞,以条件培养基对其体外培养诱导分化获取内皮祖细胞,通过双荧光染色法观察细胞对乙酰化低密度脂蛋白的摄取和与荆豆凝集素1的结合以及形态学特征鉴定内皮祖细胞。倒置显微镜下计数贴壁细胞数量和集落数目以反映细胞增殖情况。结果:与常氧居住组相比,其余三组贴壁细胞数量和集落数目显著增加(P<0.01),高住低练组贴壁细胞数量显著高于常氧训练组和低氧居住组(P<0.01),常氧训练组贴壁细胞数量与低氧居住组比较无显著性差异(P>0.05)。结论:低氧和运动都能促进内皮祖细胞增殖,低氧和运动复合刺激效果更明显。     

妊娠合并甲状腺功能减退症或亚临床甲状腺功能减退症77例临床分析

Objective To investigate the maternal and fetal outcomes of pregnant women with hypothyroidism or subclinical hypothyroidism. Methods From Jan. 2005 to Mar. 2008, clinical records of 77 women with hypothyroidism (n=57) or subclinical hypothyroidism (n = 20) during pregnancy who delivered at Peking Union Medical College Hospital were reviewed. The basic information, maternal complications and neonatal outcomes of the patients were compared with 79 healthy women who delivered during the same period. Results The prevalence of maternal hypothyroidism during the study period was 0.74% ,and that of maternal subclinical hypothyroidism was 0.26%. The mean neonatal birth weight of women with hypothyroidism was lower than that of the control [(3191.8±659.47 g) vs (3301.9±423. 1 g), P<0.05], the incidence of abnormal glucose metabolism was higher (24.6% vs 11.4% ,P<0.05), and small for gestational age infants were more common than in the control group (12. 3% vs 2. 5%, P<0. 05). The maternal and fetal outcomes of women with subclinical hypothyroidism during pregnancy showed no difference compared with the control. Conclusions Early screening for the high risk women and appropriate management are important to improve the neonatal and fetal outcomes of women with hypothyroidism and subclinical hypothyroidism during pregnancy.     

乙状结肠代阴道成形术后人工阴道脱垂一例报告及文献复习

人工阴道成形术术式多样,形成的人工阴道发生脱垂相对罕见.本文报道了2009年11月北京协和医院收治的1例乙状结肠代阴道成形术后发生人工阴道脱垂的病例,并结合文献复习,分析其特点和处理方法.     

钟南山院士答记者问——爬楼喊累的人,要查肺功能

慢性阻塞性肺病是一种严重危及人类健康的肺部疾病,全世界平均每10秒就有一人因慢阻肺而死亡,该疾病已成为世界第五大致命性疾病。中国工程院院士钟南山在"慢阻肺在中国——新挑战,新思考"媒体会上接受记者访问时说:"民众应该像对心血管疾病、糖尿病等慢性疾病的关注和防治一样,提高对慢阻肺疾病的预防和治疗。"     

HIV阳性梅毒性直肠炎1例并文献复习

梅毒性直肠炎是由梅毒螺旋体引起的肠道疾病，一期、二期梅毒均可发生。由于梅毒螺旋体和HIV有相同的传播途径，所以二者常合并感染。梅毒性直肠炎缺乏特异性临床表现及影像学特征，容易误诊及漏诊。根据患者性行为史，临床表现及梅毒血清学、肠镜、病理检查可综合诊断。本文现对1例HIV阳性梅毒性直肠炎患者临床特征进行总结，并进行相关文献复习。     

妊娠合并甲状腺功能减退症或亚临床甲状腺功能减退症77例临床分析

Objective To investigate the maternal and fetal outcomes of pregnant women with hypothyroidism or subclinical hypothyroidism. Methods From Jan. 2005 to Mar. 2008, clinical records of 77 women with hypothyroidism (n=57) or subclinical hypothyroidism (n = 20) during pregnancy who delivered at Peking Union Medical College Hospital were reviewed. The basic information, maternal complications and neonatal outcomes of the patients were compared with 79 healthy women who delivered during the same period. Results The prevalence of maternal hypothyroidism during the study period was 0.74% ,and that of maternal subclinical hypothyroidism was 0.26%. The mean neonatal birth weight of women with hypothyroidism was lower than that of the control [(3191.8±659.47 g) vs (3301.9±423. 1 g), P<0.05], the incidence of abnormal glucose metabolism was higher (24.6% vs 11.4% ,P<0.05), and small for gestational age infants were more common than in the control group (12. 3% vs 2. 5%, P<0. 05). The maternal and fetal outcomes of women with subclinical hypothyroidism during pregnancy showed no difference compared with the control. Conclusions Early screening for the high risk women and appropriate management are important to improve the neonatal and fetal outcomes of women with hypothyroidism and subclinical hypothyroidism during pregnancy.