胸水抽取方法的改进

胸水抽取方法的改进周志远徐春雷冷瑞芝张守文１９９５～１９９６年，笔者对１０例大量胸腔积液患者共２３次采用改良的胸水抽取方法，同时配合静脉途径用药，治疗效果良好。现予报道。１临床资料１０例均为结核性胸膜炎大量胸腔积液，影响呼吸功能。男性７例，女性３例；...     

血肿腔穿刺加大剂量尿激酶注入治疗高血压脑出血35例

目的探讨高血压脑出血不同手术方式的疗效。方法对我科4年来用血肿腔穿刺加大剂量尿激酶注入治疗高血压脑出血病人的临床特点及疗效进行回顾性分析。结果35例患者均随访6个月,死亡7例,死亡率为20%,全愈16例,无1例再出血,生存质量明显改善。结论大剂量尿激酶使用安全可靠,大大提高手术疗效。     

肠易激综合症的临床治疗观察

目的 探讨培菲康联合舒丽启能治疗肠易激综合症的临床意义。方法 将肠易激综合征患者107例随即分成A，B两组，A组给予培菲康（420mg tid）及舒丽启能（200mg tid），B组仅给予舒丽启能（200mg tid），疗程4周，观察两组临床疗效。结果 A组缓解率为88．9％，B组为66．0％（P〈0．01）。结论 培菲康联合舒丽启能治疗肠易激综合症有明确的临床意义。     

血小板表达TLR4调节LPS刺激血小板释放细胞因子的作用

Objective To affirm the expression of Toll like receptor 4 (TLR4) on the surface membrane of platelet and to explore the immunomodulatory factors[(interlukine-8(IL-8),β-thromboglobulin(β-TG), soluble CD40 ligand(sCD40L)] released by platelets after platelets stimulated by TLR4 ligand.Methods TLR4 expressed on the platelet was detected by flow cytometry. Monoclonal anti-human FcγRⅡantibody(Ⅳ.3)-treated human platelets were cultured with LPS in the presence or absence of blocking monoclonal antibody to human TLR4. The release of IL-8, β-TG, sCD40L were measured by specific enzymelinked immunosorbent assay. Results Human platelets could express functional TLR4. The detection rate of TLR4 on platelets were decreased after LPS involvement(P<0.01). It was noted that sCD40L and β-TG were present in large concentration in the release of platelets stimulated by TLR4 ligand but the release of IL-8 was independent of platelet activation after TLR4 engagement. The concentration of sCD40L and β-TG had no statistical difference between 1-5 μg/ml LPS. The effects of LPS on the modulation of secretory factors were attenuated by preincubation of platelets with an anti-TLR4 monoclonal antibody. Conclusion The TLR4 on platelet could recognize and link LPS, induce the release of sCD40L, β-TG by platelet, but could not influence IL-8.     

颞肌下小骨窗治疗基底节区高血压脑出血

目的探讨基底节区高血压性脑出血颞肌下小骨窗减压的手术方法、操作技巧和临床效果,进一步总结该方法在临床上的微侵袭理念。方法回顾性总结分析了采用颞肌下小骨窗减压手术治疗35例基底节区高血压性脑出血病例。结果术后24 h内35例手术患者均复查头颅CT明确颅内基底节区血肿清除效果,其中28例颅内血肿清除率>90%,4例颅内血肿清除率<70%,3例颅内再出血,出血量不多,没有再次行手术治疗。术后存活34例,死亡1例,死亡原因为颅内再出血伴肺部感染。存活者随访6个月~1年不等,根据GOS五级划分,Ⅰ级:恢复良好,患者可正常生活22例;Ⅱ级:中度残废,有功能障碍,但可独立生活7例;Ⅲ级:重度残废,清醒,但生活不能自理3例;Ⅳ级:植物生存1例;Ⅴ级:死亡1例。结论颞肌下小骨窗减压手术治疗基底节区高血压性脑出血效果令人满意,具有操作简单、创伤小、止血彻底、血肿清除率高、再出血几率小、神经功能恢复好等优点。     

血小板表达TLR4调节LPS刺激血小板释放细胞因子的作用

Objective To affirm the expression of Toll like receptor 4 (TLR4) on the surface membrane of platelet and to explore the immunomodulatory factors[(interlukine-8(IL-8),β-thromboglobulin(β-TG), soluble CD40 ligand(sCD40L)] released by platelets after platelets stimulated by TLR4 ligand.Methods TLR4 expressed on the platelet was detected by flow cytometry. Monoclonal anti-human FcγRⅡantibody(Ⅳ.3)-treated human platelets were cultured with LPS in the presence or absence of blocking monoclonal antibody to human TLR4. The release of IL-8, β-TG, sCD40L were measured by specific enzymelinked immunosorbent assay. Results Human platelets could express functional TLR4. The detection rate of TLR4 on platelets were decreased after LPS involvement(P<0.01). It was noted that sCD40L and β-TG were present in large concentration in the release of platelets stimulated by TLR4 ligand but the release of IL-8 was independent of platelet activation after TLR4 engagement. The concentration of sCD40L and β-TG had no statistical difference between 1-5 μg/ml LPS. The effects of LPS on the modulation of secretory factors were attenuated by preincubation of platelets with an anti-TLR4 monoclonal antibody. Conclusion The TLR4 on platelet could recognize and link LPS, induce the release of sCD40L, β-TG by platelet, but could not influence IL-8.     

SOCS1对炎症和辅助性T细胞作用的研究进展

细胞因子信号传导抑制因子(suppressors of cytokine signaling,SOCS)是由细胞产生并反馈性阻断细胞因子信号转导过程的负性调节因子.近年来很多学者及实验团队对其的研究不断加深,发现其主要通过JAK-STAT通路在炎症的预防及治疗中起着关键的作用并且是辅助性T细胞分化和发挥功能的重要调节剂.主要专注于SOCS1在炎症和辅助性T细胞发挥功能中的作用的最新进展.     

维库溴铵联合机械通气治疗重症哮喘的临床价值

目的 探讨肌松剂维库溴铵联合机械通气治疗重症哮喘的临床效果和安全性.方法 回顾分析急诊科采用维库溴铵救治的11例重症哮喘患者的临床资料.结果 11例患者均救治成功,其中2例需无创通气过渡撤机,通气时间 (46.7±12.5)h.维库溴铵治疗前后患者血压、心率、呼吸频率、血气指标(pH值、PaCO2、PaO2)及呼吸机压力参数(PEEPi、Ppeak)比较,差异有统计学意义(P＜0.05).结论 对于重症哮喘患者的治疗,在常规镇静及机械通气治疗不达标的情况下,加用维库溴铵,可显著改善患者临床症状,值得临床应用.     

双侧侧脑室引流脑脊液置换治疗重型脑室出血(附12例报告)

目的 探讨重型铸型性脑室出血的有效治疗方法。方法 采用双侧侧脑室穿刺,置管外引流,脑脊液置换,尿激酶灌注的方法治疗重型脑室出血全脑室铸型12例。结果 本组12例患者,72 h头颅CT显示脑室积血大部分清除,7 d头颅CT显示9例基本清除,10 d头颅CT显示2例基本清除,12 d头颅CT显示1例血肿基本清除。12例患者,经治疗4周时,GOS评分：优良5例,轻残3例,重残2例,死亡2例。结论 该治疗方法是一种治疗重症脑室出血全脑室铸型的有效的方法,可提高脑室出血患者的生存质量和生存率。     

抽脓注药治疗肛管直肠周围脓肿20例

抽脓注药治疗肛管直肠周围脓肿２０例周志远徐春雷冷瑞芝张敬东王桂林张明早１９８６年３月以来，我科对中小型肛管直肠周围脓肿，采用局部抽脓后注入抗生素治疗２０例，临床疗效良好，兹作报道。１临床资料１．１一般资料男８例，女１２例；年龄８～７６岁，平均４０．６...