老年结核性胸膜炎88例临床分析

目的 探讨老年结核性胸膜炎临床特点、及提高其治疗效果.方法 回顾性分析88例老年结核性胸膜炎患者的临床资料,并与123例青年结核性胸膜炎的临床资料进行比较.结果 老年结核性胸膜炎的临床表现与青年组有明显不同,老年组并发症明显高于青年组.PPD试验阳性率老年组明显低于青年组(P＜0.05),血性胸水老年组明显高于青年组(P＜0.05).老年组治愈32例(36.4%),明显低于青年组(96例,78.0%)(P＜0.05).老年组药物副作用明显高于青年组(P＜0.05).结论 老年结核性胸膜炎病情复杂多变,应及早诊断,及早治疗,积极处理并发症,以提高临床治愈率.     

老年与青年结核性胸膜炎临床对比分析

目的探讨老年患者结核性胸膜炎的临床特点。方法本院2003至2004年间共收治结核性胸膜炎443例,老年患者结核性胸膜炎77例,青年患者结核性胸膜炎172例,就两组临床特点实验室检查资料进行对比分析,统计学处理用卡方检验。结果老年患者结核性胸膜炎以气急、胸痛症状较多见,青年患者结核性胸膜炎发热明显,而痰血或咯血、盗汗、消瘦、纳差无明显差异。合并肺结核、慢支肺气肿多见。血液及胸水结核抗体阳性率较青年组高,血性胸水老年患者多见。治疗后胸水吸收时间慢,易出现胸膜增厚,治愈率低于青年组。结论掌握老年患者结核性胸膜炎的临床特点,综合分析,早期诊断。治疗老年患者应尽可能做到个体化用药。     

老年结核性胸膜炎67例临床分析

目的 :总结老年结核性胸膜炎的临床特点 ,并探讨其治疗方法。方法 :对住院资料完整的 67例老年结核性胸膜炎采用回顾性分析 ,并随机选择同期住院资料完整的成人结核性胸膜炎 5 2例作为对照组 ,分析其临床特点及治疗方法。结果 :老年结核性胸膜炎以咳嗽、气急、纳差症状较多见 ,发热等结核中毒症状不典型 ,合并肺结核、慢支肺气肿多见 ,治疗前总体营养状况较青年组差 ,血结核抗体阳性率较成年组高 ,治疗后胸水吸收时间慢 ,治愈率低于青年组。结论 :掌握老年结核性胸膜炎的临床特点 ,综合分析 ,早期诊断 ,加强支持营养治疗 ,可取得较好疗效。     

88例老年结核性胸膜炎临床分析

目的:探讨老年患者结核性胸膜炎的临床特点.方法:本院1996至2005年间共收治老年结核性胸膜炎患者88例,青年结核性胸膜炎患者90例,就两组临床特点实验室检查资料进行对比分析.结果:老年患者以气急、胸痛症状较多见,青年患者发热明显.老年患者合并肺结核、慢支肺气肿多见.血液及胸水结核抗体阳性率较青年组低,血性胸水老年患者多见.治疗后胸水吸收时间慢,易出现胸膜增厚,治愈率低于青年组.结论:掌握老年患者的临床特点,综合分析,早期诊断.治疗上除常规抗痨外,应加强全身支持疗法,采取多种措施,提高治愈率.     

集宁区九龙社区卫生服务站老年结核性胸膜炎临床特点分析

目的探讨老年结核性胸膜炎的临床特点.方法回顾性分析30例老年结核性胸膜炎的临床资料,并与31例中青年结核性胸膜炎进行比较.结果老年组咳嗽、气急、纳差、乏力、血性胸腔积液、合并症和副作用例数明显多于中青年组(P<0.01或P<0.05),胸腔积液吸收时间亦长于中青年组(P<0.01).两组疗效比较差异无显著性(P>0.05).结论老年结核性胸膜炎临床表现多样,因伴有老年常见合并症故易漏、误诊.     

老年人结核性胸膜炎60例临床分析

老年人结核性胸膜炎６０例临床分析张华茹，张勇刚为提高老年人结核性胸膜炎的诊治水平，探讨其临床特点，现将我院１９８３～１９９３年间收治的资料完整的老年结核性胸膜炎患者６０例临床资料进行分析。１资料与方法１．１病例选择：选取的老年性结核性胸膜炎患者，临床...     

老年结核性胸膜炎30例临床特点分析

目的探讨老年结核性胸膜炎的临床特点。方法回顾性分析30例老年结核性胸膜炎的临床资料,并与31例中青年结核性胸膜炎进行比较。结果老年组咳嗽、气急、纳差、乏力、血性胸腔积液、合并症和副作用例数明显多于中青年组(P<0.01或P<0.05),胸腔积液吸收时间亦长于中青年组(P<0.01)。两组疗效比较差异无显著性(P>0.05)。结论老年结核性胸膜炎临床表现多样,因伴有老年常见合并症故易漏、误诊。     

老年结核性胸膜炎的临床特点

近年来老年结核性胸膜炎有增多趋势,了解老年结核性胸膜炎的临床特点,对避免误诊、漏诊、延误治疗有一定意义。本文分析本院1986～1991年收治的老年初治结核性胸膜炎病人25例并与同期收治的20～39岁青年结核性胸膜炎病人89例比较。一、临床资料 1.一般情况:1986～1991年本院共收治结核性胸膜炎患者309例,其中初治者为153例;20～39岁(青年组)89例(58％),60岁以上(老年组)25例(26％)。老年组25例中男性23例,女性2例,年龄60～87岁,两组患者起     

结核性胸腔积液50例老年患者临床特点分析

目的 探讨老年结核性胸腔积液的临床特点.方法 选择诊断明确的50例老年结核性胸膜炎的及临床资料,并与60例中青年结核性胸膜炎进行比较.结果 老年组乏力、消瘦、胸闷、气短、血性胸腔积液、合并症和副作用例数明显多于中青年组(P＜0.01或P＜0.05),胸腔积液吸收时间亦长于中青年组(P＜0.01).两组疗效比较差异无显著性(P＞0.05).结论 老年结核性胸膜炎临床表现多样,因伴有老年常见合并症故易漏、误诊.     

老年结核性胸膜炎25例临床分析

近年来老年结核性胸膜炎有增多趋势（‘），了解老年结核性胸膜炎的临床特点对避免误诊、漏诊及延误治疗有一定意义。本文分析我本院1994－1998年收治的老年结核性胸膜炎25例（老年组），并与同期收治的20－40岁青年结核性胸膜炎随机抽取50例比较。l临床资料1．l～极资料老年组25例男16例，女9例，年龄60－78岁，平均68岁，病程lino－Zy，平均6。；青年组50例男26例，女24例，年龄20－40岁，平均29岁，病程15d－Za，平均4tno。病史中，老年组胸痛21例，咳嗽、哈痰17例，气紧15例，发热1例；青年组胸痛36例，发热力例，咳嗽、咯痰23例，气紧…     

Value of D-Dimers in patients with acute aortic dissection

Objective: To evaluatel the value of D-dimers in patients with acute aortic dissection (AAD). Methods: This study consisted of 16 patients with AAD and 27 non-AAD patients. Serum D-dimets were measured by Sta-Liatest D-DI immunoturbidimetric assay. Results: D-dimer level was higher (P ＜ 0.001) in patients with AAD(7.91 ± 5.52 μg/ml) than that in non- AAD group(1.57±1.24 μg/ml). D-dimer was positive (＞0.4 μg/ml) in all patients with AAD and in 10 control group patients (37%). Among patients with acute AAD, D-dimers tended to be higher in Stanford A than in Stanford B (8.67 ± 4.31 μg/ml vs. 3.24±1.27 μg/ml, P ＜0.01). D-dimer values tended to be higher in more extended disease(3.84 ± 1.65 μg/ml, 8.57 ± 3.58 μg/ml and 11.87 ± 5.69 μg/ml in thoracic aorta, thoracic and abdominal aorta, thoracic and abdominal aorta and iliacal arteries, respectively, P ＜ 0.05 for both 8.57 ± 3.58 and 11.87 ± 5.69 vs. 3.84 ± 1.65 ). Including the control group into the analysis, we found a sensitivity of 100%, a negative predictive value of 100%, and a specificity of 66% and a positive predictive value of 64% for D-dimer in diagnosis of AAD in our patients with suspected AAD. Conclusion: D-dimer was elevated in patients with AAD. A negative D-dimer test result could be useful in excluding AAD.     

Research of combined liver-kidney transplantation model in rats

Objective： To set up a simple and reliable rat model of combined liver-kidney transplantation. Methods： SD rats served as both donors and recipients. 4℃ sodium lactate Ringer＇s was infused from portal veins to donated livers,and from abdominal aorta to donated kidneys, respectively. Anastomosis of the portal vein and the inferior vena cava （IVC） inferior to the right kidney between the graft and the recipient was performed by a double cuff method, then the superior hepatic vena cava with suture. A patch of donated renal artery was anastomosed to the recipient abdominal aorta. The urethra and bile duct were reconstructed with a simple inside bracket. Results： Among 65 cases of combined liver-kidney transplantation, the success rate in the late 40 cases was 77.5%. The function of the grafted liver and kidney remained normal. Conclusion： This rat model of combined liver-kidney transplantation can be established in common laboratory conditions with high success rate and meet the needs of renal transplantation experiment.     

BLOOD PRESSURE CHANGE WITH AGE IN SALT-SENSITIVE TEENAGERS

Objective To observe blood pressure change with age in salt-sensitive teenagers whose salt sensitivity were determined by repeated testing.Methods Salt sensitivity was determined through intravenous infusion of normal saline combined with volume-depletion by oral diuretic furosemide in 55 teenagers. After five years, salt sensitivity was re-examined and subject blood pressure was followed up. Blood pressure changes in salt-sensitive teenagers were compared to that of non-salt sensitive teenagers over five years.Results After 5 years, the repetition rate of salt sensitivity determined by intravenous saline loading is 92.7%. In teenagers with salt sensitivity on the baseline, both the systolic blood pressure increments and increment rates were much higher than non-salt sensitive teenagers (12.7±12.1 mmHg vs. 2.8±5.2 mmHg, P＜ 0.01; 12.2%± 12.0% vs. 2.5% ±4.4%, P＜ 0.001,respectively). There was a similar trend for diastolic blood pressure (8.4 ± 6.4 mmHg vs. 3.7 ± 6.4 mmHg, P = 0.052; 13.2% ±10.6 % vs. 6.8%± 10.1%, P = 0.053, respectively).Conclusions Salt sensitivity determined by intravenous saline loading showed good reproducibility. Blood pressure increments with age were much higher in salt-sensitive teenagers than non-salt sensitive teenagers, especially in terms of systolic blood pressure.     

安心颗粒对急诊经皮冠状动脉介入术后生活质量影响的研究

目的：评价使用安心颗粒对急诊经皮冠状动脉介入术（PPCI）术后生活质量的影响.方法：将160例接受PPCI的急性ST段抬高型心肌梗死患者随机分为安心颗粒组（术前顿服安心颗粒8.8g,术后安心颗粒4.4 g/次,每日2次）和对照组（仅接受基础药物治疗）.所有患者均服用阿司匹林、氯吡格雷和阿托伐他汀.分别在入院时、出院前1d、出院后180 d时,应用心肌梗死多维度量表（MIDAS）、中文版SF-36评价量表对患者生活质量评分.并观察术后30 d以内的出血并发症、血小板减少症发生情况.结果：入院时和出院前1d,两组患者的心肌梗死MIDAS、SF-36量表评分比较无差异（P＞0.05）;出院后180 d时,与对照组比较,安心颗粒组MIDAS、SF-36评分明显减低（P＜0.05）;组内与入院时比较,两组出院前1d、出院后180 d时,MIDAS、SF-36评分均降低（P＜0.05）.两组患者在随访期间均无大量出血、少量出血、重度和极重度血小板减少症发生,安心颗粒组有4例、对照组有7例发生不明显出血（P＞0.05）.两组发生轻度血小板减少症的患者数比较无差异（P＞0.05）.结论：PPCI使用安心颗粒,能改善急性ST段抬高型心肌梗死患者的生活质量,且不增加出血风险.     

The comparative studies of the influences of Urapidil and Nicardipine on sino-atrial node function, atrio-ventricular node function and hemodynamics

Objective:To investigate the influences of urapidil and nicardipine on rabbit sinus function,atrio-ventricular node function and hemodynamics.Methods:Thirty-two Angora's rabbits were selected and randomly divided into four groups.U1 group:urapidil 0.25 mg/kg;U2 group:urapidil 0.5 mg/kg;N1 group:nicardipine 10 μg/kg;N2 group:nicardipine 20 μg/kg.All these medicine were administrated within 30 seconds.Measurements were taken before and after the administration of urapidil or nicardipine for the following data:mean blood pressure(MAP),heart rate(HR),sino-atrial conduction time(SACT),maximal sinoatrial recovery time(SNRTmax)corrected sinus node recovery time(CSNRT),index of sinus node recovery time(SNRTI),Wenckebach A-V conduction frequency (WB),and P-R interval.Results:Significant MAP and HR changes were identified in all of the four groups before and after administration of both urapidil and nicardipine.No significant changes could be found in the rest of the parameters.Intergroup analysis showed that SACT and CSNRT of N1 and N2 groups were shorter than those of the U2 group(P＜0.01);the MAP decreased(P＜0.01)and the HR increased drastically(P＜0.01).Conclusions:Neither urapidil(0.25 mg/kg,0.5 mg/kg)nor nicardipine(10μg/kg,20μg/kg)has any significant influence on rabbit sinus function or rabbit atrio-ventricular node function.Nicardipine could be a better choice than urapidil for parafunctional sinus node patients.     

Expression of OPGmRNA and ODFmRNA in the patients of hip fracture due to osteoporosis

Objective：To investigate the gene expression of osteoprotegerin（OPG） and osteoclast differentiation factor（ODF） in the bone tissue of patients with hip fracture due to osteoporosis. Methods：OPGmRNA and ODFmRNA in the bone tissue in 50 cases of osteoporosis sufferers（over 50 years old） with hip fracture（Observer Group） and 30 cases of hip facture sufferers with no osteoporosis（Control group） were analyzed with the Semi-Quantitative RT-PCR method. Results：The mRNA expressed of ODF, OPG were both high in the patients with hip fracture. In the control group, the expression of OPG mRNA was observed, while the expression of ODF mRNA was very slight. Conclusion：Aged patients contained all signals including OPG, ODF that are essential for inducing osteoclastogenesis and promoting bone resorption.     

The clinicopathological and immuohistochemical analysis of solid-pseudopapillary tumor of the pancreas： report of 9 cases

Objective：To investigate the clinical features, pathological characteristics and immunophenotype of solid-pseudopapillary tumor of the pancreas（SPTP）. Methods：Nine surgically treated cases of SPTP were retrospectively reviewed. Hematoxylin and Eosin（HE） staining and immunohistochemical staining were used to analyze all cases, and the general clinical data was collected. Results：Six patients were asymptomatic except for a palpable mass. Two patients complained of vague-epigastric pain. One patient appeared jaundice. The tumor was encapsulated and solid tissues alternately with cystic tissues. Histologically, the histological structure of solid portion was pseudopapillary with a fibrovascular core. Tumor cells were uniform and medium-sized which were arranged in sheets ets or nests or pseudopapillary patterns. Immunohistochemical studies demonstrated that SPTP proved positive in vimentin（9/9 cases）, AAT（9/9 cases）, NSE（9/9 cases）, ACT（7/9 cases）, CK20（2/9 cases）, CgA（1/9 cases）, S-100（3/gcases）, PR（4/gcases）, Syn（3/9 cases） and CD56（5/9cases）, negative in CEA and ER. Conclusion：SPTP is a tumor predominantly occurring in young women frequently without special symptoms. This tumor has various characteristical histological patterns with different immunophenotype.     

Dynamic Changes in Serum Estradiol and Progesterone levels in Patients of Premenstrual Syndrome with Adverse Flow of Liver-qi

Objective:To probe into the influence of changes of ovarian hormones on the pathogenesis of the specific sub-type premenstrual syndrome(PMS)and reveal partial microcosmic mechanisms of adverse flow of liver-qi.Methods:Estradiol(E2)and progesterone(P)levels in serum were determined at different phases of menstrual cycle by radioimmunoassay.Results:In the group of PMS with adverse flow of liver-qi.the secretive peak value Of E2 and P at the follicular phase significantly decreased,and the secretive peak value at the luteal phase did not come into being.Conclusions:Low E2 and P secretive peak at the follicular phase and absence of secretive peak at the luteal phase is one of the microcosmic mechanisms of PMS with adverse flow of liver-qi.One of the pathophysiologic mechanisms of specific sub-type PMS is probably the continuous low level of E2and P.     

Real-time Three-dimensional Echocardiography in Assessment of Left Ventricular and Right Ventricular Volumes

Real-time three-dimensional echocardiography (RT3DE)is a new ultrasound technique that enables dynamic threedimensional visualization and quantification of the heart in real time. Investigation of feasibility and methodology of RT3DE in determining left ventricular (LV) and right ventricular (RV) volumes, RT3DE was performed in 35 normal adults using Philips SONOS 7500 system with a 2-4 MHz matrix array transducer. The 60°×60° "pyramid" volume database was obtained and analyzed on a TomTec echo workstation. Both LV and RV volumes were calculated with four 3DE methods (i.e. apical 2, 4, 8, and 16-plane) through manually tracing ventricular endocardial borders in end diastole and end systole. Stroke volumes were then calculated. LV volume was also measured by 2DE Simpson's rule using GE VIVID 7 ultrasound machine.     

SCREENING FOR A 21-CHROMOSOME ABNORMALITY IN PREIMPLANTED EMBRYOS OF ELDERLY WOMEN

Increasing maternal age is the only etiological factor unequivocally linked to Down's syndrome in humans. The occurrence rate of newborns with Down's syndrome is about 1/220 in women over 35 years old. However, the occurrence rate in embryos fertilized in vitro, of the elder woman is unclear. Using FISH we screened the number of chromosome 21 in preimplanted embryos of 5 elderly women (average age, 38.4 years) to study the feasibility and necessity of screening trisomy 21 in embryos in patients over 35 years old at the in vitro fertilization (IVF) center.