高原昏迷12例的临床病理学研究

报道12例高原昏迷的病理组织学和超微结构变化,总结了本病的临床病理学特点并探讨其发病机理.脑重量1260～1730克,平均1448克。光镜观察脑组织疏松水肿,4例脑出血,6例小血管水肿并微血栓形成。神经细胞呈缺血缺氧性改变。电镜观察神经原纤维溶解,突触肿胀,髓鞘变性或解离,核蛋白体减少.本病基本原因为高原急性缺氧造成神经组织损伤和功能障碍,临床早诊断早治疗尤为重要.     

细支气管腺瘤的CT表现与病理对照研究

本研究回顾性分析了16例肺细支气管腺瘤(BA)的CT表现及相应的病理改变。共纳入16例BA患者, 病变直径8～32 mm, 10例表现为磨玻璃密度, 6例为实性结节, 4例有囊腔形成, 1例增强扫描呈轻度强化。病理上主要表现为基底细胞层和腔面细胞层构成的双层细胞结构呈乳头状和/或沿肺泡壁(平坦状)生长。影像上表现为实性结节的BA在病理上表现为肺泡腔内分泌黏液较多, 而影像上表现为磨玻璃密度结节的BA在病理上表现为肺泡腔内黏液较少。     

肺泡微石症的CT表现

目的 研究肺泡微石症的CT表现.方法 收集经临床病理证实肺泡微石症6例,其中男3例,女3例,年龄26～51岁,其中3例为一家族发病.6例均做了胸部X线和CT检查.结果 根据本病的临床、肺实质和肺间质的侵犯程度将其分为3类,轻度表现为肺实质微结石形成,见1例;中度除肺实质微结石形成外伴有轻度肺间质损害,见3例;重度表现有严重的肺间质纤维化,见2例.结论 根据肺实质和肺间质损害分类,其与临床和影像表现一致,有助于本病影像诊断.     

急性高原肺水肿116例胸部X线片分析

作者分析了海拔 3 65 0m地区的急性高原肺水肿患者的X线表现。结果发现 ,1 1 6例急性高原肺水肿患者 ,肺泡实变型占 79% ,其中弥漫型肺泡实变占 49% ,中央型和局限型分别占 1 4%和 1 6% ,肺间质渗出型占 2 1 %。肺动脉高压占 5 1 % ,右侧水平裂增厚占 1 1 %。急性高原肺大肿X线表现的病理基础一般认为 ,因急性高原缺氧迅速引起肺动脉高压 ,肺血容量及毛细血管通透性增加 ,导致血管内水份外渗过多 ,聚集于肺间质和肺泡腔内 ,形成间质性肺水肿和肺泡性肺水肿 ,分别表现为肺纹理增多夹杂斑点结节状影和肺泡实变影。同时 ,由于低氧性肺动脉高…     

高龄老人肺炎临床特点与护理

随着年龄增长,老年人免疫功能逐渐下降,老年人的肺脏、肺组织呈老年性改变,肺实质细胞数减少,肺弹性减弱,肺泡壁间质纤维增加,肺动能贮备力下降.由于动脉硬化,肺血循环障碍等病理生理特点易患肺炎,肺炎的发病率很高,是老年人的多发病.据报道有并发病的死亡率高达57%,无并发病死亡率达17%.因而临床的老年人肺部感染的观察护理十分重要.现将我院1991～1993年住院80岁以上高龄老人肺炎45例临床特点及护理体会如下:     

外科治疗肺大皰症38例疗效观察

我院 1988年 3月～ 1998年 12月共收治肺大症 4 1例 ,其中手术 38例 ,术后病理证实均诊断正确。现将手术体会报告如下。1　临床资料1 1　一般情况　本组 38例 ,男 31例 ,女 7例 ,年龄 13～ 34岁 ,首次发病 2 5例 ,2次发病 8例 ,3次发病 5例 ,其中双侧先后发病 4例。1 2　症状与体征　一般多无临床症状 ,阳性体征也不明显 ,如肺大破裂 ,常为突发气短并伴有进行性呼吸困难伴咳嗽、胸痛 ,本组 32例入院时呈端坐呼吸 ,患侧肺叩诊呈过清音 ,呼吸音消失。1 3　Ｘ线检查　 2 3例患侧肺被压缩 90 %以上 ,其中 15例同时伴有中少量胸腔积液 ,6例肺…     

高原肺水肿超微结构变化

本文使用电镜对高原肺水肿患者及同海拔健康者各４名肺组织的超微结构改变进行观察。结果揭示肺水肿患者呼吸系统广泛水肿，肺泡上皮细胞明显肿胀、水肿，肺泡Ⅱ型上皮细胞损害较重，肺毛细血管细胞连接间隙增宽，气血屏障内外侧结构局部缺损，这些形态学改变是高原肺水肿作为一种高蛋白、高渗出性肺水肿的病理基础。     

结节型支气管肺泡细胞癌的CT-病理对照

作者回顾性研究了11例病理证实的结节型肺泡癌CT表现。男性7例,女性4例,年龄35～70岁,病变平均直径2.7±0.7cm。光镜显示大量细胞并明显贴近肺泡壁呈鳞屑状而无其它原发腺癌的证据时即可确认之。采用Somatom DR扫描机,层厚8mm,自肺尖扫至肺底。至结节区于深吸气末屏气附加2mm薄层扫描(时间1.2～5s,350mAs,120kVp)。6例薄层扫描采用高分辨率算法重建。以肺窗(窗位—700HU,窗宽1500HU)观察所有病例并专设一窗     

CT引导肺穿刺活检23例分析

目的探讨CT引导下肺穿刺活检的临床诊断价值。方法回顾分析23例CT引导下肺穿刺活检的病理诊断结果与穿刺术中遇到的问题。结果腺癌7例，鳞癌8例，结核3例，小细胞未分化癌1例，小细胞肺泡癌1例，神经鞘瘤1例，未采集到标本1例，穿刺未成功1例。阳性率91．3％。结论（汀引导肺穿刺活检临床诊断价值高。     

肺癌36例非转移性肺外表现分析

肺癌非转移性肺外表现常常被忽视。为提高认识,1988年6月～1998年6月,我们收集肺癌130例,对其中非转移性肺外表现36例进行了分析。1　临床资料1.1　一般情况　本组36例,男27例,女9例,男∶女=3∶1;年龄22～86岁,平均58岁。鳞癌14例,腺癌8例,小细胞癌5例,大细胞癌3例,肺泡细胞癌2例,未分型4例。1.2　非转移性肺外表现　主要为肌无力症、周围神经病变等神经肌肉症状,库欣综合征、低钾血症、高血糖、高血压、乳腺增生等内分泌功能失调症状和骨关节病变,以及贫血、皮损、静脉栓塞等(附表)。附表　肺癌36例非转移性肺外表现分布(例)病理类型神经肌…     

Knee injury and Osteoarthritis Outcome Score (KOOS) - validation of a Swedish version

The Knee injury and Osteoarthritis Outcome Score (KOOS) is a self-administered instrument measuring outcome after knee injury at impairment, disability, and handicap level in five subscales. Reliability, validity, and responsiveness of a Swedish version was assessed in 142 patients who underwent arthroscopy because of injury to the menisci, anterior cruciate ligament, or cartilage of the knee. The clinimetric properties were found to be good and comparable to the American version of the KOOS. Comparison to the Short Form-36 and the Lysholm knee scoring scale revealed expected correlations and construct validity. Item by item, symptoms and functional limitations were compared between diagnostic groups. High responsiveness was found three months after arthroscopic partial meniscectomy for all subscales but Activities of Daily Living.     

Endovascular management of carotid-cavernous fistulas

Objective To investigate endovascular treatment of traumatic direct carotid-cavernous fistulas （CCF） and their complications such as pseudoaneurysms. Methods： Over a five-year period, 22 patients with traumatic direct CCFs were treated endovascularly in our institution. Thirteen patients were treated once with the result of CCF occluded, 8 twice and 1 three times. Treatment modalities included balloon occlusion of the CCF, sacrifice of the ipsilateral internal carotid artery with detachable balloon, coll embolization of the cavernous sinus and secondary pseudoaneurysms, and covered-stem management of the pseudoaneurysms. Results All the direct CCFs were successfully managed endovascularly. Four patients developed a pseudoaneurysm after the occlusion of the CCF with an incidence of pseudoaneurysm formation of 18.2% （4/22）. A total number of 8 patients experienced permanent occlusion of the ICA with a rate of ICA occlusion reaching 36.4% （8/22）. Followed up through telephone consultation from 6 months to 5 years, all did well with no recurrence of CCF symptoms and signs. Conclusion Traumatic direct CCFs can be successfully managed with endovascular means. The pseudoaneurysms secondary to the occlusion of the CCFs can be occluded with stent-assisted coiling and implantation of covered stents.     

The acutely limping child

Acute limping may be the result of multiple pathologies in children. The differential diagnosis varies based on the age of the child. Irrespective of age, the initial imaging work-up includes AP and frog leg radiographs of the pelvis and ultrasound; MRI may sometimes be helpful. In children less than 3 years, infections and trauma are most frequent. MRI is the imaging modality of choice when osteomyelitis is clinically suspected. Between the ages of 3 and 10 years, transient synovitis of the hip and Legg-Calvé-Perthes disease are main considerations but infection, inflammation and focal bony lesions are also considered. In children over 10 years, slipped capital femoral epiphysis also is considered.     

Do Balance Board Training Programs Reduce the Risk of Ankle Sprains in Athletes?

Introduction Ankle sprains are the most common musculo-skeletal injury that occurs in athletes,particularly in sports that require jumping and landing on one foot such as soccer,and basketball(1-4).These injuries often result in significant time loss from participation,long-term disability,and have a major impact on health care costs and resources(5-8).     

High Intensity Interval Training:New Insights

KEY POINTS ·High-intensity interval training(HIT)is characterized by repeated sessions of relatively brief，intermittent exercise.often performed with an“a11 out”effort or at an intensity close to that which elicits peak oxygen uptake(i.e.，≥90%of VO2 peak).     

Developmental validation of the PowerPlex(®) ESI 16 and PowerPlex(®) ESI 17 Systems: STR multiplexes for the new European standard

In response to the ENFSI and EDNAP groups’ call for new STR multiplexes for Europe, Promega^® developed a suite of four new DNA profiling kits. This paper describes the developmental validation study performed on the PowerPlex^® ESI 16 (European Standard Investigator 16) and the PowerPlex^® ESI 17 Systems. The PowerPlex^® ESI 16 System combines the 11 loci compatible with the UK National DNA Database^®, contained within the AmpFlSTR^® SGM Plus^® PCR Amplification Kit, with five additional loci: D2S441, D10S1248, D22S1045, D1S1656 and D12S391. The multiplex was designed to reduce the amplicon size of the loci found in the AmpFlSTR^® SGM Plus^® kit. This design facilitates increased robustness and amplification success for the loci used in the national DNA databases created in many countries, when analyzing degraded DNA samples. The PowerPlex^® ESI 17 System amplifies the same loci as the PowerPlex^® ESI 16 System, but with the addition of a primer pair for the SE33 locus. Tests were designed to address the developmental validation guidelines issued by the Scientific Working Group on DNA Analysis Methods (SWGDAM), and those of the DNA Advisory Board (DAB). Samples processed include DNA mixtures, PCR reactions spiked with inhibitors, a sensitivity series, and 306 United Kingdom donor samples to determine concordance with data generated with the AmpFlSTR^® SGM Plus^® kit. Allele frequencies from 242 white Caucasian samples collected in the United Kingdom are also presented. The PowerPlex^® ESI 16 and ESI 17 Systems are robust and sensitive tools, suitable for the analysis of forensic DNA samples. Full profiles were routinely observed with 62.5 pg of a fully heterozygous single source DNA template. This high level of sensitivity was found to impact on mixture analyses, where 54–86% of unique minor contributor alleles were routinely observed in a 1:19 mixture ratio. Improved sensitivity combined with the robustness afforded by smaller amplicons has substantially improved the quantity of data obtained from degraded samples, and the improved chemistry confers exceptional tolerance to high levels of laboratory prepared inhibitors.