Electrotaxis of alveolar epithelial cells in direct-current electric fields

Purpose: This study aims to elucidate the electrotaxis response of alveolar epithelial cells (AECs) in direct-current electric fields (EFs), explore the impact of EFs on the cell fate of AECs, and lay the foundation for future exploitation of EFs for the treatment of acute lung injury. Methods: AECs were extracted from rat lung tissues using magnetic-activated cell sorting. To elucidate the electrotaxis responses of AECs, d...     

重症急性胰腺炎"个体化治疗方案"评估

重症急性胰腺炎“个体化治疗方案”是在 1991年提出来的[1] 。当时的背景情况是 :70年代我国对坏死性胰腺炎的治疗还处在全部用非手术治疗的阶段。由于临床的治疗失败教训 ,我们被迫采取手术干预 ,手术方式由引流、灌洗、坏死清除发展到规则性切除包括胰腺次全切除[2 ] ,手术疗     

过量服用"感康"致急性肾衰竭1例

病　　例患者 ,女性 ,6 3岁 ,朝鲜族 ,农民。因躁动不安 ,意识欠清 ,少尿水肿 2d入院。 2d前因“感冒”自行顿服“感康”6片 ,服药约 4h后出现躁动不安 ,意识欠清 ,当时无抽搐发作 ,无肢体运动障碍 ,在当地医院作头CT未见异常 ,查脑脊液压力不详 ,潘氏反应 (+) ,细胞数 10× 10 6/L ,蛋白0 .5 g/L,怀疑脱髓鞘脑病 ,具体治疗不详 ,病情未见缓解。继之出现眼睑水肿伴少尿 ,2 4h尿量约 4 0 0ml,化验肾功能有改变 ,Scr 30 1μmol/L ,为求进一步治疗入我院。查体 :血压 12 0 /75mmHg。意识不清 ,无自主语言 ,查体不合作 ,双肺呼吸音粗 ,可闻及…     

冬季海南"候鸟人群"急性胆囊炎临床特点分析

目的探讨海南冬季"候鸟人群"急性胆囊炎发作的临床特点。方法回顾性分析2017年至2019年3个冬季(11月~次年2月)在解放军总医院海南医院因急性胆囊炎入院治疗的患者资料。依据确诊时抵达海南的时间分为短期组(<30 d)、中期组(30~89 d)和长期组(>90 d),比较三组患者的一般资料、合并疾病情况、胆囊炎临床特点等,并进一步分析短期组化脓性胆囊炎和非化脓性胆囊炎患者临床特征。结果共纳入120例患者,其中短期组49例,男性29例,女性20例,年龄(65.18±15.02)岁;中期组24例,男性13例,女性11例,年龄(66.21±11.93)岁;长期组48例,男性30例,女性18例,年龄(60.73±12.54)岁。三组患者的年龄、性别、体质量指数、吸烟史及饮酒史情况的组间差异均无统计学意义(P>0.05)。三组患者治疗方式及转归情况差异均无统计学意义(P>0.05)。与长期组患者相比,短期组患者合并高血压[20.83%(10/48)比48.98%(24/49)]和糖尿病[10.42%(5/48)比30.61%(15/49)]比例较高,短期组的胆囊壁厚度较长期组厚[0.60(0.40,0.70)cm比0.50(0.30,0.60)cm],差异具有统计学意义(P<0.017)。短期组急性胆囊炎患者中化脓性胆囊炎比例高于长期组[48.15%(13/27)比17.24%(5/29)],差异具有统计学意义(P<0.017)。短期组中化脓性胆囊炎的泥沙样结石[38.46%(5/13)比14.29%(2/14)]、胆囊穿孔[30.77%(4/13)比0]、胆囊坏疽[53.85%(7/13)比7.14%(1/14)]、胆囊周围积液[76.92%(10/13)比14.29%(2/14)]、腹腔积液[46.15%(6/13)比7.14%(1/14)]比例高于非化脓性胆囊炎患者,差异均具有统计学意义(P<0.05)。结论"候鸟人群"抵达海南短期内发作急性胆囊炎者炎症重,易合并化脓、穿孔、坏疽等,合并高血压病和糖尿病者可能是"候鸟人群"抵达海南后短期内发作急性胆囊炎的高危人群。     

HBV感染与妊娠期急性脂肪肝的相关性研究

目的：探讨HBV感染对妊娠期急性脂肪肝（AFLP）的发生率及妊娠结局的影响。方法采用回顾性调查方法对HBV感染的AFLP孕妇9例和无HBV感染的AFLP孕妇42例进行对比分析,采用t检验和χ2检验进行统计学分析,观察HBV感染对妊娠期肝内胆汁淤积症（ICP）发生率及妊娠结局的影响。结果伴有HBV感染的AFLP孕妇发生率显著高于一般人群,且其发病时间显著早于无HBV感染的AFLP患者,两者差异均具有统计学意义（P均＜0.05）;伴HBV感染的AFLP孕妇早产发生率、新生儿窒息率、产后出血发生率均显著高于无HBV感染的AFLP孕妇,差异均具有统计学意义（P均＜0.05）。结论 HBV感染可使AFLP的发生率增高,易引起早产、新生儿窒息率及产后出血率增高,应加强对该类患者的孕产期监护和治疗,以保证母婴的健康和安全。     

降结肠癌引起"左腰部脓肿"1例报告

降结肠癌常表现为大便习惯改变和便血,也可发生急性梗阻,但本例以左腰部脓肿为首发临床表现的却极为少见。现报告如下。病例介绍患者男,44岁。因左腰部肿痛一周,加重一天急诊入院,患者平时无消瘦、贫血、腹痛、血便、大便习惯改变。入院体检:神清,T38℃,心肺腹部(一)。左腰部10     

"秦氏疼痛方"外敷治疗后肢急性软组织损伤大鼠模型的实验研究

目的 探讨中药"秦氏疼痛方"外敷治疗后肢急性软组织损伤大鼠模型的抗炎作用及其机制.方法 成年雄性SD大鼠40只,随机分成正常对照组(10只,直接生理盐水外敷)、模型对照组(10只,急性压榨伤造模后生理盐水外敷)、扶他林乳剂对照组(10只,急性压榨伤造模后扶他林乳剂外敷)、"秦氏疼痛方"治疗组(10只,急性压榨伤造模后"...     

老年AECOPD患者发生急性肾损伤的危险因素分析

目的探讨老年慢性阻塞性肺疾病急性加重(AECOPD)患者中急性肾损伤(AKI)的发病率及相关影响因素。方法回顾性分析本院2014年1月至2020年4月间收治的诊断为AECOPD的1 523例老年患者的临床资料, 记录患者的年龄、性别、合并症、基础疾病、实验室检查等临床指标, 按是否发生AKI分为AKI组(325例)与非AKI组(1 198例), 分析老年AECOPD患者发生AKI的危险因素。结果与非AKI组相比, AKI组的年龄偏高, 急性呼吸衰竭、肺性脑病、心血管疾病及肾脏病的比例更高, 白细胞、C反应蛋白、血钾水平偏高而血红蛋白、血白蛋白、血小板水平偏低(均P<0.05)。多因素logistic回归分析结果显示高龄(OR=1.06,P<0.001)、并发有急性呼吸衰竭(OR=1.49,P=0.015)、肺性脑病(OR=2.34,P=0.015), 高血压病(OR=1.38,P=0.032)、冠状动脉粥样硬化性心脏病(OR=1.54,OR=0.005)、心房颤动(OR=1.54,P=0.043)、慢性肾脏病(OR=4.48,P<0.001)及白细胞计数(OR=1.0...     

急性坏疽性胆囊炎的“冷分离”腹腔镜胆囊切除术

目的探讨急性坏疽性胆囊炎时"冷分离"腹腔镜胆囊切除术的可行性以及手术技巧。方法回顾性分析河南科技大学第一附属医院普外科41例急性坏疽性胆囊炎行腹腔镜胆囊切除术的临床资料。术中采用分离钳剥离、配合吸引器刮吸的"冷分离"技术切除胆囊。结果 39例完成腹腔镜胆囊切除术,2例中转开腹手术,手术中转率为4.9%。手术时间为(70.37±13.35)min,术中无肝胆管损伤,术后无胆囊床渗血或胆漏发生。术后并发切口感染2例,切口血清肿1例,下肢浅静脉血栓形成1例,右下肺感染1例,均治愈出院。本组前12例平均手术时间为(86.67±11.69)min;后29例平均手术时间为(63.55±6.23)min,两者比较,差异有统计学意义(P0.01)。结论急性坏疽性胆囊炎行"冷分离"腹腔镜胆囊切除术安全可行,分离钳和吸引器相结合的"冷分离"技术是手术成功的有效方法。     

N-乙酰半胱氨酸对重症急性胰腺炎大鼠肠道屏障功能障碍与二次打击的保护作用

目的 观察N-乙酰半胱氨酸(NAC)对重症急性胰腺炎(SAP)大鼠肠屏障功能障碍与二次打击的防护作用.方法 雄性Wistar大鼠54只随机分为SAP组(n=24)、SAP+NAC组(n=24)和假手术组(n=6).建模后3、6、12、24 h,取腹主动脉血液和小肠、胰腺、肺脏、肝脏组织.光镜下观察小肠组织病理改变,检测各时段血浆肿瘤坏死因子(TNF)-α、白细胞介素-6(IL-6)和二胺氧化酶(DAO)活性,以及胰腺、肺脏、肝脏中髓过氧化物酶(MPO).结果 SAP组各时间点血液TNF-α、IL-6、DAO均较假手术组显著升高(P＜0.01),6、12、24 h胰腺、肺脏、肝脏MPO较假手术组显著升高(P＜0.05或P＜0.01);与SAP组比较,SAP+NAC组各时间点血液TNF-α、IL-6显著下降(P＜0.05或P＜0.01),6、12、24 h三个时间点DAO活性均显著降低(P＜0.05或P＜0.01),12、24h胰腺、肺脏、肝脏MPO显著减少(P＜0.05或P＜0.01).结论 NAC可有效防护SAP大鼠肠屏障功能障碍,并可减轻胰腺、肺脏、肝脏遭受二次打击的严重程度.     

供肝零时相活检组织学特征与术后早期并发症的相关性研究

目的探讨供肝零时相活检病理学改变与术后早期并发症的关系,寻找预示并发症发生的早期形态学指标,为临床采取预防性诊疗措施提供依据。方法91例肝移植术中零时相活检标本,经常规病理制片,HE染色,利用双盲法进行组织形态学观察。结果91例供肝有40例（44.0%）发生缺血-再灌注损伤。其术后发生排斥反应和胆道并发症的概率及出现晚期或持续性保存损伤的概率显著高于无缺血-再灌注损伤表现的供肝（P〈0.05）。中央型坏死和细胞凋亡程度较重时排斥反应和胆道并发症发生的概率均显著高于程度较轻的供肝（P〈0.05）。汇管区炎症较重的供肝术后出现晚期或持续性保存损伤的概率显著高于汇管区炎症较轻的供肝（P=0.021）。结论供肝术中灌注后零时相活检的组织病理学改变对术后采取预防性诊疗措施具有重要指导意义。     

Hemolytic uremic syndrome (HUS) secondary to cobalamin C (<Emphasis Type="Italic">cblC</Emphasis>) disorder

Diarrhea-positive hemolytic uremic syndrome (HUS) is a common cause of acute renal failure in children. Diarrhea-negative (D−), or atypical HUS, is etiologically distinct. A Medline search identified seven previously reported D− cases of HUS secondary to cobalamin C (cblC) disease presenting in infancy. An infantile presentation is reported to be associated with a high mortality rate (6/7 cases). We describe the results of a 5-year longitudinal follow-up in a child diagnosed with D− HUS secondary to cblC disease in infancy. Mutation analysis in this patient identified homozygosity for the 271 dupA mutation (c.271 dupA) in the cblC MMACHC gene. We briefly review the published experience in cblC-associated HUS to highlight the clinical characteristics of this uncommon, but potentially treatable, condition.     

Acute Renal Failure as a Complication of Acute Pancreatitis

To assess the prevalence of acute renal failure (ARF) inpatients with acute pancreatitis, as well as the factors predictive of a lethal outcome, we retrospectively studied the data of all patients admitted to our hospital over a 5-year period. Between 1989 and 1993, 554 patients presented with acute pancreatitis, of which 24 (4.4%) subsequently developed ARF. Death occurred in 14/24 (58%) of patients with ARF, and was associated with an increased incidence of multiorgan failure. There was no statistically significant difference in the age, admission blood pressure, or admission pulse rate of the patients who survived and those who died. In contrast, death was associated with a higher Ranson score, and the increased prevalence of multiorgan failure. The length of hospitalization of the nonsurviving group was significantly shorter. Acute renal failure is not a common finding in patients with acute pancreatitis. However, when it occurs, it is associated with a poor prognosis, and is predicted by a higher Ranson score and the presence of multiorgan failure.     

Severity of illness scores and the outcome of acute tubular necrosis

The outcome of patients with acute renal failure (ARF)due to acute tubular necrosis (ATN) was evaluated inthis study. Two hundred and twenty-two patients witha mean age of 55.l ± 17.7 years (range 19–97years; male 153, female 69) who developed ATN in theperiod from July 1991 through January 1997 werestudied. Patients were divided into four groupsaccording to their APACHE II scores at the time of thediagnosis of ATN. Group I included patients with anAPACHE II score of 14 or less (n = 70), Group II with ascore of 15–18 (n = 52), Group III with a score of 19–23(n = 58), and group IV with a score of 24 or above(n = 42). The mean APACHE II score for each of the fourstudy groups was 11 ± 0.4, 16 ± 0.2, 20 ±0.2, and 29 ± 0.7, respectively. Patient survivalwas evaluated by the Kaplan-Meier analysis withcensorship at 12 months. Survival rates at 180 dayswere 67%, 47%, 39%, and zero%, for group I through IV respectively, χ² = 27.99, p < 0.0001,with a median survival of >365, 120, 31, and 11days, for groups I through IV, respectively. For patients with oliguria (n = 88) survival at 180days was 23% vs. 58% for patients without oliguria(n = 134), p < 0.0001, median survival 13 vs. 364 d.Six months survival of those who required dialysis(n = 79) was 25% vs. 58% for those whom dialysis wasnot needed (n = 143), p = 0.001, median survival 15 vs.364 d, respectively. In patients with sepsis (n = 58),6 months survival was 35% vs. 50% for those withoutsepsis (n = 164), p = 0.013, median survival 14 vs. 169 d. In patients who required mechanical ventilation(n = 72), 6 months survival was 17% vs. 62% for those whodid not need respiratory support (n = 150), p = 0.0001,median survival 13 vs. > 365 d, respectively. Finally, 6 months survival in patients with one(kidney only), two, three, and four organ failure was76, 30, 11, and zero percent, respectively, p = 0.0001,median survival > 365, 16, 11, and 12 days,respectively. We conclude that the use of the APACHE II score forthe stratification of the severity of illness could beof clinical utility in predicting mortality inpatients with ATN. Other predictors of poor prognosisinclude the need for dialysis, the presence ofoliguria, the need for mechanical ventilation, thepresence of sepsis, and the number of failed organs. This revised version was published online in August 2006 with corrections to the Cover Date.     

A case of a giant cystic lymphangioma mimicking acute appendicitis

Cystic lymphangiomas are rare tumours that can mimic various causes of acute abdomen including appendicitis. They exhibit variations in two characteristics on presentation: they can arise from a wide range of organs including various intra-abdominal structures and they can have a wide variation in size on presentation. We report a case of a gigantic cystic lymphangioma presenting as an acute abdomen closely mimicking acute appendicitis and we conduct a review of the relevant literature.