不同临床表现的腔隙性脑梗死患者的临床分析

目的探讨和研究不同临床表现的腔隙性脑梗死患者的临床资料,为临床诊断和治疗提供依据。方法选取本院近年来收治的74例腔隙性脑梗死患者的临床资料作为研究对象进行分析。结果患者在临床表现方面主要表现为运动性偏瘫,这在所有患者中占比重最大;影像学检查方面,具有临床症状的患者病灶部位基本都位于基底节区,无明显临床症状的患者病灶部位则主要位于基底节区以外的脑实质;有症状和无症状患者在其他伴发症状对比上,差异无统计学意义（P〉0.05）。结论腔隙性脑梗死的患者临床表现主要以运动性偏瘫为主,表现为肢体功能障碍,而不同临床表现的患者在影像学检查结果上也存在一定差异,掌握其特点能够为临床诊断和治疗提供重要的参考价值。     

腔隙性脑梗死临床分析

目的 探讨腔隙性脑梗死(LCI)的临床特点.方法 回顾性分析50例LCI患者的临床资料.结果 本组50例患者中高血压痛41例(82%),高脂血症17例(34%),高黏血症20例(40%),糖尿病12例(24%).常见临床类型为单纯运动性偏瘫22例,单纯感觉性卒中10例,无症状腔隙性梗塞6例,共济失调性卒中5例,腔隙状态5例,CT漏诊2例,后经MRI检查确诊.病灶部位主要在基底节区22例,内囊6例,丘脑区4例.结论 高血压是LCI的直接原因,腔隙病灶主要位于基底节;腔隙状态的预后差,MRI对脑干、小脑及(O)＜5mm或发病24h内的病灶优于CT.     

CT、MRI检测早期腔隙性脑梗死的价值研究

目的分析电子计算机断层扫描(CT)和磁共振成像技术(MRI)检测在早期腔隙性脑梗死患者诊断中的价值。方法选取在我院经MRI弥散加权序列技术(DWI)确诊的120例早期腔隙性脑梗死患者作为研究对象。所有患者均进行了CT、常规序列MRI检查,对比分析CT、MRI检查诊断早期腔隙性脑梗死的部位、病灶数量、病灶尺寸与金标准的差异及两种方法检查的差异,计算CT、MRI诊断腔隙性脑梗死的符合率。结果 (1)CT、MRI与DWI检查出的早期腔隙性脑梗死患者部位构成情况比较差异无统计学意义,CT与MRI之间的检出部位构成比较差异无统计学意义(P>0.05);(2)CT、MRI检查出的早期腔隙性脑梗死病灶数量较DWI少,CT较MRI少(P>0.05);(3)CT检查出的早期腔隙性脑梗死病灶直径高于MRI和DWI,MRI高于DWI(P<0.05);(4)MRI诊断腔隙性脑梗死与金标准的符合率高于CT(P<0.05)。结论 MRI常规序列检查诊断早期腔隙性脑梗死对小病灶的检出率及病灶数量更具优势,为早期腔隙性脑梗死患者的治疗提供更为详尽可靠的数据,具有更高的临床价值。     

CT和MRI在筛查早期腔隙性脑梗死患者诊断中的价值对比分析

目的对CT和MRI在筛查早期腔隙性脑梗死患者诊断中的价值进行对比分析。方法选取2011年10月至2014年9月我院收治的早期腔隙性脑梗死患者100例分别进行CT和MRI扫描检查,对两种检查的诊断价值进行分析。结果 MRI扫描检查病灶定位、病灶总数量、成像清晰满意度、小病灶发现情况均显著优越于CT检查,MRI扫描检查检查费用、扫描操作时间均高于CT扫描检查,差异性显著,存在统计学意义(P<0.05)。两种扫描检查均没有发生不适症状发生。结论 MRI扫描检查对于早期腔隙性脑梗死可更加清楚、明确的对病灶位置及数量进行准确的诊断,成像更加清晰,医师满意度较高,能够更加清楚的发现微小病灶,但CT扫描检查更加经济方便,因此CT可进行筛查诊断,MRI适合对病灶进行进一步诊断和治疗,二者均具有较高的临床价值。     

腔隙性脑梗死112例临床特点及预后分析

目的 总结腔隙性脑梗死的临床特点.方法 选择112例腔隙性脑梗死病例资料进行回顾性分析.结果 约40%患者有轻微症状,25%患者无临床症状体征,只在脑CT或核磁共振（MRI）影像上有病变显示.65%的患者为多发性腔隙性脑梗死,112例患者累计病灶219个.再发者76例,其中46%患者发展为痴呆、语言障碍、双侧瘫.结论 腔隙性脑梗死患者症状体征大都较轻,其临床表现多样化;再发者比率高;再发后随其梗塞灶的增多,出现认知障碍和其他功能异常加重,远期预后不佳.     

腔隙性脑梗死的临床病因分析与前瞻性研究

目的研究分析腔隙性脑梗死的易患因素、梗死部位与临床意义。方法回顾性分析106例经CT证实有腔隙性脑梗死患者的临床资料,对易患因素、梗死部位、临床表现及预后加以分析研究。结果腔隙性脑梗死患者男性多于女性,多发于基底节、半卵圆中心区,临床体征类型多,以运动性偏瘫多见。结论腔隙性脑梗死具有高发性、症状无特异性,常常容易忽略或误诊,对高发人群应进行重点防治,早发现早治疗,结合CT或MRI提高诊断准确率。     

CT与核磁共振在腔隙性脑梗死中的诊断意义分析

目的探讨CT与核磁共振在腔隙性脑梗死中的诊断意义。方法选择我院腔隙性脑梗死患者共60例,均为初次发病患者。本组60例均行CT和MRI检查。分析CT及MRI图形,记录不同部位下的病灶数量。结果MRI检测结果：基底节区病灶数量为18个、脑干病灶数量为15个、丘脑病灶数量为14个、额叶病灶数量为11个、顶叶病灶数量为8个、小脑病灶数量为7个、颞叶病灶数量为6个、枕叶病灶数量为4个。CT检查结果：基底节区病灶数量为10个、脑干病灶数量为8个、丘脑病灶数量为9个、额叶病灶数量为4个、顶叶病灶数量为3个、小脑病灶数量为4个、颞叶病灶数量为2个、枕叶病灶数量为4个。MRI共检测出病灶数量为83个,CT检查出病灶数量共43个,CT检查病灶数量结果与MRI比较,差异有统计学意义（P〈0．05）。结论核磁共振对腔隙性脑梗死有较高诊断价值,对病灶检查结果优于CT,值得借鉴。     

MRI和CT检查在腔隙性脑梗死中的应用分析

目的分析MRI(磁共振成像)和CT(电子计算机断层扫描)检查在腔隙性脑梗死患者中的诊断效果。方法抽取2015年3月至2017年4月前来我院就诊的84例腔隙性脑梗死患者,所有患者均行MRI和CT检查,根据影像学结果比较两种检查方法的诊断效果。结果 84例腔隙性脑梗死患者经MRI检查确诊756个病灶,CT检查确诊158个病灶,差异有统计学意义(P <0.05);丘脑、额叶、内囊检出率MRI检出率高于CT(P <0.05);MRI和CT在基底节、顶叶和脑干检查中差异无统计学意义(P> 0.05);MRI检查出273个直径<5 mm的病灶,CT仅检查出7个,二者比较差异较大(P <0.05)。结论 MRI和CT检查均可应用于腔隙性脑梗死诊断中,但MRI检查优于CT,可作为腔隙性脑梗死患者临床诊断首选方法。     

小剂量尿激酶、低分子肝素钠和硫酸镁治疗急性腔隙性脑梗死

我院于1999～2003年应用小剂量尿激酶、低分子肝素钠和硫酸镁治疗急性腔隙性脑梗死,现报告如下. 1资料与方法 1.1病例选择本文68例病程均少于6小时,经头CT、MRI及临床表现诊断为"基底节区腔隙性脑梗死".     

133例腔隙性脑梗死临床CT分析

目的：探讨CT对腔隙性脑梗死的诊断价值。方法：133例经CT诊断及临床治疗确诊的腔隙性脑梗死进行回顾性分析。结果：133例患者共发现腔隙灶315个,多数具有典型的CT表现,部分可疑病灶及较小病灶通过薄层扫描或重叠层面扫描可以发现病变,对少数CT检查阴性者,48h后短期复查均可明确诊断。结论：腔隙性脑梗死的CT表现和诊断对临床具有重要价值。     

Developments in multiple breath washout testing in children with cystic fibrosis

Background: Lung clearance index (LCI) is becoming recognized as an important addition in the monitoring of pediatric cystic fibrosis (CF). The non-invasive technique is easy to perform in all ages, reproducible and increasingly being used in clinical trials. There is interest in utilizing it within the clinic setting but its current use is mostly as a research tool. The procedure is highly dependent on skilled operators and a relaxed testing environment is key to obtaining good quality measurements.

Conclusions: Standardization of LCI is part of an ongoing collaborative, multicenter process. This review describes the background to LCI, discusses technical issues and limitations and provides examples of its utility in clinical and research contexts.     

银屑病性关节炎的临床研究与X线分析

目的:回顾分析银屑病性关节炎(PsA)的临床特点及X线表现,以提高对PsA X线表现的认识。方法:对2016年—2019年收治的20例PsA的临床表现及X线表现进行分析,总结出PsA的常见X线表现。结果:20例PsA中,8例有单个关节的受累变化,12例有两个及以上关节的受累变化。临床表现为关节疼痛及周围软组织肿胀,常表现为“腊肠样”变化;X线片表现为关节间隙狭窄或增宽,关节边缘和中央部骨侵蚀及骨质增生,关节边缘虫蚀状破坏,晚期出现骨性强直。结论:PsA的X线表现具有多样性,实验室检查缺少特征性,需结合临床资料以提高诊断的准确性。     

一氧化碳中毒迟发性脑病28例临床分析

目的:探讨一氧化碳中毒迟发性脑病的临床特点。方法:对已经确诊的28例一氧化碳中毒迟发性脑病的临床资料进行回顾性研究。结果:28例患者均有精神行为异常,20例不能完成平时熟悉的日常活动,4例表情呆滞,行动迟缓,3例步态不稳,2例大小便不能自理。结论:一氧化碳中毒迟发性脑病临床表现复杂多样,提高对本病的认识是防止漏诊误诊的关键,高压氧治疗有效。     

艾滋病合并肺结核28例临床及CT表现

目的探讨艾滋病（AIDS）合并肺结核的临床及CT表现特点。方法对28例已确诊AIDS合并肺结核患者的临床资料及CT表现进行分析。结果AIDS合并肺结核常见临床表现为：咳嗽、咳痰、发热、盗汗、消瘦、呼吸困难、腹泻、浅表淋巴结肿大等。CT表现多为：弥漫粟粒性病变、斑片浸润灶、肺门或纵隔淋巴结肿大、胸腔积液。空洞及钙化少见。结论AIDS合并肺结核的临床及CT表现多为不典型,其表现与机体免疫状态有关。当AIDS患者肺内出现弥漫粟粒性病变、斑片浸润灶、肺门或纵隔淋巴结肿大、胸腔积液时应首先诊断合并肺结核的可能。     

Emerging drugs for Cushing’s disease

Introduction: Considering the effects of uncontrolled hypercortisolism on morbidity and mortality, there is a clear need for effective medical therapy for patients with Cushing’s disease (CD). Therefore, the search for new medical effective tools remains active, and already promising results have been obtained.

Areas covered: The importance of the design and conduct of trials to validate old drugs or to test new compounds is discussed. The results of the ongoing clinical trials, targeting the specific properties of drugs, such as ketoconazole, LCI699, mifepristone, etomidate and pasireotide, are also reported. The authors also emphasise the advantages and drawbacks of each particular drug, and the potential combined use of agents with complementary mechanisms of action.

Expert opinion: CD is an excellent example of a situation where effective therapy is essential, but where the balance of risk and benefit must be carefully judged. Metyrapone is the drug of choice when rapid control of the hypercortisolaemia is required, ketoconazole represents a good second-line drug, although in the future LCI699 may be a better alternative. Mifepristone can also be used in the rare situation when previous drugs are inappropriate. Etomidate is useful where immediate parenteral action is required. For drugs working directly on the pituitary, cabergoline is occasionally effective and pasireotide can be attempted in patients with mild CD.     

小儿肺炎支原体感染的临床分析

目的:探讨小儿肺炎支原体(MP)感染的临床特点及诊断治疗。方法:回顾性分析了286例MP感染患儿的临床特点及诊治过程。结果:286例MP感染中,均有呼吸系统表现,其中支原体肺炎200例(69.9%),肺外感染106例(37.1%),神经系统、心血管系统、泌尿系统、血液系统、消化系统及皮肤、淋巴结均可受累。结论:MP感染临床表现多样,可伴随多系统损害。早期诊断可结合临床表现,确诊依赖于抗MP-IgM的检查。     

45例老年患者药物性肝损伤临床特点分析

摘 要 目的:探讨老年患者药物性肝损伤病历特点及发病因素,为临床防治提供资料。方法：回顾性分析我院45例老年药物性肝损伤患者服药史、临床表现、基础疾病、治疗及转归等。结果：45例中女32例,男13例;基础疾病主要为心血管病（26%）、骨关节病（14%）、感染性疾病（12%）、感冒（10%）、皮肤病（6%）等;涉及药品64种,其中前5位是中药（56.2%）、解热镇痛药（9.4%）、心血管类药（9.4%）、抗感染药（7.8%）、消化系统药（6.3%）;主要临床表现为尿黄、乏力、纳差等;45例患者治愈34例,好转11例。结论：引起老年人药物性肝损伤的药物以中药为主,临床表现形式多样,但转归较好。     

硫普罗宁对合并乙型肝炎的肺结核患者抗结核药物治疗时保肝作用的观察

目的 研究硫普罗宁治疗乙型肝炎病毒标志物阳性肺结核患者短程化疗中对肝脏的保护和治疗作用.方法 收集我院收治的乙型肝炎病毒标志物阳性肺结核患者640例,按住院号分为治疗组330例和对照组310例.2组均采用相同的肺结核化疗方案,治疗组在强化阶段加服硫普罗宁100 mg,3次/d.定期复查2组患者肝功能变化,并观察其临床症状.结果 治疗组有70例(21.2%)ALT升高,且为一过性,无一例停止化疗;对照组有150例(48.4%)ALT升高,6例出现黄疸,8例中断治疗.2组ALT升高程度及肝损害程度差异具有统计学意义(P＜0.05).治疗组发热、咳嗽、盗汗平均消退时间分别为(10.0±4.6)、(10.8±5.2)及(12.4±7.0)d;对照组分别为(12.8±4.0)、(12.6±4.4)、(16.2±6.4)d.2组差异有统计学意义,P＜0.01.结论 硫普罗宁能减轻化疗中出现的肝脏不良反应,保护肝功能,改善结核中毒症状,对结核患者短程化疗具有积极的辅助治疗意义.

Abstract：

Objective To study the proctective effect of liver function with tiopronin in tuberculousis patients with hepatitis B. Methods Pulmonary tuberculosis patients with hepatatis B were randomly divided into 2 groups: tiopronin treatment group and normal treatment group. Two groups were given short-course anti-tuberculous treatment. The abnormalisise of hepatic function,clinical manifestations and the onset time of abnormalisise of hepatic function and clinical manifestations were compared and analyzed. Results There was a significant improvement in the abnormalisise of hepatic function and clinical manifestations in tiopronin treatment group (P ＜ 0.05).Conclusions Tiopronin can reduce the liver adverse reactions,protect liver funtions and improve the toxic symptoms. It will play a positive role in adjuvant therapy of short-couse chemotherapy of pulmonary tuberculousis patients with hepatitis B.     

儿童蚂蚁咬伤35例临床分析

目的：总结儿童蚂蚁咬伤的临床特点、诊断及治疗。方法：选取2011年6月至2014年6月因蚂蚁咬伤在我院就诊的35例患儿,对其临床资料、实验室检查、治疗方案进行分析。结果：35例患儿均治愈。26例表现局部变态反应,予抗过敏治疗后治愈。3例表现严重过敏反应,其中2例患儿出现过敏性休克,1例出现窦性心动过速,予抗休克、相应抢救措施等处理后治愈。结论：蚂蚁咬伤后可出现轻重不同的变态反应,及早识别严重过敏反应,及时予对症、抗过敏等治疗预后良好。     

Sustained response to interferon-α or to interferon-α plus ribavirin in hepatitis C virus-associated symptomatic mixed cryoglobulinaemia

BACKGROUND: Hepatitis C virus (HCV) infection has been associated with mixed cryoglobulinaemia. AIM: To investigate the efficacy of anti-viral therapy on the eradication of HCV and its clinical manifestations in patients with HCV-associated symptomatic mixed cryoglobulinaemia. PATIENTS AND METHODS: 18 out of 32 patients with symptomatic mixed cryoglobulinaemia (MC group) received a 12-month course of interferon (3 MU three times a week, subcutaneously). Nonresponders or relapsers to this therapy were treated with interferon plus ribavirin (1200 mg/day, orally) for 12-months. 226 patients with HCV infection and without cryoglobulins were studied in comparison (Hepatitis C group). Serial quantification of serum HCV-RNA and cryoglobulins were performed. RESULTS: In the MC group, 10 out of 18 patients (55%) receiving interferon showed an end of treatment response, but at the end of follow-up, only five (28%) patients had a sustained response. In the hepatitis C group, 91 patients (47%) showed an end of treatment response but only 42 (20%) a sustained response. In the MC group alanine transaminase, cryocrit and rheumatoid factor decreased significantly in responders, with an improvement or disappearance of the MC-associated clinical manifestations. Alanine transaminase, cryocrit and rheumatoid factor increased in the relapsers and the clinical manifestations reappeared. Nonresponders and relapsers to interferon in the MC group were retreated with interferon plus ribavirin. Five out of eight nonresponders showed a end of treatment response but it was sustained in three of them. In the relapsers, treatment with combined therapy achieved a sustained response in four out of the five patients (80%). CONCLUSIONS: Interferon as monotherapy or combined with ribavirin is a safe and effective treatment in patients with HCV-associated MC. The presence of cryoglobulins does not affect the response to anti-viral treatment in patients with HCV infection. The eradication of HCV is associated with an improvement or disappearance of MC-associated clinical manifestations.