致心律失常性右室心肌病患者Epsilon波的检出率

Objective To investigate the prevalence of Epsilon wave in patients with arrhythmogenic right ventrieular cardiomyopathy (ARVC). Methods The Epsilon wave was detected in 32 patients [24 men, mean age (42.3±13.3) years] with ARVC using three different electrocardiography (ECG) recording methods: standard twelve leads ECG (S-ECG), right precordial leads ECG (R-ECG) and Fontaine bipolar precordiai leads ECG (F-ECG). The Epsilon wave was defined as wiggle, small spike wave and smooth potential between the end of the QRS complex and the beginning of the ST segment. Results Epsilon wave was detected in 37.5%, 37.5% and 50.0% patients with ARVC by S-ECG, R-ECG and F-ECG respectively. The detection rates derived from the three recording methods were similar(P ＞ 0.05). The Epsilon wave was only detectable by S-ECG in one case, by R-ECG in three cases, and by F-ECG in five cases. The detection rate of Epsilon wave was 50.0% by combined use of S-ECG and R-ECG (SR-ECG), 56.3% by combined use of S-ECG and F-ECG (SF-ECG), and 65.6% by combined use of the three recording methods (SRF-ECG). The detection rate was significantly higher by SF-ECG (56.3%) and SRF-ECG (65.6%) than by S-ECG alone (37.5%, all P ＜0.05). Most Epsilon waves detected by the S-ECG, R-ECG and F-ECG were small spiked waves. Conclusion Combined use of S-ECG, F-ECG and R-ECG could increase the detection rate of Epsilon wave in patients with ARVC.     

致心律失常性右室心肌病患者Epsilon波的检出率

Objective To investigate the prevalence of Epsilon wave in patients with arrhythmogenic right ventrieular cardiomyopathy (ARVC). Methods The Epsilon wave was detected in 32 patients [24 men, mean age (42.3±13.3) years] with ARVC using three different electrocardiography (ECG) recording methods: standard twelve leads ECG (S-ECG), right precordial leads ECG (R-ECG) and Fontaine bipolar precordiai leads ECG (F-ECG). The Epsilon wave was defined as wiggle, small spike wave and smooth potential between the end of the QRS complex and the beginning of the ST segment. Results Epsilon wave was detected in 37.5%, 37.5% and 50.0% patients with ARVC by S-ECG, R-ECG and F-ECG respectively. The detection rates derived from the three recording methods were similar(P ＞ 0.05). The Epsilon wave was only detectable by S-ECG in one case, by R-ECG in three cases, and by F-ECG in five cases. The detection rate of Epsilon wave was 50.0% by combined use of S-ECG and R-ECG (SR-ECG), 56.3% by combined use of S-ECG and F-ECG (SF-ECG), and 65.6% by combined use of the three recording methods (SRF-ECG). The detection rate was significantly higher by SF-ECG (56.3%) and SRF-ECG (65.6%) than by S-ECG alone (37.5%, all P ＜0.05). Most Epsilon waves detected by the S-ECG, R-ECG and F-ECG were small spiked waves. Conclusion Combined use of S-ECG, F-ECG and R-ECG could increase the detection rate of Epsilon wave in patients with ARVC.     

血清胸苷激酶1在肿瘤临床治疗中的价值探讨

目的 研究血清胸苷激酶1（STK1）在肿瘤疗效评估中的价值.方法 采用高灵敏度的增强化学发光法检测102例恶性肿瘤患者化疗过程中的血清TK1水平,随访6个月,并结合实体瘤疗效评估标准（RECIST）进行疗效综合评估.结果 43例患者,化疗前TK1平均水平为（3.55±2.82）pM,化疗后TK1平均水平为（2.20±1.17）pM,化疗前后比较具有显著性差异（P=0.0002）.血清胸苷激酶1与RECIST评估治疗效果符合率为60.5％（26/43）.结论 血清TK1在肿瘤疗效评估中具有重要价值.     

外伤性硬膜下积液转化为慢性硬膜下血肿10例临床分析

目的：探讨外伤性硬膜下积液转化为慢性硬膜下血肿的原因、治疗方法和预防。方法：回顾性分析我院2009年1月至2014年7月期间收治的10例外伤性硬膜下积液患者,分析患者由硬膜下积液转化为慢性硬膜下血肿的原因,针对外伤性硬膜下积液转变为血肿情况行硬膜下血肿钻孔引流术,术中证实为慢性硬膜下血肿,留置硬膜下血肿腔引流管。结果：10例患者均经钻孔引流治疗后痊愈。结论：外伤性硬膜下积液有向慢性硬膜下血肿转化的可能,钻孔引流治疗是比较好的手术方式。     

体外碎石治疗急诊输尿管结石的探讨

我院于1990年8月至2000年8月应用HX-902体外碎石机治疗急诊输尿管结石358例,经术后调查,效果非常满意,现报导如下: 1临床资料 本组病例为358人,其中男性219人,女性139人,年龄为18～64岁,平均43.5岁.结石大小及分布:本组病例中结石直径1.5～2.0cm患者66例,1.0～1.5cm128例,1.0cm以下者164例.分布情况为输尿管上段结石165例,输尿管中段结石为87例,输尿管下段结石为106例.     

重型颅脑创伤患者的营养支持

目的 探讨颅脑创伤昏迷患者营养支持的治疗方案.方法 对40例重型颅脑创伤伴有不同程度昏迷不能进食的患者给予肠外、肠内联合营养支持治疗,与同期未做肠外营养支持治疗的40例患者进行对照分析,探讨合理的营养支持方案.结果 观察组血红蛋白、总蛋白在治疗第7天及14天时,均高于对照组,差异有显著性(P＜0.05);淋巴细胞及血糖在治疗第7天时,观察组低于对照组,差异有显著性(P＜0.05);白蛋白在治疗第7天时,观察组高于对照组,差异有显著性(P＜0.05).结论 重型颅脑创伤患者早期采用肠外、肠内联合营养支持可取得较好效果.     

嗅鞘细胞移植修复脊髓损伤

背景：脊髓损伤后导致损伤平面以下的运动、感觉及自主神经功能障碍,其修复一直是神经科学研究领域的一大难题。 目的：对嗅鞘细胞移植治疗脊髓损伤的可能机制及在实验研究、临床应用等方面进行分析,探讨其对脊髓神经功能恢复的作用。 方法：回顾性分析以往嗅鞘细胞移植治疗脊髓损伤的实验基础研究和临床研究的状况,分析嗅鞘细胞移植后的存活数量和时间与损伤脊髓结构和功能的恢复关系,明确限定临床研究入选病例及排除病例的标准,明确移植细胞的来源、类型及植入方法,建立客观有效的评估标准。 结果与结论：嗅鞘细胞移植治疗脊髓损伤动物实验已经取得了满意的效果,脊髓功能评分及感觉与运动功能均较移植前明显提高(P < 0.001),动物实验中成功的经验为临床试验和应用提供了依据,部分临床试验最长患者随访5年,但因临床研究病例数较少,随访期短,到目前还不能判断其大宗病例的最终恢复程度,还需要进一步观察和研究。但这一研究结果的重要意义有助于找到合理的策略,使嗅鞘细胞发挥最大的修复效果。     

胰岛细胞瘤文献复习及误诊2例分析

胰岛细胞瘤是少见的神经内分泌源性胰腺肿瘤,以胰岛素瘤多见[1],胰岛素瘤典型临床表现为阵发性低血糖;发作时血糖低于2.8 mmol/L;口服或静脉注射葡萄糖后症状立即消失,上述三项被称为Wipple三联征.现就我院收治的2例胰岛素瘤诊治经过分析如下,以提高对该病的认识.     

卡维地洛和美托洛尔治疗原发性轻中度高血压疗效比较

目的评价卡维地洛和美托洛尔治疗原发性轻中度高血压的疗效及安全性。方法68例原发性轻中度高血压患者随机分为卡维地洛组（n=33）和美托洛尔组（n=35），分别接受卡维地洛（一日2次，每次6．25～25mg）和美托洛尔（一日2次，每次12．5～50mg）治疗，为期12周。观察治疗前后24小时、日间、夜间平均血压及谷／峰比值、不良反应和实验室检查指标的变化。结果治疗后两组24小时、日间、夜间平均收缩压和舒张压均有明显下降（P〈0．05），且均有较好的谷／峰比。两组总有效率无显著差异（P〉0．05）。两组均未见严重不良反应。结论卡维地洛和美托洛尔均能平稳、有效、安全地治疗原发性轻中度高血压。相对于美托洛尔，卡维地洛对心率及糖酯代谢的影响较小。