心先安与米力农治疗充血性心力衰竭对比性探讨

目的对比心先安与米力农治疗充血性心力衰竭的疗效,对左室收缩功能的影响.方法选择充血性心力衰竭85例,心先安治疗组44例,静滴心先安150mg/天,米力农组41例,静滴米力农10mg/天,两组均为7天一疗程.比较用药前后心功能改善情况,心脏彩超左室收缩功能改善情况.结果心先安治疗组心功能改善有效率86.4%,米力农组85.4%,经Ridit检验P＞0.05,疗效无差异.两组均可提高左室收缩功能.结论心先安与米力农治疗充血性心力衰竭疗效相似(P＞0.05),值得在临床上推广应用.     

菌必治致脑水肿、药疹1例

菌必治致脑水肿、药疹１例邹惠秋，刘一平，张立君患者女，５６岁。因咳嗽，咳少量白色粘痰伴发冷发热１周于１９９３年２月２２日入院。入院时检查：体温３７．５℃，呼吸２０次／分，脉博９０次／分；血压１３．０／９．０ｋＰａ。神清，表浅淋巴结无肿大。全身皮肤无原...     

基于ECRS原则的流程再造程序对冠状动脉介入日间手术病人的效果分析

目的:探究基于ECRS原则的流程再造程序应用于经皮冠状动脉介入治疗(PCI)日间病人的效果。方法:选取103例冠状动脉介入日间手术病人为研究对象,根据随机数字表法分为对照组51例和观察组52例。对照组给予常规救治流程护理,观察组给予基于ECRS原则的流程再造护理程序护理,比较两组病人冠状动脉介入前等待时间、手术相关指标及复发风险。结果:观察组病人抽血时间、分诊评估时间、血液检查时间、心电图检查时间、家属决策时间、就诊至经皮冠状动脉介入时间、门-球时间(B-T-B)、急诊至冠心病重症监护病房(CCU)时间、CCU至导管室时间、入导管室至球囊扩张时间均短于对照组,院内再PCI率、再发心肌梗死率均低于对照组,90 min内PCI率、抢救成功率高于对照组,经比较差异均有统计学意义(P<0.05)。结论:基于ECRS原则的流程再造程序对行PCI日间手术病人干预,可有效缩短冠状动脉介入前等待时间、入导管室至球囊扩张时间,降低院内再PCI率、再发心肌梗死率,提高抢救成功率。     

影响牙髓内注射麻醉效果的因素

牙髓病的治疗应在无痛情况下进行。当浸润麻醉和传导麻醉效果不能满足无痛要求的麻醉强度时,可采用牙髓内注射麻醉法进行追加麻醉。有关牙髓内注射麻醉的影响因素仍存在许多争议。本组旨在确定牙髓内注射麻醉的效果是取决于注射麻醉剂时形成的反向压力和麻醉剂的共同作用,还是仅仅取决于反向压力。１　方法病例选自因外伤或不可复性牙髓炎需进行牙髓摘除术而来我院牙体牙髓科就诊的患者。在征求患者同意的情况下,将患者随机分为３组。首先行常规浸润和传导麻醉,若达不到麻醉效果时,采用牙髓内注射麻醉法进行追加麻醉。第１组注射生理盐…     

丙泊酚致无痛人流患者短暂精神功能障碍4例

丙泊酚诱导迅速,经过平稳,持续时间很短。苏醒快而完全,是目前无痛人流手术首选静脉麻醉药。其常见不良反应有短暂呼吸抑制、血压心率下降、癫痫样反应等。我院2003年12月至2006年2月共施行丙泊酚无痛人流手术2672例,发生精神功能障碍4例（1．49‰）,现报告如下。     

公共场所从业人员HBsAg携带情况的调查

为了解我市公共场所从业人员HBsAg携带情况,1989年我们对公共场所979名从业人员进行了HBsAg的检测。调查对象和方法白城市旅店、理发、浴池、商业及文化娱乐公共场所从业人员。采用反向间接血凝法,倍比稀释1:6为阳性。调查结果HBsAg总阳性率为2.86%(28/979),男、女阳性率分别为2.65%(7/264)和2.94%(21/715),二者无显著性差异(p>0.05)。从年龄上看,以18～20岁年龄组为高(5.44%);而50～60岁组阳性率为0,二者差异显著(p<0.01)。该结果与国内报道相符。可考虑为青年人活动量大,接触范围广,与暴露机会多有关。     

辅用抗生素治疗冠心病100例疗效观察

有资料认为，肺炎衣原体与冠状动脉疾病、动脉硬化性颈动脉疾病及卒中有关。１９９７～１９９９年，我们对１００例冠心病患者加用抗生素治疗，效果满意。现报告如下。 临床资料：选择１９８例住院冠心病患者，随机分为两组：①治疗组（１００例）：男６４例，女３６例；平均年龄６１．２岁；②对照组（９８例）：男６３例，女３５例；平均年龄６０．８岁。两组患者年龄、性别无显著差异（ Ｐ＞０． ０５）。 方法：治疗组每日应用罗红霉素１５０ｍｇ，２次／ｄ，３０天后停药；对照组不加用抗生素。冠心病的常规治疗两组相同。随访６个月以…     

克山病患者抗氧化能力测定

Objective To explore the relationship between myocardial damage and antioxidant capacity in vivo of Keshan disease patients and to analyze the possible pathogenesis. Methods In the period from 2005 to 2006, 41 chronic and latent Keshan disease cases were chosen as the case group from such serious endemic areas as Yongjin Village, Xinfa Village of Fuyu County, Fuan Village of Shangzhi County, Xinghuo Village of Wudalianchi County, 61 healthy people from the same area as internal controls, 48 healthy people from Xianglansan Village of Wangkui County, an un-endemic area, as external control. Fasting peripheral venous blood was collected from all the people. And blood selenium, glutathione peroxidase(GSH-Px) and suporoxide dismutase.(T-SOD) activities, malondialdehyde (MDA) levels were examined. Results Blood selenium level of the patient group [(34.80±13.30) μg/L], GSH-Px[(104.10±34.19)U/L]and T-SOD[(92.16±17.98)×103 U/L]actives were significantly lower than the internal control group [(41.24±13.57)μg/L, (118.57±25.49)U/L, (104.82±13.56)×103 U/L]and the external control group [(48.33±16.51)μg/L, (155.00±24.01)U/L, (108.48±12.73)×103 U/L], respectively, with a statistically significant difference(all P < 0.05). MDA level of the patient group[(7.12± 1.37)μmol/L]was higher than that in the internal control group[(5.36±1.18)μmol/L]and the external control group[(5.22±0.83)μmol/L]with a statistically significant differences(both P < 0.05). The blood selenium level, GSH-Px activity of internal control group was resoectively lower than that in the external control group, the differences being statistically significant(beth P < 0.05). Conclusions Selenium deficiency may lead to reduced antioxidant capacity and enhanced oxidative damage in Keshan disease patients in vivo. There may be a certain relationship between oxidative stress disorder and myocardial damage of Keshan disease.     

克山病患者抗氧化能力测定

Objective To explore the relationship between myocardial damage and antioxidant capacity in vivo of Keshan disease patients and to analyze the possible pathogenesis. Methods In the period from 2005 to 2006, 41 chronic and latent Keshan disease cases were chosen as the case group from such serious endemic areas as Yongjin Village, Xinfa Village of Fuyu County, Fuan Village of Shangzhi County, Xinghuo Village of Wudalianchi County, 61 healthy people from the same area as internal controls, 48 healthy people from Xianglansan Village of Wangkui County, an un-endemic area, as external control. Fasting peripheral venous blood was collected from all the people. And blood selenium, glutathione peroxidase(GSH-Px) and suporoxide dismutase.(T-SOD) activities, malondialdehyde (MDA) levels were examined. Results Blood selenium level of the patient group [(34.80±13.30) μg/L], GSH-Px[(104.10±34.19)U/L]and T-SOD[(92.16±17.98)×103 U/L]actives were significantly lower than the internal control group [(41.24±13.57)μg/L, (118.57±25.49)U/L, (104.82±13.56)×103 U/L]and the external control group [(48.33±16.51)μg/L, (155.00±24.01)U/L, (108.48±12.73)×103 U/L], respectively, with a statistically significant difference(all P < 0.05). MDA level of the patient group[(7.12± 1.37)μmol/L]was higher than that in the internal control group[(5.36±1.18)μmol/L]and the external control group[(5.22±0.83)μmol/L]with a statistically significant differences(both P < 0.05). The blood selenium level, GSH-Px activity of internal control group was resoectively lower than that in the external control group, the differences being statistically significant(beth P < 0.05). Conclusions Selenium deficiency may lead to reduced antioxidant capacity and enhanced oxidative damage in Keshan disease patients in vivo. There may be a certain relationship between oxidative stress disorder and myocardial damage of Keshan disease.     

乳腺肌上皮癌2例

正乳腺肌上皮癌(myoepithelial carcinoma,MEC)是一种发生于乳腺的罕见恶性肿瘤。WHO(2003)乳腺和女性生殖系统肿瘤病理学与遗传学分类[1]将其归为肌上皮病变(myoepithelial lesions,MEL),又称恶性肌上皮瘤(malignant myoepithelioma,MME);WHO(2012)乳腺肿瘤分类[2] 将MEC归入化生性癌,只在梭形细胞癌(spindle cell carcinoma,