慢性阻塞性肺疾病合并支气管内膜结核1例漏诊分析

目的：探讨慢性阻塞性肺疾病（COPD）合并支气管内膜结核（EBTB）漏诊的原因,加深对该疾病的认识及其诊治措施。方法：分析收治的1例慢性阻塞性肺疾病合并支气管内膜结核患者的临床资料。结果：患者,男,61岁,以反复咳嗽、咳痰、喘息、气促10余年,加重10d入院,常规抗感染、解痉平喘、祛痰治疗无改善,胸部CT示＂桶状＂胸,肺纹理增强。痰涂片查见抗酸杆菌。支气管镜示支气管内膜结核。结论：COPD合并支气管内膜结核临床无明显特异性,易出现误诊及漏诊,应引起临床重视。     

在B超监测下经胎盘作羊膜腔穿刺术的可行性分析

为探讨前壁胎盘者经胎盘行羊膜腔穿刺的可行性 ,利用 B超监测将 487例羊膜穿刺病人分成前壁胎盘组 2 50例 (实验组 )和后壁胎盘组 2 37例 (对照组 ) ,并分别寻找作羊膜穿刺术时前壁胎盘和后壁胎盘的最佳进针位置及测量深度。结果 :2 50例前壁胎盘组中有 2 5例为血性羊水 (占实验组的 1 0 .0 0 % ) ,其中 4例血性羊水细胞培养失败(1 .60 % ) ;一次性穿刺成功 2 4 1例 (96.40 % )。 2 37例后壁胎盘组中有 1 3例抽出血性羊水 (占对照组的 5.49% ) ,其中3例羊水细胞培养失败 (1 .2 7% ) ;一次性穿刺成功 2 30例 (97.0 5% )。经卡方检验两组均无显著性差异。说明通过 B超监测可顺利完成前壁胎盘者经胎盘羊膜腔穿刺术。     

心得安联合消心痛预防肝硬化再出血疗效观察

肝硬化并发上消化道出血后,约50～70％的幸存者会发生再出血,其死亡率达30～70％。当前预防再出血的主要非手术措施之一是药物降低门脉高压(PHT),主要药物有β受体阻滞剂、硝基血管扩张剂、血管紧张素转换酶抑制剂等,其作用机理各不相同。为较好地发挥各种药物降低PHT疗效、减少副作用,现多采用联合用药。本研究目的即为观察β受体阻滞剂(心得安)联合硝基血管扩张剂(消心痛)预防肝硬化再出血的疗效。 1 资料与方法     

急性心肌梗塞后心室重构

心室重构（Ventricularremodeling）又称心脏重构、心肌重构，简单来说是指心脏结构发生了改变。它往往是充血性心力衰竭最早的解剖基础，并贯穿于整个病程发展过程中，越来越引起临床医生的关注。急性心肌梗塞（Acutemyocardialinfarction，AMI）后的心室重构，是指急性心肌梗塞后左心室梗塞区和非梗塞区结构及形态的改变，根据其发生时间及演变，可分为梗塞区伸展（Infarctexpansion）和左心室扩张（Ventriculardilation）[1]。1发病机理和病理改变梗塞区伸展，是梗塞区不成比例地拉长、变薄，使局部室壁变形，心室腔扩大，但无新的心…     

一例睾丸肿瘤五家医院误诊误治的教训

一例睾丸肿瘤五家医院误诊误治的教训杭州市空军杭州医院３１０００４许龙根［病例］２７岁。１９９２年２月在２米高处不慎跌落，阴囊右侧撞在方桌角１：，当时觉疼痛，阴囊皮肤瘀血，皮下血肿，在某部医院诊断为阴囊血肿。１个月后疼痛仍未缓解，再次在该院就诊，查右睾...     

枯痔液的薄层鉴别

枯痔液的薄层鉴别武警江西总队医院药局蒋云根，傅龙根，董世光（南昌３３０００１）枯痔液系我院自行设计研制的一种治疗各种类型痔疮的复方中药注射液。经长期的临床应用，取得了较好的疗效。为进一步控制该自制制剂的质量，本文采用薄层色谱法对其中的主要有效成分大黄...     

氯沙坦对肾移植术后受者血红蛋白的影响及其使用的安全性

Objective To evaluate the influence of losartan on levels of hemoglobin (Hb) in patients after renal transplantation. The safety of losartan in these patients was also evaluated. Methods Sixty-six hypertensive patients after renal transplantation with stable allograft function and serum creatinine levels below 176. 8 μmol/L (2 mg/dl) were divided into treatment group (n = 34) treated with losartan at a dose of 50 mg/d, and control group (n = 32) not treated with losartan. Each participant was followed up for 6 months, and differences in Hb, whole blood CsA trough concentration, blood pressure (BP), serum creatinine (Cr) and GFR were compared at baseline, and at the month 1, 2, 3 and 6. Results Serum Cr in treatment group showed a slight, hut significant increase at the month 1 (P<0.05 vs baseline), then gradually returned to the baseline until the month 6. Relatively, the estimated glomerular filtration rate (GFR) in treatment group was decreased slightly and temporarily. The Fib level in treatment group kept on dropping in the first two months (P <0.01 vs baseline), then remaining stable since the month 3. An uptrend of Hb was seen in the control group hut there was no statistically significant difference. For patients with Hb≥160 g/L, a progressive decrease in Hb was observed after losartan treatment (P<0.01 vs baseline), while a slight, non-significant decrease in the controls. For patients with Hb <160 μmol/L, Hb in treatment group was decreased in the first two months (P<0.01 vs baseline at the month 2), then gradually increased to baseline from the month 3 to 6. A progressive increase in Hb was seen in control group (P < 0.05 vs baseline). Conclusion Losartan can effectively and safely relieve and prevent posttransplantation erythrocytosis following renal transplantation.     

氯沙坦对肾移植术后受者血红蛋白的影响及其使用的安全性

Objective To evaluate the influence of losartan on levels of hemoglobin (Hb) in patients after renal transplantation. The safety of losartan in these patients was also evaluated. Methods Sixty-six hypertensive patients after renal transplantation with stable allograft function and serum creatinine levels below 176. 8 μmol/L (2 mg/dl) were divided into treatment group (n = 34) treated with losartan at a dose of 50 mg/d, and control group (n = 32) not treated with losartan. Each participant was followed up for 6 months, and differences in Hb, whole blood CsA trough concentration, blood pressure (BP), serum creatinine (Cr) and GFR were compared at baseline, and at the month 1, 2, 3 and 6. Results Serum Cr in treatment group showed a slight, hut significant increase at the month 1 (P<0.05 vs baseline), then gradually returned to the baseline until the month 6. Relatively, the estimated glomerular filtration rate (GFR) in treatment group was decreased slightly and temporarily. The Fib level in treatment group kept on dropping in the first two months (P <0.01 vs baseline), then remaining stable since the month 3. An uptrend of Hb was seen in the control group hut there was no statistically significant difference. For patients with Hb≥160 g/L, a progressive decrease in Hb was observed after losartan treatment (P<0.01 vs baseline), while a slight, non-significant decrease in the controls. For patients with Hb <160 μmol/L, Hb in treatment group was decreased in the first two months (P<0.01 vs baseline at the month 2), then gradually increased to baseline from the month 3 to 6. A progressive increase in Hb was seen in control group (P < 0.05 vs baseline). Conclusion Losartan can effectively and safely relieve and prevent posttransplantation erythrocytosis following renal transplantation.     

巨大精索脂肪瘤一例报告

患者,53岁。因左阴囊内肿块9年余,于1988年5月10日入院。1979年初发现左阴囊内肿块约乒乓球大小,无疼痛,随后肿块逐渐增大如胎儿头大小,下坠感明显,无畏寒发热,但影响行走、排尿和性生活。查体:一般情况良好,心肺、腹部无异常发现。阴囊肿块约22×18×15cm,阴囊皮肤暗红色,阴茎龟头缩入阴囊肿块皮肤内。肿块质中,表面凹凸不平,无压痛,不能回纳,透光试验阴性,未扪及正常的左侧睾丸和附睾。双侧腹股沟淋巴结无肿大。拟诊为左睾丸肿瘤,于1988年5月14日在硬膜外麻醉     

骨髓细胞门静脉输注诱导移植肾免疫耐受的临床研究初探

目的 探索供者骨髓细胞受者门静脉输注诱导移植肾免疫耐受的临床应用方法。方法 8例亲属供肾肾移植受者（实验组），移植术前经门静脉注射供者的骨髓细胞，进行移植后的临床效果观察，移植肾肾内免疫状态分析，尿细胞流式细胞分析和细胞因子测定，结果与6例亲属供肾肾移植病人（对照组）进行比较。结果 实验组在临床上和移植肾免疫状态上均表现出免疫低反应性，IL－10（Interleukin-10)表达较高，TNF－a(Tumor necrosis factor-α）表达较低。结论 我们认为，将供者骨髓细胞进行受者的门静脉输注是一种可行的诱导免疫耐受的方法，可以诱导产生临床肾移植的免疫低反应。