心血管疾病并发焦虑抑郁症状2050例心理干预治疗分析

目的:了解心血管疾病并发焦虑抑郁症状的情况并探讨心理干预等对焦虑抑郁症状的影响。方法:对住院的2050例心血管疾病并发焦虑抑郁症状的患者进行回顾性分析。结果:心血管疾病患者中并发有焦虑抑郁症状者占56%;其常表现为类似心绞痛、左心衰竭症状,可并发有心律失常;高血压病并发有焦虑抑郁患者对血压升高的耐受性差,动态血压检查以非勺型改变者居多;单纯使用心血管药物治疗效果欠佳,心理干预,焦虑抑郁症状严重者结合抗焦虑抑郁药物疗效显著。结论:心血管疾病患者常并发焦虑抑郁症状,心理干预治疗等可有效改善患者的症状。     

Pneumocephalus after thoracoscopic excision of posterior mediastinal tumor.

Pneumocephalus is a very rare complication of video-assisted thoracoscopic surgery (VATS). A 66-year-old man developed pneumocephalus secondary to thoracoscopic excision of a neurogenic tumor in the posterior mediastinum. Pneumocephalus was diagnosed by brain computed tomography. Neurosurgical intervention was performed after conservative therapy had failed. The patient's condition had resolved without any neurologic sequelae 2 years later. When a patient has a relatively large amount of chest tube drainage and neurologic symptoms after VATS, the possibility of pneumocephalus due to cerebrospinal fluid leakage must be considered.     

Studies on Toxicity of Nitroquine-Dapsone Compound and Therapeutic Effects of Folic or Folinic Acid on Toxicated Animals

The toxic effects of nitroquine-dapsone compound(NQD)in mice and dogs were studied.The therapeutic index of NQDin mice is 1911,the greatest among the 6 antimalarials tested.Thetoxic effects of NQD(50 mg/kg/day for 3 days per os)and nitro-quine in dogs were manifested by injuries on the adrenal cortexand intestinal epithelium.When folic acid(4 mg/kg/day for 4 days)or calcium leucovorinum(0.3 mg/kg/day for 4 days)were usedconcomitantly with NQD,the death rate and the incidence of dia-rrhea in the toxicated dogs were greatly reduced,the injury on theintestinal epithelium was much milder,and the goblet cells weremuch more numerous than those without treatment.The results suggestthat folic acid and calcium leucovorinum can protect the undifferen-tiated cells in the intestinal crypts from being injured by NQD.     

产科危重患者多器官功能障碍综合征的临床分析

目的 :分析产科危重患者多器官功能障碍综合征 (MODS)的发病特点及诱因 ,以及与急性生理与慢性健康状况评分II(APACHEII)的关系。方法 :回顾分析 2 0 0 0年1月至 2 0 0 4年 4月转入GICU产科危重患者中发生MODS 6 6例的临床资料 ,并计算其A PACHEII评分。结果 :产科MODS患者诱因主要是产科因素 ,共 4 8例 (72 .73% ) ,死亡 7例 (14 .5 8% ) ,以重度子痫前期或子痫及产后出血为主 ;诱因 18例妊娠合并内外科疾病 ,死亡 11例 ,死亡率为 6 1.11% ,以妊娠合并心脏病和妊娠合并重症肝炎为主。产科MODS患者死亡率随着器官损害数的增多而上升 ,差异有显著性 (P <0 .0 5 ) ;随着器官损害数的增多 ,APACHEII评分逐渐升高 ,差异有显著性 (P <0 .0 5 ) ;APACHEII评分用于预测MODS死亡阳性率 ,2 ,3,4 ,5个器官受损害 ,其阳性率分别为 33.4 5 % ,5 7.12 % ,97.0 9% ,10 0 %。结论 :产科多器官功能障碍 /衰竭的产科主要诱因是重度子痫前期 /子痫 ,产后出血 ;产科MODS患者死亡率也随着器官损害数的增多而上升 ;APACHEII评分可在一定程度上作为评定产科MODS患者病情危重程度和预测预后的指标。     

核磁共振法测定非离子表面活性剂 HLB 值的研究 2.几种混合体系 HLB 值的测定与计算

本文应用核磁共振法(NMR)测定了几种混合体系的 HLB 值与混合体系中各组分的 HLB 值。实验结果表明,混合体系中各组分在核磁共振图谱中的积分曲线高度也具有加和性。混合体系的 HLB 值是体系中各组分 HLB 值的加权平均值。因此,对混合体系的 HLB 值可以应用 NMR 法直接测定,也可应用 NMR 法测定各组分的 HLB值,通过计算求得,计算值与实测值完全一致。     

室间隔夹层瘤的超声诊断(附4例报告)

目的 总结室间隔夹层瘤的超声心动图诊断及临床应用价值。方法1985～2005年超声诊断罕见的室间隔夹层瘤4例。超声主要取左室长轴、四腔心、五腔心、大动脉短轴及非标准切面，观察主动脉窦的形态及结构：如扩张窦瘤的大小、窦壁厚度、窦瘤破口的部位、窦瘤破口与室间隔之间的关系，主动脉窦瘤与室间隔夹层瘤之间交通口的大小，测量形成室间隔夹层瘤的大小及夹层瘤左、右室面的厚度，结合彩色多普勒观察心动周期夹层瘤与主动脉窦瘤血流动态变化，频谱多普勒测量窦瘤与室间隔夹层瘤之间的血流速度。结果4例室间隔夹层瘤均为主动脉右窦破人室间隔基底段，且均行手术治疗证实超声诊断。结论超声心动图对室间隔夹层瘤可直接做出诊断，超声诊断价值在于早发现、早诊断、及早治疗，并可为外科选择手术方式提供重要的有价值的依据。     

PET measurement of cardiac and nigrostriatal denervation in Parkinsonian syndromes.

Scintigraphic imaging with (123)I-metaiodobenzylguanidine ((123)I-MIBG) has demonstrated extensive losses of cardiac sympathetic neurons in idiopathic Parkinson's disease (IPD). In contrast, normal cardiac innervation has been observed in (123)I-MIBG studies of multiple-system atrophy (MSA) and progressive supranuclear palsy (PSP). Consequently, it has been hypothesized that cardiac denervation can be used to differentiate IPD from MSA and PSP. We sought to test this hypothesis by mapping the distribution of cardiac sympathetic neurons in patients with IPD, MSA, and PSP by using PET and (11)C-meta-hydroxyephedrine ((11)C-HED). Also, the relationship between cardiac denervation and nigrostriatal denervation was investigated by measuring striatal presynaptic monoaminergic nerve density with PET and (11)C-dihydrotetrabenazine ((11)C-DTBZ). METHODS: (11)C-HED and (11)C-DTBZ scans were obtained for patients with IPD (n = 9), MSA (n = 10), and PSP (n = 8) and for age-matched control subjects (n = 10). Global and regional measurements of (11)C-HED retention were obtained to assess the extent of cardiac sympathetic denervation. (11)C-DTBZ binding was measured in the caudate nucleus, anterior putamen, and posterior putamen. RESULTS: As expected, extensive cardiac denervation was observed in several of the patients with IPD. However, substantial cardiac denervation was also seen in some patients with MSA and PSP. (11)C-DTBZ studies demonstrated striatal denervation in all patients with IPD and in most patients with MSA and PSP. No correlation was found between cardiac (11)C-HED retention and striatal (11)C-DTBZ binding. CONCLUSION: Cardiac sympathetic denervation was found to occur not only in IPD but also in other movement disorders, such as MSA and PSP. This finding implies that scintigraphic detection of cardiac sympathetic denervation cannot be used independently to discriminate IPD from other movement disorders, such as MSA and PSP. Cardiac sympathetic denervation was not correlated with striatal denervation, suggesting that the pathophysiologic processes underlying cardiac denervation and striatal denervation occur independently in patients with parkinsonian syndromes. These findings provide novel information about central and peripheral denervation in patients with neurodegenerative disorders.     

化疗药物配制方法探讨

为探讨化疗药物正确的配制方法，有效地预防化疗药物可能存在的职业危害，并使病人得到准确的用药剂量。提出配制化疗药物应在专门的化疗药物配制阃配制，使用特制的层流净化操作台，不具备条件者可在排风设备良好、空气流通的场所内配制。配制人员必须熟练掌握化疗药物的药理知识，配制时应严格做好查对工作。     

差式氧化数法——计算有机物氧化还原当量的简捷方法

本文提出的“差式氧化数法”特别适用于有机化学反应方程式的平衡。在未平衡方程式之前即可直接求出有机物的氧化还原当量,然后再平衡方程式。较以前先平衡方程式,再间接计算氧化还原当量的方法简便,快速,易掌握。