B超引导胸膜活检在中、大量胸腔积液鉴别诊断中的价值

胸腔积液是胸膜疾病的常见表现,胸穿抽液送检多能明确病变性质,推测可能病因,但病原学或病理细胞学阳性率低.2002-2006年我们应用B超引导胸膜活检术鉴别诊断40例中大、量胸腔积液,现将结果报告如下.[第一段]     

羟基磷灰石/多聚左旋乳酸椎间融合器的力学评价

目的:评价羟基磷灰石和多聚左旋乳酸(hydroxyapatite/poly-L-lacticacid,HA/PLLA)制成的可吸收性腰椎椎间融合器(cage)的力学特性。方法:形状相同的HA/PLLAcage和Brantigan碳纤维cage及与cage外径相同的人尸体髂骨块各16枚,在材料实验机MTS上分别将3种椎体间置入体行压缩破坏(n=8)和压缩疲劳(n=8)试验,记录置入体压缩破坏时的最大压力、弹性系数以及1万次压力负荷后的高度变形率,并加以比较。结果:在瞬间破坏压力和弹性系数方面,HA/PLLAcage和碳纤维cage均显著高于髂骨块(P<0.05),但两种cage间差异无显著性(P>0.05)。1万次压力负荷后,两种cage的高度压缩率均显著小于髂骨块(P<0.05),且HA/PLLAcage的平均压缩率显著小于碳纤维cage(P<0.05)。结论:HA/PLLAcage和碳纤维cage较髂骨块具有更强的力学稳定性;与碳纤维cage相比,HA/PLLAcage不仅具有同等的瞬间抗破坏强度,而且具有更强的抗重复负荷变形的能力。     

胰岛素样生长因子及其结合蛋白在儿童白血病中的动态变化

胰岛素样生长因子(IGFs)在儿童急性白血病治疗过程中会出现相应改变，IGFs具有促生长作用，体外试验证实对白血病细胞系有剂量相关的促增殖效应。同时，具有生物活性的游离IGF-I水平始终增高，IGFs在儿童白血病的发生、发展中起重要作用，其结合蛋白在血清和脑脊液中也会出现不同的变化，可作为疾病复发和中枢神经系统白血病的监测指标之一。     

甲状软骨发育不全一例

1 病历摘要 患者男，33岁，因无意间发现甲状软骨移位于2008年5月5日来我院就诊。患者平素身体健康，否认有颈部外伤史，颈部无疼痛，无声音嘶哑、胸闷、呼吸不畅，否认有咽部异物感，无呛咳或吞咽困难等症状。体格检查：一般状况良好，心肺无异常。颈部皮肤无红肿、局部无压痛、颈部淋巴结无肿大，甲状软骨向右侧移位明显；双侧甲状腺未发现占位性病变。CT显示甲状软骨板无骨折征，向右侧移位，见图1。诊断为甲状软骨发育不全，未予特殊处理，嘱患者注意观察病情变化，如有不适及时复诊。     

新疆哈萨克族闭角型青光眼临床前期虹膜周边切除术的意义

新疆哈萨克族多居住于北疆边远牧区，发生急性闭角型青光眼来医院检查时患眼多为晚期；我们在处理急性青光眼的同时，劝其另一眼做虹膜周边切除术以预防青光眼急性发作导致失明，现报告如下。     

177例脑出血临床分析

2002年8月~2005年8月,我科收治脑出血病人177例,经确诊治疗分析,发病年龄在45~65岁为高锋期,平均年龄54.8岁,高血压脑出血152例,占85.8%,通过回顾177例病历,我们的体会是治疗脑出血要三早:早发现,早治疗,早预防。1临床资料1.1一般资料:本组177例,男性101例,女性76例,年龄最小7岁,最大84岁,平均年龄54.8岁。0~14岁4例,15~30岁8例,31~40岁16例,41~50岁34例,51~60岁52例,61~70岁37例,70岁以上267例。1.2出血种类:蛛网膜下腔出血6例,高血压性脑出血152例,自发性出血14例,脑血管动脉瘤破裂出血5例。1.3治疗结果:治愈38例,好转78例,死亡12例,无效1…     

糖尿病肾病的预防及治疗

在代谢控制效果时，其肾病变发展相对更快。一旦发生肾脏损害，出现持续性蛋白尿则病情不可逆转，往往进行性发展至终末期肾功能衰竭。因此，探讨高血糖这一重要危险因素对进一步认识DN的发病机制。建立合理的治疗新策略以及对DN的早期诊断均具有重要意义。[第一段]     

生理盐水用于会阴切开缝合术后擦洗效果观察

目的观察生理盐水用于会阴切开缝合术后伤口擦洗的效果。方法按时间顺序将790例会阴切开缝合术后产妇分为对照组371例，观察组419例。分别采用5％活力碘与生理盐水擦洗外阴及伤口，比较两组伤口愈合情况。结果两组伤口愈合情况比较，差异无显著性意义（P〉0．05）。结论采用生理盐水擦洗会阴及伤口对伤口愈合亦可起到与活力碘同样的作用，且成本低，对皮肤无刺激。     

Ross术后中远期主动脉瓣反流的危险因素分析

Objective To analyze the risk factors of the postoperative mid- and long-term aortic valvular regurgitation after ROSS procedure(pulmanary valve homograft transplantation). Methods Between March 1998 and July 2007,47 patients[25male, 22 female, mean age (13.31±5.79) years, ronge 1-34 years] with aortic valvular disease underwent the Ross procedure at our insti tution. There were 6 patients suffering fron rheumatic heart disease and 41 patients suffering from congenital heart disease. The aver age aortic blood flow velocity was (4.67±3.47) m/s, the average pressure gradient across aortic valve (88.26±58.06)mm Hg, LVEDD (45.53 ±10.78) mm, EF 0.69±0.08. All the patients were followed up in out-patient departement by ultrasonic cardio gram. Multiple logistic regression analysis was performed to find out the risk factors of the postive aortic valvular regurgitation. Results There was no poetoperative death in hospital. The mean follow-up periods was (36.15±22.1) months, rasnge from 12 to 110 months and none long-dated death. Compared with the data recorded in hospital, the diamenters of the aortic sinus and aortic annu lus enlarged significantly, respectively from (26.16±5.10) mm to (32.37±6.84) tam and from (19.41 ～3.98) mm to (23.45± 5.86) mm. The average flow velocity d the homograft (new aortic valve) was(1.39±0.48) m/s, graclient pressure (8.17+6.16) mm Hg. Mild aortic regurgitstion was present in 5 patients (10.6%), moderate aortic tegmgitafion in 2 pmieats (4.3%) and aevere aortic regurgitation in 1 petient (2.1%). The rate of free from regurgitation was 82.9%. Multiple logistic analyses identified the per esence of bicuspid aortic valve, enlargement of aortic annulus and age above 14 years as the risk factors for posterative aortic regurg itation. Conclusion The Ross procedure is a safe and effective procedure with good clinical results in mid-and long-term follow-up. However, the presence of bicuspid aortic valve, enlargement of aortic annulus and age above 14 years preoperatively were identified as the risk factors for postoperative aortic regurgitation.