气管切开术的并发症(附213例病例分析)

本文报道了气管切开术各种并发症的发病率,并对术中或术后并发症的病的病因、发病机理、治疗和预防进行了讨论。     

The contemporary role of antioxidant therapy in attenuating liver ischemia-reperfusion injury: a review.

Oxidative stress is an important factor in many pathological conditions such as inflammation, cancer, ageing and organ response to ischemia-reperfusion. Humans have developed a complex antioxidant system to eliminate or attenuate oxidative stress. Liver ischemia-reperfusion injury occurs in a number of clinical settings, including liver surgery, transplantation, and hemorrhagic shock with subsequent fluid resuscitation, leading to significant morbidity and mortality. It is characterized by significant oxidative stress but accompanied with depletion of endogenous antioxidants. This review has 2 aims: firstly, to highlight the clinical significance of liver ischemia-reperfusion injury, the underlying mechanisms and the main pathways by which the antioxidants function, and secondly, to describe the new developments that are ongoing in antioxidant therapy and to present the experimental and clinical evidence about the role of antioxidants in modulating hepatic ischemia-reperfusion injury.     

眼针治疗阵发性室上性心动过速120例的即时疗效观察

目的:观察眼针对阵发性室上性心动过速的即时疗效。方法:选择符合诊断标准的门诊患者120例,针其眼针穴区:心区和上焦区。针后30分钟描记心电图,计算心率,观察眼针对阵发性室上性心动过速的影响。结果:显效103例,占85.83%;有效9例,占7.5%;无效8例,占6.66%;总有效率93.33%.结论:眼针对阵发性室上性心动过速有较好的即时疗效。     

Transvaginal sonography in the assessment of distal ureteral calculi.

OBJECTIVES: To explore the morphological and functional findings of transvaginal sonography (TVS) in the diagnosis and management of distal ureteral calculi. METHODS: We retrospectively reviewed the imaging studies in seven cases of distal ureteral calculi (study group) and 20 cases of female volunteers without urinary tract infection (control group). All 27 patients had undergone TVS for assessment of the lower urinary tract. The variables measured on ultrasound included the presence or absence of distal ureteral calculi, the size and location of a calculus if present, the presence or absence of the ureter jet phenomenon, morphological changes of the ureteral papilla and adjoining tissue, and the height of the ureteral papilla, as well as vascular changes seen on Doppler imaging. RESULTS: In the controls, 80% of the ureteral papillae were triangular and 20% trapezoidal. The average (+/-SD) height of the ureteral papillae was 3.5 +/- 0.7 mm on the right and 3.6 +/- 0.9 mm on the left. There was no statistically significant difference between the heights of the right and left papillae (P = 0.619). In the study group, echogenic stones were identified in all seven patients and a hypoechogenic tubular structure connected to the involved papilla was identified in 6/7 patients. The average height of the involved papilla was 6.7 +/- 1.6 mm. Ureteric jets were visible in all patients in both the study and control groups. CONCLUSION: In patients with distal ureteral calculi, TVS provides a rapid, non-invasive and repeatable means of assessing the morphology and function of the distal ureter.     

100例性病患者心理健康状况调查分析

目的：探讨性病患者的心理健康状况,为临床治疗和护理提供依据。方法：采用症状自评量表（SCL-90）对100例性病患者的心理健康状况进行测验。结果：100例性病患者SCL-90检测的阳性率为51%,阳性样本因子分居前的是敌对、强迫症状、抑郁、人际敏感。结论：性病患者广泛存在的心理问题,在药用治疗的同时应注意心理方面的治疗和疏导。     

An exceptional postoperative gastric tube bleeding after esophageal resection for cancer

A case of gastric tube bleeding after an Ivor-Lewis esophagectomy with gastroesophageal anastomosis is reported. During the early postoperative course, the patient had a gastric tube stasis that improved progressively. The subsequent onset of a serious and intermittent hematemesis, which was endoscopically deemed to be the result of a hemorrhagic gastritis, required multiple blood transfusions. The evolution to a severe hemodynamic instability obliged us to reoperate on the patient. During surgery, a band-related obstruction of the first jejunal loop with local signs of vascular hypertension was noted. As soon as the obstruction was solved, the gastric bleeding stopped. The authors discuss the clinical aspects and physiopathology of the gastric tube bleeding and, in particular, they evaluate the influence of the intestinal obstruction with vascular involvement on the development of this exceptional and severe complication.     

广西边远少数民族学生体型及体质量指数3年追踪**

背景: 前期研究表明广西18~22岁少数民族学生体质量偏轻。 目的：拟进一步了解广西2645名少数民族学生体型及体质健康状况，寻找影响的关联因子。 设计、时间及地点：追踪调查，于2004-12/2007-12在广西民族大学完成。 对象：广西民族大学2003/2005三次体质健康测试的全体学生2 645人。男1 337人，女1308人，年龄为18~20岁，共15个民族。 方法：根据2003年教育部、体育总局《学生体质健康标准（试行方案）》和实施方法分为形态指标、技能指标和身体素质指标3大类。对2 645名少数民族身体机能与体质量指数变化的跟踪调查。 主要观察指标：身高、体质量、肺活量、立定跳远、坐位体前屈、体质量指数。 结果：①广西民族大学2003级学生大学3年期间男生身高、体质量增长率比全国同期多2.45%，身体形态发育正处于高峰期，女生成偏瘦型体型，身体形态发育情况总体欠佳。②男女学生在刚入校时肺活量机能较差，远远低于同期全国平均水平。3年后男生肺活量增长率为11.55%、女生肺活量增长率为27.72%，分别高于全国同期肺活量增长率。③坐位体前屈机能高于同期全国平均水平，男生呈逐年上升趋势，同期全国男性呈下降趋势；同期全国乡村女生均呈逐年上升趋势。④立定跳远机能提高较大，3年后增长率为18.15%，明显高于全国同期立定跳远增长率水平的2.61%。女生立定跳远机能总体不如全国同期水平。⑤体质量指数总体与同期全国乡村男女学生体质量指数比较稍低一些(P < 0.01)。 结论：2 645名少数民族学生发育正处于高峰期；肺活量机能不及全国同期平均水平。男女体质量指数分布有所不同，体质量偏轻者女生多于男生，表明学生营养状况总体欠佳。     

Intussusception in Taiwanese children: analysis of incidence, length of hospitalization and hospital costs in different age groups.

BACKGROUND AND PURPOSE: This study investigated the characteristics of intussusception in Taiwanese children of different age groups, including the incidence, length of hospitalization and hospital costs. METHODS: Children with a diagnosis of intussusception who were hospitalized from 1999 through 2001 were identified from a nationwide health insurance claims database. The incidence of intussusception was calculated by age, gender, and season. Length of hospitalization and hospital costs were also analyzed. RESULTS: A total of 6988 cases of intussusception were identified in Taiwan from 1999 to 2001. Among them, 4859 cases occurred in children below 15 years of age. The average incidence among children below age 15 years was 34.5 per 100,000, with a peak incidence of 118.8 per 100,000 observed among children younger than 24 months old. The highest incidence of intussusception in Taiwanese children occurred between 12 and 24 months of age. According to the data for patients below 15 years of age hospitalized for intussusception in year 2000, males were more likely to be affected than females (61.3% vs 38.7%). Intussusception-related hospitalizations were rare in infants in the first few months of life, increased in those 6 to 12 months old, and peaked among children 1 to 3 years old. Among the 952 patients with intussusception admitted to hospitals in 2000, 297 (31.2%) received surgery, incurring higher median medical costs (New Taiwan Dollars [NT dollars] 42,265 or US dollars 1234) and longer median hospital stay (6.2 days) than the 655 patients who did not require surgery (NT dollars 6290 or US dollars 185 for hospitalization of 2.4 days). CONCLUSIONS: The study found that the incidence of intussusception peaked in the second year of life in Taiwanese children. There was also a male predominance and lack of seasonal variation in incidence.     

Acute pancreatitis combined with acute Budd-Chiari syndrome as the initial manifestation of small cell lung cancer.

Tumor metastasis to the pancreas is a rare but recognized cause of acute pancreatitis. Autopsy series have reported a 24-40% of pancreatic involvement in small cell lung cancer. However, only a very few cases of tumor-induced acute pancreatitis have been described. Budd-Chiari syndrome complicating lung cancer is a rarely reported condition. We report a 68-year-old woman with extensive small cell lung cancer with the unusual initial presentation of both acute pancreatitis and acute Budd-Chiari syndrome. This patient suffered from progressive epigastralgia for 3 weeks. Severe epigastralgia with radiation to back and progressive jaundice developed 2 days prior to admission. After admission, the liver enlarged rapidly and the ascites increased markedly. Chest roentgenogram showed a mass lesion over the left lower lung field. Poorly differentiated carcinoma cells were found in ascites and bone marrow. The patient died on the ninth day of hospitalization before chemotherapy was initiated. Prompt diagnosis of extensive-stage small cell lung cancer may allow early chemotherapy treatment which favorably influences recovery when the pancreatitis is mild. Although prolonged survival might have been expected had this patient recovered from pancreatitis and received chemotherapy, diagnosis was delayed due to difficulty in immunohistochemical diagnosis of the tumor and the unusual clinical presentation. The use of stains employing antibodies against neurofilament and neuron-specific enolase cell antigens is important for early diagnosis of poorly differentiated metastatic tumor cells.