彩色多普勒组织显像对川崎病心肌病变的诊断价值

应用彩色多普勒组织显像(DTI)比较观察10例川畸病(KD)患儿与143例正常儿童二尖半环、左室壁及心内膜不同时相运动速度的变化.结果显示10例KD患儿的二尖半环舒张早期运动速度(MVR-DeV)明显降低,与对照组比较有显著差异,同时KD患儿M VR-DeV的异常率显著高于DTI的其它检查指标.     

Emergency free flaps to the type IIIC tibial fracture

Type IIIC tibial fractures are complex injuries involving extensive bone and soft-tissue devascularization that result in a high percentage of complications and ultimate amputation. An emergency free flap transfer not only may salvage the limb but also may improve the aesthetic and functional results of reconstruction by placing the injured structures in a well-vascularized bed. Two cases of type IIIC tibial fracture were treated in this manner, and we present our experience with a 30-month follow-up of one patient and a 6-month follow-up of another patient.     

四叠体池蛛网膜囊肿

目的:探讨四叠体池蛛网膜囊肿的临床特征和治疗方法。方法:对11例四叠体池蛛网膜囊肿进行了回顾性总结分析。所采用的手术方法有:①脑室分流手术;②囊肿-腹腔分流术;③囊肿切除;④囊肿切除加囊肿-脑池分流术,或囊肿部分切除(即囊肿开窗术),或囊肿切除加脑室-脑池分流术。结果:其主要临床表现以颅内压增高症和中线综合征为主。上述方法中单纯囊肿壁切除只能使部分病人的病情缓解,脑室分流或囊肿切除加脑室分流手术的疗效较好。结论:四叠体区蛛网膜囊肿常合并梗阻性脑积水,单纯囊肿切除不能解除多数病人的梗阻性脑积水。作者根据囊肿是否与蛛网膜下腔相通提出:对交通性蛛网膜囊肿采用单纯性脑室分流术,对非交通性者采用囊肿切除加脑室分流手术的治疗方法。     

Wegener肉芽肿8例临床分析

报告８例Ｗｅｇｅｎｅｒ肉芽肿病。本组疾病的病理特点均表现为坏死性血管炎及肉芽形成。临床特点为：发热（３８－４０℃）、鼻塞、鼻衄、咳嗽、口腔及鼻咽部溃疡，皮下结节：Ｘ线表现为肺部多发性结节及空洞阴影，副鼻窦炎症。尿常规检查异常，诊断主要依靠病变组织活检。环磷酰胺和肾上腺皮质激素联合治疗效果显著。     

血清载脂蛋白A1,B100含量测定在冠心病诊断中的价值

分别采用联合火箭免疫电泳技术和酶法对49例冠心病患者和50例健康人血清载脂蛋白 A_1(apoA_1),载脂蛋白 B_(100)(apoB_(100)),以及血清总胆固醇(TC)、甘油三酯(TG),高密度脂蛋白胆固醇(HDL—ch)的含量进行了测定。结果冠心病患者血清 apoB_(100)(0.99±0.26g/L)明显高于健康人(0.62±0.18g/L);而apoA_1/apoB_(100)比值(1.22±0.35)则明显低于健康人(2.12±0.49);TC,TG,HDL-ch 的含量亦有统计学意义。提示,在预示冠心病危险因素的各种脂类及脂蛋白中,以 apoB_(100)增高 apoA_1/apoB_(100)比值降低最为灵敏,最为准确,且高于单纯测定TC,TG 和 HDL-ch。     

Efficacy of radical neck dissection for the control of cervical metastasis after radiotherapy for nasopharyngeal carcinoma

Fifty-one patients who had persistent or recurrent neck disease from nasopharyngeal carcinoma after radiotherapy underwent radical neck dissection. The follow-up period ranged from 0.5 to 9 years (median: 2 years). Multiple cervical lymph node involvement was present in 51% of the patients (26 of 51). Malignant cells were detected in 88% of the resected specimens (45 of 51). The clinical sign of fixation of lymph node is the only factor that affects the successful control of neck disease (p = 0.04). Extracapsular extension of the nodal disease was present, and 35% of the lymph nodes were adherent to surrounding structures at operation (18 of 51). There was one hospital mortality and the overall morbidity was minimal. The actuarial survival at 5 years was 38%, and the probability of control of neck disease was 66%. Radical neck dissection is effective in controlling post-irradiation cervical metastasis from nasopharyngeal carcinoma.     

MRI同层动态增强对垂体微腺瘤的诊断价值

目的：分析垂体微腺瘤的MPd同层动态增强特征。方法：对40例临床怀疑为垂体微腺瘤的病人行同层动态增强MPd扫描，并绘出时间一信号强度曲线图。结果：40例病人中共检出垂体微腺瘤26例。同层动态增强后垂体微腺瘤的MPd表现为圆或椭圆形的低或稍低信号，似“充盈缺损”；垂体微腺瘤的最大信号强度多出现在注入造影剂后32～96s，以64s最明显。结论：同层MPd动态增强对垂体微腺瘤的诊断有较高价值。     

结肠癌伴糖尿病病人的围手术期护理

[目的]探讨结肠癌伴糖尿病围手术期的最佳护理措施。[方法]对41例患有糖尿病的结肠癌围手术期病人,采取术前心理护理、控制血糖、清洁肠道、术后安置合适体位、加强引流管护理、积极预防并发症、良好的营养支持。针对易发生感染性并发症的特点,加强对呼吸道、皮肤、泌尿系、伤口感染预防的护理。[结果]发生与感染有关的并发症5例,其中肺部感染2例、切口感染2例、尿路感染1例。[结论]通过以上方法护理,使围手术期并发症明显减少,而且方法简便易行,容易做到。     

MHC—I类抗原加工途径异常与肿瘤关系的研究进展

随着免疫学研究的不断深入，MHC－I类抗原呈递细节已逐渐明晰，全面认识肿瘤细胞MHC－I类相关抗原加工途径缺陷或改变与肿瘤生物学及肿瘤临床的关系，将有助于肿瘤的诊治和预防。