促红细胞生成素对大剂量异丙肾上腺素所致心肌损伤及细胞凋亡的作用

目的观察促红细胞生成素（erythropoietin,EPO）对异丙肾上腺素（isoproterenol,ISO）引起大鼠心肌损伤及心肌细胞凋亡相关基因表达的影响。方法将雄性Sprague—Dawley（SD）大鼠分为3组：对照组、ISO组和EPO治疗组,检测血肌酸激酶、肌酸激酶同工酶水平及心肌caspase-3、iNOS的蛋白表达变化。结果EPO治疗组心肌酶水平及caspase-3、iNOS的蛋白表达均较ISO组明显减低。结论促红细胞生成素可以显著减轻异丙肾上腺素引起的心肌损伤,抑制caspase-3、iNOS蛋白表达。     

危重病患者输血相关性移植物抗宿主病预后分析

目的对ICU患者输血相关性移植物抗宿主病(TA-GVHD)的预后进行分析。方法采用PCR技术进行TA-GVHD插入基因片段及人Y染色体特异基因荧光检测,比较阳性组和阴性组的差异。结果52例患者中有31例患者输血后出现TA-GVHD检测阳性的结果,阳性患者死亡率为41.9%,阴性为47.6%,二者无显著差异。结论ICU中无典型症状的TA-GVHD患者并不增加ICU患者死亡率。     

桥小脑角肿瘤漏诊分析

自１９９５年以来,我们共开展乙状窦后入路血管减压松解梳理术治疗三叉神经痛６４例。术中发现桥小脑角区域肿瘤１２例,术前均常规行桥小脑角横断层面ＣＴ扫描,其中仅１例术前ＣＴ诊断为占位病变,余１１例均报告无异常发现。本病术前漏诊率高,为提高术前诊断正确率,现将临床资料总结如下,仅供参考。１　临床资料１２例桥小脑角区域肿瘤的临床资料与漏诊及术后病理诊断见表１。表１　１２例桥小脑角区域肿瘤临床资料编号性别年龄（岁）病程（年）术前ＣＴ报告术前诊断术中所见病理报告并发症１女６９１４无异常发现左三叉神经痛（Ⅰ～…     

肾嗜酸细胞腺瘤的CT表现及鉴别诊断

<正>肾嗜酸细胞腺瘤是一种少见的肾脏实质肿瘤,由于对该肿瘤缺乏认识而常误诊为肾癌。本文回顾性分析笔者所在医院经手术、病理证实的6例,结合相关文献,探讨肾嗜酸细胞腺瘤影像表现,分析其误诊原因。1资料与方法 1.1一般资料6例肾嗜酸细胞腺瘤中,男4例,女2例;年龄40⁷2岁,平均62.8岁。2例在正常体检时B超发现,4例因血尿、高血压经B超发现。     

纵隔外伤性血肿误诊为纵隔肿瘤1例报告

纵隔外伤引起纵隔占位性影像学改变较为少见，容易被误诊为纵隔肿瘤而手术治疗。现将近年遇见的1例报告如下。     

影响老年危重病念珠菌血症患者预后的多因素分析

Objective To evaluate the prognostic factors of elderly patients with noscomial Candidemia in intensive care unit. Methods A retrospective study was carried out in 75 elderly patients with noscomial Candidemia from 2001 to 2008. Multivariate logistic regression analysis was performed to find the correlations of prognosis with clinical and biochemical parameters. Results A total of 75 Candida strains were isolated from blood. The proportion of non-albicans species reached to 70.7%. Fluconazole-resistant candidiasis was increased. Overall mortality rate was 48.0%.Multivariate logistic regression analysis showed that septic shock, comorbid bacteremia, higher serum creatinine and sequential organ failure assessment (SOFA) score more than 10 were independent predictors for in-hospital mortality (Ward=6.34, 5.15, 8.04, 6.82, all P＞0.05). Conclusions Noscomical Candidemia in elderly critical illness patients leads a high mortality, the proportion of nonalbicans species and fluconazole-resistant candidiasis increase. The blood culture and drug sensitive test should be performed routinely to provide proper evidence for antifungal therapy. Monitoring the high risk factors, effective and reasonable therapeutics are the guarantee for reducing the mortality induced by Candidemia.     

原位心脏移植术后的监测与处理

我院于1997年6月19日对1例终末期扩张型心肌病患者施行同种原位心脏移植术,目前患者健康情况良好,恢复了正常生活。现将术后近期的监测与处理情况报道如下。     

股骨头缺血坏死的介入灌注治疗疗效评价

目的通过介入灌注方法评价股骨头坏死治疗效果。方法对59例股骨头坏死患者在DSA下行经股动脉穿刺插管,在旋股内、旋股外动脉和圆韧带动脉缓慢注入山莨菪碱5mg,尿激酶10万单位、复方丹参10mL,低分子右旋糖酐20mL。然后持续静脉点滴尿激酶20万单位持续1周。结果 59例患者治疗后3个月复查,疼痛消失占44%,其中Ⅰ期、Ⅱ期占65.6%;疼痛减轻占37.3%,跛行消失30%,其中Ⅰ期、Ⅱ期占50%;局部微循环改变占67.7%,其中Ⅰ期100%、Ⅱ期80%;Ⅲ期52%;Ⅳ期30%。DSA主要改变为:①股骨头区域血管数量增,②局部血流速度增快;③侧枝循环增多。结论介入治疗股骨头坏死对Ⅰ期、Ⅱ期疗效明显,对Ⅳ期效果不明显。