巨大卵巢冠囊肿误诊1例

1　病例分析患者 ,2 3岁。因腹痛 3年余 ,腹部膨隆 6个月 ,以巨大卵巢囊肿收入院。患者已婚未孕。既往月经规律 ,于 3年前自感腹胀 ,腹部膨隆似妊娠 ,患者自感疲倦 ,时感低烧 ,以腹胀待查 ,结核性腹膜炎收治内科 ,抽放“腹水”约 2 0 0 0ｍｌ,症状好转 ,并给予抗结核药物治疗 ,腹部缩小 ,诊断尚未明确即出院。以后每隔 1年在外院抽放腹水 ,每次约 30 0 0ｍｌ,清亮、淡黄色 ,共 2次。体格检查 :营养发育中等 ,无消瘦面容 ,心肺无异常 ,肝脾未触及 ,腹部膨隆 ,触痛 (一 ) ,腹围 10 0ｃｍ ,腹部可触及足月妊娠样之包块 ,包块上达剑突下。妇科检…     

热休克蛋白70对大鼠心脏停搏供体肝移植的保护作用

目的：采用心脏停搏供体大鼠原位肝移植模型,观察热休克蛋白70（HSP70）对心脏停搏后不同时间的供肝缺血再灌注损伤的影响。 方法：以缺血预处理方法诱导大鼠肝脏组织产生HSP70,以预处理(IP)与否及供体心脏停搏45 min或60 min的不同,将供体大鼠分为4组(IP-45,IP-60,C-45和C-60)。于肝移植术后1 h采血检测肝功能,术后1 h及7 d切取肝脏,观察肝脏病理学改变,并观察各组大鼠术后存活时间。结果：缺血预处理后24~48 h,肝组织HSP70表达明显增强;肝移植术后1 h,血清ALT和AST水平IP组明显低于对照(C)组（P<0.05）;术后7 d,IP组移植肝光学显微镜下肝小叶结构完好,汇管区有少量淋巴细胞浸润,C组移植肝则出现了较多的肝细胞坏死和气球样变。C-45和C-60组1周存活率分别为12.5%和0;而IP-45和IP-60组1周存活率分别为62.5%和37.5%。 结论：HSP70明显改善术后肝脏功能和减轻肝脏病理学改变,显著提高心脏停搏供体肝移植的存活率,HSP70对心脏停搏供体肝移植缺血再灌注损伤具有明显保护作用。     

免疫吸附技术及护理

目的讨论免疫吸附技术及护理.方法配合治疗进行护理.结论建立静脉通道,加强局部观察,保持静脉通道畅通.在吸附治疗过程中根据患者血管条件及操作规程,适当调节泵出血液的速度和压力,以确保吸附过程的正常进行.每个吸附周期后及时用pH试纸检查冲洗吸附泵后排出液体的pH值,使其处于中性.     

FKN对外周血单个核细胞ERK1/2活化和TNF-α表达的影响及ERK1/2的临床作用

目的 探讨趋化因子(FKN)对单个核细胞细胞外信号调节激酶(extracellular signal-regulated kinase,ERK)1/2和肿瘤坏死因子-α(tumor necrosis factor-α,TNF-α)表达的影响及ERK1/2在其中的作用.方法 抗凝血用Ficoll密度梯度离心法分离外周血单个核细胞.将每份提取的单个核细胞分为3组:空白对照组、FKN组、FKN+PD98059(ERK特异性阻断剂)组;分别应用Western印迹法和酶联免疫法检测各组单个核细胞中磷酸化ERK1/2及TNF-α的表达水平.结果 FKN诱导组磷酸化的ERK1/2和TNF-α表达较空白组显著增多(P<0.05);PD98059组磷酸化的ERK1/2和TNF-α表达较FKN组显著减少(P<0.05).结论 FKN-CX3CR1可能通过增加单个核细胞磷酸化ERK1/2和TNF-α的表达而促进动脉粥样硬化的进展,FKN可能是通过ERK1/2途径诱导单个核细胞TNF-α的表达.     

大剂量阿托伐他汀预防对比剂肾病

Objective To compare the efficacy of high and low dose atorvastatin on preventing contrast induced nephropathy (CIN) in patients underwent diagnostic and therapeutic coronary intervention. Methods All patients received atorvastatin 10 mg/d on the basis of hydrated therapy (n =100) and high dose group received additional atorvastatin 80 nag at 12 to 24 hours before procedure (n =50). Scr, Ccr, blood β2-M, urine NAG/Cr, and urine osmolality before and after the procedure were compared between the groups. Results Baseline demographic characteristics and nephropathy risk factors were similar between groups. Cer was significantly reduced while blood β2-M and uric NAG/Cr were significantly increased in low dose group (all P ＜ 0.05) . Blood β2-M in the high dose group was significantly lower than that in the low dose group at day 1 [(2.35±0.52) mg/L vs. (2.67±0.64) mg/L, P =0.008], day 3[(2.49±0.55)mg/L vs. (2.80±0.64) mg/L,P =0.011] and day 5[(2.29±0.53) mg/L vs. (2.56±0.66) nag/L, P = 0.026] post-procedure respectively; urine NAG/Cr in the high dose group was also significantly lower than that in the low dose group at day 1 [(1.19±0.30) U/mmol vs. (1.46±0.34) U/mmol, P ＜ 0.001], day 3 [(1.30±0.30) U/mmol vs. (1.59±0.33) U/mmol, P ＜ 0.001], and day 5 [(1.10±0.30) U/mmol vs. (1.34±0.35) U/mmol, P = 0.001] post-procedure respectively;Cer in the high dose group was significantly higher than that in the low dose group at day 1 [(73.69±20.99) mL/min vs. (65.19±18.72) mL/min,P =0.035], day 3[(64.04±15.82) ml/min vs. (56.79±14.50)ml/min,P =0.019] post-procedure respectively. Conclusion High dose atorvastatin use before angiography is superior than low dose atorvastatin on attenuating contrast induced renal dysfunction.     

大剂量阿托伐他汀预防对比剂肾病

Objective To compare the efficacy of high and low dose atorvastatin on preventing contrast induced nephropathy (CIN) in patients underwent diagnostic and therapeutic coronary intervention. Methods All patients received atorvastatin 10 mg/d on the basis of hydrated therapy (n =100) and high dose group received additional atorvastatin 80 nag at 12 to 24 hours before procedure (n =50). Scr, Ccr, blood β2-M, urine NAG/Cr, and urine osmolality before and after the procedure were compared between the groups. Results Baseline demographic characteristics and nephropathy risk factors were similar between groups. Cer was significantly reduced while blood β2-M and uric NAG/Cr were significantly increased in low dose group (all P ＜ 0.05) . Blood β2-M in the high dose group was significantly lower than that in the low dose group at day 1 [(2.35±0.52) mg/L vs. (2.67±0.64) mg/L, P =0.008], day 3[(2.49±0.55)mg/L vs. (2.80±0.64) mg/L,P =0.011] and day 5[(2.29±0.53) mg/L vs. (2.56±0.66) nag/L, P = 0.026] post-procedure respectively; urine NAG/Cr in the high dose group was also significantly lower than that in the low dose group at day 1 [(1.19±0.30) U/mmol vs. (1.46±0.34) U/mmol, P ＜ 0.001], day 3 [(1.30±0.30) U/mmol vs. (1.59±0.33) U/mmol, P ＜ 0.001], and day 5 [(1.10±0.30) U/mmol vs. (1.34±0.35) U/mmol, P = 0.001] post-procedure respectively;Cer in the high dose group was significantly higher than that in the low dose group at day 1 [(73.69±20.99) mL/min vs. (65.19±18.72) mL/min,P =0.035], day 3[(64.04±15.82) ml/min vs. (56.79±14.50)ml/min,P =0.019] post-procedure respectively. Conclusion High dose atorvastatin use before angiography is superior than low dose atorvastatin on attenuating contrast induced renal dysfunction.     

个案管理对提高老年性痴呆患者生活质量的效果研究

目的探讨社区个案管理对提高老年性痴呆患者生活质量的效果。方法选取本院辖下2个卫生服务中心2012年4月—2013年4月筛选的40例老年痴呆患者,随机分为干预组和对照组,各20例。对照组实行常规社区管理模式,干预组实行社区个案管理模式,即在常规社区管理的基础上,对老年性痴呆患者实施日常生活能力、益智、行为矫正等训练。并于1年后对两组患者干预前后简易智力量表（MMSE）、日常生活能力量表（ADL）、临床痴呆评定量表（CDR）进行评估。结果干预组干预后认知能力、ADL和痴呆程度较干预前均有改善,差异有统计学意义（P〈0.05）,而对照组仅ADL较自身干预前有改善,差异有统计学意义（P〈0.05）。两组干预后认知能力、ADL和痴呆程度比较,差异有统计学意义（P〈0.05）。结论社区个案管理模式可提高老年痴呆患者的生活自理能力和社会适应能力,改善生活质量,有效延缓病情进展。     

军队数字化医院建设发展及趋势

阐述了军队数字化医院的概念,对比分析了当前军内外医院信息化建设的现状,明确了军队医院数字化建设的方向,提出了军队数字化医院建设的举措。     

孕晚期孕妇母胎依恋现状及影响因素分析

目的: 分析孕晚期孕妇母胎依恋现状及其影响因素。方法: 便利取样法,选取2019年8月至12月于天津市某三级甲等医院产科门诊就医的210例孕晚期孕妇为研究对象。采用一般资料调查表、母胎依恋关系量表（MAAS）等研究工具进行调查。采用多重线性逐步回归分析法进行多因素分析。结果: 孕晚期孕妇MAAS得分（75.93±6.03）分。多重线性逐步回归分析结果显示,家庭人均月收入、抑郁、消极应对及领悟社会支持是孕晚期孕妇母胎依恋的影响因素（P<0.01）,解释总变异量的43.3%。结论: 孕晚期孕妇母胎依恋水平处于较高水平,受多种因素影响。医护人员可通过提高其积极应对能力和社会支持水平,改善其母胎依恋质量,从而促进母婴健康。     

双嘧达莫预处理对大鼠原位肝移植缺血再灌注损伤的保护作用

目的:探讨双嘧达莫(DP)预处理对大鼠原位肝移植缺血再灌注损伤(IRI)的保护作用及机制。方法:建立大鼠原位肝移植动物模型,应用不同剂量DP(B组:0.1mg·kg-1、C组:0.2mg·kg-1、D组:0.4mg·kg-1)进行预处理,并与盐水预处理组(A组)进行对照,分别检测移植前、移植后6h血清肝酶谱及移植前、移植后1h及6h肝组织一氧化氮(NO)、髓过氧化物酶(MPO)水平。结果:C、D组与A组比较能明显降低移植后血清肝脏酶学水平、增加组织内NO水平、降低MPO水平(P<0.01),C组作用更为明显。结论:DP预处理能够对大鼠原位肝移植的IRI产生保护作用。