老年人静脉血细胞分析参考值范围的调查研究

Objective To establish the reference range of venous blood cells of healthy aged people by means of investigation on the reference range of venous blood cells of healthy adults and the aged.Methods The parameters of 3302 venous blood samples from the healthy adults and the aged were analyzed by applying SymexKX-21N hematology analyzer,and the test results were statistically analyzed with SPSS10.0 software.Results The reference range of the healthy aged people(males and females):WBC(3.57-9.00)×109/L and(3.52-8.39)×109/L;RBC(3.78-5.42)×1012/L and (3.44-4.83)×1012/L;hemoglobin(Hb)121.40-168.10 and 107.90-147.90 g/L;hematocrit(HCT)36.62%-49.18% and 32.82%-44.03%;mean corpuscular volume(MCV)85.10-100.60 and 84.70-100.60 fL;mean corpuscular hemoglobin(MCH)28.54-34.48 and 28.20-34.10 pg;mean corpuscular hemoglobin concentration(MCHC)322.00-357.00 and 320.00-352.00 pg/L;coefficient of variation of red blood cell distribution width(RDW-CV)12.13%-15.10% and 10.20%-17.12%;platelet(PLT)(70.00-240.00)×109/L and(77.00-262.00)×109/L;mean platelet volume(MPV)9.77-15.37 and 9.51-15.55 fL;platelet distribution width(PDW)11.44%-27.77%;platelet hematocrit(PCT)1.10-2.73 and 1.13-2.99 mL/L;large platelet ratio(P-LCR)24.35%-70.14%.The differences of the parameters(WBC,RBC,Hb,HCT,MCHC,PLT and PCT)were statistically significant between senile males and senile females(P＜0.01),while the other parameters weren't(P＞0.05);the differences of parameters(WBC,MPV,PDW and P-LCR)were not significant between adults and the ageds(P＞0.05),while the other parameters were(P＜0.05).There were also significant differences(P＜0.05)between the test results and the reported date about the blood cell parameters of adults and the ageds.Conclusion The reference range of the healthy ageds is different from that of adults;therefore it is necessary to establish the laboratory reference range of venous blood cells of the elderly in this region scientifically and rationally.     

家用微波炉在胸腹水细胞免疫组化染色运用的探讨

目的：研究微波对胸腹水细胞免疫组化染色的应用。方法：运用方阵选择法选择微波处理胸腹水细胞免疫组化染色时最佳抗体的浓度、微波炉功率及微波作用时间，对8例淋巴瘤及10例非肿瘤患者胸腹水细胞使用微波技术进行CD45RO／CD45RA免疫组化染色．并与经典染色方法进行比较。结果：使用微波技术进行免疫组化染色．抗体及酶标记抗体作1：5稀释、微波炉功率200～250W、微波作用时间2～3分钟，染色效果最佳，染色时间从经典染色的5．5小时缩短为1．5小时；8例淋巴瘤病人3例CD45RO阳性，5例CD45RA阳性，10例非肿瘤病人均为阴性，与经典方法一致。结论：采用微波技术对胸腹水细胞进行免疫组化染色较经典方法节约时间，且染色效果一致，可以使免疫组化染色从特殊项目变成检验科常规项目。     

健侧C7神经移位时健侧C7神经吻合口至效应器长度的测量

目的 为健侧颈7移位提供解剖学依据.方法 在30侧成人上肢标本上测量经皮下和椎前两种健侧C7移位时,正中神经返支起点至健侧C7神经吻合口之间的距离,并对两者进行比较:分别测量尺神经深支以及正中神经返支起点以上365 mm点距肱骨外上髁的长度.结果 经椎体前通路时测得效应器与健侧C7神经吻合点之间长度为(80.6±2.9)cm,经颈前皮下通路时长度为(86.5±3.1)cm.两者相比有统计学意义(t=6.32,P<0.05).测量正中神经返支和尺神经深支起点上365 mm分别位于肱骨外上髁上(4.6±0.7)cm和(6.7±0.8)cm处,两点均位于肘上部.结论 健侧C7移位修复正中神经不能恢复内在肌功能;经椎前通路优于经皮下通路;高位正中神经和尺神经损伤均位于肘上.     

三才汤对衰老动物肠道菌群的调整作用

本文讨论了三才汤水煎剂对D－gal衰老模型小鼠肠道菌群的影响，结果表明，三才汤能够对衰老小鼠的肠道菌群加以调整。     

老年人静脉血细胞分析参考值范围的调查研究

Objective To establish the reference range of venous blood cells of healthy aged people by means of investigation on the reference range of venous blood cells of healthy adults and the aged.Methods The parameters of 3302 venous blood samples from the healthy adults and the aged were analyzed by applying SymexKX-21N hematology analyzer,and the test results were statistically analyzed with SPSS10.0 software.Results The reference range of the healthy aged people(males and females):WBC(3.57-9.00)×109/L and(3.52-8.39)×109/L;RBC(3.78-5.42)×1012/L and (3.44-4.83)×1012/L;hemoglobin(Hb)121.40-168.10 and 107.90-147.90 g/L;hematocrit(HCT)36.62%-49.18% and 32.82%-44.03%;mean corpuscular volume(MCV)85.10-100.60 and 84.70-100.60 fL;mean corpuscular hemoglobin(MCH)28.54-34.48 and 28.20-34.10 pg;mean corpuscular hemoglobin concentration(MCHC)322.00-357.00 and 320.00-352.00 pg/L;coefficient of variation of red blood cell distribution width(RDW-CV)12.13%-15.10% and 10.20%-17.12%;platelet(PLT)(70.00-240.00)×109/L and(77.00-262.00)×109/L;mean platelet volume(MPV)9.77-15.37 and 9.51-15.55 fL;platelet distribution width(PDW)11.44%-27.77%;platelet hematocrit(PCT)1.10-2.73 and 1.13-2.99 mL/L;large platelet ratio(P-LCR)24.35%-70.14%.The differences of the parameters(WBC,RBC,Hb,HCT,MCHC,PLT and PCT)were statistically significant between senile males and senile females(P＜0.01),while the other parameters weren't(P＞0.05);the differences of parameters(WBC,MPV,PDW and P-LCR)were not significant between adults and the ageds(P＞0.05),while the other parameters were(P＜0.05).There were also significant differences(P＜0.05)between the test results and the reported date about the blood cell parameters of adults and the ageds.Conclusion The reference range of the healthy ageds is different from that of adults;therefore it is necessary to establish the laboratory reference range of venous blood cells of the elderly in this region scientifically and rationally.     

游离上臂外侧皮瓣修复手部深度烧伤

2005年10月至2008年4月,我们应用游离上臂外侧皮瓣修复手部深度烧伤11例,术后疗效满意,报道如下. 资料与方法 一、临床资料 本组11例,其中男8例,女3例,年龄14～50岁;受伤原因:热压伤3例,电击伤3例,热水烫伤3例,火焰烧伤2例.创面面积最大6.0 cm×4.0 cm,最小3.0 cm×3.0 cm.手术时机选择在伤后2～4 d.     

经桡动脉冠状动脉支架脱落的处理一例

随着支架设计的逐步改进,支架具有了更好的柔韧性和通过性。同时,随着指引导管提供了更好地的支撑力,支架脱落的平均发生率从早期的1.43%～8.3%,降到现在的0.32%～1.7%。但是,一旦发生支架脱落,出现合并症和局部血管并发症的概率较高。如果支架脱落发生在冠状动脉内,死亡率为6.2%,急诊搭桥率为17%。正如本例报告的特点,支架脱落的危险因素包括冠脉血管因素:如钙化、近端血管扭曲、预扩张不充分;操作因素:导引导管支撑力较差或同轴性较差;支架因素:早期需要手工捏至球囊上的支架或者通过近端支架置入远端支架等。支架脱落的治疗措施包括争取取出支架,如采用圈套器、远端球囊扩张、双导丝缠绕;挤压法,采用一个支架压扁另一个支架;在靶病变近端释放支架等方法。本例病例报道,在发现支架脱落后,术者将导引导管,导引导丝和支架一同撤到桡动脉位置,支架遗留在桡动脉处。后经股动脉途径完成介入治疗。术后第7天,再次对桡动脉进行造影,使用8F血管鞘头端进入桡动脉,在透视下,于体外用手固定脱落的支架,经血管鞘导入活检钳,最终取出脱落的支架。术者采取的措施,避免了支架脱落在冠脉内,降低了发生严重冠脉并发症的可能。在经股动脉途径完成介入治疗后,择期取出支架,最大程度上保证了患者的安全。待患者的情况稳定后,又尝试了使用活检钳,经大直径血管鞘的头端,配合体外固定支架,最终取出支架。此种挽救措施,的确为处理支架脱落的并发症提供了一种积极和有效的范例。但是,个例的报道经验,仍需要读者慎重借鉴和谨慎操作。应对支架脱落的最好方法,还是在于术前和术中的预防。     

肺炎克雷伯菌ESBLs基因型与Ⅰ类整合子的相关性研究

整合子与基因盒是细菌基因组中可移动的遗传物质,是细菌的天然克隆与表达,携带位点特异性重组系统组分,可将许多耐药基因盒整合在一起,从而形成细菌的多重耐药性[1]。产ESBLs的肺炎克雷伯菌(K.pneumoniae Kpn)的耐     

低分子肝素联合辛伐他汀治疗不稳定型心绞痛52例疗效观察

目的:为了提高不稳定型心绞痛患者的生活质量,本文对低分子肝素联合辛伐他汀治疗不稳定型心绞痛的临床疗效进行了观察研究。方法:选择2010年6月～2011年6月期间,我院收治的不稳定型心绞痛患者52例。随机将患者分成观察组和对照组。两组均根据实际病情给予常规治疗,观察组加用低分子肝素联合辛伐他汀治疗,对照组则仅加用低分子肝素进行治疗,比较分析两组患者临床疗效,心绞痛发作次数以及持续时间等指标。结果:与对照患者相比,观察组患者显效率和总有效率均均明显提高,分别可以达到42.31%和92.31%,且无效率明显降低,仅为7.69%。另外,与对照组患者相比,观察组患者心绞痛发作次数以及持续时间明显减少,差异均具统计学意义(P<0.05)。讨论:采用低分子肝素联合辛伐他汀治疗不稳定型心绞痛,能够明显提高患者的治疗效果,减轻患者的痛苦,对提高患者的生活质量具有十分积极的现实意义。     

急性非ST 段抬高心肌梗死临床与冠状动脉病变特点分析

目的 分析急性非ST段抬高心肌梗死(NSTEMI)患者临床特点及冠状动脉病变特点.方法 收集明确诊断的85例NSTEMI及116例急性ST段抬高心肌梗死(STEMI)患者,对高危因素、并发症、预后、心肌酶峰值、冠脉造影结果进行对比分析.结果 NSTEMⅠ组糖尿病、高脂血症、梗死后心绞痛、半年内再梗死发生率显著高于STEMⅠ组,泵衰竭、心源性休克发生率及死亡率显著低于STEMⅠ组(P< 0.05);NSTEMⅠ组肌钙蛋白T、心肌酶峰值低于STEMⅠ组(P< 0.05);NSTEMⅠ组多支病变的比例明显高于NSTEMⅠ组,完全闭塞率低于STEMⅠ组(P< 0.05).结论 NSTEMI具有良好的近期预后,但远期预后有可能较STEMI差.