染发剂致肝损伤一例

患者,女性,38岁,因乏力、尿黄、皮肤瘙痒半月余人院。患者于2007年2月20日起出现全身轻度乏力,尿色深黄如浓茶,伴躯干及四肢皮肤瘙痒。食欲及大便正常,当时未引起重视。于3月2日出现皮肤明显黄染,在外院就诊,查血生化示：总胆红素（TBil）98．8μmol／L,直接胆红素（DBil）70．6μmol／L,丙氨酸氨基转移酶（ALT）389U／L,天冬氨酸氨基转移酶（AST）333U／L,碱性磷酸酶（ALP）1218U／L,γ-谷氨酰转肽酶（GGT）949U／L;腹部CT示”肝脏轻度肿大”。     

线粒体动力相关蛋白1在炎症性肺实质疾病中的作用机制及研究进展

线粒体动力相关蛋白1(Drp1)作为介导线粒体分裂的主要蛋白, 对维持线粒体的形态、功能和完整性至关重要, 并参与细胞的生理活动及疾病的发生、发展进程, 尤其在炎症性肺实质疾病的能量代谢中发挥关键调节作用。文章探讨了Drp1的结构与功能, 并对其在急性呼吸窘迫综合征、肺动脉高压、哮喘、慢性阻塞性肺疾病中的作用机制进行综述, 为炎症性肺实质疾病的防治提供理论依据。     

布加氏综合征转流术麻醉体会

临床资料:男8例,女6例;年龄29～38岁。ASA分级Ⅱ级5例,Ⅲ级9例。术前合并腹水、下肢浮肿者5例,肝肾功能轻度异常者7例,重度异常者2例;合并心电图ST-T改变者3例。行腔-房转流术9例,肠系膜上静脉-房转流术5例。 麻醉及监测:14例均选静吸复合麻醉。①麻醉诱导:静注安定、芬太尼及氯化琥珀胆碱,气管插管成功后行桡动脉、锁骨下静脉、下腔静脉穿刺插管测中心静脉压(CVP),平均动脉压(MAP)及下腔静脉压力变化,连续监测ECG、尿量、观察眼结膜充血情况。②麻醉维持:普鲁卡因、芬太尼、氯化琥珀胆碱静滴及安氟醚吸入;有肝肾功能严重异常者肌松药选用卡肌宁0.3～0.5mg/(kg·30min)。围术期血液动力学变化见附表。     

B超诊断肝脓肿1例的体会

Ｂ超诊断肝脓肿１例的体会江苏省赣榆县人民医院王月兰患者男，４３岁。因右上腹隐痛伴持续高热１７天入院。查体：体温３９℃，心率８０次，两肺未见异常。肝脾肋下未触及，肝区程度扣击痛，腹部无异常。血红细胞４．２×１０（１２）／Ｌ，白细胞８．３×１０９／Ｌ，中...     

经尿道与耻骨上经膀胱前列腺电切术并发症的观察及护理

目的 探讨经尿道前列腺电切术（TURP）与耻骨上经膀胱前列腺电切术（SPP）的并发症的观察和护理.方法 将125例良性前列腺增生症患者随机分为观察组和对照组,观察组65例行TURP,对照组60例行耻骨上SPP,比较2组术后并发症发生情况.结果 观察组术后继发性出血、膀胱痉挛、尿失禁、尿路感染等并发症发生率均低于对照组（P〈0.05）.结论 TURP的并发症比耻骨上SPP的少,还具有创伤小、失血少、恢复快、住院时间短等优点,效果明显优于耻骨上SPP.     

抗病毒药联合Denver管治疗乙型肝炎肝硬化难治性腹水2例

核苷(酸)类抗病毒药运用于失代偿性乙型肝炎肝硬化,可明显改善预后,延缓或避免肝移植.但伴有难治性腹水的失代偿性乙型肝炎肝硬化患者,在药物有效抑制病毒的初期,临床改善相对滞后,不少患者未等到获益,即因腹腔感染、肝肾综合征等并发症死亡[1].我们对2例乙型肝炎肝硬化难治性腹水患者行抗病毒治疗的前后,联合Denver管腹腔静脉分流术(PVS)治疗腹水,使抗病毒效果充分发挥,获得4.5 ～ 5.5年长期生存的疗效,现报道如下.     

Characteristics of neutrophils infiltration in ventilation-induced lung injury

Neutrophils play a critical role in ventilation-induced lung injury. This study was aimed to investigate the characteristics of neutrophils influx in lungs induced by high tidal volume ventilation. Anaesthetized rats were randomly divided into low tidal volume ventilation group (Vt: 7 mL/kg, LV group) or high tidal volume ventilation group (Vt:42mL/kg, HV group ) (n=40 in each). Rats in each group were ventilated for 0, 60, 90, 120 and 240 min. The wet/dry lung weight ratio (W/D) was measured. The levels of macrophage inflammatory protein-2 (MIP-2) and tumor necrosis factor-α (TNF-α), and the activity of myeloperoxidase (MPO) were detected by enzyme-linked immunosorbent assay (ELISA). The number of neutrophils in bronchoalveolar lavage fluid (BALF) was counted after Wright’s staining, and the percentage of netrophils in lung tissues calculated. Histopatholgical examination was used to observe the changes of lung tissues after different ventilations. The results showed that the W/D weight ratio was increased, and the levels of MIP-2 and TNF-α significantly enhanced in HV group at 90, 120 and 240 min. Neutrophils in BALF and the neutrophil percentage in lung tissues were also elevated at 120 and 240 min, which coincided with the enhanced activity of MPO in HV group. The lung injury was significantly related with the ventilation time and the infiltration of neutrophils in lungs in HV group. In conclusion, in ventilation-induced lung injury, neutrophil infiltration is present in a time-dependent manner and associated with the aggravated lung injury. Pulmonary structural damage may be the main reason for ventilation-induced lung injury.     

腰方肌阻滞与肋缘下腹横肌平面阻滞在腹腔镜胃癌根治术后镇痛效果的比较

目的:比较超声引导下腰方肌阻滞（quadratus lumborum block, QLB）与肋缘下腹横肌平面阻滞（transverse abdominal plane block, TAPB）用于腹腔镜胃癌根治术的术后镇痛效果。方法:选择2021年1月至2021年7月择期在全身麻醉下行腹腔镜胃癌根治术的患者60例,采...     

TGF-β1基因多态性对乙肝肝纤维化的影响

目的:探讨TGF-β1基因-509C＞T多态性与乙肝肝纤维化的关系及其对血浆TGF-β1浓度的影响.方法:应用ARMS-PCR结合测序的方法,测定92例健康对照组和93例乙肝患者(肝纤维化组)TGF-β1基因-509位点的单核苷酸多态性,并确定其基因型和等位基因频率的分布;ELISA法检测血浆中TGF-β1和Ⅳ型胶原的浓度,放射免疫法检测血浆中透明质酸和Ⅲ型前胶原N端肽的浓度.结果:TGF-β1-509位点基因型及等位基因分布频率在肝纤维化组和正常对照组中并无显著差异,-509CC基因型在肝纤维化程度比较高的Child-Pugh C级组中的分布频率明显高于TT基因型(P＜0.05).肝纤维化组中的血浆TGF-β1、Ⅳ型胶原、透明质酸及Ⅲ型前胶原N端肽的浓度显著高于对照组(P＜0.05).在对照组中,血浆TGF-β1浓度在-509位点两种基因型之间并无明显差别;而在肝纤维化组中,-509CC基因型者血浆TGF-β1浓度显著高于TT基因型者(P＜0.01).结论:TGF-β1基因-509 C＞T多态性与肝纤维化的发生没有密切关系,但与肝纤维化的进展程度相关;该多态性影响肝纤维化患者血浆中TGF-β1的浓度.