Old pulmonary embolism causing intrabronchial bleeding

A 51-year-old man was admitted because of hemoptysis. Physical examinations and chest XP revealed no abnormal findings. Fiberoptic bronchoscopy showed pulsatile bleeding at the orifice of right B6. Right bronchial arteriography showed a markedly dilated and tortous bronchial artery and shunting to the pulmonary arterial system in the middle and lower lobes. Pulmonary arteriography showed complete obstruction of the right middle lobar and lower lobe segmental arteries (A6, 9, 10). The hemoptysis was thought to be due to increased blood flow of the right bronchial artery, which compensated for reduced right pulmonary arterial flow. Right middle and lower lobe resection was done to prevent further hemoptysis. The resected specimen revealed old thromboemboli in the right middle and lower lobe pulmonary arteries. In this case old pulmonary embolism should be considered as a cause of intrabronchial bleeding.     

A Bronchial Response Comparison of Exercise and Methacholine in Asthmatic Subjects

The authors compared the inhaled methacholine and exercise responses in 22 stable unmedicated asthmatic patients. The exercise and methacholine challenges were performed at one to three week intervals. Bronchial responsiveness to methacholine was measured in relation to the concentration of methacholine (PC₂₀M). The response to exercise was expressed as the percentage of fall in FEV₁, from the pre-exercise FEV₁ The findings showed that 21 of 22 subjects demonstrated a fall in FEV₁, of more than 20% after methacholine challenge, while only 9/22 subjects experienced a similar decrease in FEV₁. All 9 of these positive response exercise cases completed three consecutive exercise challenges prior to the methacholine challenge. Of these cases, five were refractory to the repeated exercise challenge, and the PD₂₀M at the nonexercise stage was significantly lower than the postexercise state. In fact, the methacholine challenge sensitivity actually decreased (PD₂₀ increased) after repeated exercise. The authors concluded that methacholine seems to be a more sensitive bronchial provocation test than exercise. Second, only 55.6% of the exercise test-positive subjects were refractory to the second exercise challenge. Therefore, other factors besides the release of mediators should be considered in exercise induced asthma. Third, methacholine sensitivity actually decreased (PD₂₀ increases) after repeat exercise challenge.     

Effect of temperature in focal ischemia of rat brain studied by 31P and 1H spectroscopic imaging

³¹P, ¹H and lactate spectroscopic imaging was used to evaluate the effects of hypothermia on focal cerebral ischemia produced by middle cerebral artery occlusion. The effects on high energy phosphate metabolism, pH, lactate and NAA were investigated in 24 spontaneously hypertensive rats subjected to either permanent or transient ischemia. Under either normothermic (37.5°C) or hypothermic (32°C) conditions, with permanent 6-h occlusion, there was little difference between groups in either the NMR measurements or the volume of infarction. In animals that underwent 3 h of ischemia followed by 12 h of reperfusion, the ischemic changes in lactate, pH, NAA, and high-energy phosphate returned toward control values, and there was a protective effect of hypothermia (infarct volume of 211 ± 26 and 40 ± 14 mm³ in normothermic and hypothermic groups, respectively). Thus, hypothermia did not ameliorate the changes in lactate, pH, NAA, or high energy phosphate levels occurring during ischemia, however, during reperfusion there was an improvement in both the recovery of these metabolites and pathological outcome in hypothermic compared with normothermic animals.     

帕金森氏病和肌营养不良症（Erb型）中线粒体DNA的部分缺失

用ＰＣＲ技术对１２例神经肌肉性疾病患者的１６个标本进行了线粒体ＤＮＡ缺失情况的研究。发现２例帕金森氏病患者的肌肉组织以及其中１例的外周血和另１例肌营养不良（Ｅｒｂ型）患者的肌肉组织中线粒体ＤＮＡ至少有５２６ｂｐ的缺失。还对线粒体ＤＮＡ的部分缺失与疾病发生的关系进行了讨论。     

应用生存分析寻找急性髓性白血病治疗前和治疗反应预后因素

对１２８例急性髓性白血病患者的化疗前和化疗反应因素的研究表明，诱导化疗反应比化疗前因素的预后意义更突出。影响缓解的因素包括年龄、脾肿大、诱导期血小板低于６０×１０￣９／Ｌ日数比例（ｐＣ＜６０日数比）、诱导期体温高于３８℃日数比例（体温＞３８日数比）和白细胞低于１×１０￣９／Ｌ日数比例（ＷＢＣ＜１日数比）。影响生存的因素则是诱导期平均最低白细胞计数、ＭＢＤＩ、ＰＣ＜６０日数比和体温＞３８日数比。ＰＣ＜６０日数比比ＷＢＣ＜１日数比更明显地与诱导化疗剂量相关。对诱导化疗反应良好的特征为ＭＢＤＩ＞６０％、平均为１４％的ＷＢＣ＜１日数比以及ＰＣ＜６０日数比＜２０％。     

大面积Ⅲ度烧伤一次性切痂治疗的探讨

目的：探索大面积Ⅲ度烧伤一次性切痂手术的可行性，方法：１０例烧伤病人（总面积３５％～８５％，Ⅱ度２０％～６０％）术前置Ｓｗａｎ－Ｇａｎｚ导管，于血流动力，血气等动态监测下，一次将Ⅱ度烧务面创面全部切除，用异体和（或）自体皮全覆盖，结果：最大切面积６０％最大手术面积（切痂及供皮）达７１％，术中血流动及组织氧合指标短时间降低，术后迅速回升，２４ｈ多可恢复，术后均未发生内脏并发症，１０例均治愈，平均住字     

口服Sumatriptan治疗偏头痛的临床评价

本文报告口服Sumatriptan 100mg对偏头痛急性发作119例次的治疗结果。治疗后4h内显效91例次(76.5％),好转16例次(13.4％),无效12例次(10.1％),总有效率为89.9％。对偏头痛伴随症状恶心、呕吐和畏光、畏声的缓解率分别为94.2％、96％和94.3％。     

上腹器官簇移植术实验中血流动力学及血生化的变化

目的:观察上腹器官簇移植术实验中血流动力学及血生化变化。方法:杂种猪32只。随机分为供体组和受体组,无肝期行体外静脉转流。测定术中的血流动力学和血生化指标。结果:(1)术中血流动力学在无肝期初期及开放后早期时间内有明显的波动,心输出量、血压、肺动脉压和肺毛细血管楔压下降,心率加快;(2)转流在一定程度上稳定血流动力学;(3)生化变化:开放前行肝冲洗的8例,血钾仅轻度升高;未作冲洗的6例,则血钾明显升高;(4)开放后均有不同程度的代谢性酸中毒。结论:上腹器官簇移植术,机体血流动力学及血生化均有改变,特别是在肝移植阶段明显。其它器官移植期处理也应考虑肝移植后续作用的影响。     

电刺激膈神经中枢端引起降压反应的外周机理

电刺激麻醉家兔膈神经中枢端呆引起动脉血压下降，此降压反应不能被剪断双侧迷走神经所阻断；但可被静脉注射心得１．０ｍｇ／ｋｇ部分阻断；也可被静注射酚妥拉明２．０ｍｇ／ｋｇ部分阻断，去除缓冲神经后其降压效应更为明显。     

加强爱婴医院文化建设 促进母乳喂养

爱婴医院的文化氛围与爱婴医院的建立和发展密切相关。为搞好爱婴医院文化建设与管理,促进母乳喂养,本文对近几年发展起来的爱婴医院文化的构成、功能、特征和今后发展的标准进行了讨论。