MRI relaxation fluctuations in acute reperfused hemorrhagic infarction.

MRI evaluations of intramyocardial hemorrhage in acute infarction have relied on T(2) and T(2)(*) shortening only. We propose a more comprehensive evaluation of hemorrhagic infarction based on the concept that fluctuations in T(2) and T(1) relaxation in acute reperfused infarction will reflect transient edema and hemoglobin oxidative denaturation to uncompartmentalized methemoglobin. Anteroapical infarction was created via percutaneous balloon in young swine (22-25 kg, N = 12). T(2), T(1), diastolic wall thickness (DWT), and the Gd-DTPA partition coefficient (lambda) were measured on days 0, 2, and 7. DWT was elevated at 1 hr postreperfusion (128% +/- 53%, P = 0.0001), and alleviated on days 2 and 7 (48% +/- 10%, P = 0.008; 53% +/- 24%, P = 0.003). T(2) and T(1) elevations were coincident with early edema (DeltaT(2) = 55% +/- 24%, P < 0.0001; DeltaT(1) = 27% +/- 18%, P < 0.04). T(2) and T(1) were nearly normal on day 2 (DeltaT(2) = 8% +/- 8%, P = 0.27; DeltaT(1) = 0% +/- 1%, P = 0.65). On day 7, T(2) increased while T(1) decreased (DeltaT(2) = 27% +/- 16%, P = 0.005; DeltaT(1) = -14% +/- 10%, P = 0.02). Lambda was elevated by >150% at all time points (P < or = 0.002). Histology verified hemorrhagic injury. T(1) and T(2) fluctuations are consistent with transient edema, as well as hemoglobin oxidative denaturation to decompartmentalized methemoglobin. This methodological development may broaden our understanding of hemorrhagic microvascular injury and improve its detection in clinical populations.     

女性生殖道不同部位检测支原体的序贯试验分析

目的探讨解脲脲原体和人型支原体在女性生殖道的主要寄生部位.方法采用载量一致的标准无菌棉拭子分别于女性阴道穹窿和宫颈口采样,用法国生物梅里埃ID试剂进行解脲脲原体和人型支原体的培养鉴定及半定量计数,按照双向质反应开放型序贯试验设计,对检测结果进行比较分析.结果阴道穹窿部位标本中两种支原体的总阳性数和≥10^4ccu/ml半定量阳性数均高于宫颈口标本.结论对女性进行生殖道支原体感染的检测时应采集阴道穹窿标本,以提高检出率.     

学龄前儿童困难型气质影响因素的回归分析

目的 了解学龄前儿童困难型气质的影响因素。方法 对1150名学龄前儿童的气质类型进行评定，以筛选出的85例困难型气质儿童为研究对象，平易型气质儿童为对照，进行1：2病例对照研究，采用单因素和多因素条件logistic回归进行统计分析。结果 回归分析发现学龄前儿童困难型气质的影响因素主要有出生窒息（OR=8．93）、高热史（3岁前）（OR=2．85）、母亲打骂儿童情况（OR=5．266）、父母带儿童参加社会交往活动频率（OR=0．648）和长辈对儿童教育方式的一致性（OR=2．435）等。结论 学龄前儿童困难型气质受多种因素的影响，重视困难型气质儿童的早期发现，对其采取恰当的教养方式，做好围产期和儿童保健工作，有助于促进儿童健康成长。     

针刺配合中药熏蒸治疗腰椎间盘突出症80例

腰椎间盘突出症系腰椎间盘退变后凸起或破裂，压迫脊神经或马尾神经，引起腰痛、下肢痛或膀胱、直肠功能障碍的一种疾病。2001～2002年我科采用针刺配合中药熏蒸治疗腰椎间盘突出症，效果良好，现总结如下。     

The significance of a rapid cold hemagglutination test for detecting mycoplasma infections in children with asthma exacerbation.

BACKGROUND AND PURPOSE: Mycoplasma pneumoniae infection is a frequent cause of community-acquired respiratory infections in children and adults. However, standardized, rapid, specific methods for its diagnosis are lacking. The relationship between M. pneumoniae infection and asthma exacerbation has been recently discussed in the literature. We investigated the accuracy of rapid detection of mycoplasma infection by cold hemagglutination test compared to conventional enzyme immunoassays. The clinical characteristics of mycoplasma infection seen during emergent visits in asthmatic children were reviewed. METHODS: We retrospectively reviewed medical records of patients with asthma exacerbation visiting the Department of Pediatric Emergency, National Taiwan University Hospital, over a 12-month period. Subjects 2-18 years of age diagnosed with asthma at our outpatient clinic were included in this study. Patients with immunodeficiency, congenital anomalies, neurological diseases and irregular follow-up were excluded. RESULTS: A total of 269 children (174 males and 95 females) with a mean (+/- standard deviation) age of 6.15 +/- 3.08 years were included. The prevalence of asthma exacerbation in regular follow-up patients was 13.4%, and as many as 19.6% of cases (74/378 person-times) required hospitalization. Asthma attacks were most prevalent during December. 126 patients had both rapid cold hemagglutination testing and mycoplasma immunoglobulin M titers determined using acute blood samples drawn in the emergency room; 46 (36.5%) of these patients demonstrated mycoplasma infection. Sensitivity and specificity of the rapid cold hemagglutination test was 78.3% and 41.3%, respectively. The positive predictive value was 43.4%. Comparison of patients with or without mycoplasma infection revealed no differences in gender, age, chest X-ray findings, and most symptoms/signs and laboratory data, except that more signs of fever and auscultatory rales were seen in the non-mycoplasma infection group. CONCLUSIONS: Mycoplasma infections could be an exacerbating factor for asthma, and the rapid cold hemagglutination test should not be a guideline for prescribing macrolides in the emergency room.     

Pretreatment with recombined human erythropoietin attenuates ischemia–reperfusion-induced lung injury in rats

Objective: Based on the findings that erythropoietin (EPO) has been proved to be a multiple functional cytokine to attenuate ischemia–reperfusion (I/R) injury in various organs such as brain, heart, and kidney in animals, this experiment was designed to evaluate the effect of pretreatment with recombined human erythropoietin (rhEPO) on I/R-induced lung injury. Methods: Left lungs of rats underwent 90 min of ischemia and then were reperfused for up to 2 h. Animals were randomly divided into three experimental groups as sham group, I/R group, and rhEPO + I/R group (a single dose of rhEPO was injected intraperitoneally 3000 U/kg 24 h prior to operation). Lung injury was evaluated according to semi-quantitive analysis of microscopic changes, tissue polymorphonuclear neutrophils (PMNs) accumulation (myeloperoxidase (MPO) activity), and pulmonary microvascular permeability (Evan's blue dying method). Peripheral arterial and venous blood samples were obtained for blood–gas analysis after 5 min occlusion of right lung hilus at the end of reperfusion. The serum concentration of tumor necrosis factor (TNF)- was also measured by the method of enzyme-linked immunosorbent assay. Results: Histological injury scoring revealed significantly lessened lung alveolus edema and neutrophils infiltration in the rhEPO pretreated group compared with I/R group (p < 0.05). The rhEPO pretreated animals exhibited markedly decreased lung microvascular permeability (p < 0.05) and myeloperoxidase activity (p < 0.05). Blood–gas analysis demonstrated that the pretreated animals had significantly ameliorated pulmonary oxygenation function (p < 0.05). The serum concentration of tumor necrosis factor- in rhEPO pretreated group was markedly decreased compared with that of I/R group (p < 0.05). Conclusions: Pretreatment with rhEPO appears to attenuate I/R-induced lung injury. This function is partly related with the capacity that rhEPO inhibits the accumulation of polymorphonuclear neutrophils in lung tissue and decreases the systematic expression of tumor necrosis factor-.     

创伤输血的研究进展

现代创伤大多数伤情严重，失血量大。早期输血是救治危重患者的主要手段之一，尤其是失血性休克患者，尽快输血，改善组织微循环，可取得理想的救治效果。Schulman等报告美国每年创伤患者的数量庞大，仅1996年就有173900人死于创伤，2782400人因创伤而入院接受治疗，他们当中15％入院时即处于休克状态，为挽救其生命就需要输血。随着我国工业的快速发展，创伤患者逐年增多，输血在创伤救治中扮演着重要的角色。国内有关创伤输血的研究报道较少，为此，笔者对创伤患者输血相关的问题综述如下。     

Bax，Bcl-2在非小细胞肺癌中的表达相关性研究

目的 研究Bax，Bel-2在人类非小细胞肺癌中的表达及其相关性。方法 应用免疫组织化学（S—P法）检测80例非小细胞肺癌组织标本和40例肺良性病变组织中Bax，Bcl-2的表达水平。结果 ①非小细胞肺癌组织中Bax，Bel-2表达水平分别为63．8％，51．2％，二者表达均与组织学类型无关；②Bax，Bel-2在非小细胞肺癌中表达呈负相关。结论 Bax，Bel-2共同参与细胞凋亡，促进非小细胞肺癌的发生发展。     

脑卒中后吞咽困难的影像学分析

目的明确脑卒中后吞咽困难在X线透视影像学上的表现及特点.方法对56例脑卒中后吞咽困难患者及30名健康志愿者进行X线电视透视检查,记录异常表现,测量定量参数.统计方法采用秩和检验、t检验、卡方检验及Logistic回归分析.结果脑卒中后所有吞咽器官都表现功能异常,口期吞咽异常者46例,咽期异常者56例.与正常组对照,误吸组喉上抬幅度、速度降低,环咽肌打开宽度减少,吞咽潜伏期延长.34例存在误吸.误吸与舌运动减弱（P=0.021）、舌与硬腭接触不良（P=0.021）、声门关闭不全（P=0.011）、喉上抬慢且幅度降低（P=0.003）、吞咽延迟（P=0.001）及穿透（P=0.000）有关.结论脑卒中可损伤所有参与吞咽的器官,咽期吞咽更易受损,舌肌无力、声门关闭不全、喉结构上抬差及吞咽延迟可造成误吸.