老年人血清胆红素水平与冠状动脉病变程度的关系

目的观察老年人血清胆红素与冠状动脉病变的关系。方法经冠状动脉造影确诊的冠心病患者80例,其中冠状动脉轻度狭窄组15例,中度狭窄组32例,重度狭窄组33例;另外选取冠状动脉造影正常者40例做对照。采用重氮苯磺酸法测定血清胆红素水平,并对胆红素与各因素进行直线相关分析。结果冠心病组血清胆红素水平明显低于正常对照组,血清胆红素水平与冠状动脉病变程度成显著负相关关系(r=-0.26,P<0.05)。结论冠心病患者血清胆红素水平较正常人明显降低。低血清胆红素可能是冠心病的一种危险因素。血清胆红素水平与冠状动脉狭窄程度有明显相关性。     

血清白蛋白水平对血液透析低血压发生的影响

目的了解血浆白蛋白水平对血液透析时低血压发生率的影响。方法按血清白蛋白水平分为三组:血清白蛋白>35g/L组、25-35g/L组和<25g/L组,观察三组在血透期间低血压的发生率。结果随着血清白蛋白水平的下降,低血压的发生率呈升高趋势,三组的发生率分别为4.8%,6.4%,25.7%,三组间有显著性差异(P<0.01)。结论血浆白蛋白在维持血透期间的血压起着重要的作用,低白蛋白血症,尤其白蛋白<25g/L时,易发生低血压,在拟定超滤方案时应充分考虑这一因素。     

小儿阻塞性睡眠呼吸暂停低通气综合征的诊断及治疗

目的探讨基层医院小儿阻塞性睡眠呼吸暂停低通气综合征(OSAHS)的诊断和治疗。方法对临床疑似患儿,用多功能监测仪行夜间持续脉搏氧饱和度和呼吸监测、头颈侧位摄片、纤维鼻咽镜检查,确诊后行手术治疗。结果患儿多有睡眠粗响鼾声、扁桃体和(或)腺样体肥大,呼吸道感染、中耳炎、发育不良及中枢系统并发症的发生率较高。最低氧饱和度(85±7)%,睡眠呼吸暂停指数(apneaindex,AI)≥1者22例,睡眠呼吸暂停低通气指数(apneahypopneaindex,AHI)≥5者30例。在全麻下行扁桃体和腺样体切除术,同时行改良悬雍垂腭咽成形3例,双侧鼓膜切开引流术15例。术后症状及相关指标改善明显。结论便携式多功能监测仪可精确诊断OSAHS,扁桃体和腺样体切除是有效的治疗方法。     

腹腔镜结合术中内窥镜治疗结直肠良性病变13例分析

目的 探讨腹腔镜手术结合术中内窥镜治疗结直肠良性病变的方法和临床意义.方法 回顾性分析2004年6月至2006年12月13例结直肠良性病变以腹腔镜结合术中内窥镜治疗的患者的临床资料.结果 结肠多发性息肉1例,息肉3枚,直径1.5 cm～2.5 cm,乙状结肠、降结肠和直肠上段单发息肉或腺瘤11例,病变直径1.5 cm～3.0 cm,降结肠憩室并出血1例,直径1 cm,全部患者均在腹腔镜下结合术中内窥镜定位,经腹壁小切口找到定位处肠管切开后完整切除病变或缝扎憩室.无术后并发症.结论 腹腔镜结合术中内窥镜治疗结直肠良性病变定位准确、创伤小、安全有效,适合结直肠大部分位置良性疾病的治疗.     

平阳霉素加地塞米松局部注射治疗婴幼儿血管瘤

目的探讨平阳霉素+地塞米松局部注射治疗婴幼儿血管瘤的疗效。方法将平阳霉素8 mg+地塞米松5 mg+2%利多卡因1~2 ml+生理盐水3~8 ml稀释后,行血管瘤内注射至肿胀发白为限,1次平阳霉素用量不超过8 mg。观察2周,视瘤体颜色及硬度决定是否继续用药,直至瘤体开始变硬萎缩为止,平阳霉素注射总量不超过40 mg。近两年来,用该方法治疗1~8个月龄婴幼儿体表增生期血管瘤36例,其中颜面部24例,胸部3例,背部2例,上肢5例,足2例;草莓状血管瘤30例,混合型血管瘤6例。血管瘤最小面积0.6 cm×1.2 cm,最大面积23.0 cm×12.0 cm。结果1次注射治愈2例,2~3次注射治愈25例,4~5次治愈9例,其中局部坏死1例(为足背足底大面积草莓状血管瘤),经换药及手术愈合。随访6~19个月,未见复发,除1例遗留瘢痕外,其余全部无瘢痕愈合。有效率达100%。结论平阳霉素+地塞米松局部注射治疗婴幼儿血管瘤,具有疗效显著、简便易行、安全可靠等优点,是治疗增生期血管瘤首选方法之一,值得推广。     

Sprengel畸形并先天性垂直距骨1例

患者女,10岁。双侧肩部不对称并行走不便8年余就诊。查体:左肩部明显畸形,左肩关节外展80°。左肩胛骨纵短横宽,其脊柱缘相对接近中线。脊柱略左侧弯,略有斜颈,双侧足弓平坦。X线表现:左肩胛骨小、短、宽而厚,轻度旋转,左肩胛骨脊柱缘向脊柱侧隆起,中央部明显突出(图1),上缘超出第一肋骨颈,盂小而浅。左锁骨较长,左肩锁关节位置高。C7脊椎裂(图2),左第一、二前肋发育不全。C7左侧出现一粗大的骨块(即肩椎骨或称肩胛上骨)向左下方延伸,指向肩胛骨脊柱缘的突起部位,其间似形成关节。脊柱轻度左侧弯。距骨长轴呈垂直状,跟骨与距骨相重叠呈足…     

氟伐他汀对缺血性脑卒中患者的疗效观察及护理措施

Objective To explore the effect and nursing main points of fluvastatin on the patients with cerebral arterial thrombosis. Methods Eighty-five patients with cerebral arterial thrombosis were randomly divided into three groups. Group Ⅰ was the negative control group. Group Ⅱ was the conventional-dose therapy group and group Ⅲ was the high-dose therapy group. Each group was treated with related therapy and care. The blood lipids in all groups were tested before the treatment, 4 weeks, 12 weeks and 24 weeks after the treatment; the carotid intima-media thickness (IMT) were measured by the Germany SEQUOIAS-512-B ultra machine before the treatment and 24 weeks after the treatment; At the same time, the side effects of fluvastatin were recorded. Results The results of blood lipid tests showed that the LDL, TC and TG in two treated groups were significantly decreased compared to negative control group (P<0.05). After treated for 24 weeks, the carotid intima-media thickness (IMT) in two treated groups were significantly reduced (P<0.05); the side effects of fluvastatin were infrequent and there was no significant different among the three groups (P>0.05). Conclusion The effects of different doses of fluvastatin on cerebral arterial thrombosis were significantly different. With the dose of fluvastatin increased, the serum LDL-L and TC reduced more obvious and the inhibition on carotid atherosclerosis shows more obvious, and the side effects did not increased.     

Antisense Smad2 inhibits high glucose-stimulated production of extracellular matrix in cultured rat glomerular mesangial cells

Transforminggrowthfactor-β1(TGF-β1)is amultifunctionalpolypeptidethatregulatesanum-berofcellularprocesses,includingcellprolifera-tion,differentiation,apoptosis,migration,matrix synthesis,andtheimmuneresponse[1,2].Inchron-icrenaldiseases,TGF-β1isakeymediatorofex-tracellularmatrix(ECM)accumulation[3].Oneof thetargetrenalcellsforTGF-β1isglomerular mesangialcellsthatarecapableofproducingcom-ponentsofECM,suchascollagens,lamininand fibronectin[4,5].Recentstudiesindicatedthatinhi-bitionofT…     

Effect of hepatitis C antibody screening in blood donors on post-transfusion hepatitis in Taiwan

A national screening programme for antibody to hepatitis C virus (HCV) in blood donors in Taiwan began in July 1992 using a second-generation immunoassay. To study the impact of this screening on post-transfusion hepatitis in Taiwan, a prospective study on post-transfusion hepatitis, that was started in 1987, was continued. As of June 1994, 245 patients who received a blood transfusion after July 1992 had completed a follow-up period for more than 6 months post-transfusion. Of them, seven (2.8%) recipients developed acute post-transfusion hepatitis. The hepatitis in six cases could not be attributed to infection by hepatitis A, B, C, D, E viruses or cytomegalovirus (CMV) or Epstein-Barr virus (EBV). The remaining patient seroconverted to both IgG and IgM anti-CMV. All seven patients recovered in 6 months without development of chronicity, and the mean peak alanine aminotransferase level was lower compared with that of the cases before anti-HCV screening (i.e. pre-July 1992). These results indicate that the current anti-HCV screening has effectively interrupted HCV transmission through blood transfusion in Taiwan.     

肝动脉化疗栓塞术治疗肝癌的临床与病理的联系

作者将9例肝动脉化疗栓塞术(HAE)后二期切除的肝癌标本,多处切片作病理检查,结合病人的临床过程分析HAE的治疗作用,肝癌包膜对HAE的影响,HAE的效果及HAE后手术的时机等。作者认为,HAE对肝癌的治疗效果是姑息性的,故HAE后应争取在30～60天内再手三术探查,争取切除肿瘤。否则,HAE后肝癌复发的可能性极大。