成骨肉瘤的诊断与治疗问题(附67例分析)

本文报告成骨肉瘤67例,经截肢术后5年生存率为14%。治疗失败的主要原因为术后肺转移。对部分病例采用常规化学疗法,但未能提高生存率。对成骨肉瘤的诊断和治疗作了讨论。     

高频双向喷射通气和常规机械通气对蒸气吸入性损伤犬治…

目的：观察高频双向喷射通气（ＨＦＴＪＶ）和常规机械通气（ＣＭＶ）对蒸气吸扩性损伤犬的呼吸循环动力学参数、肺容量及血气的影响。方法：通过服气吸入致伤，复制了犬重度蒸气吸入性损伤模型。结果：①两种通气下呼吸系统总阻力（Ｒｒｓ）、肺阻力（ＰＬ）均显著高于对照值（Ｐ〈０．０１），呼吸系统总顺应性（Ｃｒｓ）、肺顺应性（ＣＬ）均显著低于对照值（Ｐ均〈０．０５），但两者之间比较，Ｒｒｓ、ＲＬ和Ｃｒｓ、ＣＬ的变化     

抗休克治疗截肢后烧伤患者1例的临床分析

估算烧伤面积与判别烧伤深度是常规烧伤治疗的第一步,也是烧伤抗休克、补液的重要依据之一[1]。至于截肢后烧伤的患者抗休克治疗是否有其自身的特殊性,本组认为在临床中该类病例十分少见,值得思考。本组对1例截肢后烧伤患者行抗休克治疗,从其特殊性讨论烧伤抗休克治疗的综合处理。现报道如下。1临床资料患者,男,25岁,体质量65kg,2年前因车祸致左下肢膝关     

不同生长期杠柳各部位活性成分的累积变化

目的 考察一年内不同生长期杠柳各部位（根皮、根木质部、茎皮、茎木质部和叶）中主要活性成分杠柳毒苷和4-甲氧基水杨醛的量,研究其动态累积变化规律,确定其最佳采收期。方法 每月平行采样2次,超声提取法制备样品,RP-HPLC法测定杠柳毒苷和4-甲氧基水杨醛的量。结果 杠柳各部位成分累积动态变化曲线呈“双峰”型,其中茎皮中杠柳毒苷的量最高可达1.400%;根皮中4-甲氧基水杨醛累积量最高达0.781%,而其他部位均低于0.2%。结论 整个生长周期杠柳各部位中两种成分的累积变化呈一定的规律性,其变化可能与不同生长阶段及相应的生理代谢活动等密切相关;茎皮和根木质部均可作为提取杠柳毒苷的新药用部位,最佳采收期为生长期。     

经鼻持续气道正压通气(NCPAP)在婴幼儿重症肺炎中的应用

目的探讨经鼻持续气道正压通气（NCPAP）在婴幼儿重症肺炎中的应用价值。方法回顾分析我院2009年6月至2012年6月所收治的120例婴幼儿重症肺炎病例,在综合治疗基础上给予NCPAP,观察NCPAP应用前后缺氧改善情况,并发症及转归。结果经过临床治疗,患者的各项临床症状均显著改善,临床治疗前后PaO2、PaCO2、心率和呼吸等各项指标对比均具有显著的统计学差异（P〈0.05）。结论鼻持续气道正压通气（NCPAP）适合应用于婴幼儿重症肺炎,早期呼吸支持,能有效改善缺氧和促进疾病转归,耐受性、安全性好。     

单臂外固定架治疗高龄老人股骨粗隆间骨折的疗效观察(附56例报告)

目的 观察高龄老人股骨粗隆间骨折采用单臂外固定支架治疗效果.方法 年龄大于75岁,伤前能够独立行走,随访时间1.5～3.5年,平均2.5年.结果 骨折均愈合,未出现髋内翻,钉道感染5例,处置后愈合.螺钉松动3例.结论 单臂外固定架治疗高龄老人股骨粗隆间骨折创伤小,手术时间短,效果满意.     

Notch信号在急性早幼粒细胞白血病患者骨髓中的表达

目的：通过检测急性早幼粒细胞性白血病（APL）患者治疗前后骨髓中Notch信号途径中受体、配体和靶基因的表达情况,探讨其在APL发生中的作用.方法：采用半定量RT-PCR技术检测APL患者治疗前后骨髓中Notch1,Notch2,Notch3,Notch4,Delta-like-l,Delta-like-4,Jagged1,Jag-ged2,Hes1,Hes5的表达.结果：受体Notch2、配体Jagged1、靶基因Hes1的表达在APL完全缓解后明显下调,其它受体、配体及靶基因的变化无统计学意义.结论：在APL患者治疗前后存在Notch基因的改变,Notch信号的这些改变在APL的发病机制中可能有重要作用.     

强化精氨酸肠内营养对烧伤患者营养状况和细胞免疫的影响

Objective To investigate the effects of arginine enriched enteral nutrition (EN) on nu-tritional status and cellular immunity of severely burned patients. Methods Randomized, single blind, parallel and positive control investigation was employed in the study. Thirty severely burned patients were di-vided into enteral immune nutrition (EIN) group and EN group. Sixteen patients in EIN group received en-teral nutrition enriched with arginine, while the other 14 patients in EN group received standard enteral nu-trition. Nutritional support was continued for 14 days. Gastrointestinal reaction of patients in 2 groups was observed. Fasting venous blood was drawn from patients of both groups before receiving nutrition treatment and on the morning of 7th, 14th day of treatment. Level of serum protein, hepatic function parameters, renal function parameters, fasting-blood glucose, and subpopulations of T lymphocytes in peripheral blood were determined. Results (1) Incidence of gastrointestinal side effect in EIN group (25.0%) was close to that of EN group (21.4% , P>0.05). (2) Compared with pre-treatment days, levels of prealbumin and transferrin in serum of patients in 2 groups on 7th and 14th post-treatment days were significantly increased (P<0.05 or P<0.01), but there was no significant difference between 2 groups. The level of total serum protein on 14th day of treatment of patients was significantly increased in both groups, and that of EIN group (66±7 g/L)was significantly higher compared with that in EN group (64 ± 11 g/L, P<0.05). The level of serum albumin (29±5, 32±5 g/L, respectively) of patients in EIN group on 7th and 14th day of treat-ment were significantly higher than that (26±4 g/L, P <0.05) in pre-treatment days, however there was no significant difference in EN group. (3) There was no significant difference in respect of hepatic function, renal function, and fasting-blood glucose between pre-treatment and post-treatment periods in both groups (P>0.05). (4) The ratio of CD4+ , CD8+ on 14th day of treatment in EIN group was close to that of pre-treatment level. In EN group, cell percentage of CD4+ significantly decreased, while that of CD8+ significantly increased (P<0.05), and CD4+ was significantly higher [(56±8) %] in EIN group than that in EN group [(55±12) % , P <0.05]. In both groups, cell percentage of CD3+ was significantly higher than that in pre-treatment days (P<0.05), while there was no obvious change in CD4+/CD8+. Conclusions Arginine enriched enteral nutrition can effectively improve nutritional status and cellular immune function of burn patients.     

MRV与常规MRI联合应用对脑静脉窦血栓的诊断价值

目的：探讨MRI与磁共振静脉血管成像（MRV）联合应用于检测脑静脉窦血栓（CVST）的价值。方法：回顾性分析12例（男4例,女8例）CVST病人的CT、MRI（MRV）及DSA影像学资料,其中12例CVST患者均行MRIT2WIFSE、T1WI TSE、T2WI FLAIR和VEN3DPCA序列检查,4例行CT检查,其中2例行DSA检查。结果：CT检查可为CVST的早期诊断提供重要线索,但阳性率低。MRI（MRV）可直接显示出血栓、血流。并可反复无创检查,在诊断和把握病情上极为有用。结论：MRI及MRV的联合应用是目前诊断CVST之首选方法。