小儿腹泻诊断中轮状病毒检测的重要作用

目的了解我市轮状病毒引起小儿腹泻感染情况,做到早期检测,早期发现,早期治疗。结果小儿腹泻中轮状病毒感染率达55.0%。其中水样便65.5%,稀便46.6%,烂便39.2%。结论对小儿腹泻及早进行轮状病毒检测,有助于诊断小儿腹泻感染情况,及早采取相应治疗及隔离措施。     

儿科急诊抢救中存在问题的分析及对策

"工欲善其事,必先利其器",具备抢救急重危患儿的能力,是每个儿科护士在护理危重患儿中的利器之一.因此,本文针对护理人员在急诊抢救护理过程中的问题进行分析,提出解决问题的相应对策,以提升护理专业素质.     

缺血性脑血管病与颈动脉粥样硬化及其危险因素的关系

目的探讨缺血性脑血管病(ICVD)与颈动脉粥样硬化及其危险因素的关系。方法对186例ICVD患者与194例非脑血管病患者和正常体检者(对照组)行颈部血管超声检查和血液生化检查;比较两组间的颈动脉硬化程度及脑卒中危险因素的差异。结果ICVD组年龄[(69±7)岁]和患有高血压(66.1%)、糖尿病(53.4%)、代谢综合征患者(44.6%)的比率非常明显高于对照组[(61±5)岁、48.8%、15.2%、12.9%](均P<0.001)。ICVD组颈动脉粥样硬化分级计分≥2分(斑块发生率)、≥3分(血管狭窄发生率)分别为69.3%、20.4%,明显高于对照组的33.5%和5.1%(均P<0.05)。结论颈动脉粥样硬化是ICVD的危险因素之一;各种危险因素的聚集对ICVD的发生起重要作用。     

Gd-BOPTA增强MRI对小肝癌的诊断价值

目的　比较Gd BOPTA增强MRI与MRI平扫、Gd DTPA动态增强MRI在诊断小肝癌 (SHCC)方面的差异 ,进一步提高小肝癌检出率和诊断准确性并观察其不良反应。资料与方法　手术或穿刺病理证实为SHCC患者 2 5例。采用GESigna 1.5T磁共振扫描仪。行SE序列T1WI、FSE序列T2 WI及Gd DTPA快速动态增强多期扫描。Gd BOPTA增强扫描亦采用静脉团注快速动态增强扫描 (同Gd DTPA) ,并在团注后 15min、6 0min行SE序列T1WI和FMPSPGR序列T1WI扫描各 1次。观察MRI平扫、Gd DTPA快速动态增强和Gd BOPTA增强扫描及延迟扫描对病灶的检出率、包膜显示情况以及病灶的强化特征并行统计学分析。观察其不良反应。结果　 2 5例患者共发现病灶4 2个。对SHCC病灶的检出率 ,MRI平扫为 6 9.0 5 % ,Gd DTPA增强为 85 .71% ,Gd BOPTA增强 (动态 延迟 )为95 .2 4 % ,和Gd DTPA增强之间无统计学差异 ,和MRI平扫有统计学意义。病理检查发现 30个病灶有包膜。Gd BOPTA增强对SHCC包膜的显示 ...     

腹腔镜下治疗输卵管妊娠术28例临床分析

目的 :对腹腔镜下治疗输卵管妊娠手术做出评价 ,并与传统剖腹手术方法比较。方法 :在电视腹腔镜下行保守性手术 8例及根治性手术 2 0例 ;对照组 2 8例采用传统剖腹手术方法。结果 :两组手术时间、尿TT恢复正常时间、切口感染差异均无显著性 (P >0 .0 5 ) ,两组术中出血、术后体温、肛门排气时间、下床活动时间、住院天数差异有显著性 (P <0 .0 1)。结论 :腹腔镜下治疗输卵管妊娠术具有创伤小 ,康复快 ,术中出血少 ,术后感染率低等优点 ,有助于提高患者生活质量 ,是临床上的理想手术方式     

消化内镜病毒污染的现状及对策

从乙型肝炎病毒、丙型肝炎病毒和人类免疫缺陷病毒污染情况综述了消化内镜病毒污染的现状，分析了污染的原因以及消化内镜消毒现状。     

原发性十二指肠恶性肿瘤的影像学诊断

目的 探讨X线、CT及血管造影对原发性十二指肠恶性肿瘤的诊断价值及鉴别诊断。资料与方法 回顾分析经手术和／或病理证实的46例原发性十二指肠恶性肿瘤的l临床及影像学资料，46例全部作过十二指肠气钡双对比造影，并有13例作低张十二指肠插管造影；28例作CT检查；11例作数字减影血管造影。结果 胃十二指肠双对比造影及低张十二指肠插管诊断十二指肠癌24例；平滑肌肉瘤6例；恶性淋巴瘤4例。诊断总符合率为73．91％(34／46)。误诊率为17．39％(8／46)，漏诊率为8．7％(4／46)。CT检查28例，确诊十二指肠癌4例，平滑肌肉瘤7例。误诊为腹腔脓肿2例，平滑肌瘤6例，腹腔恶性肿瘤9例。诊断符合率为39．29％(11／28)，误诊率为60．71％(17／28)。血管造影11例，9例检出病变，6例确诊为十二指肠恶性肿瘤，3例误为良性肿瘤，2例未发现明显肿瘤血管。确诊率为54．55％(6／11)，误、漏诊率分别为27．27％(3／11)、18．18％(2／11)。结论 胃十二指肠气钡双对比造影是发现十二指肠恶性肿瘤最简单易行的方法，它和胃镜配合能得到病理学诊断。低张十二指肠插管造影对重度肠腔狭窄或阻塞患者显示病变范围起补充作用。CT能显示管外型恶性肿瘤的软组织块影及管壁破坏和有无淋巴结肿大。血管造影能根据血供来源明确钡餐难发现、CT仅显示与肠管无明显联系的平滑肌肉瘤，并可进行栓塞IE血治疗。     

大,巨型垂体腺瘤的手术入路选择

自１９９０年以来收治直径在２－５．６ｃｍ的大、巨型垂体腺瘤３３例。依肿瘤生长形态与扩展范围将其简略分为三种类型。Ａ型：瘤体位于鞍内或侵入蝶窦；Ｂ型；瘤体呈椭圆形或哑铃向鞍上扩展，三脑室明显移位抬高；Ｃ型：瘤体巨大侵入三脑室阻塞室间孔或明显的鞍周扩展。     

Binding of platelet agglutinating protein p37 from the plasma of a patient with thrombotic thrombocytopenic purpura to human platelets

We have previously reported the purification of a 37 kDa platelet agglutinating protein (PAP p37) from the plasma of a patient with thrombotic thrombocytopenic purpura (TTP) that was shown to be present in a subset of TTP patients. To gain further insight into the interaction between PAP p37 and platelets, we have studied the properties of PAP p37 binding to platelets. Washed human platelets from two normal donors and two TTP patients after recovery were used for the experiments. The PAP p37 binding to platelets was specific, concentration dependent and saturable. Scatchard analysis demonstrated about 20,564-27,090 PAP p37 binding sites per platelet. Stimulation of platelets with thrombin or ADP did not have any significant effect on its binding. Thiol- and serine-specific protease inhibitors did not inhibit PAP p37 binding to the platelets. Sugars such as glucose, fructose, mannose, and sialic acid, at 40 mM, inhibited its binding to platelets by 44%, 73%, 79%, and 91% respectively, but galactose and amino sugars did not have any significant effect. At 250 micrograms/ml, Concanavalin-A inhibited 42% of binding, but other lectins, such as phytohemagglutinin-P, potato lectin and helix pomatia lectin (snail), did not. Pre-incubation of 125I-PAP p37 with the adult human IgG, decreased its binding to the platelets. The monoclonal antibodies to GP Ib (6D1) and GP IIb-IIIa complex (10E5) did not inhibit the binding of 125I-PAP p37 to platelets. Fibrinogen and von Willebrand factor did not affect the binding either. These results suggest that PAP p37 binds to platelets on the sites other than GP Ib or GP IIb-IIIa complex.     

Effect of fathers'' age and birth order on occurrence of congenital heart disease.

STUDY OBJECTIVE--The aim was to examine if there is an effect of fathers' age and of birth order on the occurrence of congenital heart disease. DESIGN--This was a hospital based case-referent study including use of birth defects surveillance data. SUBJECTS--Subjects were 497 cases of congenital heart disease aged between 3 months and 5 years, born in Beijing and Hebei Province, China; 6222 children without congenital heart disease serve as reference baseline. MEASUREMENTS AND MAIN RESULTS--With stratified analysis and logistic regression analyses, congenital heart disease was found to be associated with fathers' age less than 25 years (odds ratio 2.63), independent of mothers' age and of birth order. There was also evidence to show a higher birth order effect on the occurrence of congenital heart disease independent of parental ages. CONCLUSION--Higher birth order and fathers aged less than 25 years were both independently associated with some categories of congenital heart disease and with congenital heart disease overall.