不同高压氧治疗方案对急性一氧化碳中毒受损心肌的疗效分析

Objective To investigate the effects of different hyperbaric oxygen ( HBO) treatment profiles on damaged myocardium induced by acute carbon monoxide poisoning. Methods One hundred and fifty-five serious cases of acute carbon monoxide ( CO) poisoning admitted into the hospital for treatment from October 2006 to March 2010 were randomly divided into the routine HBO treatment group (the routine group,75 cases) and the improved HBO treatment group (the improved group,80 cases). The treatment profile of the routine HBO treatment group: the patients were compressed for 20 min to the treatment pressure of 0.25 Mpa. Following stabilization at the said pressure, the patients breathed oxygen twice for 30 min plus 10 min, once a day. The whole treatment course consisted of 12 sessions, with the patients receiving HBO treatments from 9 to 68 times. The treatment profile of the improved HBO treatment group: the patients were given routine HBO treatment in the first 5 days, then, received improved HBO treatment, with a treatment profile of lower pressure (0.20 Mpa) , shorter oxygen-breathing time, lengthening of oxygen-breathing intervals and intermittent oxygen breathing. Total oxygen-breathing time was 4 times, each for 10 min plus 3 times each for 5 min. Then, the patients were decompressed to the surface following 20-min oxygen-breathing decompression. The patients received treatment for a succession of 3 days, then, had 1-day interval, and the whole treatment course consisted of 10 sessions. Changes in ST-T and myocardial enzymes of both the routine HBO treatment group and the improved HBO treatment group were measured and analyzed. Results ST-T recovery rate of the improved HBO treatment group increased (56% ,28% ) obviously, when compared with that of the routine HBO treatment group(P ＜ 0. 05). ST-T worse rate decreased significantly following HBO treatment on the 3rd and 6th days (21% and 25% on the 3rd day, 16% and 27% on the 6th day) respectively (P＜0.01). Statistical differences could be seen in the myocardial recovery rate and worse rate, when a comparison was made between them (P＜0. 05, P＜0. 01). Conclusions The improved HBO treatment profile showed better therapeutic effect on damaged myocardium induced by CO poisoning. This treatment profile should be used instead of other treatment profiles.     

CT引导下经皮肺穿刺术对肺内病灶诊断价值及常见并发症分析

CT引导下经皮肺穿刺对肺内病灶,尤其是经气管镜检查管腔内未见病灶而无法确诊的病例,提供了一种定位准确,穿刺成功率高而并发症相对较少的检查手段.我科近年来开展此项工作完成78例,报告如下.     

高分化肝细胞性肝癌伴肝血吸虫病1例

病人,女,70岁。体检发现肝脏占位性病变15 d。无腹痛、腹胀,无嗳气、呕吐等自觉症状。检查:腹平坦,右上腹可触及一8 cm×5 cm大小的肿块,质硬,表面光滑,无压痛。脾肋下未触及。B超检查示肝体积增大,右叶斜径164mm,左叶前后壁65 mm,回声粗,右叶见120 mm×116 mm巨大光团,分布不均匀,边缘不光滑,与周围组织界限不清。CT检查示右肝占位性病变。临床以原发性肝癌收住院。一肿物,大小10 cm×9 cm。切面灰白、灰黄色。镜检:癌组织呈细梁型结构,呈梁索状排列。癌细胞大小较一致。核轻度异型,偶见核分裂,部分区域癌细胞呈空泡状,血窦丰富。周围肝…     

MEBO治疗小面积烧烫伤经验总结

目的:观察患者或家庭成员使用湿润烧伤膏(MEBO)治疗小面积烧伤的疗效,探讨非专业科室或非医务人员使用MEBO治疗小面积烧烫伤的经验及家庭治疗的可行性。方法:对不同深度,不同部位的小面积烧烫伤,医务人员进行首次清创换药后均改由患者或家庭成员涂药治疗,保证每6小时涂药1次,适时清除创面药物及分泌物。结果:本组23例中,15例热水、热液烫伤,2例火焰烧伤,3例电击伤,3例摩托车热排气管烧伤,深度为Ⅱ度-Ⅲ度,面积1％-8％TBSA不等,全部治愈。结论:患者或家庭成员使用MEBO治疗小面积烧烫伤,疗效可靠,简便实用。     

湿润烧伤膏治疗隆乳术后乳房假体外露的体会

目的：探讨湿润烧伤膏(MEBO)治疗隆乳术后乳房假体外露的临床疗效。方法：对5例乳房假体外露创面应用MEBO治疗，根据情况分别采用暴露疗法和包扎疗法。结果：疗程最短2周，最长4周，全部封闭创口。结论：MEBO具有抗感染，改善局部血液循环，清除坏死组织，促进创面愈合等作用，用于美容外科有独特的优点。     

环氧合酶-2反义核酸对膀胱癌细胞恶性表型的抑制作用

目的探讨环氧合酶-2(COX-2)反义核酸对膀胱癌细胞恶性表型的抑制作用。方法采用脂质体介导方法,分别构建转染COX-2反义真核表达载体和空载体的膀胱癌细胞系5637-AS细胞和5637-P细胞,RT-PCR及W estern b lot分析转染细胞COX-2 mRNA及蛋白表达水平。MTT比色实验、Boyden侵袭小室法和裸鼠成瘤实验分别检测转染细胞体外增殖速度、体外侵袭力和体内成瘤性。结果RT-PCR结果显示,5637-AS细胞COX-2/磷酸甘油醛脱氢酶(GAPDH)mRNA比值(0.65)明显低于5637(0.92)和5637-P细胞(0.90);W estern b lot提示5637-AS细胞COX-2/β-actin比值(0.29)明显低于5637细胞(0.46)和5637-P细胞(0.44)。MTT比色实验显示5637-AS细胞较5637-P、5637细胞生长速度减慢,三者倍增时间分别为3.6 d、2.9 d和2.9 d。体外侵袭实验结果表明,5637-AS侵袭细胞数显著低于5637细胞及5637-P细胞(18.20±5.97比45.40±8.12,18.20±5.97比44.10±6.47,P<0.01)。裸鼠成瘤实验中,5637-P、5637细胞接种裸鼠后第5天肿瘤长出,而5637-AS细胞第7天肿瘤长出;30 d后5637-AS细胞接种组瘤体重量(392.15 mg±33.58 mg)明显小于5637细胞(738.26 mg±66.32 mg),和5637-P细胞接种组(698.53 mg±88.76 mg),P<0.01。结论膀胱癌细胞中COX-2过表达与细胞的恶性表型相关,反义技术抑制COX-2表达可以逆转膀胱癌细胞的恶性表型。     

冷冻治疗对大鼠C6脑胶质瘤细胞凋亡和p21表达的影响

目的研究冷冻治疗对大鼠C6脑胶质瘤细胞凋亡及其调控机制的影响。方法建立C6大鼠脑胶质瘤动物模型,于冷冻治疗后第15天留取标本,以末端标记法(TUNEL)、流式细胞仪(FCM)检测肿瘤细胞凋亡,以免疫组化技术检测p21蛋白的表达。结果冷冻可诱导C6大鼠脑胶质瘤细胞凋亡,上调p21的表达,二者呈显著正相关(P<0.01)。FCM分析显示G1峰前出现典型的亚二倍体峰。结论诱导细胞凋亡可能是冷冻杀伤脑胶质瘤细胞的另一重要机制;p21基因可能参与了这种细胞凋亡的调控。     

立体定向手术在颅内囊性病变中的应用

目的探讨脑立体定向技术在颅内囊性病变中的应用。方法采用螺旋CT引导立体定向手术23例,包括脑脓肿、蛛网膜囊肿、透明隔囊肿、囊性胶质瘤及颅咽管瘤。结果23例手术均准确定位,良性病变获得治愈,囊性胶质瘤及颅咽管瘤明显改善症状,肿瘤缩小或消失。结论脑立体定向技术定位准确、微创、安全、并发症少,尤其适合于颅内囊性病变的治疗。     

腋窝皱襞小切口腋臭根治术35例临床分析

腋臭属局限性臭汗症,其病因目前公认与腋下大汗腺排泄的汗液有关[1].患者多为女青年,由于刺鼻异味,影响日常工作和生活.我院于2003年至今开展腋窝皱襞小切口腋臭根治术治疗腋臭共35例,疗效满意,报告如下.