金黄色葡萄球菌性烫伤样皮肤综合征患儿的护理体会

目的：讨论金黄色葡萄球菌性烫伤样皮肤综合征（以下简称SSSS综合征）的护理要点,减少并发症的发生。降低复发率。方法：收集2008年10月-2009年10月共计18例SSSS综合症的护理经验进行回顾性分析。结果：18例SSSS综合症患儿,除1例治疗后好转外,其余均痊愈出院,皮肤处无色素沉着斑。有效率90％。结论：通过18例SSSS综合症患儿的针对性护理,可以得出护理措施正确与直接影响患儿预后。     

自制掌趾脓疱病洗剂联合UVB治疗掌趾脓疱病临床疗效观察

我所据多年治疗掌趾脓疱病临床经验,经药理学研究,筛选出6味中药浸泡病区并结合UVB治疗掌趾脓疱病,取得显著疗效,于2008年9月至2010年8月,我们与去炎松尿素软膏对照,进行系统临床观察,取得满意效果,现将结果报告如下。     

毛囊角化病1家系

临床资料患者男,33岁。因全身泛发皮疹20余年,来我院门诊就诊。患者20余年前,无明显诱因面部、胸背部出现密集分布粟粒至绿豆大,肤色扁平丘疹,伴少许瘙痒,逐渐加重,四肢亦出现类似皮疹,泛发全身,多次外院治疗,均未确诊,具体情况均不详,病情夏重冬轻,该患者3代8人中共有3人患病（图1）,患者父母非近亲结婚。     

毛囊角化病1家系

临床资料患者男,33岁.因全身泛发皮疹20余年,来我院门诊就诊.患者20余年前,无明显诱因面部、胸背部出现密集分布粟粒至绿豆大,肤色扁平丘疹,伴少许瘙痒,逐渐加重,四肢亦出现类似皮疹,泛发全身,多次外院治疗,均未确诊,具体情况均不详,病情夏重冬轻,该患者3代8人中共有3人患病(图1),患者父母非近亲结婚.     

128层CT头颈部DSA:不同管电压及对比剂浓度的对照研究

目的:对比不同管电压及对比剂浓度在头颈部MSCT数字减影血管造影(MSCTDSA)检查中的可行性。方法:42例行MSCTDSA的患者平均分为A、B组,采用不同电压和不同浓度对比剂行平扫和增强扫描并记录数据,采用4分法对颅内动脉分支显示情况进行评价并行统计学分析。结果:2组相比,平扫和增强扫描的CT容积剂量指数差异均有统计学意义(P0.05),射线剂量分别降低约53.7%、33.0%,上矢状窦强化程度差异有统计学意义(P0.05),其余所测2组各目标血管CT值差异无统计学意义。大脑中动脉分支显示情况评分差异无统计学意义(P0.05)。结论:头颈部MSCTDSA技术采用低电压及低浓度对比剂扫描方案有重要的临床应用价值。     

慢性乙型肝炎抗病毒治疗的进展

全球约有3．5亿乙肝病毒携带者，亚太地区占1／3，而我国是乙肝感染高发区。据全国最新流行病学调查显示，我国HBV携带者占总人数的10％，约有1．3亿ASC，其中1／4为慢性乙型肝炎(CHB)，其中又有15％～25％可发展成肝硬化或肝癌。要阻断慢性乙肝向肝硬化、肝癌发展，则进行抗病毒治疗是关键。     

异维A酸治疗成人表皮松解性角化过度型鱼鳞病二例

例1，女，21岁。因全身反复起水疱，脱屑21年而就诊。患者于出生后4个月四肢开始出现针尖大小水疱，疱液呈黄色，浆液性，渐增大，并逐渐踊溃、糜烂。约1周后开始好转，但周边仍有新疱发生；1个月后皮损逐渐蔓延至全身。此后皮疹反复发作，冬季惧棕褐色厚的鳞屑性皮损为主，伴有瘙痒，夏季皮疹则加重，水疱增多。发病后患都曾先后至安徽     

低能量放电下标测无室性早搏的流出道室性心动过速

Objective This study reported initial experience of a new mapping method for ablation of syncope-caused ventricular tachycardia (VT) without combining frequent premature ventricular contraction (PVC). Methods All 11 recruited patients were female, mean age (39. 9 ± 13.7)years. They had experienced at least 1 syncope episode and were refractory to 2 or more antiarryhthmic agents in the past 1 to 3 years. Results ( 1 ) Clinical arrhythmia characteristics: In 5 patients, PVC or VT was induced by programmed stimuli without intravenous isoproterenol in right ventricular outflow tract(RVOT). In these patients, Holter monitoring recorded more PVCs ( mean 3678 beats/24 hours) with ventricular bigeminy or trigeminy, but less VT (mean 5. 8 episodes/24 hours). These patients suffered more transient amaurosis than syncope except one older woman combining hypertension. While in other 6 patients, VT could not be induced with programmed stimuli unless isoproterenol was administrated. These patients all suffered syncope in their medical history, their Holter monitoring recorded more VT (mean 15.5 episodes/24 hours)less PVC (mean 1208 beats/24 hours )with few ventricular bigeminy or trigeminy. (2) Electrophysiologic mapping and catheter ablation: Induced PVC or VT were frozen on monitor screen as reference, ablation catheter was posited on expected area of RVOT, pace mapping was performed firstly and Low Radio Frequency(LRF) energy( 15 ～20 W)was delivered at sites that paced VT morphology identical to reference VT in all 12 leads of ECG. Once the sites was found that VT morphology induced by LRF was identical to reference VT in all 12 leads of ECG,the radiofrequency energy would be increased to 35 ～50 W(50 ～55℃ )on same site until VT was eliminated. Then enlarge ablation area to about 1 cm2 around this site. All 11 patients were induced identical VT during low radiofrequency energy. ( 3 ) No VT/PVC was induced through program stimuli or intravenous isoproterenol repeatedly after ablation was considered as successful end point. Ten patients reached the end of ablation in the procedure ,9 targets located at sepal or posterior wall in RVOT, 1 did base of right coronary cusp. The only failure one also could be induced frequent matched VT by LRF, activating mapping found the earliest activated site located in inferior of left coronary cusp. However,PVC couldn't be eliminated,which suggested the target may locate at the pericardial layer.(4)No syncope or amaurosis was observed in 3 ～ 14 months of follow-up. Conclusions Low energy stimuli mapping can be used as a new mapping method as well as active mapping, pace mapping and spike potential mapping, especially to those patients suffer from repeat syncope or amaurosis induced by VT without combining frequent premature ventricular contraction.