口腔闭合压用于脱离呼吸机的预估

将21例呼衰机械通气患者按能否成功停机2h分为停机失败组和停机成功组。停机时口腔闭合压(PO.1)测定结果显示6例停机失败者PO.1均在0.44kPa以上,平均值为0.55±0.11kPa,15例停机成功者,PO.1除3例外均低于0.44kPa,平均值为0.38±0.10kPa,两组间PO.1差别显著(P<0.001)。若以PO.1 0.44kPa为临界值预测患者能否成功停机,其敏感度为100％,特异度为80％,预测准确度为85.7％。资料表明慢性阻塞性肺病(COPD)呼衰患者经适当机械通气等治疗后,PO.1可随病情好转而下降,认为PO.1可用作判定呼衰病情发展预测能否成功停机的参考指标。     

红斑狼疮古今中医病名探源

本文通过对中医文献资料的系统回顾和分析,从病因、病机及症状三个方面,对红斑狼疮相关的历代中医病名论述作了初步的探讨。根据病因命名的有“日晒疮”、“肾脏风毒”;根据病机命名的有“阴阳毒”、“温（瘟）毒发斑”、“热毒发斑”、“血热发斑”、“伏气温病”等名称;根据临床症状命名则更多。从命名发现,古代医家尤其重视红斑狼疮的皮肤表现,如“温毒发斑”、“红蝴蝶”、“鸦疮”、“赤丹”等病名,从一定程度上反映了红斑狼疮的特征性表现,但所反映的病情往往很局限,而且在不分型的情况下很难把握病情和预后,因此,将红斑狼疮中医病名进行规范化具有一定的积极意义。     

多层螺旋CT对颈部囊性肿块的诊断价值

目的 分析颈部囊性肿块的多层螺旋CT（MSCT）特征.方法 回顾性分析36例经病理证实的颈部囊性肿块,其中淋巴结病变9例,脓肿3例,涎腺病变2例,甲状舌骨囊肿9例,鳃裂囊肿5例,甲状腺病变2例,囊性水瘤3例,皮样囊肿1例,喉气囊肿1例,神经鞘瘤1例.结果 增强MSCT可以显示肿块的囊性特征.淋巴结病变为液化坏死所致,有较厚的囊壁;涎腺囊性病变表现各异;先天性囊肿常表现为光滑、壁薄和无增强的肿块,多数囊肿具有特定的解剖位置,如甲状舌骨囊肿主要位于颈前中线和舌骨水平,鳃裂囊肿多位于颌下腺后方和颈动脉鞘外侧,皮样囊肿位于口底.结论 MSCT影像学检查能准确对肿块定位、定性,对术前制定方案具有重要价值.     

不同结核病患者CD4+CD25+Foxp3+调节性T细胞表达的变化

Objective To investigate the expression of CD4 + CD25 + Foxp3 + regulatory T cell in patients with tuberculosis, and to discover its role in the immune response to mycobacterium tuberculosis. Methods Thirty-three patients with tuberculosis and 30 healthy controls were selected who were consulted in our hospital. Patients were classified by their chemotherapy and smear sputum and CD4 + CD25 + Foxp3 + regulatory T cell were detected by flow cytometry. Results Expression of CD4 + CD25high and CD4+ CD25 + Foxp3 + regulatory T cell in experimental group were ( 8.84 ± 2.55 ) % and (6.30 ± 1.38 ) % respectively, which were significantly higher than they were in control group (t = 3.57,4. 01, P ＜ 0. 01 ). The expression of CD4 + CD25high and CD4+ CD25 + Foxp3 + regulatory T cell in patients with positive smear sputum were also significant higher than that in patients with negative smear sputum ( t = 2. 51,2. 42,P ＜ 0.05). No significance was founded between the first-visit group and revisit group ( t = 0. 03, 0. 02, P ＞ 0.05 ). Conclusions CD4 + CD25high and CD4 + CD25 + Foxp3 + regulatory T cell in patients with tuberculosis were higher than healthy control, which may result in immune suppression.