伴有晕厥症状的急性肺血栓栓塞症患者的临床特点分析

目的 回顾性分析25例伴有晕厥症状的急性肺血栓栓塞症(PTE)患者的临床特点及住院转归情况.方法 2011年1月至2015年12月期间北京医院确诊的289例PTE患者,按照是否伴有晕厥症状分为晕厥组和无晕厥组,记录两组患者年龄、性别、危险因素、临床症状、实验室检查、影像学特征、危险度分级、治疗情况和住院转归情况.结果 晕厥组25例,占所有PTE患者的8.7%,其中,男14例,女11例,平均(62.0±14.0)岁.晕厥组和无晕厥组在年龄、性别、基础疾病及危险因素等方面差异无统计学意义;晕厥组中心悸和发绀发生率高于无晕厥组(分别是36.0% vs 13.3%和24.0% vs 9.5%,P=0.002、0.030);心电图检查中,SⅠQⅢTⅢ表现的比例较无晕厥组差异有统计学意义(16.6% vs 2.9%,P=0.001);超声心动图检查中,右心室前后径/左心室前后径>0.6的比例较无晕厥组差异有统计学意义(50.0% vs 27.3%,P=0.034);晕厥组主肺动脉及肺动脉干受累的比例高于无晕厥组,两组差异有统计学意义(55.0% vs 29.8%,X2=5.34,P=0.021);晕厥组高、中危患者的比例要显著高于无晕厥组(76.0% vs 32.6%,X2=18.60,P<0.001).两组的全因死亡率差异无统计学意义(12.0% vs 9.8%,X2=0.12,P=0.730),但晕厥组死于PTE的比例较无晕厥组高(12.0% vs 2.6%,X2=5.87,P=0.015).结论 伴有晕厥症状的PTE患者常累及主肺动脉和肺动脉干,伴有右心功能不全,疾病危险程度更为严重,可能是疾病预后不佳的标志.     

老年肺癌合并静脉血栓栓塞症的临床研究

目的探讨老年肺癌合并静脉血栓栓塞症(VTE)的临床特点、危险因素及预后,提高防治意识,减少血栓事件发生。方法对北京医院2003年1月至2013年4月老年肺癌合并VTE的患者进行回顾性临床分析,记录年龄、性别、临床表现、病理类型、TNM分期、体力状态(PS)评分、化疗方案及预后等临床信息。结果老年肺癌组49例,年龄(72.8±5.56)岁,非老年组30例,年龄(54.2±8.29)岁。老年组基础疾病的发生率高于非老年组;近期卧床(24.49%对6.67%)和PS评分(2.32±1.38对1.37±1.10)亦高于非老年组(P值分别为0.048和0.02)。在两组患者中,以NSCLC为主,病理类型多为腺癌,TNM分期Ⅲ~Ⅳ期居多。老年组呼吸困难症状(36.74%对13.33%)及肺栓塞严重程度指数(PESI)评分(116.92±21.34对100.5±18.12)多于非老年组(P值分别为0.028和0.04)。老年肺癌组3、6、9和12个月VTE累积发生率分别为71.4%、77.6%、83.7%和87.8%;非老年组分别为76.7%、80.0%、83.3%和83.3%。生存分析显示,两组中位生存时间差异无统计学意义[(6.0±2.25)个月对(9±7.48)个月,P=0.657]。结论老年肺癌合并VTE患者具有较多的基础疾病,而且卧床患者较多;老年组PTE患者中呼吸困难症状多见,疾病危险程度高于非老年组,老年组患者预后较非老年组差。     

非球面切削与波前引导切削LASIK矫治近视的术后视觉质量分析

目的：对比分析非球面切削、波前引导切削与常规切削LASIK治疗近视的术后视觉质量。

方法：从本院2007-01/2009-12收治的行LASIK手术治疗的近视患者当中选取90例180眼为研究对象,按照切削方式的不同按自愿非随机选择原则分为3组：非球面切削组、波前引导切削组和常规切削组; 每组均包括低度近视(屈光度≤-3.00D)、中度近视(-3.25 ～-6.00D)、高度近视(-6.25～-9.00D)各10例20眼。对比分析术后3组患者的裸眼视力、角膜 Q 值、高阶像差(RMS值)等视觉质量参数以及患者视觉满意度。

结果：不同激光切削方式术后的裸眼视力均达到1.0以上,组间差异均无显著性(P=0.26); 术后角膜Q值均有所增加,但非球面切削组明显小于常规切削组和波前引导切削组(P<0.05); 术后各组的高阶像差RMS值均较术前增加,非球面切削组和波前引导切削组明显小于常规切削组(P<0.05),非球面切削组和波前引导切削组两组间差异无显著性意义; 术后3组患者均感到满意,非球面切削组视觉非常满意度要高于另外两组,但差异不具有统计学意义(P=0.57)。

结论：常规切削、非球面切削、波前引导切削LASIK治疗近视均能够取得较好的视觉质量,其中非球面切削的临床应用效果更好。     

8～15岁近视性屈光参差者调节及双眼视功能的相关研究

目的 对8～15岁近视性屈光参差者进行调节及双眼视功能检查,以明确近视性屈光参差者调节及双眼视功能的关系,为近视性屈光参差的防控提供可靠的依据.方法 收集近视性屈光参差者60名,低度屈光参差者(1.00D≤双眼等效球镜差<2.50D)30名,中高度屈光参差者(双眼等效球镜差≥2.50D)30名.其中同期检查的对照组30...     

基于纳米孔测序技术的临床检测研究进展

鉴于目前一代测序通量低,二代测序读长短的限制,一种新的克服上述缺点的技术应运而生。基于纳米孔的三代测序技术不依赖DNA聚合酶的链式反应,通过识别电信号判别碱基,具有广泛的应用前景,同时也面临着更多挑战。目前在在感染性病原、传染病防控、遗传变异及肿瘤诊断等方面有诸多应用。     

江西近视手术人群角膜前表面非球性参数调查分析

Objective To assess the distribution features of Q-value of corneal anterior surface in Jiangxi myopia population for laser refractive surgery and to investigate the relationship between Q-value and other related parameters, such as spherical equivalent (SE), corneal curvature, cornea astigmatism, wavefront data and age. Methods The K&Q calculator of Orbsean- Ⅱ anterior segment system was used to obtain the Q-value of 6 mm optical zone in 411 cases (822 eyes) .There were 188 male subjects (376 eyes) and 223 female subjects (446 eyes). Accnrding to SE, subjects were divided into three groups including low myopia, moderate myopia and high myopia. According to different age, subjects were divided into three groups including group Ⅰ (age from 17 to 25), group Ⅱ (age from 26 to 34) and group Ⅲ (age from 35 to 44). Statistical analysis was used to comprehend the distribution characters of Q-value and its relations with SE, corneal curvature, cornea astigmatism, wavefront data and age. Results The Q-value of 822 eyes (411 cases) distributed as positive normal distribution, the average of Q- value was -0.148± 0.120 (range from -0.73 to 0.56) and -0.130± 0.128for male subjects and -0.163± 0.110 for female ones with statistically significant difference in Q-value in different genders (t=4.069, P <0.01). A significant difference was observed in Q-value among 17-25 years, 26-34 years and 35-44 years groups (F =4.567, P <0.05) as well as between 26-34 years group and 35-44 years group (P =0.004). However, there was no significant difference found between different myopic groups (F =1.434, P >0.05). The Q-value shown significantly negative relationship with C12, the Q-value show poor relationship with cornea curvature, cornea astigmatism, RMSh and C8. But the Q-value was not related with SE, RMSg, C7, cornea thickness, ocular pressure and age. Conclusions In Jiangxi myopia population for refractive surgery corneal curvature of majority population become flatter from center to periphery (Q<0), minority become steeper from center to periphery (Q>0). The Q-value of corneal anterior surface is independent from myopic SE. The Q-value show poor relationship with cornea curvature, cornea astigmatism, RMSh and C8, C12 is the most important related factor of Q-value. The Q-value is significantly greater in males than in females. A significant difference is observed in Q-value between 26-34 years and 35-44 years group.     

江西近视手术人群角膜前表面非球性参数调查分析

Objective To assess the distribution features of Q-value of corneal anterior surface in Jiangxi myopia population for laser refractive surgery and to investigate the relationship between Q-value and other related parameters, such as spherical equivalent (SE), corneal curvature, cornea astigmatism, wavefront data and age. Methods The K&Q calculator of Orbsean- Ⅱ anterior segment system was used to obtain the Q-value of 6 mm optical zone in 411 cases (822 eyes) .There were 188 male subjects (376 eyes) and 223 female subjects (446 eyes). Accnrding to SE, subjects were divided into three groups including low myopia, moderate myopia and high myopia. According to different age, subjects were divided into three groups including group Ⅰ (age from 17 to 25), group Ⅱ (age from 26 to 34) and group Ⅲ (age from 35 to 44). Statistical analysis was used to comprehend the distribution characters of Q-value and its relations with SE, corneal curvature, cornea astigmatism, wavefront data and age. Results The Q-value of 822 eyes (411 cases) distributed as positive normal distribution, the average of Q- value was -0.148± 0.120 (range from -0.73 to 0.56) and -0.130± 0.128for male subjects and -0.163± 0.110 for female ones with statistically significant difference in Q-value in different genders (t=4.069, P <0.01). A significant difference was observed in Q-value among 17-25 years, 26-34 years and 35-44 years groups (F =4.567, P <0.05) as well as between 26-34 years group and 35-44 years group (P =0.004). However, there was no significant difference found between different myopic groups (F =1.434, P >0.05). The Q-value shown significantly negative relationship with C12, the Q-value show poor relationship with cornea curvature, cornea astigmatism, RMSh and C8. But the Q-value was not related with SE, RMSg, C7, cornea thickness, ocular pressure and age. Conclusions In Jiangxi myopia population for refractive surgery corneal curvature of majority population become flatter from center to periphery (Q<0), minority become steeper from center to periphery (Q>0). The Q-value of corneal anterior surface is independent from myopic SE. The Q-value show poor relationship with cornea curvature, cornea astigmatism, RMSh and C8, C12 is the most important related factor of Q-value. The Q-value is significantly greater in males than in females. A significant difference is observed in Q-value between 26-34 years and 35-44 years group.     

《中国肺动脉高压诊断与治疗指南(2021版)》解读——具有明显肺静脉或肺毛细血管受累的肺动脉高压

肺静脉闭塞病(PVOD)和肺毛细血管瘤病(PCH)是一类引起肺动脉高压的罕见疾病,目前统称为具有明显肺静脉或肺毛细血管受累的肺动脉高压,是动脉性肺动脉高压(PAH)中的一个亚类.这一类型肺动脉高压以肺小静脉或肺毛细血管受累为主要特点,临床表现、病理特征上具有高度相似性,目前认为这两种疾病是同一种疾病的两种表现.PVOD...