阴性支气管异物误诊和漏诊分析

目的　分析阴性支气管异物误诊和漏诊原因。方法　回顾分析 5 a间证实误诊和漏诊阴性支气管异物 35例。结果　造成误诊和漏诊的原因有 :病史不详、接诊医师对本病认识或警惕性不够、X线检查方法不当或诊断经验不足、未及时行支气管镜检。结论　病史及临床表现对诊断有重要意义 ,X线检查是诊断的主要手段 ,必要时应及时行支气管镜检查。     

我国城市地区癌症筛查项目人员对筛查工作意愿倾向的多中心调查及政策建议

目的 基于癌症筛查实际供方角度,从工作人员主观感受及意愿层面评价癌症筛查项目的可持续性。方法 2014-2015年,基于城市癌症早诊早治项目,在16个省份项目点选取2013-2015年所有承担项目的医院、CDC和社区卫生服务中心,采用纸质问卷和网络调查开展访谈,对象包括宏观管理人员、具体项目管理人员和一线工作人员等。结果 最终完成访谈4 626份,访谈对象总体认为参加项目的最大收获在于社会价值感的提升（63.6%）、当地影响力（35.9%）及专业技能提升（30.6%）等;最大困难在于社会物质激励不够所致工作积极性低（30.9%）、信息采集口径不一致（28.3%）、部门间协调（24.4%）和机构间沟通衔接困难（23.5%）等。当单项筛查服务劳务补偿约50元时,工作人员会考虑加班工作。63.7%的受访者有长期筛查服务意愿,主要原因：可通过项目提升个人/团队在当地影响口碑（48.7%）、通过项目提升个人/团队专业技能（43.1%）等;无服务意愿者主要担心工作量超负荷（59.8%）、对日常工作的干扰（49.8%）等。结论 收获与困难相关结果提示,若要长期可持续性开展癌症筛查工作,建议加强项目内荣誉激励、对外宣传及专业能力建设,根据具体情况提高劳务补偿。服务意愿结果则提示,应从政府和领导层面加强信息化建设及机构/部门间协调,机构内应合理协调筛查项目与日常工作。     

大鼠血管紧张素Ⅱ2型受体基因转染对颈动脉球囊损伤后新生内膜形成的影响

目的　探讨腺病毒载体介导的大鼠血管紧张素Ⅱ2型受体(AT2R)基因转染对大鼠颈动脉球囊损伤后新生内膜形成的影响。方法　应用带有绿色荧光蛋白报告基因的重组腺病毒载体将大鼠AT2R基因转移至颈动脉球囊损伤模型中,2 1d后取材,应用免疫组织化学方法检测AT2R在动脉壁中的表达,图像分析观察其对新生内膜形成的影响。结果　在体大鼠颈动脉腺病毒载体的转染率达4 0 % ,AT2R基因在血管壁的新生内膜、中膜、外膜稳定表达,转染AT2R基因的球囊损伤后颈动脉与绿色荧光蛋白基因对照组相比,血管新生内膜 中膜面积比降低了4 8%。结论　AT2R基因转染可抑制颈动脉球囊损伤后新生内膜的形成,对血管成形术后再狭窄可能有一定的预防作用。     

High preoperative serum globulin in rectal cancer treated with neoadjunctive chemoradiation therapy is a risk factor for poor outcome

An elevated serum albumin (ALB) and albumin/globulin ratio (AGR) has been reported to be associated with a favorable prognosis for certain malignancies; however, little is known about the prognostic significance of globulin (GLB) in rectal cancer treated with neoadjuvant chemoradiation therapy (NCRT). The purpose of this study was to evaluate whether GLB analysis could predict the prognosis of patients received NCRT. A retrospective cohort of 293 locally advanced rectal cancer patients receiving NCRT followed by radical surgery was recruited between January 2006 and December 2012 at Fudan University Shanghai Cancer Center. Levels for preoperative GLB and ALB were obtained and used to calculate the AGR. Survival analysis was used to evaluate the predictive value of GLB. X-tile program determined 28.50, 36.20 and 1.20 as optimal cut-off value for GLB, ALB and AGR in terms of survival. Univariate and multivariate analysis revealed that low GLB levels were significantly associated with favorable rectal cancer-specific survival (RCSS) (P < 0.05). Conversely, low ALB levels were associated with a significantly worse RCSS (P = 0.010). Collectively, high preoperative GLB level was a significantly unfavorable factor for rectal cancer patients treated with NCRT. This easily obtained variable may serve as a valuable marker to predict the outcomes of such patient population.     

Follow-up examination of 12 heart transplant recipients with cardiac CT

ObjectiveThe aims of this study were to observe the changes of a transplanted heart with cardiac computed tomography (CT) and to evaluate the clinical application of the examination.MethodsCardiac CT was performed on 12 heart transplant recipients, of which 4 cases were also examined by echocardiography. Coronary arteries, the cardiac chamber, and the wall were shown with three-dimensional imaging techniques, and their changes were analyzed and discussed.ResultsTwelve heart transplant recipients were successfully examined by CT. All transplanted hearts were found with good anastomosis at the great vessels and atria. Coronary allograft vasculopathy was found in 7 cases, of which 4 cases were found with ventricular dilation or ventricular septum thickening and 1 with tricuspid regurgitation. Ventricular dilation was found in other 3 cases, of which 1 was found with ventricular septum thickening and 1 with tricuspid regurgitation. No abnormality was found by cardiac CT in the rest 2 cases, which were found with mitral regurgitation by echocardiography.ConclusionCardiac CT can clearly and directly display the changes in the shape of a transplanted heart and coronary artery abnormalities. It will become an ideal noninvasive follow-up method for the heart transplant recipients.     

长春龙嘉国际机场口岸蚤、螨本底监测分析

目的 掌握长春龙嘉国际机场口岸蚤、螨本底构成情况,为口岸防控媒传疾病提供科学依据.方法 在2010年7月至2011年6月期间,采用鼠笼法捕获活鼠,用集蚤法、鼠体螨指数法对鼠体表面的蚤、螨进行分析,并进行分类鉴定.结果 共捕获鼠62只,鼠体染蚤率为20.97％.蚤5种30只,其中同源栉眼蚤指名亚种为优势种,构成比为50.0％.共捕获螨70只,鼠体带螨率为29.03％,其中耶厉螨为优势种,构成比为57.1％.结论 应加强媒介控制的力度,有效防止蚤、螨等医学媒介生物在口岸地区引起疾病的传播.     

珲春口岸鼠类种群消长及体外寄生虫调查分析

目的调查掌握珲春口岸鼠类种群构成、季节消长规律及体外寄生虫种类,防止鼠类传播传染病在珲春口岸传入、传出,加强检验检疫措施提供科学依据。方法于2009年5月-2010年4月采用夹夜法对珲春口岸辖区四个出入境口岸区域的鼠情及体外寄生虫进行调查。结果经过一年的调查,共捕获鼠类326只,经签定分类为1目2科4属4种。其中以褐家鼠为优势种,占捕鼠总数的52.45%;其次为黑线姬鼠,占41.72%;10月份密度最高,为3.50%;2月份最低,为1.50%,年平均密度为2.26%;体外寄生虫检出蚤、革螨两类,蚤分类鉴定为3科4属4种,总指数为12.88%;革螨分类鉴定为2科3属5种,总指数为109.44%。结论本次调查显示,珲春口岸的鼠类密度已超过国家规定标准[1]要求,为下步采取控制措施提供了依据。     

延吉机场口岸鼠类携带病原情况调查

目的 了解延吉机场口岸鼠类病原携带情况,为口岸传染病监测和媒介生物控制提供依据.方法 采用ELTON夹夜法捕鼠,搜集鼠类体表寄生虫、个体测量后解剖取鼠肺、肝、脾置于医用冻存管内,做好标记,保存于管液氮罐中,检测鼠疫菌、地方性斑疹伤寒立克次体、汉坦病毒.结果 本次调查共捕获鼠类150只,其中6份鼠肺汉坦病毒检测阳性.结论 应进一步开展口岸鼠类携带病原调查,掌握其变化规律.有针对性的开展预防与控制工作.     

经导管封堵成人多孔型房间隔缺损的体会

目的:通过对多孔型房间隔缺损(ASD)进行经导管封堵治疗,探讨多孔型ASD介入治疗的适应证及注意事项。 方法:先经心脏超声检查确诊为多孔型ASD,后在局部麻醉下用测量球囊进行试封堵,同时用心脏超声检测试封堵时两ASD闭合情况及孔间距,并确定置入封堵器数量及大小,术后用心脏超声进行随访观察。 结果:全组6例双孔型ASD患者中2例分别置入2个封堵器,4例置入1个封堵器。术后随访1个月至2年,4例无残余分流,1例随访2年虽仍有少许残余分流,但自觉症状好转,心影缩小。另1例术后1个月因残余分流而被迫手术取出。 结论:经导管封堵成人多孔型ASD安全、有效,对两ASD相距较远者应放置2个封堵器,对两ASD相距较近者则可用1个封堵器封堵。