Polymyositis associated with hypothyroidism or hyperthyroidism: two cases and review of the literature

Studies confirming a possible relationship of polymyositis within thyroid dysfunction, either hypothyroidism or hyperthyroidism, are hardly available. To define the association, identify clinical, laboratory, electromyographic, and pathologic features in polymyositis (PM) patients with hypothyroidism or hyperthyroidism, we conducted a MEDLINE and Chinese biomedicine database search to identify relevant literature published in the past 25 years. Seventeen cases were included. All patients were female (10 hypothyroidism patients, seven hyperthyroidism patients). The mean (SD) age of PM, hypothyroidism, and hyperthyroidism at diagnosis was 54.8 (16.7), 55.5 (16.5), and 32.7 years (10.2), respectively. PM diagnosis can precede or parallel hypothyroidism while PM may occur following the diagnosis of hyperthyroidism. The most common comorbidities were malignant tumors in these disorders, including thymoma, colon cancer, and thyroid cancer. Muscle weakness was described in 100% of patients. Other common manifestations included muscles’ atrophy and pain, deep tendon reflexes, polyarthralgia, and dysphagia. Most patients had markedly elevated creatine kinase and the presence of anti-Sjogren’s syndrome A (SSA) antibodies was also found in two cases. Malignancy associated with PM may more frequently occur in hypothyroidism than in hyperthyroidism. The abnormalities on electromyography and biopsy did not differ from those findings of PM. Therapy consisting of corticosteroids, thyroid hormone, or anti-thyroid drugs was administrated; however, poor prognosis seemed to be associated with malignant tumors as well as older age and the presence of anti-SSA antibodies. It is reasonable to suggest that those patients should be routinely evaluated for thyroid function, especially in older female and patients suffering from cancers.     

我院供配电系统运行技术管理

安全供电是保障医院正常运转的必要条件。本文以我院供配电工作实践为例,对医院供配电运行和安全技术管理做一简述,旨在帮助供电管理人员更好地为医院、病人提供优质、经济、安全、可靠的用电环境。     

食管癌木后并发乳糜胸的护理干预

目的：探讨29例食管癌根治术后患者并发乳糜胸的护理方法。方法：给予29例患者生长抑素治疗，同时加强对胸腔引流液的观察，做好呼吸道管理、营养支持、饮食宣教等一系列护理干预措施。结果：除2例经生长抑素治疗无效、行再次开胸结扎胸导管治愈外，其他27例患者应用生长抑素保守治疗均治愈，治愈时间8～21天。结论：应用生长抑素保守治疗食管癌根治术后并发乳糜胸患者，同时配合一系列精心的护理干预措施可以提高乳糜胸的治疗效果。     

发热门诊2365例患者临床资料分析

目的 分析发热门诊患者的流行病学特征,及时了解掌握发热门诊患者的发热原因和规律,为疾病的预防和治疗提供科学依据.方法 对2009年5月至2011年10月到我院发热门诊就诊患者的年龄、性别、体温、发病时间、血常规情况进行统计分析.结果 2364例患者中,男性l294例,女性1070例,男女之比1.21:1;就诊患者以中青年为主,其中16～35岁患者占56.72％；发病最高峰为10月份,其次为9月份.血常规检验结果显示:血象变化以中性粒细胞(NC)增高和淋巴细胞(LC)降低同时改变为主.结论 病毒感染是发热门诊患者就诊的主要原因,中青年为发热患者的主要人群,有必要加强中青年群体呼吸道传染病的健康宣传教育.     

Cyberwand双导管超声吸附碎石治疗特殊人群膀胱结石

目的 探讨应用Cyberwand双导管超声吸附碎石系统治疗特殊人群膀胱结石的价值.方法 2008年7月～ 2011年10月我院收治因各种原因需长期留置膀胱造瘘管致膀胱结石形成患者89例,其中神经源性膀胱49例,前列腺增生不能耐受手术行膀胱造瘘者14例,肿瘤局部浸润行尿流改道者1 1例,反复尿道狭窄手术失败保留造瘘者15例.均通过膀胱造瘘口肾镜应用Cyberwand双导管超声吸附碎石. 结果 所有手术均顺利完成,手术时间平均40(30～70)min.无膀胱穿孔、大出血、结石残留、输尿管开口损伤等.所有患者均获随访,平均6(1 ～24)个月.13例患者术后7个月再发膀胱结石,再次行上述处理,结石清除干净. 结论 对于各种原因需长期留置膀胱造瘘管的患者所形成的膀胱结石,通过造瘘口Cyberwand双导管超声吸附碎石,效果良好,创伤轻微,具有很好的推广价值.     

老年心尖肥厚型心肌病冠脉造影特征

目的了解老年心尖肥厚型心肌病(APH)患者冠脉造影及心室造影特征。方法对我科1996～2003年7例老年APH患者冠脉造影资料进行分析。结果所有患者左冠脉普遍增粗,肌桥形成,心室造影见左室“黑桃样”改变,5例合并冠脉狭窄。结论老年APH患者以冠脉普遍增粗、肌桥形成及左室“黑桃样”改变为特征性冠脉造影改变,且合并冠心病概率高。