64层CT血管造影在胸痛三联征诊断中对比剂用量及注药方式应用体会

<正>急性冠状动脉综合征(acute coronary syndrome,ACS)、主动脉夹层(aortic dissection,AD)、肺动脉栓塞(pulmonary embolism,PE)被称为胸痛三联征,是临床急性胸痛的常见原因,早期诊断对于患者的治疗和预后至关重要。胸部计算机断层血管造影(computed tomography angiography,CTA)技术已经广泛于胸痛三联征的影像学诊断,其临床应用价值国内外报道较多~([1]),然而合理的扫描方案,特别是合理的对比剂的用量和注药方式有关报道较少,对此我们进行了应用研究,取得良好的效果,现报告如下。1资料与方法1.1一般资料     

胃癌组织中高迁移率蛋白A1 A2表达对胃癌侵袭转移的影响及机制研究

<正>胃癌(gastric cancer)是全球范围内致死率第二位的恶性肿瘤,尽管目前胃癌根治术已渐趋成熟,放疗、化疗、免疫疗法、分子靶向治疗等综合疗法也在不断发展,但值得注意的是胃癌的治疗却常因肿瘤转移和复发而失败。肿瘤的浸润、转移是肿瘤细胞同宿主细胞间表现复杂的交互程序[1],此过程涉及多种不同的基因及产物,因此探讨癌变浸润转移的分子机制成为肿瘤基础研究的热点。研究表明,高迁移率族蛋     

京尼平苷对高糖高脂诱导的胰岛β细胞胰岛素分泌的影响

目的研究京尼平苷对高糖高脂诱导的胰岛β细胞胰岛素分泌的影响。方法用高糖高脂孵育大鼠胰岛β细胞(INS-1)及原代大鼠胰岛,同时用京尼平苷干预,用放射免疫法检测胰岛素分泌量。结果京尼平苷增加高糖高脂孵育后INS-1细胞的数量;京尼平苷促进高糖高脂孵育后INS-1细胞的胰岛素分泌;京尼平苷改善高糖高脂孵育后原代大鼠胰岛的胰岛素分泌,且通过胰高糖素样肽-1(GLP-1)受体发挥作用。结论京尼平苷通过GLP-1受体调节高糖高脂诱导后胰岛β细胞的胰岛素分泌。     

单孔腹腔镜胆囊切除术在有腹部手术史患者中的应用

目的:探讨Hasson法建立气腹行单孔腹腔镜胆囊切除术在有腹部手术史患者中的应用优势及操作技巧。方法:回顾分析2011年11月至2018年10月为117例合并腹部手术史患者行单孔腹腔镜胆囊切除术的临床体会。结果:113例成功完成手术,4例因腹腔内粘连严重无法显露术野及胆囊三角中转开腹,成功率96.6%。术后患者恢复良好,切口美观隐蔽,无网膜损伤及相关并发症发生。结论:Hasson法建立气腹行单孔腹腔镜胆囊切除术,可灵活选取切口部位直视下开腹,避免了粘连肠管网膜的损伤,有效松解腹腔粘连带,对于有腹部手术史的胆囊良性疾病患者是安全、可行、微创、美观的治疗选择。     

散结通络汤治疗湿热瘀阻型结节性红斑临床观察

目的:观察散结通络汤治疗结节性红斑的临床疗效。方法;60例患者按随机数字表法分为治疗组和对照组各30例。对照组口服白芍总苷胶囊治疗,治疗组口服散结通络汤治疗;疗程1个月。观察临床疗效及治疗前后血沉、C反应蛋白等主要指标。结果:治疗组总有效率为83.33%;对照组为63.33%,治疗组临床疗效优于对照组(P﹤0.05);治疗组和对照组均能降低患者的血沉、C反应蛋白数值(P﹤0.01),治疗后两组C反应蛋白差异非常显著,治疗组优于对照组(P﹤0.01)。结论:散结通络汤治疗结节性红斑疗效明确,在临床疗效、降低C反应蛋白方面优于口服白芍总苷胶囊治疗。     

多系统受累干燥综合征合并淋巴细胞性垂体炎一例及文献复习

<正>干燥综合征(Sj■gren′s syndrome,SS)是以侵犯唾液腺、泪腺等外分泌腺体为主的系统性自身免疫病,以血清中存在大量的自身抗体如抗SSA、SSB抗体为特点[1]。临床表现主要是淋巴细胞浸润引起的外分泌腺功能受损,导致口、眼干,此外也可以出现多系统脏器受累。淋巴细胞性垂体炎(lymphcytic hypophysitis,LH)是一种少见的自身免疫性内分泌疾病,病理可见垂体淋巴细胞浸润。好发于育龄期女性,临床表现多为头痛、视觉障碍、内分泌轴紊乱及中枢性尿崩症,具有自行缓解又复发的特点。现报道经我院收治的1例原发性干燥综合征(pSS)同时出现神经、肾脏、肺脏多脏器受累合并LH患者,并进行2年随诊。同时对国内外相关文献复习,以     

冠状动脉介入治疗后的卧床体位和时间新进展

冠状动脉造影（CAG）是指左右冠状动脉开口处插入一种特制的冠状动脉导管，注入造影剂，从而显示冠状动脉走行和病变的一种心血管造影方法。可明确冠状动脉狭窄部位，定量诊断冠心病，为估计患者预后、决定药物及介入治疗提供了更为确切的指标。经皮冠状动脉腔内成形术（PTCA）即用经皮穿刺的方法送入球囊导管，扩张狭窄动脉的一种冠心病血管重建技术。经皮穿刺冠状动脉内支架安置：术是将金属或塑料制成的支架置人病变的冠状动脉．支持管径以保持其管腔内血流畅通。     

Pediatric intracranial aneurysms——clinical characteristics and therapeutic strategies

Objective To assess the radiological characteristics and therapeutic strategies of intracranial aneurysms in children. Methods From our dedicated neurovascular databank of patients, we reviewed 23 consecutive children who had 24 intracranial aneurysms. There were 14 boys and 9 girls with a mean age of 9.09 years ( range 1 - 14 years ). Results Intracranial aneurysms in children ≤ 14 years constituted 1.3% of all intracranial aneurysms. Internal Carotid artery (ICA) and middle cerebral artery (MCA) were the most frequent sites for aneurysms. About 58.3% of the aneurysms were complex, including dissecting, pseudoaneurysm, giant and fusiform aneurysm. 1/3 of all aneurysms were located in posterior circulation. Only 1 case had multiple aneurysms in this case series. Almost half of all cases presented with subarachnoid hemorrhage and others presented with mass effect. 14 cases underwent endovascular treatment. 4 patients received microsurgical therapy. 5 cases did not receive microsurgical or endovascular therapy, 2 of them whose aneurysms spontaneously thrombosed during follow up. One boy with left vertebral artery giant aneurysm died after endovascular therapy owing to gradual thrombosis in basilar artery. Another child had poor outcome because of rerupture of aneurysm before operation. Whereas the majority had a favorable outcome. Conclusions Intracranial aneurysms in children had many clinical and radiological characteristics different from those in adults : ( 1 ) remarkable male predominance; ( 2 ) ICA and MCA were the most common sites for aneurysms; (3) high incidence of large, traumatic, infectious, dissecting and fusiform aneurysms. (4)For pediatric intracranial aneurysms, both microsurgical approaches and endovascular treatment were effective. Endovaacular therapy was the best choice for complex aneurysms.