一氧化氮代谢物的测定及其与病毒性肝炎若干相关因素的分析

测定了423例各型肝炎、肝炎后肝硬化患者一氧化氮代谢物NO2-／NO3-的值，并与42例正常人作对照，结果肝硬化组NO2-/NO3-值高于对照组及其他各型肝炎组（P＜0．01）。肝硬化NO2-／NO3-的升高与血浆白蛋白（ALB）呈负相关，与腹水量呈正相关，与门脉宽度呈正相关．而与TBA、SB、ALT、AST、凝血酶原活动度等无相关性。提示一氧化氮可能在高动力循环、腹水生成、白蛋白合成方面起重要作用。     

急性心肌梗死介入治疗中无再流现象的研究

目的探讨急性心肌梗死（AMI）冠状动脉介入治疗（PCI）并发的无再流现象及相关的危险因素：方法对我院2002年2月～2005年6月对AMI行PCI遇到的23例无再流现象的急救处理，及其原因进行分析。结果23例无再流患者中，18例出现急性冠脉闭塞的表现，需紧急行冠脉内应用硝酸甘油、地尔硫卓等处理，伴严重低血压者需升压药及主动脉气囊反搏术（IABP），多数病人在应用以上药物后有效，3例无效，2例死于心血管崩溃。无再流现象多发生在植入第1个支架后，少数发生在植入第2个支架后。结论AMI行冠脉介入治疗时，支架植入后易并发无再流现象．硝酸甘油和钙离子拮抗剂为首选药物，低血压时应同时应用升压药物及IABP等；     

Microcirculatory derangements in acute pancreatitis

During the past decade, a considerable number of experimental studies have confirmed the hypothesis that microcirculatory derangements play a pivotal role in the pathogenesis of acute pancreatitis, including the process of conversion from edematous to necrotizing injury. Predominant microcirculatory disorders are nutritive capillary perfusion failure, with the consequence of prolonged focal hypoxia or anoxia, and inflammation-associated microvascular leukocyte recruitment, CD11b- and intercellular adhesion molecule (ICAM)-1-mediated leukocyte-endothelial cell interaction and loss of endothelial integrity, which may result in both edema formation and necrosis. A variety of proinflammatory mediators, such as oxygen radicals, leukotrienes, platelet-activating factor, and interleukins, but also bradykinin and endothelins, seem to be involved in triggering the manifestations of these microcirculatory disorders. In contrast, the anti-inflammatory interleukin-10, as well as nitric oxide, are thought to be capable of protecting from these pancreatitis-associated microvascular injuries. This knowledge may be encouraging for the development of novel therapeutic strategies, aiming at the attenuation of microcirculatory disorders, and, thus, preventing tissue injury in acute pancreatitis.     

无痛人工流产术的护理体会

为解决早孕人工流产疼痛问题和减少人工流产术并发症的发生，我院采用异丙酚复合芬太尼麻醉用于人工流产术，取得优良效果，现将护理体会介绍如下。     

男子不育症105例临床分析

目的：探讨男子不育症的临床特点及治疗策略。方法：回顾性分析105例男子不育症的临床资料及随访结果。结果：105例男子不育症患者睾丸体积测量显示：其中72例睾丸体积≥18ml，15例睾丸体积≤12ml，18例睾丸体积在12ml-18ml之间。精液分析结果：89例显示各项指标异常－其中16例精液不液化，64例显示弱精症或少精症，9例显示无精症（做睾丸活检4例，结果显示大量间质细胞，生精细胞幼稚、量少），23例精液中出现白细胞。经过临床综合治疗，随访3－5年，恢复生育力5例，精液不液化改善8例，精液常规指标改善46例。结论：男子不育症病因复杂，治疗效果不理想。治疗上应采取个性化原则，分而治之。     

Perfil clínico de pacientes con fibrilación auricular tratados con anticoagulantes orales de acción directa atendidos en atención primaria. Estudio SILVER-AP

Objective

To analyse the clinical characteristics and management of patients with non-valvular atrial fibrillation (NVAF) treated with direct oral anticoagulants (DOAC).

Efeitos das alterações no oxigênio cerebral durante cirurgia de revascularização do miocárdio sobre a disfunção cognitiva no pós‐operatório em pacientes idosos: estudo piloto

Background and objectives

Postoperative cognitive dysfunction is common after cardiac surgery. Adequate cerebral perfusion is essential and near infrared spectroscopy (NIRS) can measure cerebral oxygenation. Aim of this study is to compare incidence of early and late postoperative cognitive dysfunction in elderly patients treated with conventional or near infrared spectroscopy monitoring.