急性右下腹痛的B超诊断

急性右下腹痛是医院急诊病人的常见症状。对２０６例急性右下腹痛病人进行Ｂ超检查，包括急性盆腔炎，急性阑尾炎，输尿管结石，输卵管妊娠破裂，卵泡破裂，卵巢囊肿蒂扭转，阑尾粘液腺癌，腹腔淋巴结核合并感染，因阑尾炎的Ｂ超诊断报道较少，所以着重详细描述了各类型阑尾炎的声像图特征，报道的相关病例全部经手术及病理证实，认为Ｂ超检查对急性右下腹痛的诊断和鉴别诊断有一定的临床意义。     

Endocrinology: Intravenous albumin does not prevent the development of severe ovarian hyperstimulation syndrome in an in-vitro fertilization programme

A cohort study was undertaken to compare the effect at the timeof oocyte retrieval of the i.v. administration of either 1000ml of lactated Ringer' solution or 1000 ml of a 5% solutionof human albumin on in-vitro fertilization patients at riskfor severe ovarian hyperstimulation syndrome (OHSS). A totalof 207 patients with an oestradiol concentration > 10 000pmol/l and/or > 15 follicles (>10 mm diameter) on theday of human chorionic gonadotrophin (HCG) injection were reviewed.Of these, 158 women received 500 ml of lactated Ringer’ssolution both before and after egg retrieval, and 49 women receivedtwo infusions of 500 ml of 5% human albumin in normal salineat the time of egg retrieval. Severe OHSS developed in two patientswho received human albumin and in 10 women who did not receivethe albumin. This difference was not statistically significant.There were no differences between the two groups in terms ofage, number of follicles punctured at transvaginal oocyte retrievalor oestradiol concentration at the time of HCG injection. Theadministration of a 5% human albumin solution does not preventthe development of severe OHSS in at risk patients. It doesappear to blunt the severity of the condition.     

Data Bank and Consulting System for Medical Management of Patiens with Acute Radiation Sickness

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Correct positioning for cardiac angiography: Insights from mri

The recommended angiographic projections for optimally demonstrating various cardiac structures vary, and do not always achieve their aim. To determine the most appropriate radiographic projections to optimally demonstrate cardiac structures, we reviewed the orientations of major cardiac structures and the associated great vessels, as demonstrated by axial MRI. Measurements were made from 187 MRI examinations of the heart. These measurements confirmed that the optimum angiographic projections for various cardiac structures are at variance with a number of the recommended views. Recommendations for the angiographic projections most likely to provide optimum display of various cardiac structures and associated great vessels in different patient populations are presented. © 1993 Wiiey-Liss, Inc.     

肾综合征出血热内分泌组织中的病毒抗原、病变及其关系

作者应用免疫细胞化学法研究了HFRS尸检内分泌及其有关组织中病毒抗原的分布,病毒抗原阳性细胞与病变的关系,病变的类型及病毒感染对胰腺内胰岛素表达的影响,所用的一抗有抗肾综合征出血热(HFRS)病毒糖蛋白(G_2),核蛋白(NP)及血凝素(HA)抗原的单克隆抗体(15种)和多克隆抗体(PAb)以及抗胰岛素(INS)单克隆抗体。结果显示,内分泌组织中有两种染色形态的病毒抗原,一种是胞浆弥漫染色的抗原,为G_2,NP或HA阳性,阳性细胞弥漫分布,另一种是以病毒包涵体(IB)形式出现的颗粒性抗原,MAbs染色多为实性,PAb染色多为空泡状。在9例胰腺组织中,有4例几乎在所有腺上皮细胞和少数胰岛细胞均为IB阳性,但PAb染色可在胰岛细胞中显示出空泡状IB。在其它内分泌组织中,IB只在少数细胞中出现。抗原阳性细胞很少出现坏死,但在脑垂体及肾上腺灶性或片状凝固性坏死区域也有弥漫性抗原阳性及IB存在。胰腺组织的胰岛素染色显示,除1例胰岛INS强阳性,其余8例均有明显的INS染色减弱及阳性细胞减少的表现。结果提示,内分泌组织中有两种病变,即以IB为特征的病毒直接感染引起的细胞病变,是病毒的弱致病变作用,该病变可能对细胞的内分泌功能产生影响;另一种病变是组织的灶性或大片性同步性凝固性坏死,是继发于病毒感染后的出血和休克,该病变会     

Association of passive smoking with increased coronary heart disease risk is not explained by elevation of leucocyte count

The increased risk of coronary heart disease in cigarette smokersmay be due at least partly to an elevation of the leucocytecount Chronic passive smoking has also been found to be associatedwith an increased risk of coronary heart disease, but its effecton the leucocyte count has not been reported. In this study250 male factory employees aged 20–64 years were interviewedon smoking behaviour and exposure to environmental tobacco smoke,and blood counts were determined. Urinary cotinine was measureby radio-immunoassay and corrected for urinary creatinine concentrations.Mean leucocyte count was significantly higher among smokerscompared with non-smokers (8,666 compared to 6, 900; p<0.001).On the basis of smoking history, passive smokers had leucocytecounts similar to non-smokers. These findings were confirmedwhen leucocyte counts were compared with urine cotinine to creatinineratios. The association of haematocrlt and haemoglobin withsmoking was similar to that of leucocyte count These findingssuggest that any association of passive smoking with coronaryheart disease is not through an elevation of leucocyte count.     

Critical review of treatment trials in hypertension

Summary: Despite numerous deficiencies in some antihypertensive drug treatment trials, and some questionable selections of studies for inclusion in several meta-analyses, undoubtedly such trials have shown treatment benefits from reducing hypertension. Complications that can be corrected or prevented include malignant hypertension, hypertensive heart failure, stroke and coronary artery morbidity. the all-cause mortality has been lowered in several trials. the benefits have been seen in subjects aged over 60 years, in women and men, and in patients with isolated systolic hypertension. the benefits have been achieved using a wide range of drugs, not only with beta-blockers or diuretics. Non-pharmacological means of lowering blood pressure have not been evaluated in relation to morbidity.     

HELLP syndrome associated with factor V R506Q mutation

The pathogenesis of HELLP (haemolysis, elevated liver enzyme and low platelet count) syndrome, a severe presentation of pre-eclampsia, is still an enigma. Activated protein C resistance resulting from a mutation in coagulation factor V has recently emerged as the leading cause of thrombosis in pregnancy. We report on two patients with HELLP syndrome who were found to be heterozygous for factor V R506Q mutation, leading to activated protein C resistance. These findings suggest that the pathogenesis of HELLP syndrome is associated with a thrombotic process, and point to the potential benefit of anti-thrombotic therapy in this condition.     

ECAT angina pectoris study: baseline associations of haemostatic factors with extent of coronary arteriosclerosis and other coronary risk factors in 3000 patients with angina pectoris undergoing coronary angiography

The ECAT Angina Pecioris Study is a European multicentre studyinvestigating the pathogenetic and possibly predictive roleof the haemostatic system in the progress of coronary heartdisease. In this paper we report the cross-sectional analysisof haemostatic factors in 3043 patients, who underwent coronaryangiography due to angina pectoris. Fibrinogen levels were higherin patients with one or more coronary stenoses of at least 50%than in patients without, by an average of 0.16 g. l^–1(P <0.0001). Depressed fibrinolytic activity due to higherlevels of PAI was also associated with the presence of coronarystenoses. There was no association with the extent of coronaryarteriosclerosis, as assessed by the number of involved arteries,except that patients who had more vessels with total occlusionshad higher fibrinogen levels. Depressed fibrinolytic activitywas also clearly associated with diabetes, obesity, higher triglyceridelevels, smoking and impaired cardiac pump function as assessedby ejection fraction. Cholesterol levels were particularly correlatedwith protein C and plasminogen.     

阻塞性睡眠呼吸暂停综合征的临床研究

强调对阻塞性睡眠呼吸暂停综合征的认识，以达到对该病的早期诊与治疗。方法应用Ａｕｔｏｓｅｔ诊疗系统及鼻持续正压通气治疗仪，对６６例ＯＳＡＳ患者进行确诊及序贯治疗。