肺尖断层对中老年肺尖和锁骨下区慢性结核诊断价值的研究

文章对３３例中老年肺尖和锁骨下区慢性结核作平片和肺尖断层对照分析。结果表明：断层对该部位慢性结核多形态病灶检出率和病情判断明显优于平片。着重对空洞、结核球和合并肺癌断层影像研究。肯定断层诊断价值。     

Ethical Issues in Psychotherapy

Abstract: The goal of psychotherapy is not only the dissolution of the symptoms, but also to attempt to bring about an improvement in adaptability and deepening the achievement of self-understanding. The nature of psychotherapy is based on the relationship between the therapist and patient. Such a goal and nature mean that some kinds of psychotherapy are beyond the medical model. In this paper ethical issues in psychotherapy are discussed as follows. 1) some complicated matters in informed-consent, 2) the hit or miss techniques of the poorly trained therapist, 3) the protection of privacy, 4) the sexual misconduct of therapists with patients, 5) special consideration for child-adolescent patients.     

老年急性心肌梗塞37例临床分析

对３７例老年急性心肌梗塞与５０例老年前期急性心肌梗塞病人进行临床对比分析．结果显示：部分老年急性心肌梗塞病人发病不典型，并发症多，死亡率高，这可能与并发室颤、房室或束支传导阻滞、心衰等有关．     

紧急纤维支气管镜在老年高危患者中的应用

目的　研究紧急纤维支气管镜 (纤支镜 )在老年高危患者中的应用。方法　老年急危重症患者 77例 ,其中急性生理和慢性健康评估 (APACHEⅡ )计分 >14分者 65例。所有患者共行 10 2例次紧急纤支镜操作 ,其中肺泡灌洗、气道分泌物吸引 76例次 ;纤支镜引导下经鼻气管插管 19例次 ;异物吸出 6例次。结果　 10 2例次紧急纤支镜操作抢救总有效率为 80 .3 % ,无危及生命的并发症发生。结论　紧急纤维支气管镜是抢救急危重症患者呼吸道病变紧急处理的有力武器 ,高龄严重心、肺功能障碍不是纤支镜操作的禁忌证     

中老年人24小时动态血压变化的研究

目的探讨血压正常老年患者和老年高血压患者24h动态血压波动规律及与靶器官损害的关系.方法采用无创伤袖带式动态血压监测仪检测36例中年人(对照组),50例血压正常老年患者,60例老年高血压患者的动态血压.结果血压正常老年患者较中年血压正常者24h动态血压呈杓型曲线的比例明显下降.血压正常老年患者,血压昼夜波动曲线与心、脑、肾损害无相关性.老年高血压患者,血压曲线呈非杓型者比例增高,血压昼夜节律消失较节律正常的高血压患者有更显著的靶器官损害.结论对于非高血压患者,随年龄的增加,血压昼夜节律消失者增多,血压曲线变化与心、脑、肾损害无关,可能与原发病有关.对于高血压患者,血压昼夜节律紊乱可作为靶器官损害的预测因子.     

A clinical and genetic study of 56 Saudi Wilson disease patients: identification of Saudi-specific mutations

Wilson disease (WD) is a hereditary disorder, with recessive transmission and genetic heterogeneity. Several mutations of ATP7B, the gene underlying WD, were reported in many ethnic groups. In this study, mutation screening in ATP7B of 56 Saudi Arabian WD patients was undertaken. The clinical data of all patients were recorded. The entire ATP7B coding sequence, including intron-exon boundaries were screened for mutation by the polymerase chain reaction (PCR)-based mutation detection technique and DNA sequencing. Thirty-nine patients were symptomatic at presentation and 17 subjects were pre-symptomatic siblings of affected patients. Fourteen patients had neurological, 11 patients had mixed (hepatic and neurological), and 14 patients had hepatic presentations. Family history suggestive of WD was present in 72% of cases and 68% had consanguineous parents. Genetic analysis showed disease-causing mutations in three exons (exons 8, 19 and 21) of the ATP7B gene in 28 patients (50%). Mutations in exons 21 (18 cases) and 19 (one case) were unique for Saudis. This large series of Saudi patients with WD has shown wide variability in the genomic substrate of WD. There is no correlation between genotype and clinical presentation.     

高龄髋部骨折的治疗

目的研究高龄髋部骨折手术治疗的特点。方法回顾52例高龄(80岁以上)髋部骨折的手术选择及术前、术后的注意事项。结果除3例患者疗效欠佳外,其余取得较好效果。结论高龄髋部骨折患者,应慎重、认真对待,手术治疗可取得较好的结果,提高生活质量。     

中老年普外非急诊入院患者营养状况调查(附169例分析)

本文报道了169例中、老年普外科非急诊入院患者营养状况调查,多参数指标包括人体测量和实验室检查。结果显示40％患者有不同程度的营养不良。120例(71％)患者在8项调查指标中,有2～6项异常。按消化道和非消化道疾病进行比较,体重身高指数(WT/HT)、上臂周径(AMC)在中年组有显著差异(P<0.05)。     

Amputation in elderly and high-risk vascular patients

Fifty-eight patients underwent lower limb amputation for arterial disease over a 30-month period. Mean age of the patients was 72 years. Cardiopulmonary and metabolic risk factors were present in the majority of the patients. Postoperative one-year and three-year mortality rates were 24, 40, and 76%, respectively. Contralateral amputation was required in one-third of the patients after a mean period of eight months. Only younger and healthier patients returned to a meaningful social life after appropriate prosthetic fitting. In view of the high mortality and morbidity rates, above-knee amputation seems a better choice than below-knee amputation in these elderly and high-risk patients.