利奈唑胺治疗老年院内获得性肺炎临床观察

目的:观察利奈唑胺与万古霉素老年院内获得性肺炎的疗效与安全性.方法:回顾性分析应用利奈唑胺(68例)与万古霉素(56例)治疗老年院内获得性肺炎患者的临床资料,比较两组患者临床总有效率、细菌清除率及不良反应情况.结果:利奈唑胺和万古霉素治疗院内获得性肺炎临床有效率分别为73.5%、51.8%(P＜0.05),对病原菌的清除率分别达70.1%、72.1%(P＞0.05),两组患者药品不良反应发生率无统计学差异,但万古霉素治疗组出现肾毒性9例,较利奈唑胺不良反应严重.结论:利奈唑胺治疗老年院内获得性肺炎安全可靠.     

急性有机磷中毒与心房颤动的关系

Objective To explore the relationship between acute organophosphate poisoning and atrial fibrillation (AF). Methods Three hundred and twenty-two acute organophosphorus poisoning of elderly patients treated from January 2000 to June 2008 in our hospital were analyzed. Among these patients, 36 cases with AF were selected as case group and 38 age-gender-matched cases without AF were selected as control group. Serum cholinesterase (ChE), myocardial damage markers such as creatine kinase (CK), creatine kinase-MB isoenzyme (CK-MB) and Troponin- Ⅰ (cTn-Ⅰ) were compared between the two groups. Results ChE was decreased in the two groups, and ChE was lower in case group than in control group [(1126. 42±1047.02) vs. (1604.82±934.06)U/L, t= 2.07, P=0. 0414]. CK, CK-MB and cTn-Ⅰ were increased in different degree in the two groups. There was no difference in CK between the two groups [(609.97±597.84) U/L vs. (462.84± 530. 71)U/L, t= 1. 121, P= 0. 266]. CK-MB and cTn-I were higher in case group than in control group [(97.31±104.50) vs. (55. 16±69.62)U/L, t=2. 052,P=0. 0438; (2.39±0. 88) vs. (1.81± 1.38) μg/L, t = 2. 132, P = 0. 036, respectively9 . Conclusions AF caused by acute organophosphate poisoning may be related to the decrease of ChE activity, acetylcholine accumulation and myocardial injury.     

急性有机磷中毒与心房颤动的关系

Objective To explore the relationship between acute organophosphate poisoning and atrial fibrillation (AF). Methods Three hundred and twenty-two acute organophosphorus poisoning of elderly patients treated from January 2000 to June 2008 in our hospital were analyzed. Among these patients, 36 cases with AF were selected as case group and 38 age-gender-matched cases without AF were selected as control group. Serum cholinesterase (ChE), myocardial damage markers such as creatine kinase (CK), creatine kinase-MB isoenzyme (CK-MB) and Troponin- Ⅰ (cTn-Ⅰ) were compared between the two groups. Results ChE was decreased in the two groups, and ChE was lower in case group than in control group [(1126. 42±1047.02) vs. (1604.82±934.06)U/L, t= 2.07, P=0. 0414]. CK, CK-MB and cTn-Ⅰ were increased in different degree in the two groups. There was no difference in CK between the two groups [(609.97±597.84) U/L vs. (462.84± 530. 71)U/L, t= 1. 121, P= 0. 266]. CK-MB and cTn-I were higher in case group than in control group [(97.31±104.50) vs. (55. 16±69.62)U/L, t=2. 052,P=0. 0438; (2.39±0. 88) vs. (1.81± 1.38) μg/L, t = 2. 132, P = 0. 036, respectively9 . Conclusions AF caused by acute organophosphate poisoning may be related to the decrease of ChE activity, acetylcholine accumulation and myocardial injury.     

院前溶栓缩短ST段抬高型心肌梗死再灌注时间对预后的影响

治疗ST段抬高型心肌梗死（STEMI）的关键在于早期、完全和持续开通梗死相关血管,而早期再灌注尤为关键,自发病至实施再灌注所需时间一定程度上较再灌注方式更重要,能否早期、及时获得再灌注很大程度上决定了患者的预后。现对我院收治的STEMI患者作一回顾性分析,比较院前及院后溶栓对预后的影响。     

白三烯调节剂与免疫治疗对未控制型哮喘的疗效观察

支气管哮喘（以下简称哮喘）是一种在世界范围内严重危害公共健康的疾病。本文总结了40例未控制哮喘通过加强控制气道慢性炎症及针对性变应原特异性免疫治疗后,使哮喘得到控制。现报告如下。     

铜绿假单胞菌耐药性变迁分析

目的 了解医院铜绿假单胞菌耐药性变迁,为合理使用抗菌药物提供依据.方法 采用K-B法测定细菌药敏试验,对2004年1月-2007年12月的所有铜绿假单胞菌药敏试验结果使用WHONET软件进行分析,结果氨苄西林、头孢唑林、头孢替坦的耐药率均100.0%,头孢他啶、头孢哌酮、头孢哌酮/舒巴坦、哌拉西林的耐药率均较低,其中头孢哌酮/舒巴坦的耐药率最低,2007年为3.2%,左氧氟沙星的耐药率逐年递增,而环丙沙星的耐药率,由15.6%下降至9.6%,庆大霉素由20.0%下降至16.4%,而阿米卡星的耐药率由11.1%下降至4.8%,亚胺培南和美罗培南的耐药率均约10.0%.结论 铜绿假单胞菌的耐药性基本稳定,临床医师在治疗时应根据药敏结果和抗菌药物的药理学特点合理选用抗菌药物,以提高疗效并减少耐药菌株产生.     

急性有机磷中毒与心房颤动的关系

Objective To explore the relationship between acute organophosphate poisoning and atrial fibrillation (AF). Methods Three hundred and twenty-two acute organophosphorus poisoning of elderly patients treated from January 2000 to June 2008 in our hospital were analyzed. Among these patients, 36 cases with AF were selected as case group and 38 age-gender-matched cases without AF were selected as control group. Serum cholinesterase (ChE), myocardial damage markers such as creatine kinase (CK), creatine kinase-MB isoenzyme (CK-MB) and Troponin- Ⅰ (cTn-Ⅰ) were compared between the two groups. Results ChE was decreased in the two groups, and ChE was lower in case group than in control group [(1126. 42±1047.02) vs. (1604.82±934.06)U/L, t= 2.07, P=0. 0414]. CK, CK-MB and cTn-Ⅰ were increased in different degree in the two groups. There was no difference in CK between the two groups [(609.97±597.84) U/L vs. (462.84± 530. 71)U/L, t= 1. 121, P= 0. 266]. CK-MB and cTn-I were higher in case group than in control group [(97.31±104.50) vs. (55. 16±69.62)U/L, t=2. 052,P=0. 0438; (2.39±0. 88) vs. (1.81± 1.38) μg/L, t = 2. 132, P = 0. 036, respectively9 . Conclusions AF caused by acute organophosphate poisoning may be related to the decrease of ChE activity, acetylcholine accumulation and myocardial injury.     

急性有机磷中毒与心房颤动的关系

Objective To explore the relationship between acute organophosphate poisoning and atrial fibrillation (AF). Methods Three hundred and twenty-two acute organophosphorus poisoning of elderly patients treated from January 2000 to June 2008 in our hospital were analyzed. Among these patients, 36 cases with AF were selected as case group and 38 age-gender-matched cases without AF were selected as control group. Serum cholinesterase (ChE), myocardial damage markers such as creatine kinase (CK), creatine kinase-MB isoenzyme (CK-MB) and Troponin- Ⅰ (cTn-Ⅰ) were compared between the two groups. Results ChE was decreased in the two groups, and ChE was lower in case group than in control group [(1126. 42±1047.02) vs. (1604.82±934.06)U/L, t= 2.07, P=0. 0414]. CK, CK-MB and cTn-Ⅰ were increased in different degree in the two groups. There was no difference in CK between the two groups [(609.97±597.84) U/L vs. (462.84± 530. 71)U/L, t= 1. 121, P= 0. 266]. CK-MB and cTn-I were higher in case group than in control group [(97.31±104.50) vs. (55. 16±69.62)U/L, t=2. 052,P=0. 0438; (2.39±0. 88) vs. (1.81± 1.38) μg/L, t = 2. 132, P = 0. 036, respectively9 . Conclusions AF caused by acute organophosphate poisoning may be related to the decrease of ChE activity, acetylcholine accumulation and myocardial injury.     

急性有机磷中毒与心房颤动的关系

目的 探讨急性有机磷中毒与心房颤动(房颤)的关系. 方法 回顾分析322例老年急性有机磷中毒患者的临床资料,选取其中36例发生房颤患者,同时选取年龄和性别均匹配的38例非房颤患者作为对照.对两组患者的胆碱酯酶(ChE)、心肌损伤标志物如肌酸肌酶(CK)及其同工酶(CK-MB)、肌钙蛋白(cTn-Ⅰ)进行对比分析. 结果 两组患者ChE均降低,房颤组ChE 10～3300U/L,平均(1126.42±1047.02)U/L,非房颤组ChE(178～3700)U/L,平均(1604.82±934.06)U/L,房颤组低于非房颤组(t=2.077,P=0.041).CK、CK-MB、cTn-Ⅰ两组患者均有不同程度增高.CK:房颤组(80～2212)U/L,平均(609.97±597.84)U/L;非房颤组50～2200 U/L,平均(462.84±530.71)U/L,两组差异无统计学意义(t=1.121,P=0.266).CK-MB:房颤组8～468 U/L,平均(97.31±104.50)U/L;非房颤组6～300 U/L,平均(55.16±69.62)U/L,房颤组高于非房颤组(t=2.052,P=0.044).cTn-Ⅰ:房颤组1.2～5.0 μg/L,平均(2.39±0.88)μg/L,非房颤组0.1～6.0 μg/L,平均(1.81±1.38)μg/L,房颤组高于非房颤组(t=2.132,P=0.036). 结论 急性有机磷中毒致房颤与ChE活力降低、乙酰胆碱(ACh)蓄积、心肌损伤可能有密切关系.     

Crouzon综合征患者鼻腔结构及气流场分析

目的建立Crouzon综合征患者鼻腔计算流体力学分析方法(computational fluid dynamics,CFD)模型,分析Crouzon综合征患者鼻腔吸气相气流流体动力学特征,对比术前、术后鼻腔气流流场的改变情况。方法 11例确诊为Crouzon综合征的患者,通过螺旋CT薄层扫描获取DICOM格式数据文件,建立CFD模型,在Fluent软件中模拟并分析静态吸气相Crouzon综合征患者鼻腔的流场特征,并对其中5例患者的术前、术后鼻腔流场变化信息进行对比分析。结果 Crouzon综合征患者鼻腔呈现前后径较短并且较为高拱的结构特点;鼻瓣区为鼻腔最为狭窄的区域,是产生明显压降的关键区域;随着距前鼻孔距离的增加,鼻腔内压力逐渐下降,下鼻甲前端(大约距前鼻孔2 cm处)以前的鼻腔压降已占有整个鼻腔压力的大部分(占总鼻腔压力的69%～88%,平均79.24%);截骨前移或牵引成骨术增加了鼻腔前后径,改变了鼻阻力。结论通过对Crouzon综合征患者鼻腔结构及部分术后的鼻腔结构CFD数值模拟分析,具体直观的认识到Crouzon综合征患者鼻腔内气流分布状况以及手术对鼻腔结构和气流场的影响,鼻瓣区对鼻腔气流流场分布起到关键性作用,截骨前移或牵引成骨术改变了鼻阻力,改善了鼻腔通气功能,但不影响鼻腔气流场的分布。