左侧腹股沟斜疝嵌顿并阑尾炎1例报告

1 病历 患者,男,1岁4个月,因左侧阴囊可复性包块1年余,不能还纳伴疼痛6小时,至我院就医。查体:心、肺未见异常。腹软,肠鸣音减弱,左侧阴囊及腹股沟区包块约7cm×6cm×4cm,质中等硬度,触痛明显,包块不能还纳。查血:白细胞16.4×10~9/L,中性粒细胞0.86,淋巴细胞0.14。以左侧嵌顿性腹股沟斜疝收     

超声诊断胎儿全前脑伴多发畸形1例

<正>孕妇,42岁,孕26周,孕3产1,第一胎体健。常规产前超声检查:双顶径6.1cm,头围22.2cm,腹围20.5cm,股骨长4.3cm,胎心率142次/min。胎盘位于子宫前壁,功能Ⅰ级,厚度3.0 cm。羊水最大深度约4.5 cm。脐动脉S/D:3.3,阻力指数:0.7,搏动指数:1.1。胎儿颅骨光环完整,脑中线消失,仅见单一扩张的脑室,背囊明显可见,丘脑融合,第三脑室及透明隔腔未见显示(图1);     

跟骨牵引加夹板、外固定支架、带锁髓内钉急诊治疗老年胫腓骨开放性骨折的临床对照研究

目的比较跟骨牵引加夹板、外固定支架、带锁髓内钉急诊治疗老年胫腓骨开放性骨折疗效。方法选择2005年5月~2011年5月我院收治的96例老年胫腓骨开放性骨折患者。经常规清除异物、切除失活组织、修复血管和神经,保留具有软组织项链的碎骨,清除已分离的小碎骨后安装手术方式分为跟骨牵引加夹板组38例、外固定支架组40例、带锁髓内钉组18例,术后随访。结果三组患者愈合时间基本相同;治疗后三组患者中,跟骨牵引加夹板组膝、踝关节恢复最好(P0.01);离床下地活动时间:外固定支架组最长(P0.05),带锁髓内钉组最短;骨折愈合时间:跟骨牵引加夹板组最长,带锁髓内钉组最短(P0.05);外固定支架组、带锁髓内钉组均未发生骨不连,唯跟骨牵引加夹板组3例;伤口感染跟骨牵引加夹板组最多(P0.05);跟骨牵引加夹板组延迟愈合患者例数最少(P0.05)。结论跟骨牵引加夹板法可保持骨折部位良好对位及稳定,有利于组织修复及骨折愈合,不影响关节功能锻炼,为治疗老年胫腓骨开放性骨折的有效办法,值得临床推广。     

冠心病患者与高敏C反应蛋白、脂连素和补体C3关系的临床研究

目的：通过观察冠心病患者外周血中高敏C反应蛋白（hs-CRP）、脂连素和补体C3的水平,探讨炎症和补体代谢异常在冠心病发病中的意义。方法：冠心病患者35例,年龄、性别、体重与其匹配的健康对照24例,用酶联免疫法测定血清hs-CRP及血浆脂联素的浓度,用免疫散射比浊法测定血清补体C3浓度。并分析浓度的改变与冠心病的关系。结果：冠心病患者血清hs-CRP和补体C3水平明显高于健康对照组[（5.92±9.63）mg/L比（2.27±2.42）mg/L,（1.55±0.40）g/L比（1.27±0.25）g/L,P=0.038,0.002],血浆脂联素水平明显低于健康对照组[5.08（1.07～15.5）mg/L比10.25（4.51～28.23）mg/L,P=0.000];血浆脂联素与补体C3、甘油三酯、体重、腰围、腰臀比值呈负相关（P均〈0.05）,补体C3与TG正相关（P=0.000）,与脂联素负相关（P=0.041）。结论：hs-CRP、脂连素和补体C3与冠心病的发生发展密切相关,提示炎症反应和补体代谢异常在冠心病的发病中起重要作用。     

产前超声筛查胎儿畸形在基层医院的应用价值

<正>我国人口众多,畸形儿的出生给家庭及社会带来极大负担,关系到每一个家庭的幸福。及早发现胎儿畸形,降低畸形儿的出生,在孕妇妊娠不同时期进行超声检查至关重要。但每个地区仅靠为数不多的产前诊断中心来减少畸形儿的出生显然不够,这需要广大基层医院开展胎儿畸形筛查。本研究回顾分析了2010年5月至2013年12月在我院产科引产或分娩证实的64例畸形儿病例,对其中59例在我院行超声     

体操治疗颈椎病

八年前,我的后颈及后脑剧烈疼痛,十分难受。经照片检查,系患颈椎骨质增生,即颈椎病。当时,在医院作了几次中药理疗之后,有所好转,但不久又复发。一友人教我一种活动颈椎的体操,照做之后果然立竿见影,疼痛很快消失了。八年来,我坚持天天做操,不需服药,有效地控制了症状。 这种体操简单易学,做一次只需3分钟。其做法: 第一节,转头。站立,双足分开至平肩宽,两手叉腰。头先向左转,然后再向右转,注意转的时候尽可能望到后方。两边各做10次。 第二节,抬头。站立,双足分开至平肩宽,两手叉腰。头向后仰,要能望到头顶上天空或天花板。做10次。     

高脂血症患者瘦素与补体C3、C4及备解素关系的研究

目的观察高脂血症患者瘦素、补体C3、C4及备解素(Pf)表达水平变化以及它们之间的关系。方法选取高脂血症患者31例,年龄、性别、体重相匹配正常人18例作为对照,用酶联免疫夹心法(ELISA法)测定血浆瘦素,用免疫散射比浊法检测血清补体C3、C4及Pf,分析瘦素与补体C3、C4及Pf表达水平之间的关系。结果高脂血症患者血浆瘦素较正常对照组明显升高(非正态分布,中位数为8849.50pg/mlvs5909.25pg/ml,P=0.039);高脂血症患者血清补体C3、C4及Pf较正常对照组明显升高(1.63±0.39)g/Lvs(1.31±0.29)g/L,(0.42±0.14)g/Lvs(0.33±0.10)g/L,(0.45±0.09)g/Lvs(0.39±0.06)g/L,P=0.004,0.014,0.017;血浆瘦素与补体C3(r=0.420,P=0.003)及Pf(r=0.435,P=0.002)呈正相关,与补体C4的表达不相关(P>0.05)。结论瘦素可能影响补体的表达和激活。     

Clinical Effect of Fuzheng Jiedu Granule (扶正解毒颗粒) on Serum NO,NOS and Microelements in Patients with Coronary Heart Disease in Long-term Contact with Nickel

Objective: To study the clinical effect of Fuzheng Jiedu granule (扶正解毒颗粒, FJG) and its influence on serum nitric oxide (NO), nitric oxide synthase (NOS) and rnicroelements in patients with coronary heart disease who are in long-term contact with nickel. Methods: Sixty patients were randomly divided into two groups, the treated group and the control group, 30 in each group. Conventional Western medicinal treatment was applied to both groups, but to the treated group, FJG was given additionally by oral intake, and the therapeutic course for both groups was 4 weeks. Besides, a health control group was set up with 15 healthy subjects selected from the same area, who had no history of contact with nickel. Clinical symptoms of the patients and changes in their electrocardiogram (ECG) and serum levels of NO, NOS and microelements were observed before and after treatment. Results: The total effective rate on clinical symptoms in the treated group was 93.3% and that in the control group 63.3%, comparison between the two showing significant difference (P＜0. 05); the total effective rate on ECG in the two groups was 90.0% and 56.7% respectively, which also showed significant difference ( P＜0. 05). After treatment, levels of serum NO, NOS, Mg, Zn and Ca increased and those of Ni, Mn and Fe decreased significantly ( P＜0. 05 or P＜0.01) in the treated group, while in the control group, changes in these laboratory indexes were insignificant. Conclusion: FJG could lower the blood nickel level and regulate the unbalance of microelements, help restore serum NO and NOS in persons exposed to nickel and improve the clinical symptoms of patients with coronary heart disease and in long-term contact with nickel.     

女性盆腔腹膜后肿瘤的诊治分析

目的提高基层医院对女性原发性盆腔腹膜后肿瘤的诊断特点和治疗手段的认识。方法回顾性分析我院2003年7月至2013年7月间收治的5例女性盆腔腹膜后肿瘤的临床资料,结合文献复习对女性盆腔腹膜后肿瘤的诊断和治疗进行探讨。结果 5例原发性盆腔腹膜后肿瘤的诊断,4例术前误诊,手术处置正确,1例放弃治疗,经验与教训并存。结论女性原发性盆腔腹膜后肿瘤诊断不易,极易误诊为女性生殖器肿瘤,应高度警惕,临床治疗原则多以手术切除为主。