急性缺血性脑卒中患者rt-PA静脉溶栓DNT延误的影响因素分析

目的探讨急性缺血性脑卒中(AIS)患者到院至静脉溶栓治疗时间(DNT)延误的影响因素。方法88例行重组组织型纤溶酶原激活剂(rt-PA)静脉溶栓的AIS患者,根据DNT是否延误分为延误组(26例)和非延误组(62例)。比较两组患者年龄、性别、入院时美国国立卫生研究院卒中量表(NIHSS)评分、既往史、溶栓前用药史、就诊时间、入院时血压、卒中类型、各流程段时间,分析急性缺血性脑卒中患者rt-PA静脉溶栓DNT延误的影响因素。结果延误组患者年龄(66.42±9.86)岁、高血压病史占比53.85%、溶栓前使用抗高血压药占比42.31%高于非延误组的(59.24±9.35)岁、25.81%、11.29%,CT检查时间(32.80±11.45)min、CT结果时间(50.75±15.80)min、生化结果时间(62.75±11.00)min、患者及家属知情同意耗时(20.00±9.25)min长于非延误组的(24.55±7.05)、(35.45±8.75)、(44.70±5.55)、(10.37±5.73)min,差异均具有统计学意义(P<0.05)。多因素Logistic回归分析显示,患者年龄、溶栓前使用抗高血压药、CT检查时间以及患者及家属知情同意耗时是急性缺血性脑卒中患者rt-PA静脉溶栓DNT延误的影响因素。结论患者年龄、溶栓前使用抗高血压药、CT检查时间以及患者及家属知情同意耗时是急性缺血性脑卒中患者rt-PA静脉溶栓DNT延误的影响因素,优化AIS的院内诊治流程,提高医师知情同意谈话技巧,对人民群众进行健康科普教育以提高其对AIS的认识,均有利于缩短DNT。     

肺癌患者肺部感染菌分布情况及对其预后的影响

肺癌最常见的并发症是肺部感染。并且对其预后产生一定影响，我们就肺癌患者肺部感染菌分布情况及其对肺癌病死率产生的影响做了调查，结果报告如下。     

阴茎尖锐湿疣鳞癌变并腹股沟淋巴转移误诊1例报告

病例　男性 ,32岁 ,已婚 ,农民。因龟头、包皮内板、冠状沟反复起菜花状赘生物、淡褐色皮疹 3年余 ,右腹股沟肿块破溃流脓性分泌物 ,伴肉芽样增生 2月余 ,以“龟头尖锐湿疣、性病性淋巴肉芽肿”于 2 0 0 1年 5月 15日入院。病史 :3年前曾有不洁性交史 ,患过“龟头尖锐湿疣”,经用电灼、CO2 激光等治疗 ,口服阿昔洛韦片 ,肌注重组干扰素等治疗 ,皮损愈合。术后于 3、6、12个月分别复发3次 ,皮疹做醋酸白试验 ( ) ,第 3次病理活检示 :乳头瘤样增生。用CO2 激光治疗后 ,延长抗病毒、免疫增强剂的治疗时间。查体 :T37 7℃ ,P82次 /min ,神志…     

患感冒别上班

不要以为生病时坚持上班是动力和负责任和勇敢的行为，相反，这样做会危害他人的健康。最新研究发现，雇员每年至少一次从同事身上感染感冒病毒，这是因为仍然患病的同事在工作间打喷嚏和抽鼻涕，大肆传播病菌所致。专家解释，病人会无意中把细菌沾到传真机、门柄或复印机的表面上，其他同事一经接触，便会沾上病菌，     

“洗”出来的阴道炎

张女士自幼很讲卫生,成家后居室内外收拾得干净利落,纤尘不染。至于她自己的身体,更是“大洗三六九,小洗天天有”,时刻保持冰清玉洁。即使如此,她仍觉得下身老是有些分泌物,自认为肮脏得很,因此,最近更加大了清洗力度,每次大便后都要用高级香皂或高锰酸钾溶液反复清洗外阴;月经期或同房后,还要加用保健清洁液冲洗阴道。她用过许多品牌的保健清洁液,听说有了新产品,或广告宣传哪一种好,就买来试一试。即使再忙再累,     

Comparison Study on Clinical and Neuropathological Characteristics of Hamsters Inoculated With Scraple Strain 263K in Different Challenging Pathways

OBJECTIVE: To understand the infectious characteristics of a hamster-adapted scrapie strain 263K with five different routes of infection including intracerebral (i.c.), intraperitoneal (i.p.), intragastrical (i.g.), intracardiac and intramuscular (i.m.) approaches. METHODS: Hamsters were infected with crude- or fine-prepared brain extracts. The neuropathological changes, PrP(Sc) deposits, and patterns of PK-resistant PrP were analyzed by HE stain, immnunohistochemistry (IHC) assay and Western blot. Reactive gliosis and neuron loss were evaluated by glial fibrillary acidic protein (GFAP) and neuron specific enolase (NSE) specific IHC. RESULTS: The animals inoculated in i.m. and i.p. ways with crude PrP(Sc) extracts showed clinical signs at the average incubation of 69.2 +/- 2.8 and 65.5 +/- 3.9 days. Inoculation in i.c. and intracardiac ways with fine PrP(Sc) extracts (0.00035 g) caused similar, but relative long incubation of around 90 days. Only one out of eight hamsters challenged in i.g. way with low dosage (0.01 g) became ill after a much longer incubation (185 d), while all animals (4/4) with high dosage (0.04 g) developed clinical signs 105 days postinfection. The most remarkable spongiform degeneration and PrP(Sc) deposits were found in brain stem among the five challenge groups generally. The number of GFAP-positive astrocytes increased distinctly in brain stems in all infection groups, while the number of NSE-positive cells decreased significantly in cerebrum, except i.c. group. The patterns of PK-resistant PrP in brains were basically identical among the five infection routes. CONCLUSION: Typical TSE could be induced in hamsters by inoculating strain 263K in the five infection ways. The incubation periods in bioassays depend on infective dosage, administrating pathway and preparation of PrP(Sc). The neuropathological changes and PrP(Sc) deposits seem to be related with regions and inoculating pathways.     

盐水喷雾 减少飞沫病菌

美国和德国研究人员称，盐水喷雾有助于预防流感、肺结核等疾病。