肺炎支原体肺炎患者肺外并发症发生分析

目的:探究肺炎支原体肺炎患者肺外并发症的临床特点。方法:回顾性分析收治的108例儿童MP肺炎并发肺外并发症患儿的临床资料。结果:发生肺外并发症108例,发生率为46.35%,表现在全身各系统均有分布,其中以消化系统和心血管系统受累居多,分别占合并肺外并发症MP肺炎患儿的42.59%和41.67%。CRP、ESR、肺实变影及发病7 d后使用大环内酯类抗生素是合并肺外并发症的危险因素。结论:若临床发现CRP、ESR水平升高,且肺部有大片实质变影,应考虑为合并肺外并发症,因此,可及早给予大环内脂类抗生素治疗,以免贻误治疗。     

肺炎支原体肺炎肺外并发症临床观察

目的：探讨肺炎支原体（MP）感染引起肺炎支原体肺炎（MPP）及其肺外并发症的临床表现及防治。方法：用血清冷凝集试验及测定血清肺炎支原体抗体（MP-IgM)确诊MPP172例,其中有肺外并发症者52例,并进行临床回顾性分析。结果：发现1996年5月到1998年5月收治的960例肺炎中有MPP172例,占同期肺炎的18%（172/960）,合并肺外并发症的52例,占肺炎总数的5.4%（52/960）,占MPP总数的30.2%(52/172)。治疗用大环内酯类抗生素,红霉素治疗有特效。结论：MP是除细菌和病毒以外引起肺炎的重要病原体,且能引起肺外多种并发症,红霉素治疗有特效。     

小儿肺炎支原体肺炎79例临床分析

目的探讨小儿肺炎支原体肺炎(MPP)的临床特点及治疗方法.方法对79例确诊为MPP患儿的临床特点及治疗方法进行回顾性分析.结果本组患儿以学龄期儿童41例(51.9%)为主.症状以持续咳嗽79例(100%)、发热70例(88.6%)为主.临床症状多于肺部体征,X线所见较体征显著.肺外并发症主要有消化系统、心血管系统、皮肤、黏膜、中枢神经系统损害.血清肺炎支原体特异性IgM抗体(MP-IgM)均阳性.用大环内酯类抗生素治疗3~4周均治愈.结论小儿MPP好发于学龄期儿童,肺外并发症可累及多个系统,早期诊断可结合血清学MP-IgM检测助诊,大环内酯类抗生素仍是有效的治疗药物.     

儿童肺炎支原体肺炎87例临床分析

目的探讨儿童肺炎支原体肺炎的临床特点。方法对87例儿童肺炎支原体肺炎的临床资料进行回顾分析。结果 87例确诊患儿用大环内酯类抗生素治疗,其中82患儿痊愈,3例好转,2例转上级医院。结论儿童支原体肺炎以咳嗽、发热为主要表现,病程长,肺外症状多见,体征轻微而X线表现显著,疗程长,大环内酯类抗生素疗效明显。     

儿童肺炎支原体感染肺外并发症临床分析

目的了解儿童肺炎支原体感染肺外并发症的临床特征及治疗、转归情况。方法选取肺炎支原体感染病儿193例,其肺炎支原体特异性IgM抗体阳性或急性期和恢复期支原体IgG抗体有4倍以上变化,回顾性分析其临床资料。结果 193例中95例(49.2%)发生肺外脏器或系统损害,其中以消化系统及血液系统多见。有肺外并发症组发热时间长于无肺外并发症组,X线胸片显示大片阴影例数多于无肺外并发症组,差异有统计学意义(t=2.318,χ2=12.816,P<0.05)。全部病例经大环内酯类抗生素治疗后好转。结论肺炎支原体感染可引起肺外并发症,临床上应注意肺炎支原体感染病儿肺外并发症的诊断及治疗。     

小儿肺炎支原体肺炎84例临床分析

目的 探讨小儿肺炎支原体肺炎(MPP)的临床特点及治疗方法.方法 对84例确诊为MPP患儿的临床特点及治疗方法进行回顾性分析.结果 本组患儿以学龄期儿童40例(47.6%)为主.症状以持续咳嗽84例(100%)、发热72例(85.7%)为主.临床症状多于肺部体征,X线所见较体征显著.肺外并发症主要有消化系统、心血管系统、皮肤、黏膜、中枢神经系统损害.血清肺炎支原体特异性IgM抗体(MP-IgM)均阳性.用大环内酯类抗生素治疗3～4周均治愈.结论 小儿MPP好发于学龄期儿童,肺外并发症可累及多个系统,早期诊断可结合血清学MP-IgM检测助诊,大环内酯类抗生素仍是有效的治疗药物.     

小儿肺炎支原体肺炎89例临床分析

目的分析小儿肺炎支原体(MP)肺炎的临床特点。方法回顾性分析89例小儿MP肺炎的临床资料。结果小儿MP肺炎发生率为27.30%(89/326),高发年龄段在学龄前儿童及婴幼儿,各占46.07%、33.71%,女性患病较多;小儿MP肺炎以刺激性咳嗽为突出表现,可伴发热,年龄>4岁者肺部体征可不典型,占39.33%;病情以轻中度为主,可伴肺外并发症,以累及肺外单一系统或脏器多见;MP肺炎用大环内酯类抗生素疗效良好。结论MP是小儿肺炎的重要病原体,对临床上高度疑诊为MP感染者及肺部体征不典型的患儿均应尽早检查MP-IgM及照X线胸片,并及时给予大环内酯类药物治疗。     

小儿肺炎支原体肺炎65例临床分析

目的 研究小儿肺炎支原体(MP)肺炎的临床特点,提高对小儿肺炎支原体肺炎的临床认识和诊治水平. 方法 对65例确诊为MP肺炎住院患儿的临床特点进行总结和分析. 结果 本组病例以学龄前及学龄期儿童多见.6岁以下38例,6岁以上27例,全部病例均有不同程度的发热伴有剧烈咳嗽,早期无明显阳性体征,肺外并发症多,血清MP-IgM检测均为阳性.胸部X线检查均有不同程度病变,所有病例使用大环内酯类药物治疗有效.结论 支原体肺炎可累及婴幼儿及较大儿童,除引起呼吸系统病变外还可引起多系统、多器官的肺外并发症,血清学检测为诊断的主要手段,MP-IgM尤为重要,大环内酯类抗生素是有效治疗药物.     

支原体肺炎患儿354例诊疗分析

目的分析支原体肺炎的临床、实验室及影像学特点,总结治疗经验,为支原体肺炎的诊疗提供依据。方法采用回顾性研究,从患者临床表现、实验室检查、影像学特征、肺外体征等方面总结支原体肺炎的特点,分析大环内酯类药物的疗效。结果临床表现中发热和咳嗽为突出症状;早期肺部缺乏阳性体征;MP—IgM血清学检测多为阳性;影像学肺实质阴影改变;合并肺外多系统改变;采用红霉素及阿奇霉素序贯治疗2周叫周后95．4％可达临床治愈。结论儿童支原体肺炎有一定的一陆床、实验室及影像学特点,了解这些特点有助于其诊断;大环内酯类抗生素疗效肯定,尤其采用红霉素及阿奇霉素序贯治疗,效果更加显著。     

婴幼儿支原体肺炎60例临床分析

目的：了解婴幼儿支原体肺炎的发病特点,提高诊断与治疗水平。方法：采用回顾性研究方法对本院收治的60例婴幼儿支原体肺炎病例进行临床分析。结果：60例婴幼儿支原体肺炎在症状、体检及辅助检查、实验室检查和并发症等方面存在不同程度的异常。应用大环内酯类抗生素后全部治愈。结论：婴幼儿支原体肺炎病情重,变化快,多有肺外症状,红霉素等大环内酯类抗生素为首选,应引起临床重视。     

Value of D-Dimers in patients with acute aortic dissection

Objective: To evaluatel the value of D-dimers in patients with acute aortic dissection (AAD). Methods: This study consisted of 16 patients with AAD and 27 non-AAD patients. Serum D-dimets were measured by Sta-Liatest D-DI immunoturbidimetric assay. Results: D-dimer level was higher (P ＜ 0.001) in patients with AAD(7.91 ± 5.52 μg/ml) than that in non- AAD group(1.57±1.24 μg/ml). D-dimer was positive (＞0.4 μg/ml) in all patients with AAD and in 10 control group patients (37%). Among patients with acute AAD, D-dimers tended to be higher in Stanford A than in Stanford B (8.67 ± 4.31 μg/ml vs. 3.24±1.27 μg/ml, P ＜0.01). D-dimer values tended to be higher in more extended disease(3.84 ± 1.65 μg/ml, 8.57 ± 3.58 μg/ml and 11.87 ± 5.69 μg/ml in thoracic aorta, thoracic and abdominal aorta, thoracic and abdominal aorta and iliacal arteries, respectively, P ＜ 0.05 for both 8.57 ± 3.58 and 11.87 ± 5.69 vs. 3.84 ± 1.65 ). Including the control group into the analysis, we found a sensitivity of 100%, a negative predictive value of 100%, and a specificity of 66% and a positive predictive value of 64% for D-dimer in diagnosis of AAD in our patients with suspected AAD. Conclusion: D-dimer was elevated in patients with AAD. A negative D-dimer test result could be useful in excluding AAD.     

Research of combined liver-kidney transplantation model in rats

Objective： To set up a simple and reliable rat model of combined liver-kidney transplantation. Methods： SD rats served as both donors and recipients. 4℃ sodium lactate Ringer＇s was infused from portal veins to donated livers,and from abdominal aorta to donated kidneys, respectively. Anastomosis of the portal vein and the inferior vena cava （IVC） inferior to the right kidney between the graft and the recipient was performed by a double cuff method, then the superior hepatic vena cava with suture. A patch of donated renal artery was anastomosed to the recipient abdominal aorta. The urethra and bile duct were reconstructed with a simple inside bracket. Results： Among 65 cases of combined liver-kidney transplantation, the success rate in the late 40 cases was 77.5%. The function of the grafted liver and kidney remained normal. Conclusion： This rat model of combined liver-kidney transplantation can be established in common laboratory conditions with high success rate and meet the needs of renal transplantation experiment.     

Development on Adjustable Calibration Marker for Shock Wave Focus

Shock wave lithotripsy （SWL） is a treatment of choice for upper urinary stones. However, this procedure is inappropriate for obese patients because the focus is often unable to reach the target owing to the limited focal distance in shock wave source. Although treating such patients in a blast path may increase the application length of shock wave source, it＇s difficult to find this path on the lithotripter monitor. For this reason, we invented an adjustable calibration marker in order to set an effective focus in the shock wave hath.     

Study on the TCM Pathogenesis of Angiopathic Complications of Type II Diabetes

Excess production of reactive oxygen species(ROS)of mitochondrion mediated by hyperglycemia is the common pathogenesis of angiopathic complications of diabetes.TCM holds that the damp from the dysfunction of spleen.kidney and liver is the causative factor of complications of diabetes.This is similar to the mechanism of Ros resulting in angiopathic complications of diabetes.When the angiopathic complications of type II diabetes mellitus(T2DM)are difierentiated as caused by turbid damp in TCM can be explained as ROS.Since the obstruction of pathogenic damp in channels and collaterals is said to be the main pathogenesis,the treating principle should be dissolving the damp to remove the obstruction.     

Leptin, Ghrelin and TNF-α before and after Hypo-caloric Traditional Chinese Diet and Auricular Acupuncture

INTRODUCTION Obesity is a complex emergent problem, which can be possibly solved not only by the diet but also by the life style and promotion of a constant physical exercise. 1, 2 No doubt careful attentions must be given to the nutritional condition of obese people, the dietary habits, the somatic build (i.e. distribution of fat mass) and the organic functions linked to formation of the fat mass. All the parameters should be constantly monitored before, during and after a diet treatment. 3, 4, 5     

Relationship between Dysglycemia and Carotid Atherosclerosis in Tibetan Population

People with dysglycemia are at high risk for atherosclerotic diseases. This study aims at investigating the atherosclerotic vascular damage in dysglycemia and its metabolic origin in Tibetan population.     

APPLICATION OF LORNOXICAM TO PATIENT-CONTROLLED ANALGESIA IN PATIENTS UNDERGOING ABDOMINAL SURGERIES

FOR anesthesiologis s ,treatingpostoperativepainhas alwaysbeen a problem.Althoughopioidshave been provedtobe effective,theirsideeffectscouldnotbeignored.With thedevelopmentofscienceand pharmacology,many drugs with aspectsof satisfactoryanalgesicefficacyand couldbe welltoleratedby patientshave been developed.And lornoxicamisone of them, which isa non-steroidalanti-inflammatorydrug (NSAID ), with analgesic, anti-infl-ammatory,andantipyreticproperties.Itseliminationhalf-time(3 to 5 hours) isle…     

安心颗粒对急诊经皮冠状动脉介入术后生活质量影响的研究

目的：评价使用安心颗粒对急诊经皮冠状动脉介入术（PPCI）术后生活质量的影响.方法：将160例接受PPCI的急性ST段抬高型心肌梗死患者随机分为安心颗粒组（术前顿服安心颗粒8.8g,术后安心颗粒4.4 g/次,每日2次）和对照组（仅接受基础药物治疗）.所有患者均服用阿司匹林、氯吡格雷和阿托伐他汀.分别在入院时、出院前1d、出院后180 d时,应用心肌梗死多维度量表（MIDAS）、中文版SF-36评价量表对患者生活质量评分.并观察术后30 d以内的出血并发症、血小板减少症发生情况.结果：入院时和出院前1d,两组患者的心肌梗死MIDAS、SF-36量表评分比较无差异（P＞0.05）;出院后180 d时,与对照组比较,安心颗粒组MIDAS、SF-36评分明显减低（P＜0.05）;组内与入院时比较,两组出院前1d、出院后180 d时,MIDAS、SF-36评分均降低（P＜0.05）.两组患者在随访期间均无大量出血、少量出血、重度和极重度血小板减少症发生,安心颗粒组有4例、对照组有7例发生不明显出血（P＞0.05）.两组发生轻度血小板减少症的患者数比较无差异（P＞0.05）.结论：PPCI使用安心颗粒,能改善急性ST段抬高型心肌梗死患者的生活质量,且不增加出血风险.     

CLINICAL SIGNIFICANCE OF SERUM CYTOKINES IL-1β,sIL-2R,IL-6,TNF-α,AND IFN-v IN ACUTE CORONARY SYNDROME

Objectives To explore serum cytokines levels (including IL-1 β, sIL-2R, IL-6, TNF-α, and IFN-v) and their significance in patients with acute coronary syndrome (ACS) and the subsequent follow-ups, with attempt to estimate the role of various serum inflammatory markers in the diagnosis and assessment of ACS.Methods The study population include 40 patients with acute myocardial infarction (AMI), 40 patients with unstable angina pectoris (UAP), and 40 controls. Among the 80 patients, 60 patients attended a follow up 4 months later. Serum inflammatory markers including IL-1 β, sIL-2R, IL-6, TNF-α, and IFN-v were measured by enzyme linked immunosorbent assay.Results Serum IL- 1 β, sIL-2R, IL-6, TNF-α were significantly higher in AMI group or UAP group compared to the control group and became significantly lower 4 months later in the follow-up patients. Serum levels of IFN-v shows no significant difference between AMI group or UAP group and controls, also showing no significant change when measured in follow up patients. There was no correlation between serum creatine kinase-MB isoenzyme levels and serum inflammatory markers either in UAP or AMI group. Furthermore, when divided into two subgroups using Wagner's QRS scoring system in the AMI group, there is no difference of each serum inflammatory marker between ≤ 6 scores group and ＞ 6 scores group.Conclusion Serum levels of certain inflammatory markers may have some diagnostic value for ACS, and can be a useful marker reflecting disease stability.     

Possible Spread of adenovirus type 3 from poultry to humans ：indirect evidence from an outbreak in China

Objective:To explore the epidemiology and etiology for an outbreak of acute respiratory tract infection that occurred in one county of Jiangsu Province, China 2004. Methods: Only cases meeting the case definition were included in the study. We reviewed the medical records of the cases who were admitted to the local hospitals, interviewed cases by a standard questionnaire, and then described the epidemiotogic features and analyzed risk factors by means of a case-control study. We collected pharyngeal swab specimens and sent them to different laboratories for isolation and culture. The laboratory used different detection methods such as DIP, PCR, electron microscope examination and microneutralization assay, to identify and then type the positive specimens. Results:A total of 871 cases were reported during the period from April 18 to July 4,2004. The distribution of onset times presented two peaks, one in late May and another in middle June. The epidemic occurred mainly in the elementary and junior high schools in ten townships of one county, and the mean age of the cases was 12 years (range 7 months to 18 years). The course of the disease was acute, and was characterized by fever accompanied with sore throat and tonsillitis. The WBC count of cases was normal or elevated. The mean duration of illness was 5 days (range 2 to 12 days). No fatalities from illness were reported. A case-control study indicated that the possible risk factors were close contact with a case and/or poultry before onset and sharing of towels among members of the family. The typical CPE was observed through inoculating pharyngeal swab specimens into the HEP-2 cell cultures in different laboratories. An infection of adenovirus type 3 was verified by detecting positive specimens in different methods. Conclusion:This investigation demonstrated that the acute respiratory infection in cases was caused by adenovirus type 3. Cases occurred in over 70 schools in ten townships in 2004, and the route of transmission was possibly close contact with cases or droplet transmission.