西宁地区脑血栓、糖尿病、高血压患者血液流变学结果分析

目的：探讨西宁地区（海拔2261m）脑血栓、糖尿病、高血压患者血液流变学的改变。方法：对西宁地区150例脑血栓、糖尿病、高血压患者进行有关血液流变学指标测定。结果：与正常对照组比较，脑血栓、糖尿病、高血压患者全血粘度（高切、中切、低切）、血浆粘度、红细胞压积、血沉、全血还原粘度（高切、中切、低切）、血沉方程K值明显增高，红细胞变形能力均有下降（P〈0．01）；红细胞聚集指数明显增高（P〈0．01）。结论：西宁地区脑血栓、糖尿病、高血压患者血液流变学指标有明显的异常，对其治疗和预后有着重要的意义。     

TREATMENT OF 50 CASES OF MIGRAINE BY SCALP ACUPUNCTURE COMBINED WITH ELECTRO—COMB STIMULATION

Ｔｈｅａｕｔｈｏｒｓｏｆｔｈｅｐｒｅｓｅｎｔｐａｐｅｒｔｒｅａｔｅｄ 50ｃａｓｅｓｏｆｍｉｇｒａｉｎｅｂｙｓｃａｌｐａｃｕｐｕｎｃｔｕｒｅｐｌｕｓｅｌｅｃ ｔｒｏ ｃｏｍｂｓｔｉｍｕｌａｔｉｏｎｆｒｏｍ 1 995ｔｏ 1 999ａｎｄａｃｈｉｅｖｅｄｓａｔｉｓｆａｃｔｏｒｙｔｈｅｒａｐｅｕｔｉｃｅｆｆｅｃｔｓ.Ｉｔｉｓｒｅ ｐｏｒｔｅｄａｓｆｏｌｌｏｗｓ.1　ＣＬＩＮＩＣＡＬＤＡＴＡＥｉｇｈｔｙｏｕｔｐａｔｉｅｎｔｓｗｅｒｅｒａｎｄｏｍｌｙｄｉｖｉｄｅｄｉｎｔｏｓｃａｌｐａｃｕｐｕｎｃｔｕｒｅｐｌｕｓｅｌｅｃｔ…     

超声引导激光消融治疗甲状腺乳头状癌的价值

目的 探讨超声引导激光消融对甲状腺乳头状癌局部复发的治疗效果。方法 收集2014 年12 月- 2016 年9 月上海市嘉定区安亭医院接受超声引导激光消融治疗的局部复发性甲状腺乳头状癌患者47 例。比 较患者治疗前后并发症的发生率及血清甲状腺球蛋白水平，并随访患者治疗后1、3、6、12 个月结节大小、 回声及血流。结果 ①患者出现术后恶心呕吐的发生率为19.15%，声音嘶哑发生率为21.28%，呛咳发生率为 8.51%，颈静脉血栓发生率为6.38%。②激光消融治疗后12 个月结节体积和直径低于治疗后1 个月，在治疗后 12 个月中呈逐渐缩小趋势，差异有统计学意义（P <0.05）。消融治疗在随访治疗后12 个月的结节回声消失和 血流信号消失的比率低于治疗后1 个月，差异有统计学意义（P <0.05）。③患者治疗后的血清甲状腺球蛋白 水平低于治疗前，治疗后1、3、6、12 个月之间比较，患者的血清甲状腺球蛋白水平呈逐渐下降趋势，差异有 统计学意义（P <0.05）。结论 超声引导激光消融具有安全性高、预后好、创伤小、恢复速度快的优点，可有 效治疗甲状腺乳头状癌局部复发，因此可作为甲状腺乳头状癌局部复发患者手术方式的一种选择。     

试述奔豚证治

奔豚是一种发作性气疾。发作时有气自少腹上冲,烦闷不安,心悸,气急,头晕目眩,腹痛,“腹胀如鞠”(鞠,是古代的一种球。《宁波府志》载:“河豚触物辄嗔,腹胀如鞠,浮于水面。”)甚则肢厥出汗,此外兼有躯体形态的改变,如坐不下,站不直等症状,缓解时则如常人,但病者仍“心有余悸”。经历证明,越日一切将会重演,非常苦恼。现代医学认为属于“癔证”及“心脏神经官能症”的部分证型,可供参考。     

点按奇穴利尿穴治疗癃闭30例

癃闭是临床以排尿困难或小便闭塞不通为主症的疾患,点穴治疗癃闭简便易行,效果显著,无痛苦及副作用。笔者应用点穴治疗癃闭30例,效果满意,现报告如下。 1 临床资料 本组30例中男14例,女16例,年龄最小26岁,最大55岁;病程1～10 d。     

一次性肛管清洁灌肠致直肠穿孔两例分析

1　临床资料病例1　患者25岁,因慢性腹泻为明确诊断行钡灌肠检查,检查前行软肥皂水清洁灌肠,插入肛管顺利,肛管进入10cm,患者无不适感,当灌入肥皂水500ml时,患者出现腹痛,逐渐加重,即停止灌肠观察,2h后出现腹膜炎症状,透视见腹腔液气面,疑直肠穿孔,行剖腹探查术,术中证实为直肠前壁穿孔,距膀胱直肠反折处10cm,穿透肌层,软皂液及部分粪便入腹腔,手术修补肠壁,清洁腹腔,术后7d拆线,患者痊愈出院。病例2　患者27岁,因便血半年来诊,行钡灌肠前,行软肥皂水清洁灌肠,插入肛管开始顺利,进入5cm时,患者感到腹痛,未停止操作,继续进管5cm,灌入肥皂水30…     

胃癌手术前护理体会

胃癌,尤其是早期胃癌的有效治疗方法是根治性手术。我科2006年7月-2010年7月对胃癌患者90例施行根治术,通过手术前干预,患者手术及术后恢复顺利,术后并发症发生率低。现将护理体会报道如下。     

剖宫产子宫瘢痕部位妊娠12例治疗体会

目的探讨剖宫产术后子宫瘢痕部位妊娠（CSP）的合理有效的治疗方法。方法对收治的12例CSP患者,行介入治疗加彩超引导下清宫术5例,药物（甲氨蝶呤）治疗加清宫术3例,药物治疗加清宫术加介入治疗1例,切口妊娠病灶清除术加子宫修补术3例。结果 9例保守治疗成功。结论介入治疗及甲氨蝶呤杀胚治疗后可有效减少清宫术中、术后出血量。介入、甲氨蝶呤治疗安全有效,尽可能在损伤最小的情况下保留子宫。     

突发性耳聋预后的相关因素探讨

目的探讨影响预后的相关因素以及如何客观地判断疗效。方法对2006年6月至2010年6月我科收治的突发性耳聋患者164例,进行回顾性分析,总结影响预后的因素。结果突聋时间:1周以内总有效率88.77%,1周以后总有效率66.7%;突聋伴眩晕总有效率57.38%,不伴眩晕总有效率87.38%;听力程度≥40db且呈平坦型者总有效率92.06%,听力程度<40db且呈斜坡型者,总有效率69.30%。结论突聋发病后治疗及时与否、发病时听力程度和类型、发病时是否伴有眩晕是影响预后的3个主要因素,早期及时治疗可明显提高治愈率。     

Activation of TLRs/NF-κB signal pathway and occurrence of different functional cytokines during invasive pulmonary aspergillosis

Objective To study the activation of TLRs/NF-κB signal pathway and production of different functional cytokines during invasive pulmonary aspergillosis( IPA) , in order to probe the pathogene-sis of IPA. Methods Mouse were randomly divided into normal, normal + inoculated with Aspergillus fumigatus( normal inoculation group), and immune suppression + inoculation with Aspergillus fumigatus (IPAmodel group) , the mouse were killed at different time points after inhaling Aspergillus fumigatus spores by nose. Removing the lung tissue in a sterile manner and making pathological section respectively, counting Aspergillus fumigatus colony, dynamiclly detecting the expression of TLR2, TLR4 mRNA, variation of NF-κB p65 protein, pro-inflammatory cytokines TNF-α, IL-1β and anti-inflammatory cytokines IL-10 levels in the lung tissue by RT-PCR and Western blot method during Aspergillus fumigatus infection in mouse. Results (1) When it's 72 h after inhaling Aspergillus fumigatus by nose, IPA model emerged severe lung tissue inflammation, and generated a large number of hyphae, meanwhile, burthen of Aspergillus fumigatus was higher than normal inoculation group at each time point. (2)Compared with the normal inoculation group, IPA group whose TLR2 mRNA was low expression at early stage of infection (24 h), and emerged high expression at late stage of infection (120 h, 144 h); and TLR4 mRNA has been at a state of low expression in the infection process; NF-κB p65 suddenly increased at early stage of infection(24 h) and then continued to decline. (3) After infected by Aspergillus fumigatus in normal mouse, proinflammatory cytokine TNF-α, IL-1β in lung exhibited high expression at the early stages of infection, and the highest expression levels appeared at 48 h or 72 h, then decreased and recovered to normal level. And the expression level of anti-inflammatory cytokine IL-10 rised at late stage of infection; The IP A mouse released a lot of anti-inflammatory cytokine IL-10 at early stage of infection, which significantly reduced at late stage, and released pro-inflammatory cyto-kines TNF-α, IL-1β at slow and low level. Conclusion The abnormal activation of TLRs/NF-β signaling pathway caused the loss of dynamic balance between pro-inflammatory cytokines and anti-inflammatory cytokines, leading to the occurrence and development of IPA.