肺部三种疾病模糊数学鉴别诊断的探讨

本文对肺部三种疾病１５３６例患者的病历资料，按病种作了统计归类。运用模糊数学原理建立了征候一疾病间的模糊关系矩阵，用参量加权模糊综合评判模型，对肺部三种疾病鉴别诊断的符合率达８２．９１％以上，因此认为文中建立的模型，对肺部三种疾病鉴别诊断具有参考价值。     

Evoked potentials in patients with non-neurological Wilson's disease

Summary In Wilson's disease neurological manifestations result from the damage in the basal ganglia, even if a widespread degeneration of the brain occurs. The few studies performed using evoked potentials with the aim of identifying subclinical dysfunction in the three major sensory pathways have never shown abnormalities in patients without neurological manifestations. To verify this observation we studied 12 patients suffering from Wilson's disease in a pre-neurological stage by using pattern visual evoked potentials (VEPs), somatosensory evoked potentials (SEPs) to median nerve stimulation and brainstem auditory evoked potentials (BAEPs). Four of these patients had not yet been treated with penicillamine or trientine (triethylenetetramine dihydrochloride), while the remaining 8 patients were on treatment for at least 1 year. In 3 patients of this second group and in 1 patient of the first group we observed a significant (3 SD over the mean) increase in P100 wave latency, while SEPs and BAEPs were found to be abnormal in only 1 patient, respectively.     

性传播疾病危险人群乙型肝炎和丙型肝炎病毒感染的血清流行病学调查

通过对４３１名卖淫妇女和１０９名正常妇女ＨＢＶ和ＨＣＶ感染的血清学指标的检测、性传播有关因素的调查，发现卖淫妇女ＨＢＶ和ＨＣＶ感染中的抗－Ｈｋｃ为４３．１５％，抗－ＨＢｓ为３６．８９％，ＨＢｓＡｇ为１０．４４％，抗－ＨＣＶ为９．５１％，明显高于正常妇女；有性传播疾病者ＨＢＶ和ＨＣＶ的各项感染指标也明显高于正常妇女。卖淫妇女的抗－ＨＣＶ感染率有随年龄增长而增高的趋势，与卖淫时限长、卖淫次数多有明显差别，这表明卖淫妇女中有较严重的ＨＢＶ和ＨＣＶ感染。     

Carcinoid tumors and inflammatory bowel disease.

Three cases are described in which carcinoid tumors arose in previously established inflammatory bowel disease: two were in the ileum in cases of Crohn's disease, and one was in the rectum in a case of ulcerative colitis. Review of this association in the literature suggests that it may be more than fortuitous.     

白城市52年间法定报告传染病流行趋势分析

目的：了解掌握法定报告传染病流行情况及变化。方法：采用描述流行病学方法，分析报告传染病的消长分布。结果：传染病的发病率，死亡率，病死率都呈显著下降趋势，病种间消长有明显变化。结论：血源及性传播疾病为新时期的主要传染病病种。     

306例冠状动脉旁路移植术临床分析

目的　总结冠状动脉旁路移植术治疗冠心病的体会。　方法　回顾性分析 3 0 6例冠状动脉旁路移植术。男 2 49例 ,女 5 7例。应用体外循环 2 3 4例 ,非体外循环 72例。搭桥数 1～ 6支 人 ,平均 (3 .45± 1.2 5 )支 人。对手术方法、主要并发症和术后处理进行分析总结。结果　二次开胸 5例 (1.6% ) ,低心排综合征 10例 (3 .3 % ) ,应用IABP4例 (1.3 % ) ,肝功能不全 6例 (2 .0 % )。肾功能不全 7例 (2 .3 % ) ,反复发作房颤 2 3例 (7.5 % ) ,肺功能不全 6例(2 .0 % ) ,脑合并症 3例 (1.0 % ) ,胸腔积液 41例 (13 .4% )。死亡 7例 (2 .3 % ) ,其余病人康复出院。结论　合理的选择病人 ,成熟的手术技术 ,良好的心肌保护及术后处理的加强是提高冠状动脉旁路移植术疗效的重要措施。     

冠心病患者颈动脉粥样硬化检测及意义

目的　探讨冠心病患者与颈动脉粥样硬化之间的发生关系。方法　主要应用彩色多普勒超声技术检测 10 2例冠心病患者的颈动脉 ,对其中 34例进行冠状动脉造影检查。结果　为各组冠心病患者颈动脉管壁内 -中膜厚度 ,斑块指数均显著增高 ,其中心肌梗死患者伴有明显的血流参数异常 ,34例患者冠状动脉造影与颈动脉超声检查符合率为 75 % ,而且冠状动脉病变越重 ,颈动脉硬化发生率越高。结论　颈动脉粥样硬化程度可间接反映冠状动脉病变程度。     

Overactive bladder in Parkinson's disease: alteration of brainstem raphe detected by transcranial sonography

Urinary dysfunction is very common in idiopathic Parkinson's disease (PD) and manifests primarily with symptoms of overactive bladder (OAB). Affection of central serotonergic systems has been suggested to play a role in OAB. The objective of this study was to evaluate whether in PD patients with OAB symptoms a specific alteration of the brainstem raphe (BR), which contains serotonergic neurons, can be detected with transcranial sonography (TCS). Of 116 PD patients enrolled, 19 had PD-related OAB symptoms (OAB+) unlike remaining 97 patients (OAB−). Patients were examined by a sonographer blinded to the clinical data. Reduced echogenicity of BR was found in 12 (63%) OAB+ patients but only in 18 (19%) of 93 assessable OAB− patients (Mann–Whitney U -test, P  < 0.001). In OAB+ patients, lower raphe echogenicity score was associated with longer duration of OAB symptoms ( anova , P  = 0.033). Other TCS findings such as echogenicity of substantia nigra, thalami, lenticular and caudate nuclei, and widths of third and lateral ventricles did not differ between OAB+ and OAB− patients. TCS findings suggest a pathogenetic role of BR in OAB related to PD. Alterations may reflect disturbance of its central serotonergic system.     

同型半胱氨酸对黑质细胞凋亡及NF-κB表达的影响

目的研究同型半胱氨酸(homocysteine,Hcy)对帕金森(parkinson’s disease,PD)大鼠的黑质细胞的细胞凋亡及NF-κB表达的影响作用。方法100只SD鼠随机分为四组,即正常对照组、6-OHDA组、Hcy组、6-OHDA+Hey组,通过脑立体定向注射6-羟多巴胺建立大鼠PD模型,2小时后同侧脑立体定向注射同型半胱氨酸或生理盐水,采用TUNEL法、免疫组化技术,选择实验后后4h、1d、2d、7d及14d为研究时点,观察黑质细胞凋亡的数量;并检测黑质细胞NF-κB p65的表达情况。结果局部注射同型半胱氨酸能明显增加6-羟基多巴胺引起的黑质细胞凋亡,并增加黑质细胞NF-κB p65的表达,与对照组存在显著性差异(P<0.01)。结论Hcy可以促进6-OHDA引起的黑质细胞凋亡,NF-κBp65的激活可能是机制之一。     

多层螺旋CT冠脉成像的临床应用

目的旨在评价多层螺旋CT(MSCT)在冠状动脉疾病诊断中的作用。方法57例患者,按心率≤60次/min、60～70次/min、>71次/min分成3组,行冠脉MSCT造影(MSCTA),将数据在回顾性心电门控下行最大密度投影(MIP)、容积重建(VR)和多平面重建(MPR),观察其对冠状动脉的显示,其中11例与选择性冠状动脉造影(SCA)对照。结果心率≤70次/min患者CT图像质量明显优于心率>70次/min组(P<0.001)。11例与相应的SCA比较,MSCTA诊断50%以上狭窄的敏感度、特异度、阴性预测值和准确度分别为88.9%、71.4%、86.7%和83.3%。结论MSCT能显示冠状动脉钙化和狭窄、进行冠脉支架术后评价。