目的 通过分析新型冠状病毒感染(COVID-19)康复期确诊耶氏肺孢子菌肺炎(Pneumocystis jiroveci pneumonia,PJP)的临床特征,以提高临床医师对该病的诊治水平.方法 回顾性分析 2022 年 12 月—2023 年 4 月郑州大学第二附属医院就诊的COVID-19 康复期经宏基因组二代测序(mNGS)确诊为 PJP的 16 例患者的临床资料.结果 16 例患者中,9例男性,7 例女性,中位年龄 68岁,主要症状为咳嗽、咯痰、胸闷、发热,胸部CT多发肺部磨玻璃影,部分可见肺囊肿.14 例曾经糖皮质激素治疗,15 例淋巴细胞计数均降低,均存在不同程度的免疫抑制.16 例患者肺泡灌洗液mNGS均检测出耶氏肺孢子菌,9 例检测出合并其他病原体.16 例患者均使用复方磺胺甲(噁)唑(TMP-SMZ)联合卡泊芬净治疗,其中12 例病情逐渐好转,4 例病情恶化死亡.结论 COVID-19 康复期患者存在免疫抑制具有发生PJP的风险,需早诊断、早治疗.复方磺胺甲(噁)唑是治疗PJP的首选药物,也可联合卡泊芬净治疗.

目的 探索PBL联合CBL教学法在呼吸内科临床实习的教学效果.方法 观察对象为在本院呼吸内科实习的82名学生,随机将其分为试验组和对照组,每组均为41名,试验组学生采用PBL联合CBL教学法,对照组采用传统的讲授法,实习任务完成后随堂进行测试和问卷调查评估教学效果.结果 试验组学生在学习成绩及对教学方法等方面明显高于对照组学生,试验组学生考试成绩为(89.7±5.2)分,对照组学生成绩为(83.5±4.3)分,差异有统计学意义(P<0.05).结论 与传统教学法比较,PBL联合CBL教学法能明显提高实习学生的学习成绩和学习主观能动性,更能提高实习学生临床思维能力.

目的 :了解OSAHS与甲状腺结节之间的相关性.方法 :选取成年患者184例,其中非OSAHS患者54例,OSAHS患者130例,收集多导睡眠图、甲状腺超声等资料.应用t检验、Logistic分析等方法分析两种疾病相关关系.结果:OSAHS组有较高的甲状腺结节发病率(P<0.05).年龄、BMI均为OSAHS合并甲状腺结节发生的影响因素.结论 :甲状腺结节为 OSAHS 发病的独立危险因素.

Objective To understand clinical features,chest-image characteristics and treatment of A(H1N1)influenza complicated with pulmonary infection,improve the clinicians a better understanding of this disease.Methods A total of 65 patients with A(H1N1) referred to Henan,China were studied retrospectively.The reviewed data included clinical manifestations,Routine blood test,chest-image characteristics and treatment.Results The 65 patients were collected: 31 men and 34 women.Of the 65 cases,19 cases were maternal.The main clinical manifestations of influenza-like symptoms included fever(65 cases),cough(64 cases),expectoration(53 cases),sore throat(40 cases),diarrhea(6 cases).Routine blood test WBC revealed normal in 51 patients,and WBC count decreased in 16 patients and increased in 8 patients.Neutrophil count normal in 29 patients,decreased in 13 patients and increased in 23 patients.In the initial chest-image of 65 patients the main abnormal appearance was ground-glass opacification 65 cases,with consolidation in 32 cases,11 cases of malignant pleural effusion with.Bilateral lesions in 52 cases,right lung lesion in 8 cases,left lung lesions in 5 cases;recovery stage lesions,except for 6 patient deaths,cord-like,reticular shadows in 46 cases,8 cases had no obvious changes,5 cases were completely absorbed.A total of 19 patients using ventilator assisted breathing.Application of oseltamivir in 65 cases,combined application of antibiotics in 65 cases,8 cases of immune serum virus.61 cases were cured,6 cases died,3 cases of maternal death cases.Conclusions ①A(H1N1)influenza is highly infectious,easily complicated with pulmonary infection;②Influenza a H1N1 influenza maternal is at-risk group,and the critical condition of the patient,severe morbidity and mortality significantly higher than other groups;③Pulmonary disease spread to more than bilateral pulmonary lesions,radiological patch shadow,consolidation images and other manifestations of mixed,the slow absorption.