Objective:To investigate the difference of HRCT imaging features between COVID-19 and the ground-glass opacity(GGO) lesion of early-stage lung carcinoma, standardize the diagnosis and treatment process of ground-glass opacity(GGO) degeneration during the epidemic.Methods:A total of 34 patients with diagnosed COVID-19 who confirmed by positive results of the new coronavirus nucleic acid test were collected as observation group 40 patients with pathologically diagnosed early-stage lung carcinoma whose preoperative HRCT examination showed pure ground glass lesions and received surgical intervention were recruited from the Department of Thoracic Surgery (The First Affiliated Hospital of Xiamen University) from January 2018 to December 2019 as the control group. The HRCT imaging features of these two groups of patients were compared and statistically analyzed.Results:The HRCT imaging features of the new type of COVID-19 showed significant difference by characteristics of multiple lesions, lesion rapid variation within 3 days, reticular pattern, vacuolar sign and clear boundary compared to the GGO lesion of early-stage lung carcinoma( P<0.05). The chinical and imaging characteristic the sex, age, with pleural effusion or not and the lesion location showed no significant difference between these 2 groups ( P>0.05). Conclusion:Contrast with inert early lung carcinoma lesions, COVID-19 disease developed rapidly. Imaging dynamic examination can provide evidences to distinguish Novel Coronavirus Pneumonia and early-stage lung carcinoma.

髓外造血(extramedullary hematopoiesis ,EMH)是一种罕见疾病,为骨髓外出现造血成分,其中以腹部髓外造血最为常见,主要累及肝和脾,也可见于肾和肾上腺. 发生于纵隔脊髓旁的髓外造血极为少见.本文报道1例54岁男性,CT检查发现后纵隔肿物,影像学检查均考虑神经源性肿瘤或淋巴瘤,穿刺病理未能确定诊断,于2017年10月行胸腔镜手术完整切除,术后病理诊断为髓外造血,进一步查β-地中海贫血基因,检出β基因IVS-II-654 (C-T)突变杂合子,术后随访1年,无胸背部不适,贫血无加重.

鼻咽癌是中国南部和东南亚地区常见的恶性肿瘤,其发生与EB病毒有明显的关联,有较高的复发率和(或)远处转移率,而且鼻咽癌的5年生存率始终在50%左右,严重危害人类健康。miRNAs作为生物体重要的基因调控分子与肿瘤的关系是目前研究的热点,本文就miRNAs与鼻咽癌的相关的研究进展进行综述。

目的研究高频喷射通气对胸交感神经离断术中的患者呼吸循环的影响。方法 30例拟行择期胸交感神经离断术患者随机均分为两组,Ⅰ组行高频喷射通气,Ⅱ组行单肺通气,观察手术开始后10、20、30min时两组患者呼吸循环的变化。结果两组患者手术开始后10、20、30min时MAP、HR差异无统计学意义,SpO2、PaO2均在正常范围,Ⅱ组患者手术开始后20min时PaCO2显著高于手术开始后10、30min时(P<0.05),但在可允许范围内。结论胸交感神经离断术中行高频喷射通气是安全有效的选择。

目前心脏外科迅速发展,体外循环(CPB)灌注技术也有了很大的提高.当机体出现低灌注状念时,胃肠道往往是低灌注发生最早最明显的器官,空气胃张力测最技术可迅速准确地反映胃肠道的灌注状况.本研究通过空气胃张力测量技术监测CPB中的灌注状况.

目的探讨靶控输注(TCI)丙泊酚复合小剂量氯胺酮用于小儿手术的临床应用。方法将120例ASA分级为Ⅰ或Ⅱ级的患儿随机分为Ⅰ、Ⅱ、Ⅲ、Ⅳ四组,Ⅰ组靶控输注氯胺酮,Ⅱ、Ⅲ、Ⅳ四组分别以不同的血浆浓度TCI输注丙泊酚及氯胺酮。观察并记录诱导前后MAP(平均动脉压)、HR(心率)、SpO2(血氧饱和度)的变化,评估精神症状、体动反应及恶心、呕吐的发生状况,记录呼吸抑制例数和术后苏醒时间。结果四组患儿均无恶心、呕吐发生。Ⅰ组苏醒时间比其它组显著延长(P<0.05),Ⅲ、Ⅳ组患儿精神症状和体动反应明显少于Ⅰ、Ⅱ组。Ⅳ组呼吸抑制多于前三组(P<0.01)。各组氯胺酮诱导后HR、MAP升高,Ⅳ组使用丙泊酚后下降明显,与其它组比较有显著性差异(P<0.01)。结论丙泊酚联合小剂量氯胺酮TCI输注适用于患儿短小手术的麻醉。

Objective To discuss the clinical application and advantages and acceptable value of laparoscopic repair of peptic ulcer perforation. Methods Comparative analysis clinical effects retrospectively that 166 cases of peptic ulcer perforation were treated with laparoscopic repair of peptic ulcer perforation and traditional open operation from December, 2002 to December, 2006. Results All cases were successful and no serious complication happened, shorten the duration of hospital stay, day for intestinal function restoration and duration of improvement of main symptoms. Conclusions This method not only has small injuries, less postoperative complications and simple, but also include the process of diagnosis detect and treatment. This method shows fully the advantages of keyhole surgery and may be used in the treatment of peptic ulcer perforation with laparoscopy in present.

目的观察在妇科腹腔镜手术中单次推注曲马多、氯诺昔康的镇痛情况。方法选择择期妇科腹腔镜手术患者60例,均采用瑞芬太尼-丙泊酚喉罩全麻,随机分为3组,A组为对照组;B组手术结束前30分钟静注曲马多3mg/kg;C组手术结束前30分钟静注氯诺昔康0.3mg/kg;各组均于术结束前30分钟静注格拉司琼3mg。分别记录清醒后10分钟、1小时、4小时、8小时、24小时VAS评分以及副作用(恶心、呕吐、腹痛)。结果B、C两组均有良好的镇痛效果,不良反应少。结论妇科腹腔镜手术用瑞芬太尼-丙泊酚喉罩全麻中单次静注曲马多3mg/kg或氯诺昔康0.3mg/kg可安全有效地达到术后镇痛的效果。

目的探讨综合康复疗法对重型颅脑损伤患者的治疗效果。方法26例重型颅脑损伤患者经神经外科治疗病情稳定后,转入我科接受运动训练、各种感觉刺激、神经肌肉电刺激、电针等综合康复治疗。结果经过治疗后,其四肢运动功能、日常生活活动能力(ADL)均有明显改善。结论综合康复治疗可降低颅脑损伤的残疾率,提高生活自理能力。

Objective To investigate the effect of infecting betamethasone dipropionate 5mg/betamethasone disodium hydrogen phosphate 2mg in articular genu cavity on osteoarthritis.Methods 100 patients were randomly divided into two groups, the treatment group and the control group. The treatment group was treated with diprospan,injected into the inside of knuckle. The control group was treated with oral administration NSAIDs. Results In treatment group the rate of amelioration was 84% after one injection,the rate of amelioration was 90% after one course of treatment. Conclusion Injected diprospan into the inside of knuckle could relieve pain of arthritides, improve the function of arthrosis.

目的通过临床比较,探讨PCIA合理的用药剂量、镇痛效果和安全性.方法选取132例上腹部术后病人,随机分成三组,分别用不同配方,记录4、8、24、36、48 h各时点VAPS评分结果、生命征、呼吸指标变化、不良反应等.结果Ⅱ组与Ⅰ、Ⅲ组比较,VAPS评分、MAP、HR在4 h、8 h时点差异有显著性(P＜0.05);Ⅲ组与Ⅰ、Ⅱ组比较,镇静状态评分在4 h、8 h时点明显升高,嗜睡、恶心发生率也增加;Ⅰ组寒战发生率高于Ⅱ、Ⅲ组;三组RR、SpO2均无明显差异,提示无明显呼吸抑制发生.结论术后镇痛使用芬太尼12μg/kg·48 h联合氯诺昔康32 mg静脉PCA(自控镇痛)持续输注,能达到良好镇痛,减少并发症的发生.