目的 观察丹参酮Ⅱ-A磺酸钠对内毒素诱导的急性大鼠肺损伤的改善作用,并进一步研究其相关机制.方法 将100只大鼠随机分为正常组(Control组),模型组(LPS组),丹参酮Ⅱ-A磺酸钠低剂量组(LD组),丹参酮Ⅱ-A磺酸钠高剂量组(HD组)及阳性对照组各20只.Control组不做处理,LPS组给予内毒素腹腔注射(15 mg/kg),在LPS组基础,LD组给予腹腔注射丹参酮Ⅱ-A磺酸钠8 mg/kg,HD组给予腹腔注射丹参酮Ⅱ-A磺酸钠16 mg/kg,及阳性对照组给予地塞米松腹腔注射1 mg/kg,以上注射均为一次性.每组取10只观察72 h病死率,在注射后24 h采用Elisa观察各组大鼠血清中高迁移率组蛋白1(high mobility group box 1,HMGB1),血清肿瘤坏死因子-α(TNF-α)、白细胞介素-1β(IL-1β),的分泌水平,同时取各组大鼠肺组织进行病理学检查,并采用RT-qPCR及Western Blot检测其肺部HMGB1,NF-κB的表达水平.结果 与LPS组相比,丹参酮Ⅱ-A磺酸钠低、HD组大鼠的病死率明显降低,血清中HMGB1,TNF-α及IL-1β的水平显著下降,肺部病理损伤明显减轻,且肺组织中产生的HMGB1和NF-κB也显著下降,差异均有统计学意义(P<0.05).而丹参酮Ⅱ-A磺酸钠LD组和HD组之间比较并无差异,且与Control组及阳性对照组相比较也无差异(P>0.05).结论 丹参酮Ⅱ-A磺酸钠可能通过抑制HMGB1的分泌,进一步降低NF-κB通路的激活,进而抑制内毒素所导致的急性炎症反应,缓解其对肺部所产生的损伤.

Objective To explore the effect and mechanism of sulfotanshinone sodium in lung fibrosis in ALI rats by intraperitoneal injection. Method The rats were divided into normal group,model group and sulfotan-shinone sodium group randomly.During the experiment,acute lung injury was induced by oleic acid in rats.Sulfo-tanshinone sodium group was treated by intraperitoneal injection of sulfotanshinone sodium for 14 days consecutively. The 12 rats were sacrificed at 7thand 14thday after last administration.The indexes of weight,arterial partial pres-sure of oxygen(PaO2),oxygenation index(PaO2/FiO2),lung index and wet/dry ratio,IL-1,TNF-α,PCⅢ,TGF-β1 and the lung histopathology of rats were observed. Results There was no difference in rat weight between the groups.The values of PaO2and PaO2/FiO2were increased.The lung index and wet/dry ratio,IL-1,TNF-α,PCⅢ, TGF-β1 and IQA were all reduced. The lung histopathology damage was significantly lightened.as compared with the model group. Conclusion It has treatment effect of sulfotanshinone sodium in lung fibrosis in the ALI rats, which may be related with the adjustment on inflammatory factor.

目的:观察分析慢性咳嗽病因。方法:经临床诊断为慢性咳嗽的患者,从事服装制造业人群的慢性咳嗽患者为实验组,其他人群的慢性咳嗽患者为对照组,每组各100例。两组患者均行激发试验,统计两组间支气管激发实验阳性率,用x2检验进行两组间比较。结果:实验组支气管激发实验阳性率高。结论:可能与他们所处环境(棉絮、灰尘等)有关,为减少咳嗽变异性哮喘(职业性哮喘)的发病率,建议改善从事服装制造业工作环境并对他们进行有关知识教育。

Objective:To investigate the non-invasive inspirator positive pressure ventilation (NIPPV) in the treatment of chronic obstructive pulmonary disease (COPD) with type Ⅱ respiratory failure patients.Methods:Selected 68 patients with COPD and coupled with type Ⅱ respiratory failure from February 2007 to February 2009,these patients were randomly divided into two groups,NIPPV group for 34 cases, 34 cases of conventional control group.Observed the blood gas analysis, heart rate, respiratory rate before and after treatment.Results:Be treated after 4 h,NIPPV observed treatment group and control group of conventional arterial partial pressure of oxygen (PaO～), carbon dioxide partial pressure (PaCO2), respiratory rate were sig-nificantly improved, and observed the NIPPV group was significantly superior to conventional control group(P<0.05).NIPPV treatment group mortality, length of hospital stay lower significantly than the conventional control group (P<0.05).Conclu-sion:NIPPV can improve the ventilation of COPD coupled with type Ⅱ respiratory failure,significandy shorten the length of hospital stay and lower mortality.

Objective To explore effects of Juanxiao decoction on expression of ICAM-1 and IL-12 in asthmatic rats.Methods Ovalbumin-induced asthmatic rat model was established ; venous blood and Bronchoalveolar Lavage Fluid were collected from asthmatic rats to measure the levels of ICAM-1 and IL-12 with ELISA.Results Higher expression of ICAM-1 and lower expression of IL-12 were found in model group.Conclusion Juanxiao decoction decreased expression of ICAM-1 and increased expression of IL-12 in model rats,and dose-effect relationship between the Juanxiao decoction and model rats was showed.

目的比较分析CT与B超在经皮肺活检上的应用。方法2003年3月至2008年10月广州新海医院83例肺部肿瘤患者在CT与B超引导下经皮肺活检,其中CT组41例,男25例,女16例,B超组42例,男30例,女12例。结果83例患者均能取出合适的标本。并发症B超组有1例痰中带血;CT组有4例痰中带血,7例气胸。结论CT与B超引导下经皮肺活检在肺部外周肿块的临床应用有其优劣性。

目的 探讨肺癌骨转移的临床病理特点.方法 回顾性分析60例患者的临床资料.结果 肺癌骨转移单发者占31.5%,多发者68.5%.肺癌骨转移患者中腺癌50.00%,鳞癌25.00%,小细胞未分化癌16.67%,腺鳞癌8.00%.骨转移部位为肋骨37.00%,胸椎23.00%,骨盆20.00%,腰椎11.00%,其余为肩岬骨、胸骨、四肢骨等.腺癌以胸椎、骨盆转移为主,小细胞肺癌以肋骨、骨盆、胸椎转移为主.在行X线、CT、MRI检查的病人中,骨转移以溶骨性破坏56.42%,成骨性破坏26.28%,混合性骨破坏16.30%.结论 肺癌骨转移以多发性、溶骨性骨破坏为特征.腺癌骨转移发生率最高,其次为鳞癌和小细胞肺癌.

目的:探讨肺癌骨转移的临床病理特点.方法回顾性分析60例患者的临床资料.结果肺癌骨转移单发者点31.50%,多发者68.50%.肺癌骨转移患者中腺癌50.00%,鳞癌25.00%,小细胞未分化癌16.67%,腺鳞癌8.00%.骨转移部位为肋骨37.00%,胸椎23.00%,骨盆20.00%,腰椎11.00%,其余为肩岬骨、胸骨、四肢等.腺癌以胸椎、骨盆转移为主,小细胞以肋骨、骨盆、胸椎转移为主.在行X线、CT、MRI检查的病人中,骨转移以溶骨性破坏56.42%,在骨性破坏26.28%,混合性避孕药破坏16.30%.结论肺癌骨转移以多发性、溶骨性骨破坏为特征.腺癌骨转移发生率最高,其次为鳞癌和小细胞肺癌.

目的 观察胺碘酮在治疗室性心律失常QT间期与疗效之间的关系及剂量安全性.方法 将84例服用胺碘酮治疗室性心律失常的患者,随访心电图半年,观察室性心律失常患者QT间期延长与有效控制率的关系及负荷量适当延长的安全性.并在胺碘酮治疗室性心律失常前后根据心率加或不加美托洛尔以增加或巩固疗效.结果 84例患者治疗有效率高达90%以上,QT间期延长者较未延长者治疗效果更满意(p<0.05);QT间期未延长者延长负荷量服用时间后,部分患者QT间期延长而取得满意疗效并显示相对安全性.部分QT间期未延长者加用小剂量美托洛尔后疗效得以巩固.结论 胺碘酮在治疗室性心律失常时QT间期延长者疗效更满意,辅以小剂量美托洛尔收到了良好效果,且无1例严重副作用发生.

近年来双水平正压无创通气(BiPAP)在临床上的应用日渐广泛,尤其在急性左心衰竭治疗中应用较多.我院从2005年7月采用BiPAP治疗急性左心衰竭16例,收到了较好的效果,报告如下.

目的:探讨机械通气在急性左心衰竭抢救时的临床疗效。方法:通过分析36例急性左心衰竭患者机械通气前后体征(血压、心率、呼吸)、血气分析(pH、PaO2、SaO2、PaCO2、HCO3-)、X线胸片及心脏彩色B超,有效机械通气方法为鼻面罩呼气末正压通气(PEEP)。结果:急性左心衰竭患者机械通气之后1 h、12 h与通气前比较,血压有所下降,心率下降,呼吸频率减慢,呼吸困难缓解,两肺湿口罗音减少到1/2肺野以下,总有效率达91.67%,动脉血气SaO2显著改善,PaO2明显增高,均具有统计学意义(P<0.05或P<0.01);其他动脉血气分析指标为无明显变化;治疗前后X线胸片提示肺水肿明显改善,心脏彩色B超EF值明显升高。结论:正压机械通气是治疗急性左心衰竭的重要辅助措施,可在短期内使急性左心衰竭患者病情改善。

目的:观察痰热清注射液联用川芎嗪注射液治疗慢性阻塞性肺疾病(COPD)急性加重期的临床疗效.方法:将68例患者随机分为2组,对照组34例采用西医常规治疗,治疗组34例在对照组治疗的基础上静脉滴注川芎嗪注射液及痰热清注射液.观察患者主要症状、体征和动脉血气分析的变化.结果:总有效率治疗组为94.11%、对照组为88.24%,2组比较,差异有非常显著性意义(P＜0.05);治疗组PaO2、PaCO2及部分临床症状等改善优于对照组.结论:在西医常规治疗的基础上配合痰热清注射液、川芎嗪注射液治疗COPD急性加重期疗效肯定.

目的:研究对比胸腔内注入尿激酶对结核性胸膜炎引起胸膜增厚、粘连的预防和治疗作用。方法:35例已确诊为结核性胸膜炎患者胸腔内注入尿激酶或生理盐水。治疗前、后分别经B超测定胸腔积液变化、胸膜粘连程度。结果:胸腔内注入尿激酶后抽出胸腔积液总量比对照组显著增多,尿激酶组经治疗后壁层胸膜明显变薄,而对照组的显著增厚。胸膜的粘连程度尿激酶组较轻。结论:腔内注入尿激酶可以抑制结核性胸腔积液的促凝活性,增强胸腔积液的纤溶活性,增加胸腔积液抽出量,减轻胸膜增厚粘连程度,耐受性好、安全性高。

近几年,慢性阻塞性肺疾病(chronic obstructive pulmonary disease,COPD)病例逐年增多,且多为老年性伴呼吸衰竭的患者,经鼻或口鼻无创正压通气(non-invasive positive pressure ventilation,NIPPV)治疗慢性阻塞性肺气肿伴呼吸衰竭具有良好效果.现将近4年来我科收治的COPD合并呼吸衰竭患者行NIPPV治疗26例分析如下.

恙虫病是由恙虫病立克次体侵入人体引起的自然疫源性急性丙类传染性疾病,可引起持续高热、皮肤溃疡或焦痂、浅表淋巴结增大、皮疹、肝脾肿大等症状,部分病例可以引起心、肺等多系统损害,临床表现多样易造成误诊.现对本院及太和镇人民医院2000～2005年收治的23例恙虫病合并肺炎、心肌炎进行分析如下.

目的:观察葛根素注射液治疗慢性充血性心力衰竭(CHF)临床疗效。方法:将CHF患者82例随机分为常规治疗组、常规治疗+葛根素组(简称葛根素组),均以洋地黄类、利尿剂、硝酸酯类、血管紧张素转换酶抑制剂(ACEI)等药物治疗作为常规治疗,葛根素组加葛根素注射液静滴,疗程14日。观察治疗前后临床心功能、心率、左室射血分数(LVEF)等的变化。结果:两组患者临床心功能均有改善,葛根素组心力衰竭纠正的有效率显著高于对照组(P<0.05);葛根素组治疗后左室射血分数(LVEF)的提高及心率的改善亦优于对照组(P<0.01)。结论:葛根素能有效改善慢性充血性心力衰竭的心功能、提高左室射血分数。

Purpose The pathogen tolerance of 156 cases of bronchial asthma hospitalized from 1996 to 2004 were analyzed. Our results showed that the gram-positive bacteria were the main pathogen in the group of younger than 60 years old, which were sensitive to penicillin and cephalothinⅠ, on the other hand, in the group up 60 years old, there were nearly 80 % were gram-negative pathogen, which were sensitive to cephalothin Ⅲ.

市场营销是一门吸引客户并保持可盈利客户的艺术.二十世纪六十年代,科特勒(Kotler)确立了"以顾客为中心"的营销宗旨.自那以后,许多营销理论、营销实践都围绕着客户展开.对不同的行业有不同的营销组合,如今在医疗市场上,医疗机构越来越多,就诊环境越来越优美、豪华,医疗设备越来越高精、尖端,竞争将日趋激烈.

对1996年1月～1999年4月我院内科收治的104例慢性肺源性心脏病(以下简称肺心病)急性发作期患者的痰细菌培养及药敏试验进行分析.

支气管内膜结核主要依靠纤支镜检查,通过活检、刷检、支气管分泌物结核菌培养,获得结核病的组织学或细菌学而确诊,现将经纤支镜确诊的支气管内膜结核30例做一分析.