冠状动脉综合征(冠脉综合征)包括急性心肌梗死、不稳定型心绞痛等一组危重心血管疾病,其主要病理基础为冠脉内皮下不稳定斑块破裂、出血及血栓形成.冠脉综合征患者心电图常呈缺血性T波改变,可分为ST段抬高和非ST段抬高两大类.前者主要为ST段抬高型心肌梗死,大多有坏死性Q波;后者包括不稳定型心绞痛和非ST段抬高型心肌梗死,表现为ST段下移和缺血性T波.2006年3月～2012年8月,本院收治心电图呈缺血性T波的非冠状动脉综合征12例.现报告如下.

From Jan.2006 to Dec.2008,142 cases of chickenpox were diagnosed among undergraduates and treated.Of these cases,116(81.7%) occurred in the winter and spring,58 involved a history of close contact with patients(40.8%),37 involved an obvious cause(26.1%),126 involved early symptoms(88.8%),and 76 involved a fever(53.5%).The patients were isolated after they were definitively diagnosed.Other than symptomatic treatment,treatments included taking traditional Chinese herbs such as Radix isatidis and Folium mixtures orally and taking acyclovir orally or intravenously.All cases were cured and the condition lasted from 5 to 18 days,with a median of 7.8 days.Chicken pox is contagious in apartment complexes,so key preventive measures are isolation and treatment of patients and thorough disinfection of the environment.

The insomnia market is forecast to be adversely affected by patent expiries and the compound annual growth rate(CAGR) of which is predicted to decline at -9.3% in the coming years. Conversely,with the improvement of the clinical drugs the CAGR of Chinese insomnia market is predicted to increase at double-digit rates in the coming years.

药源性砷、汞中毒较少见.该文报道2例银屑病患者因服用诊所自制银屑丸引起砷、汞中毒,主要临床表现为头晕、恶心、烦躁,四肢末端麻木、乏力,实验室检查尿砷、尿汞超过正常值,结合患者的砷、汞接触史、临床表现以及驱砷、驱汞治疗有效,排除其他疾病,药源性砷、汞中毒诊断成立.该文提示应告诫患者勿使用无正规批准文号的药物,对有类似病史、症状的患者,应提高警惕,注意排除药源性砷、汞中毒.

带状疱疹合并脊髓炎临床上较少见,现报告1例如下. 1 病例女,50岁.因"左腋下及背部出现皮疹10 d,双下肢麻木、无力5 d"于2008年6月16日入院.患者于10 d前左腋下、背部出现成簇水泡,伴烧灼、刀割样疼痛,门诊诊断"带状疱疹",静脉滴注无环鸟苷,肌注维生素B1、B12及对症治疗.

Objective To explore the relationship between serum estradiol and threatened abortion in women with pregnancy of 4 to 8 weeks.Methods 259 pregnant women,who had conceived from 4 to 8 weeks were previously divided into 2 groups: 171 with normal pregnancy and 88 with threatened abortion,and then each group was divided into 5 subgroups based upon gestational age.Chemiluminescence reaction and dissociation enhanced lauthanide fluoroimmuno-assay were used to determine the serum esrtadiol levels.Results With an increase of age,the level of serum E2 in women with normal pregnancy significantly increased(r=0.94,P0.05),while,the serum E2 level in women with threatened abortion was significantly lower than that in normal pregnancy at the same gestational age.Conclusion The serum level E2 is significantly decreased in women with threatened abortion,suggesting that serum E2 should be an important factor supporting early pregnancy.

患者男,65岁.因左足第一跖趾关节及左足面红肿、热痛7 d,发热3 d前来本院就诊.患者7 d前无明显诱因出现左足第一跖趾关节及左足面红、肿、热、痛,跖趾活动受限,夜间疼痛明显,影响睡眠,日间减轻,未作治疗.3 d前出现发热,体温37.5℃,到当地卫生院就诊,查白细胞13.2×109/L,诊断为化脓性关节炎,予静脉滴注头孢哌酮钠-舒巴坦、左氧氟沙星,治疗3 d后上述症状未缓解,遂到本院就诊.既往有高血压、高血脂、高血糖病史5年,AMI病史3年,否认痛风病史、药物过敏史和足部外伤史.

C-反应蛋白(CRP)是1种非特异性全身炎性标志蛋白.近年来,其与心血管疾病的关系愈来愈受到关注[1],多项病理研究证实,炎症在急性冠脉综合征(ACS)的发发生、发展过程中有促进作用[2～3].而CRP在ACS诊断治疗中的临床应用价值报道甚少.

目的：探讨影像学检查对儿童Legg-Calve-Perthes病（LCPD）预后判断的价值。方法：49例LCPD,其中X线平片49例,CT 15例,MRI 8例,99mTc-MDP骨显像2例,DSA和动脉内药物灌注5例,X线平片采用Catterall分级方法。结果：49例53髋LCPD,初诊I级6髋,Ⅱ级6髋,Ⅲ级13髋,Ⅳ级20髋,修复后扁平髋和巨髋、大转子高位8髋。治疗后32例38髋LCPD得到随访,随访时间4-39（17.7±10.5）月,其中I级5髋变差,1髋痊愈;Ⅱ级2髋变差,2髋好转;Ⅲ级5髋变差,5髋好转;Ⅳ级3髋变差,15髋好转。结论：影像学检查对LCPD预后判断起重要作用,其中X线平片分期对本病的诊治有重要的指导意义,患者避免负重预后好。

1 引言 近年来,老年人消化系统疾病的发生率逐年增高.据统计发现,老年人消化系统疾病的发生率较中年人增高17%.而且老年人的胃肠病变多不典型、常易误诊,其治疗及预后也与中、青年人迥然不同[1,2].下面谈谈我们对老年人消化系统疾病的诊治体会.