目的:调查县级医院中毒患者的临床特征及救治情况。方法:回顾性分析2015年4月至2019年4月江苏省人民医院溧阳分院中毒住院患者的资料。结果:共有480例急性中毒病例，农药（51.67%）和药物（28.75%）是最常见的毒物种类，以有机磷农药和镇静安眠类药物居多。自杀是最常见的原因（80.00%），90.00%为经口摄入中毒，77.65%的经口摄入中毒予以洗胃、3.23%予以催吐。42例行机械通气治疗，5例行血液净化治疗，5例行心肺复苏治疗。根据预后将患者分为治愈组、死亡组和自动出院组，其构成比分别为69.17%、1.67%和29.17%。结论:农药中毒的发生率最高，经口摄入是最常见的中毒途径，中毒的原因以自杀最为多见，洗胃、催吐、拮抗剂、机械通气等治疗已被常规开展。

Objective To explore the correlation of leukotriene pathway genetic polymorphism and ischemic stroke susceptibility. Methods We enrolled 690 in-hospital patients with ischemic stroke and 690 counterparts without ischemic stroke from First Affiliated Hospital of Nanjing Medical University between January 2009 and January 2011.Polymorphisms of ALOX5 rs2029253 A/G,LTA4H rs6538697 T/C and LTC4S rs730012 A/C were genotyped via polymerase chain reaction and restriction fragment length polymorphism(PCR-RFLP) assay.Multivariate Logistic regression model was employed to determine the correlation between leukotriene pathway polymorphisms and the risk factors of ischemic stroke. Results Carriers of C allele in rs730012 were more susceptible to ischemic stroke(OR=1.37,95%CI 1.08～1.73,P=0.009).The rs2029253 GG genotype showed a reduced risk(OR=0.72,95%CI 0.55～0.93,P=0.013) while the rs6538697 CC genotype was associated with increased risk of ischemic stroke(OR=1.77,95%CI 1.09～2.89,P=0.022).The rs730012 variant,after adjusting for confounding factors,was not associated with altered risk of ischemic stroke(P>0.05). Conclusion Leukotriene pathway polymorphisms may impact on the incidence of ischemic stroke and is featured by independent genetic effects.

Objective To evaluate the clinical efficacy of interventional embolization with microcoils for emergency treatment of ruptured intracranial aneurysm.Methods Sixteen patients with ruptured intracranial aneurysms were treated with interventional embolization within 3 days after onset. One wide-neck aneurysm was embolized with stent-assistant technique.Results Intraarterial embolization was successfully performed in all cases. The occlusion was complete in 10 aneurysms, nearly complete in 3 and partially in 3. Intraoperative aneurysmal rupture occurred in 1 patient with anterior communicating artery aneurysm, which was embolized immediately. Forteen patients rehabilitated without disability remained, one with mild extremity disability and another one was dead.Conclusion Emergency intraarterial embolization of ruptured intracranial aneurysm with microcoils is safe and effective, which can effectively protect the patients from aneurysm rupture again.

Objective The suture methods for the establishment of rat model of focal cerebral ischemia/reperfusion is used widely,but problems such as model unstability,low achievement ratio always exist.The Objective of this study is to improve the methods for getting successful of middle cerebral artery occlusion(MCAO) model.Methods Some newer methods were employed to overcome some drawbacks in traditional methods: 1) continuous laser doppler fluid meter was employed to monitor local cerebral blood flow;2) which was reduced to 15% of baseline; 3) the opposite common carotid artery was clamped;4) silicone rubber coated monofilament was selected to reduce the risk of vessel injury and intracranial bleeding.Results As soon as the filament got into the suitable position,the local cerebral blood flow would decreased sharply to 30% or less of baseline,but rarely to 15% of baseline.When the opposite common carotid artery was clamped simultaneously,the local cerebral blood flow would reduced to 15% or less of baseline.Monofilament of 0.35 mm diameter,5 mm coated with silicone rubber coated was more reliable than those we once used,because it had smooth,soft,and flexible tip,which could reduce the risk of vessel injury and intracranial bleeding.The model was produced success in 44 of 50 rats,achievement ratio was 88%.Conclusion The cerebral blood flow reduction to 15% or less of baseline is a key factor in suture methods for rat model of focal cerebral ischemia/reperfusion.Silicone-rubber coated monofilament is more reliable in the experiment.

Objective To study the differentiating diagnosis value of rapid measurement of brain natriuretic peptide(BNP) in aged patients with acute dyspnea. Methods BNP was measured with immunofluorescence assay in 60 aged patients with acute dyspnea.Left ventricular ejection fraction was determined by echocardiography. Results The BNP level in patients with dyspnea caused by heart failure was significantly higher than that of non-heart failure patients, and with heart failure,the level of BNP increased accordingly. Conclusions BNP assay was a convenient and sensitive method for differentiating diagnosis in patients with dyspnea.

尼卡地平是第二代二氢吡啶类钙拮抗剂,其静脉制剂在国外已用于治疗高血压急症,具有起效快、疗效高、降压平稳、副作用轻等优点.1998年1月至1998年10月,我们使用静脉滴注尼卡地平治疗24例高血压急症,观察其临床疗效及短期不良反应,现报告如下.