肾综合征出血热胸部并发症的CT 表现

目的:总结肾综合征出血热(EHF)胸部并发症的CT表现和探讨胸部CT表现对肾综合征出血热的诊断价值。方法:分析60例经HFRS-IgM阳性确诊的HFRS的胸部螺旋CT表现,其中轻型5例、中型20例、重型28例、危重型7例。结果:肺部感染22例,肺水肿12例,胸腔积液41例,心包积液17例,其中,心包积液合并肺水肿者4例,肺部感染并胸腔积液者4例,胸腔积液合并下肺局部膨胀不全18例,胸部CT检查正常8例。结论:肾综合征出血热,胸部并发症发生几率较高,以胸腔积液及胸腔积液并下肺膨胀不全发生几率最高,HFRS的胸部CT表现对于临床有很好的治疗意义,早期CT检查可准确显示肾综合征出血热病人胸部改变的特征。     

268例难治性下呼吸道感染的细菌学分析

通过本组２６８ 例难治性呼吸道感染病人标本培养结果分析,阳性２４６ 例占９１．８ ％ ,有１５４ 例检出厌氧菌,占５７ ％ ,１０４ 例检出需氧菌,占３９ ％ ,混合感染１３３ 例,占５０ ％ 。试验结果证实,厌氧菌感染在难治性下呼吸道感染病例中占了很大比例,这一结果为难治性下呼吸道感染的治疗提供了有价值的参考数据。     

甘肃省麻疹监测系统报告病例的流行病学分析

目的分析甘肃省近年来麻疹报告发病特点,为实现消除麻疹目标措施的制定提供参考依据。方法对甘肃省2009—2010年疾病监测信息报告系统和麻疹监测系统报告的疑似麻疹病例进行分析。结果 2009—2010年报告麻疹病例1 463例,主要集中在15岁以下年龄组,占病例总数的74.16%,≥15岁病例占病例总数的25.91%。4～7月为发病的高峰季节。对15岁以下进行流行病学调查的病例分析,20.86%的病例未接种过麻疹类疫苗,32.71%的病例免疫史不详。对病例的接触史分析,在发病前7～21d有5.82%的病例明确接触过发热出疹性病人,有12.43%的病例曾去过医院。分离出麻疹病毒H1a基因型,对麻疹疫苗免疫和疫情的防控有指导意义。结论根据麻疹发病年龄构成及免疫史分析,个别地区常规免疫接种不足是造成麻疹发病的主要原因,同时要注意控制院内感染的发生。需要在提高麻疹疫苗常规免疫覆盖率的基础上,进一步深入和规范监测工作,提高监测调查质量。     

沭阳县2007年麻疹疫情流行病学分析及应对措施

了解沭阳县2007年1月至8月份麻疹流行病学特征,为制订消除麻疹策略提供依据。采用描述流行病学方法对法定传染病报告系统和麻疹监测系统资料进行分析。结果显示,沭阳县2007年1月至8月份共发生麻疹150例,其中≤8月龄、8月~15岁、15~19岁、≥20岁成人,分别占26.00%、44.66%、12.67%和16.67%;无免疫史、有1次免疫史、有2次免疫史和免疫史不详的病例分别占46.67%、10.67%、8.00%和34.66%。因此,适时在重点人群中强化麻疹免疫,是短期内迅速提高人群免疫水平,降低发病率乃至阻断麻疹病毒传播的有效手段。     

儿童意外吸入磷化铝中毒55例临床分析及文献

目的:分析儿童意外吸入磷化铝中毒的临床特点、治疗方法及死亡原因。方法:对本院儿科2014年5月～2018年8月收治的55例意外吸入磷化铝中毒患者进行回顾性分析,根据病情严重程度将其分为轻度(31例)和重度(14例),统计患儿的年龄、性别、发病季节、中毒吸入时间、中毒就诊时间、临床症状、实验室及心电图检查。结果:55例吸入磷化铝中毒患儿中,死亡10例,存活45例,死亡患者均为重度中毒者,死亡原因为循环衰竭。轻度中毒毒素吸入时间平均为25.1 h,中毒后平均就诊时间14.6 h;重度中毒毒素吸入时间平均为185.4 h,中毒后平均就诊时间38.5 h;临床表现为恶心呕吐55例(100%),头晕、面色苍白14例(25%),心悸16例(29%),呼吸衰竭14例(25%),严重的心律失常8例(14.5%),低血压、心源性休克10例(18%);心电图检查:室上性心动过速1例,室性心动过速4例,II度II型房室传导阻滞1例,窦性心律不齐5例,窦性心动过速26例;实验室检查中心肌酶升高19例(34.5%);肝功能异常12例(21.8%);肾功能异常6例(10.9%);代谢性酸中毒14例(25%)。治疗上主要为对症支持治疗。结论:儿童意外吸入磷化铝中毒以重度中毒病例死亡率高,多为循环衰竭所致,目前无特效解毒药物,早期诊断和早期综合性治疗尤为重要。     

乳腺浸润性导管癌96例影像诊断体会

目的：探讨全数字化乳腺摄影与彩色多普勒相结合对乳腺癌的诊断价值。方法：搜集经X线摄影及超声检查并经病理证实为乳腺浸润性导管癌的96例进行回顾性分析。结果：96例乳腺癌中,单发病灶83例,多发病灶13例。采用全数字化X线摄影单独诊断乳腺癌80例,诊断符合率83.33%,采用超声单独诊断乳腺癌87例,诊断符合率90.63%。结论：乳腺X线与超声相结合,诊断乳腺癌95例,诊断符合率99.06%,此二种检查综合诊断,可明显提高乳腺癌的诊断符合率,减少漏诊和误诊。     

自固化磷酸钙人工骨修复小儿局部骨缺损的临床应用

目的：研讨自固化磷酸钙人工骨（Calcium Phosphate Cement,CPC)填充修复小儿局部骨缺损的临床意义,方法：选用CPC修复小儿骨缺损18例,年龄最小8个月,最大12岁,平均8岁,骨缺损部位：肱骨9例,胫骨6例,胫骨3例,病因,单纯性骨囊肿8例,骨纤维异常增生症5例,动脉瘤样骨囊肿4例,嗜酸性肉芽肿1例,骨缺损大小,最大7cm,最小2cm,平均5cm,CPC填充方式：单纯粉末7例,粉末＋松质骨粒6例,粉末＋条形骨块5例。CPC初步固化时间,最短15分钟,最长30分钟,平均20分钟,随访时间：13－27个月,平均18．5个月。结果：全组18例应用CPC后未见明显局部和全身不良反应。手术前后血PH值钙磷代谢无异常改变。X线片显示：CPC与宿主骨接触紧密,无脱落,术后3个月出现降解,新生骨形成。结论：CPC安全无毒,使用方便,易塑形,生物相容性好,能在体内降解,可以替代自体骨材料在小儿局部骨缺损应用。     

A protein-RNA docking benchmark (II): extended set from experimental and homology modeling data

We present here an extended protein-RNA docking benchmark composed of 71 test cases in which the coordinates of the interacting protein and RNA molecules are available from experimental structures, plus an additional set of 35 cases in which at least one of the interacting subunits is modeled by homology. All cases in the experimental set have available unbound protein structure, and include five cases with available unbound RNA structure, four cases with a pseudo-unbound RNA structure, and 62 cases with the bound RNA form. The additional set of modeling cases comprises five unbound-model, eight model-unbound, 19 model-bound, and three model-model protein-RNA cases. The benchmark covers all major functional categories and contains cases with different degrees of difficulty for docking, as far as protein and RNA flexibility is concerned. The main objective of this benchmark is to foster the development of protein-RNA docking algorithms and to contribute to the better understanding and prediction of protein-RNA interactions. The benchmark is freely available at http://life.bsc.es/pid/protein-rna-benchmark.     

沭阳县2006-2009年急性弛缓性麻痹病例流行病学分析

为了进一步掌握沭阳县急性弛缓性麻痹(AFP)病例流行特征,从而提高AFP病例的监测工作质量。根据AFP病例个案调查表进行统计分析。结果显示,沭阳县2006-2009年AFP病例监测系统共报告AFP患者28例,15岁以下儿童AFP病例年平均报告发病率为2.31/10万,其中0~4岁发病占67.86%,全程免疫占89.29%,地级医院报告病例占32.14%,AFP患者粪便标本采集率为100%。沭阳县AFP病例监测工作的各项监测指标完成情况较好,但存在薄弱环节,建议不断提高基层医务人员的AFP病例的识别能力和报告意识,消除薄弱环节,不断提高AFP监测工作质量。     

桡骨远端不稳定骨折的治疗策略

目的：探讨桡骨远端不稳定骨折的最佳治疗方案,以便能够获取更好的功能康复。方法：2007年1月-2011年12月共收治桡骨远端不稳定骨折51例,其中采用外支架撑开复位外固定5例,后路复位钢板内固定治疗23例,前路钢板固定17例,前后路联合固定6例,术后均早期进行关节功能锻炼。结果：51例均获得随访,X片提示均已骨性愈合。采用Gartland和Werley评分系统评估腕关节功能,其中外支架固定,优1例,良1例,中2例,差1例,优良率40％;后路固定,优12例,良6例,中3例,差2例,优良率78-3％;前路固定,优9例,良6例,中1例,差1例,优良率88．2％;前后路联合,优2例,良1例,中2例。差1例,优良率50％。结论：桡骨远端不稳定骨折正确的手术策略能够获得更好的功能恢复,其中前路手术固定效果优于后路固定。     

Expression of cytokeratin 20 in urine cytology smears: a potential marker for the detection of urothelial carcinoma

BACKGROUND: Urine cytomorphology is one of the oldest methods for screening and monitoring patients with transitional cell carcinoma (TCC). Sensitivity of urine cytology is relatively low. Ancillary techniques on urine sample may increase the sensitivity. AIM: To explore the utility of cytokeratin 20 (CK20) immunostaining in identifying malignant cells in urine cytology smears. MATERIALS AND METHODS: Fourteen cases each of confirmed TCC and benign urinary cytology along with five cases of atypical cells in urine were immunostained with a monoclonal CK20 antibody. Of 14 cases of TCC, 12 showed strong positive staining with the antibody. All benign cases were negative except for a few cases in which the umbrella cells were weakly to moderately positive. In all five cases of atypical urine cytology the atypical cells stained positive with the antibody. These cases were later confirmed as TCC on histopathology of bladder wall biopsy. CONCLUSION: CK20 is an important biomarker that can be used to identify TCC in urine cytology smears. It is particularly useful in those cases where malignancy cannot be confirmed by morphology alone.     

濮阳市2008—2012年手足口病流行病学特征分析

目的了解濮阳市手足口病流行病学特征,为制定防控策略提供科学依据。方法通过国家疾病监测信息管理系统收集的全市2008—2012年6月6日手足口病疫情资料进行描述和分析,并对部分病例和重症病例标本进行肠道病毒病原学检测。结果全市共报手足口病16 492例,发病高峰是每年的3-5月(第12～20周),呈典型的单峰型曲线;发病年龄以0～4岁居多;男性多于女性;散居儿童多于托幼机构儿童,爆发病例多发生在托幼机构,手足口病病原有EV71、CoxA16和其他肠道病毒,以EV71和CoxA16为主。结论手足口病发病有明显的季节性、年龄和性别差异,小年龄组儿童是手足口病预防控制重点人群,流行年度和流行季节的优势毒株为EV71,重症患者中EV71占到86.35%;非流行年和季节手足病例主要由CoxA16和其他肠道病毒引起。手足口病防控重点应体现在对病例分类管理上,同时应继续加强重症病例疫情监测和爆发控制。     

Malignant tumors of the stomach: apropos of 583 anatomo-clinical cases

A retrospective study interesting 582 anatomoclinical cases of gastric malignant tumors was realised in two anatomo-pathological services of Tunis from 1970 to 1985. The average age of patients is 55 years old, with extensive ranges from 17 to 85 years old. The authors point out significative male predominance 64.6% of cases. The ulcered form is the most frequent, about 3.8% of macroscopic aspect cases. Among these last, the authors find 26.7% of ulcerating and polypoid form with invasive characteristics, and 18.83% of linitis plastica. The pyloric area localisation is the most frequent, 68% of cases. Diffuse tumors are observed in 8.47% of cases and numerous stomach localisation in 0.82% of cases. 84% of histological aspect are represented by adenocarcinoma, the most frequent of them (35%) is well differentiated type, then the poorly differentiated (20%) and atypic form (19.75%). Frequency of lymphosarcoma reaches 14.7%, the first is the centroblastic form, then lymphoblastic and lymphoplasmocytic forms. Concerning evolution, gastric cancer is an infiltrative tumor: serosal surface is attempted in 69.5% of cases, and during the first chirurgical act half cases show lymph nodes metastasis.     

肾综合征出血热胸部并发症的CT表现

目的：总结肾综合征出血热（EHF）胸部并发症的CT表现和探讨胸部CT表现对肾综合征出血热的诊断价值。方法：分析60例经HFRS-IgM阳性确诊的HFRS的胸部螺旋cT表现,其中轻型5例、中型20例、重型28例、危重型7例。结果：肺部感染22例,肺水肿12例,胸腔积液4l例,心包积液17例,其中,心包积液合并肺水肿者4例,肺部感染并胸腔积液者4例,胸腔积液合并下肺局部膨胀不全18例,胸部CT检查正常8例。结论：肾综舍征出血热,胸部并发症发生几率较高,以胸腔积液及胸腔积液并下肺膨胀不全发生几率最高,HFRS的胸部CT表现对于临床有很好的治疗意义,早期CT检查可准确显示肾综合征出血热病人胸部改变的特征。     

紫杉醇联合解毒饮治疗头颈部恶性肿瘤的近期疗效观察

目的观察紫杉醇联合解毒饮对头颈部恶性肿瘤的近期疗效和毒副作用。方法选择51例头颈部恶性肿瘤患者选用紫杉醇与卡铂方案化疗,每4周重复用,共3~6周期,同时煎服解毒饮和静滴鱼腥草注射液。结果初治的19例患者中,CR 2例(10.5%),PR 6例(31.6%),RR为42.1%;复治的32例患者中,CR 2例(6.3%),PR 9例(28.1%),RR为34.4%;初治疗效优于复治。结论紫杉醇联合解毒饮对头颈部恶性肿瘤有较好的近期疗效,尤其对初治者效果更佳,而且毒副作用比较轻。     

深圳市2005—2012年脊髓灰质炎疫苗相关病例流行病学分析

目的了解深圳市脊髓灰质炎疫苗相关病例(VAPP)发生情况及流行病学特征,为消灭脊髓灰质炎后期脊灰疫苗免疫策略的研究提供基础数据。方法采用流行病学方法对深圳市2005—2012年残留麻痹急性弛缓性麻痹AFP病例个案资料、病原学检测结果、VAPP病例进行分析。结果 2005—2012年共报告残留麻痹病例55例,其中VAPP病例8例,占15.54%;深圳市VAPP病例均为小年龄组小于6月龄的儿童,总发生率0.20/10万,无接触者VAPP病例,其中首次服苗的VAPP发生率为0.51/10万;无明显的地区和时间分布聚集性。结论 VAPP的发生是接种脊髓灰质炎减毒活疫苗难以克服的弱点,为减少VAPP病例及防止脊灰疫苗衍生病毒的发生,应在消灭脊髓灰质炎后期科学、合理地调整消灭脊髓灰质炎的免疫策略。     

La thalassémie chez les Québécois francophones.

Eighty-five cases of beta-thalassemia minor were found between January 1975 and November 1977 in 18 families of French-speaking Quebeckers without Mediterranean ancestry. Most of the families had settled in Quebec more than 200 years ago, largely in Portneuf county. This is the first report of such a number of cases of beta-thalassemia in this population. Thus, beta-thalassemia minor is a relatively common condition in Quebec and must be considered in cases of microcytic anemia without evidence of iron deficiency. The hematologic findings were similar to those reported in the past in other populations. Two cases of delta beta-thalassemia minor (in sisters) are also reported; this is the first report of such cases in French Canadians.     

Morphological study on the human anterior cardiac veins, venae cordis anteriores.

The way in which the anterior cardiac veins end in the right atrium is very inconstant; separate opening is very rare and course and situation also changes a lot. We found the vein of Galen in about 90.59% of the cases and its ending differs from the usual. We found the anterior ventricular veins in about 91.45% of the cases; there is only one such vein in 57.00% of the cases, two in 33.64% and three in 9.34%; their origin and opening vary greatly. We saw the vein of Cruveilher in 68.37% of the cases, a lower percentage than that found by other authors. It also differs in its origin, course and opening. The vein of Zuckerkandl was found in 47.00% of the cases, lesser percentage than that found by other authors. The common canal is very important and very frequent in our cases. It opens into the right atrium by one orifice in 27.68% of the cases, by two in 63.93% and by three in 8.19%.     

毒蛇咬伤患者院前早期程序化急救处理方案的应用观察

目的探讨毒蛇咬伤患者院前早期程序化急救处理方案的应用价值。方法回顾性分析我院58例毒蛇咬伤患者应用院前早期程序化急救处理方案的临床资料。结果 58例毒蛇咬伤患者经院前早期程序化急救处理后,痊愈出院53例,好转3例,自动出院1例,院前死亡2例（眼镜王蛇咬伤1例,银环蛇咬伤1例）。结论院前急救是蛇伤治疗前期的一个关键性步骤,院前早期程序化急救处理方案应用于蛇伤患者,有利于提高抢救成功率。     

Preoperative aspiration cytology of breast tumors

During a ten-year period, 1,942 aspirations of 1,906 mammary tumors in 1,874 patients were performed before excisional biopsy or mastectomy. The cytology findings were categorized as positive (1,107 cases), suspicious (152 cases), atypical (183 cases), benign (166 cases) and unsatisfactory (298 cases). All cytologically positive cases with follow-up were confirmed histologically or by clinical observation. Follow-up showed that 96% of the cases in the suspicious category, 86% of the cases in the atypical category, 51% of the cases in the benign category and 72% of the cases in the unsatisfactory category had malignant neoplasms. Aspiration cytology diagnosed 1,031 of 1,539 primary malignant mammary neoplasms (67%) and 19 of 28 neoplasms (68%) metastatic to the breast; if unsatisfactory cases are excluded, these figures become 1,031 of 1,365 cases (75%) and 19 of 25 (76%), respectively. If those cases reported as suspicious are included with the positive cases and those reported as atypical are included with the negative cases, aspiration cytology would have a sensitivity of 84% for the presence of carcinoma, a specificity of 97% for the absence of carcinoma, a predictive value of 99% for a positive diagnosis and a predictive value of 56% for a negative diagnosis; the diagnostic efficiency would be 86%. Our findings reaffirmed that the cytologic diagnosis of mammary carcinomas is reliable but that negative or inconclusive cytologic findings should not be regarded as a definitive diagnosis if there is clinical suspicion of a malignant neoplasm.