中国实用医刊杂志   部级期刊

摘要：目的 探讨贲门癌高、低发区幽门螺杆菌(Hp)感染与贲门癌变的关系.方法 于贲门癌高、低发区分别选择262例贲门癌患者取外周全血,利用胃Hp检测试条检测Hp感染情况并进行分析.结果 贲门癌高、低发区贲门癌患者Hp感染率分别为49%、48%.高、低发区贲门癌患者Hp感染率男女分别为64%、36%和92%、8%,两者比较差异均有统计学意义(P均＜0.05),高、低发区贲门癌患者Hp感染率随年龄增长均明显增高(P＜0.05),50～70岁为发病高峰年龄;高发区贲门癌家族史阳性患者Hp感染率明显高于低发区贲门癌家族史阳性患者,低发区贲门癌家族史阳性患者Hp感染率明显低于贲门癌家族史阴性患者Hp感染率(P＜0.05).结论 Hp感染可能与贲门癌的发生、发展有一定关系,Hp感染率高的人群贲门癌易感性较低. Abstract： Objective To further elucidate the possible relationship between infection of Helicobacter pylori(Hp)and gastric cardia carcinogenesis on the subjects from HIA and LIA for GCC.Methods Helicobacter pylori Kit were undertaken to determine the expression of Hp in gastric cardia carcinogenesis.Two hundred and sixty -two surgical resected GCA specimens were selected randomly from the hospital(161 from the HIA, 101 from the LIA).Results The ratio of Hp infection of the gastric - cardia adenocarcinoma was 49% and 48% in high and low - incidence areas for gastric cardia carcinogenesis (P ＞ 0.05).However, in high and low - incidence area, the rate of Hp infectiion of GCA in male was higher than in females and the older was higher than the young.The ratio of Hp infection of FH(+)in high - incidence area was apparently higher than that in the low - incidence area.However, in the LIA,the rate of Hp infection of FH(+)was apparently higher than the Hp infection of FH(-), P ＜ 0.05.Conclusions The affectability of GCA of Hp infection is low.Hp infection is correlated with the carcinogenesis and development of cardiac cancer in high and low - incid

摘要：目的 初步比较胎盘、脐血和外周血来源的造血干细胞的免疫原性.方法 应用单向混合淋巴细胞培养的方法将胎盘、脐血和外周血三种来源单个核细胞的增殖情况进行比较.结果 单向混合淋巴细胞培养中胎盘、脐血和外周血来源的细胞的增殖比较差异有统计学意义(P＜0.01).结论 胎盘较脐血和外周血来源的造血干细胞的免疫原性低,更适合用于异基因造血干细胞移植. Abstract： Objective To compare phenotypic characteristics and immunog- genicity of hematopoietic stem cell(HSC)from placenta(PT), from cord blood(CB)and from peripheral blood(PB).Methods Comparing cell proliferation of PT, CB and PB using mixed - lymphocyte reactions(MLR).Results There was a difference in proliferation of PT, CB and PB(P ＜ 0.01).Conclusions Immunogenicity of HSC from PT are lower than that what from CB and PB.HSC of PT are more suitful for transplant of allogen hematopoietic stem cell.

摘要：目的 探讨最佳的补钙方法以预防外周血造血干细胞(PBSC)采集中的枸橼酸盐中毒(CI).方法 对141例自体患者或异体供者进行了166例次的PBSC采集,按补钙方法不同将患/供者随机分为三组,即口服组(66例次):采集中每小时服1次10%葡萄糖注射液20 ml+10%葡萄糖酸钙20 ml,整个过程口服3～4次;静注组(52例次):采集中每小时静脉缓慢注射1次10%葡萄糖注射液20 ml+10%葡萄糖酸钙10 ml,整个采集过程应用3～4次;静滴组(50例次):采集中静脉持续滴注10%葡萄糖注射液350 ml+10%葡萄糖酸钙30 ml,速度为25～30滴/min,出现CI症状时稍加快滴速.采集中密切观察并记录CI发生情况.结果 口服组CI发生率为28.1%,其中轻度12例次,中度6例次,无重度中毒者,出现CI的平均时间为开始采集后122 min;静注组CI的发生率为18.2%,其中轻度7例次,中度1例次,无重度中毒者,出现CI的平均时间为开始采集后134 min;静滴组CI的发生率为10.0%,均为轻度中毒者,出现CI的平均时间为开始采集后172 min.三组间的CI发生率(χ2=6.612,P＜0.05)及CI程度(χ2=7.290,P＜0.05)的分布比较差异均有统计学意义,其中以静滴组CI的发生率最低、程度最轻,而CI发生时间差异无统计学意义(χ2=1.427,P＞0.05).结论 静脉滴注葡萄糖酸钙是预防造血干细胞采集中枸橼酸盐中毒的最佳方法,其疗效佳和安全性好,值得临床推广应用. Abstract： Objective To study the best method of calcium supplementation for preventing citrate intoxication(CI)during peripheral blood stem cell(PBSC)harvesting.Methods According to the different methods of administration of calcium gluconate, 166 procedures of PBSC harvesting in 141 patients/donors were randomly divided into three groups - group oral administration, group intravenous injection and group intravenous drip.In group oral administration(n = 66), 10% calcium gluconate 20 ml in 10% GS 20 ml was administrated by oral one time per hour during harvesting.When

摘要：目的 探讨治疗前后混合性结缔组织病外周T细胞亚群改变及共刺激分子的表达.方法 流式细胞仪检测初诊混合结缔组织患者及治疗后患者外周血T细胞表面标志CD3/CD4/CD8及CD28/CD152在外周血T淋巴细胞上的表达水平.结果 与初治组相比,共刺激分子CD28在CD4+T和CD8+T淋巴细胞上的表达均有明显降低(P＜0.05),CD152在CD4+T淋巴细胞上的表达有明显降低(P＜0.05),而CD152在CD8+T淋巴细胞上的表达增加(P＜0.05).结论 混合性结缔组织病患者T淋巴细胞亚群及共刺激分子异常表达可能与免疫功能紊乱及疾病发生发展有关. Abstract： Objective To investigate the changes of expression of costimulatory molecule on peripheral blood lymphocyte subpopulations inpreliminary -diagnosis and post- treatment patients with mixed connetive tissue disease.Methods The expression of costimulators CD28 /CD152 and marks of lymphocyte cell CD3/CD4/CD8 on lymphocyte subsets in inpreliminary -diagnosis and post -treatment patients with mixed connetive tissue disease was deter mined by flow cytometry.Results The CD28 expressed on CD4 + T and CD8 + T cells were significantly decreased(P ＜ 0.05)in post - treatment patients.The CD152expressed on CD8 +T cell was significantly decreased(P ＜ 0.05)in post- treatment patients,while CD152 expressed on CD8 +T was signifantly increased(P ＜ 0.05).Conclusions The changes of expression of costimulatory molecule on peripheral blood lymphocytes may play an important role in immune dysfunction of MCTD patients.

摘要：目的 采用超声检查评价脑梗死患者颈动脉粥样硬化斑块稳定性及分布状况.方法 对100例脑梗死患者和20例健康体检者行颈动脉彩色多普勒超声检查,根据超声检查结果将检出颈动脉粥样硬化斑块的患者分为稳定斑块组和易损斑块组.观察脑梗死患者颈动脉粥样硬化斑块的发生率,分析脑梗死与不同颈动脉斑块的关系.结果 100例脑梗死患者中有78例检出颈动脉粥样硬化斑块,其中41例检出易损斑块.20例老年健康体检者中有9例检出颈动脉粥样硬化斑块,其中3例为多发斑,6例为双侧斑.超声检查对脑梗死患者颈动脉粥样硬化斑块的检出率明显高于对照组(P＜0.01).结论 彩色多普勒超声检查能无创评价脑梗死患者颈动脉粥样硬化斑块的稳定性,从而有助于判断脑梗死患者缺血发生机制和评价危险因素,在高危人群筛查、指导药物和手术治疗方面有着广阔的应用前景. Abstract： Objective To evaluate state of carotid atherosclerotic plaques stability and distribution in patients with cerebral infarction by color Doppler ultrasonography.Methods Carotid artery color Doppler ultrasonography was performed in 100 patients and 20 normal control subjects.The patients with carotid atherosclerotic plaques were divided into either stable -plaques and unstable -plaques groups according to the results of ultrasonography.The incidence of carotid atherosclerotic plaques was observed in patients with cerebral infarction.The relashionship between cerebral infarction and carotid atherosclerotic plaques with stable or unstable was analyzed.Results Seventy - eight cases in the 100 patients with cerebral infarction were detected carotid atherosclerotic plaques(78%), of this patients, 41 cases were unstable- plaques.Nine cases in the 20 normal control subjects were detected carotid atherosclerotic plaques.The detectable rate of carotid atherosclerotic plaques in cerebral infarction was significantly higher than that in con

摘要：目的 探讨神经梅毒患者的临床表现、实验室检查、影像学特征、诊断、治疗及预后.方法 对我院2000年至2009年诊治的37例神经梅毒患者的临床资料进行回顾性分析.结果 本组37例患者中,脑血管型神经梅毒16例,麻痹性痴呆13例,脊髓梅毒3例,脑膜型神经梅毒2例,无症状神经梅毒2例,树胶肿型神经梅毒1例.血清快速血浆反应素(RPR)试验、梅毒螺旋体血凝试验(TPHA)试验均阳性.脑脊液(CSF)的RPR试验阳性率为67.6%,TPHA试验阳性率为100%;脑脊液检查蛋白增高阳性率为64.9%,细胞数增高阳性率为54.1%.结论 神经梅毒患者的临床表现复杂,诊断应结合临床表现、实验室及影像学检查综合分析,脑脊液检查是关键,应争取早期诊断、早期治疗以改善预后.同时应从公共卫生的的理念上去规划和实施梅毒的预防和治疗,以降低神经梅毒的发病率. Abstract： Objective To investigate the clinical manifestations, laboratory tests, imaging features,diagnosis, treatment and prognosis of neurosyphilis.Methods The 37 cases of patients with neurosyphilis admitted in our hospital from 2000 to 2009 were analyzed retrospectively.Results Among the 37cases, the cerebral vascular neurosyphilis in 16 cases, paralytic dementia in 13 cases, spinal cord syphilis in 3 cases, meningeal neural syphilis in 2 cases, asymptomatic neurosyphilis in 2 cases, gumma type in 1case.Serum rapid plasma reagin(RPR)test and treponema pallidum hemagglutination assay(TPHA)test were all positive.the positive rate of cerebrospinal fluid(CSF)the RPR was 67.6%, the TPHA was 100% ,the cerebrospinal fluid examination revealed CSF protein increase was 64.9% and cell number elevation was 54.1%.Conclusions Because of theclinical manifestations of neurosyphilis are complex, the diagnosis should be comprehensive analysis, according to the clinical characteristics, laboratory and imaging features,the cerebrospinal fluid examination is the key.It is should be strived for early dia

摘要：目的 改良急性重度有机磷农药中毒(AOPP)的治疗方法.方法 将我院2005年1月至2008年12月收治的48例重度AOPP患者随机分为两组,对照组按常规洗胃、阿托品、复能剂、保肝、利尿治疗,观察组在此基础上加用树脂罐血液灌流(HP)治疗,并在围术期应用中药生大黄导泻排毒及输注新鲜冰冻血浆,分别对神志恢复时间、阿托品总用量、胆碱酯酶复活时间、胆碱酯酶(ChE)恢复达50%的时间,并发症(农药中毒反跳、中间综合征、多脏器损害、多脏器衰竭、迟发性神经损害)发生率和治愈率、病死率进行监测.结果 观察组较对照组阿托品用量少(t=4.35,P＜0.01),意识恢复快(t=3.61,P＜0.01),ChE恢复50%的时间快(t=2.94,P＜0.01),治愈率高(96.0%vs65.2%,χ2=5.57,P＜0.05＝,病死率低(4.0%vs 34.8%,χ2=5.57,P＜0.05).结论 HP治疗并在围术期应用中药生大黄导泻排毒及输注新鲜冰冻血浆的方法能迅速清除体内毒物,减少并发症,提高急性重度AOPP的治愈率. Abstract： Objective To improve the treatment of acute severe organophosphorus pesticide poisoning(AOPP).Methods The 48 cases of severe AOPP patients were randomly divided into two groups, control group(n = 23)according to conventional gastric lavage, atropine, rehabilitation can be agents, liver,diuretic treatment, the observation group in this basis can increase resin hemoperfusion treatment and application in perioperative medicine detoxification catharsis rhubarb and fresh frozen plasma infusion.Results The observation group with less atropine than in control group(t =4.35, P ＜0.01), awareness and rapid recovery(t =3.61, P ＜0.01), ChE time to restore 50% faster(t =2.94, P ＜ 0.01), a high cure rate (96.0% vs 65.2% , χ2 =5.57, P ＜ 0.05＝, low mortality(4.0% vs 34.8%, χ2 =5.57, P ＜0.05).Conclusions This therapy method can poison the body quickly cleared to reduce the complications of severe acute AOPP,and to improve cure rate.

摘要：目的 观察重组人血小板生成素(rhTPO)治疗慢性难治性特发性血小板减少性紫癜(ITP)的临床疗效及不良反应.方法 24例慢性难治性ITP患者皮下注射rhTPO 300 IU/(kg·d),疗程14 d或血小板＞100×109/L后停药.结果 24例患者rhTPO治疗后,显效12例,有效5例,用药前血小板平均值为(10±5)×109/L,治疗后血小板计数的升高的最高值为(129±97)×109/L,与用药前比较差异有统计学意义(t=5.822,P＜0.01).多数患者对药物耐受良好.结论 rhTPO治疗慢性难治性ITP具有良好的疗效,不良反应轻微. Abstract： Objective To observe the efficacy and toxicity of recombinant human thrombopoietin (rhTPO)in the treatment of chronic refractory idiopathic thrombocytopenic purpura(ITP).Methods Twenty- four patients with chronic ITP were administered with rhTPO subcutaneously at 300 IU/(kg · d)for 14 days or until the platelet count ＞ 100 × 109/L.Results Out of 24 patients with ITP, 12 cases showed significant response and 5 cases showed good response to the treatment with rhTPO.The peak platelet count after treatment was(129 ± 97)× 109/L, significantly higher than the mean platelet count [(10 ±5)× 109/L]before treatment(t = 5.822, P ＜0.01).The agent was well tolerated in most patients.Conclusions rhTPO exerts satisfactory efficacy in the treatment of chronic ITP with mild side effects.

摘要：目的 探讨增生性糖尿病视网膜病变(PDR)中组织型纤溶酶原激活物(t-PA)及纤溶酶原激活物抑制剂(PAI)的表达及其与血管内皮生长因子(VEGF)表达的相关性.方法 在玻璃体手术中采集PDR 35眼玻璃体,同时采集因黄斑裂孔行玻璃体手术20眼玻璃体作为对照组,采用酶联免疫吸附法检测t-PA和PAI的表达浓度,并与VEGF的表达进行相关性分析.结果 PDR眼玻璃体中VEGF、t-PA及PAI的表达浓度与对照眼玻璃体中的表达浓度比较差异有统计学意义(P＜0.01).t-PA及PAI的表达与VEGF的表达经统计学分析,差异有统计学意义(P＜0.01).结论 在PDR眼内视网膜新生血管的发生过程中不但有VEGF,还可能同时有多种生物活性物质的参与. Abstract： Objective To evaluate the correlation between the expression of tissue plasminogen activator(t -PA)and plasminogen activator inhibitor(PAI)with vascular endothelial growth factor (VEGF)expression in proliferative diabetic retinopathy(PDR).Methods Vitreous samples were taken from 35 eyes with PDR and analyzed with enzyme linked immunosorbent assay(ELISA)for the expression of VEGF, t - PA and PAI.Control samples were from 20 eyes with idiopathic macular hole and analyzed in the same way.The correlation between VEGF expression and the expression of t - PA and PAI in proliferative diabetic retinopathy were studied.Results VEGF, t - PA and PAI were significantly expressed as compared with those in control subjects(P ＜0.01).The expression of t- PA and PAI were highly correlated with that of VEGF in proliferative diabetic retinopathy(P ＜ 0.01).Conclusions It is suggest that a number of bioactive substances may be involved in the pathogenesis of angiogenesis in PDR.The expression of t - PA may beupregulated by the activation of VEGF, which may further facilitate the process of angiogenesis in PDR.Meanwhile, the correlated expression of PAI may suggest the presence of an endogenous angiogenesis mechanism accompanying the activities of VEGF.

摘要：目的 观察喉罩与面罩对无抽搐电休克治疗患者的呼吸功能及血流动力学的影响.方法 将60例需行无抽搐电休克治疗的患者随机分为喉罩组和面罩组,在麻醉前(T0)、麻醉后(T1)、应用喉罩/面罩前(T2)、应用喉罩/面罩后(T3)、通电即刻(T4)、通电后(T5)、去除喉罩/面罩后(T6)记录血氧饱和度(SpO2)、心率(HR)、收缩压(SBP)、舒张压(DBP)四项指标,并计算心率与收缩压的乘积估计心肌的耗氧(HR×SBP).结果 两组比较,SpO2差异无统计学意义(P＞0.05),HR、SBP、DBP、SBP×HR在T3时喉罩组显著高于面罩组(P＜0.05),T0、T1、T2、T4、T5、T6时差异无统计学意义(P＞0.05).结论 两种通气方法都可以安全用于无抽搐电休克治疗,面罩更易操作且血流动力学稳定,喉罩应用在稍长时间的控制通气麻醉更合适. Abstract： Objective To observe the effects of laryngeal mask and face mask on respiratary function and hemodynamics of patients under going modified electroconvulsive therapy(MECT).Methods Sixty patients undergoing MECT were randomly divided into laryngeal mask and face mask group,SpO2, HR, SBP and DBP were recorded and cross product of HR and SBP was computed to estimate myocardial oxygen consumption(HR × SBP)at preanesthesia(T0), postanesthesia(T1), pre - laryngeal mask/face mask(T2)usage, post - laryngeal mask/face mask(T3)usage, electrifing at once(T4), post -electrifing(T5)and removing of laryngeal mask/face mask(T6).Results There was no significant difference in SpO2 between the two groups(P ＞ 0.05); HR, SBP, DBP and HR × SBP were significantly higher in the laryngeal group than that in the face mask group at T3(P ＜ 0.05), but there were no significant differences at T0, T1, T2, T4, T5 and T6(P ＞ 0.05).Conclusions Both ventilation approaches can be used in MECT securely,face mask is operated more easily and have more stable hemodynamics,but laryngeal mask is more suitable for anesthesia needing slightly long- playing controlled ventilation.

摘要：目的 探讨成人喉乳头状瘤恶变的临床特征、病理特点及远期治疗效果.方法 对62例成人喉乳头状瘤患者手术前后的临床及病理资料进行分析.结果 62例成人喉乳头状瘤中发生恶变17例,其中术前经1次病理检查确诊者5例(29.4%),经2～7次病理检查确诊8例(47.1%),术后确诊4例(23.5%);其早期病理特征是部分区域恶变,而其他部位还保持着喉乳头状瘤的特点.其中声门型14例(T1N0M06例,T2N0M05例,T3N0M0 2例,T3N1M0 1例),声门上型3例(T4N0M01例,T4N1M02例).行全喉切除术4例,喉部分切除术13例,术后1年内全部拔管,拔管率100%.3年、5年生存率分别为88.2%(15/17)、76.5%(13/17).结论 必要时反复活检是术前确诊成人喉乳头状瘤恶变的重要方法,彻底的手术切除是其治疗的重要手段. Abstract： Objective To explore the malignant change of laryngeal papilloma in adults, especially its pathological figures, clinical characters and long -term results.Methods Analysis was made for the pre - and post - operated clinical and pathological dates of 62 laryngeal papilloma cases.Results Malignant changes had been found in 17 cases.Among these cases, 5 were diagnosed after 1 biopsy, 8were diagnosed after 2 up to 7 biopsies, 4 were diagnosed after surgeon.It was the character of earlier pathological changes that there were malignant changes in part areas, whereas normal papilloma in the other areas of the laryngeal neoplasm.There were 14 of 17 cases whose malignant changes were in glottis (T1N0M0 6 cases, T2N0M0 5 cases, T3N0M0 2 cases, T3N1M0 1 case).Malignant changes of the other 3cases were in supraglottic area(T4N0M0 1 case, T4N1M0 2 cases).Total laryngectomy was performed for 4 cases, and partial laryngectomy was selected for other 13 cases.The decannulation rate was 100% after 1 - year' s follow - up.The overall 3 - years and 5 - years survival rates were 88.2%(15/17)and 76.5%(13/17)respectively.Conclusions It is important to repeat biopsies if necessary to avoid fail to rep

摘要：目的 观察短期应用阿托伐他汀对高血压病患者左室舒张功能及C反应蛋白(CRP)的影响.方法 选择高血压病患者87例,分为阿托伐他汀组(49例)及对照组(38例).对照组给予常规降压药物治疗,治疗组在常规治疗基础上加用阿托伐他汀.测定治疗前后二尖瓣舒张早期峰值流速(E)及减速时间(DT)、舒张晚期峰值流速(A)、舒张早期与舒张晚期峰值流速之比(E/A)、等容舒张时间(IVRT)、低密度脂蛋白胆固醇(LDL-C)、总胆固醇(TC)及CRP的水平.结果 治疗12周后治疗组与治疗前比较差异有统计学意义(P＜0.05),E峰增高,A峰降低,E/A比值增加,IVRT缩短,DT缩短(P＜0.05),与对照组比较差异均有统计学意义(P＜0.05).治疗组CRP、LDL-C、TC水平较治疗前显著降低(P＜0.05),与对照组比较差异有统计学意义(P＜0.05).治疗前后治疗组TC、LDL-C水平与E/A均无相关性(P＞0.05).结论 短期应用阿托伐他汀可降低高血压病患者CRP水平,改善左室舒张功能. Abstract： Objective To observe the effects of atorvastatin on C - reactive protein and left ventricular diastolic function in patients with essential hypertension.Methods Eighty - seven patients with essential hypertension were randomly divided into two groups, including control group and atorvastatin group.The control group was treated with normal therapy, whereas atorvastatin group was treated with normal therapy and atorvastatin.The early filling velocity of the E wave, peak A wave velocity, E/A ratio, isovolumic relaxation time(IVRT), DT, LDL - C, TC and CRP were observed before and after treatment.Results Compared with the control group, peak E wave velocity of atorvastatin group was increased,peak A wave velocity decreased, E/A ratio increased, IVRT and DT shortened, the level of LDL -C ,TC and CRP decreased(P ＜0.05).Before and after treatment of atorvastatin group there was no correlationship between the level of LDL - C, TC and CRP and E/A.Conclusions Short - term application of

摘要：目的 建立豚鼠形觉剥夺性近视眼(FDM)动物模型,观察视网膜中褪黑素和诱导型一氧化氮合酶(iNOS)在FDM中的变化及作用.方法 将出生7 d的30只豚鼠用半透明眼罩遮盖右眼,左眼作为对照,遮盖8周,然后检影验光检测双眼屈光度,A超测量双眼眼轴长度;免疫组化法分析褪黑素和iNOS的表达.结果 形觉剥夺使眼轴增长,近视屈光度增加,视网膜中褪黑素免疫活性降低而iNOS的活性增加(P＜0.05).结论 褪黑素和iNOS可能参与调控FDM的形成,褪黑素和iNOS之间呈负相关,也可能同时受其他因子的调控. Abstract： Objective Using a guinea pig model to explore the effects of retinal melatonin and iNOS on FDM.Methods Thirty guineas 7 day - old, their right eyes were worn with monocular translucent goggles for 8 weeks, the left eyes were contral eyes.The axial length was measured with A - mode ultrasound, and retino -scopic refraction was performed.Melatonin and iNOS was analysed with immunohistochemistry.Results The axial length of occluded eyes were significantly longer than control eyes (P ＜ 0.05).Form -deprivation eyes were significantly more myopia than control eyes(P ＜ 0.05).Form - deprivation reduced the immunostaining of melatonin, increased the immunostaining of iNOS.Conclusions Melatonin and iNOS may be involved in the positive regulation in FDM.The similar expression of melatonin and iNOS implied some interaction between the melatonin and iNOS, probably other factors also involve in the regulation procedure in FDM.

摘要：目的 探讨新生儿化脓性脑膜炎(以下简称化脑)的早期诊断和治疗方法.方法 回顾性分析2004年5月至2008年6月我们收治的新生儿化脓性脑膜炎31例患儿的临床资料,总结早期诊治的经验.结果 新生儿化脑早期表现不典型,中枢神经系统表现缺乏特异性,惊厥多为微小型,早期诊断困难.本组治愈21例,约占67.7%,3例死亡患儿发病至就诊时间均超过48 h,其中2例出生体重＜2500 g;存活者11例合并神经系统并发症,约占42.3%.结论 新生儿化脑病死率和致残率较高,早发现、早诊断、积极治疗为改善预后之关键,临床应动态观察、及时脑脊液检查并全面分析,重视治疗中的影像学检查,以便早期发现并发症. Abstract： Objective To investigate the methods of early diagnosis and treatment in neonatal purulent meningitis.Methods clinical datas of 31 cases with neonatal purulent meningitis were collected and analyzed retrospectively from May 2004 to June 2008.Results Early clinical manifestation was atypical in neonatal purulent meningitis.Manifestation of central nervous system defected specificity.The convulsion was mainly D form.It was difficult to make early diagnosis.Twenty -one cases were cured,accounting for 67.7%.It spent more than 24 hours from onset to visit doctor in 3 death cases.The weight were ＜ 2500 g in 2 of 3 death cases.Complication in nervous system was found in 11 survivals,accounting for 42.3%.Conclusions The mortality and disability rate are very high in neonatal purulent meningitis.Early find, diagnosis and active treatment are key factors to improve the prognosis.

摘要：目的 探讨鼻咽癌的误诊、误治原因,从中吸取经验教训,减少误诊,提高诊断符合率.方法 对16例鼻咽癌误诊患者的临床资料进行综合分析,并讨论其误诊原因及防范措施.结果 误诊时间2～10个月,确诊前就诊次数3～7次,误诊疾病主要有:颈部淋巴结炎及淋巴结核8例(50%),分泌性中耳炎5例(31.3%),血管神经性头痛1例(6.3%),鼻中隔偏曲1例(6.3%),腺样体残留1例(6.3%).误诊病例病理诊断主要为低分化癌12例(75%),未分化癌3例(18.8%).结论 该病误诊的主要原因为医源性误诊,占87.5%,其次为患者自误,占12.5%.因此,临床各科医师都应提高对鼻咽癌的认识,特别是耳鼻咽喉科医师,更应从中吸取经验教训,减少误诊,提高早期诊断率和治愈率. Abstract： Objective To study the causes of erroneous diagnosis of nasopharyngeal carcinoma, in order to decrease erroneous diagnosis,draw a lesson and improve diagnostic accurancy.Methods Statistical analysic on clinical material(16 cases)of erroneous diagnosis of nasopharyngeal carcinoma.Studying the cause of erroneous diagnosis and the methed of prevention.Results Time of erroneous diagnosis was 2 - 10 months.Times of erroneous diagnosis was 3 - 7.Diseases of erroneous diagnosis was:Cervical adenitis & cervical lymphoid tuberculin 8 cases(50%), secretory otitis media 5 cases(31.3%), angioneurotic headache 1 case(6.3%),deflection of nasal septum 1 case(6.3%),adenoid vegetation lasted 1 case(6.3%).Major erroneous diagnosis of clincopathological features ,hypodifferentiated carcinoma 12 cases(75%),undifferentiated carcinoma,3 cases(18.8%).Conclusions The first cause of erroneous diagnosis is from doctors(87.5%),the second is mistaked by patients(18.5%).So we ought to enhance recognition for it in order to decrease erroneous diagnosis,draw a lesson and improve diagnostic accurancy and cure rate.