中国实用医刊杂志   部级期刊

摘要：目的 观察健康人T波峰末间期(TpTe)及其离散度和心率校正的TpTe(TpTe/√RR)及其离散度,分析TpTe和心率的关系,为临床进行TpTe 的研究提供适用的正常对照值.方法 选取1012名健康体检者,其12导联心电图T波在Ⅱ、Ⅴ3、Ⅴ4和Ⅴ5导联直立,终末部清晰可辨.分别测量标Ⅱ、V3、V4和V5导联QT间期、QTP间期(自QRS波群起点至T波最高点的时间),计算TpTe(TpTe = QT间期 - QTP间期)和TpTe 离散度,TpTe /√RR及其离散度.相关分析探究TpTe与心率的关系.结果 ① TpTe 各导联总均值为(84±10)ms,95%可信区间为64.87~103.71 ms.标Ⅱ导联TpTe 最短为(82±10)ms,Ⅴ4、Ⅴ5导联TpTe 相等且最长为(85±10)ms,标Ⅱ导联与Ⅴ3导联及Ⅴ4、Ⅴ5导联比较差异均有统计学意义(q=7.98,P＜0.01;q=8.07,P＜ 0.01),而Ⅴ3导联与Ⅴ4、V5导联比较差异无统计学意义(q=0.09,P＞0.05).TpTe离散度为(4±7)ms,95%可信区间为10.49~17.92 ms.TpTe及其离散度各导联性别和年龄组间差异均无统计学意义(P＞0.05).②TpTe/√RR各导联总均值为(92±12)ms,95%可信区间为69.07~114.47 ms.标Ⅱ导联TpTe/√RR最短为(89±11)ms,Ⅴ4、Ⅴ5导联TpTe/√RR相等且最长为(93±11)ms,标Ⅱ导联与Ⅴ3导联及Ⅴ4、Ⅴ5导联比较差异均有统计学意义(q=7.70,P＜0.01;q=7.58,P＜0.01),而Ⅴ3导联与Ⅴ4、Ⅴ5导联比较差异无统计学意义(q=0.124,P＞0.05).TpTe/√RR离散度为(4±8)ms,95%可信区间为11.95~19.64 ms.TpTe/√RR及其离散度各导联性别和年龄组间差异均无统计学意义(P＞0.05).③ 随着心率从60~100次/min渐次增快,QT间期逐渐缩短,二者呈显著负相关(r=-0.599,P＜0.01),而TpTe却无明显变化,与心率无相关性(标Ⅱ导联:r=-0.102,P＞0.05;Ⅴ3导联:r=-0.077,P＞0.05; Ⅴ4 =Ⅴ5导联:r=-0.084,P＞0.05).结论①得到了健康人TpTe及其离散度和TpTe/√RR及其离散度的参考值;②在正常心率范围,TpTe不受心率快慢的影响,不必进行心率校正. Abstract： Objective To investigate

摘要：目的 探讨微创腔镜辅助下甲状腺切除术与传统开放甲状腺切除术在治疗效果方面的差异.方法 搜集自2008年8月至2010年8月年我院开展的腔镜辅助下甲状腺切除术与同期传统开放甲状腺切除术共计210例,其中腔镜辅助组98例,传统手术组112例.结果 腔镜辅助组切口长度(2.2±0.4) cm、术中出血量(13±7) ml、术后第1天引流量(19±10) ml、手术时间(105±43) min.传统手术组切口长度(5.60±1.0) cm、术中出血量(39±13) ml、术后第1天引流量(51±9) ml、手术时间(60±10) min.两组喉返神经麻痹各1例,无术后出血.结论 对于特定的甲状腺结节患者,腔镜辅助下甲状腺切除术是安全有效的.由于美容效果好、患者术后康复快,是甲状腺外科手术的发展方向. Abstract： Objective To compare the outcome of two groups between minimally invasive video-assisted thyroidectomy(MIVAT) and conventional thyroidectomy. Methods Two hundred and ten patients were enrolled in the study dated from August 2008 to August 2010, 98 patients treated with MIVAT and 112 patients treated with conventional thyroidectomy. Results Patients underwent MIVAT had a mean incision length of (2.2±0.4) cm, compared with (5.6±1.0) cm for conventional thyroidectomy. The mean surgical time for MIVAT was (105±43) minutes, and for conventional thyroidectomy was (60±10) minutes. The mean drainage of the first day after surgery was (19±10) ml in MIVAT group, and the other group was (51±9) ml. The mean intraoperative blood loss was lower in MIVAT group [(13±7) ml] than that in the conventional thyroidectomy group[(39±13) ml]. There was no difference in vocal cord paralysis or postoperative hematoma. Conclusions MIVAT is safe in selected thyroid nodule patients, and has been a new trend for thyroidectomy because of its cosmetic result and quickly recovering.

摘要：目的 探讨基层医院在蝶鞍区病变微侵袭外科治疗的可行性及最佳手术方式.方法 回顾性分析2003年7月至2009年5月收治的70例蝶鞍区病变患者的临床资料.其中垂体腺瘤56例,垂体转移癌1例,颅咽管瘤3例,鞍结节脑膜瘤2例,脊素瘤1例,空蝶鞍综合征3例,脑脊液鼻漏2例,视神经损伤2例.显微镜下经鼻一蝶入路,采取两种入路方式,手术29例,显微镜、鼻内窥镜联合应用经鼻、蝶入路手术15例,鼻内窥镜下采取两种入路方式手术26例.结果 56例垂体腺瘤全切27例,次全切24例,部分切除5例,垂体转移癌予以大部分切除,鞍结节脑膜瘤2例全切,脊索瘤1例次全切,颅咽管瘤3例部分切除,空蝶鞍综合征填塞术3例,2例术后视力改善明显,1例改善不明显,脑脊液漏2例均成功修补,视神经管减压1例效果良好,1例无效.结论 基层医院科室联合,技术、设备共享,可以在蝶鞍区病变微侵袭外科治疗方面取得突破;内镜下经鼻、蝶入路是处理鞍区病变的最佳手术方式,但不能取代显微外科手术,最大限度的利用各自的优点,在鞍区病变的治疗方面将发挥更大作用. Abstract： Objective To explore the feasibility and optimal operating methods of microinvasional surgery for the occupying lesions at sella region in matrical hospital. Methods to analyse 70 cases with lesion at sella region from 2003 to 2009, including 56 patients with pituitary adenoma, 1 with metastatic carcinoma, 3 with craniopharyngioma, 2 with meningioma, 1 with chordoblastoma, 3 with empty sella syndrome, 2 with cerebrospinal rhinorrhea, 2 with optic nerve decompression. Twenty-nine patients were managed by micro transnasal-sphenoidal approach, 15 by combined application of nasal endoscope and microscope, 26 by nasal endoscope. Results Of all 56 patients with pituitary adenoma, the tumors were totally removed in 27 cases and subtotally removed in 24 cases, partial removed in 5 cases. The tumor of the patient with metastatic car

摘要：目的 探讨重症支原体肺炎(MPP)患儿的临床特征、治疗方案和转归,以利早期识别重症支原体肺炎,并且把握治疗时机进行合理治疗.方法 对10例重症支原体肺炎患儿的临床资料进行回顾性分析,并进行随诊.结果 与轻症组相比,重症支原体肺炎患儿入院前发热天数、总发热天数明显增多,外周血白细胞总数及C-反应蛋白明显增高,血沉增快,IgM、IgE水平明显增高.10例重症支原体肺炎患儿中,急性期10例肺实变,6例合并中至大量胸腔积液,其中1例合并支原体脑炎.10例患儿治疗除应用抗生素外均加用糖皮质激素,疗效满意,恢复期2例患儿遗留闭塞性细支气管炎,1例遗留中枢神经系统后遗症.结论 对于临床上有上述表现的重症肺炎患儿应考虑到MPP的可能性,治疗上除应用大环内酯类抗生素外,可加用利福平、糖皮质激素治疗. Abstract： Objective To study the clinical characteristics, therapeutic regimen and outcome of severe mycoplasma pneumonia (MP) in children.Methods Clinical data of 10 children with severe mycoplasma pneumonia were retrospectively analyzed and followed-up.Results In severe MP cases, the fever duration prior to hospitalization and the total fever duration were more prolonged, peripheral blood leucocytes counts, C-reactive protein and erythrocyte sedimentation rate increased, and serum IgM and IgE levels increased as compared to mild MP cases. Of the 10 cases of severe MP, 10 manifested as pulmonary consolidation, 6 as pulmonary consolidation complicated with moderate to large pleural effusion and with 1 of them complicated with central nervous systen mycoplasma infection. Ten severe MP cases were administered with glucocorticoid as well as antibiotics, and the therapeutic effect was satisfactory. In the convalescence stage, 2 cases were complicated with bronchiditis obliterans.Conclusions Severe MP is characterized by rapid progression, pulmonary consolidation, moderate to severe pleural effusion, o

摘要：目的 探讨低位大骨瓣开颅术治疗额颞顶部广泛对冲伤的临床应用价值.方法 采用低位大骨瓣开颅术对46例额颞顶部广泛对冲伤患者进行手术治疗,术后3~6个月采用格拉斯哥预后分级标准进行临床疗效的评定,并对并发症进行分析.结果 46例中预后良好22例(47.83%),中度残疾6例(13.04%),重度残疾4例(8.7%),死亡14例(30.43%),术后主要并发症为迟发性颅内血肿、脑穿通畸形、脑积水、颅骨缺损综合征等.结论 低位大骨瓣开颅术是治疗额颞顶广泛对冲伤(尤其是单侧)的良好手术方式. Abstract： Objective To evaluate the value of low large trauma craniotomy in frontotemporal and parietal contrecoup craniocerebral injury. Methods Forty-six patients with frontotemporal and parietal contrecoup craniocerebral injury were treated by low large trauma craniotomy. Based on GCS, the clinical curative effect and complications of these patients during 3 to 6 months after operation were evaluated. Results Twenty-two cases (47.83%)recovered well, 6 cases(13.04%)suffered from moderate disability, 4 cases(8.7%) remained severe disability, and 14 cases (30.43%) died. The common comlications after operation were delayed intracranial hematoma, cerebral penetrating malformation, hydrocephalus, defect of skull syndrome and so on. Conclusions Low large trauma craniotomy is a good therapeutic method for frontotemporal and parietal contrecoup craniocerebral injury.

摘要：目的 观察双水平气道正压通气(BiPAP)呼吸机面/鼻罩正压通气治疗急性左心功能衰竭(简称左心衰)所致严重低氧血症的作用,评估其治疗急性左心衰所致低氧血症的临床疗效.方法 将80例急性左心衰伴严重低氧血症患者随机分为治疗组和对照组各40例,两组均给予强心、镇静、利尿、血管扩张药、解痉平喘等常规治疗,对照组加低浓度氧疗,治疗组加面罩BiPAP呼吸机治疗,观察两组临床症状、体征、血气分析变化.结果 治疗组患者临床症状、体征、血气等明显改善,显效率为80.0%,总有效率为95.0%;对照组显效率为47.5%,总有效率为75.0%,两组显效率比较差异有统计学意义(P＜0.05).结论 及早使用双水平呼吸道正压通气结合抗心力衰竭药物治疗急性重度左心衰对心功能改善有明显疗效,能及时有效地改善患者症状及低氧血症,缩短急性左心衰病程,是一种快速、安全、有效的抢救方法. Abstract： Objective To observe the effect of facial mask /nasal mask positive pressure ventilation with BiPAP ventilator on serious hypoxemia due to acute left heart failure(ALHF) and heart function and to discuss the curative effect. Methods Eighty cases of serious hypoxemia due to ALHF were randomly divided into comparison group and treatment group. The two groups were both given the conventional treatment such as cardiac, sedation, diuretics, the vasodilatation medicine, antispasmodic and antiasthmatic. The comparison group was in addition added the low concentration oxygen treatment, and the treatment group received face mask BiPAP ventilator treatment. Clinical symptoms, signs, blood gas analysis and adverse reactions were observed. Results In the treatment group, the clinical symptoms,signs and blood gas were much improved,the marked effective rate was 80.0%,the total effective rate was 95.0%;In the control group,the marked effective rate was 47.5%, the total effective rate was 75.0%. There was significant differ

摘要：目的 探讨青年急性进展型脑梗死患者进展与治疗前后血中D-二聚体(D-D)、高敏 C-反应蛋白(hs-CRP)含量变化与脑梗死发展的关系.方法 选择急性脑梗死 A 组(未发生进展)30例、B组(发生进展)20例和正常对照组50例分别测定其hs-CRP、D-D进展及治疗前后含量并加以分析.结果 青年急性进展型脑梗死组D-D和 hs-CRP含量明显高于对照组和非进展型脑梗死组(P＜0.01); D-D和 hs-CRP含量经统计学处理呈正相关(r=0.64,P＜0.01);而且脑梗死在治疗和有效控制后D-D和 hs-CRP含量明显下降(P＜0.01).结论 血中D-D和 hs-CRP与青年急性进展型脑梗死的发生、发展及预后有密切关系,可作为评估的指标之一,对于脑梗死的进展预测和干预处理有一定临床价值. Abstract： Objective To study the correlation between the levels of D-Dimer(D-D),high sensitive C-reactive protein(hs-CRP) in serum of the young patients with acute progressive cerebral infarction before and after the proceeding and treatment. Methods Levels of hs-CRP, D-D were detected respectively in serum of the 20 young patients with acute progressive cerebral infarction, the 30 young patients with acute non- progressive cerebral infarction and 50 healthy people sampled as control group and correlation were analysed before and after the proceeding and treatment. Results Compared with healthy person and young patients with non-progressive cerebral infarction, the levels of D-D and hs-CRP in serum of young patients with progressive cerebral infarction were significantly higher (P＜0.01). The level of D-D was positively correlated with that of hs-CRP,The levels of D-D and hs-CRP in serum of patients with cerebral infarction were significantly lower than before after having been treated and intervented effectively. Conclusions The levels of D-D,hs-CRP are closely related to the existence and development of the young patients with cerebral infarction. The levels of D-D and hs-CRP can be used as one of the assessment

摘要：目的 了解基层计划生育服务人员对宫内节育器(IUD)失败原因的认识,探讨导致IUD失败的主要影响因素,并提出预防策略.方法 采用定性研究的方法对县、乡计划生育技术服务人员进行小组集中访谈,对访谈资料进行转录、编码、分类、汇总和分析.结果 大多数技术服务人员认为脱落、移位、出血、疼痛等不良反应问题是导致IUD使用失败的直接原因;其次是操作不规范、不能知情选择、放环过早等原因;还有部分人员认为服务对象的传统观念、恐惧心理也是导致失败的原因之一.结论 积极开展学历教育和业务练兵活动,提高技术服务人员的技术水平和服务能力;加强术前咨询、宣教和随访,提高IUD的续用率,减少失败率;加大对IUD新产品的开发力度,推广新产品和新技术. Abstract： Objective To study the view of grassroots service of family planning departments on the failure of intrauterine contraceptive device, and to explore the main influencing factors of induced failure about IUD, and to give suggestions on prevention strategies. Methods Stratified sampling was adopted in this study, and quality study method (focus group discussion) was conducted to investigate grassroots service of family planning departments in three counties of Henan province. Results Most grassroots service personnel think that the direct reason of failure of IUD among women was the adverse reaction, such as expulsion, bleeding, pain, et al. The second reason were non-standard operation, non-informed choice, advanced place IUD, et al. Furthermore, some family planning technical service personnel think that traditional values and fearing were the major reasons of failure of IUD. Conclusions We should employ the qualified service staffs and give them the necessary training, and try to upgrade their skills and service; Intensify preoperative consultation, publicity and education and postoperative follow-up, improve sustaining rates of IUD and reduced

摘要：目的 评价欧普乐喉罩自主通气吸入七氟烷与气管插管麻醉在乳腺癌改良根治术中的应用效果.方法 选择60例行乳腺癌改良根治术的患者,随机分为气管内插管组(E组)和置入喉罩组(L组)各30例.麻醉诱导:E组依次静脉注射咪达唑仑0.05 mg/kg、异丙酚1.5 mg/kg、维库溴铵0.1 mg/kg以及瑞芬太尼1.5 μg/kg,下颌松弛后进行气管插管.L组应用循环呼吸回路诱导,使回路内充满7%七氟烷气体,吸入7%～8%的七氟烷,并向输液器莫非式滴管内加入瑞芬太尼1.5 μg/kg,下颌稍松弛后置入喉罩.麻醉维持:E组静脉常规给药,L组以吸入七氟烷为主.观察并记录围麻醉期各时点的血流动力学变化、呼气末二氧化碳分压(PETCO2)、脑电双频指数(BIS)和麻醉恢复期不良反应情况.每组随机选择10例患者于不同时点采集静脉血检测血浆肾上腺素(E)、去甲肾上腺素(NE)浓度.结果 两组患者心率(HR)、收缩压(SBP)、舒张压(DBP)和血浆E、NE的浓度在诱导前比较差异无统计学意义(P＞0.05),E组在气管插管和拔出气管导管时HR、SBP、DBP和血浆E、NE的浓度与诱导前及L组比较差异有统计学意义(P＜0.05),L组各时点HR、SBP、DBP和血浆E、NE的浓度比较差异无统计学意义(P＞0.05).麻醉恢复期不良反应E组躁动、呛咳、声音嘶哑与L组比较差异有统计学意义(P＜0.05).结论 欧普乐喉罩自主通气吸入七氟烷应用于乳腺癌改良根治术中麻醉效果确切,苏醒迅速安全,比气管插管麻醉应激反应轻,并发症少. Abstract： Objective To compare the application of laryngeal mask self-ventilation and endotracheal intubation inhalation of sevoflurane anesthesia in modified radical mastectomy. Methods Sixty cases of breast cancer under general anesthesia were randomly divided into endotracheal intubation group (E group) and LMA group (L group), 30 cases of each group. Induction of anesthesia: E group followed by intravenous injection of midazolam 0.05 m

摘要：目的 观测缺血性脑卒中颅外段颈动脉狭窄的发生率及粥样硬化斑块性质;了解患者牛津郡社区卒中项目(OCSP)分型与颅外段颈动脉病变之间的关系.方法 纳入并登记2008年1月至2009年12月郑州大学第一附属医院神经内科连续入院的缺血性脑卒中患者,行颈部双功能彩色多普勒超声检查,观测患者的颈动脉狭窄程度及粥样斑块性质.结果 符合标准的缺血性脑卒中患者854例,其中675例(79%)患者进行了颈动脉彩超检查,OCSP各亚型构成比如下:部分前循环梗死占32.7%,腔隙性脑梗死占26.1%,完全前循环梗死占23.0%,后循环梗死占18.2%.颅外段颈动脉狭窄215例(31.9%),其中颈动脉狭窄≥50%包括颈动脉闭塞在内共93例(13.8%).在386例(57.2%)患者中共检出515个粥样硬化斑块,其中不稳定斑块占51.0%,发生部位以颈动脉分叉处最常见,占61.5%(317/515).OCSP亚型间比较,重度颈动脉狭窄患者中,部分前循环梗死发生率最高(14.5%),中度颈动脉狭窄患者中,完全前循环梗死发生率最高(22.6%),且不稳定斑块的检出率最高(P＜0.05).结论 缺血性脑卒中患者颈动脉病变常见,OCSP分型可能与颈动脉病变有相关性. Abstract： Objective To observe the incidence of extracranial carotid artery stenosis and plaque nature,and to understand the relationship between Oxfordshire community stroke project (OCSP) classification and extracranial carotid artery in ischemic stroke. Methods From Jan. 2008 to Dec. 2009 in department of neurology of the first affiliated hospital of Zhengzhou university, the consecutive patients with ischemic stroke admitted to hospital were registered, and by neck color Doppler ultrasound the degree of carotid stenosis and the characteristics of atherosclerotic plaque were recorded.Results Eight hundred and fifty-four cases of ischemic stroke were registered in two years, of which 675 cases (79%) underwent carotid ultrasonography examination. The proportion of ischemic stroke subtyp

摘要：目的 探讨男性患者无痛膀胱镜检查中脑电双频指数(BIS)监测在指导麻醉深度、减少麻醉并发症方面的意义.方法 将80例ASA分级Ⅰ～Ⅱ级门诊行膀胱镜检查的男性患者随机分为BIS组(Ⅰ组)和对照组(Ⅱ组),每组40例.静脉给予芬太尼1 μg/kg、丙泊酚0.5 mg/kg负荷量后,丙泊酚的维持量Ⅰ组根据BIS监测调节使BIS维持在40~60之间,Ⅱ组根据临床体征调节.比较膀胱镜检查时间、丙泊酚用量、术中反应及苏醒时间等.结果 两组患者麻醉前平均动脉压(MAP)、心率、脉搏血氧饱和度、BIS比较差异均无统计学意义(P＞0.05).MAP在麻醉诱导入睡后两组均有下降,但Ⅰ组降幅小于Ⅱ组(P＜0.05).Ⅰ组丙泊酚用量明显少于Ⅱ组,苏醒时间I组明显短于Ⅱ组(P＜0.05),术中不良反应发生率I组明显少于Ⅱ组(P＜0.05).结论 男性患者无痛膀胱镜检查中BIS监测可较好的控制麻醉深度,减少麻醉并发症的发生. Abstract： Objective To observe the application of bispectral (BIS) index monitoring in male patients in checking of painless cystoscopy under propofol intravenous anesthesia and to investigate the feasibility of BIS on guilding the anesthetic depth. Methods Eighty ASA Ⅰ-Ⅱ male patients undergoing selective cystoscopy check with propofol-fentanyl anesthesia were randomly divided into two groups: BIS group (groupⅠ,n=40) and control group (group Ⅱ,n=40). Anesthesia was induced with fentanyl 1 μg/kg and propofol 0.5 mg/kg. In groupⅠ, propofol infusion was adjusted to achieve a target BIS of 40-60. In group Ⅱ, propofol dose was adjusted according to the standard clinical signs. The amount of propofol, intraoperative responses and recovery parameters were recorded. Results MAP, HR, SpO2 and BIS of all the patients were not signifisantly different before anesthesia. The amount of propofol used and time of recovery were significantly less in group Ⅰ than that in group Ⅱ(P＜0.05). A MAP decrease of two groups was found duri

摘要：目的 探讨镇静剂(咪达唑仑)和肌松剂(维库溴铵)联合氧驱动雾化吸入布地奈德治疗儿童重症哮喘的临床疗效及对患儿肺功能的影响.方法 将86例重症哮喘患儿随机分为两组,观察组45例,采用咪达唑仑与维库溴铵联合氧驱动雾化吸入布地奈德治疗;对照组41例,单独采用布地奈德治疗.结果 观察组的总有效率明显高于对照组,两组比较差异有统计学意义(P＜0.05).观察组咳嗽消失、喘息消失及哮鸣音消失时间均明显短于对照组,差异均有统计学意义(P＜0.05).对照组治疗后第1秒用力呼气量(FEV1)、第1秒用力呼气量占用力肺活量的百分比(FEV1%)与治疗前比较差异无统计学意义(P＞0.05).观察组治疗后FEV1、FEV1都较治疗前明显升高,差异有统计学意义(P＜0.05);并且观察组FEV1、FEV1%都较对照组升高明显,差异有统计学意义(P＜0.05).结论 咪达唑仑、维库溴铵联合氧驱动雾化吸入布地奈德治疗哮喘的疗效显著,肺功能状态改善明显,不良反应少,是治疗儿童重症哮喘的有效方法. Abstract： Objective To discuss the clinical effect of midazolam,vearonium,vecuronium combined oxygen-driren buaesonide inhalation in treating the children with severe asthma and the influence to lung function of the children.Methods The 86 cases of the children with severe asthma were divided into observation group(n=45) and control group (n=41). The obserration group was treated by midazolm,vecuronicum combined oxygen-driren budesoniae of midazolam,control group was treated by budesonide individually. Results The total effective of observation group was higher than that of the control group (P＜0.05). The disappearance of cough,asthma and wheeze was shortter than control group (P＜0.05). There was no significant difference in the FEV1 and FEV1% of control group between before and after treatment (P＞0.05). After treatment,the FEV1 and FEV1% in the treatment group was higher than before treatment and that of c

摘要：目的 观察瑞舒伐他汀对急性脑梗死患者疗效及脑梗死体积变化的影响.方法 将100例急性脑梗死患者随机分为观察组52例和对照组48例,对照组患者入院后均给予常规治疗方法,观察组在对照组治疗的基础上加服瑞舒伐他汀20 mg/d.两组均连续治疗30 d.检测两组患者神经功能缺损程度评分和脑梗死灶体积.结果 治疗后观察组梗死灶体积显著低于治疗前及对照组(P均＜0.05);观察组患者神经功能缺损程度评分低于对照组(P＜0.01),Barthel指数高于对照组(P＜0.01);观察组总有效率显著高于对照组(P＜0.05).瑞舒伐他汀不良反应轻微.结论 瑞舒伐他汀能加速脑梗死患者神经功能的恢复,可缩小脑梗死体积,有保护神经的作用. Abstract： Objective To observe the effect of rosuvastatin on efficacy and volume changes of cerebral infarction in patients with acute cerebral infarction. Methods One hundred patients with acute cerebral infarction were randomly divided into observe group (52 cases) and control group (48 cases). The control group were given conventional treatment after admission, the observe group were given rosuvastatin(20 mg/day) treatment on the basis of conventional treatment.Both groups were treated for 30 days. Neurological deficit scores and infarct volumes of two groups were recorded. Results After treatment, the infarct volume of the observe group was significantly lower than before treatment and the control group(P all＜0.05),the neurologic impairment score of the observe group was lower than the control group(P＜0.01),the Barthel index of the observe group was higher than the control group(P＜0.01),the total effective rate of the observe group was significantly higher than the control group (P＜0.05). The side effects of rosuvast were minor. Conclusions Rosuvastatin can accelerate the recovery of neurological function in patients with cerebral infarction, can reduce infarct size and has the effect of nerve protection.

摘要：目的 探讨初开展电视胸腔镜下周围型肺癌切除和淋巴结清扫的方法及体会.方法 完全在胸腔镜下行解剖性肺叶切除和淋巴结清扫治疗周围型肺癌21例,其中右肺上叶9例,中叶1例、下叶2例,左肺上叶4例、下叶5例.结果 手术均顺利,每例切除淋巴结6~15枚,平均8~10枚.无手术相关死亡及严重并发症随访3~6月,无肿瘤转移和复发.结论 胸腔镜肺叶切除治疗周围型肺癌安全可行,掌握好手术适应证,临床可以开展. Abstract： Objective To explore the beginning of video-assisted thoracoscopic resection of peripheral lung cancer and lymph node dissection methods and experience. Methods Twenty-one cases of VATS anatomic pulmonary lobectomy and lymph node dissection for treatment of peripheral lung cancer, of which the right lung upper lobe of 9 cases, the mid-1 case, lower lobe 2 cases, left lung upper lobe 4 cases, lower lobe 5 cases. Results The operation was successful, removal of lymph nodes 6 to 15 per case, with an average of 8 to 10. There was no operative death or severe complications. Follow-up 3 to 6 months, no tumor metastasis or recurrence. Conclusions Thoracoscopic lung resection for peripheral lung cancer is feasible and safe, master surgical indications and it could be carried out clinically.

摘要：目的 探讨窒息新生儿血清胱抑素C(Cys C)水平的变化及临床意义.方法 对临床确诊的62例不同程度窒息新生儿和对照组25例无窒息新生儿进行血清Cys C、尿素(Urea)和肌酐(Cr)检测,并进行比较分析.结果 窒息新生儿血清Cys C、Urea及Cr的含量高于对照组(P＜0.05),其中重度窒息组的上述指标含量高于轻度窒息组(P＜0.05),提示窒息程度越重、肾功能受损程度越严重,血清Cys C能更早反映窒息新生儿的肾功能损伤.结论 新生儿窒息缺氧可导致肾功能损伤,而血清Cys C可作为判断肾功能受损较敏感的指标.