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Results:50 patients with lesions associated with anterior descending artery was 35,and the right coronary artery 19,circumflex 10.26 patients with single-vessel disease,18 patients with double-vessel disease,and three lesions 6,the survival rate of PCI is 98%.we follow up from 6 to 40 months after surgery,Chest pain occurred again in 7 patients, 3 patients performed PCI, and 1 case had stent obstruction,1 case died of AMI.

结果:50例病变相关动脉为前降支35处,右冠状动脉19处,回旋支10处。单支病变26例,双支病变18例,三支病变6例;PCI成功率98%;术后随访6~40个月,7例再次出现胸痛发作,3例患者行PCI术,其中1例为原有支架闭塞;急性心肌梗死死亡1例,为心肌梗死后心功能衰竭。

Among them, 20 patients were candidates of valve replacement and 18 PDA and pericarditis had their blood samples taken before operation,and 1,2,24 and 48 hours after closure of thorax for measurement of concentrations of CK、CK-MB and TnT,together with ECG recording. Results Of the 60 patients, concentrations of cTnT before operation were normal; 2 hours after aortic unclamping, the correlation coefficient between cTnT and aortic clamping was r = 0.873( P<0.01), the regression analysis showed Y = 0. 019X-0. 026. Of the 20 patients, ECG showed the myocardium was ischemic; CK、CK-MB and cTnT all rose significantly, reaching the peak after closure of thorax. Of the 18 patients, the ECG and cTnT before operation and after closure of thorax were normal; except 2 patients with pericarditis.

结果 60例瓣膜手术患者术前cTnT均在正常值范围内,主动脉开放后2 h时,阻断时间和cTnT的相关系数为r=0.875(P<0.01),回归方程为Y=0.019X-0.026;其中20例瓣膜手术患者心脏经过阻断后,心电图有缺血性改变,周围血液中的CK、CK-MB和cTnT均有明显升高,分别在关胸后2 h达到高峰,数值分别为术前的12.6、9.2和257倍;18例行动脉导管结扎和心包剥脱术的患者术前和关胸后的心电图和血液中的cTnT均正常,CK和CK-MB除2例心包炎患者关胸后出现明显变化外,余均未见改变。

Doctors then begin information gathering by using open-ended questions to elicit comprehensive information from patients. While listening to patients, doctors should maintain an open-minded and impartial attitude of listening by giving neutral feedback or continuer, such as "m-hng" which encourages patients to continue their narrations, in response to information provided by patients. If patients agendas are not revealed at this stage, doctors may also try specific open-ended questions for clarifying agendas, such as What do you think causes your problems?

在第四议题我们提出四个洞察病人求医动机的步骤与方式:透过一开始的寒暄问暖,提供病人「语言暖身」的机会,建立与病人的信任关系使其卸下心防;在主诉阶段透过「开放式问句」询问病人之适;在聆听叙述时,可透过「中性回应词」(例如「嗯哼」、「然后」),以保持中立且不打断的聆听态度并取得病人就医问题全貌;若上述步骤未能导出动机,则可视情况以开放式问句询问病人,例如「汝感觉是什麽原因予汝这呢难苦钦?

Of these patients, 67,924 had a creatinine level of less than 2.0 mg per deciliter. Cardiac troponin I was measured in 61,379 patients, and cardiac troponin T in 7880 patients (both proteins were measured in 1335 patients). Overall, 4240 patients (6.2%) were positive for troponin.

在这些患者中67924例患者肌酐小于2.0mg/L.61379例患者接受了心肌肌钙蛋白I检查,7880例患者接受心肌肌钙蛋白T检查(1335例患者接受了两种蛋白检查)。4240例(6.2%)患者肌钙蛋白阳性。

Among 275 patients who underwent partial laryngectomy, 126 patients totally restored their swallowing protection, phonation and respiration, 128 patients basically recovered their pronouncing and language communication function, 15 patients pronounced very hoarse, however they could contact by the whispered voice in a short distance and telephone, although 125 patients manifest wrong deglutition to different level, their swallowing protection basically recovered after swallowing education.

本组275例喉部分切除手术有126例(45.82%)病人喉的吞咽保护、发音和呼吸功能全部恢复,128例(48.00%)基本恢复了发音、语言交流功能,15例声音重度沙哑,近距离耳语或通过电话尚能进行语言交流。125例(45.45%)术后出现不同程度的误吸,其中116例经过吞咽训练后基本恢复了正常吞咽功能,9例误吸较重者经训练后在特殊体位下亦基本恢复了正常吞咽功能,未出现因严重误吸导致吸入性肺炎或行胃造瘘和气、食管分离手术者。

We reviewed all skin lesions in all HIV patients diagnosed in our department between 1990 and 1998 to document the spectrum of skin manifestations, the frequency of each disorder, and their relationship with CD4 counts. A total of 64 HIV patients were studied, including 38 with acquired immunodeficiency syndrome CD4 200 x 10(6 cells/L and 26 who had not developed AIDS. There were 142 episodes of skin conditions representing 25 different skin diseases, including oral candidiasis (15% in non-AIDS vs 71% in AIDS patients), drug eruptions, herpes simplex, seborrheic dermatitis, dermatophytosis, herpes zoster, secondary syphilis, condyloma acuminatum, Kaposi's sarcoma (16% among AIDS patients), hairy leukoplakia, and molluscum contagiosum (13% among AIDS patients), in decreasing order.

我们回顾自 1990 年到 1998 年人类免疫不全病毒感染患者在本院皮肤科的诊断,归纳整理各种皮肤疾病发生的机率及与 CD4 数值间的关系。64 位人类免疫不全病毒感染患者,包括 38 位爱滋病患者(CD4 200 x 10(6) cells/L)及 26 位非爱滋病患者,共有 142 种皮肤症状,分属於 25 种不同种类的皮肤疾病,依发生率的高低,包括口腔的白色念珠菌感染(非爱滋病患者:15%;爱滋病患者:71%)、药物疹、单纯疹、脂漏性皮肤炎、皮癣菌感染、带状疱疹、二期梅毒、尖圭湿疣、卡波西氏肉瘤(爱滋病患者:16%)、毛状黏膜白斑、传染性软疣(爱滋病患者:13%);并针对较特殊的病例做一介绍,如疣状的单纯疱疹病毒感染、临床表现像尖圭湿疣的传染性软疣感染及与爱滋病相关的色素性红皮症。

There were 36 males and 40 females,with the average age of 47.7 years.36 patients presented with sciatica and perineal numbness,11 patients had painless mass and the other 20 were identified due to other causes.Among 67 benign neurogenic tumors,54 were originated from S1-S3 nerves,3 from S4-S5 nerves and 11 from the presacral space without caudal involvement.Giant cell tumor was found in 60 patients,which included 24 males and 36 females,with an average age of 32 years.Upper sacrum(S1-S2) was involved firstly.There were 56 patients(average,37.7 years) diagnosed as other primary benign bone tumors,which included 24 cases of teratomas,epidermoid cyst or dermoid cyst.Other malignant tumors,including chondrosarcoma (17),Ewing′s sarcoma/PNET(14),multiple myeloma(12),lymphoma(6) and osteosarcoma(6) were found in 64 patients.

其中脊索瘤95例,男62例,女33例,平均年龄55.7岁,骶尾区疼痛是主要症状(82例),半数以上患者伴有坐骨神经痛,肿瘤多先累及低位骶骨(S3~S5);神经源性肿瘤76例,男36例,女40例,平均年龄47.7岁,神经纤维瘤43例,神经鞘瘤24例,恶性神经鞘瘤9例,主诉多为坐骨神经痛、会阴部麻木(36例)和无痛性包块(11例),20例患者为查体或其他原因检查时发现,67例骶骨良性神经源性肿瘤起源于S3以上神经者54例,起源于S3以下神经者3例,发生于骶前未累及骶管者10例;骨巨细胞瘤60例,男24例,女36例,平均年龄32岁,腰骶尾部不适(37例)、坐骨神经痛(21例)是主要的临床表现,肿瘤多先累及上位骶骨(S1~S2);骶骨其他原发良性肿瘤及瘤样病变56例,包括畸胎瘤、皮样囊肿、表皮样囊肿共24例;其他原发恶性肿瘤64例,包括软骨肉瘤17例,尤文肉瘤14例,多发性骨髓瘤12例,成骨肉瘤6例等。

ResultsEffective rate of chemotherapy was 86.6% which was associated with clinical stage and histology. Eight-four patients received radical hysterectomy. The histological grade of 17 patients was lowered, lymph nodes in 19 patients were positive, and 6 patients had parametrium invasion. One patient died within 1 year after the operation, and 5 patients recurred.

结果:新辅助化疗的近期有效率为86.6%;与疗效有关的因素为临床分期和病理类型;新辅助化疗后84例患者可以手术,术后病理降级的有17例,术后淋巴结阳性者19例,宫旁浸润者6例;随访中1例患者术后1年内死亡,5例复发,余患者均健在。

To date,it has been documented after transfusion of unirradiated blood components to at least 87 patients:in patients with severe combined immunodeficiency,thymic hypoplasia,and Wiskott Aldrich syndrome premature newborns and those with erythroblastosis fetalis; patients with hematologic malignancies including Hodgkin\'s and non-Hodgkin\'s lymphomas,acute myelocytic and lymphoblastic leukemias,chronic lymphocytic leukemia,and aplastic patients with solid tumors including neuroblastomas, glioblastoma,rhabdomyosarcoma,cervical carcinoma,small cell lung cancer,and germ cell tumor;patients after cardiac surgery and cholecystectomp-60;and in an apparently healthy 22-year-old woman.

目前为止,输注未辐照血液成分后,至少引起了87例TA-GVHD的发生,主要见于以下病人:严重的免疫缺陷病人、胸腺发育不全、Wiskott Aldrich综合症、早产儿、胎儿红细胞增多症、何杰金与非何杰金氏淋巴瘤等恶性血液病人、急性粒细胞性和淋巴细胞性白血病、慢性淋巴细胞性白血病、成神经细胞瘤等实体瘤病人、横纹肌赘瘤、宫劲癌、小细胞肺癌、微细胞瘤、心脏和胆囊手术病人。

Twenty - three patients underwent ictus therapy of corticosteroids for (8±4) days. The extenuation time of corticosteroid' dosage was (33 ±26) mg /d. Of the 40 patients, 36 were IgG positive with an average A value of (0.91±0. 24) and 4 patients were IgG negative. Twelve patients ( 30%) were with type I avascular necrosis of femoral head, including 3 cases with unilateral left - necrosis and 9 cases of bilateral necrosis. The other 28 patients were without necrosis.

结果全疗程使用的糖皮质激素总量平均为4949 mg±2959 mg,糖皮质激素应用天数平均为24 d±5 d,其应用天数主要集中在16-30 d,使用冲击疗法的病例有23例,其持续天数平均为8 d±4 d,减药速度平均为33 mg/d±26 mg/d.40例患者中,血清抗体IgG测定阴性4例,阳性36例,其吸光度值平均为0.91±0.24。

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