目的 通过测定川崎病(KD)患儿血清1,25(OH)₂D₃水平,探讨其与冠脉损伤(CAL)之间的关系。方法 选取在我院儿科住院的KD患儿200例,依据是否发生CAL分成CAL组(172例)和非冠脉损伤组(NCAL,28 例),并分别检测静脉内丙种球蛋白(IVIG)注射前后血清1,25(OH)₂D₃水平。选取35例健康儿童作为对照组,检测其血清1,25(OH)₂D₃水平,并进行比较。结果 IVIG输注前:CAL组和NCAL组血清1,25(OH)₂D₃水平较对照组低下(P＜0.05),CAL组最低(P＜0.05);IVIG输注后:NCAL组血清1,25(OH)₂D₃水平与对照组相比,差异无统计学意义(P＞0.05),CAL组血清1,25(OH)₂D₃水平较NCAL组和对照组低(P＜0.05);IVIG输注前后比较:CAL组和NCAL组血清1,25(OH)₂D₃水平在IVIG输注后均较输注前升高(P<0.001)。结论 KD患儿血清1,25(OH)₂D₃水平低下,而且血清1.25(OH)₂D₃水平越低,出现CAL的几率越大。

Objective The serum level of 1,25(OH)₂D₃ was detected to investigate the its relationship with coronary artery lesion (CAL) in children with Kawasaki disease (KD).Methods A total of 200 children with KD in our hospital were divided into CAL group (172 cases) and no CAL group (NCAL,28 cases) according to the CAL situation.Serum 1,25(OH)₂D₃ level before and after intravenous immunoglobulin (IVIG) injection was detected respectively.While 35 healthy children were enrolled as control group, comparing with KD children.Results Before IVIG injection,the levels of 1,25(OH)₂D₃ in the CAL and NCAL groups were lower than that in the control group (P＜0.05),and which in the CAL group was the lowest (P＜0.05).After IVIG injection,the level of 1,25(OH)₂D₃ showed no significant difference between the NCAL group and the control group (P＞0.05),and the level of 1,25(OH)₂D₃ in CAL group was lower than that in the NCAL group and control group (P＜0.05).Serum 1,25(OH)₂D₃ level in both CAL and NCAL groups increased after IVIG injection compared with that before injection (P<0.001).Conclusions The serum 1,25(OH)₂D₃ level was low in children with KD,and the lower serum 1,25(OH)₂D₃ level,the higher the incidence of CAL.

目的 观察灵芝孢子粉对中重度慢性阻塞性肺疾病(COPD)稳定期患者肺功能、6分钟步行距离及T淋巴细胞亚群的影响。方法 选取稳定期中重度COPD门诊患者19例,服用灵芝孢子粉6个月后观察患者服药前后肺功能的变化及循环血液中CD4⁺、CD8⁺T淋巴细胞的比例变化,症状评分(CAT评分)以及对6 MWT的影响。结果 服用灵芝孢子粉6个月后,中重度COPD患者的六分钟步行距离延长,平均增加19 m(P＜0.01),患者的CAT评分也有改善(P＜0.01),患者肺功能与服药前相比有改善趋势,其中FEV₁较服用前平均增加60 mL(P>0.05),FVC平均增加为130 mL(P<0.01),FEV₁/FVC比例降低0.47(P>0.05);外周血CD4⁺T淋巴细胞比例增加(P<0.01),CD8⁺和CD4⁺/CD8⁺T淋巴细胞亚群比例未见明显变化(P＞0.05)。结论 服用灵芝孢子粉6个月后对肺功能无明显作用,但能改善中重度COPD患者的CAT症状评分,可能与升高CD4⁺T淋巴细胞比例有关。

Objective To observe the effects of Ganoderma lucidum spore powder on lung function, 6-minute walking distance and T lymphocyte subsets in patients with moderate to severe chronic obstructive pulmonary disease(COPD). Methods Nineteen patients with moderate-to-severe COPD outpatients in stable phase were enrolled. After taking Ganoderma lucidum spore powder for 6 months, the changes of lung function and the proportion of CD4⁺ and CD8⁺ T lymphocytes in circulating blood, the symptom score(CAT score) and impact on the 6 MWT were observed. Results After taking Ganoderma lucidum spore powder for 6 months, the six-minute walking distance of patients with moderate to severe COPD was prolonged, with an average increase of 19 meters(P<0.01). The patient's CAT score was also improved(P<0.01). There was an improvement trend in increasing average FEV1 by 60 mL(P>0.05), FVC increased to 130 mL(P<0.01) and the FEV1/FVC ratio decreased by 0.47(P>0.05). The proportion of CD4⁺ T lymphocytes in peripheral blood increased(P<0.01), and the proportion of CD8⁺ and CD4⁺/CD8⁺ T lymphocyte subsets did not reach the significance(P>0.05). Conclusion After taking Ganoderma lucidum spore powder for 6 months, it has no significant effect on lung function, but it may improve the CAT symptom score of patients with moderate to severe COPD, which may be related to the increase of CD4⁺ T lymphocyte ratio.

目的 分析高压氧治疗对面部填充术后血管并发症的疗效。方法 将62例面部填充剂注射后并发症患者根据高压氧介入时机分为A组和B组,A组在在常规治疗的基础上,48小时内进行高压氧治疗,B组在在常规治疗的基础上,48小时后进行高压氧治疗,在治疗结束后对两组患者进行疗效分析。结果 A组患者的治疗疗效较B组患者治疗疗效好,差异有统计学意义(P<0.05)。结论 高压氧治疗对面部填充剂注射后并发症疗效是肯定的,且高压氧介入时间越早效果越好。

Objective To analysie effect of hyperbaric oxygen therapy on vascular complications after facial filling. Methods 62 patients with complications after injection of facial filler according to the timing of hyperbaric oxygen intervention were divided into group A and group B.Group A was treated with hyperbaric oxygen within 48 hours on the basis of conventional treatment.Group B was treated with hyperbaric oxygen 48 hours later on the basis of conventional treatment to analysie the efficacy of the two groups of patients after the end of treatment. Results The efficacy of group A patients was better than that of group B, the difference was statistically significant P<0.05. Conclusion Hyperbaric oxygen therapy is effective in the treatment of complications after facial filler injection, and the earlier the hyperbaric oxygen intervention time is taken, the better the effect is.

目的 根据巨脑回畸形的病理特点,对比其它影像检查,研究该病的超声特点,探讨新生儿期巨脑回畸形的超声诊断价值。方法 对5例新生儿巨脑回畸形的患儿的超声资料进行分析。结果 5例超声检查均表现为大脑脑回明显宽大,脑沟、脑回稀少,皮层明显增厚,大脑表面光滑,且5例均伴有不同程度的其它颅脑畸形。结论 新生儿巨脑回畸形具有一定的超声特征,超声检查在新生儿巨脑回畸形的诊断中具有重要的价值。

目的 回顾性分析支气管肺泡细胞癌(bronchioloalveolar carcinoma,BAC)临床特点,提高早期BAC的确诊率,减少误诊。方法 对2013年—2014年间在我院确诊的BAC病例5例的临床资料进行回顾性分析。结果 5例患者中男4例,女1例,年龄在50～73岁之间,在社区医院均曾误诊为肺炎,所有患者均在我院经支气管镜肺活检后确诊为BAC。结论 BAC是一种较为特殊的肺癌,临床上症状无特异性,极易误诊为普通肺炎。由于BAC预后差,误诊后果严重,对初诊为普通肺炎的患者经常规抗感染治疗后临床症状及影像学表现改善不明显时,应及时进行各项检查、明确诊断,以便有效改善患者预后。

Objective To elevate the clinical diagnosis of BAC (bronchioloalveolar carcinoma) so as to reduce misdiagnosis by using retrospective analyses. Methods Retrospective analyses were used to study the five BAC patients, who were diagnosed in our hospital from 2013 to 2014. Results 4 of 5 male, and 1 female, age between 50 and 73, were diagnosed as pneumonia. All of them were made a definite diagnosis as BAC after performing transbronchial lung biopsy. Conclusion BAC is an exceptional lung adenocarcinoma and there is no specific clinic symptom. BAC was easily misdiagnosed as common lung pneumonia. There will be serious consequences after misdiagnosis of BAC due to its poor prognosis. Those patients who were misdiagnosed as common lung disease, but there was no obvious improvement after accepting long anti-infective therapy and there was negatively detection of pathogenic bacteria in them, are needed to perform all other clinical examination to clarify a diagnosis, and to further improve the prognosis of the patients.