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find Author "毛辉" 18 results
  • 咳嗽性晕厥一例

    Release date:2016-09-08 09:52 Export PDF Favorites Scan
  • 呼出气挥发性有机物在呼吸系统非感染性疾病中的应用

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  • The Experimental Study of the Influence of Applying Gastric Pacing to Postsurgical Gastric Dynamic

    ObjectiveTo explore the feasibility and curative effect of gastric pacing on postsurgical gastroparesis. MethodsThe indexes of gastric dynamic of applying gastric pacing to the experimental animal model of acute postsurgical gastroparesis was compared with that of injecting erythromycin (1 mg/kg).ResultsThe pressure of gastric antrum and the pressure gradient between gastric antrum and duodenum were respectively higher than basic pressure in the two experimental groups (P<0.01); Except duodenal pressure, the indexs of gastric dynamic of pacing group were higher than that of erythromycin group (P<0.05). The gastric emptying rate of pacing group 〔(66.37±7.21)%〕 was higher than erythromycin group 〔(49.92±9.27)%, (P<0.01)〕. ConclusionHigherfrequency gastric pacing can improve the indexes of gastric dynamic and be applied to treat postsurgical gastroparesis, its effect may be better than erythromycin.

    Release date:2016-08-28 04:47 Export PDF Favorites Scan
  • Clinical characteristics of bone marrow tuberculosis and literature review

    Objective To improve the knowledge of bone marrow tuberculosis by summarizing the risk factors, clinical features, diagnosis, therapeutic response and prognosis. Methods The medical records of 62 patients with bone marrow tuberculosis from January 2004 to December 2014 were retrospectively analyzed. Results The patients included 34 males and 28 females. Their age ranged from 15 to 80 years with a mean age of 45.3±35.7 years. Among them, 21 cases (33.9%) had one or more risk factors such as advanced kidney disease or liver disease, chronic respiratory disease, rheumatoid immune system disease and diabetes. No specific clinical features were found in patients with bone marrow tuberculosis, and the most common symptom was fever (98.4%). Blood routine examination revealed that variety of hematological abnormalities include leucopenia, thrombocytopenia, anemia or pancytopenia occurred in 59 patients (95.2%). Chest CT scan showed typical disseminated tuberculosis in 22 patients (36.1%), secondary pulmonary tuberculosis in 6 patients (9.8%), and atypical manifestations of tuberculosis in 26 patients (42.6%). The common patterns of abdomen abnormalities on ultrasonic testing or CT scan were hepatosplenomegaly. Bone marrow biopsy was performed in all the 62 patients, among them, the needle-aspirated bone marrow specimens showed granulomatous lesions in 53 patients (85.5%). The acid-fast staining of bone marrow smear was performed in a total of 57 patients, which was positive in 28 patients (49.1%). Twenty-five patients completed phone call follow-up, and 8 patients died from bone marrow tuberculosis and its complications. Conclusions Bone marrow tuberculosis is a rare manifestation of disseminated tuberculosis. The common symptom of this disease is pyrexia . The clinical presentations and laboratory examinations of this disease are nonspecific. Bone marrow biopsy is a major method for diagnosis. Part of patients with bone marrow tuberculosis lack of imaging proof for lung lesion. Therefore, we should heighten vigilance for bone marrow tuberculosis in patients with fever of unknown origin.

    Release date:2017-04-01 08:56 Export PDF Favorites Scan
  • Airway hemangioma: a case report and literature review

    ObjectiveTo explore the clinical features, diagnosis, differential diagnosis, pathological characteristics, management and prognosis of airway hemangioma, and improve the level of the diagnosis and therapy.MethodsThe clinical data of a patient with airway hemangioma admitted to West China Hospital of Sichuan University were retrospectively analyzed. The related literatures were reviewed. Databases including PubMed, Ovid Medline, Embase, VIP, Wanfang and Chinese National Knowledge infrastructure were searched using the keywords as " Trachea” OR " Bronchus” AND " Hemangioma” from January 1976 to October 2016.ResultsThe patient was a 32-year-old male presented with hemoptysis and backache more than 10 days. His enhanced chest CT scan revealed thickening of the esophagus wall and narrowing of the lumen of esophagus. A wide range of vascular tumor like changes in the trachea and the two sides of bronchus were found by the fiberoptic bronchoscopy and gastroscope examination suggested esophageal varices. Although the patient had a wide range of airway lesions, the symptom of hemoptysis was relieved after the conservative treatment. The patient’s condition was stable until now. From January 1976 to October 2016, a total of 34 related articles were retrieved and 36 cases of airway hemangioma were reported. The etiology of the disease remains unknown. Recurrent hemoptysis was the common symptoms of airway hemangioma, and imaging changes lacking characteristics. Histopathological examination revealed dilated, thin-walled and different size of vascular or hyperplastic capillary and immunohistochemical staining was positive for vascular endothelial cell specific CD34 and Ⅷ factor.ConclusionsHemangioma is a common benign tumor of head and neck in infants and children. Hemangioma is very rarely occurred in trachea in adults. Clinical and imaging manifestations are not specific, and diagnosis relies on histopathological examination. Fiberoptic bronchoscopy and three dimensional reconstruction of thoracic vessels with CT play important roles in the whole process of diagnosis and treatment of airway hemangioma. It should be differentiated from lymphangioma. The prognosis of airway hemangioma is good.

    Release date:2017-07-24 01:54 Export PDF Favorites Scan
  • 以乳糜胸作为首发表现的原发性系统性淀粉样变性一例并文献复习

    目的探讨原发性系统性淀粉样变性的临床表现、诊断、治疗及预后,提高对累及胸膜的原发性系统性淀粉样变性的临床认识。方法报道四川大学华西医院收治的 1 例以乳糜胸作为首发表现的原发性系统性淀粉样变性患者,回顾性分析国内外文献。以“Amyloidosis,pleura”为检索词,在 PubMed 数据库检索,检索时间为 1968 年 12 月至 2019 年 9 月,共检测到相关英文文献 57 篇,报道 18 例患者。以“淀粉样变,胸膜”为检索词,在中国期刊网全文数据库检索,检索时间为 1981 年 3 月至 2019 年 9 月,共检索到相关中文文献 12 篇,报道 7 例患者。结果58 岁男性患者,临床表现为间断性背痛。查体:胸廓对称,双侧肩胛下角第 7 肋间各有一引流管,引流出乳白色液体。双下肺叩诊呈浊音,双下肺呼吸音低至消失,心脏及腹部查体未见异常。血清免疫固定电泳示可疑 IgA κ 型 M 蛋白条带,血清游离 κ 轻链检测 745 mg/L(参考值 6.7~22.4 mg/L)。胸部 CT 示双侧胸腔积液,双肺门淋巴结增大,腹部增强 CT 示胃壁广泛增厚伴腹腔、腹膜后广泛淋巴结增大,经多次胃镜行胃黏膜组织活检,胃组织刚果红染色阳性,胸腔积液流式细胞学见克隆性浆细胞,骨髓流式细胞学见 4% 克隆性浆细胞,确诊为原发性系统性淀粉样变性。在上述数据库中共检索 69 篇文献,经筛选除外资料不详后,有 18 篇文献 20 例患者明确诊断为胸膜淀粉样变性,符合检索条件。此类患者临床表现及影像学均无特异性,确诊依据胸膜活检刚果红染色阳性或胸腔积液查见淀粉样蛋白。结论原发性系统性淀粉样变性累及胸膜,临床表现及影像学缺乏特征性,与肿瘤胸膜转移、胸膜间皮瘤等疾病易混淆,但多数患者血清中会出现单克隆性免疫球蛋白增多,其诊断主要依靠活检组织病理学检查。治疗方案仍以化疗为主。

    Release date:2020-11-24 05:41 Export PDF Favorites Scan
  • 胸腔子宫内膜异位症致血性胸腔积液一例并文献复习

    目的 拓展血性胸腔积液的鉴别诊断范畴,加深临床医师对胸腔子宫内膜异位症的认识,为其诊断、治疗提供有价值的参考。方法 报道1例罕见的胸腔子宫内膜异位症致血性胸腔积液患者的诊治经过,并在PubMed数据库以胸腔子宫内膜异位症为关键词进行文献检索予以文献复习。结果 该患者血性胸腔积液于外院初诊为癌性胸腔积液,入院后经胸腔镜获取病理组织行病理活检和免疫组织化后明确诊断为胸腔子宫内膜异位症,通过胸腔置管引流及促性腺激素释放激素类似物治疗后目前随访3个月暂未见复发。检索相关文献发现,胸腔子宫内膜异位症导致血性胸腔积液患者临床罕见,发病机制不明确,缺乏特异的症状及影像学特征,其诊断需基于临床表现、影像学及病理活检,治疗需依据病情合理选择药物及手术,但该病复发率较高。结论 胸腔子宫内膜异位症为胸腔积液的罕见病因,需加深对其认识避免误诊及漏诊,对于症状与月经周期存在时间关系、右侧胸腔病变、育龄期女性、病情反复的患者临床需谨慎排除。

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  • 遗传性抗凝血酶缺乏症一例并文献复习

    目的 加强临床医生对遗传性抗凝血酶缺乏症的认识,促进该病的早期诊断,改善患者预后。方法总结了1例罕见的遗传性抗凝血酶缺乏症患者的临床特点及诊治经过,并以 “遗传性抗凝血酶缺乏症”“临床特征”“达比加群酯”为关键词检索万方中文数据库,以“Hereditary antithrombin deficiency”“clinical characteristics ”“dabigatran etexilate ”为关键词检索PubMed数据库予以文献复习。结果该患者青年时期即发现非寻常部位血栓(颅内静脉窦),本次就诊期间发现多部位血栓形成,低分子肝素抗凝效果不佳,多次查抗凝血酶Ⅲ明显低于正常,进一步行基因全外显子组测序提示存在遗传性抗凝血酶Ⅲ缺乏症相关的SERPINC1基因致病变异,明确诊断为遗传性抗凝血酶缺乏症后予以达比加群酯抗凝治疗好转,随访至今未再复发。检索相关文献发现,遗传性抗凝血酶缺乏症临床相对罕见,该病具有不同的临床和基因分型,诊断的建立需依据相应的流程,其治疗及预后尚缺乏统一的认识。结论遗传性抗凝血酶缺乏症系静脉系统血栓的罕见病因,对于年轻血栓形成患者、复发性血栓或有家族聚集倾向的血栓患者,需警惕此病的可能;通过对该病的早期诊断、早期合理使用抗凝药物有助于改善预后。

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  • 重组结核杆菌融合蛋白在结核感染中诊断价值的研究进展

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  • 胸膜上皮样血管内皮细胞瘤一例并文献复习

    目的探讨胸膜上皮样血管内皮细胞瘤(PEH)的临床表现、影像、病理学特征、诊断、鉴别诊断、治疗及预后, 提高对该病的诊治水平。 方法以"胸膜上皮样血管内皮细胞瘤"为检索词检索了四川大学华西医院2007年1月至2014年12月的住院患者资料, 仅有1例呼吸内科收治的患者符合条件, 就此回顾性分析其临床特点, 并进行相关文献复习。以"胸膜上皮样血管内皮细胞瘤"为检索词检索万方数据库和中国期刊网全文数据库, 以"pleural epithelioid hemangioendothelioma"为检索词检索PubMed、Embase、Ovid及Cochrane数据库, 检索时间为1975年1月至2015年4月。 结果68岁女性患者, 临床表现胸背痛, 查体发现除左侧胸腔积液体征外, 有新近发生的脊柱侧弯畸形及杵状指。胸部增强CT示左侧胸膜弥漫增厚伴胸腔大量积液, 部分包裹, 左肺舌叶及下叶压迫性不张, 不张舌叶内见密度减低影, 右肺散在结节。经胸膜活检获得病理, 组织学上查见异型细胞巢, 进一步免疫组化染色血小板内皮细胞黏附分子(CD31)蛋白阳性, 至此明确诊断。本例患者拒绝化疗, 明确诊断11个月后死亡。文献复习显示, 在上述数据库中共检索到74篇文献, 经筛选后, 有26篇文献40例患者明确诊断为PEH且具备相应临床资料, 符合检索条件。此类患者主要的临床表现为胸痛及呼吸困难, 影像学主要表现为胸腔积液, 胸膜不规则增厚, 组织病理学呈现血管内皮源性免疫标志物阳性。 结论PEH为罕见的低度恶性血管源性肿瘤, 病因不清, 临床表现及影像学不具有特征性, 与肿瘤胸膜转移、胸膜间皮瘤等疾病易混淆, 其诊断主要依靠活检组织病理学检查。现有的治疗手段有限, 尚无有效的治疗措施。预后与性别、年龄及病变累计范围等多种因素有关。

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