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find Author "王利民" 19 results
  • 以淋巴管平滑肌瘤病为主要肺部表现的结节性硬化症

    Release date:2016-09-14 11:23 Export PDF Favorites Scan
  • 急性间质性肺炎的治疗进展

    急性间质性肺炎( acute interstitial pneumonia, AIP) 是一种突发起病、快速进展为呼吸衰竭并需机械通气的间质性肺疾病, 其病理特点为弥漫性肺泡损伤。最早在1944 年Hamman和Rich[ 1] 报告了一组以暴发起病、进展迅速并短时间内死亡为特点的病例, 在病理上主要表现为肺泡间隔增厚水肿、通明膜形成及肺间质广泛纤维增生, 此后有人称此为Hamman-Rich 综合症。1986 年Kuzenstein 等[ 2 ] 报道了8 例与Hamman-Rich 综合症相类似的病例, 并正式更名为急性间质性肺炎。2002 年ATS/ERS 将AIP列为特发性间质性肺炎的一个亚型。AIP 确切的病因及发病机制尚不清楚, 因其临床表现及病理特点类似于ARDS, 有人认为AIP是特发性ARDS[ 3] 。目前AIP 尚无有效规范的治疗方法, 临床上主要以大剂量糖皮质激素的应用及机械通气支持治疗为主。现结合有限的文献资料对AIP 的治疗作进一步探讨。

    Release date:2016-08-30 11:53 Export PDF Favorites Scan
  • Relationship Between Ku80 Protein Content and Sensitivity to Cisplatin of HumanLung Cancer Cells

    Objective Non-small cell lung cancer ( NSCLC) cells are relatively resistant to chemotherapy, and the outcomes are not always satisfactory. This study was designed to explore the relationship between the content of Ku80 protein of human lung cancer cells and their sensitivity to cisplatin.Methods The lung cancer cells isolated frommalignant pleural effusion samples frompatients with primary lung cancer were cultured in vitro. The sensitivity to cisplatin was tested with the method of CCK-8 expressed as half maximal inhibitory concentration ( IC50 ) . The relative content of Ku80 protein was determined by Western blot. The correlation between sensitivity to cisplatin of lung cancer cells and the relative content of Ku80 protein was analyzed. Results The IC50 of NSCLC group was significantly higher than that of SCLCgroup [ ( 4. 40 ±3. 39) mg/L vs. ( 1. 02 ±0. 54) mg/L, P lt; 0. 001] . The relative content of Ku80 protein of NSCLC group was statistically higher than that of SCLC group [ ( 0. 80 ±0. 45) vs. ( 0. 48 ±0. 25) , P lt;0. 05] . The correlation coefficient between content of Ku80 protein and IC50 was 0. 618 ( P lt; 0. 001) .Conclusions The content of Ku80 protein of NSCLC patients is higher than that of SCLC patients. Itmay be one of the mechanisms contributing to chemotherapeutic resistance of NSCLC. There is a negative relationship between Ku80 protein content of cancer cells and their sensitivity to cisplatin suggesting that the content of Ku80 protein may be served as a candidate index for predicting sensitivity of lung cancer cells to cisplatin.

    Release date:2016-08-30 11:54 Export PDF Favorites Scan
  • Clinical Characteristics of Polyarteritis Nodosa which Begin with Pulmonary Lesions: Three Cases Report

    Objective To summarize the clinical characteristics of polyarteritis nodosa which begin with pulmonary lesions, so as to make early diagnosis and treatment possible. Methods Clinical data of three patients of polyarteritis nodosawhich began with pulmonary lesions were summarized includingmode of onset, evolvement of symptom and sign, data of laboratory test. The results of vascular ultrasound and histopathology examination were analyzed for their diagnostic value.Results Cough, sputum productive cough, and irregular high fever were present in the earlier period. Increases of C-reactive protein ( CRP) , erythrocyte sedimentation rate ( ERS) , white blood cell count ( WBC) , and anemia were main laboratory findings. Computed tomography revealed scattered infiltration in the lung. Anti-infective treatment was ineffective. Involvement of skin, kidney, gastrointestinal tract, nerve and muscle was present in sequence. Two of the three cases were confirmed by pathological biopsy. The symptoms were improved by the treatment with glucocorticoid. Conclusions Polyarteritis nodosa which begin with pulmonary lesions is easy to misdiagnose due to atypical symptoms. It is important for diagnosis of polyarteritis nodosa to collect evidence of systematic involvement through taking careful history and physical examination. Further angiography and biopsy can confirm the diagnosis. Cytotoxic drugs and/ or glucocorticoid are effective for the treatment of polyarteritis nodosa.

    Release date:2016-08-30 11:56 Export PDF Favorites Scan
  • 合并慢性肾功能不全患者的冠状动脉旁路移植术

    目的 总结合并慢性肾功能不全的冠心病患者行冠状动脉旁路移植术(CABG)的临床经验。方法 1997年4月至2004年11月,对18例合并慢性肾功能不全[术前血清肌酐(Cr)129~497μmol/L(216.0±98.3μmol/L)]的冠心病患者行CABG,其中体外循环CABG和非体外循环CABG各9例。结果 术后住院死亡3例,其中大面积脑梗死、肾功能衰竭1例;肾脏和呼吸功能衰竭1例;肺部感染、呼吸功能衰竭1例。4例患者采用腹膜或血液透析。随访11例,失访4例,随访时间2~22个月(7.6±7.3个月),随访期间无明显的心绞痛发作5例,心绞痛较术前明显减轻5例,有较剧烈的胸痛发作1例。血清Cr较术前变化不明显4例(变化〈50μmol/L),较术前明显增高(Cr增高〉100μmol/L)5例。长期腹膜透析1例,脑出血1例,死亡2例(脑梗死、肺部感染);抗凝治疗发生并发症1例。结论 对合并肾功能不全的冠心病患者积极改善肾功能,通过适当的围术期处理,行CABG后的近期结果是可以接受的。

    Release date:2016-08-30 06:23 Export PDF Favorites Scan
  • Change and Significance of Urinary Total Bile Acids in Intrahepatic Cholestasis with Pregnancy

    目的:测定妊娠期肝内胆汁淤积症(ICP)患者血清及尿液的胆汁酸水平,探讨ICP时母体胆汁酸转运的变化及意义。方法:ICP患者(ICP组)及正常妊娠(对照组)各20例。血清及尿液总胆汁酸测定采用速率法。结果:(1)ICP组与对照组相比,血清及尿液中总胆汁酸水平均明显升高,差异有显著性(Plt;0.05);(2)对照组尿液总胆汁酸水平明显高于血清,差异有显著性(Plt;0.05),而ICP组血清和尿液总胆汁酸水平无显著性差异(Pgt;0.05);(3)两组中血清与尿液总胆汁酸水平均无相关性(Pgt;0.05)。结论:ICP患者母血中总胆汁酸水平明显增加,而总胆汁酸经尿液的排泄未成比例增加,这可加重胆汁淤积,引起围产儿不良结局。

    Release date:2016-09-08 09:54 Export PDF Favorites Scan
  • 原发于颅内的血管周细胞瘤术后肺转移一例

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  • Influence of Early Surgery on the Outcome of Infective Endocarditis

    ObjectiveTo study the relationship between the timing of surgery and one-year outcome in patients with infective endocarditis. MethodsWe retrospectively analyzed the clinical data of 97 patients suffered from leftside native valve infective endocarditis with neoplasm, admitted in Shanghai First People's Hospital between January 2000 and December 2011. There were 65 males and 32 females with mean age of 55.2±16.3 years (ranged 29 to 75 years). They were divided into two groups according to whether the surgery was performed within a week after diagnosis. The in-hospital mortality and one-year mortality, embolism and re-infection were calculated and compared between the two groups. ResultsThere was no significant difference in the in-hospital mortality between the early surgery group and the conventional surgery group (1.9% versus 6.7%, P=0.241). While there was a significant difference in the rate of inhospital embolism related complications (1.9% versus 13.3%, P=0.030) between the two groups. There was no significant difference in one-year mortality between the two groups (1.9% versus 8.9%, P=0.122). The incidence rate of embolism related complication was 5.8% in the early surgery group and 20.0% in the conventional surgery group with a statistical difference (P=0.034). There was one patient with recurrent cerebral infarction among the 11 patients of cerebral infarction in the early surgery group,while 6 recurrent patients in the 9 patients with cerebral infarction in the conventional surgery group (9.1% versus 66.7%, P<0.005). ConclusionsEarly surgery in patients with left-side native valve infective endocarditis can't reduce the in-hospital mortality and one-year mortality but does decrease embolic events significantly. Early surgery is feasible in the patients with cerebral infarction.

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  • Comparison of monopolar and bipolar radiofrequency ablation in patients with atrial fibrillation and concomitant rheumatic heart disease

    Objective To compare the effect of monopolar and bipolar radiofrequency ablation in patients with atrial fibrillation and concomitant rheumatic heart disease. Methods The clinical data of 261 patients who underwent valve replacement and radiofrequency Maze Ⅲ procedure in Shanghai First People's Hospital from 2010 to 2015 were retrospectively analyzed. According to the radiofrequency ablation system, patients were assigned to a monopolar radiofrequency ablation group (n=209, 129 males, 80 females, aged 59.6±9.7 years) and a bipolar radiofrequency ablation group (n=52, 36 males, 16 females, aged 58.6±11.2 years). After procedures, clinical factors such as patients' basic information, perioperative complication and mortality, the elimination rate of atrial fibrillation were measured. Results There was no statistic difference in perioperative morbidity and mortality between two groups. The ablation time of the monopolar radiofrequency ablation group was longer than that of the bipolar group (29.7±3.3 minvs. 22.3±7.8 min,P=0.035). Postoperative diameter of left atrium was reduced in both groups. Compared with the monopolar radiofrequency ablation group, bipolar group had a better elimination rate of atrial fibrillation at three months and one year follow-up (82.0%vs. 66.3%,P=0.037; 80.0%vs. 59.6%,P=0.008). Conclusion Valve replacement combined with radiofrequency Maze Ⅲ procedure is safe and efficient. Compared with monopolar radiofrequency ablation, bipolar radiofrequency ablation has advantage on elimination rate of atrial fibrillation, ablation time and cardiopulmonary bypass time.

    Release date:2017-03-24 03:45 Export PDF Favorites Scan
  • 快速生长的肺巨细胞癌一例

    Release date:2019-03-22 04:20 Export PDF Favorites Scan
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