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    find Author "王茂筠" 8 results
    • 左下肺片團影

      討論病案為胸部 CT 平掃顯示的肺部片團影像,是呼吸系統常見的影像學改變,臨床多考慮感染性疾病、腫瘤或非感染非腫瘤性病變。初診醫師根據臨床特征、影像學細微的差異,對患者進行胸部增強 CT 易于發現此病灶為血管結構,并非常見的感染或腫瘤病變。有條件的單位可進行肺血管重建、心室聲學造影以及肺動脈造影,就能確診肺動靜脈瘺。臨床醫師以此為最終診斷是非常普遍的,但專科醫師應結合患者受涼感冒后易發生鼻衄且有家族史,全面考慮并深入探究其可能的病因如先天性或遺傳性因素的可能,應當熟悉各種罕見病的臨床特征,如遺傳性出血性毛細血管擴張癥。通過家系資料收集、連鎖分析,目標基因全外顯子測序,最終證實該例患者是遺傳性出血性毛細血管擴張癥,臨床表現出動靜脈瘺并有其他部位出血。

      Release date:2018-01-23 02:34 Export PDF Favorites Scan
    • 替加環素成功治療肺感染廣泛耐藥肺炎克雷伯菌一例

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    • Relationships Between Health-Related Quality of Life and Social Support in Patients with Obstructive Sleep Apnea-Hypopnea Syndrome

      Objective To study the relationships among health-related quality of life( HRQL) ,social support, excessive daytime sleepiness ( EDS) and PSG parameters in patients with obstructive sleep apnea-hypopnea syndrome ( OSAHS) . Methods Eighty-five patients were recruited who were diagnosed as OSAHS by overnight polysomnography from August 2007 through November 2007 in West China Hospital.The Calgary sleep apnea quality of life index ( SAQLI) was used for HRQL, social support rating scale ( SSRS) was used for social support, and Epworth sleepiness scale( ESS) was used for EDS. The Pearson linear correlation and stepwise multiple regression analysis were used to analyze the correlation among SAQLI, SSRS, ESS, and PSG. Results The SAQLI was correlated with SSRS score ( r =0. 402, P lt;0. 01) ;ESS score ( r = - 0. 505, P lt;0. 01) ; apnea-hypopnea index ( AHI) ( r = - 0. 269, P lt; 0. 05) and lowest artery oxygen saturation ( LSaO2) ( r = 0. 226, P lt; 0. 05) . Stepwise multiple regression analysis determined two variables, the SSRS and ESS score, as independent factors for predicting the total score of SAQLI which accounted for 37. 3% of the total variance in the total score on SAQLI ( R2 = 0. 373, P lt; 0.001) .Conclusions The HRQL of patients with OSAHS was correlated with the SSRS score, ESS score and PSG parameters. The former two were the more important factors to affect the HRQL of patients with OSAHS.

      Release date:2016-09-14 11:23 Export PDF Favorites Scan
    • Nocturnal oximetry saturation monitoring combined with clinical score in preliminary screening of obstructive sleep apnea hypopnea syndrome

      Objective To discuss the screening and diagnostic value of nocturnal oximetry saturation monitoring combined with clinical score (CS) for patients with obstructive sleep apnea hypopnea syndrome (OSAHS). Methods A total of 106 snorers were recruited in the analysis whose general information and medical history were collected respectively. All patients received polysomnography (PSG) and oximeter monitoring. The patients were divided into a non-OSAHS group and an OSAHS group according to apnea hypopnea index (AHI). A correlation analysis was made between PSG-AHI and oximeter-ODI to analyze the diagnostic sensitivity and specificity of different ODI combined with CS for OSAHS. Results The AHI, ODI, CS for the non-OSAHS group were 1.8±1.4 times/h, 2.6±3.5 times/h and 1.0±0.8; while for the OSAHS group they were correspondingly 37.3±23.9 times/h, 31.0±24.1 times/h, 2.6±1.1. There was a significant correlation between ODI and AHI (r=0.943, P<0.01). The sensitivity and specificity of ODI≥5 times/h combined with CS≥2 for diagnosis of OSAHS were 91.7% and 94.1% respectively, which had the value of preliminary screening. The sensitivity and specificity of ODI≥10 times/h combined with CS≥2 for diagnosis of OSAHS were 77.8% and 100.0% respectively, which would not result in misdiagnose for severe patients with AHI >30 times/h, so it could be an index of severe OSAHS screening. Conclusion Nocturnal oxyhemoglobin saturation monitoring combined with clinical score is of significant value for initial diagnosis of OSAHS.

      Release date:2017-05-25 11:12 Export PDF Favorites Scan
    • Diagnosis of Asthma with the Measurement of Exhaled Nitric Oxide: A Systematic Review

      Objective To review literatures regarding the diagnosis of asthma with the measurement of exhaled nitric oxide( eNO) and assess the effectiveness and accuracy of eNO in the diagnosis of asthma.Methods MEDLINE, OVID, CBMdisc, CNKI( 1991 to 2008) for studies involving the diagnostic value of eNO were searched, and references of included studies were also hand searched. QUADAS ( Quality Assessment of Diagnostic Accuracy Studies) items were used for quality assessment in the systematic review. Meta-disc software was used to analyze heterogeneity. Sensitivity, specificity and summary diagnostic odds ratio( SDOR) were used for the pooled analysis. The summary receiver operating characteristic ( SROC)curves were drew and the summary areas under the SROC ( SAUC) were calculated. Finally, sensitivity analysis was performed. Results Eleven literatures with15 studies were included. These 15 studies had well controlled the bias of partial verification, differential verification, incorporation and withdrawals. The possibility of the disease progression bias was less and the reference standard review could have a greater bias. The spectrumcomposition of a study, the inclusion and exclusion criteria and the reporting quality were poorly reported. In statistical analysis, the totally pooled sensitivity, pooled specificity, SDOR, SAUC of the measurement of eNO in the diagnosis of asthma was 0. 68, 0. 79, 12. 73, 0. 8446, respectively. Sensitivity analysis demonstrated no disproportionate influences of individual study. Conclusions eNO has a certain value in the diagnosis of asthma. To make further analysis, more studies with high quality are needed.

      Release date:2016-09-14 11:23 Export PDF Favorites Scan
    • Genotypes of Aminoglycosides Modifying Enzymes in Imipenem-Resistant Pseudomonas Aeruginosa

      Objective To describe and compare the distributions of aminoglycosides modifying enzymes ( AMEs) in imipenem-resistant Pseudomonas aeruginosa ( IRPA) collected from5 cities in China. Methods A total of 146 strains of IRPA were collected from 5 cities of China ( Chengdu, Hangzhou, Beijing, Shanghai, and Guangzhou) . The polymerase chain reaction ( PCR) were used to amplify the genes of AMEs in IRPA. Results Six positive genotypes were amplified out of 16 genotypes of AMEs by PCR. The total positive rate of AMEs is 65. 06% . The positive rates of genes of aac( 3) -Ⅱ, aac( 6′) -Ⅰ, aac( 6′) -Ⅱ, ant( 2″) -Ⅰ, ant ( 3″) -Ⅰ and aph( 3′) -Ⅵ were 33. 6% , 15. 8% , 19. 9% , 28. 8% , 14. 4%, and 4. 8% , respectively. The genotypes of AMEs were discrepant in different areas as 6 genotypes in Huangzhou and Shanghai, 4 genotypes in Chengdu and Beijing, and 3 genotypes in Guangzhou. Conclusion The results show that the positive rate of AMEs genes is high in IRPA, and the distribution is discrepant among different areas.

      Release date:2016-09-13 04:07 Export PDF Favorites Scan
    • VTE抗凝相關大出血風險及相關預測模型研究進展

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    • 肺吸蟲病誤診為結核性胸膜炎一例

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  • 松坂南