Objective To investigate the clinical characteristics of acute myocardial infarction ( AMI) in elderly patients with acute exacerbation of chronic obstructive pulmonary disease ( AECOPD) .Methods Clinical data of 16 elderly patients with AECOPD and AMI from may 2007 to December 2009 were reviewed. Meanwhile, 128 elderly AECOPD patients without AMI were analyzed as control. Results Neither the AMI group nor the control group had typical precordial pain, conscious disturbance, andhypotension. Compared with the control group, the main symptoms of the AMI group were worsening of chest tightness and dyspnea( 16 /16 vs. 4/128, P lt;0. 01) ,most of which accompanying fever( 11/16 vs. 6/128, P lt;0. 05) and anorexia ( 10/16 vs. 23 /128, P lt; 0. 05) . The incidence of patches-like shadow on chest X-rayincreased ( 16 /16 vs. 62/128, P lt;0. 05) , PaO2 ( mm Hg) decreased ( 43. 72 ±3. 64 vs. 82. 26 ±11. 41, P lt;0. 001) , the red blood cell count ( ×1012 /L) increased ( 6. 43 ±0. 42 vs. 4. 11 ±1. 24, P lt; 0. 05) , the concentration of total cholesterol ( mmol /L) increased ( 6. 51 ±0. 84 vs. 3. 93 ±1. 14, P lt; 0. 05) , the needfor invasive mechanical ventilation increased ( 13/16 vs. 11 /128, P lt; 0. 05) , the days in hospital were prolonged ( 35 ±13 vs. 11 ±3, P lt; 0. 01) , the cost ( 1000 RMB) increased( 32 ±11 vs. 7. 6 ±2. 8, P lt;0. 01) , and the mortality also increased ( 2/16 vs. 3 /128, P lt;0. 01) . Conclusion AMI should be alerted in the case of sudden exacerbation of chest tightness and dyspnea in elderly patients with AECOPD.
【摘要】 目的 探討綜合性醫院內獲得性免疫缺陷綜合征（acquired immune deficiency syndrome，AIDS）患者的肺部表現及其特征。 方法 回顧性分析2006年2月－2009年12月收治的58例AIDS患者肺部病變的臨床資料。 結果 58例患者中男47例，女11例，男女比例為4.27∶1；年齡6~78歲，平均43歲，其中lt;50歲者36例，占62.1%，gt;50歲22例，占37.9%。肺部表現是AIDS患者入住綜合性醫院的常見臨床表現，居各種臨床表現的首位（占55.2%）。主要有彌漫性肺部疾病和肺結核，分別是21例（36.2%）和23例（39.7%），收治的主要科室是呼吸內科38例（65.5%）和傳染科12例（20.7%）；常見的臨床癥狀有發熱、咳嗽、活動后氣促或呼吸困難；其肺部影像學表現多樣，有毛玻璃樣變、彌漫性結節影、斑片影、肺內塊影或肺內空洞、纖維條索影或伴胸水；其常見伴隨癥狀有口腔潰瘍真菌、腹瀉或其他消化道癥狀，及其皮疹、貧血、神經系統癥狀等；同時也有部分患者合并乙型肝炎病毒/丙型肝炎病毒/梅毒等混合感染。 結論 AIDS的肺部病變是綜合性醫院住院AIDS患者的主要表現，提高呼吸科醫師對AIDS患者肺部表現的認識將有利于AIDS的臨床防治。【Abstract】 Objective To investigate the clinical characteristics of acquired immune deficiency syndrome (AIDS) with pulmonary diseases in comprehensive hospitals. Methods The clinical data of 58 cases of AIDS with pulmonary diseases admitted in our hospital from 2006 to 2009 were analysed retrospectively. Results Among the patients, there were 47 males and 11 females, and the proportion of the number of males to females was 4.27∶1. Their age ranged from 6 to 78 years old, averaging at 43. Thirty-six patients (62.07%) were under 50 years old; and there were 22 patients (37.93%) aged 50 or above. The pulmonary expression was common in AIDS patients admitted into comprehensive hospitals, occupying the first place in various clinical manifestatiosn (55.24%). Pulmonary expressions of AIDS were mainly diffuse pulmonary diseases and pulmonary tuberculosis, which had 21 (36.21%) and 23 (39.66%) cases respectively. Chief treating departments were Department of Respiratory Medicine (65.52%) and Department of Infective Diseases (20.69%). Its common symptoms included fever, cough, shortness of breath after activities or dyspnea; Its pulmonary image had various manifestations including ground-glass opacity (GGO), diffuse nodal shadow, spot and thin piece shadow, pulmonary chunk shadow or cavity, fibre twigs shadow or/and hydrothorax; Its common combined symptoms included oral cavity ulcer fungus infection, diarrhoea or other digestive tract symptoms, and erythra, anemia, and nervus system symptoms, etc. There were still some other cases of combined viral hepatitis type B, type C, or syphilis. Conclusion Pulmonary diseases of AIDS are the main expressions of patients with AIDS in comprehensive hospitals. It will be beneficial to clinical prophylaxis and treatment of AIDS to heighten the knowledge of respiratory physicians on pulmonary expressions of patients with AIDS.
ObjectiveTo compare the effectiveness of anterior cruciate ligament (ACL) reconstruction between the ligament advanced reinforcement system (LARS) and bone-patellar tendon-bone (BPTB) autograft. MethodsBetween July 2007 and July 2011, 50 cases (50 knees) of ACL injury were treated with LARS in 24 cases (LARS group) and with BPTB in 26 cases (BPTB group), respectively. There was no significant difference in age, gender, time from injury to surgery, and injury reason between BPTB group and LARS group (P gt; 0.05). The postoperative rehabilitation protocol was performed in 2 groups. ResultsAll incisions healed at the first stage. All patients were followed up 2-3 years. The results of Lachman test, anterior drawer test, and pivot shift test were negative. Screw loosening in femur and tibia occurred in 1 case of each group respectively, anterior knee pain in 2 cases of BPTB group and in 1 case of LARS group. The Lysholm and Tegner scores were significantly higher in LARS group than in BPTB group at 2 and 6 months after operation (P lt; 0.05); but no significant difference was found between 2 groups at 12 and 24 months (P gt; 0.05). The IKDC scores showed no significant difference between 2 groups at different time points after operation (P gt; 0.05). During follow up, KT-1000 arthrometer and knee stability showed significant differences in antedisplacements of the tibia between 2 groups at all time points after operation (P lt; 0.05). ConclusionLARS has less trauma and earlier functional recovery than BPTB autograft for ACL reconstruction, but the long-term effectiveness is similar.