简介：摘要目的探讨乙二胺四乙酸二钠(EDTA)导致血小板假性减少的原因并作出纠正。方法用ABXPENTER60血液分析仪检测,对血小板低于正常参考值的患者,同时采集末梢血手工计数血小板并作末梢血及抗凝血涂片显微镜镜检。结果手工血小板计数与EDTA抗凝血计数结果相比,差异有统计学意义(P<0.01);手工血小板计数结果与枸橼酸抗凝血标本血液分析仪计数结果相比,差异无统计学意义(P>0.05)。结论对于首次血小板计数减低的标本均应手工计数血小板并作末梢血涂片镜检,以排除是否存在抗凝剂所致血小板聚集现象。

简介：<正>正月十三夜,酣睡中的人们还沉浸在节日浓郁的喜悦气氛中。凌晨1点15分,一阵急促的电话声敲响了刚刚睡下的公安民警,“119”报称:“天祝县华藏镇华干路安徽家具店发生了火灾”。在局值班的政委孔宪忠立刻率刑侦、消防、缉私队干警奔赴火场。

简介：摘要新型冠状病毒(2019-nCoV)引发的COVID-19已蔓延至全世界，升级为国际突发公共卫生事件。COVID-19患者主要表现为呼吸系统症状，重症患者还可合并肺外多器官功能损伤。人体免疫系统可有效抵御病毒入侵，然而多项临床现象和病理解剖提示COVID-19患者病程中存在免疫应答失衡。免疫失衡和过度的炎症激活与COVID-19患者的疾病进展、不良预后密切相关。本文从机体固有免疫、适应性免疫、细胞因子风暴等角度综述了COVID-19患者发病过程中的免疫特征，以期阐述COVID-19免疫相关的发病机制，为临床预防及治疗COVID-19提供理论依据。

简介：摘要The present global pandemic of COVID-19 has brought the whole world to a standstill, causing morbidity, death, and changes in personal roles. The more common causes of morbidity and death in these patients include pneumonia and respiratory failure, which cause the patients to require artificial ventilation and other techniques that can improve respiratory function. One of these techniques is chest physiotherapy, and this has been shown to improve gas exchange, reverse pathological progression, and reduce or avoid the need for artificial ventilation when it is provided very early in other respiratory conditions. For patients with COVID-19, there is limited evidence on its effect, especially in the acute stage and in patients on ventilators. In contrast, in patients after discharge, chest physiotherapy in the form of respiratory muscle training, cough exercise, diaphragmatic training, stretching exercise, and home exercise have resulted in improved FEV1 (L), FVC (L), FEV1/FVC%, diffusing lung capacity for carbon monoxide (DLCO%), endurance, and quality of life, and a reduction in anxiety and depression symptoms. However, there are still controversies on whether chest physiotherapy can disperse aerosols and accelerate the rate of spread of the infection, especially since COVID-19 is highly contagious. While some authors believe it is possible, others believe the aerosol generated by chest physiotherapy is not within respirable range. Therefore, measures such as the use of surgical masks, tele-rehabilitation, and self-management tools can be used to limit cross-infection.

简介：<正>2014年12月8日,根据《中华人民共和国食品安全法》和《食品安全国家标准管理办法》规定,经食品安全国家标准审评委员会审查通过,中华人民共和国国家卫生和计划生育委员会发布《食品安全国家标准食品添加剂硬脂酸钾》(GB31623-2014)等13项食品安全国家标准和《食品安全国家标准食品添加剂天门冬氨酸钙》(GB29226-2012)第1号修改单。

简介：19年前,徐汇区住宅建设办公室和徐汇区城市建设开发总公司改制成立了上海城开（集团）有限公司。19年后的今天,跻身中国房企50强的上海城开已从专业化房地产开发商,成功转型为城市核心区域运营商。在城开成立19周年前夕,上海城开（集团）有限公司党委书记、副董事长、总裁杨彪在位于徐家汇的公司总部会议室接受媒体专访时表示：随着住宅用地愈来愈难取得,今后公司会加大对一线城市商业地产的开发,增加经营性物业的收入占比。

简介：摘要目的探讨胎盘早剥预防、诊断、治疗，降低孕产妇及围产儿死亡率。方法回顾性分析2010年1月—2014年12月年间我院共收治胎盘早剥19例胎盘早剥的临床资料。结果19例胎盘早剥中，无孕产妇死亡，因术中胎盘剥离面出血行宫腔纱条填塞止血保留子宫1例，因子宫卒中严重，子宫次切术1例，围生儿死亡6例，死亡率为37.58%，其中胎死宫内4例，新生儿死亡1例。结论重视妊娠高血压疾病及相关疾病，警惕胎盘早剥的发生，合理B超检查，防止延误病情，早诊断早治疗，积极防治并发症。

简介：19世纪是一个艺术发生重大发展变革的时期。随着西方社会的不断进步,学院派的纯粹理性化创作方式不再占据权威地位,越来越多的艺术家开始追求更加个性化、自由化、感性化、生活化的艺术形式,从而使得19世纪成为充满艺术探新实验的时代,艺术家们开始探索许多边缘化的艺术领域,从而出现了众多特点迥异的艺术潮流。

简介：摘要胆总管的结石有非常多的术式，开腹术更适合于基层医院开展。取消了胆管取石后T管的放置，可明显的消除胆瘘的发生，风险小、疼痛少且有效，笔者所采用的开腹胆囊切除经胆囊管行胆总管探查取石，适应于广大基层医疗单位，具有一定的临床实用意义。

简介：摘要目的分析产褥期常见致病菌及治疗方法。方法回顾本院2015～2016年23～36岁产褥期感染及治疗方法。结果产褥感染为妇产科常见急性并发症，是由分娩及产褥病原体感染所致的生殖道炎症反应，常见的致病菌有革兰氏阳性球菌包括B族链球菌、表皮葡萄球菌、松鼠葡萄球菌、人葡萄球菌人亚种、溶血葡萄球菌、粪肠球菌、金黄色葡萄球菌等），革兰氏阴性菌，包括大肠埃希菌、奇异变形杆菌、肺炎克雷伯菌、洛非不动杆菌等；常见真菌，包括白假丝酵母菌、白色念珠菌、光滑念珠菌等。治疗上经予全身抗感染及局部阴道灌洗、感染部位的切开引流治疗后病情好转。

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简介：摘要目的探讨超声诊断表皮样囊肿的应用价值。方法回顾性分析总结19例已手术病理证实的表皮样囊肿声像图。结果有18例呈形态规则，边界清晰，内部无血流的类实性肿物。有1例合并炎性，边界欠清，形态欠规则并有少量血流信号。19例肿物的内部回声由囊内容的成分含量多寡和成分排列的不同而不同。结论表皮样囊肿囊声像图有一定的特征性，在判别良恶性时，可提供有意义的参考依据。

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简介：目的探讨浮肩损伤的临床特征及治疗方法。方法回顾分析2000年4月至2006年7月收治的，经手术治疗的19例浮肩损伤患者的临床资料。患者均有不同程度的合并损伤，其中肋骨骨折、血气胸和（或）肺挫伤占89．5％。受伤至手术时间3～42d，平均10．2d。术后3个月对患者肩关节功能根据Herseovici标准进行评定，并对浮肩损伤的临床特征和治疗进行总结。结果术后随访3～50个月，平均16．2个月。肩胛颈骨折在目标区上均获解剖复位，锁骨和肩胛骨均愈合。根据Herscovici标准进行评定，优15例（78．9％），良3例（15．8％），可1例（5．3％）。结论浮肩损伤多南高能量直接暴力所致，常伴有合并损伤。切开复位内固定能恢复肩关节的动力平衡及稳定性，可早期进行功能锻炼，是一种较好的治疗方法。

简介：Aseriesof96-htyphoontrackpredictionexperimentswerecarriedoutusingmediumrangeforecastingsystemofNMCbyaddingBOGUStyphoon(simplifiedasB-TC)intothefirstguessfieldortheanalysisfieldinordertoprovidelongertimetyphoontrackforecast.TheresultsshowthatT106L19couldprovideabetterforecasttotyphoontrackswhentheB-TCwasadded,especiallywhenthetyphoonvortexisevenweaker.ThesensitiveexperimentsonwheretoaddtheB-TCshowthattheresultsfromaddingtheB-TCintothefirstguessfieldarebetter.TheresultsalsoshowthattheinitializationsmoothestheB-TCalotandthiswillaffectthetyphoontrackprediction.

简介：摘要目的总结手足口病并发脑干脑炎患儿的临床特征，为手足口病并发脑干脑炎的诊断和治疗提供依据。方法收集我院2016年6月-2017年10月诊断为手足口病并发脑干脑炎患儿的临床资料，分析临床表现、实验室检查、神经电生理检查、影像学检查、治疗及转归等特征。选择同期诊断为手足口病并发病毒性脑炎的患儿作为对照组，进行脑干脑炎危险因素进行分析。结果19例手足口病并发脑干脑炎患儿进入分析。临床表现19例患儿均有发热和皮疹；15例神经系统症状多见于肢体震颤，12例眼球异常运动（游动或上翻），8例患儿烦躁和惊恐，14例脑神经损害多见于单侧脑神经损害，9例舌咽和迷走神经麻痹。15例出现呼吸衰竭，3例出现肺出血。结论手足口病患儿如出现肢体震颤、眼球异常运动（游动或上翻）等症状，应警惕脑干脑炎的发生。BAEP检查对脑干损伤有较好的诊断价值。及时和规范治疗后大多数患儿的预后良好。

简介：目的探讨腹腔镜肝囊肿开窗术的临床效果。方法对19例肝囊肿病人行腹腔镜下囊肿开窗术,其中单发17例,多发2例;位于右肝14例,位于左肝5例。术前均经B超和CT检查证实,并排除先天性肝胆管囊肿。结果19例均顺利完成手术,无中转开腹,平均手术时间40（20～80）min,除1例因引流出少量胆汁而留置引流2周外,其余均在3～4d后出院。15例随访0.5～6.8年,2例复发,予开腹手术治愈。结论腹腔镜肝囊肿开窗术具有损伤小、术后疼痛轻、恢复快等优点,但应严格掌握手术适应证。

简介：AbstractImportance:Within the coronavirus disease 2019 (COVID-19) global pandemic, more attention is warranted for whether this new infectious disease has unique manifestations in children.Objective:To retrospectively determine the epidemiological and clinical characteristics of 35 children with COVID-19 in Beijing, China.Methods:We collected data for 35 children diagnosed with COVID-19 who were admitted to Beijing Ditan Hospital from January 2020 to June 2020, and analyzed their epidemiological characteristics, clinical manifestations, laboratory examinations, chest imaging findings, treatments, and outcomes.Results:The children comprised 18 boys (51.4%) and 17 girls (48.6%) aged 6 months to 15 years. All patients had clear epidemiological history, with family clusters accounting for 28 cases (80.0%) and clear tracing of exposure to high epidemic areas in the remaining 7 cases (20.0%). Four (11.4%) patients were classified as asymptomatic, 17 (48.6%) as acute upper respiratory infection, and 14 (40.0%) as mild pneumonia, with no severe or critical cases. Clinical manifestations were mild, including fever in 18 (51.4%), cough in 14 (40.0%), and nausea and diarrhea in 7 (20.0%) patients. White blood cell count was mostly normal (26 cases, 74.3%) or decreased (7 cases, 20.0%); lymphocyte percentage was increased in 24 (68.7%); neutrophil percentage was decreased in 25 (71.4%); alanine aminotransferase was increased in 3 (8.6%); and serum potassium was decreased in 4 (11.4%). Time to negative viral nucleic acid testing was 2-42 days (mean: 14.0 ± 9.4 days). Chest imaging examination revealed that 20 patients (57.1%) had different forms of lung inflammation. Treatment was mainly isolation and nutritional support. Eleven patients were treated with interferon atomization inhalation. No patients required oxygen therapy. All 35 children were cured and discharged. Length of hospital stay was 9-54 days (mean: 25.4 ± 13.8 days). During regular follow-up after discharge, 5 children showed positivity again in the viral nucleic acid test and were re-hospitalized for observation and treatment. The mean length of re-hospitalization stay was 10.8 days.Interpretation:Children with COVID-19 mainly become infected within their family, and children of all ages are generally susceptible. The disease in children is mostly mild and the prognosis is good. Nucleic acid tests in some patients become positive again after discharge, suggesting that it is of great significance to carry out centralized isolation medical observations and active nucleic acid tests in close contacts for early detection of patients and routine epidemic prevention and control.

简介：摘要目的探讨分析十二指肠损伤的临床治疗方式及疗效。方法19例患者全部属于闭合性损伤,其中14例是车祸引发的损伤，2例由于上腹挤压造成损伤，其余3例被钝器所伤。19例患者十二指肠发生损伤的部位如下9例降部,2例球部,4例水平部,2例升部,2例多发性损伤。5例合并脾脏破裂，4例合并肝损伤,1例合并结肠损伤,1例合并胰腺损伤,3例合并空肠损伤,2例合并肾脏损伤。结果接受手术治疗之后，18例获得治愈，占总数的94.7%；1例死亡,占总数的5.3%。6例患者在术后引发不同的并发症，其中2例肠瘘,1例胰瘘,1例腹腔脓肿,2例多器官功能衰竭。导致1例死亡的原因是患者存在肠瘘，最终使多器官功能发生衰竭。讨论十二指肠的生理学特点、发生损伤的部位、解剖位置等都存在显著的特殊性。医护人员要时刻保持谨慎的态度，尽最大的努力降低漏诊的机率。十二指肠存在损伤将会对患者全身产生较大的影响,所以在接受手术治疗之后，必须要进行高效的综合治疗，避免出现术后感染并及时补充肠内营养，只有这样才能获得令人满意的临床疗效。