简介：目的：建立人血清帕拉德福韦浓度检测方法并运用于人体药代动力学研究。方法：血清样品乙腈沉淀蛋白处理后，采用液相色谱串联质谱（LC-MS／MS）法测定。以0．2mmol·L^-1乙酸铵水溶液（A）-乙腈（B）为流动相，ThermoBDSHYPERSILC18column（150mm×2．1mm，5μm）分离，梯度洗脱。帕拉德福韦及内标（恩替卡韦）监测离子对为m／z424．1→151．0；m／z278．3→152．1。运用建立的方法测定健康受试者血清中药物浓度。结果：帕拉德福韦血清药物浓度在0．5-500ng·mL^-l的范围内线性关系良好，方法回收率、日内及日间精密度均符合方法学要求。结论：该方法专属性强、灵敏度高，可用于帕拉德福韦人体药动学研究。

简介：肱骨近端骨折是常见的老年骨质疏松性骨折，发病率占全身骨折的2．5％～5．0％。随着人口结构的老龄化和预期寿命的延长，发病人数呈快速上升趋势，同时骨折严重性也随之增加，无移位或轻微移位骨折占整个肱骨近端骨折的比例下降了近50%。肱骨近端骨折畸形愈合导致患者生活自理能力下降。

简介：摘要目的探讨肺栓塞误诊常见原因分析及第二代炫速双源CT肺动脉成像联合双能量肺灌注在避免误诊中的临床价值以降低误诊率、病死率,提高对肺栓塞的认识和诊断.方法回顾性分析３３例经第二代炫速双源CT肺动脉成像联合双能量灌注成像扫描诊断明确的肺栓塞的临床资料及误诊情况,就误诊原因加以分析.结果肺栓塞常见误诊原因为临床医生对肺栓塞的认识或重视不足;肺栓塞常起病隐匿,症状缺乏特异性;且如合并心、肺慢性疾病掩盖了肺栓塞的临床表现.第二代炫速双源CT肺动脉成像联合双能量灌注成像扫描时间短,危重患者及急诊排查均可适用,它一站式检查同时完成CTPA及肺通气灌注扫描两项检查,在临床上可早期确诊急性肺栓塞,提高肺栓塞的临床确诊率及减少临床误诊率.结论加强对肺栓塞的认识,对疑似肺栓塞症状患者,特别对有肺栓塞高危因素的人群,应尽早行特异性检查如第二代炫速双源CT肺动脉成像联合双能量灌注成像以提高确诊率和早期抢救成功率.关键词肺栓塞;误诊;第二代炫速双源CTAnalysisofclinicalmisdiagnosisin３３patientswithacutepulmonaryembolismandSecondgenerationofHyun－speeddual－sourceCTmisdiagnosisofpulmonarylungperfusionImagingincombinationwithenergyinavoidingmisseddiagnosisanditsclinicalvalueBaotouofInnerMongoliaCentralHospitalJiaXiaoQingWangYuanChangXiaoYueYaoXingYanDingLinFangCode０１４０４０AbstractObjectiveStudyoncommoncauseofpulmonaryembolismmisdiagnosisanalysisandsecondgenerationHyun－speeddual－sourceCTmisdiagnosisofpulmonarylungperfusionImagingincombinationwithenergytoavoidmisdiagnosisofclinicalvalueinordertoreducerates,mortalityrates,increasedawareＧnessanddiagnosisofpulmonaryembolism??MethodRetrospectiveanalysisof３３casesofdiagnosedpulmonaryembolismofclinicaldataandmisdiagnosis,missed,misseddiagnosisanalysisMethodsRetrospectiveanalysisof３３casesofsecondgenerationofHyun－speeddual－sourceCTofpulmonaryperfusionImaＧgingincombinationwithenergyscanindiagnosisofspecificpulmonaryembolismofclinicaldataandmisdiagnosis,missed,misseddiagnosisanalysis??ResultsCommonmisdiagnosisforpulmonaryembolismofclinicaldoctorofpulmonaryembolismawarenessorinsufficientattention;pulmonaryembolismofteninsidiousonset,symptomsoflackofspecificity;andcombinedheartandlungchronicdiseasemaskedtheclinicalmanifestationsofpulmonaryembolism??SecondgenerationofHyun－speeddual－sourceCTofpulmonaryperfusionImagingincombinationwithenergyscantimeisshort,criticallyillpatientsandemergencytroubleＧshootingcanbeapplied,One－stopcheckbothCTPAandpulmonaryventilationperfusionscanchecksearlyintheclinicaldiagnosisofacutepulmonaryembolism,improvetheclinicaldiagnosisofacutepulmonaryembolismandreduceclinicalmisdiagnosisrate??ConclusionStrengthentheawarenessofpulmonaryembolism,thesymptomsofpatientswithsuspectedpulmonaryembolism,Especiallytohaveriskfactorsofpulmonaryembolisminthepopulation,shouldasfarasearlyspeＧcificlaboratoryexaminationsuchasthesecondgenerationHyunspeeddualsourceCTpulmonaryangiographycombinedwithdualenergyperfusionimaginginorＧdertoKiemyprwoovredsthediagnosisrateandearlyrescuesuccessrate??pulmonaryembolism;misdiagnosis;SecondgenerationofHyun－speeddual－sourceCT中图分类号R５６３文献标识码A文章编号１００８－６３１５(２０１５)１２－０４１１－０２