MedNexus
2016年 · 第129卷第17期
出版日期 2016-09-05电子版 ￥0.00元
MedNexus
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Editorial
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支气管扩张作为慢性阻塞性肺疾病的共病：意义和未来研究Ya-Hong Chen, Yong-Chang Sun
中华医学杂志英文版2016年 129卷 17期
DOI: 10.4103/0366-6999.189071
摘要
慢性阻塞性肺疾病（COPD）是一种发病率和死亡率都很高的异质性疾病。[
Original Article
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非艾滋病免疫功能低下患者肺孢子虫肺炎放射学分期与预后的关系Xiang-Dong Mu, Peng Jia, Li Gao, Li Su, Cheng Zhang, Ren-Gui Wang, Guang-Fa Wang
中华医学杂志英文版2016年 129卷 17期
DOI: 10.4103/0366-6999.189068
摘要
Background:
Although radiological features of pneumocystis pneumonia (PCP) in non-Acquired Immune Deficiency Syndrome (AIDS) immunocompromised patients have been reported by other authors, there were no studies on the radiological stages of PCP previously. This study aimed to elucidate the radiological stages and prognoses of PCP in non-AIDS immunocompromised patients.
Methods:
Retrospective analysis of radiological manifestations and prognoses of 105 non-AIDS PCP immunocompromised patients from August 2009 to April 2016 was conducted. Chest radiograph was divided into three stages: early stage (normal or nearly normal chest radiograph), mid stage (bilateral pulmonary infiltrates), and late stage (bilateral pulmonary consolidations); chest high-resolution computed tomography (HRCT) was also divided into three stages: early stage (bilateral diffuse ground-glass opacity [GGO]), mid stage (bilateral diffuse GGO and patchy consolidations), and late stage (bilateral diffuse consolidations).
Results:
The case fatality rate (CFR) of all patients was 34.3% (36/105), all of them took routine chest X-ray (CXR), and 84 underwent chest CT examinations. According to the CXR most near the beginning of anti-PCP therapy, 18 cases were at early stage and CFR was 0 (0/18, P < 0.01), 50 cases were at mid stage and CFR was 28.0% (14/50, P> 0.05), and 37 cases were at late stage and CFR was 59.5% (22/37, P < 0.01). According to the chest HRCT most near the beginning of anti-PCP therapy, 40 cases were at early stage and CFR was 20.0% (8/40, P > 0.05), 34 cases were at mid stage and CFR was 47.1% (16/34, P > 0.05), and 10 cases were at late stage and CFR was 80.0% (8/10, P < 0.05); barotrauma, including pneumothorax, pneumomediastinum, and pneumohypoderma, was found in 18 cases and the CFR was 77.8% (14/18, P < 0.01).
Conclusions:
Based on the radiological manifestations, the course of PCP in non-AIDS immunocompromised patients can be divided into three stages: early stage, mid stage, and late stage. The prognoses of patients treated at early stage are good, and those at late stage are poor. Furthermore, the CFR of patients with barotrauma is high.
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巨噬细胞抑制细胞因子-1作为I期和II期非小细胞肺癌诊断和预后的新生物标志物Yu-Ning Liu, Xiao-Bing Wang, Teng Wang, Chao Zhang, Kun-Peng Zhang, Xiu-Yi Zhi, Wei Zhang, Ke-Lin Sun
中华医学杂志英文版2016年 129卷 17期
DOI: 10.4103/0366-6999.189052
摘要
Background:
Increased level of serum macrophage inhibitory cytokine-1 (MIC-1), a member of transforming growth factor-β superfamily, was found in patients with epithelial tumors. This study aimed to evaluate whether serum level of MIC-1 can be a candidate diagnostic and prognostic indicator for early-stage nonsmall cell lung cancer (NSCLC).
Methods:
A prospective study enrolled 152 patients with Stage I–II NSCLC, who were followed up after surgical resection. Forty-eight patients with benign pulmonary disease (BPD) and 105 healthy controls were also included in the study. Serum MIC-1 levels were measured using an enzyme-linked immunosorbent assay, and the association with clinical and prognostic features was analyzed.
Results:
In patients with NSCLC, serum protein levels of MIC-1 were significantly increased compared with healthy controls and BPD patients (all P < 0.001). A threshold of 1000 pg/ml of MIC-1 was found in patients with early-stage (Stage I and II) NSCLC, with sensitivity and specificity of 70.4% and 99.0%, respectively. The serum levels of MIC-1 were associated with age (P = 0.001), gender (P = 0.030), and T stage (P = 0.022). Serum MIC-1 threshold of 1465 pg/ml was found in patients with poor early outcome, with sensitivity and specificity of 72.2% and 66.1%, respectively. The overall 3-year survival rate of NSCLC patients with high serum levels of MIC-1 (≥1465 pg/ml) was lower than that of NSCLC patients with low serum MIC-1 levels (77.6% vs. 94.8%). Multivariate Cox regression survival analysis showed that a high serum level of MIC-1 was an independent risk factor for reduced overall survival (hazard ratio = 3.37, 95% confidential interval: 1.09–10.42, P = 0.035).
Conclusion:
The present study suggested that serum MIC-1 may be a potential diagnostic and prognostic biomarker for patients with early-stage NSCLC.
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由A引起的感染爆发肺炎克雷伯菌ST11克隆共产生肺炎克雷伯菌碳青霉烯酶-2和RmtB在中国教学医院的应用Jun Li, Ming-Xiang Zou, Hai-Chen Wang, Qing-Ya Dou, Yong-Mei Hu, Qun Yan, Wen-En Liu
中华医学杂志英文版2016年 129卷 17期
DOI: 10.4103/0366-6999.189049
摘要
Background:
Klebsiella pneumoniae carbapenemase (KPC)-producing K. pneumoniae bacteria, which cause serious disease outbreaks worldwide, was rarely detected in Xiangya Hospital, prior to an outbreak that occurred from August 4, 2014, to March 17, 2015. The aim of this study was to analyze the epidemiology and molecular characteristics of the K. pneumoniae strains isolated during the outbreak.
Methods:
Nonduplicate carbapenem-resistant K. pneumoniae isolates were screened for blaKPC-2 and multiple other resistance determinants using polymerase chain reaction. Subsequent studies included pulsed-field gel electrophoresis (PFGE), multilocus sequence typing, analysis of plasmids, and genetic organization of blaKPC-2 locus.
Results:
Seventeen blaKPC-2-positive K. pneumoniae were identified. A wide range of resistant determinants was detected. Most isolates (88.2%) coharbored blaKPC-2 and rmtB in addition to other resistance genes, including blaSHV-1, blaTEM-1, and aac(3)-IIa. The blaKPC-2 and rmtB genes were located on the conjugative IncFIB-type plasmid. Genetic organization of blaKPC-2 locus in most strains was consistent with that of the plasmid pKP048. Four types (A1, A2, A3, and B) were detected by PFGE, and Type A1, an ST11, was the predominant PFGE type. A novel K. pneumoniae sequence type (ST1883) related to ST11 was discovered.
Conclusions:
These isolates in our study appeared to be clonal and ST11 K. pneumoniae was the predominant clone attributed to the outbreak. Coharbing of blaKPC-2 and rmtB, which were located on a transferable plasmid, in clinical K. pneumoniae isolates may lead to the emergence of a new pattern of drug resistance.
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闭塞性细支气管炎综合征中成纤维细胞支持气道上皮祖细胞的能力受损Su-Bei Zhang, Xin Sun, Qi Wu, Jun-Ping Wu, Huai-Yong Chen
中华医学杂志英文版2016年 129卷 17期
DOI: 10.4103/0366-6999.189058
摘要
Background:
Bronchiolitis obliterans syndrome (BOS) often develops in transplant patients and results in injury to the respiratory and terminal airway epithelium. Owing to its rising incidence, the pathogenesis of BOS is currently an area of intensive research. Studies have shown that injury to the respiratory epithelium results in dysregulation of epithelial repair. Airway epithelial regeneration is supported by stromal cells, including fibroblasts. This study aimed to investigate whether the supportive role of lung fibroblasts is altered in BOS.
Methods:
Suspensions of lung cells were prepared by enzyme digestion. Lung progenitor cells (LPCs) were separated by fluorescence-activated cell sorting. Lung fibroblasts from patients with BOS or healthy controls were mixed with sorted mouse LPCs to compare the colony-forming efficiency of LPCs by counting the number of colonies with a diameter of ≥50 μm in each culture. Statistical analyses were performed using the SPSS 17.0 software (SPSS Inc., USA). The paired Student’s t-test was used to test for statistical significance.
Results:
LPCs were isolated with the surface phenotype of CD31-CD34-CD45- EpCAM+Sca-1+. The colony-forming efficiency of LPCs was significantly reduced when co-cultured with fibroblasts isolated from patients with BOS. The addition of SB431542 increased the colony-forming efficiency of LPCs to 1.8%; however, it was still significantly less than that in co-culture with healthy control fibroblasts (P < 0.05).
Conclusion:
The epithelial-supportive capacity of fibroblasts is impaired in the development of BOS and suggest that inefficient repair of airway epithelium could contribute to persistent airway inflammation in BOS.
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柔性纤维支气管镜在患者侧卧位气管插管中的评价：一项前瞻性随机对照试验Hui Li, Wu Wang, Ya-Ping Lu, Yan Wang, Li-Hua Chen, Li-Pei Lei, Xiang-Ming Fang
中华医学杂志英文版2016年 129卷 17期
DOI: 10.4103/0366-6999.189069
摘要
Background:
There is an unmet need for a reliable method of airway management for patients in the lateral position. This prospective randomized controlled two-center study was designed to evaluate the feasibility of intubation using a flexible fiberoptic bronchoscope in the lateral position during surgery.
Methods:
Seventy-two patients scheduled for elective nonobstetric surgery in the lateral decubitus position requiring tracheal intubation under general anesthesia at Lishui Central Hospital of Zhejiang Province and Jiaxing First Hospital of Zhejiang Province from April 1, 2015, to September 30, 2015, were enrolled in this study. Patients were randomly assigned to the supine position group (Group S, n = 38) and the lateral position group (Group L, n = 34). Experienced anesthetists performed tracheal intubation with a fiberoptic bronchoscope after general anesthesia. The time required for intubation, intubation success rates, and hemodynamic changes was recorded. Between-group differences were assessed using the Student’s t-test, Mann–Whitney U-test, or Chi-square test.
Results:
The median total time to tracheal intubation was significantly longer in Group S (140.0 [135.8, 150.0] s) compared to Group L (33.0 [24.0, 38.8] s) (P < 0.01). The first-attempt intubation success rate was significantly higher in Group L (97%) compared to Group S (16%). Hemodynamic changes immediately after intubation were more exaggerated in Group S compared to Group L (P = 0.02).
Conclusion:
Endotracheal intubation with a flexible fiberoptic bronchoscope may be an effective and timesaving technique for patients in the lateral position.
Trial Registration:
Chinese Clinical Trial Register, ChiCTR-IIR-16007814; http://www.chictr.org.cn/showproj .aspx?proj=13183.
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肾脏疾病改善危重患者总体结局尿量标准的价值：一项多中心前瞻性队列研究的二次分析Jun-Ping Qin, Xiang-You Yu, Chuan-Yun Qian, Shu-Sheng Li, Tie-He Qin, Er-Zhen Chen, Jian-Dong Lin, Yu-Hang Ai, Da-Wei Wu, De-Xin Liu 等
中华医学杂志英文版2016年 129卷 17期
DOI: 10.4103/0366-6999.189059
摘要
Background:
Urine output (UO) is an essential criterion of the Kidney Disease Improving Global Outcomes (KDIGO) definition and classification system for acute kidney injury (AKI), of which the diagnostic value has not been extensively studied. We aimed to determine whether AKI based on KDIGO UO criteria (KDIGOUO) could improve the diagnostic and prognostic accuracy, compared with KDIGO serum creatinine criteria (KDIGOSCr).
Methods:
We conducted a secondary analysis of the database of a previous study conducted by China Critical Care Clinical Trial Group (CCCCTG), which was a 2-month prospective cohort study (July 1, 2009 to August 31, 2009) involving 3063 patients in 22 tertiary Intensive Care Units in Mainland of China. AKI was diagnosed and classified separately based on KDIGOUO and KDIGOSCr. Hospital mortality of patients with more severe AKI classification based on KDIGOUO was compared with other patients by univariate and multivariate regression analyses.
Results:
The prevalence of AKI increased from 52.4% based on KDIGOSCr to 55.4% based on KDIGOSCr combined with KDIGOUO. KDIGOUO also resulted in an upgrade of AKI classification in 7.3% of patients, representing those with more severe AKI classification based on KDIGOUO. Compared with non-AKI patients or those with maximum AKI classification by KDIGOSCr, those with maximum AKI classification by KDIGOUO had a significantly higher hospital mortality of 58.4% (odds ratio [OR]: 7.580, 95% confidence interval [CI]: 4.141–13.873, P < 0.001). In a multivariate logistic regression analysis, AKI based on KDIGOUO (OR: 2.891, 95% CI: 1.964–4.254, P < 0.001), but not based on KDIGOSCr (OR: 1.322, 95% CI: 0.902–1.939, P = 0.152), was an independent risk factor for hospital mortality.
Conclusion:
UO was a criterion with additional value beyond creatinine criterion for AKI diagnosis and classification, which can help identify a group of patients with high risk of death.
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中国缺血性心力衰竭患者使用降落伞装置进行经皮心室重构治疗：降落伞中国研究的三个月主要终点结果Yue-Jin Yang, Yong Huo, Ya-Wei Xu, Jian-An Wang, Ya-Ling Han, Jun-Bo Ge, Rui-Yan Zhang, Xiao-Yan Yan, Run-Lin Gao
中华医学杂志英文版2016年 129卷 17期
DOI: 10.4103/0366-6999.189048
摘要
Background:
The primary cause of ischemic heart failure (HF) is myocardial infarction (MI) resulting in left ventricle (LV) wall motion abnormality secondary to ventricular remodeling. A prospective, nonrandomized study conducted in China was designed to assess safety and efficacy of the percutaneous ventricular restoration therapy using Parachute device (CardioKinetix, Inc., CA, USA) in ischemic HF patients as a result of LV remodeling after anterior wall MI.
Methods:
Thirty-one patients with New York Heart Association (NYHA) Class II, III ischemic HF, ejection fraction between 15% and 40%, and dilated akinetic or dyskinetic anterior-apical wall without the need to be revascularized were enrolled from seven sites in China from October to December 2014. The Parachute device was implanted through femoral artery. All patients received low-dose aspirin and anticoagulation with warfarin for at least 12 months postdevice implantation. The primary end-point was the assessment of efficacy as measured by the reduction in LV end-systolic volume index (LVESVI) against baseline LVESVI at 3 months postdevice implantation, determined by the echocardiography and measured by echocardiography core laboratory. Quality of life was assessed using EQ-5D and visual analog scale (VAS). For quantitative data comparison, paired t-test (normality data) and signed-rank test (abnormality data) were used; application of signed-rank test was for the ranked data comparison.
Results:
A change in LVESVI as measured by echocardiography from the preimplant baseline to 3-month postdevice implantation revealed a statistically significant reduction from 77.5 ± 20.0 ml/m2 to 53.1 ± 17.0 ml/m2 (P < 0.0001). The trial met its primary end-point. Of the 31 patients, the procedural success was 96.8%. Overall, NYHA HF class assessment results showed an improvement of more than half a class at 3 months (P < 0.001). Quality of life assessed by the VAS value increased 11.5 points (P < 0.01), demonstrating improvement at 3 months.
Conclusion:
The favorable outcomes observed in the high-risk patients provide reassuring safety and efficacy data to support adoption of this technology as a therapeutic option for ischemic HF patients.
Trial Registration:
ClinicalTrials.gov, NCT02240940; https://clinicaltrials.gov/ct2/show/NCT02240940.
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肌萎缩侧索硬化患者腹直肌失神经与通气功能障碍的关系Hua-Gang Zhang, Shuo Zhang, Ying-Sheng Xu, Nan Zhang, Dong-Sheng Fan
中华医学杂志英文版2016年 129卷 17期
DOI: 10.4103/0366-6999.189070
摘要
Background:
Spontaneous potentials in electromyography (EMG) of paraspinal muscles are associated with diaphragm denervation and, therefore, poor respiratory function in amyotrophic lateral sclerosis (ALS) is understandable. EMG changes in the rectus abdominis (RA) display an effect similar to those in paraspinal muscles with respect to the function of lower motor neurons in the thoracic spinal cord. The RA denervation was examined to determine its association with ventilation dysfunction in ALS.
Methods:
We collected the clinical data of 128 patients with sporadic ALS in Department of Neurology of Peking University Third Hospital from 2009 to 2013. EMG, Revised ALS Functional Rating Scale (ALSFRS-R) and forced vital capacity (FVC) were performed in all patients and the differences in the EMG changes in RA between those with and without FVC ≥ 80% were analysed.
Results:
The mean FVC value was 83.4% ± 17.1% (range: 45%–131%) of the predicted value. A total of 79 patients displayed FVC ≥80%, and 49 patients displayed FVC <80%. Compared with the patients displaying a normal FVC (60/79, 75.9%), spontaneous activity in RA was significantly different among those patients displaying an FVC <80% (47/49, 95.9%). In addition, spontaneous potentials in RA were more frequently detected in patients exhibiting dyspnea (32/33, 97.0%) than in patients without dyspnea (75/95, 78.9%).
Conclusion:
Spontaneous potentials in RA are associated with ventilation dysfunction and dyspnea in ALS patients.
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超声引导下输尿管软镜治疗肾盏憩室结石的回顾性分析Ji-Qing Zhang, Yong Wang, Jun-Hui Zhang, Xiao-Dong Zhang, Nian-Zeng Xing
中华医学杂志英文版2016年 129卷 17期
DOI: 10.4103/0366-6999.189060
摘要
Background:
Percutaneous nephrolithotomy (PCNL) is the most widely recommended treatment for calyceal diverticular calculi, providing excellent stone-free results. However, its invasiveness is not negligible considering its major complication rates. Flexible ureteroscopy (FURS) is currently used to treat calyceal diverticula. However, the greatest drawback of FURS is locating the diverticulum since its neck is narrow and concealed. In such a case, the FURS procedure must be converted to PCNL. The aim of this study was to evaluate ultrasound-guided flexible ureteroscopy (UFURS) identifying diverticulum and the management of calyceal diverticular calculi.
Methods:
A retrospective analysis was conducted on 24 patients who had calyceal diverticular calculi. In all 12 patients in the UFURS group, direct FURS failed to find evidence of calyceal diverticula but were confirmed with imaging. The other 12 patients in the PCNL group received PCNL plus fulguration of the diverticular walls.
Results:
Puncture of calyceal diverticulum was successful in all 12 UFURS patients. Two patients in this group had postoperative residual calculi and two patients developed fever. In the PCNL group, percutaneous renal access and lithotomy were successful in all 12 patients. One patient in this group had residual calculi, one had perirenal hematoma, and two patients developed fever. No significant difference was found in the operating time (UFURS vs. PCNL, 91.8 ± 24.2 vs. 86.3 ± 18.7 min), stone-free rate (UFURS vs. PCNL, 9/12 vs. 10/12), and rate of successful lithotripsy (UFURS vs. PCNL, 10/12 vs. 11/12) between the two groups (all P > 0.05). Postoperative pain scores in the FURS group were significantly lower than that in the PCNL group (2.7 ± 1.2 vs. 6.2 ± 1.5, P < 0.05). Hospital stay in the UFURS group was significantly shorter than that in the PCNL group (3.4 ± 0.8 vs. 5.4 ± 1.0 days, P < 0.05). All patients were symptom-free following surgery (UFURS vs. PCNL, 10/10 vs. 12/12).
Conclusion:
Ultrasound-guided puncture facilitates identification of calyceal diverticula during FURS and improves the success rate of FURS surgery.
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ST段抬高型心肌梗死患者的大多数罪魁祸首病变中存在严重狭窄Li Sheng, Shuang Li, Jian-Qiang Li, Jing-Yi Xue, Yan-Ming Sun, Yong-Tai Gong, Ling Jing, Dang-Hui Sun, Wei-Min Li, Ding-Yu Wang 等
中华医学杂志英文版2016年 129卷 17期
DOI: 10.4103/0366-6999.189053
摘要
Background:
Previous studies revealed that culprit vessels of ST-segment elevation myocardial infarction (STEMI) were often related to mild or moderate stenosis. However, recent studies suggested that severe stenosis was primarily found in culprit lesions. The objective of this study was to analyze the stenosis severity of culprit lesions in STEMI patients and to clarify the paradoxical results.
Methods:
A total of 489 consecutive STEMI patients who underwent primary percutaneous coronary intervention were retrospectively studied from January 2012 to December 2014. The patients were divided into three groups based on stenosis severity using quantitative coronary analysis: Group A, 314 cases, stenosis ≥70%; Group B, 127 cases, stenosis 50–70%; and Group C, 48 cases, stenosis ≤50%. The clinical, demographic, and angiographic data of all groups were analyzed.
Results:
Patients in Group A exhibited a significantly higher prevalence of history of angina pectoris (95.9% vs. 62.5%, P < 0.001), multivessel disease (73.2% vs. 54.2%, P = 0.007), and lower cardiac ejection fraction (53.3 ± 8.6 vs. 56.8 ± 8.4, P = 0.009) than those in Group C. Multivariable analysis revealed that history of angina pectoris (odds ratio [OR]: 13.89, 95% confidence interval [CI]: 6.21–31.11) and multivessel disease (OR: 2.32, 95% CI: 1.25–4.31) were correlated with severe stenosis of the culprit lesion in Group A.
Conclusions:
Most culprit lesions in STEMI patients were severe stenosis. These patients exhibited a higher prevalence of angina history and multivessel diseases.
Review Article
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为中风患者提供高质量的健康信息Hong-Sheng Du, Jing-Jian Ma, Mu Li
中华医学杂志英文版2016年 129卷 17期
DOI: 10.4103/0366-6999.189065
摘要
Objective:
High-quality information provision can allow stroke patients to effectively participate in healthcare decision-making, better manage the stroke, and make a good recovery. In this study, we reviewed information needs of stroke patients, methods for providing information to patients, and considerations needed by the information providers.
Data Sources:
The literature concerning or including information provision for patients with stroke in English was collected from PubMed published from 1990 to 2015.
Study Selection:
We included all the relevant articles on information provision for stroke patients in English, with no limitation of study design.
Results:
Stroke is a major public health concern worldwide. High-quality and effective health information provision plays an essential role in helping patients to actively take part in decision-making and healthcare, and empowering them to effectively self-manage their long-standing chronic conditions. Different methods for providing information to patients have their relative merits and suitability, and as a result, the effective strategies taken by health professionals may include providing high-quality information, meeting patients’ individual needs, using suitable methods in providing information, and maintaining active involvement of patients.
Conclusions:
It is suggested that to enable stroke patients to access high-quality health information, greater efforts need to be made to ensure patients to receive accurate and current evidence-based information which meets their individual needs. Health professionals should use suitable information delivery methods, and actively involve stroke patients in information provision.
Criteria and Guidance
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心肺复苏后昏迷评估的中国专家共识Neurocritical Care Committee of the Chinese Society of Neurology (NCC/CSN)
中华医学杂志英文版2016年 129卷 17期
DOI: 10.4103/0366-6999.189054
摘要
心肺复苏（CPR）后昏迷患者的预后可能较差（定义为大脑功能类别评分为3至5分）。[
Clinical Practice
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中国上海首次人感染甲型H7N9禽流感病毒后5名幸存者的长期随访Xin-Jun Tang, Xiu-Hong Xi, Cui-Cui Chen, Min Tang, Shu-Jing Chen, Zhen-Hua Zhu, Dong-Ni Hou, Shui-Hua Lu, Tao Li, Chun-Xue Bai 等
中华医学杂志英文版2016年 129卷 17期
DOI: 10.4103/0366-6999.189061
摘要
2013年3月底，上海确诊首例人感染甲型H7N9禽流感病毒病例。2013年4月至5月，上海市公共卫生临床中心收治了18例甲型H7N9禽流感病毒感染患者，最终，其中12例存活。这些患者的短期预后已经在前面描述过，[
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原发性小肠鳞状细胞癌的发病机制及临床特点Feng-Dan Wang, Zhi-Wei Wang, Hua-Dan Xue, Huan-Wen Wu, Yan Zhang, Jian-Chun Yu, Zheng-Yu Jin
中华医学杂志英文版2016年 129卷 17期
DOI: 10.4103/0366-6999.189067
摘要
相对于胃肠道的长度和表面积，小肠恶性肿瘤非常罕见，全球发病率为<每10万人口中有1人。[
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先天性同乳伴巨乳的矫正：一例罕见病例报告及设计的治疗算法Kyu Nam Kim, Won Ha, Chi Sun Yoon, Hoon Kim
中华医学杂志英文版2016年 129卷 17期
DOI: 10.4103/0366-6999.189066
摘要
乳房发育症被定义为两个乳房的内侧汇合或乳房被胸骨上的软组织统一，使它们不可分离。它最早是由Spence在整形外科文献中描述的等人.1984年。[
Correspondence
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类似肺曲菌瘤的囊性支气管扩张Hong-Xia Shao, Hui Ning, Li Li, Qi Wu, Yong-Mei Wang, Zhi-Heng Xing, Cheng-Zhi Wang
中华医学杂志英文版2016年 129卷 17期
DOI: 10.4103/0366-6999.189051
摘要
致编者：一名65岁女性患者，主诉咯血和左上胸疼痛约1周。病史提示冠心病、阵发性房颤，吸烟40年左右，不饮酒，无特殊接触史。既往有慢性咳嗽史，无呼吸困难或咯血约20年。体格检查显示，一名发育良好、营养良好的女性没有明显的痛苦。患者无发热，心率78次/分钟，血压130/70 mmHg，呼吸频率18次/分钟，室内空气氧饱和度100%。无外周淋巴结病。胸部听诊稍减弱，左上肺闻及呼吸音，双肺未闻及干湿罗音。
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肺叶切除术后呼吸困难和疲劳：优化资源分配的测量量表Massimiliano Polastri, Andrea Dell’Amore, Giampiero Dolci, Niccolò Daddi
中华医学杂志英文版2016年 129卷 17期
DOI: 10.4103/0366-6999.189063
摘要
致编者：肺叶切除术微创技术的疗效在文献中引起了极大的兴趣。最近，已经报道了电视辅助胸外科（VATS）的新手术策略和技术改进。[
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