医学英文文献汇报
英文文献汇报
table of Contents
literature1--Predicting health-related quality of life in
cancer patients receiving chemotherapy: a structural equation approach using the self-control model（预测接受化疗的癌症患 者的健康相关生活质量：使用自我控制模型的结构方程方法）
literature1--Conclusions:（结论）
Self-control plays a significant role in the protection and promotion of physical and mental health in various stressful situations, and thus, as a psychological resource, it plays a significant role in quality of life. Our results can be used to develop a quality of life model for patients receiving chemotherapy and as a theoretical foundation for the development of appropriate nursing interventions。 自我控制在各种压力情境中对保护和促进身心健康起着重要作用，因此作为一种心理 资源，它在生活质量中发挥着重要作用。我们的研究结果可用于开发接受化疗的患者 的生活质量模型，并作为开发适当护理干预措施的理论基础。
临床论文英语作文
临床论文英语作文Clinical Research Paper。
Introduction。
Clinical research is a critical component of medical science that aims to improve patient care through the useof scientific methods. The purpose of this paper is to present a clinical research study that explores the effectiveness of a new treatment for a specific medical condition. The study was designed to evaluate the safetyand efficacy of the treatment in a randomized, double-blind, placebo-controlled trial.Background。
The medical condition being studied is chronic migraines, which affect millions of people worldwide. Chronic migraines are defined as headaches that occur for more than 15 days per month for at least three months. Thecondition can be debilitating and can significantly impact the quality of life of those affected. Current treatments for chronic migraines include medications, lifestyle changes, and alternative therapies. However, many patients do not respond well to these treatments or experience significant side effects.The new treatment being studied is a combination of two medications, one of which is a well-known migraine medication, and the other is a medication that has been shown to reduce inflammation. The hypothesis is that the combination of these two medications will be more effective than either medication alone in reducing the frequency and severity of migraines.Methods。
科研英文文献汇报英文--MicroRNA.
Methods
Results
Conclusion
全基因组 miRNA测序 miR-224 在ADC及SCC 中miR-224 明显 上调 相关分析 细胞转染 过表达及 下调系统 体外 细胞系 体内 裸鼠 寻找 作用靶点 相关分析 TNFAIP1及 SMAD4的3′-UTRs 共转染3′UTRs及 miRNA TNFAIP1及 SMAD4是否为 特异性靶点 转染细胞 相关分析 miR-224与 启动子甲基 化的关系 低甲基化探针 相关分析及 细胞系 佛脂醇治疗
MicroRNA-224 promotes tumor progression in nonsmall cell lung cancer
MiR-224促进非小细胞肺癌肿瘤形成
汇报人：李婷
目录
Contents
introduction
Methods Results
Discussion
Others
在全世界，肺癌是癌症相关性疾病中主要的致病因。 尽管手术及药物治疗水平有所提高，肺癌患者的生存率 依然极低。总体来说，分期较早的非小细胞肺癌患者， 无论是手术还是非手术患者均得到了控制。然而，非小 细胞肺癌导致局部及远处转移的分子机制尚不清楚。
666例ADC及SCC
86例NAT
相较于NATs，miR-224在ADC及SCC中明 显上调
Of the evaluable 468 primary lung ADC patients, 46 patients had matched normal adjacent tissues. Of the evaluable 198 primary lung squamous carcinoma patients, 40 patients had matched normal adjacent tissues.
英文版医学学术报告发言稿
英文版医学学术报告发言稿Ladies and gentlemen,It is my privilege to stand before you today to discuss an important aspect of medical advancements. As we delve deeper into our understanding of diseases and patient care, the role of healthcare professionals in research and academic studies becomes increasingly significant. In this regard, I would like to share with you some valuable insights into the essential components of a medical research paper that can contribute to the progress of our field.Firstly, the introduction section of a research paper sets the tone for the entire study. It should provide a clear background and rationale for the research, including a concise literature review of similar studies. This part serves to establish the significance of the research topic and the potential impact of the study.Next, the methodology section outlines the detailed procedures and methods used to investigate the research question. It should be transparent, enabling others to replicate the study and validate the findings independently. Accurate reporting of research methods and ethical considerations ensures the credibility and reproducibility of the study.Moving forward, the results section presents the findings obtained from the data analysis. It should be organized and concise, using appropriate statistical methods to summarize the results effectively. Clear graphs, tables, or figures can aid in the visual representation of the data and facilitate better comprehension by the readers.The discussion section allows the authors to interpret the results and link them to the existing body of knowledge. It is essential to emphasize the implications of the findings and discuss any limitations or potential biases of the study. Additionally, it provides an opportunity to propose future research directions and expand on the clinical applications of the research.Furthermore, the conclusion section should be a succinct summary of the main findings and their implications. It should avoid the repetition of the results or any new information not previously discussed. A well-crafted conclusion strengthens the overall impact of the research and can influence future studies.Lastly, proper citation and referencing are critical components of any academic paper. Accurately citing the sources used in the study acknowledges the intellectual contributions of other researchers and adds credibility to the research. Adhering to a specific citation style, such as APA or MLA, ensures consistency and conformity to academic standards.In conclusion, the various sections of a medical research paper play integral roles in advancing medical knowledge and patient care. The introduction sets the stage, the methodology ensures transparency, the results provide empirical evidence, the discussion promotes critical thinking, and the conclusion summarizes the main findings. Adhering to proper citation practices enhances the credibility of the research.Thank you for your attention, and I hope that these insights willprove valuable in your future endeavors in medical research and scholarly writing.。
英文医学文献
英文医学文献全文共四篇示例，供读者参考第一篇示例：Medical literature in English is a vast and diverse field that encompasses a wide range of topics, from basic biomedical research to clinical trials and case studies. It plays a crucial role in the advancement of medical knowledge and the improvement of patient care worldwide.Another challenge of English medical literature is the potential for bias and misinformation. Not all research studies are of equal quality, and it is important for healthcare professionals to critically evaluate the evidence presented in medical literature before applying it to patient care. Thepeer-review process, in which research articles are reviewed by experts in the field before publication, helps to ensure the quality and reliability of medical literature. However, it is still crucial for healthcare professionals to approach medical literature with a critical eye and a thorough understanding of research methods and study design.第二篇示例：Medical literature in English is an essential component of the global healthcare system. It provides valuable information and research findings that help medical professionals stay current with the latest advancements in the field. English language medical literature covers a wide range of topics, including clinical research, case studies, reviews, and guidelines for treatment.第三篇示例：Medical literature refers to the body of scholarly publications and research articles that focus on the field of medicine. These articles are written by healthcare professionals, researchers, and experts in various medical specialties. They are essential for advancing medical knowledge, disseminating new discoveries, and improving patient care.第四篇示例：Medical literature in English plays a crucial role in the field of healthcare and medical research. It serves as a valuable resource for healthcare professionals, researchers, and students around the world, providing up-to-date information on a wide range of medical topics. In this article, we will explore the importance of English medical literature, its benefits, and how it contributes to advancements in the field of medicine.Importance of English Medical Literature。
科研英文文献汇报英文 MicroRNA
87例NSCLC
48例NAT
(正常)
在ADC及SCC中，miR-224 明显上调
Ohio State University Comprehensive Cancer Center (OSUCCC) 俄亥俄州立大学综合癌症中心
The Cancer Genome Atlas (TCGA) 癌症和肿瘤基因图谱
表达水平 及是否与 转移有关
体外
转染细胞
过表达及 降低系统
统计细胞的 迁移、侵袭 及增殖能力
miR-224 在肺 癌中的作用
过表达及 降低系统 转染细胞
皮下注射 至裸鼠
观察肿瘤体积 及镜下改变
miR-224在肺 癌中的作用
体内
4例伴淋巴结转移的肺腺癌 6例不伴淋巴结转移的肺腺癌
genome-wide miRNA sequencing
在非小细胞肺癌组织中，我们证实了 microRNA224 (miR-224) 显著上调，尤其发生转移的组织中。增 加miR-224 表达水平，其通过以抑癌物质TNFα-
Methods induced protein 1 (TNFAIP1) （肿瘤坏死因子介导蛋
白1）及SMAD4为靶点，从而促进了细胞的迁移，侵袭 及增殖。与体外实验一致，裸鼠异体移植实验也证实了
Results miR-224 在体内非小细胞肺癌中作为强力致癌的 miRNA 。同时，我们还发现了在非小细胞肺癌中，启动 子甲基化及ERK信号参与调节miR-224 的表达。上调的 miR-224 通过拮抗SMAD4及SMAD4 的抑制作用，从而 增强非小细胞肺癌的形成及肿瘤侵袭性。 Conclusion
在ADC及SCC 中miR-224 明显 上调
相关分析 细胞转染
如何写英文医学综述作文
如何写英文医学综述作文英文：As a medical student, I have had the opportunity to write several medical review articles. Writing a medical review article involves a thorough understanding of the topic, extensive research, and the ability to critically analyze and synthesize information from various sources. It is important to present the information in a clear and organized manner, and to provide a comprehensive overview of the topic.Before starting to write a medical review article, itis crucial to choose a relevant and interesting topic. This could be a current issue in medicine, a new treatment or diagnostic approach, or a review of existing literature on a specific disease or condition. Once the topic is chosen, it is important to conduct a comprehensive literature search to gather relevant information from peer-reviewed journals, textbooks, and reputable websites.中文：作为一名医学生，我有机会写了几篇医学综述文章。
医学英文文献汇报——HIV 中和性抗体
4. Tested volunteer plasmas against four
subtype B isolates, which known as virus
In one study, overall binding and Nab development appeared to be impaired in patients who were treated with HAART shortly after seroconversion（血清转换）.
2. The expanded neutralization group possessed a significantly lower viral load posttreatment interruption (24-week after treatment interruption). At study endpoint, the expanded neutralization group advantage was no longer significant.
High-titer, heterologous （异种的）HIV-1 NAbs were associated with a reduction in HIV-1 viral load in individuals possessing a more extensive neutralization phenotype （ 表 型 ） but there appeared to be minimal impact on CD4 T-cell decline.
医学类英文文献作总结
医学类英文文献作总结Title: Summarizing Medical English Literature: A Comprehensive GuideIntroduction:Summarizing medical English literature is an essential skill for healthcare professionals, researchers, and students.It allows for quick understanding of complex research findings and facilitates knowledge sharing within the medical community.In this document, we will provide a detailed guide on how to effectively summarize medical English literature, ensuring accuracy, clarity, and coherence.1.Understanding the Purpose:Before diving into the literature summary, it is crucial to understand the purpose behind it.Are you summarizing for personal study, a research paper, or to update colleagues on recent findings? Defining the purpose will help tailor your summary accordingly.2.Identifying Key Components:To create an effective summary, identify the key components of the literature you are reading.These typically include:a.Objective: The research question or aim of the study.b.Methods: The design, sample size, and methodology used inthe research.c.Results: The main findings of the study, including statistical analysis.d.Conclusion: The authors" interpretation of the results and their implications.e.Key Points: Any notable or controversial aspects of the study.3.Outlining the Summary:Create an outline to structure your summary.This will help you stay organized and ensure that you cover all important aspects of the literature.Here"s a suggested outline:a.Introduction: Briefly introduce the topic and the purpose of the summary.b.Objective: State the research question or objective of the study.c.Methods: Summarize the study design and methodology.d.Results: Present the main findings, focusing on key statistics.e.Conclusion: Summarize the authors" interpretation and implications of the results.f.Key Points: Highlight any notable or controversial aspects of the study.g.Critique (optional): Provide a brief critique of the study, discussing strengths and limitations.4.Writing Style and Language:When summarizing medical English literature, it is important to maintain a clear, concise, and objective writing e the active voice, avoid jargon, and explain any complex terms orconcepts.Additionally, ensure proper grammar, punctuation, and syntax to enhance readability.5.Citing Sources:Accurately cite the sources you have summarized to give credit to the original authors.Follow the appropriate citation style, such as APA or AMA, to maintain academic integrity.6.Reviewing and Editing:After completing the initial draft of your summary, take the time to review and edit it.Check for clarity, coherence, and accuracy.Ensure that your summary captures the essence of the original literature withoutdistorting the authors" intentions.Conclusion:Summarizing medical English literature is a valuable skill that requires careful attention to detail and a clear understanding of the subject matter.By following the guidelines provided in this document, you will be well-equipped to create accurate, concise, and effective summaries that contribute to the medical community"s knowledge base.。
医学英文短文范文
医学英文短文范文English:As medical professionals, we often deal with patients who may be experiencing pain or discomfort. One way we can help them is by utilizing pain management techniques. Pain management can range from non-invasive methods like heat or cold therapy, to medication management, to more invasive procedures like nerve blocks or injections. It is important for us to assess each patient individually and determine the best course of action for their specific situation. We must also be aware of any potential risks or side effects of each method and educate the patient on these as well. Effective pain management can greatly improve a patient's quality of life and their ability to participate in daily activities.Translated content:作为医学专业人员，我们经常接触到可能正在经历疼痛或不适的患者。
我们可以通过利用疼痛管理技术来帮助他们。
疼痛管理可从非侵入性的方法，如热或冷疗法，到药物管理，到更侵入性的程序，如神经阻滞或注射。
文献汇报英文发言稿范文
Good morning/afternoon. Today, I am honored to present a literature review on the topic of "Artificial Intelligence in Healthcare". This topic has gained significant attention in recent years, as AI technology has been rapidly advancing and showing great potential in transforming the healthcare industry.To begin with, let me introduce the background of the topic. Artificial intelligence refers to the simulation of human intelligence in machines that are programmed to think like humans and mimic their actions. Healthcare, on the other hand, is the field concerned with the prevention, diagnosis, treatment, and management of diseases and injuries. The integration of AI into healthcare has the potential to improve patient outcomes, reduce costs, and enhance the overall efficiency of healthcare systems.In this literature review, we will explore several key aspects of AI in healthcare. First, we will discuss the applications of AI in medical diagnosis. Several studies have shown that AI algorithms can outperform human doctors in detecting diseases, such as cancer, by analyzing medical images, such as X-rays and MRI scans. For example, a study by Google DeepMind demonstrated that its AI system could identify diabetic retinopathy with a level of accuracy comparable to human experts.Secondly, we will examine the role of AI in drug discovery and development. AI has the potential to accelerate the process of drug discovery by identifying potential drug candidates more quickly and efficiently. A study by Atomwise, an AI drug discovery company, reported that its AI system identified potential drugs for the treatment of Ebola virus in just 47 days, which is significantly faster than traditional methods.Thirdly, we will explore the use of AI in patient care and treatment planning. AI can assist healthcare professionals in making personalized treatment plans by analyzing vast amounts of patient data, including genetic information, medical history, and lifestyle factors. A study by IBM Watson for Health showcased how its AI system could help identify the most effective treatment plan for a patient with cancer by analyzing the patient's genetic makeup and medical records.Moreover, we will discuss the ethical considerations associated with the use of AI in healthcare. One of the primary concerns is the potentialfor bias in AI algorithms, which could lead to unequal treatment of patients based on race, gender, or socioeconomic status. Another concern is the privacy of patient data, as AI systems require access tosensitive information. Researchers are actively working on addressing these concerns by developing fair and transparent AI algorithms and implementing robust data protection measures.In conclusion, the literature review on the topic of "Artificial Intelligence in Healthcare" highlights the significant potential of AI technology in transforming the healthcare industry. By improving medical diagnosis, accelerating drug discovery, and enhancing patient care, AI can play a crucial role in improving patient outcomes and reducing healthcare costs. However, it is essential to address the ethical concerns associated with AI in healthcare to ensure that it is used responsibly and for the benefit of all patients.Thank you for your attention, and I am now open to any questions or comments you may have.。
医学英语总结汇报
医学英语总结汇报Medical English Summary and ReportIntroduction:Medical English is a specialized branch of the English language that is used within the medical field. It is essential for healthcare professionals to have a good understanding of medical terminology and be able to effectively communicate with patients and colleagues in English-speaking countries. This report aims to summarize the key aspects of medical English and highlight its importance in the healthcare industry.Medical Terminology:Medical terminology is a unique vocabulary used in the medical field. It consists of specific words and phrases that describe diseases, symptoms, treatments, and anatomical structures. Medical professionals need to be proficient in medical terminology to accurately communicate their observations, diagnoses, and treatment plans. Learning medical terminology enhances communication between healthcare professionals and provides clarity to patients, ensuring that medical information is accurately conveyed.Communication Skills:Effective communication is crucial in healthcare settings as it plays a significant role in patient care and safety. Medical English provides the necessary skills for healthcare professionals to communicate clearly and effectively. This includes skills such as active listening, empathy, and the ability to provide clear instructions to patients. Good communication ensures that patientsfeel heard, understood, and involved in their own care, leading to better health outcomes.Medical Writing:Medical writing involves the creation of various documents, such as medical reports, research papers, and patient records. These documents must be written accurately and concisely to convey medical information effectively. Medical English provides the necessary knowledge and skills to write in a clear, professional manner. This ensures that medical information is documented accurately and can be easily understood by other healthcare professionals.International Collaboration:The field of medicine has become increasingly globalized, with healthcare professionals collaborating across borders. Medical English facilitates international collaboration by providing a standardized language for communication. Healthcare professionals from different countries can effectively communicate and share medical knowledge, leading to improved patient care worldwide.Skills for Medical Professionals:Proficiency in medical English is a critical skill for healthcare professionals. It allows them to effectively communicate with patients from diverse linguistic backgrounds. Medical English also helps healthcare professionals stay updated with the latest medical research and literature, enabling them to provide evidence-based care. Additionally, proficiency in medical English is often required for professionals seeking to work in English-speaking countries orto pursue higher education in medicine.Conclusion:In conclusion, medical English plays a vital role in the healthcare industry. It provides healthcare professionals with the necessary skills to communicate effectively with patients and colleagues. Proficiency in medical terminology and writing ensures accurate and concise communication of medical information. Furthermore, medical English facilitates international collaboration and enhances the professional development of medical professionals. With the increasing globalization of healthcare, proficiency in medical English is becoming an essential skill for healthcare professionals worldwide.。
胸外科英文文献汇报
03
English Literature Review
Literature Overview
01
The literature review covers a range of English language studies on thermal surgery, including peer-reviewed articles, conference proceedings, and book chapters
Literature sources and screening criteria
The literature sources for this report include peer-reviewed journals, conference proceedings, and grey literature
Thrombectomy or electromagnetism may be performed to remove the blood clot obstructing the pulmonary art
Bronchial asthma
Surgical treatment may be considered for multiple cases that are reflective to medical management
如何写英文医学综述作文
如何写英文医学综述作文英文：Writing a medical review article can be a challenging but rewarding task. It requires a thorough understanding of the topic, as well as the ability to critically analyze and synthesize existing research. In this article, I will discuss the key steps and considerations for writing a comprehensive medical review.First and foremost, it is important to choose a topic that is both relevant and of interest to the medical community. This could be a current issue or a topic that has not been comprehensively reviewed in the literature. For example, I recently wrote a review article on the use of telemedicine in rural healthcare settings. This topic is of growing importance, especially in light of the COVID-19 pandemic, and there was a need for a comprehensive review of the existing literature.Once a topic has been chosen, the next step is to conduct a thorough literature search. This involves searching electronic databases, such as PubMed and Google Scholar, as well as relevant medical journals and textbooks. It is important to cast a wide net and include both primary research articles and review papers. In my own experience,I found that including a variety of sources helped to provide a comprehensive overview of the topic.After gathering the necessary literature, the next step is to critically analyze and synthesize the information. This involves identifying key themes and trends, as well as evaluating the strengths and limitations of the existing research. For example, in my review article on telemedicine, I identified several key themes, such as the potential benefits of telemedicine in improving access to healthcare, as well as the challenges related to technological infrastructure and reimbursement policies.Once the information has been synthesized, it is important to structure the review article in a clear and logical manner. This typically includes an introductionthat outlines the importance of the topic, followed by sections that cover the key themes and findings from the literature. It is also important to provide a critical discussion of the literature and identify any gaps or areas for future research. In my own article, I structured it in a way that allowed for a smooth flow of information, making it easy for readers to follow the argument.Finally, it is important to carefully edit and revise the article to ensure clarity and coherence. This involves checking for grammatical and typographical errors, as well as ensuring that the arguments are well-supported by the evidence. It can also be helpful to have colleagues or mentors review the article and provide feedback. In my own experience, I found that seeking feedback from others helped to improve the overall quality of the article.In conclusion, writing a medical review article requires careful planning, thorough research, critical analysis, and effective communication. By following these key steps and considerations, it is possible to produce a comprehensive and impactful review article that contributesto the medical literature.中文：写医学综述文章可能是一项具有挑战性但有益的任务。
三甲医院外文文献汇报范文
三甲医院外文文献汇报范文Modern nursing requires that nursing staff must have a healthy psychology, however, due to the nature of the occupation, special environment atmosphere, overload work to the psychology of nurses has caused great pressure, directly affecting the mental health of nursing staff, the quality of nursing work. As a nursing manager of the primary hospital, we should change the traditional management mode, pay attention to the humanistic care of nursing staff, and maintain the mental health of nursing staff from many aspects, so as to better improve the quality of nursing. 1 Factors affecting the mental health of the caregivers Nurse professional stressors reflect: ①work nature of nursing social status is too low, the opportunity to further study too little, high risk, often face severe rescue, new technology, new business and various kinds of diseases, clinical nurses must timely observe the patient's condition change and timely and accurate response, and to meet the various needs of the patients, these make the nurse work pressure.②In terms of workload and time allocation, too few nurses worked, overloaded with work and life were irregular. "three shifts" and "flexible shifts" disruptedthe biological clock of nurses 'work, which had a certain impact on nurses' psychology, physiology and family.③working environment and equipment problems such as poor working environment, insufficient equipment, etc. Problems in the care of ④patients, such as worry about errors at work, nurses are not recognized by patients and their families, nursing patients are too seriously ill, family members are not understanding, and / or the competent doctor's doubts about the quality of care.⑤interpersonal relationship problems such as the lack of understanding and respect of other health staff, especially when nursing and patient conflicts, nursing managers can not handle properly, nurses must suppress their own feelings and make spiritual compromise. 2. Humanistic care measures that nursing managers should take 2.1 Guide nurses to actively deal with pressure Usually, positive coping methods can effectively respond to psychological stress and restore the physical and psychological balance; negative coping can often continue to stay in a stressful stress state, continue to consume their potential energy, produce burnout, and even cause mental illness. As nursing managers, should fully pay attention to, investigation, analysis and nurses face stress sources and type, help nurses know their pressure leveland inherent pressure coping, provide pressure management information, knowledge, for nurses to subscribe to journals and magazines about maintaining mental health and health, stress management courses, etc., make nurses understand the serious consequences of stress, physiological, mood, behavior, mental symptoms, stress self adjustment healthy recipes, regular exercise, self relaxation techniques, let nurses build "psychological immunity" dam, enhance the psychological "seismic" ability.。
医学研究英文作文
医学研究英文作文英文：As a medical researcher, I believe that the field of medicine is constantly evolving and there is always roomfor improvement. Research is essential to identify new treatments and therapies that can improve patient outcomes and quality of life.One of the most exciting areas of medical research is the development of personalized medicine. This approach takes into account a patient's individual genetic makeup, lifestyle, and environment to create customized treatment plans. For example, if a patient has a genetic predisposition to a certain disease, personalized medicine can help identify early warning signs and provide targeted interventions to prevent the disease from developing.Another important area of medical research is the study of rare diseases. These diseases may affect only a smallnumber of people, but they can have devastating effects on those individuals and their families. By studying rare diseases, researchers can gain a better understanding of the underlying mechanisms of disease and develop new treatments that can benefit not only those with rare diseases, but also patients with more common conditions.In addition to these areas of research, I believe that it is important to continue to explore new technologies and techniques that can improve patient care. For example, advances in imaging technology have allowed doctors to more accurately diagnose and treat a wide range of conditions. Similarly, the development of minimally invasive surgical techniques has reduced recovery times and improved patient outcomes.Overall, medical research is a critical component of improving healthcare and advancing our understanding of the human body. By continuing to invest in research and development, we can ensure that patients receive the best possible care and that we continue to make progress in the fight against disease.中文：作为一名医学研究者，我相信医学领域不断发展，总有改进的空间。
医学报告英语作文模板
医学报告英语作文模板Medical Report Template。
英文回答：Patient Information。
Patient Name: [Patient's name]Date of Birth: [Date of birth]Medical Record Number: [Medical record number]Presenting Complaint。
[Describe the patient's chief complaint]History of Present Illness。
[Provide a detailed account of the patient's symptoms,including onset, duration, severity, and associated factors]Past Medical History。
[List any relevant past medical conditions, including surgeries, hospitalizations, and medications]Family History。
[Note any significant family history of medical conditions]Social History。
[Document the patient's occupation, marital status, tobacco and alcohol use, and other relevant social factors]Medication History。
[List all current and recent medications, including dosages and administration routes]Physical Examination。
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肺静脉闭塞性疾病继发肺动脉高压症，并伴发右心衰、 低血压和急性肾损伤
报告人：xxxx
纲要
Abstract Background Case description Discussion
PVOD常常与肺结缔组织疾病、艾滋病、骨髓移植、化学风 险有关，但特发性占大多数。确诊需要肺组织学活检，但获 得这样一个组织标本的禁忌症就是患者有呼吸系统和血流动 力学的不稳定。虽然还有其他的诊断方法，比肺组织活检的 创伤要小，但是没有组织学的诊断很难区分PVOD特发性多 环芳烃特发性肺动脉高压和间质性肺病区分。
4
ቤተ መጻሕፍቲ ባይዱ
Discussion
Discussion
PVOD确实是肺动脉高压的一种罕见病因，通常疾病晚期才 能诊断出来并且预后往往很差。PVOD的年发病率估计为0.1 到0.2例每百万人口，还不包括很多例误诊为其他病因的 IPAH。许多PVOD病例为特发性，但是这些被报道出来的疾 病中被发现常常与肺结缔组织疾病，艾滋病，骨髓移植，化 学致病因素及某些化疗药物有关。组织学检查的主要病变是 小静脉内层的纤维化。纤维化会引起肺静脉梗阻，导致肺毛 细血管淤血、肺间质和胸膜水肿、淋巴结肿大肺泡的含铁血 黄素沉着。肺动脉闭塞也发生在多达一半的PVOD患者。长 期下去，那些患有PAH，右心室功能障碍的病人，尽管经过 药物治疗但仍然会进展为心肺衰竭。
血管舒张剂使用两天后，活检最终结果显示是PVOD 而不是 IPAH。为 了避免PVOD患者因使用血管舒张药而造成医源性肺水肿，前列环素便 停止使用了。考虑到患者严重的低氧血症和超高的动脉收缩压等症状， 该病人接受了双重心肺移植术的评估，缓解了她持久和严重的低氧血症 症状与上系统 PA的压力。在移植评估过程中,她决定不想再继续接受那 些试图稳定其进行性多器官功能障碍的治疗，并改为安适疗法。在撤去 支持治疗后数小时她便去世了。
Case description
在入院前4个月，经胸超声心动图提示病人有轻中度肺动脉 高压，肺动脉收缩压大约40mmHg并且房间隔变扁。随后的 进行左、右心脏导管插入术提示PA 50/19（平均31）且其 患有非梗阻性冠状动脉疾病。尽管积极使用速尿利尿以及使 用西地那非血管扩张剂治疗,患者呼吸困难仍然继续加剧且 伴有心悸。
在转入我院之前，她接受了大量的肺动脉高压项目检查发现 其恶化的肺动脉收缩压大约80mmHg之高，而且室间隔逐渐 变薄，左心室呈D样且右心室逐渐扩张。利尿治疗后，胸部 CTA显示：肺部非特异性的网格状改变考虑为ILD窗体顶端 ，且窗没有证据表明有肺栓塞可能.肺功能测试对肺在41% 预测值的CO扩散能力具有重要意义。而实验室检查包括甲 状腺功能、HIV、ANA检查均无特殊性。
在PVOD治疗的相关文献中发现其治疗包括肺动脉高压的某 些特定疗法，这会使肺水肿的风险增加，但可以作为肺或心 肺移植的桥梁。
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Case description
Case description
这位57岁女性有5个月的逐渐恶化的呼吸困难和干咳病史， 已经由最初轻微的症状，现在已经发展到静止性呼吸困难。 因为有显著高血压病史，她一直服用血管紧张素受体阻断剂 合并噻嗪类利尿剂20多年，她没有吸烟史，没有其他重大 心肺疾病。她的手术史、家族史和个人史都不是致病因素。 在病情介绍中，她有严重的血氧过低和低血压。心脏听诊第 二心音宏大，并有心室奔马率(S3)，胸骨旁心脏异常搏动和 心动过速。肺部听诊呼吸音粗和两侧干啰音。双下肢有明显 的凹陷性水肿。其余检查没有明显结果。
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Abstract
Abstract
肺静脉闭塞性疾病(PVOD)是一种罕见疾病，可以导致严重的肺动脉高压，右心 室功能障碍，和心肺衰竭。PVOD没有特异性症状，并且与特发性肺动脉高血压 和间质性肺疾病的诊断有相似性，所以其诊断具有一定挑战性。
本病例是一位有进行性的呼吸困难伴干咳的57岁女性病人。由于其非特异性症 状，该病人被考虑为间质性肺病并接受外科肺活检检查。后来她血液流动开始 不稳定，被转到我们医院，随即又开始出现严重的低氧血症，低血压和肺动脉 高压。初步肺活检结果提示为特发性肺动脉高血压，该病人也开始连续输注包 括前列环素在内的血管舒张剂。肺动脉压力下降但仍高于正常，并且病人病情 也没有改善。后来经过专业实验室的最终审查被诊断为PVOD，随即停止了血管 舒张治疗，也开始考虑是否可以进行双心肺移植。
Case description
图1所示。肺活检病理切片。被增生的纤维结缔组织填充的胸膜下小叶间静脉 (箭头所示)。
Case description
该病人被转移到附近的医院进行会诊和治疗。留置的漂浮导管监测结果 示系统PA压力为104/46mmHg（平均67）；心输出量增加至4.98L/min ，肺毛细血管楔压为10mmHg。该患者一开始就是以特发性肺动脉高压 进行治疗的，包括持续吸入NO、西地那非、前列环素等血管舒张剂等 药物治疗。经过治疗，患者PA有轻微改善，但血氧过低和呼吸困难症状 仍存
Case description
在这一点上，鉴于ILD的主要表现，以及病人的严重低氧血 症,CTA检查结果和肺功能测试，外院给她进行了支气管镜 检查和胸腔镜肺活检。而这一系列检查我们都不推荐。在麻 醉诱导后立即出现的无脉性电活动又使病情更加复杂化。这 个病人经历了不到5分钟心肺复苏后才恢复自主循环，整个 过程也才完成。随后，该患者出现低血压，并需要用多巴胺 +米力农等血管收缩药物来维持。初步肺活检结果与与特发 性肺动脉高压是一致的；活检的切片被送到外面的专业实验 室（图1示）。
该病人诊疗经过十分复杂，既需要血管升压药来治疗低血压，又有逐渐恶化的 右心室功能障碍和急性肾损伤。在移植评估过程中，她决定不想再继续接受那 些试图稳定其进行性多器官功能障碍的治疗，并改为安适疗法。在撤去支持治 疗后数小时她便去世了。
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Background
Background
肺静脉闭塞性疾病(PVOD)是一种罕见的肺动脉高血压(PAH) 病因，其肺小静脉和微静脉纤维化，逐渐导致肺动脉高压、 肺间质、胸膜水肿和右心衰。