海南省产妇—新生儿弓形虫感染的研究

本文报告用PCR方法和ELISA法对463例产妇及其新生儿血液标本进行弓形虫（简称为TOX）检测，51例产妇血清Tox—IgM阳性，阳性率为11．02％，61例产妇Tox—IgM阳性，阳性率为13．11％，PCR阳性率产妇为12．00％，新生儿的阳性率分别为Tox—IgG6．20％、Tox—IgG1．51％，Tox—IgG4．54％，母婴间垂直传播率为23．93％，这说明弓形虫病作为围产医学中一个严重的寄生虫病应引起广泛的重视。     

孕妇弓形虫感染的临床分析

目的探讨我市孕妇弓形虫（TOX）感染的状况及感染后对其胎儿的影响。方法采用酶联免疫吸附试验法（ELISA）检测孕妇血中弓形虫循环抗原（CAg）、免疫球蛋白G（IgG）及免疫球蛋白M（IgM）抗体。结果100例病理妊娠孕、产妇血清中TOX—CAg．TOX—IgG及TOX—IgM阳性数分别为20例（20％）、23例（23％）、10例（10％）。而100例正常孕妇血清中TOX—CAg．TOX—IgG及TOX—IgM阳性数分别为2例（2％）、3例（3％）、1例（1％）。结论TOX感染是引起胎儿流产、死胎死产和畸形的主要原因之一。因此,孕妇妊娠早期应进行弓形虫感染检测,感染者应及时治疗,以减少先天性弓形虫病,达到优生优育的目的。     

FQ-PCR检测乙型肝炎病毒DNA的临床价值

目的探讨荧光定量PCR(FQ-PCR)检测HBV-DNA的应用价值。方法从1000份用酶联免疫吸附试验(ELISA)检测乙肝五项的体格检查血清标本中,抽取288份HBsAg阳性标本及100份全阴标本,进行荧光定量聚合酶链式反应HBV-DNA定量分析。结果经FQ-PCR检测,80份HBsAg、HBeAg、HBcAb均阳性的标本,HBV-DNA阳性率为100%(80/80),平均HBV-DNA拷贝数为2.5×108拷贝/m l;164份HBsAg、HBeAb、HBcAb均阳性的标本,HBV-DNA阳性率为76.2%(125/164),平均HBV-DNA拷贝数为1.5×106拷贝/m l;12份HBsAg单项阳性的标本,HBV-DNA的阳性率为83.3%(10/12),平均HBV-DNA拷贝数为1.6×105拷贝/m l;100份HBsAg、HBsAb、HBeAg、HBeAb、HBcAb均阴性的标本,HBV-DNA的阳性率为2.0%(2/100),平均HBV-DNA拷贝数为4.5×105拷贝/m l。结论FQ-PCR可以检测HBV的感染和复制情况,对准确报告HBV感染、指导其选择治疗方案和观察疗效具有重要的临床意义。     

外周血PCR和ELISA方法早期诊断婴幼儿Cpn感染

目的探讨婴幼儿肺炎衣原体（Cpn）感染的早期诊断。方法呼吸道感染婴幼儿110例，采用荧光定量PCR（FQ-PcR）技术检测外周血单核细胞Cpn DNA，用ELISA法检测血浆肺炎衣原体IgM抗体。结果110例呼吸系统感染患儿中，PCR和ELISA同时阳性18例，PCR单独阳性15例，IgM单独阳性2例，总计35例，阳性率31．8％。FQ-PCR和ELISA法结果间差异有统计学意义（X^2=4，2007，P〈0．05）。结论肺炎衣原体是婴幼儿呼吸道感染的重要病原之一，FQ-PCR可快速、敏感、准确地定量检测外周血CPDNA载量，直接了解肺炎衣原体在患儿体内感染和复制情况。     

应用荧光杂交定量PCR和ELISA法进行产前TORCH筛查比较及临床意义的研究

目的：比较荧光杂交定量PCR和ELISA法进行产前TORCH筛查的差异，探讨病原微生物拷贝数在临床诊治中的作用；方法：分别用荧光杂交定量PCR和ELISA IgM法筛查孕期血标本272例，其中包括妊娠早期102例，晚期170例；采集121例分娩孕妇及新生儿脐带血标本；222例不明原因流产标本，其中66例采集了新鲜自然流产脱膜和绒毛；结果：孕期筛查血CMV DNA和TOX DNA的阳性率分别为1．8％（5／272）和0．36％（1／272），其中妊娠早期CMV DNA的阳性率为2．9％（3／102），晚期为1．2％（2／170），不明原因流产，查出血清CMV感染22例，TOX4例，CMV DNA和TOX DNA的阳性率分别为9．9％（22／222）和1．8％（4／222）。脱膜和绒毛均感染3例，1例血清，脱膜感染但未采到绒毛标本。有2例是母血清中查到CMV，流产组织中未查到。查出血清，脱膜和绒毛均感染TOX1例，妊娠妇女外周血CMVDAN≥10^3有88％的发生流产；结论：荧光杂交定量PCR法不但具有较高的灵敏度和特异性而且可检测病毒负载量－拷贝数／ml，拷贝数越高发生流产的可能性愈高，应推荐作为妊娠初期筛查的首选方法。     

酶联免疫吸附试验检测孕妇弓形虫感染的临床研究

目的探讨吴江地区孕产妇弓形虫（TOX）感染率及感染状况。方法酶联免疫吸附试验（ELISA）检测孕妇血清中的TOX-IgM和TOX-IgG 2项指标,比较病理妊娠孕产妇和健康孕产妇的感染率以及病理妊娠孕产妇组中年龄、孕期、季节、是否接触动物等因素与TOX-IgM及TOX-IgG感染的关系。结果 103例病理妊娠的孕产妇中（实验组）TOX-IgM阳性11例（10.7%）,TOX-IgG阳性23例（22.3%）,而1 083例健康孕产妇（对照组）TOX-IgM阳性13例（1.2%）,TOX-IgG阳性42例（3.9%）。结论弓形虫引起围生期感染,是导致流产、死胎、早产、先天畸形、听力障碍和智力障碍等的主要原因之一;实验组弓形虫感染率明显高于对照组,差异有统计学意义（P〈0.01）,且在实验组中TOX-IgM和TOX-IgG阳性率随着产妇年龄增加而增加;早孕者感染率高于中晚孕者;夏季感染率明显高于其他季节;接触动物者感染率明显高于未接触动物者。     

1012例弓形虫抗体检测及感染性调查分析

目的 :探讨不同疾病与弓形虫 (TOX)感染的相关性。方法 :回顾性调查分析 ,采用ELISA法检测TOX IgG/IgM两抗体。结果 :10 12例TOX抗体总阳性率为 5 0 .89% ,其中IgG阳性率为 19.96% ,IgM阳性率为 13.14 % ,IgG/IgM阳性率为19.79% ;临床各科的阳性率从高至低依次为眼科 76.47%、妇科 67.5 9%、儿科 62 .31%、产科 47.65 %、新生儿 39.13% ,各疾病组与正常对照组比较均有非常显著性差异 (P <0 .0 1)。结论 :开展TOX常规检测对于减少误诊误治具有重要的临床价值     

住院新生儿弓形虫与巨细胞病毒感染率调查

目的 探讨住院新生儿弓形虫(TOX)与巨细胞病毒(CMV)感率染与危害性。方法 用ELISA法检测新生儿血清CMV IgG、IgM抗体与TOX IgG、IgM抗体。结果 住院新生儿外周血CMV IgG、CMV IgM、TOX IgG、TOX IgM阳性率分别为86．8％、5．2％、16．8％、0．46％;新生儿CMV／TOX—IgG(IgM)阳性率与临床早产儿、SGA、肺炎、败血症、肝炎综合症发生率显相关,与母亲妊娠期间发热、宠物接触史显相关。结论 新生儿TOX与CMV感染是临床早产儿、SCA、肺炎、败血症、肝炎综合征发生的重要原因;母亲妊娠期间发热、宠物接触史是新生儿CMV、TOX感染的高危因素。     

延安市神经系统疾病与抗弓形虫抗体的相关性研究

目的了解延安市神经系统疾病患者TOX感染情况，探讨两者相关性。方法应用ELISA法对180例不明原因神经系统疾病患者和135例健康体检者进行ATAb检测。结果疾病组ATAb的阳性率为28．89％（52／180），健康对照组为9．63％（13／135）。不同类型疾病患者ATAb阳性率分别为：脑型28．05％（23／82）、癫痫型44．44％（4／9）、精神病型32．14％（9／28）、神经衰弱型26．23％（16／61）；不同性别患者ATAb阳性率：男性患者ATAb阳性率为35．63％（31／87），女性为22．58％（21／93）；不同年龄患者ATAb阳性率分别为：≤25岁，33．33％（6／18）；26—50岁，30．00％（18／60）；≥51岁，27．45％（28／102）。有宠物接触史者ATAb阳性率为47．62％（30／63），无接触史者ATAb阳性率为18．80％（22／117）。不同抗体TOX阳性率分别为：IgG12．22％（22／180）；IgM阳性率8．89％（16／180）；IgM、IgG双项阳性率7．78％（14／180）。结论对临床上不明原因的神经系统疾病患者，务须开展TOX的常规检测，以便及早诊治，降低TOX脑病的死亡率。     

沈阳市孕妇弓形虫感染的临床研究

目的：探讨孕妇弓形虫（TOX）感染的状况及感染后对其胎儿的影响。方法：用酶联免疫吸附试验（ELISA）法检测孕妇血中弓形虫循环抗原（CAg）、IgG及IgM抗体。结果：93例病理妊娠的孕、产妇血清中CAg阳性者19例（20．43％）,TOX—IgG阳性者21例（22．58％）及TOX—IgM阳性者9例（9．68％）。而93例正常产孕妇血清中CAg阳性者仅为2例（2．15％）,TOX—IgG阳性者3例（3．23％）及TOX-IgM阳性者1例（1．08％）。结论：TOX感染对胎儿有较大的危害,是引起胎儿流产、死产死胎和畸形的主要原因之一。因此,孕妇妊娠早期应进行弓形虫感染检测,感染者应进行治疴。     

Value of D-Dimers in patients with acute aortic dissection

Objective: To evaluatel the value of D-dimers in patients with acute aortic dissection (AAD). Methods: This study consisted of 16 patients with AAD and 27 non-AAD patients. Serum D-dimets were measured by Sta-Liatest D-DI immunoturbidimetric assay. Results: D-dimer level was higher (P ＜ 0.001) in patients with AAD(7.91 ± 5.52 μg/ml) than that in non- AAD group(1.57±1.24 μg/ml). D-dimer was positive (＞0.4 μg/ml) in all patients with AAD and in 10 control group patients (37%). Among patients with acute AAD, D-dimers tended to be higher in Stanford A than in Stanford B (8.67 ± 4.31 μg/ml vs. 3.24±1.27 μg/ml, P ＜0.01). D-dimer values tended to be higher in more extended disease(3.84 ± 1.65 μg/ml, 8.57 ± 3.58 μg/ml and 11.87 ± 5.69 μg/ml in thoracic aorta, thoracic and abdominal aorta, thoracic and abdominal aorta and iliacal arteries, respectively, P ＜ 0.05 for both 8.57 ± 3.58 and 11.87 ± 5.69 vs. 3.84 ± 1.65 ). Including the control group into the analysis, we found a sensitivity of 100%, a negative predictive value of 100%, and a specificity of 66% and a positive predictive value of 64% for D-dimer in diagnosis of AAD in our patients with suspected AAD. Conclusion: D-dimer was elevated in patients with AAD. A negative D-dimer test result could be useful in excluding AAD.     

Research of combined liver-kidney transplantation model in rats

Objective： To set up a simple and reliable rat model of combined liver-kidney transplantation. Methods： SD rats served as both donors and recipients. 4℃ sodium lactate Ringer＇s was infused from portal veins to donated livers,and from abdominal aorta to donated kidneys, respectively. Anastomosis of the portal vein and the inferior vena cava （IVC） inferior to the right kidney between the graft and the recipient was performed by a double cuff method, then the superior hepatic vena cava with suture. A patch of donated renal artery was anastomosed to the recipient abdominal aorta. The urethra and bile duct were reconstructed with a simple inside bracket. Results： Among 65 cases of combined liver-kidney transplantation, the success rate in the late 40 cases was 77.5%. The function of the grafted liver and kidney remained normal. Conclusion： This rat model of combined liver-kidney transplantation can be established in common laboratory conditions with high success rate and meet the needs of renal transplantation experiment.     

BLOOD PRESSURE CHANGE WITH AGE IN SALT-SENSITIVE TEENAGERS

Objective To observe blood pressure change with age in salt-sensitive teenagers whose salt sensitivity were determined by repeated testing.Methods Salt sensitivity was determined through intravenous infusion of normal saline combined with volume-depletion by oral diuretic furosemide in 55 teenagers. After five years, salt sensitivity was re-examined and subject blood pressure was followed up. Blood pressure changes in salt-sensitive teenagers were compared to that of non-salt sensitive teenagers over five years.Results After 5 years, the repetition rate of salt sensitivity determined by intravenous saline loading is 92.7%. In teenagers with salt sensitivity on the baseline, both the systolic blood pressure increments and increment rates were much higher than non-salt sensitive teenagers (12.7±12.1 mmHg vs. 2.8±5.2 mmHg, P＜ 0.01; 12.2%± 12.0% vs. 2.5% ±4.4%, P＜ 0.001,respectively). There was a similar trend for diastolic blood pressure (8.4 ± 6.4 mmHg vs. 3.7 ± 6.4 mmHg, P = 0.052; 13.2% ±10.6 % vs. 6.8%± 10.1%, P = 0.053, respectively).Conclusions Salt sensitivity determined by intravenous saline loading showed good reproducibility. Blood pressure increments with age were much higher in salt-sensitive teenagers than non-salt sensitive teenagers, especially in terms of systolic blood pressure.     

APPLICATION OF LORNOXICAM TO PATIENT-CONTROLLED ANALGESIA IN PATIENTS UNDERGOING ABDOMINAL SURGERIES

FOR anesthesiologis s ,treatingpostoperativepainhas alwaysbeen a problem.Althoughopioidshave been provedtobe effective,theirsideeffectscouldnotbeignored.With thedevelopmentofscienceand pharmacology,many drugs with aspectsof satisfactoryanalgesicefficacyand couldbe welltoleratedby patientshave been developed.And lornoxicamisone of them, which isa non-steroidalanti-inflammatorydrug (NSAID ), with analgesic, anti-infl-ammatory,andantipyreticproperties.Itseliminationhalf-time(3 to 5 hours) isle…     

安心颗粒对急诊经皮冠状动脉介入术后生活质量影响的研究

目的：评价使用安心颗粒对急诊经皮冠状动脉介入术（PPCI）术后生活质量的影响.方法：将160例接受PPCI的急性ST段抬高型心肌梗死患者随机分为安心颗粒组（术前顿服安心颗粒8.8g,术后安心颗粒4.4 g/次,每日2次）和对照组（仅接受基础药物治疗）.所有患者均服用阿司匹林、氯吡格雷和阿托伐他汀.分别在入院时、出院前1d、出院后180 d时,应用心肌梗死多维度量表（MIDAS）、中文版SF-36评价量表对患者生活质量评分.并观察术后30 d以内的出血并发症、血小板减少症发生情况.结果：入院时和出院前1d,两组患者的心肌梗死MIDAS、SF-36量表评分比较无差异（P＞0.05）;出院后180 d时,与对照组比较,安心颗粒组MIDAS、SF-36评分明显减低（P＜0.05）;组内与入院时比较,两组出院前1d、出院后180 d时,MIDAS、SF-36评分均降低（P＜0.05）.两组患者在随访期间均无大量出血、少量出血、重度和极重度血小板减少症发生,安心颗粒组有4例、对照组有7例发生不明显出血（P＞0.05）.两组发生轻度血小板减少症的患者数比较无差异（P＞0.05）.结论：PPCI使用安心颗粒,能改善急性ST段抬高型心肌梗死患者的生活质量,且不增加出血风险.     

The comparative studies of the influences of Urapidil and Nicardipine on sino-atrial node function, atrio-ventricular node function and hemodynamics

Objective:To investigate the influences of urapidil and nicardipine on rabbit sinus function,atrio-ventricular node function and hemodynamics.Methods:Thirty-two Angora's rabbits were selected and randomly divided into four groups.U1 group:urapidil 0.25 mg/kg;U2 group:urapidil 0.5 mg/kg;N1 group:nicardipine 10 μg/kg;N2 group:nicardipine 20 μg/kg.All these medicine were administrated within 30 seconds.Measurements were taken before and after the administration of urapidil or nicardipine for the following data:mean blood pressure(MAP),heart rate(HR),sino-atrial conduction time(SACT),maximal sinoatrial recovery time(SNRTmax)corrected sinus node recovery time(CSNRT),index of sinus node recovery time(SNRTI),Wenckebach A-V conduction frequency (WB),and P-R interval.Results:Significant MAP and HR changes were identified in all of the four groups before and after administration of both urapidil and nicardipine.No significant changes could be found in the rest of the parameters.Intergroup analysis showed that SACT and CSNRT of N1 and N2 groups were shorter than those of the U2 group(P＜0.01);the MAP decreased(P＜0.01)and the HR increased drastically(P＜0.01).Conclusions:Neither urapidil(0.25 mg/kg,0.5 mg/kg)nor nicardipine(10μg/kg,20μg/kg)has any significant influence on rabbit sinus function or rabbit atrio-ventricular node function.Nicardipine could be a better choice than urapidil for parafunctional sinus node patients.     

Dynamic Changes in Serum Estradiol and Progesterone levels in Patients of Premenstrual Syndrome with Adverse Flow of Liver-qi

Objective:To probe into the influence of changes of ovarian hormones on the pathogenesis of the specific sub-type premenstrual syndrome(PMS)and reveal partial microcosmic mechanisms of adverse flow of liver-qi.Methods:Estradiol(E2)and progesterone(P)levels in serum were determined at different phases of menstrual cycle by radioimmunoassay.Results:In the group of PMS with adverse flow of liver-qi.the secretive peak value Of E2 and P at the follicular phase significantly decreased,and the secretive peak value at the luteal phase did not come into being.Conclusions:Low E2 and P secretive peak at the follicular phase and absence of secretive peak at the luteal phase is one of the microcosmic mechanisms of PMS with adverse flow of liver-qi.One of the pathophysiologic mechanisms of specific sub-type PMS is probably the continuous low level of E2and P.     

Real-time Three-dimensional Echocardiography in Assessment of Left Ventricular and Right Ventricular Volumes

Real-time three-dimensional echocardiography (RT3DE)is a new ultrasound technique that enables dynamic threedimensional visualization and quantification of the heart in real time. Investigation of feasibility and methodology of RT3DE in determining left ventricular (LV) and right ventricular (RV) volumes, RT3DE was performed in 35 normal adults using Philips SONOS 7500 system with a 2-4 MHz matrix array transducer. The 60°×60° "pyramid" volume database was obtained and analyzed on a TomTec echo workstation. Both LV and RV volumes were calculated with four 3DE methods (i.e. apical 2, 4, 8, and 16-plane) through manually tracing ventricular endocardial borders in end diastole and end systole. Stroke volumes were then calculated. LV volume was also measured by 2DE Simpson's rule using GE VIVID 7 ultrasound machine.     

SCREENING FOR A 21-CHROMOSOME ABNORMALITY IN PREIMPLANTED EMBRYOS OF ELDERLY WOMEN

Increasing maternal age is the only etiological factor unequivocally linked to Down's syndrome in humans. The occurrence rate of newborns with Down's syndrome is about 1/220 in women over 35 years old. However, the occurrence rate in embryos fertilized in vitro, of the elder woman is unclear. Using FISH we screened the number of chromosome 21 in preimplanted embryos of 5 elderly women (average age, 38.4 years) to study the feasibility and necessity of screening trisomy 21 in embryos in patients over 35 years old at the in vitro fertilization (IVF) center.     

Scientific principles and rigorous processes should be followed in developing clinical guidelines for therapeutic interventions of integrative medicine

A clinical guideline for the therapeutic interventions of integrative medicine may be defined as a written document which states a series of recommendations on therapeutic interventions of integrative medicine for a special disease or condition. The guideline may provide assistance to medical professionals in making clinical decisions aimed at improving the clinical outcome of patients and reducing the costs of medical care（~＇4~. Recommendations issued by a guideline should be based on the best available evidence in both Western and Chinese medicine. For fulfilling this purpose, the development of clinical guidelines for therapeutic interventions in the field of integrative medicine should follow scientific principles and undergo a rigorous processes.