慢性肝炎交叉感染的临床对比分析

目的研究慢性乙型肝炎重叠甲型肝炎与乙型肝炎重叠戊型肝炎患者在临床表现、预后及病毒之间相互干扰方面的异同。方法慢性乙型肝炎重叠甲型肝炎组50例,慢性乙型肝炎重叠戊型肝炎组50例和单纯乙型肝炎组50例,其中每组各含4例肝硬化患者;对3组患者的临床表现实验室检查等进行对比分析。结果在症状、转氨酶及胆红素方面,重叠感染组均重于单纯慢性乙型肝炎组（P〈0.05或P〈0.01）。但与预后有关的一些指标,如白蛋白、凝血酶原活动度及病死率,两种重叠感染对慢性乙型肝炎的影响有所不同：甲型肝炎重叠感染似对慢性乙型肝炎影响不大,但戊型肝炎重叠感染似对慢性乙型肝炎有比较严重的不良影响。在病毒干扰方面,两种重叠感染似对乙型肝炎病毒复制均有一定抑制作用,戊型肝炎重叠感染更明显。结论甲型肝炎重叠感染对慢性乙型肝炎的症状、转氨酶、胆红素虽有一定影响,但对其预后无太大影响,对乙型肝炎病毒复制似有一定的抑制,但不如戊型肝炎明显;戊型肝炎重叠感染对慢性乙型肝炎的临床表现及其预后均有明显的影响,对乙型肝炎病毒的抑制也较强。     

乙肝患者血清HAV、HCV、HDV、HEV标志物检测结果分析

①目的探讨乙型肝炎与其它型肝炎的重叠感染情况。②方法采用ELISA方法检测375例乙型肝炎患者血清中甲、丙、丁、戊型肝炎血清标志物。③结果乙型肝炎患者双重感染占15.20%(57/375),多重感染占1.60%(6/375),尤其是与丙型肝炎的双重或多重感染占重叠感染的63.64%(42/66)。④结论乙型肝炎患者重叠或并发感染其它类型肝炎病毒的情况较为常见,临床应对乙型肝炎患者定期进行其它型肝炎标志物的检测。     

对慢性乙型肝炎重叠感染病症进行分析

目的 观察慢性乙型肝炎患者重叠感染戊型肝炎病毒临床特点及戊型肝炎病毒对慢性乙型肝炎患者的影响.方法 对60例慢性乙型肝炎病毒重叠戊型肝炎病毒感染组患者与60例单纯慢性乙型肝炎病毒感染组的临床资料进行对照分析.结果 2组的临床生化指标,总胆红素、丙氨酸氨基转移酶、天冬氨酸氨基转移酶、凝血酶原活动度、血白蛋白差异有统计学意义(P<0.01).重叠感染组HBeAg阴转率、HBV-DNA阳性率低于对照组(P<0.01).结论 慢性乙型肝炎病毒感染者重叠戊型肝炎病毒感染可使病情急性加重,易形成重症化,但戊型肝炎病毒对乙肝病毒复制有一定的抑制作用.     

慢性乙型肝炎重叠戊型肝炎感染40例临床分析

目的: 观察慢性乙型肝炎患者重叠戊型肝炎病毒感染的临床特点及戊型肝炎病毒对慢性乙型肝炎患者的影响。方法: 对40例慢性乙型肝炎病毒重叠戊型肝炎病毒感染组患者与40例单纯慢性乙型肝炎病毒感染组患者的临床特点进行对照分析。结果: 2组总胆红素、丙氨酸氨基转移酶、天冬氨酸氨基转移酶、凝血酶原活动度、血白蛋白差异均有统计学意义(P<0.05~P<0.01);重叠感染组HBeAg阴转率、HBV-DNA阳性率低于对照组(P<0.05)。结论: 慢性乙型肝炎病毒感染者重叠戊型肝炎病毒感染可使病情急性加重并形成重症化,但戊型肝炎病毒对乙型肝炎病毒复制有一定的抑制作用。     

广州地区成人急性肝炎病原学分析

对我院感染科的１９９１例成年急性肝炎进行了甲、乙、丙、丁、戊和康型肝炎的血清标志物检测，结果表明：４４．５％为乙型肝炎病毒感染，１６．２％为戊型肝炎病毒感染，１２．０％为甲型肝炎病毒感染。另外，１８．９％为２种或２种以上肝炎病毒重叠感染，感染的比例较高，同时还发现了２例庚型肝炎病毒感染。提示广州地区仍然以乙型肝炎病毒感染为主，两种或两种以上肝炎病毒重叠感染的情况与比较多见，并出现了庚型肝炎病毒感染     

128例经血感染HIV患者合并HCV和HBV感染状况

目的了解经血感染人类免疫缺陷病毒1型(HIV-1)患者合并感染乙型肝炎病毒(HBV)及丙型肝炎病毒(HCV)的情况及发病特点。方法回顾性分析128例经血感染HIV患者合并感染HBV和HCV的感染率、肝脏表现及部分免疫学特征。结果128例患者中,单纯合并HCV感染者107例(83.6%),其中40例(31.3%)出现肝功能异常或肝损害,15例(11.7%)合并肝炎症状;单纯合并HBV感染3例(2.3%),均出现肝功能异常和肝炎症状;HIV、HBV、HCV三重感染7例(5.5%),无1例存在肝功能异常和肝炎症状;11例(8.6%)患者未合并HBV或HCV。结论经血感染HIV的患者与HCV的合并感染率高于与HBV的合并感染率,HIV合并HCV感染与HBV感染的临床转归也存在差异。     

衡阳市308例乙型肝炎感染者丁型肝炎病毒感染状况的调查

本文对衡阳市城区居民３０８例乙型肝炎病毒感染者的丁型肝炎病毒感染状况进行了调查。结果表明，丁型肝炎病毒总感染阳性率不过１０．０６％，其中男性为１０．２３％，女性９．８５％，性别与年龄间感染率无显著性差异；结果还显示，慢性活动性肝炎，慢性迁延性肝炎及乙型肝支病毒感染阳性的肝硬化，肝癌患者中，其丁型肝炎病毒感染率显著高于乙型肝炎表面抗原携带者，提示丁型肝炎病毒感染在促成乙型肝炎病毒感染的慢性化进程中起一定作用和／或两者有重叠感染。     

妊娠合并病毒性肝炎37例临床分析

目的探讨肝炎与妊娠的关系。方法分析37例妊娠合并病毒性肝炎病例，甲型肝炎1例，乙型肝炎25例，丙型肝炎2例，戊型肝炎5例，乙、丙型肝炎病毒重叠感染1例，乙、戊型肝炎病毒重叠感染1例，病原未明2例。早期妊娠7例，中期妊娠12例，晚期妊娠18例。结果妊娠合并病毒性肝炎以乙型肝炎居多，随着妊娠周数增加，肝炎发病率、重型肝炎发生率及病死率增加。结论对妊娠合并肝炎患者的处理，需视不同的病程、病情采取相应的措施。     

成都地区196例乙肝患者重叠感染其他型肝炎病毒的状况分析

目的 调查成都地区乙型肝炎患者重叠感染其他型肝炎病毒的情况。方法 采用ELISA方法对196例乙型肝炎患者血清进行HAV-IgM、HCV-IgM、HDV-IgM、HEV-IgM、HEV-IgC扣HGV-IgM的检测。结果 196例乙型肝炎患者中重叠感染其他型肝炎病毒的共有18例（9．12％），其中HBV-HCV2例（1．02％），HBV-HDV1例，HBV-HEV12例（6．12％）。HBV-HGV1例（0．51％），本次调查未发现HBV-HAV重叠感染。不同乙肝两对半模式重叠感染率无显著差异（χ^2=1．72，P〉0．05）。结论 乙肝患者重叠感染其他型肝炎具有地区特异性，对于乙肝患者同时注意检查有无其他型肝炎病毒的重叠感染，对估计病情和治疗都将有重要意义。     

基于酒精性肝病合并肝炎病毒感染的临床特点分析

目的分析酒精性肝病合并肝炎病毒感染的临床特点。方法将2012年1月至2014年12月之间收治的72例酒精性肝病患者作为观察对象,30例患者合并肝炎病毒感染,42例未合并病毒感染。其中合并甲型肝炎病毒感染3例、乙型肝炎病毒感染的有18例、丙型肝炎病毒感染3例、戊型肝炎病毒感染6例。对合并感染与未感染患者的血清生化指标及并发症发生率进行对比。结果两组患者的血清肝功能均存在异常,其中合并感染组患者的ALT、AST等指标显著高于未感染组,差异显著(P0.05);同时,感染组患者的上消化道出血发生率高于未感染组,差异同样显著(P0.05)。结论酒精性肝病合并肝炎病毒感染对肝脏损害产生系统作用,加重病情。     

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.