ELISA检测住院患者梅毒抗体结果分析

目的探讨住院患者梅毒酶联免疫吸附试验(ELISA)筛查的应用价值。方法用ELISA法对2006年7月至2009年6月住院患者8970例进行梅毒抗体初筛。结果ELISA法筛查阳性检出率为1.01%(90/8950),<20岁组检出率仅为0.22%,20～50岁和50～70岁年龄组分别0.73%、0.85%,70岁以上年龄组的检出率达1.58%。结合临床表现和病史,临床确诊为梅毒现症感染的患者有48例。90例ELISA筛查阳性患者分布于各个临床科室,感染和风湿病等科室检出率0.58%,妇产科、肿瘤科和泌尿外科阳性率1.37%。结论采用ELISA法筛查,是梅毒血清学诊断较好的选择,适合手大批量样本的筛查试验。     

2169例健康体检者血脂检测及结果分析

目的了解某市健康体检者不同年龄段血脂变化规律及不同性别间血脂的差异,统计各种血脂异常检出率。方法检测对象全部为2008年10月至2009年10月来参加体检的2169例健康人群,TG、TC检测采用酶法,HDL-C、LDL-C采用直接法。结果 HDL-C、LDL-C各年龄组男女比较,差异均无统计学意义。男性:41～60岁年龄组与其他3个年龄组的TG、TC、LDL-C比较,61～84岁年龄组与其他3个年龄组的HDL-C比较,差异均有显著统计学意义(P<0.05)。女性:26～40岁年龄组与其他3个年龄组的TG比较,61～84岁年龄组与其他3个年龄组的TC比较,61～84岁年龄组与26～40岁年龄组的LDL-C比较,41～60岁年龄组与其他3个年龄组的HDL-C比较,差异有显著统计学意义(P<0.05或P<0.01)。结论将血脂检测纳入健康体检范围内,对早期发现代谢综合征及早期心脑血管疾病的一、二级预防具有重要指导意义。     

多层螺旋CT容积再现技术参数优化组合显示正常内耳结构的比较

目的 利用多层螺旋CT(MSCT)三维重建容积再现技术(VRT),比较两组不同参数阈值重建后正常内耳半规管、前庭、耳蜗的显示结果,以优化选择.方法 按年龄分为幼少年组、青年组、中年组和老年组,将58只正常内耳行高分辨率多层CT扫描后分别采用两组不同阈值行VRT重组.采用双阈值分割与手动编辑相结合的方法获取内耳结构模型后,分别使用两组(A、B组)参数得到的内耳VRT图,对显示半规管、前庭、耳蜗情况进行比较.结果:A组图像显示各年龄组内耳结构清晰.B组图像对3～15岁年龄组半规管显示不佳,对前庭窗不能显示;对16～30岁年龄组及50岁以上年龄组的前庭窗显示不佳.结论 采用双阈值分割与手动编辑相结合的方法,应用双阈值256～765、935～1 019,亮度和透明度分别为42、70的参数组合能准确清晰地显示各年龄组内耳半规管、耳蜗、蜗窗及前庭、前庭窗,这种优化组合可以应用于临床.     

成年女性不同年龄组的肝代谢功能研究

目的:探讨健康成年女性不同年龄组肝代谢功能的差别.方法:用RP-HPLC检测49例18～34岁,46例35～50岁,18例51～60岁成年女性健康受试者的唾液咖啡因清除率(SCL).结果:18～34岁年龄组的SCL在正常值范围,18～34岁年龄组、35～50岁年龄组和51～60岁年龄组各组间比较,差别显著(P＜0.001).结论:女性随着年龄的增长,SCL下降,肝代谢功能减低.     

急性穿孔性阑尾炎患儿的临床特征研究

目的：探讨急性穿孔性阑尾炎在不同年龄组患儿的临床特征差异,为临床上早期诊断急性穿孔性阑尾炎提供理论依据。方法回顾性分析2009年1月—2013年12月期间该院收治的76例急性穿孔性阑尾炎患儿的临床资料,计算比较男女患儿以及不同病程的急性阑尾炎的穿孔率,根据年龄将76例患儿分为3岁以下、4～6岁、7～12岁、13～16岁四个年龄组,比较不同年龄组的穿孔率、临床症状、体征、实验室检查和影像学检查的差异。结果患儿的总穿孔率为20．8％（76／366）,近5年的急性阑尾炎患儿的穿孔率逐年提高。男女患儿的穿孔率比较无明显差异（P ＞0．05）。年龄越小,病程越长,穿孔率越高（P ＜0．05）。临床症状中腹痛最常见,随着年龄的增长,患儿的转移性右下腹痛的发生率逐渐增高,而发热和腹泻的发生率逐渐降低（P ＜0．05）。体征中腹部压痛最常见,随着年龄的增长,患儿的腹痛压痛和肌紧张的发生率逐渐增高（P ＜0．05）。各年龄组的白细胞、中性粒细胞及腹腔平片检查结果比较无明显差异（P ＞0．05）。B 超的结果中,3岁以下年龄组的患儿的右下腹液性病变以及13～16岁年龄组的肠梗阻的发生率显著高于其他各年龄组（P ＜0．05）。CT 的结果中,13～16岁年龄组的肠壁增厚的发生率显著高于其他年龄组（P ＜0．05）。结论急性阑尾炎患儿的穿孔率逐年提高,3岁以下的患儿最高,部分症状和体征在不同年龄组的患儿的发生率不等,部分影像学检查结果在不同年龄组的患儿中有显著差异。     

我院173例儿童长期发热的抗菌药物使用研究

目的:了解不明原因长期发热疾病的病因分布,探讨长期不明原因发热患儿抗菌药物使用的合理性和有效性。方法:收集我院2012-2013年主诉为发热≥2周且最后诊断明确的完整病例共173例。按照年龄分为4组:<1岁年龄组(婴儿组)、1^<3岁组年龄组(幼儿组)、3<3岁组年龄组(幼儿组)、3⁶岁组年龄组(学龄前组)、>6岁年龄组(学龄组),统计所有病例的临床资料以及抗菌药物使用情况。结果:感染性疾病占主要地位,以呼吸道感染为主,感染的病原体中病毒居首位,支原体居第2位。全部病例入院后均使用抗菌药物,抗菌药物使用率为100%;其中使用限制级抗菌药物占51人次(占29.48%),二联使用抗菌药物22人次(占12.72%);非细菌感染和非感染性疾病使用限制级别抗菌药物34例,占限制级抗菌药物的66.67%;抗菌药物更改率达到29.41%6岁组年龄组(学龄前组)、>6岁年龄组(学龄组),统计所有病例的临床资料以及抗菌药物使用情况。结果:感染性疾病占主要地位,以呼吸道感染为主,感染的病原体中病毒居首位,支原体居第2位。全部病例入院后均使用抗菌药物,抗菌药物使用率为100%;其中使用限制级抗菌药物占51人次(占29.48%),二联使用抗菌药物22人次(占12.72%);非细菌感染和非感染性疾病使用限制级别抗菌药物34例,占限制级抗菌药物的66.67%;抗菌药物更改率达到29.41%⁶2.50%。结论:对不明原因长期发热患儿的治疗上过度依赖抗菌药物,在治疗欠佳的情况下,不应盲目更换或升级抗菌药物。     

沧州地区成年女性尿失禁调查报告

目的了解成年女性人群发生尿失禁的年龄分布与变化规律.方法采用2004年第三届国际尿失禁咨询委员会(ICI)推荐的ICIQ问卷,调查沧州地区5个县、市区的行政机关、工厂、学校和自然村5682人.年龄18～73岁,不同种族分别分三个年龄组;评估被调查者尿失禁的发病情况.结果回族18～40岁组580人,发病98人占16%,41～59岁组5 13人,发病208人占40.5%,60岁以上年龄组351人,发病286人占81.5%;汉族:18～40岁组2350人中发病470人占20%,41～59岁组1682人中发病764人占45%,60岁以上年龄组206人中发病165人占80%.结论尿失禁是一种常见病、多发病,不同人群中有不同分布,种族间发病率差异无显著性,应加强针对尿失禁的治疗宣传,关注女性健康.     

2004年至2006年住院肺结核患者结核分支杆菌耐药结果分析

目的 通过对2004年至2006年3年住院肺结核患者耐药结果分析,从而获得住院肺结核患者的耐药趋势,指导临床合理用药.方法 采用绝对浓度间接法进行分支杆菌的培养和药敏试验,以培养基上菌落数≥1 为培养阳性.结果 2004、2005、2006年总耐药率分别为50.8%、49.6%、42.9%;初治耐药率分别为40.4%、37.0%、30.0%;复治耐药率分别为77.2%、91.2%、78.2%.复治患者耐药率高于初治患者(P＜0.01).不同年龄组耐药率中初治耐药率以50～年龄组的耐药率最高,复治耐药率以＜20、20～、30～、40～年龄组的耐药率较高,其中,＜20岁年龄组的耐药率最高.耐单药率以利福平(RFP)、链霉素(SM)、异烟肼(INH)三药较高.耐多药率以链霉素 利福平(SR)、链霉素 异烟肼 利福平(SHR)、链霉素 利福平 乙胺丁醇(SRE)、链酶素 利福平 异烟肼 乙胺丁醇(SHRE)组合较高.结论 结果显示结核患者的总耐药率、初、复治患者耐药率均较高,耐药性的发生更趋向于对主要一线药物的耐药和对多种药物耐药.因此,对结核病的临床治疗和管理应给予足够的重视.     

白血病及其新克星

美国死亡率最高的十种肿瘤中，白血病排在第六位。而20岁以下年龄组，白血病的死亡率最高。白血病也是国内十种高发恶性肿瘤之一，是14岁以下少儿死亡率最高的肿瘤。左旋门冬酰胺酶(L-Asparaginase，L-Asps)是目前治疗白血病的最有效药物之一，但它的主要毒副作用也日益明显。为了弥补它的不足，药物工作者开发研制了一种治疗ALL(白血病的一种亚型)的新型药物——培门冬酰胺酶(Pegaspargase)。     

1 946例孕16周内药物流产临床分析

目的观察米非司酮(Ru486)不同服药方式用于孕16周内计生对象流产的临床疗效.方法对于合作的计生对象将Ru486、米索前列醇(PGE)以常规方法给药;对于不合作对象将Ru486 150 mg顿服48 h后给服PGE 0.6 mg;对孕≥12周、≤16周以内对象另加服PGE 0.4～0.6 mg并住院观察.结果 16～30岁与31～49岁年龄组其完全流产率分别为90.28%、94.81%(P＞0.05).孕50～112 d计生对象的常规给药与顿服给药其完全流产率分别为94.77%、97.67%(P＞0.05).孕≤49 d与孕50～112 d药物流产其完全流产率分别为93.39%、95.85%(P＞0.05).结论两种不同的服药方法,对其临床效果影响不大.孕50～112 d内的药物流产效果略优于孕49 d以内的药物流产效果.     

Synthesis,Cytotoxicity and Antileishmanial Activity of Some N-(2-(indol-3-yl)ethyl)-7-chloroquinolin-4-amines

We report herein the condensation of 4,7-dichloroquinoline (1) with tryptamine (2) and D-tryptophan methyl ester (3) . Hydrolysis of the methyl ester adduct (5) yielded the free acid (6) . The compounds were evaluated in vitro for activity against four different species of Leishmania promastigote forms and for cytotoxic activity against Kb and Vero cells. Compound (5) showed good activity against the Leishmania species tested, while all three compounds displayed moderate activity in both Kb and Vero cells.     

Efficacy of gut lavage,hemodialysis, and hemoperfusion in the therapy of paraquat or diquat intoxication

Clinical and in vitro investigations were carried out to test the efficacy of gut lavage, hemodialysis, and hemoperfusion in the treatment of poisoning with paraquat or diquat. In a patient suffering from diquat intoxication 130 times more diquat was removed by gut lavage 30 h after ingestion than was removed by complete aspiration of the gastric contents.Determination of in vitro clearances for paraquat and diquat by hemodialysis showed that, at serum concentrations of 1–2 ppm, such as are frequently encountered in poisoning in man, toxicologically relevant quantities of herbicide cannot be removed from the body. At a concentration of 20 ppm, on the other hand, hemodialysis proved to be effective, the clearance being 70 ml/min at a blood flow rate of 100 ml/min. The efficacy of hemoperfusion with coated activated charcoal was on the whole better. Especially at concentrations around 1–2 ppm, the clearance values for hemoperfusion were some 5–7 times higher than those for hemodialysis.In a patient suffering from paraquat poisoning, both hemodialysis as well as hemoperfusion were carried out. The in vitro results could be confirmed: At serum concentrations of paraquat less than 1 ppm no clearance could be obtained by hemodialysis while by hemoperfusion with activated charcoal quite high clearance values were measured and the serum level dropped down to zero.

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Zusammenfassung Klinische Untersuchungen und Laboratoriumsversuche wurden durchgeführt, um die Wirksamkeit von Darmspülung, Hämodialyse und Hämoperfusion bei Paraquat- und Deiquat-Vergiftungen zu prüfen.Bei einem Patienten wurde 30 Std nach Deiquat-Aufnahme durch Darmspülung 130mal mehr Deiquat entfernt als durch vollständige Aspiration des Mageninhaltes. In vitro-Versuche ergaben, daß bei Blutserumkonzentrationen von 1–2 ppm, die bei Vergiftungen oft gemessen werden, durch Hämodialyse keine toxikologisch relevanten Paraquat- oder Deiquat-Mengen entfernt werden können. Dagegen erwies sich die Hämodialyse bei 20 ppm und einer Blutumlaufgeschwindigkeit von 100 ml/min mit einer Clearance von 70 ml/min als wirksam. Die Hämoperfusion mit beschicheter Aktivkohle war in diesen Versuchen aber eindeutig überlegen, denn insbesondere bei Konzentrationen um 1–2 ppm waren die Clearance-Werte 5–7mal höher als bei der Hämodialyse.Die in vitro-Ergebnisse wurden bei einem Patienten mit einer Paraquat-Vergiftung bestätigt: Bei Konzentrationen unter 1 ppm war die Hämodialyse wirkungslos, während durch Hämoperfusion relativ hohe Clearance-Werte erreicht wurden, so daß der Serumspiegel rasch unter die Nachweisgrenze abfiel.

     

In vitro studies on sterically stabilized liposomes (SL) as enzyme carriers in organophosphorus (OP) antagonism

This study describes a new approach for organophosphorous (OP) antidotal treatment by encapsulating an OP hydrolyzing enzyme, OPA anhydrolase (OPAA), within sterically stabilized liposomes. The recombinant OPAA enzyme was derived from Alteromonas strain JD6. It has broad substrate specificity to a wide range of OP compounds: DFP and the nerve agents, soman and sarin. Liposomes encapsulating OPAA (SL)* were made by mechanical dispersion method. Hydrolysis of DFP by (SL)* was measured by following an increase of fluoride ion concentration using a fluoride ion selective electrode. OPAA entrapped in the carrier liposomes rapidly hydrolyze DFP, with the rate of DFP hydrolysis directly proportional to the amount of (SL)* added to the solution. Liposomal carriers containing no enzyme did not hydrolyze DFP. The reaction was linear and the rate of hydrolysis was first order in the substrate. This enzyme carrier system serves as a biodegradable protective environment for the recombinant OP-metabolizing enzyme, OPAA, resulting in prolongation of enzymatic concentration in the body. These studies suggest that the protection of OP intoxication can be strikingly enhanced by adding OPAA encapsulated within (SL)* to pralidoxime and atropine.     

Lung disease and PKCs

The lung offers a rich opportunity for development of therapeutic strategies focused on isozymes of protein kinase C (PKCs). PKCs are important in many cellular responses in the lung, and existing therapies for pulmonary disorders are inadequate. The lung poses unique challenges as it interfaces with air and blood, contains a pulmonary and systemic circulation, and consists of many cell types. Key structures are bronchial and pulmonary vessels, branching airways, and distal air sacs defined by alveolar walls containing capillaries and interstitial space. The cellular composition of each vessel, airway, and alveolar wall is heterogeneous. Injurious environmental stimuli signal through PKCs and cause a variety of disorders. Edema formation and pulmonary hypertension (PHTN) result from derangements in endothelial, smooth muscle (SM), and/or adventitial fibroblast cell phenotype. Asthma, chronic obstructive pulmonary disease (COPD), and lung cancer are characterized by distinctive pathological changes in airway epithelial, SM, and mucous-generating cells. Acute and chronic pneumonitis and fibrosis occur in the alveolar space and interstitium with type 2 pneumocytes and interstitial fibroblasts/myofibroblasts playing a prominent role. At each site, inflammatory, immune, and vascular progenitor cells contribute to the injury and repair process. Many strategies have been used to investigate PKCs in lung injury. Isolated organ preparations and whole animal studies are powerful approaches especially when genetically engineered mice are used. More analysis of PKC isozymes in normal and diseased human lung tissue and cells is needed to complement this work. Since opposing or counter-regulatory effects of selected PKCs in the same cell or tissue have been found, it may be desirable to target more than one PKC isozyme and potentially in different directions. Because multiple signaling pathways contribute to the key cellular responses important in lung biology, therapeutic strategies targeting PKCs may be more effective if combined with inhibitors of other pathways for additive or synergistic effect. Mechanisms that regulate PKC activity, including phosphorylation and interaction with isozyme-specific binding proteins, are also potential therapeutic targets. Key isotypes of PKC involved in lung pathophysiology are summarized and current and evolving therapeutic approaches to target them are identified.     

Steroidal sapogenin contents in some domestic plants

In order to find out the values of the steroid resources for the future use. the compositions and contents of steroidal sapogenins from 13 domestic plants have been investigated. As a result,Dioscorea nipponica, D. quinqueloba andSmilax china were found to have large amount of diosgenin. And pennogenin inTrillium kamtschaticum andParis verticillata, yuccagenin inAllium fistulosum, hecogenin inAgave americana and neochlorogenin inSolanum nigum were appeared to be major steroidal sapogenins.     

Gender-related symptoms and correlates of alcohol dependence among men and women with a lifetime diagnosis of alcohol use disorders

This study explored gender-related symptoms and correlates of alcohol dependence in a crosssectional study of 150 men and 150 women with a lifetime diagnosis of alcohol use disorders (AUD). Participants were recruited in equal numbers from treatment settings, correctional centres and the general community. Standardized measures were used to determine participants' use of substances, history of psychiatric disorders and psychosocial stress, their sensation seeking and family history of substance use and mental health disorders. Multivariate analyses were used to detect patterns of variables associated with gender and the lifetime severity of AUD. Men had a longer history of severe AUD than women. Women had similar levels of alcohol dependence and medical and psychological sequelae as men, despite 6 fewer years of AUD. More women than men had a history of severe psychosocial stress, severe dependence on other substances and antecedent mental health problems, especially mood and anxiety disorders. There were differences in family history of alcohol-related problems approximating same-gender aggregation. The severity of a lifetime AUD was predicted by its earlier age at onset and the occurrence of other disorders, especially anxiety, among both men and women. The limitations in the generalizability of these findings due to sample idiosyncrasies are discussed.