肺炎衣原体与突发性耳聋的相关性研究

目的 探讨肺炎衣原体（Cpn）感染与突发性耳聋（SSHL）之间的关系。方法 收集SSHL患者120例(SSHL组),另选120名健康者为对照组。分离人外周血单核细胞（PBMC）,用直接免疫荧光法（DIF）及PCR分别检测PBMC中Cpn特异性抗原（Cpn-Ag）和Cpn-DNA的表达;微量免疫荧光法检测抗Cpn抗体IgA、IgG和IgM。结果 DIF法与PCR法的检测结果比较,差异无统计学意义（P>0.05）。两组代表急性感染的Cpn-Ag和Cpn-IgM的检出率比较,差异有统计学意义（P<0.01）;两组代表慢性感染的Cpn-IgA和Cpn-IgG的检出率比较,差异有统计学意义（P<0.05）。结论 SSHL患者Cpn感染的检出率显著升高,Cpn可能是引起SSHL的一种因素。     

自制肺炎衣原体单克隆抗体检测其特异性抗原对动脉粥样硬化诊断的临床意义

目的探讨采用自制肺炎衣原体单克隆抗体(Cpn-McAb)检测人外周血单核细胞(PBMC)和冠状动脉瘤标本中肺炎衣原体特异性抗原(Cpn-Ag)的临床意义。方法采用自制Cpn-McAb的直接免疫荧光(DI)法检测颈动脉粥样硬化和健康体检者PBMC中Cpn-Ag及冠状动脉瘤和正常冠状动脉标本中Cpn-Ag的表达。结果颈动脉粥样硬化患者和健康体检者PBMC中Cpn-Ag检测结果间差异有显著性意义(P<0.01);粥样硬化冠状动脉瘤标本和正常冠状动脉标本外膜下和/或斑块内Cpn-Ag检测结果间差异有显著性意义(P<0.01)。冠状动脉瘤标本中有大量Cpn-Ag沉积,分别位于外膜下及粥样硬化斑块内,而正常血管壁中仅有少量沉积(P<0.05)。结论PBMC中的Cpn-Ag的检测可为诊治与该病原体相关的疾病提供依据;Cpn可能是动脉粥样硬化形成的原因之一。     

冠心病外周血单核细胞肺炎衣原体病原体检测的意义

目的:探讨冠心病患者外周血单核细胞(PBMC)中肺炎衣原体(Cpn)病原体检测的方法及临床意义。方法:选择150例冠心病(冠心病组)及55例非冠心病(对照组)患者,使用低渗溶血法制备PBMC,直接免疫荧光(DIF)检测Cpn包涵体,巢式PCR(nPCR)法测定外周血单核细胞中肺炎衣原体DNA。结果:150例冠心病患者Cpn包涵体阳性20例,阳性率13.3%,55例对照组中仅1例阳性,阳性率为1.8%,CpnDNA两组间阳性率分别32.7%(49/150)及1.8%(1/55),冠心病组与对照组比较包涵体及DNA检测的阳性率明显增高,(相对危险度分别为26.2、8.3,95%的可信区间分别为3·52~194·98,1·09~63·46)。结论:Cpn病原体阳性反映患者体内存在Cpn感染状态,包涵体与DNA检测两者间具有一致的阳性检出,但包涵体检测更省时省力。     

环介导等温扩增技术在小儿下呼吸道肺炎嗜衣原体感染中的应用

目的评价酶联免疫吸附试验(ELISA)和环介导等温扩增方法(loop-mediated isothermal amplification,LAMP)在检测小儿肺炎嗜衣原体(Chlamydophila pneumoniae,Cpn)中的应用价值.方法根据Genebank公布的Cpn基因序列设计6条LAMP引物(2条内引物,2条外引物,2条环引物),优化并建立LAMP检测体系.对收治的80例疑似Cpn感染患儿外周血单个核细胞中的Cpn进行检测,同时用ELISA检测Cpn特异性IgM抗体.结果80例患儿当中,Cpn 47例小儿血清IgM抗体阳性(阳性率58.8%);而LAMP能检测出57例阳性(阳性率71.3%),两者比较,差异无统计学意义(P>0.05).80例患儿当中有49例服用过大环内酯类抗生素,ELISA检测出26例阳性(53.1%),而LAMP检测率达75.6%,经统计学分析,差异有统计学意义,P<0.05.结论 LAMP检测小儿Cpn感染方法简便、快捷,尤其是对服用过抗生素的患儿也具有较高的检出率.     

肺炎衣原体感染与动脉粥样硬化的关系

目的研究肺炎衣原体(Cpn)感染与动脉粥样硬化(AS)关系和Cpn特异性抗体检测的临床意义.方法采用间接免疫荧光试验,对67例冠心病(CHD)、32例心肌梗死(MI)患者和40名正常人(对照组)的血清进行了Cpn特异性IgG、IgA、IgM抗体的检测.结果显示Cpn IgG抗体的阳性率患者组与对照组之间差异无显著性(P>0.05),Cpn IgA抗体的阳性率患者组高于对照组(P<0.01);Cpn IgG 、IgA抗体滴度和几何平均滴度患者组高于对照组(P<0.01).结论 Cpn 抗体滴度有助于疾病的诊断;持续高滴度的Cpn IgG、IgA抗体可作为Cpn 慢性感染的重要指标;慢性Cpn感染是AS发生、发展的重要危险因素.     

梧州市916例下呼吸道感染儿童肺炎支原体感染临床分析

目的 了解梧州市儿童肺炎支原体(MP)感染状况.方法 采用MP分离鉴定培养基对2007年1月至2008年12月916例下呼吸道感染患儿的痰标本进行MP培养.结果 916例下呼吸道感染患儿中,MP培养阳性247例,总检出率为27.0%.男女性别之间MP检出率无差异.～6岁组与大于6岁组之间检出率比较差异有统计学意义(χ2＝6.04,P<0.05),其他年龄组之间检出率比较差异无统计学意义(P＞0.05).2007及2008年的7～9月份MP检出率与同年其他季节比较差异有统计学意义(P<0.05).其余各季节之间MP检出率比较差异无统计学意义(P＞0.05).结论 肺炎支原体为梧州市小儿下呼吸道感染的主要病原体,各年龄段儿童普遍易感;本病的发生及流行应引起临床医生的高度重视.早期诊断十分重要.     

乙型肝炎病毒感染者血清和外周血单个核细胞培养上清细胞因子测定及临床意义

目的 观察不同HBV感染者血清和外周血单个核细胞(PBMC)培养上清中的细胞因子水平. 方法 采集不同HBV感染者血清;制备PBMC并用rHBcAg刺激,培养72h后收集培养上清.采用酶联免疫吸附法检测血清和培养上清中的IFN-γ和IL-4水平. 结果 血清IFN-γ水平,急性乙肝显著高于健康对照和HBV携带者(P<0.01和P<0.05),也高于慢性乙肝;慢性乙肝显著高于健康对照(P<0.05).血清IL-4水平,急、慢性乙肝均显著高于健康对照和HBV携带者(P<0.01和P<0.05),HBV携带者与健康对照相比差异无统计学意义.血清IFN-γ/IL-4比值,除慢性乙肝显著低于健康对照(P<0.01),其余组间差异无统计学意义.在PBMC培养上清中,急、慢性乙肝患者的IFN-γ水平显著高于健康对照和HBV携带者(P<0.05),急性肝炎组高于慢性组,但差异无统计学意义;HBV携带者与健康对照相比,差异无统计学意义.3个HBV感染组的IL-4水平与健康对照相比,差异无统计学意义. 结论 (1)与使用rHBcAg刺激后的PBMC培养上清相比,血清检测可能更加符合患者的真实细胞因子水平.(2)HBV感染时IFN-γ表达水平和IFN-γ/IL-4比值与疾病转归密切相关.     

实时荧光定量PCR法检测EB病毒感染患儿血浆EBV-DNA载量的临床意义

目的探讨实时荧光定量聚合酶链反应(PCR)法外周血血浆EBV-DNA载量检测在小儿EB病毒(EBV)感染性疾病中的应用意义。方法选取2017年12月至2019年7月于河南省儿童医院就诊的150例疑似EBV感染患儿,根据实验室EBV抗体谱检测结果分为EBV活动感染组(64例)、EBV既往感染组(65例)、非EBV感染组(21例)。所有患儿均接受外周血血浆EBV-DNA载量检测及血清EBV-CA IgM检测。分析各组外周血血浆EBV-DNA载量检测结果、血清EBV-CA IgM检测结果。结果 3组患儿血浆EBV-DNA阳性率及血浆EBV-DNA载量相比,差异有统计学意义(均P<0.05)。原发感染者外周血血浆EBV-DNA阳性检出率为83.67%(41/49),血清EBV-CA IgM阳性检出率为77.55%(38/49),差异有统计学意义(P<0.05)。活动感染者血浆EBV-DNA阳性检出率为81.25%(52/64),血清EBV-CA IgM阳性检出率为68.75%(44/64),差异有统计学意义(P<0.05)。结论实时荧光定量PCR法检测外周血血浆EBV-DNA载量是检测小儿EBV活动性感染的较好指标。     

冠心病患者肺炎衣原体包涵体的检测和意义

目的:探讨冠心病(CHD)患者血液肺炎衣原体(Cpn)包涵体的检测和临床意义。方法:收集2006年CHD患者150例和同期体检正常者55例的血液标本,采用-85℃冰冻保存的外周抗凝血液,低渗溶血制备淋巴细胞悬液,用直接免疫荧光法(DIF)检测特异性Cpn包涵体。结果:冠心病组150例,包涵体阳性20例,阳性率为13.3%;健康对照组55例,包涵体阳性1例,阳性率为1.8%,差异有统计学意义(P<0.001),相对危险度为8.3,95%的可信区间为1.09～63.46。结论:CHD患者Cpn包涵体阳性率高于健康者,说明CHD患者存在Cpn感染状况。     

芯片电泳快速检测高危型人类乳头状瘤病毒

目的 建立人类乳头状瘤病毒(human papillomavims,HPV)52和58基因型高危型的芯片电泳检测方法.方法 选取114例宫颈细胞检测患者,提取宫颈脱落细胞DNA.PCR扩增HPV高危型52和58基因型特异性DNA序列,应用优化的芯片电泳分析方法对扩增产物进行分离检测.根据细胞学诊断结果将研究对象分为4组:正常组、不典型鳞状细胞组、低度鳞状上皮内病变组和高度鳞状上皮内病变组,比较各组的HPV52、58基因型感染情况.结果 114份标本中.HPV52基因型检出率为8.8%(10/114),HPV58基因型检出率为33.3%(38/114).与正常对照组相比较,各病变组HPV52基因型检出率差异有统计学意义(P<0.05);而HPV58基因型检出率在病变组和正常对照组之间差异无统计学意义(P>0.05).结论 芯片电泳法检测快速、成本低,可用于HPV52、58基因型感染的筛查.     

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…     

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.     

Acupuncture Combined with Spinal Tui Na for Treatment of Primary Dysmenorrhea in 30 Cases

Objective: To observe the therapeutic effects in acupunture treatment of primary dysmenorrhea combined with spinal Tui Na, and study its mechanism. Methods: Thirty cases of the treatment group were treated by acupuncture combined with spinal Tui Na, and thirty cases in the control group were treated by routine acupuncture. Results: The total effective rate was 93.3% in the treatment group, and 73.3% in the control group, with a significant difference between the two groups (P<0.05). Conclusions: Acupuncture combined with spinal Tui Na has good prospects for treatment of primary dysmenorrhea.     

Luo Lingjie's Experience in Treating Chronic Nephropathy

In treating chronic nephropathy,Luo Lingjie,a chief physician,pays attention to regulating the balance between yin and yang,treating infection if present,and removing pathogenic factors.He prescribes gentle drugs and uses carefully strongly warming-tonifying ones,emphasizes the importance of persuading the patient to persist in treatment with medication and nurse one's health for recuperation,and is good at combined use of TCM and western medicine therapy and brings the merits of various therapies into full play,with obvious theraoeutic effects.     

Dr.Zhang Ren's Experience in the Acupuncture Treatment of Different Diseases with the Same Therapeutic Principle

Dr.Zhang Ren,the chief physician,is the chairman of Shanghai Acupuncture and Moxibustion Association.Having been engaged in medicine for about 40 years,he is experienced in treating various intractable diseases.In his long years of clinical practice,he advocates taking the TCM differentiation as the basis to seek for the acupuncture method for treatment of modern intractable diseases.The author of this essay had the fortune to follow Dr.Zhang in study.The following is a summary of Dr.Zhang's experience in the acupuncture treatment for different intractable diseases with the same therapeutic principle.     

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.     

猪肺磷脂注射液联合经鼻持续气道正压通气对呼吸衰竭早产儿的临床疗效及肌酸激酶同工酶活性的影响

目的 探讨猪肺磷脂注射液联合经鼻持续气道正压通气(NCPAP)对呼吸衰竭早产儿的临床疗效及肌酸激酶同工酶活性(CK-MB)的影响.方法 选取呼吸衰竭早产儿80例,分为观察组和对照组各40例.对照组采用NCPAP给氧治疗,观察组给予NCPAP给氧联合猪肺磷脂气管内给药.观察两组患儿治疗前及治疗12h、24 h后PaO2、PaCO2、血氧饱和度(SaO2)、pH的变化情况,检测治疗前及治疗5d后血清CK-MB水平;评估两组患儿的临床治疗效果.结果 两组患儿PaO2、PaCO2、SaO2、pH比较,差异均有统计学意义(P＜0.05),其中观察组治疗后的PaO2、SaO2、pH均高于对照组,PaCO2则低于对照组.两组的PaO2、SaO2、pH均随观察时间延长而升高(P＜0.05),PaCO2均随观察时间的延长而降低(P＜0.05).观察组治疗有效率为87.5％,显著高于对照组的70.0％ (P ＜0.05).治疗5d后两组患儿血清CK-MB水平均较前降低(P＜0.05),且观察组明显低于对照组(P＜0.05).结论 猪肺磷脂注射液气管内给药联合NCPAP可以显著降低呼吸衰竭早产儿CK-MB的含量,提高治疗有效率,起到很好的呼吸循环支持作用.