160名成人接种重组酵母乙肝疫苗效果观察

目的探讨成人接种重组酵母乙型肝炎疫苗（YDV）的免疫效果。方法选择160名23-48岁身体健康状况良好的中学老师，其乙型肝炎表面抗原（HBsAg）、乙型肝炎表面抗体（抗-HBs）、乙型肝炎核心抗体（抗-HBc）3项指标均为阴性。按0、1、6个月程序，每剂10μg/1.0ml接种YDV。结果第1针免疫注射后的第12、24个月时，抗-HBs阳转率分别为83、75％、67、50％。女性抗-HBs阳转率均高于男性（P〈0．05）。小于35岁组的抗-HBs阳转率均高于35岁以上组（P〈0．05）。接种重组酵母乙型肝炎疫苗后，本组观察对象均无局部和全身不良反应。结论重组酵母乙型肝炎疫苗对成人具有良好的免疫原性和安全性。     

某矿区人群接种重组酵母乙肝疫苗免疫效果分析

目的了解重组酵母乙肝疫苗(recombinant yeast-derived hepatitis B Vaccine,YDV)在不同年龄组人群中的免疫学效果和安全性。方法选择兖矿集团某矿区0～62岁的903名乙型肝炎表面抗原(HBsAg)、乙型肝炎表面抗体(抗-HBs)和乙型肝炎核心抗体(抗-HBc)三项指标均为阴性者,采用0-1-6的免疫程序接种YDV,分别于全程接种后1、12、24、36个月时检测血清HBsAg和抗-HBs。结果研究对象接种后3d内未发现中重度的局部和全身不良反应。全程免疫后第1、12、24、36个月,抗-HBs阳转率分别为86.71%、71.85%、50.23%、41.25%(χ2=477.27,P<0.01),呈逐年下降趋势(P<0.01);经年龄标准化后,女性抗-HBs阳转率在各阶段均高于男性,但无统计学意义(P>0.05);人群抗-HBs阳转率与年龄有着密切关系,随年龄升高而逐渐降低(P<0.05)。结论YDV具有良好的免疫源性和安全性。     

某高校新生接种重组乙肝疫苗的免疫效果观察

目的了解高校新生接种重组（汉逊酵母）乙肝疫苗后的效果,为乙型肝炎的预防提供依据。方法以某高校2005年入学的乙型肝炎病毒的表面抗原（HBsAg）检测呈阴性的2700名学生为对象,按免疫程序分别接种重组（汉逊酵母）乙肝疫苗5ug／支3针,观察其免疫1,2,3年后血清的抗HBs阳转率,并对免疫无应答（乙肝五项全部阴性）的学生,加强疫苗接种（10ug和20ug／支）,按免疫程序分别再接种3针重组（汉逊酵母）乙肝疫苗,1个月后再检查抗HBs阳转率。结果全程接种乙肝疫苗1年后检测抗HBs阳性率为87．69％,2年后为8400％,3年后为75．00％,与全程免疫后1年相比,差异有统计学意义（P〈0．05）。加强疫苗接种剂量10ug和20ug分别按程序接种后,1个月抗HBs阳转率分别是96％和97．87％,与加强免疫前比较,差异有统计学意义（P〈0．05）。结论重组（汉逊酵母）乙肝疫苗免疫效果良好,但必要时需加强免疫．增加抗体应答者的远期免疫效果,发挥其免疫保护作用。     

海南藏族自治州儿童重组酵母乙肝疫苗免疫后抗体调查分析

目的：观察10μg乙型肝炎基因重组（酵母）疫苗对（5～14）岁儿童的免疫后抗体产生效果，为制定有效的免疫策略提供依据。方法：按0、1、6免疫程序对（5—14）岁儿童接种酵母重组乙肝疫苗，对633名乙肝血清标志物全阴的儿童，全程免疫6个月后采集血样，采用定量放免法（PIA）进行抗体检测。结果t全程免疫6个月后，抗体阳转率92．73％，分年龄组几何平均滴度（GMC）差别无明显性（F=1．66，P〉0．05），抗体滴度（GMC）在100mIU／L以上，占81．20％，男女之间抗体阳转率及GMC构成分布差别无显著性。结论：10μg重组酵母乙肝疫苗安全有效，儿童免疫后的抗体阳转率效果明显，抗体应答水平较高。为减少无应答和低应答人数应当增大接种剂量，以增加抗体阳转机会。     

国产重组酵母乙型肝炎疫苗阻断乙型肝炎病毒母婴传播6年免疫效果观察

目的：观察国产重组酵母乙型肝炎疫苗(YDV)阻断乙型肝炎病毒母婴传播的免疫持久性及探讨母亲为HBsAg和HBeAg双阳性(乙肝双阳性)婴儿的免疫方法。方法：对母亲乙肝双阳性的97例婴儿，按0、1、6个月程序，接种国产YDV，5μg／次。于免疫后9个月和1—6岁每年各采血1次，用RIA法检测HBsAg和抗—HBs。结果：共有12例HBsAg阳性儿，HBsAg阳性率、再感染率和母婴传播阻断率分别为12．37％(12／97)、3．41％(3／88)和85．44％。免疫后1—6年的抗—HBs(＞10IU/L)阳性率分别为83．95％(68／81)、82．86％(58／70)、71．19％(42／59)、64．29％(27／42)、50．00％(13／36)和40．00％(14／35)。结论；国产YDV对乙型肝炎病毒母婴传播6年内仍有较好的阻断效果，但保护性抗体已下降到40％。母亲乙肝双阳性的婴儿3岁半需加强免疫，1岁时对抗—HBs＜30IU/L的无、弱应答儿复种效果会更好。     

大学生乙型肝炎基因重组疫苗接种效果分析

目的 观察乙型肝炎基因重组疫苗的安全性和对大学生的免疫效果,为制定免疫策略提供依据。方法 应用乙肝酶母重组疫苗,按0,1和2月3针接种乙肝血清标志物全阴的156名大学生,并用定量族免法（PIA）对免疫后的抗体反应进行检测。结果 未发现接种对象出现严重副反应。成全程免疫后2个月时,抗体阳转率达81．41％,但大多数接种者体滴度（mean geometric titer,GMT）在（10－99）IU／L之间,为低应答水平,只有1．92％的人GMT在100IU／L以上,男、女生之间抗体阳转率及GMT构成分布差异多无显著性。12名既往疫苗接种抗体无应答者复种疫苗后,有7人抗体转阳。结论 乙肝重组疫苗安全性较,对大学生免疫后的抗体阳转率尚可,但抗体应答水平较低,性别差异不明显。免疫失败后可考虑复种,以增强抗体阳转机会。     

重组酵母乙肝疫苗的免疫学效果及不良反应的年龄分组比较

目的探讨重组酵母乙型肝炎疫苗(YDV)接种成人后22~<35岁和35~≤58岁两组成人的抗体滴度和阳性率的改变。方法在辽宁省北票市部分学校选择22~58岁教师124名,接种卫生部北京生物制品研究所生产的YDV。结果教师接种乙肝疫苗后抗-HB s阳性率和平均滴度均在免疫后7个月(22~<35岁组:88.5%和313.72 m IU/m l;35~≤58岁组:77.4%和503.69 m IU/m l)时达高峰,在12个月后,抗-HB s阳性率和平均滴度出现下降。抗体滴度在免疫后3、7个月为35~≤58岁组高于22~<35岁组,而在免疫后12、24个月时情况相反;但差异均无统计学意义(P>0.05)。35岁以下组阳性率高于35岁以上组,但只在免疫后12个月时才观察到二者之间差异有统计学意义(P<0.01)。结论YDV对成人具有良好的免疫原性,其抗-HB s持续时间有待进一步观察。     

乙型肝炎病毒疫苗联合应用乙肝高效价免疫球蛋白对乙肝免疫效果的观察

．将母亲乙型肝炎表面抗原（BHsAg)阳性的223名新生儿分成4组，分别接种乙肝疫苗10μg(Ⅰ组）、20μg(Ⅱ组）、20μg加乙肝高效免疫球蛋白（HBIG）1支（Ⅲ组），20μg加HBIG2支(Ⅳ组）。随访至12个月时，抗HBs阳转率在Ⅰ、Ⅱ、Ⅲ、Ⅳ组分别为62．5％、76．8％、80．9％和84．3％，HBsAg慢性携带率各为12．5％、11.0%,4.3%和2．9％。母亲HBeAg阳性和HBsAg≥1：256者，其婴儿抗HBs阳转率低于对照组。母亲HBeAg阳性者的婴儿，易发展成为HBsAg慢性携带者。     

乙肝疫苗免疫接种无应答者中医药辨证治疗效果分析

目的：探讨乙型肝炎疫苗接种后无免疫应答者的治疗对策。方法：对按目前常规的0，1，6程序3针全程免疫后，不产生相应抗体（S／N值〈2，1）或抗体滴度很低（S／N〈10）的32例患者进行中医药辨证治疗。结果：经1个疗程（2个月）治疗后，再次接种乙型肝炎疫苗，检查乙肝5项抗-HBs（S／N值〉10）者高达53．1％。结论：对乙型肝炎疫苗接种后无免疫应答者，进行中医药辨证治疗，可提高抗-HBs阳转率。     

妊娠后期接种乙肝疫苗免疫效果的观察

妊娠妇女２９例于妊娠后期接种乙肝疫苗，观察乙肝疫苗的免疫原性、完全性及胎儿抗体运转情况。追踪观察新生儿出生后乙肝表面抗体阳转率。结果生后１个月抗－ＨＢｓ阳转率８９．６％，生后３个月抗－ＨＢｓ阳转率８６．３％，生后６个月抗－ＨＢｓ阳转率７５．８％，孕妇接种后抗－ＨＢｓ阳转率６８．９％。说明妊娠后期接种乙肝疫苗有较强的免疫原性。     

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.     

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…     

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.     

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.