HBV感染者肾损害的统计分析

目的 了解HBV感染者发生肾损害的情况,为临床治疗及提高HBV感染者生活质量提供参考.方法 收集2008年1月～2011年3月期间在本院就诊病人中检出的955例HBV感染者的临床资料,对其肾损伤情况进行统计分析.结果 出现肝损害者发生肾损害的比例高于未出现肝损害者（P＜0.01）;男性HBV感染者肾损害的发生率高于女性感染者（P＜0.01）,发生率分别为18.1%和7.1%;HBV感染者肾损害的发生率在不同年龄的人群中也具有差异（P＜0.01）,在≥51岁的感染者中较为常见.结论 HBV感染者肾损害的发生率较高,临床应密切监视HBV感染者特别是出现肝损害、≥51岁及男性的肾功能情况.     

HBV感染者不同血清学标志物模式肾损害的探讨

目的探讨HBV感染者不同血清学模式下发生肾损害的情况。方法收集2008年1月～2013年1月在本院就诊患者中检出的2495例HBV感染者的临床资料,根据其两对半检测结果进行分组,并对各组患者肾损伤情况进行统计分析。结果不同血清学模式的乙肝感染者肾损害的发生率不同;HBsAg（＋）、Anti-HBe（＋）、Anti-HBc（＋）模式的HBV感染者肾损害的发生率最高,为15.9%;其次是HBsAg（＋）、HBeAb（＋）模式,为15.3%;肾损害发生率最低的是HBsAg（＋）、HBeAg（＋）、Anti-HBc（＋）模式,为6.3%。结论乙肝患者肾损害的发生与两对半血清学模式密切相关。     

贵阳地区HIV感染者合并HCV、TP及HSV-2检测结果分析

目的了解贵阳市感染了人类免疫缺陷病毒（HIV）人群中合并丙型肝炎病毒（HCV）、梅毒（TP）及单纯疱疹病毒Ⅱ型（HSV-2）感染现状及特点。方法对204例HIV抗体确证阳性者感染者进行流行病学调查,并采集血标本进行HCV、TP和HSV-2血清学检测。结果 204例HIV感染者中,感染HCV、TP和HSV-2阳性数分别为24例（11.8%）、35例（17.2%）和4例（2.0%）;单独合并丙型肝炎感染者主要以30-40岁为主,单独合并梅毒感染者主要以20-40岁为主;HIV合并HCV感染性传播途主要以静脉吸毒者（IDU）为主,HIV合并TP感染性传播途主要以男男性行为者（MSM）为主,其次为IDU、异性性传播。结论贵阳地区HIV感染者及AIDS患者合并HCV、TP感染较为常见,应采取积极措施防止HIV、HCV、TP的合并感染及传播。     

碘对比剂肾损伤的检测方法

【摘要】对比剂肾病是碘对比剂注射后严重的并发症,对其早期及时检测及评价具有重要临床意义。病理诊断虽然可作为诊断肾脏损伤的金标准,但其有创性及次数限制也使其在临床应用有很大局限。目前临床上主要通过测量患者的Scr水平和GFR来判断肾功能,但肌酐变异较大,且对肾功能改变的反应较为滞后。中性粒细胞明胶酶相关载脂蛋白（NGAL）及胱抑制素C（CysC）在肾脏损伤后较早出现升高,已被视为现在已知最可靠的早期预测CIN的生化标志物之一。肾脏功能磁共振（fMRI）无创、无辐射,可重复性与接受性强,对对比剂肾病的早期诊断、指导治疗、判断预后都有较高的价值。本文旨在总结目前临床上对比剂肾病的不同检测方法,为临床选择更恰当的评估对比剂肾损害的方法提供依据。     

磁共振DKI评估慢性肾脏病肾功能价值的初步研究

【摘要】目的：探讨磁共振扩散峰度成像（DKI）在慢性肾病（CKD）患者肾功能评估中的应用价值。方法：招募70例CKD患者和20例健康志愿者。测量CKD患者的血清肌酐值并计算肾小球滤过率（eGFR）,将CKD患者分为2个组,轻度肾损害组［eGFR≥60mL/(min·1.73m2)］44例,中重度肾损害组26例［eGFR<60mL/(min·1.73m2)］。CKD患者和健康志愿者均行双肾常规MRI和DKI检查,获得肾皮质和髓质的平均扩散系数（MD）和平均峰度（MK）值。采用配对样本t检验比较3组中肾脏皮质与髓质DKI参数值的差异,采用单因素方差分析比较3组间肾皮质和髓质DKI参数值的差异,采用Pearson相关性分析对CKD患者的eGFR与肾脏皮质和髓质的DKI参数值的相关性进行评估,ROC用于评估DKI参数值鉴别CKD的2个亚组及鉴别对照组与轻度肾损害组的诊断效能。结果：对照组、轻度肾损害组及中重度肾损害组中肾脏皮质的MD值均明显高于髓质,而皮质的MK值均低于髓质,差异均有统计学意义（P＜0.05）。三组之间肾脏皮质和髓质的MD、MK值的差异均有统计学意义（P＜0.05）。CKD组中肾脏皮质MD值（r=0.684）和髓质MD值（r=0.451）均与eGFR呈中度正相关（P＜0.05）,CKD组中肾脏皮质MK值（r=－0.757）和髓质MK值（r=－0.719）均与eGFR呈高度负相关（P＜0.05）。各项定量参数在鉴别轻度与中重度CKD时,以皮质MK值的ROC下面积（0.907）最大,皮质MD值的截断值取2.51×10-3mm2/s或皮质MK值的截断值取0.60时鉴别诊断的特异度（95.5%）最高,髓质MK值的截断值为0.65时鉴别诊断的敏感度（80.8%）最高;在鉴别对照组与轻度肾损害组时,以髓质MD值的ROC下面积（0.851）最大,髓质MK值的截断值取0.60时鉴别诊断的特异度（100.0%）最高,皮质MD值的截断值取2.76×10-3mm2/s或髓质MD值的截断值取2.21×10-3mm2/s时鉴别诊断的敏感度（70.5%）最高。结论：磁共振扩散峰度成像可以为慢性肾病患者肾功能的评估提供有价值的信息。     

滇南地区HIV感染者并发其他疾病的统计分析

目的统计分析解放军59医院就诊病人中检测出HIV感染者并发其他疾病的情况,初步探讨其并发疾病的分布规律和特点,为提高临床诊疗技术和HIV感染者生活质量提供依据。方法采用描述性流行病学方法,回顾性分析2008年1月～2010年12月期间本院就诊病人中检出的465例HIV感染者的病例资料。结果肺结核、骨折、肝硬化、慢性结肠炎、带状疱疹和糜烂性胃炎在HIV感染者中的发病率分别为7.5%、7.1%、3.4%、2.1%、1.9%、1.3%,其中男性HIV感染者比女性感染者更容易并发骨折（P〈0.01）,而肺结核等疾病的发病率在不同性别的HIV感染者中没有差异。HIV合并HBV和HCV的感染率分别为6.9%、17.6%,HIV、HBV和HCV三者合并感染的感染率为1.3%。结论 HIV感染者应加强肺结核、骨折、肝硬化、慢性结肠炎、带状疱疹和糜烂性胃炎的预防;在艾滋病患者的临床治疗过程中,要充分考虑HIV重叠感染HBV和HCV对病人的综合影响。     

慢性丙型肝炎患者血清脂蛋白水平改变的研究

为观察丙型肝炎病毒（HCV）感染者与健康人血清高密度脂蛋白胆固醇（HDL－C）、低密度脂蛋白胆固醇（LDL－C）、载脂蛋白B（apo B)、载脂蛋白C2（apo C2)、载脂蛋白C3（apo C3)、载脂蛋白E（apo E)及脂蛋白(a)[LP(a)]水平的差异，分别取健康人及HCV感染者血清各75份，并对其进行检测。结果发现，HCV感染者血清中的HDL－C、apo B及apo C3的含量均低于健康人（P＜0．05）；LDL－C、apo C2的含量亦低于健康人，但无统计学意义（P＞0．05）；apo E及LP（a)的含量均高于健康人（P＜0．05）。另外，HCV RNA及抗－HCV均阳性的患者血清中的HDL－C、LDL－C、apo B、apo C2、apo C3、apo E及LP（a)的含量与抗－HCV阳性但HCV RNA阴性者比较有差异，但无统计学意义（P＜0．05)。     

烧伤创面切削痂植皮对纠正烧伤后肾脏损害的价值

目的　探讨烧伤合并肾脏损害的治疗方法。方法　对 47例烧伤合并肾损害进行烧伤创面切削痂植皮 ,以减少烧伤毒素、促进创面修复、促进肾脏功能恢复。结果　术后 1周观察 ,3 6例肾损害治愈、9例好转、2例无效 ;完成手术后 ,最快 3d肾损害即可控制。本组最后治愈41例、死亡 6例。结论　对于烧伤合并肾损害 ,及时采用手术治疗 ,不仅利于肾功能的恢复 ,也是保证患者最终康复的重要手段。一旦烧伤病人出现肾功能损害 ,应尽早进行烧伤创面切削痂植皮术修复深度创面。     

连芪消渴胶囊对2型糖尿病大鼠肾损害的保护作用

目的研究连芪消渴胶囊对2型糖尿病大鼠肾损害的保护作用。方法采用高糖高脂饲料配合低剂量链脲佐菌素（30mg/kg）方法诱导2型糖尿病大鼠模型。将成模大鼠分为模型组、连芪消渴胶囊（2、4、8g/kg）治疗组、盐酸二甲双胍（0.2g/kg）组,治疗8周各组大鼠进行空腹血糖、肾功能相关指标检测以及肾脏组织学观察。结果与正常组对比,模型组空腹血糖、肾指数、尿量、微量白蛋白、血肌酐、尿素氮出现明显升高,超氧化物歧化酶水平降低而丙二醛水平升高,大鼠肾脏组织出现明显损伤变化;与模型组对比,连芪消渴胶囊（4、8g/kg）治疗组肾指数、尿量、微量白蛋白、血肌酐、尿素氮明显降低,肾组织超氧化物歧化酶水平升高和丙二醛水平降低;肾脏组织结构损伤变化得到改善。结论连芪消渴胶囊具有保护糖尿病肾功能损伤的作用,该作用与其降低空腹血糖及调节肾组织氧化应激水平有关。     

乙肝和丙肝病毒感染标志物检出情况比较

我们对乙型肝炎病毒（HBV）和丙型肝炎病毒（HCV）双重感染者血清及肝组织内病毒标志物进行检测，并与单纯HBV和单纯HCV感染者作比较，着重探讨二者的相互影响。1临床资料1．l病例选择均系我院1991年1月～1995年9月的住院患者216例，男179例，女37例。年龄7～71岁。其中包括慢性肝炎轻度11例，慢性肝炎中度159例，肝硬变26例，原发性肝癌14例，亚急性重地肝炎6例。132例有肝活俭病理证实。临床及病理诊断参照lggo年（L海）全国病毒性肝炎学术会议修订的诊断方案。经检测血清抗一HAVIgM、抗一HDV反抗．HEV全部阴性，均确诊为HBV和…     

Glutamine supplementation in vitro and in vivo,in exercise and in immunodepression

In situations of stress, such as clinical trauma, starvation or prolonged, strenuous exercise, the concentration of glutamine in the blood is decreased, often substantially. In endurance athletes this decrease occurs concomitantly with relatively transient immunodepression. Glutamine is used as a fuel by some cells of the immune system. Provision of glutamine or a glutamine precursor, such as branched chain amino acids, has been seen to have a beneficial effect on gut function, on morbidity and mortality, and on some aspects of immune cell function in clinical studies. It has also been seen to decrease the self-reported incidence of illness in endurance athletes. So far, there is no firm evidence as to precisely which aspect of the immune system is affected by glutamine feeding during the transient immunodepression that occurs after prolonged, strenuous exercise. However, there is increasing evidence that neutrophils may be implicated. Other aspects of glutamine and glutamine supplementation are also addressed.     

Temporal changes in the oxidation state in in vitro blood

The rates at which the paramagnetic compounds deoxyhemoglobin (Hb) and methemoglobin (MHb) form in vivo within an area of hemorrhage are unknown. The present experiment establishes the baseline concentrations and rates of change in paramagnetic hemoglobin concentrations, as well as the pH in normal heparinized and clotted human blood maintained in vitro at 37 degrees C under anaerobic conditions over 30 hours. There was a moderate increase in Hb concentration in normal heparinized blood (average increase was 15.5%, rate = 0.50%/hour) and a slight increase in MHb concentration in the heparinized blood and clots (average increase was 1.4%, rate = 0.044%/hour). A second experiment was done to verify the activity of the RBC systems responsible for maintaining the hemoglobin molecule in the reduced state. Conversion of MHb to Hb in these samples proceeded at a rate of 5.6%/hour. In a third experiment, blood from 11 normal subjects maintained at 4 degrees C 25 degrees C was analyzed for MHb concentration over the course of 28 days. The level of MHb formation remained in the range of normal for at least 11 days in all subjects. The authors conclude that at basal conditions created in vitro, the blood levels of both Hb and MHb remain at relatively low levels. Therefore, if the accumulation of Hb and/or MHb occurs in acute in vivo hematomas it must be driven by intrinsic tissue factors.     

Carcinoma in situ in cryptorchid testes in post-pubertal patients]

The pathohistologic analysis of testis sections of 37 postpuberty patients with different types of cryptorchism is performed. The tissue samples were taken during orchiopehy, fixed in Bouin's solution and treated by the standard histologic techniques. The morphologic criteria are presented for identification of the presence of the so called carcinoma in situ cells found in two cases. Besides, in 13 patients rare, mainly single, atypical germinative cells were found in a smaller number of the seminiferous tubules. It has been concluded that the presence of carcinoma in situ cells in undescended testes of some patients and considering the simple way of sampling, lack of complications and high reliability of the diagnostic procedure, it is absolutely justified to take routine biopsy of testes during orchiopexy in each postpuberty and perhaps prepuberty patient.     

Interventions in the chest in children

The scope for image-guided intervention in the chest is very wide and encompasses procedures in the heart, pulmonary and systemic vasculature, lungs and pleural cavities, airway, and esophagus. This review describes the most important procedures that are usually performed by radiologists. Percutaneous drainage is now the most common method of treating both empyemas and lung abscesses in children. Although most lung biopsies are carried out by other means, percutaneous biopsy and localization are important alternatives for the diagnosis of focal lung lesions. Esophageal strictures are common in children and are usually best treated by balloon dilatation. The use of retrievable or biodegradable stents has recently been introduced for refractory esophageal strictures. Similarly, balloon dilatation and stenting are now increasingly used in children with stenosis or extrinsic compression of the trachea or bronchi.