A new strategy of delayed long-term prophylaxis could prevent cytomegalovirus disease in (D+/R−) solid organ transplant recipients

Abstract:  Long-term prophylaxis against cytomegalovirus (CMV) started immediately after transplantation in (D+/R−) poses a higher risk of late-onset CMV disease. Delayed CMV prophylaxis could allow a transitory exposure of the immune system to CMV, which would let the immune system mount an adequate CMV-specific cytotoxic response in (D+/R−) patients and confer protection against CMV disease. We included all (D+/R−) solid organ transplant recipients (SOT) performed at our institution (January 3/October 6) who received CMV prophylaxis (mainly with oral valganciclovir) during 100 d. In the first period (until December 4), prophylaxis was initiated immediately after transplantation (conventional prophylaxis: CP). Since January 5, it was initiated after 14 d (delayed prophylaxis: DP). Incidence and severity of CMV disease was compared between both groups. A total of 44 SOT recipients were included (CP: 26 and DP: 18). CMV disease was diagnosed in eight patients (18%), seven of 26 (27%) in the CP group, and one of 18 (5.5%) in the DP group (p = 0.07). CMV colitis was reported in five of 26 patients in the CP group (19%), whereas there were no cases of visceral CMV disease in the DP group (p = 0.048). A 14-d delay in the beginning of long-term prophylaxis against CMV in (D+/R−) is safe and could prevent the onset of late-CMV disease.     

100例性病患者心理健康状况调查分析

目的：探讨性病患者的心理健康状况,为临床治疗和护理提供依据。方法：采用症状自评量表（SCL-90）对100例性病患者的心理健康状况进行测验。结果：100例性病患者SCL-90检测的阳性率为51%,阳性样本因子分居前的是敌对、强迫症状、抑郁、人际敏感。结论：性病患者广泛存在的心理问题,在药用治疗的同时应注意心理方面的治疗和疏导。     

膀胱肿瘤2350例临床病理学特点分析

目的 探讨膀胱肿瘤的发病现状、总体趋势和病理特点.方法 整理1980-2007年2350例膀胱肿瘤病理档案,分为1980-1989、1990-1999和2000-2007年3个时间段.应用SPSS 13.0软件分析3时间段患者性别、年龄及肿瘤组织学类型间的关系.结果 2350例膀胱肿瘤中男1854例,女496例.良性92例,恶性2258例,膀胱恶性肿瘤的发病人数逐年上升.发病高峰年龄从50～69岁推迟到60～79岁.1980-1989、1990-1999和2000-2007年3个时间段中男、女恶性肿瘤病例数分别为524例和113例(4.64:11 00)、589例和164例(3.59:1.00)、675例和193例(3.50:1.00),男性约为女性的3.80倍;3时间段男性发生膀胱尿路上皮癌年龄分别为(57.5±11.7)、(62.6±12.3)、(65.9±11.3)岁,女性分别为(58.7±13.6)、(60.7±12.1)、(65.8±12.0)岁,男女各年龄段分别比较差异有统计学意义(P<0.05).男性发生鳞状细胞癌、尿路上皮癌和腺癌年龄分别为(68.05±9.7)、(59.85±14.1)、(63.4±9.9)岁,差异有统计学意义(P相似文献   

Total pancreatectomy with islet autotransplantation: an overview

Pain control is one of the most challenging aspects in the management of chronic pancreatitis. Total pancreatectomy can successfully relieve the intractable abdominal pain in these patients but will inevitably result in insulin-dependent diabetes. Islet autotransplantation aims to preserve, as far as possible, the insulin secretory function of the islet cell mass thereby reducing (or even removing) the requirement for exogenous insulin administration after a total pancreactomy. Despite the relatively small number of centres able to perform these procedures, there are important technical variations in the details of their approaches. The aim of this review is to provide details of the current surgical practice for total pancreatectomy combined with islet autotransplantation, and outline the potential advantages and disadvantages of the variations adopted in each centre.     

乌梢蛇Ⅱ型胶原蛋白对大鼠佐剂型关节炎滑膜细胞因子的作用

目的:观察乌梢蛇Ⅱ型胶原蛋白(tyPe Ⅱ collagen,CⅡ)对大鼠佐剂型关节炎(adjuvant arthritis,AA)滑膜细胞因子的作用.方法:限制性胃蛋白酶降解法提取乌梢蛇CⅡ,SDS-PAGE凝胶电泳法和紫外分光光度计法鉴定;采用完全弗氏佐剂(complete Freud′s adjuvant,CFA)足垫皮下注射诱导AA大鼠模型;收集滑膜细胞上清液,L929细胞毒性法检测滑膜细胞上清液中TNF-α生物活性,MTT法检测滑膜细胞上清液中IL-1β生物活性;ELISA法检测滑膜细胞上清液细胞因子水平.结果:提取的CⅡ分子量约为118kD～120 kD,紫外光谱吸收仪测定提取的CⅡ吸收峰为230nm,均与标准的牛鼻中隔CⅡ相符;乌梢蛇CⅡ各剂量组体外对滑膜细胞上清液TNF-α和IL-1β活性没有直接作用;乌梢蛇CⅡ中剂量组可抑制AA大鼠的滑膜细胞和派氏淋巴结共培体系上清液TNF-α和IL-1β活性(P＜0.01),乌梢蛇CⅡ低、高剂量可抑制AA大鼠的滑膜细胞和派氏淋巴结(PP)共培体系上清液IL-1β活性(P＜0.05);灌服乌梢蛇CⅡ低、中剂量组与模型组比较,TNF-α活性下降(P＜0.05);中剂量组与模型组比较,IL-1β活性下降(P＜0.05);模型组与空白对照组比较,滑膜上清液TNF-α和IL-1β水平显著升高(P＜0.01);乌梢蛇CⅡ中、高剂量组与模型组比较,均能抑制滑膜上清液TNF-α和IL-1β水平(P＜0.01);乌梢蛇CⅡ低剂量组能显著抑制滑膜上清液IL-1β水平(P＜0.01);乌梢蛇CⅡ中剂量能显著升高滑膜上清液TGF-β(P＜0.01);结论:乌梢蛇CⅡ体外对滑膜细胞炎症因子无直接作用,灌服乌梢蛇CⅡ可以抑制滑膜细胞炎症因子的水平和活性.     

MMP-2、TIMP-2与碱烧伤后角膜新生血管形成的实验研究

目的:探讨基质金属蛋白酶-2(MMP-2)、基质金属蛋白酶-2组织型抑制剂(TIMP-2)在碱烧伤大鼠角膜新生血管(CNV)形成中的表达和意义。方法:采用碱烧伤大鼠角膜建立CNV模型,摘除角膜作病理切片,多形核白细胞(PMN)记数;免疫组化法检测MMP-2、TIMP-2的表达。结果:烧伤后1d角膜缘PMN开始增多,到CNV7d组PMN增加最明显,此后逐渐减少;免疫组化显示:MMP-2在CNV中阳性表达逐渐增加,于7d表达最明显,此后随炎性细胞的减少而减弱,21d后几乎无表达;TIMP-2则于早期变化不明显,7d表达开始升高,14d达高峰。结论:烧伤后CNV形成早期,MMP-2活性增高,继而TIMP-2表达增加,使MMP-2活性受抑,基底膜降解受阻,新生血管延伸停滞;CNV形成中,MMP-2的表达增加,并与角膜的炎性反应程度一致,PMN浸润可能是CNV形成的关键因素。     

Modulation of spontaneous motility by GABAA receptor antagonism in the guinea pig isolated ileum

Rhythmic neurally mediated spontaneous contractions of the longitudinal muscle in the isolated ileum of the guinea pig, sensitive to tetrodotoxin and atropine, were depressed and most often abolished by the GABAA receptor antagonists, bicuculline methiodide, RU 5135, and picrotoxin, a Cl- -ionophore blocker, as well as by GABA desensitization. 3-Mercaptopropionic acid, known to prevent GABA release, also reduced these naturally occurring spontaneous contractions. All these strongly indicate a physiological involvement of endogenous GABA in the control of spontaneous rhythmic activity in the intestine.     

Dorsal intramedullary spinal epidermoid cysts: Report of two cases and review of literature

Intramedullary epidermoid cysts of the spinal cord are rare tumors, especially those not associated with spinal dysraphism. About 50 cases have been reported in the literature. Of these, only seven cases have had magnetic resonance imaging (MRI) studies. We report two cases of spinal intramedullary epidermoid cysts with MR imaging. Both were not associated with spina bifida. In one patient, the tumor was located at D4 vertebral level; while in the other, within the conus medullaris. The clinical features, MRI characteristics and surgical treatment of intramedullary epidermoid cyst are presented with relevant review of the literature.     

某儿童医院10年临床报告细菌性痢疾的流行病学特征

目的探讨细菌性痢疾(以下简称菌痢)近10年流行特点。方法对10年来收集的全院各科上报的菌痢进行回顾性分析。结果1993-2002年报告菌痢10861例,占传染病报告总数的62.92%,传染科门诊量占全院门诊百分比的年变化为8.54%～4.33%;菌痢发病占传染科门诊的年比率变化为1.05%～3.45%;<1岁、1～3岁、4～6岁、7～9岁、≥10岁5个年龄组,各组之间菌痢检出率差异有统计学意义,1～3岁组检出率最高;细菌性痢疾每年4月检出率开始上升,8月达最高,11月检出率恢复到上升前水平;不同性别的儿童检出率差异有统计学意义,男童明显高于女童。结论细菌性痢疾检出年龄特点为婴幼儿最高,随年龄增长,发病逐渐减少;发病高峰季节向春秋季扩展。     

2003年胶州市苯作业场所空气中苯的危害监测

近几年来随着青岛地区经济的发展,大量鞋革箱包及玩具制造,家具制造企业涌现于胶州.在这些企业里,普遍使用含有苯的强挥发性胶水粘合剂.苯系化合物已被WHO确定为强致癌性物质，由于苯系物属芳香烃类，无色透明易挥发，使人一时不易警觉其毒性。人在短时间内吸入高浓度的苯，会出现中枢神经麻醉的症状，轻者头晕、胸闷、恶心、乏力、呕吐。