乙型肝炎疫苗不传染获得性免疫缺陷综合征

本研究提供关于乙型肝炎疫苗安全性的又一个重要保证。在美国目前应用的疫苗是从乙型肝炎表面抗原阳性人群的血浆中生产的,他们中的部分人亦是获得性免疫缺陷综合症(AIDS)的高危人群。人们担心AIDs的致病因子在疫苗制造过程的灭活措施中可能继续残存。最近对作为AIDS病因的逆转病毒的鉴定已承认下列三个方面的工作:(1)通过在疫苗制造     

微创经皮肾穿刺技术治疗复杂输尿管上段“石街”

目的：探讨微创经皮肾穿刺(mini-PCN)技术治疗复杂输尿管上段“石街”的可行性和安全性。方法：对38例复杂输尿管上段“石街”采用mini-PCN技术取石。结果：结石一次取净率100％，无输尿管穿孔、狭窄、术后大出血及尿瘘。术后持续发热2例，经保守治疗好转出院。结论：mini-PCN技术治疗复杂输尿管上段“石街”具有创伤小、操作安全可靠、结石一次取净率高等优点，是治疗复杂输尿管上段“石街”的较好方法。     

金黄色葡萄球菌脑膜炎并枸橼酸杆菌肠炎1例

男,50天。因发热1个月,腹泻半月伴惊厥2次入院。于1个月前开始发热,每天在38℃至40℃左右,半月前突然惊厥1次。近半月来腹泻,大便为黄绿色粘液便,无脓血,每天4～5次。曾在当地医院使用抗生素、肾上腺皮质激素等治疗10余天,病情无明显好转,且又惊厥1次而来诊治。查体:体温40.4℃,稍瘦,神志不清。前囟2.5cm×2.5cm,饱满。角膜稍混浊。颈无抵抗感。心肺正常。拥抱反射及觅食反射消失,布氏征及克氏征未引出,巴氏征(+)。实验室检查:血红蛋白136g/L,白细     

长期应用肾上腺皮质激素致肠穿孔3例

例1 男,1岁。入院前因发热,惊厥用抗生素及氟美松治疗10天。入院后经脑脊液及 CT 检查.诊断为化脓性脑膜炎并硬膜下积液。用抗生素治疗,并加用氟美松每日3mg 静脉点滴,3天后惊厥停止,一周体温降至正常,半月复查脑脊液正常,仍用原药治疗。于第20天(共用氟美松42mg),患儿哭闹,发热,腹胀,停止排便。查体:腹部膨隆,腹肌紧张,有压痛,无反跳痛,肝浊音界消失,移动性浊音阳性,肠鸣音减弱。腹透示:腹腔内大量游离气体。以消化道穿孔、腹膜炎急     

利伐沙班用于股腘动脉粥样硬化闭塞支架植入术后的临床观察

  目的  研究利伐沙班在股腘动脉粥样硬化闭塞支架植入术后的疗效及安全性。  方法  将满足标准的87患者随机分为试验组45例和对照组42例，两组患者一般资料差异无统计学意义。试验组予利伐沙班片每次10 mg，po，qd和阿司匹林肠溶片每次100 mg，po，qd；对照组予阿司匹林肠溶片每次100 mg，po，qd，两组患者均予阿托伐他汀10 mg，po，qd和贝前列素钠40 μg，po，tid，嘱所有患者戒烟。观察随访术后当天、治疗后3个月和6个月两组患者ABI、跛行距离、支架再狭窄、支架附壁血栓形成以及二次干预率等相关疗效指标，并统计药物不良反应、不良心脑血管事件、轻度和严重出血情况等安全性指标，对随访观察的结果进行统计学分析。  结果  6个月时两组患者附壁血栓形成、ABI和跛行距离差异有统计学意义（P < 0.05），支架再狭窄差异无统计学意义（P > 0.05），两组患者二次干预率的Log-rank检验差异无统计学意义（P > 0.05），两组患者安全性对比无统计学意义（P > 0.05）。  结论  利伐沙班联合阿司匹林治疗明显的减少了支架内附壁血栓形成并延缓了术后ABI和跛行距离的下降趋势，可能对患者的长期预后有益。     

2005年云南省不明原因心源性猝死病区人群心电图分析

为了掌握云南省不明原因心源性猝死重病区非流行期和流行期人群心电图动态变化情况．作者于2005年对2个监测点进行心电图监测．现将结果报告如下。 1对象与方法 1．1监测点的选择及监测时间：在云南省不明原因心源性猝死疫区．选择历史病情较重的大姚县石羊镇叭腊么村委会阿基苴自然村和腾冲县界头乡东华村作为监测点。     

2007年云南省克山病监测报告

Objective To study the current incidence of Keshan disease in Yunnan Province,and provide scientific basis for Keshan disease(KD) prevention and control. Methods Based on the Scheme of KD Surveillance, 16 villages in 11 counties were chosen as surveillance sites by the historical data. An survey was made to the residents in the 16 surveillance sites by filling in the questionnaire, inquiry medical history, clinical examination, electrocardiogram and 2 meters post-anterior chest X-ray for suspected cases. KD cases were diagnosed according to the Diagnostic Criteria for Keshan Disease(GB 17021-1997). The prevalence data of KD in the whole province were collected from the KD case report in 2007 and the trace surveys. Results There were 6877 residents in 16 surveillance sites of 11 surveillance counties and totally 39 KD cases were diagnosed with a detection ratio of 0.57% (39/6877). The detection ratio of latent and chronic KD were 0.41%(28/6877) and 0.16%(11/6877), respectively and no acute or subacute cases were found. The cases aged 5 to 14 years old accounting for 66.67% (26/39). Electrocardiogram examination of 6877 residents were made and 5.25% (361/6877) abnormal electrocardiograms were detected in the 16 surveillance sites. Fifty-five people were checked by chest X-ray and there were 31 cases with heart-chest ratio ≤0.50, 16 cases with heart-chest ratio from 0.51 to 0.55 and 8 cases with heart-chest ratio from 0.56 to 0.60. The prevalence rate and incidence rate of chronic KD were 4.24 per 100 000 and 0.50 per 100 000 in Yunnan. No acute or subacute cases were found and the latent cases were listed. The prevalence rate and incidence rate were 7.76 per 100 000 and 1.18 per 100 000 in the 16 surveillance sites. Conclusions The incidence of KD is low incidence in Yunnan Province. Higher ineidence of chronic KD was detected in the some areas and the corresponding control measures need to be adopted.     

坐骨神经损伤多见腓总神经病变原因分析及临床意义

目的：探讨坐骨神经损伤多见腓总神经病变原因。方法：对52具防腐固定的成人尸体,解剖观测梨状肌与相对缘结构之间的关系,坐骨神经穿出部位、分支等。结果：根据坐骨神经穿出部位的不同,将104侧观察结果分两大类型;正常型即坐骨神经穿过梨状肌下孔占73．08％（76侧）,异常型占26．92％（28侧）。梨状肌与上抒肌之间的形态变化分三种形态：即三角形,72．12％（75侧）;裂隙形,20．19％（21侧）;重叠形,7．69％（8侧）。梨状肌上、下孔相对缘的结构为坐骨神经通过的“第一门槛”,而构成梨状肌上、下间隙相对缘的结构为坐骨神经通过的“第二门槛”即“双门槛”的概念。结论：坐骨神经与梨状肌的变异、梨状肌病变及“双门槛”狭窄等,均是构成坐骨神经尤其腓总神叠卡压损伤的重要因素。