95例SARS患者T细胞及其亚群动态变化的观察

对 95例SARS患者的T淋巴细胞亚群动态变化进行分析。其中 85例痊愈 ,1 0例死亡。 85例痊愈患者 ,病程第 7天平均CD4 + ( 3 2 5± 1 90 )个 /μL ,CD8+ ( 3 1 9± 3 1 5 )个 /μL ,CD4 + /CD8+ 1 .2 5± 0 .71 ,与我国正常人相比〔平均CD4 + ( 72 7± 2 5 5 )个 /μL、CD8+ ( 5 3 9± 1 3 4)个 /μL ,CD4 + /CD8+ 1 .49〕 ,T淋巴细胞亚群明显下降 (P =0 .0 0 1 )。病程第1 4天左右免疫功能逐渐恢复 ,平均CD4 + ( 5 61± 5 2 2 )个 /μL ,CD8+ ( 3 70± 2 71 )个 /μL ,CD4 + /CD8+ 1 .68± 1 .1 1。 2 1d后免疫功能基本恢复正常 ,平均CD4 + ( 675± 448)个 /μL ,CD8+ ( 4 67± 2 41 )个 /μL ,CD4 + /CD8+ 1 .48± 0 .68。 1 0例死亡患者的T细胞亚群在入院后逐渐出现下降趋势 ,病程第 7天CD4 + ( 2 48± 82 )个 /μL ,CD8+ ( 2 3 3± 1 1 5 )个 /μL ,CD4 + /CD8+ 1 .2 1± 0 .40 ,第 1 4天T淋巴细胞继续下降 ,平均CD4 + ( 1 81± 1 2 8)个 /μL ,CD8+ ( 1 73± 1 0 9)个 /μL ,CD4 + /CD8+ 1 .1 7± 0 .45 ,2 1d后CD4 + 细胞继续下降 ,平均CD4 + ( 1 2 5± 46)个 /μL ,CD8+ ( 94± 3 8)个 /μL ,CD4 + /CD8+ 1 .44±0 .5 9。结果提示 :SARS患者早期可能存在异常的免疫反应 ,这种异常免疫反应可能是导?     

酸性成纤维细胞生长因子促血管内皮细胞增殖作用的实验研究

目的　探讨不同浓度的aFGF对体外培养的大鼠主动脉内皮细胞生长的影响。方法　通过组织块培养法获取主动脉内皮细胞。将浓度为 5ng/ml,10ng/ml,2 0ng/ml的aFGF分别加入内皮细胞的培养液中作为实验组(Ⅰ～Ⅲ组 ) ,不加aFGF的组作为对照组。分别在 2 4h、48h和 72h应用MTT法进行细胞计数。结果　从大鼠主动脉成功地获取了内皮细胞。 3天内 ,实验组和对照组的主动脉内皮细胞都有不同程度的增殖 :培养 2 4h ,实验各组与对照组比较P >0 .0 5 ,无统计学差异 ;48h和 72h时 ,Ⅱ、Ⅲ组与对照组以及与Ⅰ组两两比较 ,有非常显著的差异 (P <0 .0 0 1) ;各时间段内 ,Ⅰ组与对照组 ,Ⅲ组与Ⅱ组比较 ,细胞数改变未见差异 (P >0 .0 5 )。结论　一定浓度的aFGF有非常明显的促血管内皮细胞生长的作用 ,可能对缺血性心脏病的促血管形成治疗有较大的帮助。     

双光气致急性损伤对兔肺泡Ⅱ型细胞形态学的影响

目的：通过对日本大耳兔双光气肺损伤后肺泡Ⅱ型细胞内磷脂和形态学变化的观察，探讨双光气对肺Ⅱ型细胞的损伤及其机制．方法：将纯种日本大耳白兔35只随机分为对照组(n＝10)、染毒即刻组(n＝5)、染毒2h组(n＝5)染毒4h组(n＝5)、染毒8h组(n＝5)、染毒12h组(n＝5)；采用浓度一时间法动态式染毒，染毒后按不同时间点对实验动物进行颈总动脉插管放血处死，取肺并用肺灌洗液对支气管肺泡进行灌洗，然后取肺组织作冰冻切片，进行电镜观察，并测定细胞内磷脂含量．结果：肺Ⅱ型细胞内磷脂含量在染毒即刻开始时较正常组含量下降(P＜0．01)；在染毒2h时降到最低，之后上升(P＜0．05)，而在4h后又下降(P＜0．05)．染毒终止后，损伤逐渐加重，染毒后2h磷脂因消耗而降低．染毒后4h，由于代偿功能启动，磷脂短暂升高，出现致伤性代偿期．从染毒2h后开始，细胞损伤加重，磷脂合成进入失代偿期，合成逐渐减少．到染毒后8h，肺泡Ⅱ型细胞内细胞处于致伤性和致死性细胞改变的临界点，细胞出现致死性改变，磷脂合成、分泌停止，细胞出现死亡．结论：兔在双光气染毒12h内，肺泡表面活性物质磷脂的改变有差异，随细胞损伤程度发生改变，出现明显中毒分期：即致伤性改变期、致伤性代偿期、致伤性失代偿期、致死性改变期．     

内镜下鼻胆管引流治疗急性梗阻性化脓性胆管炎(附25例报告)

目的探讨急性梗阻性化脓性胆管炎伴多器官衰竭的治疗方法。方法对25例急性梗阻性化脓性胆管炎伴多器官衰竭的患者采取以内镜下鼻胆管引流术、经鼻胆管冲洗及灌注抗生素为主的非手术综合治疗,观察患者治疗前后的血清总胆红素水平、B超下胆总管内径变化,并对患者临床资料进行回顾性分析。结果本组25例患者除2例需转外科急诊手术治疗外,其余23例内镜下胰胆管造影、内镜下鼻胆管引流术成功,胆汁引流通畅,多器官衰竭得以纠正,急性梗阻性化脓性胆管炎伴多器官衰竭治愈率为92.0%。结论对急性梗阻性化脓性胆管炎伴多器官衰竭患者采取内镜下鼻胆管引流术、静脉应用和经鼻胆管冲洗及灌注抗生素为主的综合治疗是有效、安全的。     

PULMONARY BLOOD DISTRIBUTION AFTER TOTAL CAVOPULMONARY CONNECTION OF DIFFERENT TYPES

Objective. To assess the feature of pulmonary blood flow distribution after total cavopulmonary connection (TCPC) of different types, and to provide the selection of the best type .Methods. Thirty-two consecutive survival patients after TCPC underwent radionuclide lung perfusion imaging. According to the radionuclide counts in the left and right lungs, analyses of the distribution of blood flow from superior venous cava (SVC) and inferior venous cava (IVC) and the whole pulmonary blood flow in both lungs were made. All patients were divided into 4 groups by the the anastomosis between IVC and pulmonary artery.Results. Group Ⅰ: The flow ratio of the IVC to left lung was greater than that to the right lung , P≤0. 01; the flow ratio of the SVC to right lung was greater than that to the left lung, P≤0. 01; and the whole pulmonary blood flow went dominantly to the left lung, P≤0. 05, which is not in line with physiological distribution. Group Ⅱ: the flows from the SVC and IVC were mixed in the middle of     

正常者瞳孔间距与咬合垂直距离关系的研究

目的：研究正常[牙合]者瞳孔间距（Interpupillary Distance，IPD）与咬合垂直距离（Occlusal Vertical Dimension，OVD）的关系。方法：对116名福建籍青年正常[牙合]者测量其OVD与IPD，并进行两者相关回归分析。结果：总样本的OVD均值为65．35mm±4．70mm，IPD均值为63．98mm±3．26mm，男性正常[牙合]者OVD均值为68．16mm±4．23mm，IPD均值为65．46mm±2．96mm，女性正常[牙合]者的OVD均值为63．22mm±3．86mm，IPD均值为62．86mm±3．05mm;总样本的IPD与OVD的相关系数r=0．633，男性样本的IPD与0VD的相关系数r=0．563，女性样本的IPD与OVD的相关系数r=0．531。结论：IPD与OVD间存在显著相关性，IPD可以作为需咬合重建患者确定其OVD的参考指标。     

National Study of Emergency Department Visits for Acute Exacerbation of Chronic Obstructive Pulmonary Disease, 1993–2005

Objectives: Little is known about recent trends in U.S. emergency department (ED) visits for acute exacerbation of chronic obstructive pulmonary disease (AECOPD) or about ED management of AECOPD. This study aimed to describe the epidemiology of ED visits for AECOPD and to evaluate concordance with guideline‐recommended care. Methods: Data were obtained from National Hospital Ambulatory Medical Care Survey (NHAMCS). ED visits for AECOPD, during 1993 to 2005, were identified using the International Classification of Diseases, Ninth Revision, Clinical Modification (ICD‐9‐CM) codes. Concordance with guideline recommendations was evaluated using process measures. Results: Over the 13‐year study period, there was an average annual 0.6 million ED visits for AECOPD, and the visit rates for AECOPD were consistently high (3.2 per 1,000 U.S. population; P_trend = 0.13). The trends in the use of chest radiograph, pulse oximetry, or bronchodilator remained stable (all P_trend > 0.5). By contrast, the use of systemic corticosteroids increased from 29% in 1993–1994 to 60% in 2005, antibiotics increased from 14% to 42%, and methylxanthines decreased from 15% to <1% (all P_trend < 0.001). Multivariable analysis showed patients in the South (vs. the Northeast) were less likely to receive systemic corticosteroids (odds ratio [OR] = 0.6; 95% confidence interval [CI] = 0.4 to 0.9). Conclusions: The high burden of ED visits for AECOPD persisted. Overall concordance with guideline‐recommended care for AECOPD was moderate, and some emergency treatments had improved over time.     

2008年连云港市“手足口病”流行特征及病原学分型

目的分析连云港市2008年手足口病的流行特征及病原学分型情况。方法应用流行病学方法对2008年该市的手足口病流行资料进行分析。结果依据疫情报告,实验室诊断病例45例,其中CoxA1638例,EV71型7例,其他肠道病毒0例。2008年该市临床报告手足口病例1067例,报告发病率为23.19/10万,比2007年上升442.34%,男女发病比为3.1∶1。发病年龄最小的为0岁组,最大的为8岁;0～5岁组,共计发病976例,占总发数的91.47%。发病数的构成以散居儿童最多,占76.66%。地区分布:全市各个区县均有手足口病病例报告,但城区的总体发病率高于县。结论连云港市手足口病发病率有上升趋势;控制传染源是有效防止该病流行的关键。     

结节性甲状腺肿合并其他甲状腺疾病临床分析

目的探讨结节性甲状腺肿合并其他甲状腺疾病的临床特点。方法回顾性分析我院手术治疗的4622例结节性甲状腺肿中并存其他甲状腺疾病的临床资料。结果4622例结节性甲状腺肿中700例合并其他甲状腺疾病，1418例存在不同的诊断失误。结论在诊断结节性甲状腺肿的同时应注意其合并的其他甲状腺疾病。     

The use of the Impact on Sibling scale with families of children with chronic illness and developmental disability

Objective   This study evaluated the Impact on Sibling scale, a six-item measure of parents' perception of the effects of a child's illness on healthy siblings.
Methods   Participants were 122 parents of a child with chronic illness, developmental disability, or autism spectrum disorder, and a well sibling aged 4–13 years. Parents completed the Impact on Sibling scale and the Child Behavior Checklist about the sibling, and completed the revised Impact on Family scale and the Brief Symptom Inventory about themselves.
Results   The Impact on Sibling score was correlated with measures of sibling, parent and family functioning. The internal consistency of the Impact on Sibling scale was higher for families with children with chronic illness compared with the other two diagnostic groups.
Conclusion   The Impact on Sibling scale is a brief set of items that can help identify siblings who are negatively affected by a brother/sister's illness. Findings support further research on the Impact on Sibling scale, particularly with families of children with chronic illnesses.