细小病毒性关节炎四例临床分析并文献复习

目的 通过对我科确诊的4例细小病毒B19（parvovimsB19）关节炎的临床特点的总结．提高对该病的认识。方法 报道4例确诊为细小病毒B19关节炎的临床及实验室检查特点．并进行文献复习。结果 4例患者（男性2例，女性2例），年龄15～55岁，发病年龄中位数为34岁。关节炎同时出现流感样症状、皮疹等表现，外周血细小病毒B19 IgM均阳性，3例患者外周血细小病毒B19DNA检测阳性，除外其他原因所致关节炎，治疗效果肯定，随访1～3年无一例复发。结论 对于某些症状不典型的关节炎，应警惕细小病毒B19关节炎的可能，及时行细小病毒B19抗体及DNA检测，以助诊断。     

妊娠期妇女外阴阴道念珠菌病的病原学和治疗研究

目的 调查孕妇外阴阴道念珠菌病(vulvovaginal candidiasis，VVC)的发病率，对检出的VVC进行病原学和治疗研究。方法 连续对产科门诊1000例孕妇进行VVC发病情况调查。对分离的念珠菌进行体外抗真菌药物敏感试验。对66例VVC患者应用咪康唑栓治疗，400mg／d，6d为一疗程。结果 孕妇VVC的发病率为12．7％(127／1000)。37．4％(374／1000)的孕妇以往有VVC病史，0．6％的孕妇为复发性VVc。127例VVC中，白念珠菌、光滑念珠菌、热带念珠菌和克柔念珠菌分别占87．1％、9．9％、1．5％和1．5％。有4例患者同时感染2种念珠菌。114株白念珠菌对咪康唑、克霉唑、氟康唑、伊曲康唑、制霉菌素耐药率依次为10．5％、2．6％、6．1％、7．9％和0。13株光滑念珠菌对咪康唑和制霉菌素均敏感，对克霉唑、伊曲康唑和氟康唑均敏感或剂量依赖敏感。应用咪康唑栓治疗的患者在治疗完成后1～2周及4～6周的病原学治愈率分别为84．8％和80．3％。结论 VVC是孕妇的常见病，白念珠菌仍然是主要致病菌，其次为光滑念珠菌。常用抗真菌药物对引起VVC的念珠菌存在不同程度的耐药率，应用咪康唑栓治疗孕妇VVC效果满意。     

Leukemia,lymphoma, and multiple myeloma following selected medical conditions

The role of selected prior medical conditions in the etiology of hematopoietic malignancies was examined in a case-control study of members of two regional branches of the Kaiser Permanente Medical Care Program (USA). Past history of chronic infectious, autoimmune, allergic, and musculoskeletal disorders was abstracted from medical records for leukemia (n = 299), non-Hodgkin's lymphoma (NHL, n = 100), and multiple myeloma (n = 175) cases and matched controls (n = 787). Little difference was found between cases and controls for most of the chronic conditions evaluated, including sinusitis, carbuncles, urinary tract infections, pelvic infections, herpes zoster, asthma, rheumatoid arthritis, psoriasis, bursitis, and gout. Only three statistically significant elevated risks were found, i.e., with combined disc disease myeloma among patients with prior eczema and disk and other musculoskeletal conditions, and NHL following tuberculosis. Only two of these associations showed consistent patterns by sex and geographic region (myeloma with eczema and with musculoskeletal conditions). While prior history of eczema and musculoskeletal conditions may slightly increase risk of myeloma, this study provided little if any support for an association of chronic infectious, autoimmune, allergic, and musculoskeletal conditions with subsequent occurrence of the leukemias or NHL. Additionally, these data did not support a role for chronic antigenic stimulation, as defined in previous epidemiologic studies, in the etiology of hematopoietic malignancies.Ms Doody and Drs Linet, Pottern, Boice, and Fraumeni are with the Epidemiology and Biostatistics Program, National Cancer Institute. Dr Glass is with the Kaiser Permanente Medical Care Program, Northwest Region, Portland, Oregon, USA. Dr Friedman is with the Kaiser Permanente Medical Care Program, Northern California Region, Oakland, California, USA. Address correspondence to Ms Doody, Radiation Epidemiology Branch, National Cancer Institute, Executive Plaza North, Room 408, Bethesda, MD 20892, USA. This research was supported in part by National Cancer Institute contracts NO1-CP-01047, NO1-CP-01054, NO1-CP-11009, NO1-CP-11037, NO1-CP-31035, and NO1-CP-61006.     

Establishment and characterization of a chronic infectious mononucleosislike syndrome in common marmosets

Epstein-Barr virus (EBV) was inoculated into two species of marmosets. Successful infection was established in the majority of the animals of one species, Callithrix jacchus, as evidenced by the development of high, persistent levels of antibody against virus-specific capsid and early nonstructural proteins. Antibodies also were produced against the major membrane antigen and, in some animals, against EBV nuclear antigen (EBNA) 2 but not against EBNA 1. This is the antibody profile normally noted in individuals with chronic infectious mononucleosis (IM). EBV-induced lymphoproliferation was not seen, and EBV-specific proteins were not detected in the peripheral blood lymphocytes of infected animals. Hence, EBV infection in C. jacchus apparently does not generally include extensive B-cell involvement. However, the marmosets clearly are useful as a model for EBV primary infection and also possibly for chronic IM.     

嘉兴外来人员生活环境与肠道传染病相关知信行现况调查分析

目的了解城郊结合部外来人员聚集地生活环境现况和霍乱等肠道传染病健康知信行情况,进一步明确肠道传染病防治健康教育与健康促进工作的重点开展方向。方法采用随机抽样的方法,运用统一设计的调查问卷对嘉兴市5县2区城郊结合部等外来人员聚集地进行流行病学调查。结果93.06%的调查对象以租房为主,90.61%的生活用水来源于自来水,9.25%用井水;78.61%的人知道霍乱传播途径,21.53%的人知道霍乱主要临床症状,28.03%的人知道肠道传染病全部预防措施;77.31%的知识来源于电视,其他顺位依次为书刊、广播、家人或朋友处;希望获得宣传资料形式:传单占46.68%,墙报占31.21%。结论外来人员租房人数居多,有部分人使用井水;肠道传染病相关知识了解的较少。应采取多部门齐抓共管来改善外来人员聚集地的生活环境,因地制宜地对外来人员开展有针对性的预防肠道传染病健康教育。     

Results of surgical treatment in patients with arachnoid cysts

Summary A retrospective study of 35 patients operated upon for arachnoid cysts during the last 10 years was carried out. In 19 patients treated by craniotomy, membrane resection and drainage into the basal cisterns, clinical improvement could be noted in 13 cases. Correspondingly on the CT-controls the cysts were found to have disappeared in two cases and were reduced in size in seven patients.In 11 patients, however, who were initially treated by a shunting procedure, seven patients became free of symptoms. Postoperative CT-controls showed in three cases a significant reduction of the size of the cyst, which remained unchanged in two other cases.In five patients with the combination of a nonspace-occupying arachnoid cyst and subdural effusions, drainage of the latter only was sufficient to relieve the clinical symptoms.The prominent Endings were the high complication rate of the primary or secondary shunting procedures (48%), as well as the close correlation between the clinical outcome and the postoperative CT-controls.     

传染病研究40年（1955～1995年）

本文综述本校传染病学教研室１９５５～１９９５年间所取得的科研成果。内容包括１０余种传染病与寄生虫病的临床和基础研究，其中以华支睾吸虫病、恙虫病等有广东特色的传染病以及伤寒、痢疾、病毒性肝炎等影响人民健康最普遍的传染病为重点。反映了建国以来各个时期本教研室对防治这些传染病所作的贡献。所取得的成果，相当一部分通过多年来的验证，已获得广大传染病工作者所认同或列为常规，部分已获得部委级奖励。现在重温这些成果，可能起承前启后的意义。     

传染性非典型肺炎的影像学表现

目的　研究传染性非典型肺炎的影像学表现和特征。方法　收集 80例经临床证实的传染性非典型肺炎患者的影像学资料 ,分析其特征。结果　肺部异常表现平均出现在发热后 2 .3d ,多为片状密度增高影 ,可出现在肺内任何部位 ,多发病变占一定比例 (4 3 .8% ) ,病变变化快。CT在早期诊断和预后观察中有一定意义。结论　影像学在传染性非典型肺炎的诊断和治疗效果判定中有重要作用。     

梅罗综合征和螺旋体感染的关系

用Ｗａｒｔｈｉｎ－Ｓｔａｒｒｙ螺旋体特殊染色法及透射电镜观察，分别在１９例肉芽肿性唇炎和５例梅罗综合征（ＭＲＳ）病人的病变组织内发现有螺旋体存在，并对其在光，电镜下的形态和在病变组织内的分布部位进行了描述。经用大刘量青霉素治疗１１例病人，１０例有效。本结果为ＭＲＳ的发可能和螺旋体感染有关的推测提供了依据。