LightCycler实时监测PCR定量分析血清HBV DNA

目的 检验LightCycler实时监测PCR（real-time detection PCR,RTD-PCR)对血清中HBV DNA定量检测的灵敏性和可重复性，探讨HBV血清标志物与HBV DNA定量的关系。方法 HBV定量按深圳匹基公司乙肝PCR荧光检测试剂盒使用说明，对乙肝标志物已明确的773例血清中HBV DNA定量结果进行统计分析。结果 实时监测PCR对血清中HBV DNA定量检测的灵敏性高，可检测低至1000拷贝／ml血清；可重复性好，批间误差＜20％；各种标志物类型的血清HBV DNA含量分布情况表明，HBV血清标志物中HBeAg与HBV DNA含量有明显的关系，一般HBeAg阳性血清HBV DNA含量较高，但也有相当一部分例外。结论 LightCycler实时监测PCR对血清中HBV DNA定量检测灵敏性高可重复性好；仅根据HBV血清标志物往往不能确定乙肝患者HBV DNA复制水平的高低，HBV DNA定量检测具有十分重要的临床意义。     

新时期戏剧艺术探索的成就与困顿

八十年代初中期 ,中国戏剧积极拓展我国传统戏剧的时空观、写意性特征 ,大胆借鉴西方现代戏剧的荒诞化、意象性技巧 ,出现了探索创新、多元发展的崭新局面。其中对“三一律、一堵墙”戏剧观的突破 ,运用意识形象外显人物的内心世界 ,嫁接多种艺术手段将现实时空转化为艺术时空 ,是新时期戏剧艺术探索最突出的三项成就。而过分强调形式技巧 ,脱离观众欣赏习惯 ,致使演出市场萎缩 ,观众锐减 ,无疑是新时期戏剧艺术探索中面临的最大困顿。     

Inter- and intra-individual variability of non-invasive tear break-up time in Hong Kong Chinese

Non-invasive tear break-up time (NITBUT) has been proposed as a measure of tear film integrity which is superior to the more commonly used tear break-up time (TBUT), since it does not alter the volume or the physicochemical properties of the tear layer by the addition of fluorescein. We measured NITBUT by measuring the time taken for distortions or discontinuities to appear in the reflected image of a grid pattern which covered about 80 per cent of the corneal surface. NITBUT measures were made 100 times on seven Hong Kong Chinese subjects with up to 20 consecutive measures being made on a single day. We also measured NITBUT on one occasion on an unselected population of 52 Hong Kong Chinese subjects. NITBUT shows a skewed distribution in all subjects, with many shorter values and some extremely long values. There are statistically significant variations in NITBUT from day to day, and from subject to subject. The group of 52 subjects also had a skewed NITBUT distribution with many short values and some very long values. The arithmetic mean does not adequately represent NITBUT data, either for individual subjects or for this group of subjects. As many as five to eight measures may be necessary to gain a stable estimate of the NITBUT and stability of the measure is improved if extreme values are omitted. We recommend the use of nonparametric statistics to compare NITBUT values from day to day in or between subjects.     

Effects of exposure to air pollution on blood coagulation

BACKGROUND: Consistent evidence has indicated that air pollution increases the risk of cardiovascular diseases. The underlying mechanisms linking air pollutants to increased cardiovascular risk are unclear. OBJECTIVES: We investigated the association between the pollution levels and changes in such global coagulation tests as the prothrombin time (PT) and the activated partial thromboplastin time (APTT) in 1218 normal subjects from the Lombardia Region, Italy. Plasma fibrinogen and naturally occurring anticoagulant proteins were also evaluated. METHODS: Hourly concentrations of particulate (PM10) and gaseous pollutants (CO, NO2, SO2, and O3) were obtained from 53 monitoring sites covering the study area. Generalized additive models were applied to compute standardized regression coefficients controlled for age, gender, body mass index, smoking, alcohol, hormone use, temperature, day of the year, and long-term trends. RESULTS: The PT became shorter with higher ambient air concentrations at the time of the study of PM10 (coefficient = -0.06; P < 0.05), CO (coefficient = -0.11; P < 0.001) and NO2 (coefficient =-0.06; P < 0.05). In the 30 days before blood sampling, the PT was also negatively associated with the average PM(10) (coefficient = -0.08; P < 0.05) and NO2 (coefficient = -0.08; P < 0.05). No association was found between the APTT and air pollutant levels. In addition, no consistent relations with air pollution were found for fibrinogen, antithrombin, protein C and protein S. CONCLUSIONS: This investigation shows that air pollution is associated with changes in the global coagulation function, suggesting a tendency towards hypercoagulability after short-term exposure to air pollution. Whether these changes contribute to trigger cardiovascular events remains to be established.     

分娩期子宫破裂64例分析

目的 分析分娩期子宫破裂的发病原因及预防措施。方法 回顾分析1985年8月至2001年12月，16a间64例分娩期子宫破裂的临床资料。结果 子宫收缩剂使用不当3l例，占48．4％；胎先露下降受阻13例，占20．3％；子宫疤痕16例，占25％；阴道助产4例，占6．3％。初产妇10例(10．9％)；经产妇54例(89．1％)。结论 降低分娩期子宫破裂发生率关键在于加强计划生育工作及围生期保健，严格掌握子宫收缩剂的适应证及剂量；严格首次剖宫产指征；严密观察产程，及时处理异常分娩。     

64例脾脏损伤手术的临床分析

目的探讨脾脏损伤有效的手术治疗方法。方法对手术治疗的64例脾脏损伤的病因、伤情分级、手术方法分析。结果64例脾脏中钝器伤45例,占70.31%,锐器伤19例,占29.69%。Ⅰ～Ⅱ级损伤26例占40.63%,Ⅲ～Ⅳ级损伤38例,占59.38%,64例患者死亡2例,均为Ⅳ级损伤,占3.13%。结论正确的手术方法,积极稳妥地处理合并伤是降低病死率的关键。     

外伤性肝破裂的救治

目的 分析创伤性肝破裂外科多种干预治疗的效果。方法 总结分析1982-2002年我院收治创伤性肝破裂76例的救治方法和病死率。其中Ⅲ级以上的严重肝破裂46例(60．53％)。手术治疗56例，手术方式包括单纯修补、清创性肝切除、规则性肝切除、肝周填塞止血；非手术治疗20例。结果 手术组：治愈44例，术后并发症17例均经保守治疗治愈，死亡12例，其中术中死亡2例；非手术组：治愈12例，好转6例，2例失访。全组治愈64例，死亡12例，病死率15．8％。结论 Ⅰ-Ⅱ级单纯性外伤性肝破裂可保守治疗；手术是治疗创伤性肝破裂的主要措施，正确的手术方式，积极处理合并伤，重视综合治疗可提高救治成功率。     

非霍奇金淋巴瘤85例临床及预后分析

目的：分析多种因素对非霍奇金淋巴瘤(NHL)预后的影响。方法：通过SABC法进行免疫分型，采用Kaplan—Meier法分析患者治疗后的生存期，采用Cox比例风险模型分析影响预后的因素。结果：B细胞来源-NHL(B-NHL)发病率为63．3％。T细胞来源-NHL(T—NHL)为36．7％；低度恶性占17．6％，中、高度恶性占74．1％。1、2、3、5年生存率：低度恶性患者为92．1％、84．5％、65．1％、45．1％；中、高度恶性患者为84．9％、67．5％、47．6％、28．4％。I、Ⅱ期患者为98．8％、91.5％、87．5％、70．3％；Ⅲ期、Ⅳ期患者为62．1％、55．5％、40．1％、23．8％。T—NHL为70．8％、53．5％、47．7％、30．2％；B-NHL为82．1％、70．5％、61．1％、50．1％。结论：年龄、乳酸脱氢酶水平、恶性程度、临床分期、免疫分型、身体状况评分(PS)是影响NHL预后的重要因素。