平菇栽培职业危害预防措施的研究

本文对平菇栽培过程职业危害的预防措施进行了评价。在自然通风、机械通风、喷水和采取综合措施后测定担孢子浓度,担孢子清除率分别为19.7～34.5%、55.3～76.9%、58.6～72.9%和86.8～97.4%。4层、8层纱布口罩及滤膜对担孢子的阻留率分别为59.6～73.8%、91.4%和87.6%。结果表明,采用综合防护措施并戴口罩后,平菇栽培工的呼吸道症状发生率显著降低。     

颞骨肿块的HRCT诊断与鉴别诊断

目的研究颞骨肿块的HRCT表现和临床意义。方法回顾性分析16例经手术病理或临床证实的颞骨肿块的HRCT表现。结果骨纤维异常增殖症4例,颈静脉球瘤3例,骨软骨瘤、嗜酸性肉芽肿、外耳道癌和骨瘤各2例,粘液瘤1例,HRCT表现各具特征。结论HRCT扫描能清晰显示颞骨肿块的形态、密度和范围,结合临床和其他检查有助于定性诊断,为临床治疗提供依据。     

Repair of sheep metatarsus defects by using tissue-engineering technique

Tissue-engineering bone with porous β-tricalcium phosphate (β-TCP) ceramic and autologous bone marrow mesenchymal stem cells (MSC) was constructed and the effect of this composite on healing of segmental bone defects was investigated. 10-15 ml bone marrow aspirates were harvested from the iliac crest of sheep, and enriched for MSC by density gradient centrifugation over a Percoll cushion (1.073g/ml). After cultured and proliferated, tissue-engineering bones were constructed with these cells seeded onto porous β-TCP, and then the constructs were implanted in 8 sheep left metatarsus defect (25 mm in length) as experimental group. Porous β-TCP only were implanted to bridge same size and position defects in 8 sheep as control group, and 25 mm segmental bone defects of left metatarsus were left empty in 4 sheep as blank group. Sheep were sacrificed on the 6th, 12th, and 24th week postoperatively and the implants samples were examined by radiograph, histology, and biomechanical test. The 4 sheep in blank group were sacrificed on the 24th week postoperatively. The results showed that new bone tissues were observed either radiographic or histologically at the defects of experimental group as early as 6th week postoperatively, but not in control group, and osteoid tissue, woven bone and lamellar bone occurred earlier than in control group in which the bone defects were repaired in “creep substitution” way, because of the new bone formed in direct manner without progression through a cartilaginous intermediate. At the 24th week, radiographs and biomechanical test revealed an almost complete repair of the defect of experimental group, only partly in control group. The bone defects in blank group were non-healing at the 24th week. It was concluded that engineering bones constructed with porous β-TCP and autologous MSC were capable of repairing segmental bone defects in sheep metatarsus beyond “creep substitution” way and making it healed earlier. Porous β-TCP being constituted with autologous MSC may be a good option in healing critical segmental bone defects in clinical practice and provide insight for future clinical repair of segmental defect.     

尿微量白蛋白免疫球蛋白G和α1微球蛋白在儿童过敏性紫癜早期肾损伤中的诊断价值

目的探讨尿微量白蛋白（MA）、免疫球蛋白G（IgG）和α1微球蛋白（α1-MG）检测在儿童过敏性紫癜（HSP）早期肾损伤中的诊断价值。方法采用散色比浊法检测45例HSP和49例过敏性紫癜性肾炎（HSPN）儿童尿MAI、gG和α1-MG的水平,通过与50例正常对照组儿童比较,评价其在HSP早期肾损伤中的诊断价值。结果 HSP和HSPN儿童中尿MAI、gG和α1-MG水平均显著高于正常对照组（P〈0.05）,尿MA在HSPN组中的水平显著高于HSP组（P〈0.05）,而尿IgG和α1-MG水平在HSP和HSPN组中并无显著差异（P〉0.05）。结论尿MAI、gG和α1-MG均可诊断儿童HSP早期肾损伤情况,且指标尿MA还可反映HSP肾损伤严重程度,对临床早期治疗有一定价值。     

儿童轻中度圆锥角膜患者长期配戴RGPCL效果及安全性

目的 评价低龄儿童轻中度圆锥角膜患者长期配戴硬性透气性接触镜（RGPCL）的效果及安全性。设计 回顾性病例系列。研究对象 40例儿童圆锥角膜患者。方法 对2001－2011年在北京北医眼视光学研究中心配戴RGPCL连续3年的40例年龄在3～16岁,平均（12.80±3.09）岁的儿童圆锥角膜患者,进行电脑验光及眼部相关检查,分别观察配戴RGPCL 3年间的角膜顶点厚度、角膜内皮细胞,并观察角膜地形图角膜K值、SRI、角膜散光的变化,以及角结膜有无异常反应,综合分析RGPCL对于儿童圆锥角膜控制的效果。主要指标 矫正视力、角膜K值、SRI、角膜散光、角膜厚度、角膜内皮细胞密度。结果 配戴RGPCL 3年间,矫正视力提高0.19±0.03。戴镜前与戴镜3年时比较角膜厚度变化（13.81±7.98）μm,3年间配戴镜前后比较,差异无统计学意义（P＝0.274）。角膜平坦K值、陡峭K值在戴镜前和戴镜3年时变化分别为（0.26±0.59）D,（0.97±0.75）D,角膜散光降低（0.88±0.40）D,SRI在3年间降低0.09±0.10,在配戴镜前后3年以上各数据变化均无统计学意义（P均>0.05）。并且角结膜未发现明显损伤及炎症病例。结论 低龄儿童圆锥角膜患者长期配戴RGPCL对于圆锥角膜发展有一定控制作用,眼表未见明显损害,安全有效。（眼科,2016, 25： 317－320）     

63株嗜麦芽寡养单胞菌的临床分布与耐药性分析

目的了解嗜麦芽寡养单胞菌的临床分布及对抗菌药物的耐药性。方法采用VITEK-2 COMPACT全自动微生物鉴定仪及纸片扩散(K-B)法对分离的63株嗜麦芽寡养单胞菌的来源分布、药物敏感性结果进行统计分析。结果 63株嗜麦芽寡养单胞菌在临床标本中分布以痰液为主,占87.3%;感染主要发生在新生儿科为17.4%和胸外科17.4%;其次为呼吸科14.3%和重症监护病房(ICU)14.3%;嗜麦芽寡养单胞菌对亚胺培南耐药率为100.0%;而对左氧氟沙星、米诺环素、磺胺甲口恶唑-甲氧苄啶耐药率较低分别为1.6%、3.2%、3.2%。结论应加强对嗜麦芽寡养单胞菌耐药性监测,以指导临床根据药物敏感性试验结果合理选择抗菌药物。     

白细胞介素17在儿童紫癜性肾炎发病中的作用

目的探讨紫癜性肾炎(HSPN)患儿血清白细胞介素(IL)17水平及其临床意义。方法选择2008年6月至2010年6月在南京市儿童医院门诊或住院治疗的HSPN患儿40例,同时检测同年龄段正常体检健康儿童30例作为对照。采用双抗体夹心酶联吸附法检测HSPN患儿外周血血清IL-17水平。结果过敏性紫癜肾炎患儿血清IL-17水平高于对照组,且与肾脏早期损伤相关。结论 IL-17参与了儿童HSPN的发病过程。     

多层螺旋CT在结肠癌分期中的诊断价值

目的评估多层螺旋CT对结肠癌分期的诊断价值。方法经病理证实的30例结肠癌患者行全腹部CT检查,研究其CT表现,并和病理作对照分析。结果CT显示早期结肠癌4例,中晚期结肠癌26例。CT肿瘤分期正确23例,占76.7%;估高3例,占10%;估低4例,占13.3%。结论多层螺旋CT对诊断早期结肠癌有一定价值,对中晚期癌肿价值较大,可指导临床手术及治疗方案的制定。     

平菇栽培作业职业危害的研究

通过对36处平菇生产现场、377名栽培人员的劳动卫生学调查、临床检查、免疫学研究、霉菌培养和动物实验证实,以棉籽皮为培养基栽培平菇,其职业性呼吸道疾病的病原是平菇本身释放的担孢子,而与普通高温放线菌、小多芽胞霉菌等嗜热性放线菌的孢子无关。本文并探讨了平菇栽培人员呼吸道疾病的发病规律、临床特征,建议将临床诊断分为蘑菇孢子过敏性支气管炎和肺泡炎(蘑菇工肺)。     

嗅神经母细胞瘤的CT诊断

目的 探讨CT在嗅神经母细胞瘤诊断和分期中的价值.方法 回顾性分析7例经病理证实的嗅神经母细胞瘤的CT表现和临床资料.结果 按Kadish分期标准,本组7例中2例为B期,5例为C期.病灶侵及鼻腔7例,同侧筛窦6例,对侧筛窦5例,上颌窦4例,眼眶3例,前颅窝2例.CT增强扫描5例,4例为中度均匀强化,1例轻度均匀强化,2例颅内病变不均匀强化.结论 横断面及冠状面CT扫描可清晰地显示嗅神经母细胞瘤部位及向周围侵犯的范围,能对肿瘤进行正确的分期,以便于临床制定合理的治疗方案.