以腋下淋巴结肿大为首发表现的系统性红斑狼疮1例分析

系统性红斑狼疮（SLE）是以多系统损害为特点的自身免疫性疾病。其临床表现多样化而缺乏特异性，但以腋下淋巴结肿大为首发表现者临床较为少见，现对所遇1例分析如下。[第一段]     

燃煤砷暴露对人体红细胞免疫黏附功能受损机制的探讨

目的:通过对燃煤型砷中毒患者红细胞免疫黏附功能相关指标的检测,探讨其红细胞免疫黏附功能损伤的可能机制。方法:采用ELISA法测定红细胞CR1(RBC-CR1)分子数量及PCR-RFLP法测定CR1密度基因多态性。结果:砷中毒组RBC-CR1密度基因多态性分布情况:HH型72例(70%)、HL型27例(26.2%)、LL型4例(3.8%)。砷中毒患者RBC-CR1分子数量及各基因型CR1分子数量均明显低于健康对照组,差异均有统计学意义(P<0.01)。结论:RBC-CR1数量减少可能是砷中毒引起红细胞免疫黏附功能受损的重要机制。     

髓过氧化物酶和过氧化氢酶基因多态性及其酶活力与燃煤污染型地方性砷中毒关系的探讨

Objective To detect genetic polymorphism of myeloperoxidase (MPO) gene and catalase (CAT) gene and their activities, and to analyze their relationship with arsenic poisoning caused by coal-burning. Methods One hundred and thirty arsenic poisoning patients were chosen as case group in Jiaole Village, Xingren County, Guizhou Province(an endemic area). One hundred and forty healthy residents living in 13 km away were chosen as control group. Their blood was collected. Polymerase chain reaction-restriction fragment length polymorphism technique(PCR-RFLP) was used to detect polymorphism of MPO-463G/A and CAT-262C/T. Ultraviolet spectmphotometer method was used to detect myeloperoxidase activity. Chromatometry method was used to detect catalase activity. Results The genotype frequency of MPO-463G/A at GG, GA, AA site was 47.24%(60/127), 44.09%(56/127),8.67% (11/127) in case group and 42.34% (58/137),48.17% (66/137)1,9.49% (13/137) in control group, respectively. The difference between the two groups was not significant(χ2 = 0.642, P > 0.05). The genotype frequency of CAT-262C/T, at CC, CT, TT site was 65.60%(82/125),28.80%(36/125),5.60%(7/125) in case group and 76.51%(101/132), 18.94% (25/132) ,4.55% (6/132) in control group, respectively, without significant difference (χ2 =3.845, P>0.05). The relationship between polymorphism of MPO-463G/A and CAT-262C/T and the risk of arsenic poisoning was not found in this study(ORadj= 1.36, 95%CI: 0.74-2.50 for MPO; ORadj=1.35, 95%CI: 0.69-2.63 for CAT). The activities of MPO and CAT were (25.30±8.70)U/L and (2.80± 1.09)×103 U/L in case group, while (22.76±7.59)U/L and (3.90±1.01)×103U/L in control group with a significant difference(F=0.760 for MPO, F=0.855 for CAT, all P < 0.05). The genotype of MPO-463G/A and CAT-262C/T was not found to have relationship with the activities of MPO, CAT(F=1.312,2.822 for MPO; F= 0.151,0.036 for CAT, P>0.05). Conclusions Genetic polymorphism of MPO-463G/A and CAT-262C/T is not found to have relationship with arsenic poisoning. Arsenic can lead to the change of MPO and CAT activity, which, however, may not be affected by MPO-463G/A and CAT-262C/T polymorphism.     

燃煤型砷中毒患者临床特征、多系统损害及其意义

目的 探讨燃煤型砷中毒的临床特征、多系统损害及其意义。方法 采用整群抽样与典型调查结合的方法进行现场调查，结合临床检查、生化分析和毒理学方法进行实验室检测。结果 砷进入人体的途径包括摄人富含砷食物和蔬菜以及吸入砷污染的空气；患者砷负荷、氧化损伤指标与正常人群比较差异均有统计学意义；砷中毒患者除慢性砷中毒的典型特征(皮肤角化过度、色素异常)外，肝脏、肾脏、神经系统、肺脏、心脏和球结膜微循环等损害亦很明显；多项特殊检查显示了砷的非临床早期损害。结论生活区煤砷含量高及敞灶燃煤致食物和空气砷污染是贵州省地砷病发生的主要原因；临床上以多系统损害为特点，肝硬化和皮肤癌是其主要死因；实验室特殊检查明确显示了病区非患者及中毒患者的临床前期损害，如肝、肾功能损害、氨基酸代谢异常、氧化损伤等；多指标、多检测方法的联合应用对于砷中毒的监测、诊断和防治具有重要实际意义。     

燃煤砷暴露对人体红细胞免疫黏附功能影响

地方性砷中毒包括饮水型和燃煤污染型地方性砷中毒(以下简称燃煤型砷中毒),贵州和陕西省为特有的燃煤污染型砷中毒病区[1].贵州省燃煤型砷中毒自1976年被确定以来,主要在6县(市)62个村存在不同程度的影响,其中以黔西南州兴仁县交乐村病例最为集中、病情最为严重,现有砷中毒患者约3 000例[2-3].既往研究表明,燃煤污染型砷中毒患者主要表现为以皮肤、肝脏损害为主的多系统多脏器损害[4],同时存在免疫功能的受损,体现在燃煤型砷中毒患者T淋巴细胞亚群CD3+、CD4+细胞和CD4 +/CD8+比值均明显降低[5].     

冠心病患者C反应蛋白及血尿酸检测的意义

目的：探讨C反应蛋白（CRP）和血尿酸（UA）与冠心病的相关性。方法：对123例冠心病患者和87例健康者进行血清CRP和UA检测并统计分析。结果：冠心病患者血清CRP和UA水平显著高于健康对照组（P〈0.01）。结论：CRP和UA的增高与冠心病的发展存在一定关系,可作为冠心病诊断的辅助指标之一,在疾病诊治过程中检测CRP和UA可有效的反映冠心病的发展进程及预后。     

科玛嘉念珠菌显色培养基的临床应用评价

目的评价科玛嘉(CHROMagar)念珠菌显色培养基在临床念珠菌鉴定中的应用价值。方法将标本同时接种沙氏基和CHROMagar念珠菌显色培养基,沙氏基上生长的酵母菌经ATB鉴定,CHROMagar念珠菌显色培养基根据菌落颜色直接判读。结果94份标本中CHROMagar念珠菌显色培养基鉴定出白色念珠菌35株,热带念珠菌8株,光滑念珠菌6株,克柔念珠菌2株,其他念珠菌6株,与ATB鉴定结果对比,白色念珠菌符合率为100%,热带念珠菌为100%,光滑念珠菌为85.7%,克柔念珠菌为100%。结论CHROMagar念珠菌显色培养基能快速、简便、准确鉴定临床常见念珠菌,明显提高对混合感染的识别。     

血和尿中同时检出多重耐药阴沟肠杆菌1例

阴沟肠杆菌属于人体正常菌群，当机体的免疫力低下时，可引起呼吸道感染、胆道感染、尿路感染及伤口感染等。2006年7月，我们从一位患者血液和尿液中同时分离出多重耐药阴沟肠杆菌1例，现报道如下。     

特殊表现的急性脂膜炎二例

特殊表现的急性脂膜炎二例杨健平，易宏宇，张碧霞例１女，４２岁。因上腹部疼痛伴呕吐３天入院。血／尿淀粉酶为６６／１２８温氏单位。次　日剖腹探查，见胰腺肿大，质硬，作胰包膜切开引流术。多次测腹腔引流液淀粉酶，均为１０２４Ｕ。　热退腹痛中止。１个月以后，左...