366例泌尿生殖道感染者支原体培养及药敏分析

非淋菌性尿道炎(NGU)是一组发病率较高的性传播性疾病.支原体是引起NGU的病原体之一.目前临床上难治性NGU越来越多,为了探讨其原因,更清楚地了解支原体感染及其对常用抗生素的药物敏感性,我们对的366例泌尿生殖道标本进行了支原体检测,现将结果报告如下.     

参芪冠心片治疗胸痹100例

１００例气虚血瘀型冠心病患者服用参芪冠心片后胸闷、胸痛、心悸、气短、乏力等症状大多得到改善或消失,该药并有降血压,降血脂的作用。疗效明显优于复方丹参片。     

血浆置换在ABO血型不相容的亲属活体肾移植中应用效果评价

目的观察血浆置换在ABO血型不相容亲属活体肾移植中清除血型抗体的临床应用效果。方法回顾分析2017年7月~2019年1月本院54例行ABO血型不相容肾移植患者的临床特征及行血浆置换治疗后血型抗体效价变化情况,分析血浆置换治疗过程中不良反应发生情况。结果52/54例患者血型抗体(包括IgG和IgM)效价成功降至术前目标滴度,顺利进行肾移植手术;1例患者术后出现血型抗体反弹,移植肾失功;2例患者血型抗体效价未能降至目标水平,放弃肾移植手术,继续行肾脏替代治疗。血浆置换降低ABO血型不相容肾移植受者血型抗体的总有效率为94%。128次血浆置换过程中共发生了49次轻度不良反应。结论血浆置换是降低ABO非同型肾移植受者血型抗体(包括IgG和IgM)的有效方法,可与其他免疫抑制剂联合使用,缩短移植前血型抗体高滴度受者术前预处理时间。     

狼疮肾炎患者血清晚期蛋白氧化产物水平与疾病活动的相关性

目的：探讨氧化应激标志物晚期蛋白氧化产物（ AOPP）在狼疮肾炎（ LN）患者血清水平变化及其与LN疾病活动的相关性。方法 LN患者29例,根据肾小球滤过率（eGFR）水平分为eGFR≥60 mL／（min·1.73 m2）组16例、eGFR＜60 mL／（ min·1.73 m2）组13例。同期选择性别、年龄、体重匹配的健康对照者21例（对照组）,测定各组血肌酐（Scr）、尿素氮（BUN）、血白蛋白（ALB）、血沉（ESR）、C反应蛋白（CRP）、补体C3、C4以及24 h尿蛋白定量（24hUPQ）、eGFR;ELISA法测定各组患者的AOPP、丙二醛（ MDA）、抗dsDNA抗体;运用系统性红斑狼疮（SLE）疾病活动指数（SLEDAI）积分表对LN患者的疾病活动性进行评分。结果 LN组患者CRP、ESR、24hUPQ、抗dsDNA抗体、AOPP、MDA均较对照组明显升高,差异有统计学意义（P＜0.05）,C3、C4、eGFR较对照组降低,差异有统计学意义（P＜0.05）;LN患者eGFR＜60组ESR、MDA较eGFR≥60组明显升高,差异有统计学意义（P＜0.05）;而CRP、AOPP、抗dsDNA抗体、SLEDAI积分、24hUPQ均较eGFR≥60组升高,但差异无统计学意义（P＞0.05）;血清AOPP与MDA呈显著正相关（r＝0.942,P＜0.05）,与抗dsDNA抗体呈显著正相关（r＝0.982,P＜0.05）,与SLEDAI积分呈正相关（r＝0.653,P＜0.05）,与eGFR呈负相关（r＝－0.298,P＜0.05）。结论 LN患者血清AOPP水平明显升高,且随着肾功能损害而进一步升高,可作为一种评估LN氧化应激状态的指标。 AOPP与LN疾病活动性密切相关。     

重力肌群锻炼联合运动康复干预对青年轻度脊柱弯曲伴腰背痛患者腰椎功能、疼痛及生活质量的影响

目的分析重力肌群锻炼联合运动康复干预对青年轻度脊柱弯曲伴腰背痛患者腰椎功能、疼痛及生活质量的影响。方法 75例青年轻度脊柱弯曲伴腰腿痛患者根据临床干预方法不同分为实验组(35例)和对照组(30例)。对照组给予运动康复干预,实验组在对照组基础上进行重力肌群锻炼。评估两组干预前后脊椎功能、腰背疼痛及生活质量。结果两组干预前、后躯干旋转角、椎体旋转角、最大Cobb角对比差异均无统计学意义(P0.05);干预12周,实验组最大Cobb角较对照组显著缩小(P0.05)。两组干预前视觉模拟疼痛评分(VAS)、现时疼痛强度分级(PPI)对比差异无统计学意义(P0.05);干预6周、12周VAS评分、PPI分级均较干预前显著改善(P0.05),实验组干预12周VAS评分、PPI分级均较对照组显著低(P0.05)。两组干预前生活质量各维度评分比较差异无统计学意义(P0.05),干预12周,两组各维度评分均上升(P0.05),实验组各维度评分升高幅度显著高于对照组(P0.05)。结论在青年轻度脊柱弯曲伴腰背痛患者的临床干预中应用重力肌群锻炼联合运动康复干预,可有效改善患者脊柱功能,减轻患者腰背疼痛症状并提升患者生活质量。     

microRNA-10a对胃癌细胞系BGC823迁移和侵袭能力的影响

目的：研究人微小RNA-10a（microRNA-10a,miR-10a）对胃癌细胞系BGC823迁移和侵袭能力的影响。方法：利用Transwell小室对胃癌细胞系BGC823进行侵袭筛选,获得高侵袭能力的BGC823-P3亚系;通过miRNA芯片差异分析发现miR-10a在高侵袭能力BGC823-P3细胞的表达显著高于BGC823细胞。通过化学方法合成成熟型的人miR-10a,以脂质体包裹合成的miR-10a（25、50、100、150nmol/L）转染BGC823细胞,并设空白转染、无关序列转染对照组;Real-timePCR分别检测以上各组细胞miR-10a的表达。采用细胞计数试剂盒-8（Cell Counting Kit-8,CCK-8）检测miR-10a对细胞增殖的影响,流式分析检测miR-10a对细胞凋亡的影响,Transwell小室检测miR-10a对细胞的迁移和侵袭能力的影响。结果：化学合成的成熟型miR-10a转染后,BGC823细胞miR-10a表达的提高以100nmol/LmiR-10a转染组最佳,较无关序列转染组提高了2.06倍。miR-10a（100nmol/L）的转染对胃癌细胞系BGC823的增殖和凋亡无明显影响,但对BGC823的迁移和侵袭能力有明显的促进作用,促进率分别为（88.34±0.61）%和（56.02±3.13）%。结论：转染成熟型人miR-10a能使胃癌细胞系BGC823中miR-10a的表达提高,并能显著促进胃癌细胞系BGC823的迁移和侵袭。     

化学性眼烧伤的护理体会

化学性眼烧伤是由于化学物质进入眼部所造成的疾病，现将本病的治疗和护理体会总结如下。     

白色丘疹样营养不良型大疱性表皮松解症1例

白色丘疹样营养不良型大疱性表皮松解症是营养不良型大疱性表皮松解症（epidemlolysis bullosa dystrophica，DEB）的一种类型，可为常染色体显性遗传和隐性遗传，少见散发病例。最近我科诊治1例，现报告如下。     

85例铜绿假单胞菌耐药性分析

铜绿假单胞菌是人体正常菌群之一。当人体抵抗力下降时可致各种感染，尤其是院内感染的重要致病菌。由于铜绿假单胞菌具有天然的和后天获得的耐药性给临床治疗带来很大困难，为此对本院１９９８年４月—１９９９年１月临床标本中分离到的铜绿假单胞菌的耐药性进行分析。１...     

尿流式有形成分及干化学分析在尿路感染诊断中的应用评价

Objective To evaluate the clinical application of automated urine formed elements analyzer and/or urine dipstick analyzer for examination of urinary formed elements in screening urinary tract infection (UTI). Methods 148 fresh midstream clear-catch urine samples from the UTI patients and 284 fresh midstream clear-catch urine samples from non-UTI subjects were selected. Bacteria culture was performed for bacterial colony counting and identification. Bacteria counts ( BACT), yeast-like fungus and WBC were performed by UF-looOi automated urine formed elements analyzer. Leukocyte esterase test (LEU) and nitrite test (NIT) were performed by URISYS 2400 urine dipstick analyzer. We evaluated data obtained from urine dipstick analyzer, UF-1000i and combination of UF-1000i with urine dipstick analyzer and the results was compared with those obtained from quantitative bacterial culture. Then we evaluated the sensibility, specificity, positive predictive value (PPV), negative predictive value (NPV) and accuracy. Results Among the 148 patients with UTI, the positive rate of the quantitative bacterial culture was 73.6% (109/148), the positive rate of LEU and NIT detected by dipstick test 26. 4% (39/148).There was significantly statistical difference between bacterial culture and strip test(χ2 = 55.68 ,P < 0. 05 ). The positive rate of urine flow cytometry by UF-1000i with either positive of BACT and WBC was 91.2%(135/148), which was higher than the positive rate of the quantitative bacterial culture. There was significant difference between two methods (χ2 = 14. 70, P < 0. 05 ). The positive rate of anyone positive among BACT, WBC, LEU and NIT was 94. 6% (140/148) when detected with combination of dipstick test and UF-1000i, which was higher than the positive rate of the quantitative bacterial culture. And there was significant difference between two methods (χ2 = 20. 45, P < 0. 05 ). The sensitivity of dipstick test was low (26. 4% ,39/148 ), and specificity was high ( 99. 3%, 282/284 ) . The sensitivity, specificity, positive predictive value, negative predictive value of BACT detected by UF-1000i in diagnosing urinary tract infection were 92. 6% ( 137/148 ), 39. 8% ( 113/284 ). 44. 5% ( 137/308 ) and 91.1% ( 113/124 ), respectively. If the dipstick test was combined with UF-1000i, the sensitivity, negative predictive value, specificity, positive predictive value and accuracy were 98.0% ( 145/148 ), 97.1% ( 100/103 ). 35.2% (100/284) ,44. 1% (145/329) and 56. 7% (245/432), respectively. Conclusions The combination of urine dipstick test and automated urine formed elements analyzer UF-1000i plays an important role in early diagnosis of UTI. And it has significant value in diagnosis of UTI, especially for the patients with negative bacterial cultures of urine sample.