苏州地区娱乐场所女性服务员艾滋病知识水平调查

目的 了解苏州地区娱乐场所女性服务员艾滋病相关知识知晓率及艾滋病、梅毒感染现状,为开展行为干预提供依据.方法 随机抽取苏州地区娱乐场所和非娱乐场所女性服务人员各300人进行问卷调查,对娱乐场所女性服务员进行血清学检查.结果 调查组知晓率为82.04％,对照组为80.51％.各知识点知晓率两组均较高.除“与艾滋病病毒感染者或病人共餐会感染艾滋病”、“固定性伴可降低艾滋病传播风险”外,调查组与对照组其他知识点知晓率差异均无统计学意义.媒体、书报、杂志及各种宣传活动是获得知识的主要来源,次要来源是同事朋友介绍及就医过程.调查组血清学检测RPR、TPPA实验均阳性者8人,阳性率2.67％.HIV抗体均为阴性.结论 娱乐场所女性服务员对性病/艾滋病相关知识知晓率较高,但检出梅毒阳性者.应通过多种渠道有针对性地对社会人群进行宣传教育,提倡安全套的使用及固定性伴,减少性病、艾滋病的传播机会.     

老年类风湿性关节炎的辨证施护

类风湿性关节炎属祖国医学“痹证”范畴。是以肌肉、筋骨、肢体关节疼痛、酸楚、麻木、重着、屈伸不利和关节肿大、灼热等为主要临床表现的病证。按病因可分为行痹、痛痹、着痹、风湿热痹。由于类风湿关节炎是一种慢性疾病，需要长期治疗和护理，它严重威胁着老年人的身心健康。为提高对类风湿关节炎的护理和治疗水平，笔者根据工作实践和参考有关文献，提出护理应注意以下几方面。     

血浆置换与血液灌流治疗重型肝炎临床对比研究

目的对比研究人工肝治疗中血浆置换、血液灌流的临床疗效。方法选择重型肝炎102例患者,在常规治疗的基础上随机分成两组,60例进行血浆置换治疗;42例进行血液灌流治疗,观察患者治疗前后TIB、ALB、PTA、NH,、Na、K、Crea、Urea的变化及临床症状改善。结果两组表现在TIB、ALB、PTA、NH,治疗前后有显著性差异（P〈0．01）;而Na^＋、K^＋、Crea、Urea治疗前后无显著性差异（P〉0．05）;两组治疗好转率比较：无显著性差异（P〉0．05）。结论人工肝治疗中血浆置换、血液灌流的临床疗效无明显差异,主要并发症发生率有明显差异,因为血浆置换需大量血浆,治疗过程中患者总住院费用远远超过血液灌流。     

复发性生殖器疱疹患者血清可溶性PD-1的表达和免疫学意义

Objective To determine the concentration of soluble PD-1 (sPD-1) in the sera of patients with recurrent genital herpes (RCH), and to explore the significance of abnormal expression of sPD-1 in RCH. Methods Serum samples were obtained from 88 healthy blood donors, 74 patients with RCH including 34 cases of outbreak-stage RCH and 40 cases of stable-stage RCH. The serum level of sPD-1 was measured by monoclonal antibody labeling and enzyme linked immunosorbent assay (ELISA). Results A significant difference was observed in the serum level of sPD-1 between the patients with RGH and the blood donors (33.06 ± 17.5 μg/L vs. 53.07 ± 26.3μg/L, P < 0.01) and between the patients with outbreak-stage RGH and those with stable-stage RGH (27.47 ± 12.9 μg/L vs. 37.71 ± 19.6 μg/L, P< 0.01). Conclusions There is a low expression of sPD-1 in patients with RGH, which may be one of the mechanisms underlying the escape of HSV- Ⅱ from immunologic surveillance and development of immunological tolerance.     

遗传性对称性色素异常症

报告1例遗传性对称性色素异常症家系并进行基因突变检测。先证者双手及足背褐色斑点与色素减退斑9年。皮肤科检查：双手、足背出现散在褐色斑点与色素减退斑。基因检测发现先证者及其他患者ADAR基因第8外显子存在新的突变c.2628delA。c.2628delA突变为该家系的致病突变,基因型与表型无明确相关性。     

复发性生殖器疱疹患者血清可溶性PD-1的表达和免疫学意义

目的检测复发性生殖器疱疹(RGH)患者血清中可溶性PD-1(sPD-1)蛋白的浓度,探讨sPD-1的异常表达在HSV-Ⅱ病毒感染中的意义.方法选择74例RGH患者,其中发作期RGH患者34例,稳定期RGH患者40例,同时选择88例健康献血者作为对照组;应用单克隆抗体标记、ELISA法检测sPD-1的表达情况.结果 RGH组血清sPD-1蛋白水平为(33.06±17.5)μg/L,低于对照组sPD-1水平(53.07±26.3)μg/L,两者比较差异有统计学意义(t=5.78,P<0.01).发作期RGH组血清sPD-1蛋白水平为(27.47±12.9)μg/L,稳定期RGH组为(37.71±19.6)μg/L,两组间差异有统计学意义(P<0.01).结论 RGH组血清中sPD-1异常低表达,可能是HSV-Ⅱ逃避机体免疫监视、产生免疫耐受的机制之一.

Abstract：

Objective To determine the concentration of soluble PD-1 (sPD-1) in the sera of patients with recurrent genital herpes (RCH), and to explore the significance of abnormal expression of sPD-1 in RCH. Methods Serum samples were obtained from 88 healthy blood donors, 74 patients with RCH including 34 cases of outbreak-stage RCH and 40 cases of stable-stage RCH. The serum level of sPD-1 was measured by monoclonal antibody labeling and enzyme linked immunosorbent assay (ELISA). Results A significant difference was observed in the serum level of sPD-1 between the patients with RGH and the blood donors (33.06 ± 17.5 μg/L vs. 53.07 ± 26.3μg/L, P < 0.01) and between the patients with outbreak-stage RGH and those with stable-stage RGH (27.47 ± 12.9 μg/L vs. 37.71 ± 19.6 μg/L, P< 0.01). Conclusions There is a low expression of sPD-1 in patients with RGH, which may be one of the mechanisms underlying the escape of HSV- Ⅱ from immunologic surveillance and development of immunological tolerance.     

复发性生殖器疱疹患者血清可溶性PD-1的表达和免疫学意义

Objective To determine the concentration of soluble PD-1 (sPD-1) in the sera of patients with recurrent genital herpes (RCH), and to explore the significance of abnormal expression of sPD-1 in RCH. Methods Serum samples were obtained from 88 healthy blood donors, 74 patients with RCH including 34 cases of outbreak-stage RCH and 40 cases of stable-stage RCH. The serum level of sPD-1 was measured by monoclonal antibody labeling and enzyme linked immunosorbent assay (ELISA). Results A significant difference was observed in the serum level of sPD-1 between the patients with RGH and the blood donors (33.06 ± 17.5 μg/L vs. 53.07 ± 26.3μg/L, P < 0.01) and between the patients with outbreak-stage RGH and those with stable-stage RGH (27.47 ± 12.9 μg/L vs. 37.71 ± 19.6 μg/L, P< 0.01). Conclusions There is a low expression of sPD-1 in patients with RGH, which may be one of the mechanisms underlying the escape of HSV- Ⅱ from immunologic surveillance and development of immunological tolerance.     

腹部小汗腺汗孔瘤1例

患者女,59岁.因左下腹部紫红色结节12年,于2010年2月1日来我科就诊.患者于12年前无明显诱因发现左下腹部一紫红色米粒大丘疹,逐渐增生成蚕豆大结节,无疼痛和瘙痒等自觉症状.患者既往体健,家族成员无类似病史.     

皮肤粘液性囊肿1例

患者女,49岁,已婚,农民。4年前患者在无明显诱因下,于右足背小趾跖关节后出现一囊肿,约黄豆大小,且渐增大,平时因穿鞋行走挤压可出现轻度疼痛,但从没出现破溃及出血现象。患者平素尚体健。无特殊嗜好。父母非     

播散性表皮松懈性棘皮瘤1例

患者女,24岁,已婚,农民。24年前,患者在无明显诱因下先于胸、背部出现少量扁平丘疹,色呈棕褐色,无自觉症状。皮疹随着年龄的增长而渐增多,特别是妊娠后皮疹增多更为明显,目前已无新皮疹发生。患者平素体健。无特殊嗜好。父母非近亲婚配,家族中无类似疾患。体检:系统检查无异常。皮肤科情况:胸、背部见多发针头至绿豆大小的扁平丘疹,稍隆出皮面,表面无鳞屑,色呈棕褐色,触之表面粗糙。皮疹间孤立,无融合现象。实验室检查:血、尿常规,肝、肾功能,血脂分析,血糖均无异