青海省2011-2013年临床实验室丙型肝炎抗体检测调查分析

目的：对2011-2013年青海省临床实验室丙型肝炎抗体的检测进行总结分析，提高本实验室丙型抗体的检测质量。方法：临床检验中心提供的丙型肝炎病毒质控血清。结果：2011年检测例数为1480次，平均PT78%；2012年3375次，平均PT71.6%；2013年3375次，平均PT87%。结论：2012年检出率最低。ELISA筛查抗 HCV,要注意不同试剂的评价系统及同一试剂的不同批号之间的差异,确定符合本实验室实际情况的 COV和 S/CO。临床实验室使用临界值较低的质控品是提高检出率必要措施。     

加强免疫扩散法鉴定生物工程抗体

目的：加强免疫扩散法实验标准以鉴定生物工程抗体质量。方法采用抗体加强实验和ELISA实验的方法进行诊断和鉴定。实验采用的HBsEah抗体为实验室自制，乙肝病毒表面抗原主要为上海荣盛试剂生产，羊抗体Fah以及HRP标记及底物均为Sigma生产，细菌培养基为OXOID公司生产，其他试剂均为实验室自制。结果双抗加强后免疫扩散结果分析显示，只有经羊抗人的FAS加强孔及其下排的抗原孔中出现了明显的沉淀线。说明子啊进行延时双抗的情况是形成抗原抗体的重要交联。Fah上清进行倍比稀释后，结果表明1：8稀释之前的沉淀线明显，1：16稀释之后的沉淀线不明显，可见随着稀释增加沉淀线越不明显。结论采用免疫扩散法可有效对生物工程抗体进行鉴定。     

长方案降调节天数和LH水平对体外受精结局的影响

目的：探讨长方案使用促性腺激素（gonadotropin，Gn）前降调节天数和人绒毛膜促性腺激素（human chorionic gonadotropin，HCG）注射日黄体生成素（Iuteinizing hor-mone，LH）水平对体外受精结局的影响。方法：回顾分析2006年1月至12月482例采用促性腺激素释放激素（gonadotropin hormone releasing hormone，GnRH-α）长方案控制性超排卵的资料。结果：按长方案使用Gn前降调节的具体天数分组，发现相互间获卵数、受精率、卵裂率、临床妊娠率等无统计学差异。HCG注射日LH水平高低与受精率、卵裂率、胚胎利用率无显著关系。注射HCG日LH≤1mIU／ml组和1.1—2mlU／ml组获卵数显著高于其它各组（P〈0．05）。LH≤1mIU／ml组、1.1-2mlU／ml组和2.1-5mlU／ml组3组的优质胚胎率、胚胎种植率和累计妊娠率显著高于5.1-10mIU／ml组（P〈0．05）。结论：使用促性腺激素前降调节天数对体外受精结局没有显著影响。HCG注射日的LH水平≤5mlU／ml能获得好的优质胚胎率、胚胎种植率和妊娠率。     

前列地尔注射液治疗淤胆型肝炎的疗效分析

目的：探讨前列地尔注射液治疗淤胆型肝炎的临床疗效。方法：将我院收治的50例淤胆型肝炎患者，随机分为观察组和对照组各25例。观察组：每天进行1次静脉滴注，100ml生理盐水加10μg前列地尔。对照组：每天进行1次静脉滴注，5%的250ml葡萄糖加入30ml菌栀黄注射液。两组患者的治疗时间均为2疗程，2-6周。结果：观察组厌油、纳差为2例，占8%；乏力为5例，占20%；皮肤瘙痒4例，占16%；对照组厌油、纳差为15例，占60%；乏力为14例，占56%；皮肤瘙痒为16例，64%，观察组明显低于对照组（P〈0.05），具有较好疗效。结论：在淤胆型肝炎患者的治疗过程中，应用前列地尔注射液具有较好的临床疗效，未出现明显不良反应，值得临床推广。     

整体护理在分娩期的心理护理体会

目的：观察整体护理在产妇分娩期心理护理中的应用效果。方法：回顾性分析在我院住院分娩的172例初产妇的临床资料，给予其心理护理＋整体护理。结果：本组产妇172例，剖宫产14例，其中因产程较长强烈要求剖宫产4例，胎儿宫内窘迫8例，持续性枕后位2例，其中产妇总产程为6h～10h，产时及产后2h内出血量100ml～150ml。结论：采用整体护理的方式对产妇进行心理疏导，不但可以改善其心理状况，确保分娩的安全、顺利，还能促进其术后的快速恢复，故值得临床推广使用。     

分晚时葡萄糖液与催产素滴注对脐血生化的影响

探讨分娩时母新静脉滴注葡萄糖液（总量＜1000ml）与催产素（5U／L）对新生儿脐血生化（钠，钾，氯，钙，磷，葡萄糖，尿素氮和渗透压）的影响，结果：500－1000ml输液组的肮血氯和＜500ml输液组的脐血钾分别低于未输液组，以上两个输液组及＜500ml输液量的产钳助产组的脐血糖均高于未输液组，以产钳助产组最高，其余生化值在3个输液组与未输液组之间差异无显著意义。     

7种妊娠试剂对早期妊娠诊断的比较

７种妊娠试剂对早期妊娠诊断的比较于秀娟，陈志杰，杨栋林（山东医科大学附属医院）为协助临床准确早期诊断早早孕，我们选用了７种妊娠试剂，以产品说明书为标准，严格操作规程，检测了１０２例妊娠者和４０例非妊娠者，现将结果报告如下。１材料与方法１．１试剂选择我...     

飞“黄”腾达 年年有“鱼”

原料：榾鱼1条，胡萝卜半根，豌豆50克，香葱1根，姜1块，大蒜4瓣，料酒2汤匙（30ml）,盐2茶匙（10克），干淀粉2汤匙（30克），番茄酱4汤匙（60ml）,清水100ml．糖2汤匙（30ml）,水淀粉2汤匙（30ml）,白醋1汤匙（15ml）。     

剖宫产术中应用碘伏预防切口感染220例临床分析

目的：探讨剖宫产术中应用碘伏冲洗伤口预防切口感染的效果。方法：选取2011年12月至2012年12月220例剖宫产患者作为研究对象，随机分为A组（碘伏组）110例，术中切口局部用碘伏液冲洗后用生理盐水500ml再次冲洗。B组（对照组）110例，术中局部用生理盐水500ml冲洗。结果：剖宫产术中应用碘伏冲洗伤口预防切口感染组术后产褥病率、术后腹部切口感染率明显少于对照组。结论：剖宫产术中应用碘伏冲洗伤口预防切口感染有十分肯定的效果，值得临床广泛推广应用。     

低浓度罗哌卡因微量泵硬膜外注入用于分娩镇痛156例分析

目的探讨低浓度罗哌卡因微量泵硬膜外注入用于分娩镇痛的效果。方法对宫口开大2～3cm的初产妇，在L（2-3）间隙行硬膜外穿刺。成功后先推注利多卡因5ml试剂，经观察显效，再用微量泵泵入0．185％罗哌卡因55—60ml（内含芬太尼0．1mg，氟哌啶5mg），每小时泵入7～10ml根据患者要求调节。调整麻醉平面T10～S，宫口开大9～10cm，停止用药。胎儿娩出后再继续泵入，至会阴口缝合完全，拔出麻醉管。结果经低浓度罗哌卡因微量泵硬膜外注入的156例孕产妇，分娩时完全不痛148例，轻微疼痛8例，有效率100％，无副作用。活跃期、第二产程、总产程低于对照组，阴道顺产者增加，剖宫产率下降，产后出血、新生儿窒息率均无增加。结论低浓度罗哌卡因微量泵硬膜外注入用于分娩镇痛。达到了分娩镇痛效果，降低了剖宫产率。有利于母婴安全，值得推广。     

Origin of lysozyme in amniotic fluid

We reported in a previous paper that the pattern of change in the lysozyme content of normal amniotic fluid during pregnancy resembles indices of fetal maturity such as L/S ratio, creatinine concentration and amylase activity. In order to clarify the origin of amniotic fluid lysozyme and to determine whether or not the amniotic fluid lysozyme concentration indicates the maturity of some specific fetal organ, we measured the lysozyme content of samples of materials considered to be possible sources of amniotic fluid lysozyme. These materials were amnion and--taken immediately after birth--saliva, urine and cord serum. Lysozyme content was 36.5 +/- 6.7 micrograms/ml in the saliva samples, 5.3 +/- 0.9 micrograms/ml in the urine samples, and 17.4 +/- 4.4 micrograms/ml in the cord serum samples. It is unclear, however, which material was the most important source of amniotic fluid lysozyme. The results suggested that homogenized amnion samples contained lysozyme, although the content was low, and that amnion tissue produced lysozyme in vivo. Lysozyme is an enzyme found in the lysozymes of cells. The results of this study provide evidence that amniotic fluid lysozyme originates from many sources.     

Serum amylase levels after obstetric and gynecologic operations.

The incidence of postoperative hyperamylasemia was evaluated in 131 patients who underwent obstetric and gynecologic procedures. Preoperative and postoperative serum amylase levels were determined in 178 patients who underwent routine surgical procedures. In our sample, we could not document any elevations in serum amylase levels after operations. These findings contradict those of previous reports of a high incidence of postoperative hyperamylasemia after surgical procedures except those performed upon the gastrointestinal tract. Furthermore, in spite of the fact that the female internal genitalia is rich in amylase and that pregnancy is considered a predisposing condition for the development of postoperative pancreatitis, the preoperative and postoperative serum amylase levels were consistently within normal range. We would like to conclude that the manipulation of female internal genitalia, pregnant or not, does not induce hyperamylasemia. Therefore, hyperamylasemia in postoperative gynecologic and obstetric patients should alert the clinician to the possibility of postoperative pancreatitis. We believe that our findings should be confirmed on large samples of patients.     

Rapid resolution of high level hyperamylasemia as a guide to clinical diagnosis and timing of surgical treatment in patients with gallstones

We reviewed the charts of 78 patients with acute hyperamylasemia (25 with gallstones, 38 alcoholic patients and 15 other), looking for early patterns of serum amylase flux that could distinguish gallstone associated disease. Patients with gallstones had average serum amylase levels of 1,848 +/- 289 International units per liter and 911 +/- 233 International units per liter at hospital admission and on hospital day 2, respectively; these levels were significantly greater than those in either the alcoholic or other patients. In the group of patients with gallstones, there were also dramatic decreases in serum levels of amylase at 24 hours (1,425 +/- 286 International units) after hospital admission; these decreases were not seen in the other groups of patients. At operation, the patients with gallstones had mild or no pancreatitis. All of them underwent uneventful cholecystectomy within 48 hours of hospitalization; only three patients required exploration of the common duct, and only one patient had ampullary obstruction. We conclude that rapid resolution of high level hyperamylasemia within 24 hours of hospitalization in symptomatic patients with gallstones can help to identify patients whose amylase fluctuations are indeed gallstone related, who have either mild pancreatitis or none at all, are good candidates for early cholecystectomy and are not likely to have common duct stones.     

Immunohistochemical study of amylase in common epithelial tumors of the ovary

Cellular localization of amylase in various ovarian tumors was studied by the immunoperoxidase method using an antibody to human pancreatic amylase. Amylase was present in eight of 34 serous carcinomas and eight of 27 endometrioid carcinomas. However, only in one poorly differentiated serous carcinoma and two well-differentiated endometrioid carcinomas were a large number of amylase-reactive cells found. Five benign and three borderline serous tumors contained no amylase. Also, amylase was not detected in any of 34 mucinous tumors or five malignant clear cell tumors. The results obtained suggest that amylase will be a useful tumor marker, when present, for follow-up of endometrioid and serous carcinomas of the ovary.     

The effect of severe pre-eclampsia on the pancreas: changes in the serum cationic trypsinogen and pancreatic amylase

In 13 patients with severe pre-eclampsia mean serum concentrations of cationic trypsinogen and amylase were statistically significantly higher at 64 ng/ml and 1.6 mumol/l, respectively, than the corresponding mean serum concentrations in 30 normal pregnancies, 22 ng/ml and 1.1 mumol/l respectively. These rises exceeded the expected increased values due to the slight reduction of the renal function in the pre-eclamptic patients, and therefore indicate a concomitant injury of the pancreas.     

人脐血和胎盘中肝细胞生长因子和纤维连接蛋白的测定

目的:检测人脐血、胎盘组织和胎盘基质细胞培养上清液中肝细胞生长因子(HGF)和纤维连接蛋白(Fn)的含量。方法:选择健康足月新生儿,分娩时留取脐血和胎盘组织,用ELISA法检测其中Fn和HGF的浓度,并比较分析。结果:HGF含量在脐血、胎盘组织提取液和胎盘基质细胞培养上清液中分别为1.23±0.24ng/ml、113.73±11.99ng/ml、2.23±0.31ng/ml。Fn含量分别为1105±44ng/ml、1537±319ng/ml、1027±171ng/ml。结论:与脐血相比,胎盘是提取HGF和Fn的优质材料,将其浓缩或纯化后具有很大的科研和应用价值。     

The incidence and significance of elevations of serum and urinary amylase levels following transcystic duct cholangiography

Transcystic duct cholangiography does not increase the incidence of amylase elevations or clinical pancreatitis postoperatively. Significant rises in serum and two hour urinary amylase following routine cholecystectomy are quite common, regardless of whether or not transcystic duct cholangiography is performed. Many of these elevated amylase levels may arise from sources other than the pancreas.     

The effect of severe pre-eclampsia on the pancreas: changes in the serum cationic trypsinogen and pancreatic amylase

Summary. In 13 patients with severe pre-eclampsia mean serum concentrations of cationic trypsinogen and amylase were statistically significantly higher at 64ng/ml and 1·6 μmol/1, respectively, than the corresponding mean serum concentrations in 30 normal pregnancies, 22 ng/ml and 1·1 μmol/1 respectively. These rises exceeded the expected increased values due to the slight reduction of the renal function in the pre-eclamptic patients, and therefore indicate a concomitant injury of the pancreas.     

宫腔填塞联合米索前列醇预防高危因素剖宫产产后出血的临床疗效观察

目的:探讨宫腔填塞联合米索前列醇预防高危因素剖宫产产后出血的临床疗效。方法:有剖宫产产后出血高危因素产妇125例,随机分为A组(n=63)和B组(n=62)。A、B组所有患者均于胎儿娩出后给予子宫壁肌肉内注射缩宫素20 U、静脉滴注缩宫素10 U,手术结束后给予肛塞米索前列醇400μg。但A组另于胎盘娩出、宫腔清理后给予纱布填塞宫腔。观察术中、术后2 h、术后24 h出血量及手术时间、产褥感染、不良反应情况。结果:A组术中、术后2 h、术后24 h出血量分别为:150.3±42.3 ml,282.2±55.2 ml,355.8±92.5 ml;产后出血率为1.59%;B组术中、术后2 h、术后24 h出血量分别为:206.7±33.9 ml,456.2±75.3 ml,568.4±83.2 m1;产后出血率为12.90%;A组出血量及产后出血发生率明显低于B组(P0.05),而手术时间、产褥感染、不良反应情况组间无统计学差异(P0.05)。结论:宫腔填塞纱布联合米索前列醇预防高危因素剖宫产产后出血疗效显著,可明显减少产后出血发生率。     

控制性超排卵注射hCG后血清β-hCG水平与体质量指数的关系

目的:探讨IVF-ET周期中控制性超排卵后应用外源性hCG后血β-hCG水平是否受体质量指数(body mass index,BMI)影响。方法:回顾性分析注射hCG剂量均为10000IU的288个IVF-ET周期,分析12h后血β-hCG值与BMI的关系。结果:以血β-hCG水平分成3组,各年龄、不孕年限等均无统计学差异。随血β-hCG水平升高,BMI呈下降趋势。血β-hCG低水平组(<289.6mIU/ml)BMI最高,高水平组(>482.7mIU/ml)最低,其中低水平组与中水平组(289.6～482.7mIU/ml)间有统计学差异(P<0.05)。结论:hCG对卵子成熟很关键,注射hCG后血β-hCG水平受BMI影响。