14C-尿素呼气试验检测幽门螺杆菌的初步研究

幽门螺杆菌 ( Hp)感染已公认与消化性溃疡、胃炎、胃癌、胃 MACT淋巴瘤等有密切相关。我院于2 0 0 0年 3月～ 2 0 0 1年 1 2月同时作 14 C-尿素呼气试验 ( 14 C- UBT)与快速尿素酶试验 ( RUT)、病理改良 Giemsa染色对上消化道疾病的病人进行检测来对比分析 ,以探讨 14 C- UBT检测 Hp感染的临床应用价值。1　对象与方法1 .1　对象 :选择我院胃镜受检者 1 2 6人 ,男 82人 ,女 44人 ,平均年龄 ( 4 1 .8± 1 5 .1 2 )岁 ,其中十二指肠溃疡 5 7例 ,糜烂性胃炎 2 2例 ,慢性浅表性胃炎 47例 ,排除孕妇、受检前 2周内服用抗生素、胃出血及胃…     

幽门螺杆菌感染的几种检测方法之临床比较

目的：探索基层医院如何对几种幽门螺杆菌（Hp)检测方法进行选择,并作出评价。方法：对633例因胃部不适作胃镜检查者同时作快速尿素酶试验（RUT）,涂片革兰氏染色（S）,细菌培养,组织染色（Warthin-Starry,W-S染色）等4种方法中至少3种检查,并以2种检查方法的结果一致作为幽门螺杆菌（Hp)感染与否之标准,150例行Hp根治6周后作了尿素呼气试验（13C－UBT,部分14C－UBT）,86例同时复查胃镜。结果：配对检验RUT阳性检出率高于W－S染色,细菌培养（P＜0．01）,抗Hp治疗后6周复查,以13C－UBT为标准给予评价：细菌培养敏感性低于RUT,W－S染色,特异性高,W－S染色与RUT敏感性相近,而特异性高于RUT,结论：RUT及涂片染色方法简便,快速,敏感性高,虽特异性偏低,但实用性强且价格低廉,便于基层医院广泛应用,细菌培养及W－S染色法特异性和敏感性高,但需一定条件,如能RUT配合S,细菌培养或W－S染色则最为理想,13C－UBT或14C－UBT敏感性和特异性均高,但需质谱仪,较复杂,价格较贵,故可选择性进行。     

~(14)-C尿素呼气试验检测内镜幽门螺杆菌感染

目的 :采用国产胶囊 0 .75 μcl剂量14 C 尿素呼气试验 (14 C UBT)检测内镜存否幽门螺杆菌 (Hp)交叉感染。方法 :胃镜活检组织进行快速尿素酶试验 (RUT) ,在阴性者中随机抽选 70例。在镜检后观察 4组时间 (同步 8例、1～ 5 0d 32例、5 1～ 10 0d13例、10 1～ 15 0d 17例 ) ,未经中西药抗Hp治疗 ,进行14 C UBT检测。结果 :4组时间共 70例全是校正值系小于 10 0DPM/mmolCO2 为阴性者与RUT阴性者 70例相同。结论 :14 C UBT对诊断Hp具有敏感度较高、特异性强、简便、快速安全、便于检测根治手段和监测内镜有否Hp交叉感染。     

幽门螺杆菌感染诊断方法的比较

幽门螺杆菌（Hp）感染与、十二指肠疾病密切相关这一事实已为世界瞩目。目前用于诊断Hp感染的方法很多，大致可分为侵入性及非侵入性两类。侵入性诊断即在进行胃镜检查时取胃粘膜活检作快速尿素酶实验（简称RUT）、组织学检查（Warthin-Stary或Giemsa等染色）及Hp培养法。非侵入性诊断法包括血清Hp抗体检测及^13C-^14C-尿素呼吸实验（UBT）。     

14C尿素呼气试验在诊断儿童幽门螺旋杆菌感染的临床应用

目的：探讨14C尿素呼气试验（14C UBT）对诊断儿童幽门螺杆菌（Hp）感染的临床应用.方法：对150例有消化道症状（7～14岁）的患儿进行胃镜检查,同时采用胃黏膜病理组织学、快速尿素酶（RUT法）及14C尿素呼气试验（14C UBT）进行Hp检测,并对3种方法进行比较.结果：14C UBT、病理组织学、快速尿素酶检测的阳性率分别为59.3％、58％、51.3％;敏感性分别为95.6％、97.8％、84.6％;特异性分别为93.6％、96.7％、80.8％.结论：因此认为14C UBT和病理组织学是检测Hp感染较准确的方法,而14C UBT是非侵入性操作,更能反映“全胃”的Hp感染状况,同时无创伤、费用低,易被患儿及家长接受和配合,因此便于在诊断儿童Hp感染的临床应用中推广.     

短期用药对幽门螺杆菌检测结果的影响

目的：研究短期不规则用药对幽门螺杆菌(Hp)检测结果的影响。方法：136名慢性胃炎及消化性溃疡的住院患，根据病史分为服药组即Hp检查前一周内接受过铅剂、抑酸剂治疗的患，共四例。对照组即Hp检查前未接受过药物治疗的患考，共37例。Hp检查方法包括①血清学方法；②快速尿素酶试验(RUT)；③组织学方法；④13c—尿素呼气试验(13C—UBT)。结果：服药组RUT，组织学，13C—UBT方法Hp检出率分别为9．0％，21．2％，27．3％，均显低于对照组相应Hp检出率37．8％、40．5％、48．6％(P＜0．01，P＜0．05，P＜0．05)。两组血清学方法Hp IgG、IgM阳性率各为48．5％，51．5％和54．1％，54．1％(P＞0．05)。单独服用质子泵抑制剂组RUT，组织学方法Hp检出率4．0％，16．0％显低于对照组相应方法Hp检出率(P＜0．01，P＜0．05)。单独服用枸橼酸铋钾、H2受体拮抗剂患中各方法Hp检出率与对照组检出率无显性差异(P＞0．05)。单独服用枸橼酸铋钾、H2受体拮抗剂、质子泵抑制剂三组Hp感染率14．3％、15．0％、16．0％均显低于对照组Hp感染率46．0％(P＜0．05)。结论：Hp检查前短期使用铋剂、抑酸剂可导致Hp检出率下降，短期使用质子泵抑制剂可显降低RUT、组织学方法Hp检出率；各方法中快速尿素酶试验检出率最低。血清学方法检测Hp抗体不受药物影响。     

快速尿素酶试验检测4244例胃幽门螺杆菌感染情况分析

幽门螺杆菌(Hp)感染与胃十二指肠疾病密切相关。目前用于诊断Hp感染的方法很多,大致可分为侵入性和非侵入性两类。侵入性诊断法即在胃镜检查时取胃粘膜活检作快速尿素酶试验(RUT)、组织学检查及Hp培养法;非侵入性诊断法包括血清Hp抗体检测及C13或C14-尿素呼气试验(C13或C14UBT)。为了解柳州地区上消化道疾病患者Hp感染情况,笔者在给4244例患者作胃镜检查的同时作RUT。现就有关研究结果报告如下。1　资料与方法1.1　病例选择　1997年5月至1999年8月因上腹不适、疼痛、反酸等症状到我院作胃镜检查并同时作RUT检查的门诊和住院患者共…     

唾液抗幽门螺杆菌IgG的检测

[目的]了解唾液抗幽门螺杆菌(Hp)抗体诊断Hp感染的价值.[方法]对93例病人同时进行唾液抗HpIgG测定、快速尿素酶试验(RUT)、组织涂片HE染色及病理WS银染色.[结果]唾液抗HpIgG检测阳性率近似于RUT法(P＞0.05),高于组织涂片HE染色及病理WS银染色法(P＜0.01).其诊断Hp感染的敏感性为97.0%,特异性为88.2%,准确性为95.2%,阳性预期值97.0%,阴性预期值88.2%.[结论]本方法与组织学方法比较具有更高的敏感性,且简便、快速、可靠.     

14-C尿素呼气试验检测内镜幽门螺杆菌感染

目的 :采用国产胶囊 0 .75 μcl剂量14 C 尿素呼气试验 (14 C UBT)检测内镜存否幽门螺杆菌 (Hp)交叉感染。方法 :胃镜活检组织进行快速尿素酶试验 (RUT) ,在阴性者中随机抽选 70例。在镜检后观察 4组时间 (同步 8例、1～ 5 0d 32例、5 1～ 10 0d13例、10 1～ 15 0d 17例 ) ,未     

14C-尿素呼吸试验对幽门螺杆菌的诊断价值

目的 探讨14C-尿素呼吸试验(UBT)检测幽门螺旋杆菌(Hp)对消化性溃疡和慢性胃炎的诊断和应用价值。方法 以快速尿素酶试验(RUT)和Warthin-Starry(WS)染色作对照，用14C-尿素呼吸试验对经胃镜确诊的112例消化性溃疡和429例慢性胃炎患者进行幽门螺旋杆菌检测；102例消化性溃疡和411例慢性患者在Hp治疗前后均进行Hp检测，评价该试验的敏感性、特异性、假阴性、假阳性，以及治疗前后14C -UBT的检测值。结果 以WS染色快速尿素酶试验同时阳性为标准，112例消化性溃疡中，两者同时阳性102例，同时阴性4例，WS阳性UBT阴性5例，WS阴性UBT阳性1例；敏感性为96.2％，特异性83.3％，准确度95．5％.429例慢性胃炎中，两者同时阳性411例，同时阴性8例，WS阳性UBT阴性8例，WS阴性UBT阳性2例；敏感性98％，特异性80％，准确度97.6％。Hp根除治疗后14C的检查情况见表1。结论 14C-UBT是一种快速、简便、无痛苦、敏感性和特异性好、准确度高的Hp检测方法；又不需胃镜检查，有助于Hp治疗的疗效观察。     

APPLICATION OF LORNOXICAM TO PATIENT-CONTROLLED ANALGESIA IN PATIENTS UNDERGOING ABDOMINAL SURGERIES

FOR anesthesiologis s ,treatingpostoperativepainhas alwaysbeen a problem.Althoughopioidshave been provedtobe effective,theirsideeffectscouldnotbeignored.With thedevelopmentofscienceand pharmacology,many drugs with aspectsof satisfactoryanalgesicefficacyand couldbe welltoleratedby patientshave been developed.And lornoxicamisone of them, which isa non-steroidalanti-inflammatorydrug (NSAID ), with analgesic, anti-infl-ammatory,andantipyreticproperties.Itseliminationhalf-time(3 to 5 hours) isle…     

Value of D-Dimers in patients with acute aortic dissection

Objective: To evaluatel the value of D-dimers in patients with acute aortic dissection (AAD). Methods: This study consisted of 16 patients with AAD and 27 non-AAD patients. Serum D-dimets were measured by Sta-Liatest D-DI immunoturbidimetric assay. Results: D-dimer level was higher (P ＜ 0.001) in patients with AAD(7.91 ± 5.52 μg/ml) than that in non- AAD group(1.57±1.24 μg/ml). D-dimer was positive (＞0.4 μg/ml) in all patients with AAD and in 10 control group patients (37%). Among patients with acute AAD, D-dimers tended to be higher in Stanford A than in Stanford B (8.67 ± 4.31 μg/ml vs. 3.24±1.27 μg/ml, P ＜0.01). D-dimer values tended to be higher in more extended disease(3.84 ± 1.65 μg/ml, 8.57 ± 3.58 μg/ml and 11.87 ± 5.69 μg/ml in thoracic aorta, thoracic and abdominal aorta, thoracic and abdominal aorta and iliacal arteries, respectively, P ＜ 0.05 for both 8.57 ± 3.58 and 11.87 ± 5.69 vs. 3.84 ± 1.65 ). Including the control group into the analysis, we found a sensitivity of 100%, a negative predictive value of 100%, and a specificity of 66% and a positive predictive value of 64% for D-dimer in diagnosis of AAD in our patients with suspected AAD. Conclusion: D-dimer was elevated in patients with AAD. A negative D-dimer test result could be useful in excluding AAD.     

Research of combined liver-kidney transplantation model in rats

Objective： To set up a simple and reliable rat model of combined liver-kidney transplantation. Methods： SD rats served as both donors and recipients. 4℃ sodium lactate Ringer＇s was infused from portal veins to donated livers,and from abdominal aorta to donated kidneys, respectively. Anastomosis of the portal vein and the inferior vena cava （IVC） inferior to the right kidney between the graft and the recipient was performed by a double cuff method, then the superior hepatic vena cava with suture. A patch of donated renal artery was anastomosed to the recipient abdominal aorta. The urethra and bile duct were reconstructed with a simple inside bracket. Results： Among 65 cases of combined liver-kidney transplantation, the success rate in the late 40 cases was 77.5%. The function of the grafted liver and kidney remained normal. Conclusion： This rat model of combined liver-kidney transplantation can be established in common laboratory conditions with high success rate and meet the needs of renal transplantation experiment.     

BLOOD PRESSURE CHANGE WITH AGE IN SALT-SENSITIVE TEENAGERS

Objective To observe blood pressure change with age in salt-sensitive teenagers whose salt sensitivity were determined by repeated testing.Methods Salt sensitivity was determined through intravenous infusion of normal saline combined with volume-depletion by oral diuretic furosemide in 55 teenagers. After five years, salt sensitivity was re-examined and subject blood pressure was followed up. Blood pressure changes in salt-sensitive teenagers were compared to that of non-salt sensitive teenagers over five years.Results After 5 years, the repetition rate of salt sensitivity determined by intravenous saline loading is 92.7%. In teenagers with salt sensitivity on the baseline, both the systolic blood pressure increments and increment rates were much higher than non-salt sensitive teenagers (12.7±12.1 mmHg vs. 2.8±5.2 mmHg, P＜ 0.01; 12.2%± 12.0% vs. 2.5% ±4.4%, P＜ 0.001,respectively). There was a similar trend for diastolic blood pressure (8.4 ± 6.4 mmHg vs. 3.7 ± 6.4 mmHg, P = 0.052; 13.2% ±10.6 % vs. 6.8%± 10.1%, P = 0.053, respectively).Conclusions Salt sensitivity determined by intravenous saline loading showed good reproducibility. Blood pressure increments with age were much higher in salt-sensitive teenagers than non-salt sensitive teenagers, especially in terms of systolic blood pressure.     

Acupuncture Combined with Spinal Tui Na for Treatment of Primary Dysmenorrhea in 30 Cases

Objective: To observe the therapeutic effects in acupunture treatment of primary dysmenorrhea combined with spinal Tui Na, and study its mechanism. Methods: Thirty cases of the treatment group were treated by acupuncture combined with spinal Tui Na, and thirty cases in the control group were treated by routine acupuncture. Results: The total effective rate was 93.3% in the treatment group, and 73.3% in the control group, with a significant difference between the two groups (P<0.05). Conclusions: Acupuncture combined with spinal Tui Na has good prospects for treatment of primary dysmenorrhea.     

Luo Lingjie's Experience in Treating Chronic Nephropathy

In treating chronic nephropathy,Luo Lingjie,a chief physician,pays attention to regulating the balance between yin and yang,treating infection if present,and removing pathogenic factors.He prescribes gentle drugs and uses carefully strongly warming-tonifying ones,emphasizes the importance of persuading the patient to persist in treatment with medication and nurse one's health for recuperation,and is good at combined use of TCM and western medicine therapy and brings the merits of various therapies into full play,with obvious theraoeutic effects.     

Dr.Zhang Ren's Experience in the Acupuncture Treatment of Different Diseases with the Same Therapeutic Principle

Dr.Zhang Ren,the chief physician,is the chairman of Shanghai Acupuncture and Moxibustion Association.Having been engaged in medicine for about 40 years,he is experienced in treating various intractable diseases.In his long years of clinical practice,he advocates taking the TCM differentiation as the basis to seek for the acupuncture method for treatment of modern intractable diseases.The author of this essay had the fortune to follow Dr.Zhang in study.The following is a summary of Dr.Zhang's experience in the acupuncture treatment for different intractable diseases with the same therapeutic principle.     

安心颗粒对急诊经皮冠状动脉介入术后生活质量影响的研究

目的：评价使用安心颗粒对急诊经皮冠状动脉介入术（PPCI）术后生活质量的影响.方法：将160例接受PPCI的急性ST段抬高型心肌梗死患者随机分为安心颗粒组（术前顿服安心颗粒8.8g,术后安心颗粒4.4 g/次,每日2次）和对照组（仅接受基础药物治疗）.所有患者均服用阿司匹林、氯吡格雷和阿托伐他汀.分别在入院时、出院前1d、出院后180 d时,应用心肌梗死多维度量表（MIDAS）、中文版SF-36评价量表对患者生活质量评分.并观察术后30 d以内的出血并发症、血小板减少症发生情况.结果：入院时和出院前1d,两组患者的心肌梗死MIDAS、SF-36量表评分比较无差异（P＞0.05）;出院后180 d时,与对照组比较,安心颗粒组MIDAS、SF-36评分明显减低（P＜0.05）;组内与入院时比较,两组出院前1d、出院后180 d时,MIDAS、SF-36评分均降低（P＜0.05）.两组患者在随访期间均无大量出血、少量出血、重度和极重度血小板减少症发生,安心颗粒组有4例、对照组有7例发生不明显出血（P＞0.05）.两组发生轻度血小板减少症的患者数比较无差异（P＞0.05）.结论：PPCI使用安心颗粒,能改善急性ST段抬高型心肌梗死患者的生活质量,且不增加出血风险.     

猪肺磷脂注射液联合经鼻持续气道正压通气对呼吸衰竭早产儿的临床疗效及肌酸激酶同工酶活性的影响

目的 探讨猪肺磷脂注射液联合经鼻持续气道正压通气(NCPAP)对呼吸衰竭早产儿的临床疗效及肌酸激酶同工酶活性(CK-MB)的影响.方法 选取呼吸衰竭早产儿80例,分为观察组和对照组各40例.对照组采用NCPAP给氧治疗,观察组给予NCPAP给氧联合猪肺磷脂气管内给药.观察两组患儿治疗前及治疗12h、24 h后PaO2、PaCO2、血氧饱和度(SaO2)、pH的变化情况,检测治疗前及治疗5d后血清CK-MB水平;评估两组患儿的临床治疗效果.结果 两组患儿PaO2、PaCO2、SaO2、pH比较,差异均有统计学意义(P＜0.05),其中观察组治疗后的PaO2、SaO2、pH均高于对照组,PaCO2则低于对照组.两组的PaO2、SaO2、pH均随观察时间延长而升高(P＜0.05),PaCO2均随观察时间的延长而降低(P＜0.05).观察组治疗有效率为87.5％,显著高于对照组的70.0％ (P ＜0.05).治疗5d后两组患儿血清CK-MB水平均较前降低(P＜0.05),且观察组明显低于对照组(P＜0.05).结论 猪肺磷脂注射液气管内给药联合NCPAP可以显著降低呼吸衰竭早产儿CK-MB的含量,提高治疗有效率,起到很好的呼吸循环支持作用.