超声波终止早孕的母体安全性和遗传毒理评价Ⅰ:超声对小鼠安全性的细胞遗传学研究

目的：研究超声终止早孕的安全性。方法：本实验研究选用８周龄的ＩＣＲ小鼠,用不同剂量超声分组辐照后常规交配,连续对亲代母鼠和两代仔鼠进行细胞遗传学评价。诊断组频率５ＭＨｚ,强度２４ｍＷ／ｃｍ２,照射５ｍｉｎ;治疗组频率０．８ＭＨｚ,强度１．５Ｗ／ｃｍ２,照射１ｍｉｎ。结果：染色体畸变率、姊妹染色单体交换、微核率,各处理组与对照组比较均无显著性差异。结论：超声辐照在一定剂量范围内对体细胞和生殖细胞没有致突变作用。超声波抗早孕经遗传毒理评价对母体、仔代具有安全性。     

放射工作人员细胞遗传学损伤与受照剂量的关系分析

目的:探讨放射工作人员职业低剂量辐射对细胞遗传学损伤的影响。方法:选择本院从事放射诊断、介入治疗及放射相关科研的人员共120例作为观察组,在本院从不接受放射线的科室选择30例工作人员为对照组,采用微量全血培养法检测2组染色体和微核的变化。结果:观察组个人累积受照剂量最高为89.21mSv,最低0.36mSv,平均35.87mSv;其染色体总畸变率和染色体细胞畸变率均高于对照组(P0.01),且随着累积受照剂量的增加呈现逐渐升高的趋势;微核细胞率和微核阳性检出率观察组亦高于对照组(P0.01)。结论:细胞遗传学损伤与是否受照及受照剂量存在明显的剂量反应关系,应加强对放射工作人员的职业防护。     

4335例细胞遗传学检查分析——异常核型283例含世界首报4例

我们从1992年4月～2004年12月进行各种细胞遗传学检查4335例，其中外周血染色体G显带分析2542例，羊水细胞染色体G显带分析213例，脐血细胞染色体G显带分析12例，脆性X染色体分析[Fra(x)]417例，姐妹染色单体互换(SCE)15例，染色体畸变分析1136例。     

小儿急性白血病姐妹染色单体交换动态观察的研究

我们对７６例急性白血病（ＡＬ）患儿进行了骨髓细胞姐妹染色单体交换（ＳＣＥ）频率的动态观察和分析。结果显示：初发组、部分缓解（ＰＲ）组ＳＣＥ频率增高，与完全缓解（ＣＲ）组比较均有非常显著的差异（Ｐ＜０．０１）。与对照组相比，ＣＲ组ＳＣＥ频率仍高干对照组（Ｐ＜０．０５）。持续完全缓解３年以上者ＳＣＥ频率与对照组比较无显著差异（Ｐ＞０．０５）。表明：ＡＬ患儿治疗前骨髓细胞的ＳＣＥ水平损伤严重；ＣＲ时其损伤仍未完全修复，随着病情进一步好转，ＳＣＥ频率亦趋于正常。无标记型急性淋巴细胞白血病（ＮｕＬＬ－ＡＬＬ）患儿达ＣＲ时，ＳＣＥ频率仍高于普通型急性淋巴细胞白血病（Ｐ＜０．０５），表明不同类型的ＡＬ，ＤＮＡ损伤程度和恢复速度亦不同。     

骨髓增生异常综合征的早期诊断研究

目的：联合应用四种克隆性分析法对骨髓增生异常综合征（MDS）的早期诊断进行研究。方法：对临床上怀疑为MDS的50例患者应用常规染色体核型分析，姐妹染色单体分化（SCD）染色，荧光原位杂交（FISH）和聚合酶链反应－单链构象多态性分析（PCR－SSCP）等技术分别检测染色体畸形，细胞周期时间，8三体（＋8）和N-ras突变。结果：45例符合FAB诊断标准；5例不符合FAB标准，其中2例患者只有红系病态造血改变，形态学诊断均为可疑RA，另3例患者无涉及三系的病态造血改变，形态学诊断分别为增生性贫血（1例），慢性再生障碍性贫血（2例），在这5例患者中，当色体核型分析发现4例具有克隆性当色体异常；SCD检测证实2例细胞周期时间延迟；FISH检测发现3例存在＋8异常；PCR－SSCP发现1例存在N－ras外显子1突变，证实它们实际上均为RA患者。结论：联合应用染色体核型分析，SCD、FISH和PCR－SSCP等方法可对形态学检查无病态造血或仅有一系病造血改变的不典型MDS患者有效进行早期诊断。     

389例男性生殖功能低下患者细胞遗传学分析

目的探讨男性生殖功能低下与染色体异常的关系。方法对389例生殖功能低下男性患者进行外周血淋巴细胞G显带染色体核型分析。结果 389例患者共检出染色体异常74例,其中性染色体数目异常62例;性染色体结构异常3例,46,XX男性3例,染色体易位5例,携带来源不明的标记染色体1例。结论性染色体异常是导致男性生殖功能低下的重要原因之一。     

石油作业习惯性流产女性的细胞遗传毒理学研究

目的分析石油作业女性外周血细胞姐妹染色单体互换（SCE）与习惯性流产的关系。方法随机选择习惯性流产的石油作业女性20名和健康育龄女性20名,检测其外周血细胞SCE发生率。结果实验组外周血淋巴细胞SCE发生率为（8.43±1.65）%,明显高于健康对照组（P〈0.05）。结论 SCE的发生降低了染色体结构的稳定性,并与石油作业女性习惯性流产有关。     

高原地区颅脑损伤非手术治疗患者的临床观察及护理

云南边庆香格里拉地处海拔3280m的高原地区,缺氧、寒冷、干燥的自然条件决定了高原地区颅脑损伤患者病危程度较平原地区患者更为严重,加之医疗条件相对滞后,缺少先进的诊断仪器及设备,对颅脑损伤无法进行准确地定位诊断及治疗,多数颅脑损伤患者采用非手术治疗,因而仔细周密地临床观察,认真细致地护理显得尤为重要。现将我院2004年1月-2007年5月间收治的采用非手术治疗的482例颅脑损伤患者的临床观察和护理体会介绍如下。1临床资料本组482例中男性328例,女性154例;年龄16.5~52岁,平均38.5岁;49例行气管切开,402例治愈出院,治愈率83.40%,80例…     

高原地区颅脑损伤非手术治疗患者的临床观察及护理

云南边庆香格里拉地处海拔3 280 m的高原地区,缺氧、寒冷、干燥的自然条件决定了高原地区颅脑损伤患者病危程度较平原地区患者更为严重,加之医疗条件相对滞后,缺少先进的诊断仪器及设备,对颅脑损伤无法进行准确地定位诊断及治疗,多数颅脑损伤患者采用非手术治疗,因而仔细周密地临床观察,认真细致地护理显得尤为重要.……     

SRY阳性46,XX男性综合征诊疗及细胞遗传学分析

46,XX男性综合征是一种较少见的性分化异常基因遗传性疾病~([1]),发生率是大约1:20,000～25,000~([2]),表现为性腺性别与染色体性别不一致,临床表现具有较大的异质性,成年男性多因不育、性功能障碍、男性乳房女性化发育而就诊.2008年1月我院男科门诊收治1例SRY阳性46,XX男性综合征成年患者,现就其临床特征、性激素水平检测、细胞遗传学及分子遗传学检测、诊断及鉴别诊断、治疗方法等报告如下.     

黄芪注射液对人淋巴细胞SCE和细胞增殖的影响

目的：研究黄芪注射液在不同剂量条件下对正常人外周血淋巴细胞姐妹染色单体互换（ＳＣＥ）和细胞增殖的影响。方法：以Ｂｒｄｕ－Ｇｉｅｍｓａ技术进行检测研究。结果：黄芪作用后的人淋巴细胞姐妹染色单体互换频率和细胞增殖率指数（ＰＲＩ）均有明显增高,并且其作用与剂量呈正相关。结论：黄芪注射液中存在某种成分可诱发ＤＮＡ损伤,同时黄芪还有促进细胞增殖的作用。     

Case series of COVID-19 patients from the Qinghai-Tibetan Plateau Area in China

BACKGROUNDCoronavirus disease 2019 (COVID-19) is a serious infection caused by the new coronavirus severe acute respiratory syndrome coronavirus 2. The disease was first identified in December 2019 and has caused significant morbidity and mortality worldwide. AIMTo explore the clinical characteristics and treatments for COVID-19 in the Qinghai-Tibetan Plateau Area in China.METHODSWe retrospectively analyzed the blood cell counts (neutrophils and lymphocytes), blood gas analysis, and thoracic computed tomography changes of patients from Qinghai Province before, during, and after treatment (January 23, 2020 to February 21, 2020). In addition, we summarized and analyzed the information of critical patients. All data were analyzed using SPSS 17.0 (SPSS Inc., Chicago, IL, United States). The quantitative and count variables are represented as the mean ± SD and n (%), respectively.RESULTSThe main symptoms and signs of patients with COVID-19 were fever, dry cough, cough with phlegm, difficulty breathing, and respiratory distress with a respiration rate ≥ 30 times/min, finger oxygen saturation ≤ 93% in the resting state, and oxygenation index less than 200 but greater than 100 (after altitude correction). Eighteen patients with COVID-19, of whom three were critical, and the others were in a mild condition, were included. The main manifestations included fever, dry cough, and fatigue. Three patients developed difficulty breathing and had a fever. They were eventually cured and discharged. Adjuvant examinations showed one case with reduced white cell count (6%) (< 4 × 10⁹/L), six with reduced count of lymphocytes (33%) (< 0.8 × 10⁹/L), and one with abnormal blood glucose level. All 18 patients were discharged, and no death occurred.CONCLUSIONOur findings provide critical insight into assessing the clinical diagnosis and treatment for COVID-19 in the Tibetan plateau area.     

NY/MMJ型酶联免疫反应加速仪在高原地区的临床使用

目的在昆明高原地区使用NY/MMJ型酶联免疫反应加速仪,与传统水浴箱两种仪器在使用同种诊断试剂条件下,评价该仪器的临床使用价值。方法依据美国NCCLS方案和《全国临床检验操作规程》,分别对90份乙肝两对半检测、60份丙肝病毒抗体检测、20份癌症标志物定量检测血清实行随机抽样,使用这两种仪器进行孵育反应,并对检测结果进行对比分析。结果NY/MMJ型酶联免疫反应加速仪在酶联免疫吸附分析(ELISA)中缩短反应时间而不影响反应后的结果,同时具有较好的线性、重复性、灵敏度和特异性。结论该仪器操作简易、性能稳定,对临床正确、快速诊断有很大的积极意义。     

Contrast-Enhanced Ultrasound Using Perfluorobutane-Containing Microbubbles in the Assessment of Liver Allograft Damage: An Exploratory Prospective Study

This prospective study investigated the usefulness of contrast (perfluorobutane-containing microbubbles)-enhanced ultrasound in the non-invasive assessment of liver allograft damage. Forty-one liver recipients underwent contrast-enhanced ultrasound followed by a liver biopsy. The hepatic filling rate (time between the arrival of contrast agent in the right hepatic artery and the maximum intensity of hepatic parenchyma) and parenchymal intensity difference before and after instantaneous high-power emission in the Kupffer phase were measured. Patients with allograft damage had higher hepatic filling rates and lower parenchymal intensity differences than those without damage (42.0 ± 16.9 vs. 30.5 ± 7.7 s, p = 0.005; 6.1 ± 7.4 vs. 16.6 ± 16.1 dB, p = 0.047, respectively). In the diagnosis of liver allograft damage, hepatic filling rate and parenchymal intensity difference had sensitivities of 61.5% and 90.9% and specificities of 92.6% and 63.6% using cutoffs of >38.5 s and ≤10.3 dB, respectively. In conclusion, contrast-enhanced ultrasound may be a promising tool in the detection of liver allograft damage.     

TB-DNA和IGRAs对川西高原地区肺结核诊断的适用性分析

目的探讨结核分枝杆菌DNA(TB-DNA)和γ-干扰素释放试验(IGRAs)对川西高原地区肺结核诊断中的适用性。方法选取2018年4月至2019年5月在本院住院的510例肺结核疑似患者,其中肺结核154例,非肺结核组356例,同时行TB-DNA(荧光定量PCR法)和IGRAs(ELISA法)检查,比较两种方法在不同类型肺结核和不同类型标本中的检出率。结果 TB-DNA和IGRAs对川西高原地区肺结核的诊断灵敏度分别为42.9%、73.4%,特异度分别为98.3%、70.2%,TB-DNA在结核性胸膜炎和继发性肺结核中的检出率为21.6%和52.5%,IGRAs在结核性胸膜炎和继发性肺结核中的检出率为58.8%和80.2%,两者联合在结核性胸膜炎和继发性肺结核中的检出率为70.6%和95.0%。3者在继发性肺结核中的检出率均明显高于结核性胸膜炎(P<0.05)。TB-DNA在肺泡灌洗液中检出率最高(66.0%),其次为自然咳痰(33.8%),胸水检出率最低(11.1%),且差异有统计学意义(P<0.05)。肺泡灌洗液TB-DNA与IGRAs结果一致性最好。结论 TB-DNA和IGRAs单独用于川西高原地区肺结核的诊断均不够灵敏,选择合适的标本和共同联合检测可以提高肺结核的检出率,有利于川西高原地区肺结核的早期诊断。     

血浆神经元特异性烯醇酶在脑损伤程度和预后判断的意义

目的 :探讨S -NSE浓度对判断脑损伤的程度和预后的临床价值。方法 :通过酶标法测定 4 0例颅脑损伤病人血清中NSE的含量 ,30例健康体检人S -NSE作为对照组进行研究。结果 :正常对照组NSE含量为 8 15±1 96 (ng/ml) ,研究组S -NSE浓度为 2 4 88± 13 96 (ng/ml) ,研究组S -NSE浓度较对照组明显升高 ,经统计学分析P <0 0 1有显著性差异 ;S -NSE浓度与脑损伤程度和预后相关。结论 :S-NSE浓度是判断脑损伤程度和评价预后的一个敏感指标 ,对重刑脑损伤预测预后比GCS评分更优越和准确     

A Comparison Study of Real-Time Ultrasound Elastography and Electron Microscopy for the Assessment of Liver Damage Induced by Brain Death

The aim of this study was to investigate the specificity and sensitivity of real-time ultrasound elastography (RTE) in the evaluation of liver damage induced by brain death and the correlation with ultrastructural changes in liver tissue. Eleven RTE parameters before brain death and at 0, 3, 6 and 9 h after brain death in 12 miniature pigs were collected and analyzed, and the correlation of these parameters with electron microscopy results was explored. Six of the RTE parameters, namely, mean relative strain value within the region of interest, standard deviation of the relative strain value within the region of interest, area of low strain within the region of interest, complexity of low strain area within the region of interest, skewness and correlation, significantly differed among the time periods. Categorical data were analyzed using the χ²-test. Spearman's correlation analysis was used for evaluating correlations between RTE parameters and electron microscopy results, and the correlation coefficients (r) were calculated. Electron microscopy results revealed that liver damage gradually increased after brain death, with significant differences between 0 and 9 h (χ²?=?14.143, p value?=?0.027). In addition, the six aforementioned RTE parameters significantly correlated with electron microscopy results, with the mean relative strain value within the region of interest being the strongest (r?=?–0.59, p value < 0.001) correlated parameter. RTE could provide preliminary assessment of liver damage induced by brain death, and correlates to ultrastructural changes in liver tissue.     

新生儿采用不同吸痰方法的效果及气道黏膜损伤的观察

目的观察新生儿采用不同吸痰方法的效果和气道黏膜损伤情况。方法将108例新生儿随机分为两组,常规组58例,采用常规负压吸痰;观察组50例,吸痰过程中结合应用解除负压等方法,观察两种吸痰方法效果及对气道黏膜损伤的影响。结果观察组吸痰方法明显优于常规组（P〈0．05）。结论对新生儿吸痰时结合应用解除负压的方法对黏膜损伤较小,值得临床推广应用。