不同方法检测胃黏膜活检标本中幽门螺杆菌感染状况的价值探讨

目的:探讨不同方法在胃黏膜活检标本中幽门螺杆菌(HP)感染检测中的应用价值。方法:对接受胃镜活检的胃黏膜标本500例分别采用快速尿素酶法、HE染色和免疫组化染色法检测,比较活检组织中HP感染情况。结果:免疫组化检测HP感染的阳性率(56.0%)高于快速尿素酶(33.0%)和HE(30.0%),比较差异显著(P0.05);与病理诊断结果对照,免疫组化染色检测各胃黏膜病变HP感染存在差异,其中溃疡病HP感染的阳性率最高。结论:免疫组化染色法检测胃黏膜活检标本中HP感染,所获结果准确可靠,值得加以推广。     

两种检测幽门螺杆菌方法的比较

目前对幽门螺杆菌(HP)感染的诊断已多种方法，我院病理科在HP检测实践中，借鉴文献配制了硼酸美蓝染液，与快速尿素酶试验(HPVT)进行染色比较。现报道如下。     

胆结石患者胆囊黏膜及胆汁和结石中幽门螺杆菌DNA的检测

目的 检测单纯胆囊结石患者胆囊黏膜、胆汁和胆石中的幽门螺杆菌DNA,探讨幽门螺杆菌在胆石的形成过程中的作用. 方法 选用一对来源于幽门螺杆菌特异性尿素酶A基因的引物,用PCR法对52例单纯胆囊结石患者的胆囊黏膜、胆汁和胆石中的幽门螺杆菌DNA进行检测. 结果 胆汁中幽门螺杆菌DNA的阳性率为30.8%(16例),明显高于胆囊黏膜中的15.4%(8例)和胆石中的13.5%(7例). 结论 提示幽门螺杆菌是胆石的形成过程中的重要病原菌之一.     

粪便幽门螺杆菌抗原检测在临床中的应用研究

目的 :评价幽门螺杆菌粪便抗原 (HPSA)检测在诊断幽门螺杆菌 (HP)感染的准确性及治疗后复查价值。方法 :采用酶联免疫分析法检测 10 4例患者粪便幽门螺杆菌抗原 ,以胃粘膜活检标本快速尿素酶试验 ,组织切片染色联合检测作为HP感染的诊断标准 ,对其中 2 7HP感染根治治疗结束后 4周 ,同时复查HPSA和13 C尿素呼气试验。结果 :相对于胃镜检查结果 ,HPSA的敏感性为 93 4 % ,特异性 91 3% ,阳性预测值为97 7% ,阴性预测值为 84 8% ,准确性为 92 2 % ,抗HP治疗结束后 4周复查HPSA和13 C -UBT诊断符合率为 84 7%。结论 :HPSA经济简便 ,可用于HP感染的诊断和抗HP治疗后疗效的评价     

13C-尿素呼气试验对胃癌患者幽门螺杆菌感染的诊断价值

目的 探讨检测胃癌患者幽门螺杆菌(HP)感染的最佳方法.方法 对50例胃镜病理切片确诊为胃癌的患者,并1个月内未曾使用可能影响HP检测结果的药物者同步完成多聚酶链反应(PCR)、快速尿素酶试验(RUT)、13C-尿素呼气试验(13C-UBT)检测.以PCR阳性为诊断HP感染的标准.评价13C-UBT对HP感染的诊断价值.结果 13C-UBT的敏感性100%(34/34),特异性88%(14/16),准确性96%(48/50),阳性预测值94%(34/36),阴性预测值100%(14/14).结论 13C-UBT可作为HP与胃癌相关性研究的有效方法.     

尿素酶比活性定量分析对HP感染的诊断价值

目的 :建立幽门螺杆菌 (HP)尿素酶比活性定量分析法 ,探讨该法对慢性胃病 HP感染的诊断价值。方法 :将患者胃粘膜处理后分别检测 HP尿素酶活性 ,将定量分析法与定性方法 (粘膜涂片革蓝氏染色 ,1min尿素酶试验 ,PCR法和组织学切片 HE染色法 )进行比较。结果 :HP尿素酶比活性平均值在慢性浅表性胃炎 (CSG)慢性萎缩性胃炎(CAG)、胃溃疡 (GU)、十二指肠球部溃疡 (DU)、胃癌 (GC)组分别为 2 80 .2、389.5、342 .7、832 .0、347.5 (u/ dl) ,患者各组的比活性均明显高于正常对照组 (9.1u/ dl,P<0 .0 0 1)。该法定量检测 HP:(1)敏感性为 94.0 % ,接近于 PCR法和尿素酶法 ,而高于涂片法和组织学法。(2 )特异法为 91.1% ,与尿素酶法、涂片法和组织学法相近 ,略高于 PCR法。结论 :本研究资料提示胃粘膜 HP尿素酶比活性定量分析有助 HP感染的诊断更适用于科研及治疗后的动态观察     

尿液抗幽门螺杆菌抗体的检测

目的 :建立检测尿液中抗幽门螺杆菌 (HP)抗体的方法 ,并评价其临床实用性。　方法 :应用酶标记免疫吸附测定技术检测 10 2例患者尿液、唾液和血清抗HPIgG ,根据快速尿素酶试验、HP选择性分离培养和组织切片H E染色确定其HP感染状态。　结果 :尿液、唾液和血清三种标本诊断方法的敏感性、特异性、准确性分别为 96 .7%、87.1%、93.5 % ;93.5 %、83.9%、90 .3%和 95 .2 %、93.5 %、94.6 %。　结论 :以上三种标本诊断方法依据准确性评优排序 ,应是尿液方法 >血清方法 >唾液方法 ;检测尿抗HPIgG方法因其准确、简便、易行 ,应用于流行病学调查尤为可取     

PCR法及快速尿素酶试验检测幽门螺杆菌感染的比较

通过对检测幽门螺杆菌 (Hp)的两种方法 (PCR和快速尿素酶试验 )进行了比较 ,分析了各自的优缺点。应用以上两种方法对 76例消化道疾病患者的胃黏膜标本进行幽门螺杆菌检测 ,两法阳性者认为有 Hp感染。PCR的检出率为 6 8.4% ,快速尿素酶的检出率为 71.1% ,两者的敏感性均为 10 0 % ,特异性分别为 96 %和 88% ,两种检测方法无显著性差异 ;慢性浅表性胃炎、慢性萎缩性胃炎、消化性溃疡 Hp的感染率分别为 71.1%、6 1.3%、81.8%。结果表明 :HP感染与消化性疾病密切相关 ;两种方法都是检测 Hp感染的有效方法 ,临床上应根据具体情况加以选择     

3种方法不同组合诊断幽门螺杆菌感染的比较

目的　探讨联合诊断方法 ,以提高幽门螺杆菌 (helicobacter pylori,Hp)感染的诊断敏感性和特异性。方法　2 5 9例胃镜检查患者除作组织病理检查外 ,在胃窦部取 3块胃粘膜分别作细菌培养、快速尿素酶试验、组织涂片染色。结果　检测方法中以细菌培养阳性率为最高 [76.19% (175 / 2 5 9) ];快速尿素酶试验次之 [5 8.3 % (15 1/ 2 5 9) ];组织涂片染色最低 [5 1.7% (13 4/ 2 5 9) ];后 2项与细菌培养相比有显著性差异。以 3种方法平行检测为金标准 ,细菌培养敏感性为 87.1% (175 / 2 0 1) ,快速尿素酶试验为 75 .1% (15 1/ 2 0 1) ,组织涂片染色 66.7% (13 4/ 2 0 1) ;两两平行检测的敏感性 :细菌培养加快速尿素酶试验为 99.5 % (2 0 0 / 2 0 1) ,细菌培养加组织涂片染色为 89.6% (180 / 2 0 1) ,快速尿素酶试验加组织涂片染色为 85 .1% (171/ 2 0 1)。结论　平行检测可提高 Hp感染诊断敏感性 ,细菌培养加快速尿素酶试验是提高 Hp感染诊断敏感性的一个较理想的组     

14C—尿素呼气试验与硼酸美蓝染色法检测幽门螺旋杆菌的比较

目的回顾分析14C—尿素呼气试验(14C—UBT)与组织学病理染色硼酸美蓝染色法(BAMB)对胃部幽门螺旋杆菌感染诊断的应用价值。方法选择2011年1—12月因胃部不适,如厌食、嗳气、反酸、疼痛,出血等在我院门诊和住院并且在1个月之内没有服用任何抗生素药物及铋剂和质子泵抑制剂的患者400例,进行14C—尿素呼气试验并在胃镜检查时分别取胃窦、胃体、小弯组织进行活检,病理切片作硼酸美蓝染色二次检测,比较两种检测结果的阳性率并进行统计分析。结果 14C—尿素呼气试验检测的阳性结果为285例,阳性率71.3%,硼酸美蓝法检测的阳性结果为266例,阳性率为66.5%,χ2=2.105,P=0.147,因P>0.05尚不能认为两种检测方法的阳性率不等。结论 14C—尿素呼气试验和硼酸美蓝法都是可靠的检测HP的方法,对HP感染具较准确的诊断意义及价值。     

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.     

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.     

The comparative studies of the influences of Urapidil and Nicardipine on sino-atrial node function, atrio-ventricular node function and hemodynamics

Objective:To investigate the influences of urapidil and nicardipine on rabbit sinus function,atrio-ventricular node function and hemodynamics.Methods:Thirty-two Angora's rabbits were selected and randomly divided into four groups.U1 group:urapidil 0.25 mg/kg;U2 group:urapidil 0.5 mg/kg;N1 group:nicardipine 10 μg/kg;N2 group:nicardipine 20 μg/kg.All these medicine were administrated within 30 seconds.Measurements were taken before and after the administration of urapidil or nicardipine for the following data:mean blood pressure(MAP),heart rate(HR),sino-atrial conduction time(SACT),maximal sinoatrial recovery time(SNRTmax)corrected sinus node recovery time(CSNRT),index of sinus node recovery time(SNRTI),Wenckebach A-V conduction frequency (WB),and P-R interval.Results:Significant MAP and HR changes were identified in all of the four groups before and after administration of both urapidil and nicardipine.No significant changes could be found in the rest of the parameters.Intergroup analysis showed that SACT and CSNRT of N1 and N2 groups were shorter than those of the U2 group(P＜0.01);the MAP decreased(P＜0.01)and the HR increased drastically(P＜0.01).Conclusions:Neither urapidil(0.25 mg/kg,0.5 mg/kg)nor nicardipine(10μg/kg,20μg/kg)has any significant influence on rabbit sinus function or rabbit atrio-ventricular node function.Nicardipine could be a better choice than urapidil for parafunctional sinus node patients.     

Expression of OPGmRNA and ODFmRNA in the patients of hip fracture due to osteoporosis

Objective：To investigate the gene expression of osteoprotegerin（OPG） and osteoclast differentiation factor（ODF） in the bone tissue of patients with hip fracture due to osteoporosis. Methods：OPGmRNA and ODFmRNA in the bone tissue in 50 cases of osteoporosis sufferers（over 50 years old） with hip fracture（Observer Group） and 30 cases of hip facture sufferers with no osteoporosis（Control group） were analyzed with the Semi-Quantitative RT-PCR method. Results：The mRNA expressed of ODF, OPG were both high in the patients with hip fracture. In the control group, the expression of OPG mRNA was observed, while the expression of ODF mRNA was very slight. Conclusion：Aged patients contained all signals including OPG, ODF that are essential for inducing osteoclastogenesis and promoting bone resorption.     

Dynamic Changes in Serum Estradiol and Progesterone levels in Patients of Premenstrual Syndrome with Adverse Flow of Liver-qi

Objective:To probe into the influence of changes of ovarian hormones on the pathogenesis of the specific sub-type premenstrual syndrome(PMS)and reveal partial microcosmic mechanisms of adverse flow of liver-qi.Methods:Estradiol(E2)and progesterone(P)levels in serum were determined at different phases of menstrual cycle by radioimmunoassay.Results:In the group of PMS with adverse flow of liver-qi.the secretive peak value Of E2 and P at the follicular phase significantly decreased,and the secretive peak value at the luteal phase did not come into being.Conclusions:Low E2 and P secretive peak at the follicular phase and absence of secretive peak at the luteal phase is one of the microcosmic mechanisms of PMS with adverse flow of liver-qi.One of the pathophysiologic mechanisms of specific sub-type PMS is probably the continuous low level of E2and P.     

Real-time Three-dimensional Echocardiography in Assessment of Left Ventricular and Right Ventricular Volumes

Real-time three-dimensional echocardiography (RT3DE)is a new ultrasound technique that enables dynamic threedimensional visualization and quantification of the heart in real time. Investigation of feasibility and methodology of RT3DE in determining left ventricular (LV) and right ventricular (RV) volumes, RT3DE was performed in 35 normal adults using Philips SONOS 7500 system with a 2-4 MHz matrix array transducer. The 60°×60° "pyramid" volume database was obtained and analyzed on a TomTec echo workstation. Both LV and RV volumes were calculated with four 3DE methods (i.e. apical 2, 4, 8, and 16-plane) through manually tracing ventricular endocardial borders in end diastole and end systole. Stroke volumes were then calculated. LV volume was also measured by 2DE Simpson's rule using GE VIVID 7 ultrasound machine.     

SCREENING FOR A 21-CHROMOSOME ABNORMALITY IN PREIMPLANTED EMBRYOS OF ELDERLY WOMEN

Increasing maternal age is the only etiological factor unequivocally linked to Down's syndrome in humans. The occurrence rate of newborns with Down's syndrome is about 1/220 in women over 35 years old. However, the occurrence rate in embryos fertilized in vitro, of the elder woman is unclear. Using FISH we screened the number of chromosome 21 in preimplanted embryos of 5 elderly women (average age, 38.4 years) to study the feasibility and necessity of screening trisomy 21 in embryos in patients over 35 years old at the in vitro fertilization (IVF) center.     

Scientific principles and rigorous processes should be followed in developing clinical guidelines for therapeutic interventions of integrative medicine

A clinical guideline for the therapeutic interventions of integrative medicine may be defined as a written document which states a series of recommendations on therapeutic interventions of integrative medicine for a special disease or condition. The guideline may provide assistance to medical professionals in making clinical decisions aimed at improving the clinical outcome of patients and reducing the costs of medical care（~＇4~. Recommendations issued by a guideline should be based on the best available evidence in both Western and Chinese medicine. For fulfilling this purpose, the development of clinical guidelines for therapeutic interventions in the field of integrative medicine should follow scientific principles and undergo a rigorous processes.