腺病毒感染50例临床分析与治疗

目的 总结小儿腺病毒感染的临床特点及治疗经验.方法 收集腺病毒感染患儿50例,分析其临床症状,实验室检查诊治经过.结果 50例腺病毒感染患儿中,肺炎发病率最高(30例),其次为急性毛细支气管炎,上呼吸道感染,扁桃体炎等.主要症状发热,咳嗽,肺部异常呼吸音.2例患儿合并心肌炎,1例合并中毒性脑病.全部患儿鼻咽分泌无检查证实为腺病毒感染,部分患儿合并其他病毒或细菌感染,X光胸片及CT出现肺部浸润22例,肺功能检查5例异常,50例住院患儿中40例使用抗生素,仅10例单纯抗病毒及支持治疗,7例重症肺炎患儿加激素及静脉丙种球蛋白治疗,除1例出现支气管扩张外,均治愈出院.结论 小儿呼吸道腺病毒感染发热时问长,临床表现多样,重症肺炎患儿常并发多种细菌感染和存在肺外表现,治疗上可酌情在抗病毒的同时加用抗生素,激素及丙种球蛋白等综合治疗.     

上海市男性同性恋HIV感染者中乙型肝炎、丙型肝炎病毒的合并感染情况横断面研究

目的 探讨男性同性恋HIV感染者中乙型肝炎病毒（HBV）、丙型肝炎病毒（HCV）的合并感染情况。方法 选择2016年1月~2018年1月在本区域内进行治疗的男性同性恋HIV感染者157例,以横断面调查的方法进行研究,收集所有入组患者的性别、年龄、文化程度、感染途径等资料。对所有患者HBV抗体、HCV抗体进行检测。结果 不同感染途径人群合并感染发生率对比,差异具有统计学意义（P＜0.05）:同性性行为患者单纯HIV感染发生率最高,吸毒患者HIV+HBV感染率最高,输血患者HIV+HCV感染率最高,HIV+HBV+HCV感染率最高者为吸毒患者。不同学历合并感染发生率对比,差异具有统计学意义（P＜0.05）:大专及以上的患者以HIV单纯感染为主,高中及中专患者以HIV和HIV+HBV为主,初中及以下的患者则以合并感染为主。不同职业合并感染发生率对比,差异具有统计学意义（P＜0.05）:单纯HIV感染患者以自由职业及职员为主,职员在HIV+HBV感染发病率高于自由职业者及农民,农民在HIV+HCV及HIV+HBV+HCV的发病率均高于其他职业患者。结论 男性同性恋HIV感染者中乙型肝炎病毒、丙型肝炎病毒合并感染发生率均较高,患者感染途径、文化程度及职业的不同,合并感染情况均有显著差异。     

52例肌萎缩侧索硬化症的临床及肌电图分析

目的：探讨肌萎缩侧索硬化（ALS）的临床表现及肌电图（EMG）特点,企为早期诊断提供依据。方法：回顾性研究近3年来收治的52例ALS患者的一般资料、临床表现、EMG及其它实验室检查,分析其发病特点、临床特征及EMG特点。结果：50例为散发病例,2例有ALS家族史。男性36例,女性16例,平均发病年龄54．67岁,平均病程13．69个月。起病形式均为缓慢起病,逐渐加重。几乎均以肢体肌无力、肌萎缩为首发症状,大部分患者肢体远端症状重于近端。主要临床表现为肢体肌和舌肌无力、萎缩及肌束震颤、锥体束征、构音障碍、呛咳及吞咽困难。无感觉障碍。EMG表现为广泛神经原性异常。颈椎磁共振（MRI）示74％的患者合并颈椎病。结论：ALS的诊断主要依靠临床表现及EMG检查。EMG、MRI及一些血液学检查是诊断及鉴别诊断该病的重要辅助检查手段。     

胸腺瘤病例回顾分析

目的分析胸腺瘤临床表现及消化系统症状的发生率。方法回顾性分析173例胸腺瘤临床资料。结果胸腺瘤常见首发症状是肌无力(53.75%)和肿瘤所致胸部不适症状(22.54%),部分患者体检偶然发现(13.29%)。患者具有突出的自身免疫倾向,可检测到多种自身抗体并伴随多种与免疫异常有关的疾病(副肿瘤综合征):神经系统疾病58.95%(重症肌无力56.65%)、内分泌疾病5.78%、第二肿瘤4.62%、血液系统疾病6.37%、结缔组织病1.73%、消化系统疾病1.16%。消化系统症状总发生率9.83%(17/173),以慢性腹泻最多(5.78%),多数腹泻病因不明。结论胸腺瘤具有突出的自身免疫倾向,临床表现差异大,伴随多种与自身免疫相关的疾病。不明原因的慢性腹泻常见,似与自身免疫性肠病有关。     

HIV感染者中结核杆菌ESAT-6蛋白特异性T细胞反应的检测

目的 检测结核杆菌抗原早期分泌抗原靶分子(ESAT-6)融合蛋白其在人类免疫缺陷病毒感染患者中特异性T细胞反应,从而为艾滋病合并结核杆菌感染的诊断方法的建立提供理论依据.方法利用重组表达结核杆菌ESAT-6蛋白做为抗原,通过酶联免疫斑点技术(ELISPOT)检测HIV感染者中特异性T细胞反应,并以正常健康者、无HIV感染的结核患者作为对照.结果 ESAT-6重组蛋白对结核患者外周血单核细胞ELISPOT方法检测证实其具有良好的抗原性,斑点形成单位数(SFU/106 PBMC)在结核组和HIV合并结核感染组中显著升高,并与无合并结核感染临床表现的HIV组以及健康对照组间均存在明显的差别.结论重组结核杆菌ESAT-6蛋白可以作为抗原通过ELISPOT方法检测HIV感染者中结核杆菌合并感染.     

苄星青霉素在HIV感染合并梅毒中的临床疗效观察

目的 观察苄星青霉素治疗HIV感染合并梅毒临床效果,为临床用药提供参考。方法 选取我院2016年8月~2017年11月收治的HIV感染合并梅毒患者50例作为观察组,另外选择同期梅毒患者50例作为参照组,两组患者均行苄星青霉素治疗,观察两组患者滴度血清转阴情况,评价其临床疗效。结果 观察组治疗第3、6、9、12个月后有效率分别为80.00%、84.00%、88.00%、92.00%,参照组治疗第3、6、9、12个月后有效率分别为82.00%、86.00%、90.00%、96.00%,组间对比差异无统计学意义（P＞0.05）。结论 苄星青霉素治疗HIV感染合并梅毒的效果确切,且与治疗单纯梅毒感染疗效相当。     

HIV感染合并IgA肾病4例临床和病理分析

目的 研究HIV感染合并IgA肾病患者的临床和病理特点及治疗转归.方法 选择2002-2012年在北京协和医院住院的HIV感染合并肾脏损害,并经肾脏活检证实为IgA肾病的4例患者为研究对象,回顾分析这4例IgA肾病患者的临床、病理资料及治疗随诊情况.结果 4例患者均有不同程度蛋白尿和镜下血尿,血肌酐水平在正常范围,肾脏活检病理提示为不同程度的IgA肾病.4例患者均接受了高效联合抗反转录病毒治疗(HAART).3例患者的初始治疗使用了ACEI/ARB,其中2例效果不佳联合使用糖皮质激素治疗.1例肾脏病变好转后再次出现大量蛋白尿,考虑与抗病毒药物替诺夫韦有关,调整抗病毒治疗后再次缓解.治疗过程中所有患者的HIV病毒复制并未增加.结论 HIV感染合并肾脏病变除了经典塌陷型FSGS之外还可以合并IgA肾病,肾脏活检有利于明确诊断并指导治疗.     

急性阑尾炎合并艾滋病患者临床病理特点及其对手术方式的影响

目的 探讨艾滋病患者阑尾炎病理分型特点及与临床手术方式选择的关系。方法 将2013年3月~2018年3月在广州市第八人民医院外科住院治疗的37例急性阑尾炎合并艾滋病患者设为实验组,选取同期同科室治疗的非HIV感染阑尾炎患者50例设为对照组,比较两组病理类型、临床表现和手术方式等方面特点。结果 与非HIV感染患者相比较,艾滋病患者急性阑尾炎病理类型包括急性化脓性阑尾炎、急性坏疽性阑尾炎、结核,马尔尼菲蓝状菌病,巨细胞性病毒性肠炎;其中结核,马尔尼菲蓝状菌病,巨细胞病毒性肠炎发病率高于非HIV患者,差异有统计学意义（P＜0.05）,在艾滋病患者中,导致患者腹腔镜手术中转开腹的主要病理类型包括结核、马尔尼菲蓝状菌病和急性坏疽性阑尾炎。结论 艾滋病患者急性阑尾炎病理类型包括急性化脓性阑尾炎、急性坏疽性阑尾炎、结核、马尔尼菲蓝状菌病、巨细胞病毒性肠炎;其中结核、马尔尼菲蓝状菌病和急性坏疽性阑尾炎等是艾滋病患者LA中转开腹的主要病理类型;术前建立合理的评判标准有助于减少中转开腹可能。     

人免疫缺陷病毒相关免疫性血小板减少症

人免疫缺陷病毒(HIV)是种还原病毒,它感染人T 淋巴细胞,通过逐步破坏T辅助细胞,使受感染病人处于免疫缺陷状态。此时,可伴发各种肿瘤和机会致病菌感染,它就是获得性免疫缺陷综合征(AIDS)。HIV 引起的感染有时临床症状不明显如免疫性血小板减少症(ITP)。ITP 与HIV 感染的关系早在1980年已有论述,90%以上有血小板减少症的同性恋男子有抗HIV 抗体,30%无血小板减少症的同性恋男子有HIV 感染证据。ITP 是种不常见的自身免疫综合征,其确切机制尚不清楚,但有证据表明由HIV 感染产生特异的血小板抗原。大部分病人有紫癜,容易挫伤、齿龈出     

135例HIV/AIDS患者合并HBV或/和HCV感染的分析

由于HIV、HBV、HCV传插途径类似,所以HIV感染者合并HBV和/或HCV感染并不少见.由于HBV,HCV引发的肝脏疾病是HIV感染者病死的原因之一.本文旨在调查135例HIV/AIDS患者HBV、HCV合并感染情况及分析慢性HCV感染对HIV疾病的影响.     

Renal dysplasia and asplenia in two sibs

A family is reported in which two sibs, one male and the other female, both died within 24 hours of birth with enlarged polycystic kidneys. Postmortem histology in the second child showed gross renal dysplasia. In both children the pancreas was enlarged, nodular and cystic but the liver appeared macroscopically normal. In the second child, histological examination confirmed pancreatic fibrosis with cystic dilation of ducts, but showed portal fibrosis with bile duct proliferation in the liver.
This combination of findings is very reminiscent of those in a girl and her brother reported by Ivemark et al. (1959). The children reported here also showed absence or hypoplasia of the spleen, cardiac anomalies and other features of the Ivemark syndrome (Ivemark 1955), a quite different, usually sporadic, congenital disorder. It is suggested that the children described here have a distinct lethal congenital disorder, probably inherited in an autosomal recessive manner.     

Schizophrenia in a North Swedish geographical isolate, 1900–1977. Epidemiology, genetics and biochemistry

Over 200 schizophrenic patients belonging to three major and interrelated pedigree complexes have been investigated over the past 30 years in a North Swedish geographically isolated population, presently numbering about 6,000. An intensive investigation of a number of biochemical correlates and genetic markers in a few selected families belonging to one of the major pedigrees has indicated new strategies for the current research program.
Schizophrenia, as defined operationally, is significantly associated with decreased activities of two enzymes (1) blood platelet monoamine oxidase, (2) plasma dopamine-β-hydroxylase, and (3) with the genetic marker Gc² (group specific antigen). Both enzymes are subject to genetic variation. A positive score for linkage between schizophrenia and low plasma DBH activity has been calculated, but, so far, available data are insufficient for discrimination between linkage and partial contribution of genetically controlled low plasma DBH to the pathogenesis of the disease. Alternatively, both mechanisms could be involved.
As a model for continued research, schizophrenia is explained as based on a double dominant-recessive genotype (Aabb), representing a vulnerability which in about 50 % of cases develops into clinical schizophrenia. It is suggested that the dominant mutation (A) operates on or affects MAO activity, and that the recessive genotype (bb) is instrumental in low variates of DBH activity and very likely such variates within the normal range of physiological variation. Moreover, it is suggested that the combined effects of MAO- and DBH-reduced efficiency on the metabolism of e.g. dopamine could be an essential pathogenic mechanism for the schizophrenic illness which is segregating in this population.     

The dominant diseases of modernized societies as omega-3 essential fatty acid deficiency syndrome: Substrate beriberi

About 1900, modern food selection and processing caused widespread $\text{epidemics}$ of the B vitamin deficiency diseases of beriberi and pellagra which, for genetic reasons, often expressed as different diseases ranging from bowel and heart disease to dermatoses and psychoses. But the B vitamins merely help convert essential fatty acids (EFA) into the prostaglandin (PG) tissue regulators and it now turns out that, through hydrogenation, milling and selection of w3-poor southern foods, we have also been systematically depleting, by as much as 90%, a newly discovered trace Nordic EFA (w3) of special importance to primates and sole precursor of the PG3(4) series, even as a concurrent fiber deficiency increases body demand for EFA. Since substrate EFA is processed by many B vitamin catalysts, an EFA deficiency will mimic a $\text{panh}$ypovitaminosis B, i.e., a mixture of $\text{substrate}$ beriberi and $\text{substrate}$ pellagra resembling vitamin beriberi and pellagra but exhibiting as even more diverse $\text{endemic}$ disease. This would consitute a second stage of the Modern Malnutrition and explain why some workers now hold the dominant diseases of modermized societies to be new, nutritionally based, pellagraform yet lipid-related and to range, once again, from heart disease to psychosis. It is an assumption that our dominant diseases are unrelated to each other or are merely revealed by our diagnostic acumen and therapeutic success; and that hydrogenating millions of tons of food oils annually, to destroy the rancidity producing w3-EFA, is safe for $\text{primates}$. Extensive beriberiform disease is reported here in 32 typical cases taken from medical practice which responds strikingly to linseed oil supplements (60% w3-EFA) in confirmation of identical results in Capuchins.     

What will studies of Fulani individuals naturally exposed to malaria teach us about protective immunity to malaria?

There are an estimated over 200 million yearly cases of malaria worldwide. Despite concerted international effort to combat the disease, it still causes approximately half a million deaths every year, the majority of which are young children with Plasmodium falciparum infection in sub-Saharan Africa. Successes are largely attributed to malaria prevention strategies, such as insecticide-treated mosquito nets and indoor spraying, as well as improved access to existing treatments. One important hurdle to new approaches for the treatment and prevention of malaria is our limited understanding of the biology of Plasmodium infection and its complex interaction with the immune system of its human host. Therefore, the elimination of malaria in Africa not only relies on existing tools to reduce malaria burden, but also requires fundamental research to develop innovative approaches. Here, we summarize our discoveries from investigations of ethnic groups of West Africa who have different susceptibility to malaria.     

'Very sore nights and days': the child's experience of illness in early modern England, c.1580-1720

Sick children were ubiquitous in early modern England, and yet they have received very little attention from historians. Taking the elusive perspective of the child, this article explores the physical, emotional, and spiritual experience of illness in England between approximately 1580 and 1720. What was it like being ill and suffering pain? How did the young respond emotionally to the anticipation of death? It is argued that children’s experiences were characterised by profound ambivalence: illness could be terrifying and distressing, but also a source of emotional and spiritual fulfilment and joy. This interpretation challenges the common assumption amongst medical historians that the experiences of early modern patients were utterly miserable. It also sheds light on children’s emotional feelings for their parents, a subject often overlooked in the historiography of childhood. The primary sources used in this article include diaries, autobiographies, letters, the biographies of pious children, printed possession cases, doctors’ casebooks, and theological treatises concerning the afterlife.     

Guidelines for the Validation and Use of Immunoassays for Determination of Introduced Proteins in Biotechnology Enhanced Crops and Derived Food Ingredients

Recent advancements in agricultural biotechnology have created a need for analytical techniques to determine introduced proteins in crops enhanced through modern biotechnology techniques. These proteins are expressed in plant tissues and may be present in food ingredients. Immunoassays are ideally suited for protein detection and may be used as both quantitative and threshold methods. Microplate ELISA and lateral flow devices are two of the most commonly used immunoassay formats for agricultural biotechnology applications. This paper provides general background information and a discussion of criteria for the validation and application of immunochemical methods to the analysis of proteins introduced into plants and food ingredients using biotechnology methods. It is the result of a collaborative effort of members of the Analytical Environmental Immunochemical Consortium. This collaborative effort represents the combined expertise of several organizations to reach consensus on establishing guidelines for the validation and use of immunoassays. Further, the paper offers developers and users a consistent approach to adopting the technology as well as aid in producing accurate and meaningful results.     

HLA in North Colombia Chimila Amerindians

HLA-A,-B,-C,-DRB1 and -DQB1 alleles have been studied in Chimila Amerindians from Sabana de San Angel (North Colombian Coast) by using high resolution molecular typing. A frequent extended haplotype was found:HLA-A*24:02-B*51:10-C*15:02-BRB1*04:07-DQB1*03:02 (28.7%) which has also been described in Amerinndian Mayos Mexican population (Mexico, California Gulf, Pacific Ocean). Other haplotypes had already been found in Amerindians from Mexico (Pacific and Atlantic Coast), Peru (highlands and Amazon Basin), Bolivia and North USA. A geographic pattern according to HLA allele or haplotype frequencies is lacking in Amerindians, as already known. Also, five new extended haplotypes were found in Chimila Amerindians. Their HLA-A*24:02 high frequencies characteristic is shared with aboriginal populations of Taiwan; also, HLA-C*01:02 high frequencies are found in New Zealand Maoris, New Caledonians and Kimberly Aborigines from Australia. Finally, this study may show a model of evolutionary factors acting and rising one HLA allele frequency (-A*24:02), but not in others that belong to the same or different HLA loci.     

Ultracryotomy: development and application (with examples from the yeast cytology) (author's transl)

The preparation steps usually necessary for obtaining ultrathin frozen sections of biological material (chemical prefixation, enclosing, cryoprotective treatment, freezing, sectioning, and post-staining the sections for transmission electron microscopy) are submitted to a critical analysis. The application of cryo-ultramicrotomy, in particularly for cytochemical purposes, is reviewed. Fundamental considerations of chemical prefixation and poststaining are supported by examples from yeast cytology. Furthermore, the efficiency of the cryo-ultramicrotomy (electron optical resolution of ultrastructural details) is demonstrated on yeast cells and protoplasts.     

The universal muscular chamber. A basic unit of the genitourinary, cardiovascular, gastro-intestinal, skeletal, cutaneous, respiratory and other systems, endocameral hypertension; and spasm, the key to their idiopathic diseases and arthropathies

Starting with the integument, we see many organs are contractile sacs or multiples thereof, which tubes or bags constitute the major part of the entire body. Recognition of this basic unit and its characteristics sheds new light, individually and collectively, on many disorders previously considered unrelated. Muscular tears and perforations develop in the walls of these chambers, being no way peculiar to those organs, wherein, hydrochloric acid occurs. So, it is not necessary to explain the absence of excessive acid from patients who exhibit holes in the gastric, uterine, aortic, duodenal, rectal, pulmonary, retina, and other walls. Muscle, not acid is the great common factor relating idiopathic disorders in the gastrointestinal tract to each other and to similar diseases in other systems. When the units are linked together, the lesions tend to appear as arthropathies, i.e. at the joints. Rephrasing common-place observations, frees us from conventional, conceptual cul-de-sacs. An observation is only as good as its interpretation, so all possibilities must be considered, otherwise, we will remain blinded by our misconceptions.