HBsAg阴性/抗HBc阳性献血员HBV感染状况调查

目的 对431例HBsAg阴性献血员检测抗-HBc、抗-HBs,抗-HBc阳性者196例(45.5％),其中单项抗-HBc阳性者35例(17.9％),抗-HBc/抗-HBs阳性者161例(82.1％)。对抗-HBc阳性者检测抗-HBc IgM和HBV DNA(聚合酶链法),抗-HBc IgM的检出率为32.1％(63/196),其中抗-HBc/抗-HBs阳性者检出率为29.8％(48/161),单项抗-HBc阳性者检出率为42.9％(13/35),二者无差异;HBV DNA检出率为14.8％(29/196),单项抗-HBc阳性者HBV DNA检出率为25.7％,显著高于抗-HBs/抗-HBc阳性者(12.4％)(P<0.05);抗-HBc IgM阳性者HBV DNA检出率(39.7％)也显著高于抗-HBc IgM阴性者(3.0％)(P<0.001),二者阴阳性符合率则为78.6％(154/196)。HBsAg阴性/抗-HBc阳性献血员仍有传染性存在,尤以抗-HBc IgM阳性者最具血源传播HBV的危险性,因此,建议对HBsAg阴性献血员再进一步筛检抗-HBc IgM。     

兰州地区献血员及静脉毒瘾者血清中TT病毒核酸检测及意义

目的 研究兰州地区献血员及静脉毒瘾者中TT病毒(TTV)的感染状况。方法 利用套式PCR技术检测献血员及静脉毒瘾者血清中TTV DNA。结果 献血员中TTV DNA检出率为7.5％(9/120)。静脉毒瘾者中TTVDNA枪出牢为26.8％(15/56),明显高于献血员组,结论 首次报道兰州地区存在TTV感染。静脉毒瘾者为了TTV感染的高危人群,其致病性较弱。关于TTV的病原学、流行病学、病理学及临床意义等有待进一步探索。     

PREVALENCE OF CHAGAS DISEASE AMONG BLOOD DONOR CANDIDATES IN TRIANGULO MINEIRO,MINAS GERAIS STATE,BRAZIL

Despite public health campaigns and epidemiological surveillance activities, Chagasdisease remains a major health problem in Latin America. According to data from theWorld Health Organization, there are approximately 7-8 million people infected withTrypanosoma cruzi worldwide, a large percentage of which in LatinAmerica. This study aims to examine the serological profile of blood donors in bloodbanks of Hemominas hematology center, in the town of Ituiutaba, Minas Gerais State,Brazil. The study sample consisted of 53,941 blood donors, which were groupedaccording to gender and age. Sample collections were performed from January 1991 toDecember 2011, and 277 donors (0.5%) were considered serologically ineligible due toChagas disease. Analysis of data showed no significant difference between genders. Asfor age, the highest proportion of ineligible donors was from 40 to 49 years (30%),and there was a positive correlation between increasing age and the percentage ofpatients seropositive for Chagas disease. Therefore, adopting strategies that allowthe safe identification of donors with positive serology for Chagas disease isessential to reduce or eliminate indeterminate serological results.     

有偿供血员,丙型肝炎及肝癌患者HCV基因分型

为了解本地区ＨＣＶ基因亚型的分布情况，作者对采自６６例有偿供血员、８７例输血后丙型肝炎、１５例散发性丙型肝炎和９例原发性肝癌患者的共１７７份ＨＣＶＲＮＡ阳性的血清标本，进行了ＨＣＶ基因亚型分析。结果发现除２例输血后丙肝患者系ＨＣＶ－Ⅲ感染外，其余被检者均为ＨＣＶ－Ⅱ感染。此结果表明ＨＣＶ－Ⅱ是本地区的ＨＣＶ伏势株     

职业供血人群疟疾发病与控制的研究

本研究在查明供血者疟疾分布特点的基础上,通过对A血型供血者预防性根治后疟疾发病,对有病例的血站分布和“血浆单采术”的实施等情况的调查,以及供血者免疫球蛋白含量测定和疟疾间接荧光抗体试验(IFAT)等结果综合分析阐明:98％以上的供血者疟疾发生在同时采血浆和白细胞的血站,由于血站共用分离白细胞的分浆针造成了间日疟的传播。供血者疟疾的发生随供浆次数的增加和血清IgG含量的下降而增多,供浆后症状的出现随分浆量的增加而提前。在严禁共用分浆针分离白细胞之后,即未见供血者疟疾发生。     

滤纸干血滴间接荧光抗体试验应用于人体包虫病诊断和流行病学调查的研究

1986～1988年我们应用绵羊棘球蚴囊壁冰冻切片抗原作间接荧光抗体试验分别检测了13例包虫病人血清和滤纸干血滴,结果均为阳性,阳性率为100％(13/13);24例健康人血清和滤纸干血滴的阴性率分别为95.8％(23/24)和100％(24/24)。本方法敏感性和特异性较高,可节省抗原材料,采血简便易行,是包虫病较为理想的辅助诊断方法。为了研究其实用价值,我们又检测了甘肃省天祝县251人,漳县242人和会宁县683人,阳性率分别为4.78％(12/251),5.37％(13/242)和1.17％(8/683),其结果与间接血凝试验的结果(阳性率分别为4.78％,4.96％和0.9%)之间无显著性差异(P>0.05)。作者认为将该方法用于包虫病流行区人群的血清流行病学调查,可反映人群包虫病的感染率。     

运动试验收缩压和舒张压反应异常对冠心病的诊断价值及其机制

104例患者接受冠脉造影和平板运动试验,评价运动后SBP恢复比和运动中DBP增量对冠心病的诊断价值。SBP恢复比与DBP增量异常的敏感度与特异度分别为59%、52%与96%、92%,而ST段压低标准则分别为71%与84%。高血压病组中三种指标的假阳性率分别为38%、42%与33%。SBP恢复比与EF呈负相关,与SVR呈正相关,提示运动引起的血压反应异常是左心功能受损和SVR增加所致。     

LONG TERM MANAGEMENT OF HEMORRHAGIC ESOPHAGITIS WITH CIMETIDINE AND OMEPRAZOLE

Abstract We report a patient whose severe recurrent anemia was due to overt and occult hemorrhage from peptic esophagitis. Cimetidine treatment was successful for seven years but dose reduction was followed by intractable hemorrhage which did not respond to H₂-receptor antagonists. Omeprazole therapy produced dramatic remission of symptoms and anemia.     

血胰岛素与少年儿童高血压及盐敏感性的关系

为研究血胰岛素与儿童高血压及盐敏感性的关系，对陕西汉中心血管病防治区经５年随访，年龄１０～１５岁的一组少年儿童共３００名，进行了血浆胰岛素测定及口服盐水负荷试验。发现血压偏高及家族史阳性者，胰岛素明显高于血压正常及家族史阴性者（Ｐ＜０．０１）；胰岛素偏高组５年间收缩血压百分位数保持较高百分位次或呈上升趋势；胰岛素水平与钠负荷及利钠后血压变化幅度正相关（Ｐ＜０．０５）。提示胰岛素抵抗／高胰岛素血症与盐敏感性相关联，在少儿时期已发挥作用，参与高血压的始动机制。     

氟伐他汀对冠心病的微循环及血液流变学影响

目的研究氟伐他汀对冠心病的微循环及血液流变学影响,探讨其降脂以外的作用.方法观察154例冠心痛患者氟伐他汀治疗前后血脂及血液流变学、微循环的改变.结果氟伐他汀对冠心病血脂指标、血液流变学指标、微循环定量评分有明显影响(P＜0.05或P＜0.01).结论氟伐他汀能有效降低冠心病患者血脂水平,同时改善血液流变学异常及微循环障碍,有利于防止冠心病事件及血栓并发症的发生.     

我国消化内镜工作的现状与展望

我国消化内镜工作的现状与展望张志宏内镜工作在我国已有四十余年的发展历史。从硬直式开始，至可曲式、纤维内镜、电子内镜以至超声内镜，发挥了它的积极作用，解决了许多面广量大的消化道和肝、胆、胰等腹腔疾病的诊断和治疗及科学研究工作。它的进步和发展也促进了消化...     

HIGH-DOSE THERAPY WITH PERIPHERAL BLOOD STEM CELL TRANSPLANTATION RESULTS IN A SIGNIFICANT REDUCTION OF THE HaEMOPOIETIC PROGENITOR CELL COMPARTMENT

In order to study the effect of high-dose therapy with peripheral blood stem cell transplantation (PBSCT) on the haemopoietic reserve in man, the number and composition of bone marrow (BM) and peripheral blood (PB)-derived progenitor cells were examined in 137 cancer patients. In 45 patients, paired samples from BM and PB were obtained before PBSC mobilization and 6–27 months after transplantation. Following PBSCT, the proportion of CD34⁺ cells was significantly smaller than before mobilization (BM 1.99±0.24 versus 0.8±0.09, P <0.001), and no change was observed at several follow-up visits thereafter.
The reduction was most pronounced for the primitive BM progenitor subsets such as the CD34⁺/DR⁻ and CD34⁺/Thy-1⁺ cells. The impairment of hematopoiesis was also reflected by a significant reduction in the plating efficiency of BM and PB samples.
No relationship was found between the decrease in the proportion of CD34⁺ cells and any particular patient characteristics, kind of high-dose therapy or the CD34⁺ cell content in the autograft.
In conclusion, high-dose therapy with PBSC transplantation is associated with a long-term impairment of the haemopoietic system. The reduction in the number of haemopoietic progenitor cells is not associated with a functional deficit, as peripheral blood counts post-transplantation were normal in the majority of patients.     

抗疟药咯萘啶与磺胺多辛及乙胺嘧啶配伍治疗恶性疟结果的分析

本文对咯萘啶与磺胺多辛和乙胺嘧啶配伍，多年来在海南和云南的抗药性地区治疗恶性疟的结果进行综合分析，认为这种配伍不宜用于抗药性恶性疟地区的防治。因为：（1）未能明显地延缓恶性疟原虫对该种伍用产生抗药性，纵向监测于用药8年后，出现RⅢ病列，药后24h的减虫率明显下降（P＜0．05）；（2）恶性疟治疗后28d，60％左右的病例仍携带配子体，经大劣按蚊和微小按蚊血餐后，在诞腺中可查见子孢子，表明此种配伍治疗后，会引起恶性疟的传播与扩散。     

AUSTRALIAN HEMOPHILIAC RECIPIENTS OF VOLUNTARY DONOR BLOOD PRODUCTS LONGITUDINALLY EVALUATED FOR AIDS. A CLINICAL AND LABORATORY STUDY, 1983–1986

Abstract One hundred and sixty-one Australian patients with hereditary bleeding disorders comprising hemophilia A (120), hemophilia B (18), von Willebrand's disease (16), and seven symptomatic female hemophilia A or B carriers were screened for clinical and serological evidence of exposure to HTLV-IM/LAV/ARV/HIV infection. During the previous five years (1979–1984) they had been treated almost exclusively with blood products derived from Australian voluntary donors. The prevalence of HTLV-III antibodies in 1985 was 45%, with the highest frequency being in those with severe hemophilia A (78%) and the lowest in patients with hemophilia B (6%). Antibody positivity correlated with a reduced absolute T helper (T4) cell numbers and/or an inverted T4:T8 ratio. Lymphadenopathy was detected in 23 subjects but only 13 had an abnormal T cell ratio. Comparison of seropositivity and T4:T8 ratios in 32 patients studied in 1983 and again in 1985 suggested that T4 cell deficiency reflected HTLV-III exposure rather than being a predisposing factor for infection with the virus. Individual patients showed considerable fluctuation in T cell subsets over a 12 month period of follow-up, but as a population there was a slight trend with time towards diminishing T4:T8 ratio only in the antibody positive hemophilia A patients of mild to moderate severity. Three (2%) of the 161 patients screened to date have developed confirmed AIDS with fatal outcome. Following the introduction of rigid exclusion criteria for donors and heat treatment of Australian lyophilised concentrates in late 1984, no antibody negative subjects have seroconverted. To date none of 15 regular sexual partners of antibody positive patients have been consistently seropositive and four clinically well, antibody negative babies have been born to antibody positive fathers.     

老年急性重症胆管炎的诊治分析

目的分析老年急性重症胆管炎的特性及提高治疗水平。方法回顾性分析1999年1月至2004年12月小科收治的56例急性重症胆管炎的临床病例。结果7例行ERCP＋EST取石或ERCP放置胆道支架,余49例急诊手术,25例发生呼吸系统并发症,其中2例因ARDS死亡,3例发生急性心衰,胆总管残余结行2例,外科并发症较少发生。结论老年ACST患者器官功能衰退,术前合并症多,给诊断和治疗带来一定的困难。但只要积极术前准备,及时手术．术后加强监护．处理合并疗及并发疗．便可以获得良好的治疗效果．     

老年高血压患者血压昼夜节律与颈动脉粥样硬化的相关性研究

目的探讨老年高血压患者血压昼夜节律与颈动脉粥样硬化的相关性。方法2003￣2004年来我院老年高血压患者共72例(男68例女4例),根据动态血压监测(ABPM)结果分为正常昼夜节律组,即杓型组(n=37,男35例女2例)和异常昼夜节律组,即非杓型组(n=35,男33例女2例)。对所有患者均行颈动脉超声检查,测定右侧颈总动脉(RCCA)、颈内动脉(RICA)内膜中层厚度(IMT)、管腔内径(D),并计算各自的IMT/D值,测定右侧颈动脉分叉处(RBIF)的IMT,观察并记录双侧颈动脉系统斑块的大小、数量。结果(1)两组年龄(Age)、体重指数(BMI)、总胆固醇(TC)、甘油三酯(TG)、全天平均收缩压(24hMSP)、全天平均舒张压(24hMDP)比较均无显著性差异(P>0.05)。(2)两组的RCCA及RICA的IMT、D、IMT/D比较均无显著性差异(P>0.05)。而右颈动脉分叉处IMT,非杓型组明显高于杓型组(P<0.001)。(3)两组总斑块检出率无显著差异,但多发性斑块检出率非杓型组显著高于杓型组(P<0.05)。结论老年高血压患者血压昼夜节律与颈动脉粥样硬化明显相关,异常的血压昼夜节律提示可能存在更严重的靶器官损害。     

原发性高血压患者血压昼夜节律与细胞因子的相关性研究

目的观察昼夜血压呈杓型、非杓型分布的高血压病患者血浆中细胞因子的变化,探讨细胞因子与血压昼夜节律的相关性。方法经动态血压监测将84例高血压病患者分为杓型组35例,非杓型组49例,采用双抗体夹心ELISA法分别测定血清白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)、γ-干扰素(IFN-γ),可溶性白细胞介素-2受体(sIL-2R)水平。结果非杓型组与杓型组比较,IL-6、TNF-α、sIL-2R明显升高(P<0.001;P<0.001;P<0.001),IFN-γ明显降低(P<0.01);夜间血压下降与IL-6、TNF-α、sIL-2R负相关[收缩压(SBP)与IL-6:r=-0.347,P<0.01;SBP与TNF-α:r=-0.427,P<0.005;SBP与sIL-2r:r=-0.309,P<0.01;舒张压(DBP)与IL-6:r=-0.292,P<0.05;DBP与TNF-α:r=-0.462,P<0.005;DBP与sIL-2R:r=-0.278,P<0.05];夜间血压下降与IFN-γ正相关(SBP与IFN-γ:r=0.263,P<0.05;DBP与IFN-γ:r=0.241,P<0.05)。多元线性回归分析,IL-6、TNF-α、sIL-2R与夜间血压下降直线相关(SBP:F=6.742,P<0.005;DBP:F=6.138,P<0.005)。结论血压昼夜节律异常的高血压病患者存在细胞因子水平升高,细胞因子可能参与血压昼夜节律的调节。