两种不同含量头孢呋辛治疗急性细菌性感染的成本--效果比较

目的 比较两种不同含量的头孢呋辛治疗急性细菌性感染的成本-效果。方法 用随机对照方法，40例急性呼吸道感染和20例急性泌尿道感染的患者，每组各30例，两种不同含量的头孢呋辛每次均1．5g，静点，bid，疗程5d。结果 两种不同含量的头孢呋辛治疗急性呼吸道感染和急性泌尿道感染的总有效率分别为90％和85％（呼吸），90％和100％（泌尿），2组比较无显著性差异（P〉0．05），但药品费用比较有显著性差异（P〈0．05）。结论 两种不同含量的头孢呋辛临床疗效相同，但是0．75g含量费用较低。     

中西医结合治疗复发性支原体感染性阴道炎的疗效观察

探明中西医结合治疗复发性支原体感染性阴道炎的治疗效果。方法：以随机的方式将118例复发性支原体感染性阴道炎患者分为二组，其中中西医结合组56例，用五味消毒饮加减口服及中药煎剂局部外洗坐浴，加用强力霉素0．1g，每日2次，2周为1疗程。强力霉素组以单用强力霉素口服剂量及疗程与前述相同。治疗后2周及1个月分别作支原体培养复查，治疗后2个月门诊随访并每周1次，连续3次运用FQ—PCR对阴道分泌物中的支原体基因水平进行追踪检测，比较两组的检测结果，评价其疗效。结果：治疗后2周及1个月，中西医结合组和单用强力霉素组，支原体培养的转阴率分别为100％和87．1％及100％和88．7％，有显著性差异（P〈0．01）。治疗后2个月追踪检测结果显示，中西医结合组和单用强力霉素组3次检测支原体基因的水平（％±5×10‘拷贝／llll）分别为2．54＂4-1．41，2．51±1．52，2．62士1．31和3．61±1．31，3．85±1．92，3．91±2．01，与治疗前的水平比较，均有显著性差异（P〈0．001），两组间比较发现中西医结合组3次基因水平均明显低于强力霉素组（P〈0．05—0．01），同时发现两组3次基因水平连续〈5×10。拷贝／ml，分别为53例和50例，其治愈率分别为94．6％（53／56）和80．1％（50／62），有显著性差异（P〈0．01），说明中西医结合组的疗效显著高于强力霉素组。结论：中西医结合治疗复发性支原体感染性阴道炎协同作用明显，疗效显著。     

米氮平和氟西汀治疗伴抑郁的心血管神经症的临床观察

目的：评价米氮平治疗伴抑郁的心血管神经症的临床疗效和安全性。方法：将60例伴抑郁的心血管神经官能症患者随机分为米氮平组和氟西汀组，进行为期42天的治疗观察。采用汉密顿抑郁量表（HAMD）、心血管神经症积分评价临床疗效，采用TESS、体检及实验室检查评价安全性，分别在治疗前和治疗后第7、14、28、42天评定疗效和不良反应。结果：（1）两组治疗后HAM／）和心血管神经症积分均明显低于治疗前，差异有统计学意义（P〈0．01）。（2）治疗后第7天，米氮平组HAMD量表总分、焦虑评分、迟滞评分、睡眠紊乱评分、心血管神经症积分均较氟西汀组低，且有统计学意义（P〈0．01）；研究结束时，上述指标的组间差异没有统计学意义。（3）经过42天治疗，有效率和治愈率米氮平组分别为83．3％和66．7％，氟西汀组分别为80．0％和63．3％，差异没有统计学意义（P〉0．05）。（4）安全性评定：两组比较差异无统计学意义（P〉0．05）。结论：米氮平治疗伴抑郁的心血管神经症有效而安全，且起效时间早于氟西汀。     

沙眼衣原体和解脲支原体感染与不育不孕症的相关性研究

目的：了解重庆地区不育不孕患者中CT，UU的感染情况。方法：用PCR方法检测不育不孕患者中CT，UU－DNA。结果：不育不孕症组230例中，CT阳性率为45％（103／230）；UU阳性率为56．5％（130／230）；对照组103例中CT阳性率为7．8％（8／103）；UU阳性率为10．7％（11／103）。两者差异有极显著性（P＜0．01）。结论：CT，UU感染可引起不育不孕，用相应的抗菌素治疗可恢复妊娠生育。     

58例内镜逆行胰胆管造影术患者医院感染特点及护理

目的分析内镜逆行胰胆管造影术（endoscopic retrograde cholangiopancreatography,ERCP）患者医院感染的特点及护理对策。方法随机抽取2011年l至12月ERCP发生医院感染58例患者的病例,对其数据进行统计分析,同时对护理相关问题进行讨论。结果ERCP患者发生医院感染率为12．1％（58／479）,同期住普通病房患者医院感染率为4．4％（36／812）,前者住院感染率明显高于后者（P〈0．05）。无论ERCP患者还是普通病房患者,呼吸道和泌尿道感染均是医院感染最常发生的部位,ERCP医院感染主要发生在呼吸道（67．2％）,其次是泌尿道（29．3％）,其构成比与普通病房接近。ERCP患者医院感染患者58例中死亡5例（8．6％）,高于普通病房的5．6％（2／36,P〈0．05）。结论ERCP患者医院感染率明显高于普通病房,感染部位主要是呼吸道和泌尿道,预防ERCP患者医院感染是防治工作重点,有效的护理措施可以降低ERCP患者医院感染发生率。     

泛昔洛韦治疗HBV慢性感染的临床研究

目的：观察泛昔洛韦对HBV慢性感染抗病毒的治疗效果。方法：慢性乙型肝炎患者89例，采用随机对照分组，和单用泛昔洛韦治疗组32例，和单用α－干扰素29例和单用拉米夫定28例两个对照组，对比观察三组抗病毒治疗效果。结果：治疗组泛昔洛韦血清HBV DNA阴转率40．62％（13／32），HBeAg阴转率21．88％（7／32）；对照组α－干扰素血清HBV DNA阴转率37．93％（11／29），HBeAg阴转率41．38％（12／29）；拉米夫定血清HBV DNA阴转率67．90％（19／28），HBeAg阴转率21．43％（6／28）。治疗组HBV DNA阴转时间最短1个月，最长3个月，平均1．3个月，无1例出现严重不良反应。结论：泛昔洛韦治疗HBV慢性感染安全有效。     

Twist基因蛋白表达在甲状腺乳头状癌诊断与鉴别诊断中的意义

目的探讨Twist基因蛋白在甲状腺乳头状癌中的表达状况,寻找更特异的标记物,用于甲状腺乳头状癌（PTC）与滤泡状腺瘤（FA）和良性乳头病变（BPL）的鉴别诊断。方法以50例PTC为研究组,以48例FA和47例BPL作对照组。在自制组织芯片上行免疫组织化学（SP法）标记,检测Twist基因蛋白和HBME-1,并以CK19进行对照。结果3种指标（Twist、HBME-1、CK19）阳性表达率：在PTC组分别为100％（48／48）、94．0％（47／50）和78．0％（39／50）;在FA组分别为0、6．7％（3／45）和0;在BPL组分别为7．0％（3／43）、2．1％（1／47）和0。PTC组分别与FA和BPL组比较差异均有统计学意义（P=0．000）。3种指标在鉴别诊断甲状腺良、恶性病变的灵敏度分别为：100％、96．4％和97．7％,特异度分别为：94．0％、95．7％和95．1％,准确度分别为：78．0％、100％和91．9％。结论Twist可应用于辅助诊断PTC,并可应用在对FA或BPL的鉴别诊断。     

聚乙二醇干扰素α-2a治疗HBeAg阳性慢性乙型肝炎的疗效和安全性

目的 探讨聚乙二醇α-2a干扰素（PEG INFα-2a）治疗HBeAg阳性慢性乙型肝炎的疗效和安全性。方法 按随机对照原则选择80例HBV DNA、HBeAg阳性的慢性乙型肝炎患者，按1：1随机分配进入PEG INFa-2a组和IFNα-2a组。结果 治疗6个月时，PEG INFα-2a组HBeAg血清转换率（45．7％）高于IFNα-2a组（35．1％），但P〉0．05。停药6个月后，持续的HBeAg血清转换率分别为48．6％和37．8％，P〉0．05。停药6个月后，持续的HBVDNA阴转率分别为62．9％和45．9％，P〉0．05。治疗后，两组的丙氨酸转氨酶（ALT）复常率差异无显著性，为62．9％和45．9％，停药后6个月，两组的联合应答率分别为57．1％和40．5％。PEG INFα-2a组有3例患者HBsAg阴转，而IFNα-2a组仅有1例患者HBsAg阴转。两组有相似的不良反应，不良反应间差异无统计学意义，两组治疗过程中均未发生重要的不良事件。结论PEG INFα-2a治疗HBeAg阳性的慢性乙型肝炎疗效优于普通干扰素IFN-2a，耐受性和安全性好。     

新生儿感染性疾病粒细胞集落刺激因子水平的测定

采用酶联免疫吸附试验（ELISA）测定180例新儿感染性疾病血清粒细胞集落刺激因子（G－GSF）水平，同时作血培养、C反应蛋白（CRP）、白细胞计数。结果表明：阳性率分别为：G－CSF73．9％、CRP50．5％、血培养21．1％。G－CSF阳性率明显高于后二者，差异显著（P均＜0．05）。败血症组、其他感染组、肺炎组的G－CSF阳性率分别为93．9％、85．1％、51．7％。粒细胞值＞10×109／L，G－CSF阳性组达81．2％，阴性组仅18．8％，尤其在抗感染治疗以前意义更大。提示应用ELISA技术测定G－CSF阳性率高，G－CSF水平对鉴定新生儿细菌感染具有较高的敏感性和实用价值。     

抗炎霜治疗湿疹及皮炎的临床疗效观察

目的 观察抗炎霜治疗湿疹、皮炎的临床疗效，确定其临床应用价值。方法 将984例湿疹、皮炎病例随机分成治疗组和对照组，每组各492例。治疗组给予抗炎霜治疗，每天早晚各1次，外搽患处；对照组用皮炎平软膏外用，用法与治疗组相同。两组疗程均为2周。结果 治疗组：痊愈178例（36．10％），显效230例（46．70％），好转67例（13．60％），无效17例（3．50％），有效率82．90％；对照组：痊愈118例（24．00％），显效190例（38．60％），好转151例（30．70％），无效33例（6．70％），有效率62．60％。两组有效率比较有显著性差异（P〈0．05）。结论 抗炎霜治疗湿疹、皮炎效果好，起效快，安全性良好。     

Single agent therapy for infections in cancer patients: A prospective randomized trial comparing three extended-spectrum cephalosporins

Three hundred and twenty patients were enrolled in a prospective randomized trial comparing cefoperazone, ceftizoxime and ceftriaxone for initial therapy of infectious episodes in cancer patients. Patients with neutropenia were excluded. In 286 evaluable episodes, the response rates associated with the three agents were 77 % for cefoperazone, 70 % for ceftizoxime and 72 % for ceftriaxone, with no statistically significant differences between the three treatment groups. The overall response rate for all episodes of pneumonia (64 %) was significantly lower than the response rate for all other infections (81 %; p=0.002), and the mortality associated with pneumonia (9 %) was higher than that associated with all other episodes (2 %; p=0.01). Patients with infections due to gram-negative organisms responded well to all three agents, whereas patients with gram-positive infections responded more favorably to cefoperazone. Two different schedules of ceftriaxone were used. The clinical response did not differ significantly between patients receiving ceftriaxone once daily and those receiving it twice daily. The incidence of superinfection and relapse was extremely low and all three agents were well tolerated. It is concluded that extended spectrum cephalosporins are effective as single agents for the treatment of infections in cancer patients with adequate neutrophil counts.     

唑来膦酸治疗恶性肿瘤骨转移疼痛20例临床观察

目的 :评价注射用唑来膦酸治疗恶性肿瘤骨转移疼痛的疗效和安全性。方法 :4 0例患者随机分为治疗组和对照组各 2 0例。治疗组用唑来膦酸 4mg加入生理盐水溶液 5 0ml,静滴 30min ,对照组用帕米膦酸二钠 90mg加入生理盐水溶液 75 0ml,静滴 6h。两组均一次性给药后连续观察 2 8d。结果 :治疗组有效率为 80 % ,对照组 70 % ,不良反应发生率分别为 2 5 %和 5 5 % ,两者差异均无显著性 (P >0 .0 5 )。结论 :唑来膦酸是新一代骨吸收抑制剂 ,对恶性肿瘤骨转移所致疼痛有较好的止痛效果 ,且安全性高。     

阿奇霉素治疗急性细菌性下呼吸道感染的 有效性和安全性评价

目的 对本院急性细菌性下呼吸道感染患者运用阿奇霉素治疗,分析其有效性和安全性。方法 回顾性分析2016年6月~2018年6月我院收治的96例急性细菌性下呼吸道感染患者临床资料,随机分为两组,其中实验组患者为48例,采用阿奇霉素治疗;对照组48例患者采用左氧氟沙星治疗,比较两组患者的临床疗效,临床症状持续时间以及不良反应发生情况。结果 实验组治疗总有效率（95.83%）高于对照组（70.83%）,差异具有统计学意义（P＜0.05）;实验组肺啰音、发热、咳嗽症状持续时间均短于对照组,差异具有统计学意义（P＜0.05）;实验组不良反应发生率低于对照组（P＜0.05）。结论 采用阿奇霉素治疗急性细菌性下呼吸道感染疗效确切,不良反应少,是临床上治疗急性细菌性下呼吸道感染安全性抗生素之一。     

Decreased incidence of infection after renal transplantation with the use of cyclosporine

The incidence of infection within six months of cadaveric kidney transplantation was reviewed in 183 consecutive patients. Prior to June, 1985, 91 patients received azathioprine 2 mg/kg/day and prednisone 0.5 mg/kg/day; 63 patients (group A1) also received antilymphocyte globulin 15 mg/kg/day for the first ten days, whereas for the 28 other patients (group A2) antilymphocyte globulin had to be withdrawn before 72 hours because of general intolerance. The next 92 patients received cyclosporine 5–8 mg/kg/day and prednisone 0.25 mg/kg/day (group B). The three groups were similar for all studied parameters except for the number of patients with anti-HLA antibodies. At six months the mortality rate was not significantly different between the three groups. After six months the number of infections per patient was 1.47, 1.03 and 0.84 (p<0.01) in groups A1, A2 and B respectively; the percentage of patients developing one or more infections was 81, 58 and 57 % (p<0.01); bacterial infections: 57, 50 and 34 % (p<0.01); viral infections: 40, 14 and 10 % (p<0.01); cytomegalovirus infections: 27, 11 and 4 % (p<0.001). After adjustment with logistic regression upon factors which might facilitate infections, the results showed a significantly lower incidence of infection for the cyclosporine-treated group, especially for cytomegalovirus, as compared with the antilymphocyte globulin-treated group.     

Epidemiology and outcomes of community-associated methicillin-resistant Staphylococcus aureus infection

Over a 2-year period (2003 to 2005) patients with community-associated methicillin-resistant Staphylococcus aureus (CA-MRSA) and community-acquired methicillin-susceptible Staphylococcus aureus (CA-MSSA) infections were prospectively identified. Patients infected with CA-MRSA (n = 102 patients) and CA-MSSA (n = 102 patients) had median ages of 46 and 53 years, respectively; the most common sites of infection in the two groups were skin/soft tissue (80 and 93%, respectively), respiratory tract (13 and 6%, respectively), and blood (4 and 1%, respectively). Fourteen percent of patients with CA-MRSA infections and 3% of patients with CA-MSSA infections had household contacts with similar infections (P < 0.01). Among the CA-MRSA isolates, the pulsed-field gel electrophoresis (PFGE) groups detected were USA300 (49%) and USA100 (13%), with 27 PFGE groups overall; 71% of the isolates were staphylococcal chromosome cassette mec (SCCmec) type IV, 29% were SCCmec type II, and 54% had the Panton-Valentine leucocidin (PVL) gene. Among the CA-MSSA isolates there were 33 PFGE groups, with isolates of the USA200 group comprising 11%, isolates of the USA600 group comprising 11%, isolates of the USA100 group comprising 10%, and isolates of the PVL type comprising 10%. Forty-six and 18% of the patients infected with CA-MRSA and CA-MSSA, respectively, were hospitalized (P < 0.001). Fifty percent of the patients received antibiotic therapy alone, 5% received surgery alone, 30% received antibiotics and surgery, 3% received other therapy, and 12% received no treatment. The median durations of antibiotic therapy were 12 and 10 days in the CA-MRSA- and CA-MSSA-infected patients, respectively; 48 and 56% of the patients in the two groups received adequate antimicrobial therapy, respectively (P < 0.001). The clinical success rates of the initial therapy in the two groups were 61 and 84%, respectively (P < 0.001); recurrences were more common in the CA-MRSA group (recurrences were detected in 18 and 6% of the patients in the two groups, respectively [P < 0.001]). CA-MRSA was an independent predictor of clinical failure in multivariate analysis (odds ratio, 3.4; 95% confidence interval, 1.7 to 6.9). In the community setting, the molecular characteristics of the S. aureus strains were heterogeneous. CA-MRSA infections were associated with a more adverse impact on outcome than CA-MSSA infections.     

Primary prevention with cotrimoxazole for HIV-1-infected adults: results of the pilot study in Dakar, Senegal

OBJECTIVES: To assess the efficacy and tolerance of chemoprophylaxis with cotrimoxazole compared with placebo among HIV-1-infected adults. DESIGN: Randomized, double-blind, placebo-controlled clinical trial in the urban community of Dakar, Senegal. METHODS: Eligibility criteria were age greater than 15 years, HIV-1 or HIV-1 and HIV-2 dual seropositivity, CD4 cell count lower than 400 copies/mm3, no progressive infection, no previous history of intolerance to sulphonamide, lack of severe anemia or neutropenia, and renal or hepatic failure. Written informed consent was obtained. Recruited patients received 80 mg of trimethoprim and 400 mg of sulphamethoxazole daily or a matching placebo. The main outcomes were survival and the occurrence of clinical events defined as Pneumocystis carinii pneumonia, cerebral toxoplasmosis, bacterial pneumonia, infectious enteritis, bacterial meningitis, urinary tract infection, bacterial otitis and sinusitis, and pyomyositis. RESULTS: Between September 1996 and March 1998, 297 patients were screened, and 100 were randomized in the study. Demographic, clinical, and biological characteristics of the two groups were similar as was the mean length of follow-up (7.7 months for the cotrimoxazole group vs. 8.0 months for the placebo group). There was no significant difference between the two groups in survival (hazard ratio = 0.84; 95% confidence interval [CI]: 0.36-1.94) in the probability of severe event occurrence, defined as death or hospital admission (hazard ratio = 1.10; 95% CI: 0.57-2.13), or in the probability of clinical event occurrence (hazard ratio = 1.19; 95% CI: 0.55-2.59). Adjustment for initial CD4 cell count did not change these results. A low dose of cotrimoxazole was tolerated well clinically as well as biologically; only one treatment interruption occurred as the result of a moderate cutaneous eruption (grade 2). CONCLUSION: Our study does not show a beneficial effect of chemoprophylaxis with low-dose cotrimoxazole on survival or occurrence of opportunistic or nonopportunistic infections for HIV-1-infected patients in Dakar, Senegal.     

健康教育和心理支持在神经症治中的作用

目的：探讨健康教育和心理支持在神经症治中的作用。方法：对56例首次住院神经症患者,按入院顺序分为研究组（32例）和对照组（24例）,两组接受同样的药物治疗。研究组辅以健康教育和心理支持治疗38－60天。研究组服百忧解20－30mg/日（9例）,阿米替林75－150mg/日（8例）,阿普唑仑1．6－2．8mg/日（13例）,对照组百忧解20－30mg/日（11例）,阿米替林75－200mg/日（5例）,阿普唑仑1．2－2．8mg/日（10例）,于试验前及出院时分别对两组的治愈率和90项状清单（SCL－90）进行评定和比较。结果：研究组治愈率（94％）高于对照组（71％,P＜0．05）,研究SCL－90总分及主要因子分均低于对照组（P＜0．01）。结论：神经症患者早期进行健康教育和心理支持治疗能提高治疗效果。     

漂浮疗法合并药物对原发性高血压治疗的初步观察

目的：观察漂浮治疗对原发性高血压病的治疗效果。方法：两组原发性高血压病人均继续服用医嘱药物并听健康教育课;但其中一组增加漂浮治疗,对照观察两组疗效。结果：经治疗后,漂浮组病人的收缩压与舒张压均明显下降,有效率为６９％。而对照组有效率仅１４％。精神症状明显改善,淋巴细胞转化率有所上升。结论：漂浮疗法可作为对原发性高血压病人的一种辅助治疗手段。     

可视化融合成像技术诊治腰关节突关节综合征的疗效分析*

目的探讨可视化融合成像技术诊治腰关节突关节综合征的临床效果。方法临床纳入2017年6月至2020年5月于深圳市龙岗中心医院住院和门诊收治的80例腰关节突关节综合征患者作为研究对象,按随机数字表法分为两组,各40例。其中40例患者采用可视化融合成像技术引导下诊断及介入治疗者作为研究组,仅采用X线透视引导下诊断及介入治疗者作为对照组。观察两组患者治疗前后疼痛情况,分析两组患者诊疗效果及不良反应情况。结果研究组治疗后1周、3个月、6个月、12个月的VAS评分明显低于对照组,两组比较差异有统计学意义(P<0.05);在不同治疗时期疼痛缓解方面,对照组患者总有效率明显低于研究组,差异有统计学意义(P<0.05);在术区血肿形成、术区疼痛、消化道症状及下肢疼痛等不良反应方面,对照组不良事件发生率为25%,研究组为7.5%,两组比较差异有统计学意义(P<0.05)。结论可视化融合成像技术诊治腰关节突关节综合征的临床效果明显、持久及安全性高,值得临床应用推广。     

T-dependent immunity in aged humans. II. Clinical and immunological evaluation after three months of administering a thymic extract

We investigated the effect of Thymostimulin (TP-1) (a bovine thymic extract) on some clinical and immunological parameters in hospitalized aged humans. Forty aged patients were randomized into two groups, one received no therapy and the other was treated with TP-1 for 3 mth. The Ig and complement levels, sheep rosette-forming cells, absolute lymphocyte numbers and sedimentation rate were measured on days 0, 90 and 180. Moreover, the incidence of infections was determined. The baseline immunological data of the patients studied were within the normal range. These data remained unchanged after TP-1 treatment. In the TP-1 treated group we observed a significant reduction of infections (P=0.023) in comparison to the control group. A significant reduction of the sedimentation rate was also observed in the treated group.