100例自杀死亡原因分析

为了解贵阳市自杀死亡状况，按随机整群抽样，在贵阳市区逐户筛选进行一次流行学调查，对自杀死亡原因进行分析。发现自杀死亡者初中以下文化、体力劳动多见，自杀原因以家庭社会纠纷及恋爱婚姻多见。     

192例早期新生儿死亡原因分析

目的：寻找早期新生儿死亡的原因及预防措施。方法：对6年中192例暗藏新生儿死亡的原因进行分析。结果：我院早期新生儿死亡率为6.68‰（137/20440)。我院分娩加外院分娩转来早期新生儿死亡率为9.38‰（192/20440)。192例早期新生儿死亡中有141例为基层医院生后转运或胎内转运我院,早产低体重儿的主要死因为RDS、肺炎、肺出血、先天性畸形;足月正常体重儿的主要死因是宫内外窒息、胎粪吸入性肺炎帮颅内出血,本文提出降低早期新生儿死亡率应注意的几个问题。     

死胎死产43例原因分析

分析研究围产儿死亡率及死亡原因，是检验围产医学和围产期保健质量的重要环节。其目的是了解造成围产儿死亡的确切因素，从中找出经验和教训，确保优生．为提高诊断和治疗质量提供科学依据，进一步降低围产儿死亡率。     

我院10年间围产儿死亡原因分析

本文对我院10年间的围产儿病死率及死亡原因进行回顾性分析，以提高围产儿保健水平。     

28例住院精神病人死亡原因分析

本文通过对28例在住院期间死亡的精神病人进行临床分析，结果提示，住院精神病人死亡原因主要与躯体疾病、自杀及意外等有关。     

黔西县2004～2012年孕产妇死亡原因分析

目的通过对2004~2012年34例孕产妇死亡资料的分析,探讨降低孕产妇死亡的干预措施。方法对34例孕产妇死亡资料进行回顾性分析。结果本县2004~2012年孕产妇死亡34例,死亡率呈逐年下降趋势,导致孕产妇死亡的原因顺位是：产科出血、羊水栓塞;创造条件可避免4例,占11.8%;可避免27例,占79.4%;不可避免3例,占8.8%。结论加强健康教育宣传,提高群众的自我保护意识,加强产前保健,提高住院分娩率,加强产科建设,提高基层产科人员综合素质及急救能力,是降低孕产妇死亡率的关键。     

武汉地区184例住院死亡新生儿分析

该院１９８６年至１９９６年住院新生儿死亡病案１８４例，回顾性一次统计结果高危儿占新生儿死亡率８５％以上，其中早产儿９３例，占死亡人数的５０．５％，文中还分析了死亡顺位，以及死亡与病程和时间的关系。强调加强围生期保健工作对降低新生儿死亡率的重要性     

麻风菌重组蛋白的抗原性分析

目的以ND-O-BSA、LID-1麻风菌特异抗原为参照,评价各类受检者对7种麻风菌新抗原的血清学反应性,从而筛选出可应用于麻风病诊断的抗原。方法 应用ND-O-BSA、LID-1、ML0098ss、ML0840、ML1632ss、ML2028、ML2044、ML2055ss和46f等9种合成或重组抗原建立ELISA方法,分别检测多菌型麻风病（Multibacillaryleprosy,MB）和少菌型麻风病（Paucibacillary leprosy,PB）患者以及来自非流行区、麻风病轻度和重度流行区的健康人血清中的相应抗体。结果 ELISA显示7种新抗原中ML0840与ND-O-BSA、LID-1抗原敏感性、特异性和准确性相近,在对PB患者的检测上,其准确性更显优势,高达72%。46f、ML0098ss、ML2028对MB患者的敏感性依次为86%、79%和76%,但对PB患者的检测只有ML0098ss敏感性达到55%。ML1632ss、ML2044、ML2055ss 3种抗原无论对MB还是PB患者的敏感性和特异性均较差。结论 7种麻风菌重组蛋白质均具有不同程度的抗原性,ML0840与LID-1、ND-O-BSA是目前有应用潜力的抗原,但需在血清学监测中证实其早期诊断麻风病的价值。     

动脉瘤破裂病人死亡原因分析及防治

动脉瘤性蛛网膜下腔出血,患者转归不良的主要原因为①再出血,②脑血管痉挛,③急慢性脑积水.本文回顾了80例颅内动脉瘤行手术或血管内治疗病人,15例死亡原因及防治措施.     

枣庄地区新生儿破伤风死亡原因分析(附3例报告)

婴儿死亡率一直是衡量一个国家或地区经济、文化、卫生事业发展水平的一项重要指标,也是衡量优生优育工作质量的主要指标.为探讨可行而有效的干预措施,迅速降低新生儿破伤风死亡率,到2000年降为"0"的目标,我们对98、99年3例新生儿破伤风死亡进行了病例分析.     

奉节县91例麻风病联合化疗疗效分析

目的观察麻风病联合化疗（MDT）的治疗效果。方法对麻风病患者按照麻风病联合化疗方案进行治疗，并进行定期监测和长期随访。结果91例患者完成化疗并治愈，MDT规则治疗率为100％，治愈率100％，平均临床治愈时间3年，全程细菌密度指数（B1）BT型年均下降0．6，BL、LL分别为0．58和0．63，疗程中发生麻风反应12例，新发畸残4例。治愈后监测未发现复发病例。结论通过对91例麻风患者联合化疗疗效观察，MDT疗效确切，疗程短，复发低，是治疗麻风病的有效方法。应加强麻风病的联合化疗，提高规则治疗率，及时处理麻风反应，减少畸残，治愈患者。     

Clinically Unsuspected Neuritic Leprosy with Caseation Necrosis

Leprosy is a devastating disease caused by Mycobacterium leprae. It includes a spectrum of clinicopathological lesions. Neuritic leprosy with caseation necrosis (abscess) manifesting as a soft tissue mass is a relatively rare presentation of leprosy. Here, the authors report their experience with three patients with neuritic leprosy. The patients presented with swellings in the right ulnar nerve, the right great auricular nerve, and the temporal branch of the right sixth cranial nerve. The clinical impression was that of tumorous masses. Gross examination of the biopsy specimens revealed caseous necrotic materials. Further histological evaluation disclosed tuberculoid granulomas with extensive caseation necrosis. Stains for acid-fast bacilli were positive in the third case. A comparison between the caseation encountered in the tuberculoid neurotic leprosy and the neurolysis of lepromatous neurotic leprosy has been also discussed. The findings here emphasize “mass lesion with necrosis” as a possible clinical presentation of the neuritic leprosies. The clinicopathologic features were addressed and the relevant literature was reviewed.     

Leprosy as a clinical correlation of anatomy

Leprosy is a chronic mycobacterial infection of superficial tissues which occurs in part because of a select immune incoripetence in certain individuals. The major debilitating effects of the disease are the result of neurological deficits secondary to infiltration of Schwann cells by M. leprae and resorption of phalanges and bone near the palate. An understanding of the manifestations of the disease is based upon anatomical principles. We illustrate some of these in several clinical correlations. © 1994 Wiley-Liss, Inc.     

Leprosy in Israel: an imported disease - the support of histopathological examination for its detection

Leprosy is rare and non-endemic in Israel. Cases of leprosy are invariably imported by immigrants or foreign workers arriving from endemic areas. In view of the relative rarity of the disease, clinicians and pathologists are not always alert to the possibility of the disease or recognize potential symptoms. A case history is presented of a 31-year-old immigrant presenting symptoms of skin lesions and nodules on the hands and facial region, especially the ear lobe. Confirmation of the infection was provided by histopathology of suspected lesions stained for acid-fast bacilli (modified Fite-Faraco staining).     

86例结核性胸膜炎患者的血沉回顾性分析

目的：探讨结核性胸膜炎患者血沉的变化规律及其常规测定的临床意义。方法通过查阅我院2012年9月~2013年1月的86例结核性胸膜炎患者的临床资料进行回顾性分析。结果86例结核性胸膜炎患者从性别、年龄以及体重指数3方面对血沉的增快经2检验无显著性差异,>0.05。结论结核性胸膜炎患者可能与血沉增高与否无明显相关性,因考察的样本量少,需更多临床研究去证实。     

69例脑梗死死亡患者的血液流变学分析

目的采用回顾性分析方法,通过对69例脑梗死住院死亡病例与存活病例进行1:1配对的病例对照研究,探讨血液流变学异常对脑梗死转归的影响,以便对高危因素及时予以干预.方法血液流变学数据资料源于住院病历.采用仪器MVIS-2010全自动血液流变分析系统.统计软件为SAS6.12,作配对t检验,条件logistic回归分析.结果与生存的脑梗死组比较,死亡组的全血黏度增加(P＜0.05),红细胞聚集性增强(P=0.001),纤维蛋白原浓度上升(P=0.001),相对危险度(RR)均大于1.结论全血黏度增加,红细胞聚集性增强,纤维蛋白原浓度上升,与脑梗死病人的死亡事件显著相关.纤维蛋白原是预测脑梗死死亡事件的独立预测因子.     

High Resolution Structural Changes of Schwann Cell and Endothelial Cells in Peripheral Nerves Across Leprosy Spectrum

ABSTRACT

A systematic ultrastructure of peripheral nerves across the spectrum of leprosy was studied with an aim to better understanding the pathogenesis of nerve involvement in leprosy using light and electron microscope. The pathogenesis of nerve destruction varies in leprosy considerably along the spectrum. The study has begun to shed new light on some aspects of the infection of Mycobacterium leprae (M. lepare) and phenomenon has opened new avenue of research and possible mechanism of pathogenesis in TT/BT/BL/LL leprosy. In tuberculoid type (TT) and borderline tuberculoid (BT) leprosy, the degenerative changes of Schwann cells (SCs) and presence of perineural and perivascular cuffing by mononuclear cells. The endoneurial blood vessel (EBV) showed thickening of basement membrane with hypertrophy of EC leading to narrowing or complete occlusion of lumen and causing ischemia. However, borderline lepromatous (BL) and lepromatous leprosy (LL) foamy macrophages and vacuolated SC contain numerous small dense materials, irregular in shape and size was prominent and, considered to be degenerated and fragmented M. Leprae. The dense materials were also found in the cytoplasm of vascular EC. It was revealed that besides SC, the EC of EBV frequently harbor M. leprae in LL. The lumen of the EBV was wide open with enlarged nucleus. In the present study, the ultrastructural characteristics suggest that hypersensitivity mechanisms are possibly responsible for nerve damage in TT/BT leprosy. However, the study indicates that the mechanisms of nerve damage in BL/LL are basically different wherein hypersensitivity appears to play a very limited role.     

In Vitro Stimulation of Lymphocytes in Leprosy Patients, Healthy Contacts of Leprosy Patients, and Subjects Not Exposed to Leprosy

In vitro lymphocyte stimulation was performed on peripheral blood lymphocytes from 48 leprosy patients, 15 healthy contacts of leprosy patients, and 16 normal controls who lived in a leprosy-free area and who had not been exposed to leprosy. Tuberculin PPD and an antigen fraction. MLW 1, prepared from M. leprae, were used as stimulants. The MLW 1 preparation contained one antibody-precipitable component when tested in crossed immunoelectrophoresis against a polyvalent anti-M. leprae immunoglobulin preparation, namely the ML 7 antigen. MLW 1 induced strong lymphocyte responses in patients with tuberculoid leprosy and healthy contacts of leprosy patients, but only a weak or no responses in lepromatous leprosy patients and non-exposed controls. A marked depression of the response to tuberculin PPD was observed in lepromatous leprosy patients. The specificity of the MLW 1 antigen is discussed, and a new estimator of specific lymphocyte stimulation, the delta cpm', is introduced.     

Leprosy patients with lepromatous disease recognize cross-reactive T cell epitopes in the Mycobacterium leprae 10-kD antigen

T cell responses play a critical role in determining protective responses to leprosy. Patients with self-limiting tuberculoid leprosy show high T cell reactivity, while patients with disseminated lepromatous form of the disease show absent to low levels of T cell reactivity. Since the T cell reactivity of lepromatous patients to purified protein derivative (PPD), a highly cross-reactive antigen, is similar to that of tuberculoid patients, we queried if lepromatous patients could recognize cross-reactive epitopes in Mycobacterium leprae antigens as well. T cell responses were analysed to a recombinant antigen 10-kD (a heat shock cognate protein) which is available from both M. tuberculosis (MT) and M. leprae (ML) and displays 90% identity in its amino acid sequence. Lymphoproliferative responses were assessed to ML and MT 10 kD in newly diagnosed leprosy patients (lepromatous, n = 23; tuberculoid, n = 65). Lepromatous patients showed similar, but low, lymphoproliferative responses to ML and MT 10 kD, while tuberculoid patients showed much higher responses to ML 10 kD. This suggests that the tuberculoid patients may be recognizing both species-specific and cross-reactive epitopes in ML 10 kD, while lepromatous patients may be recognizing only cross-reactive epitopes. This was further supported by linear regression analysis. Lepromatous patients showed a high concordance in T cell responses between ML and MT 10 kD (r = 0.658; P < 0.0006) not observed in tuberculoid patients (r = 0.203; P > 0.1). Identification of cross-reactive T cell epitopes in M. leprae which could induce protective responses should prove valuable in designing second generation peptide-based vaccines.     

Consequences of Smallpox Vaccination in Leprosy Patients

This study illustrates the consequences of smallpox revaccination in 45 lepromatous, 28 tuberculoid, and 47 normal individuals. Results obtained with intradermal inoculations indicated that the patients with leprosy were associated with a relative anergy against the vaccinia virus, the anergy being minimal in the tuberculoid leprosy but marked in the cases with lepromatous leprosy. Major vaccinial reactions were observed more often in patients with lepromatous leprosy than in the controls or patients with tuberculoid leprosy. Furthermore in a patient with lepromatous leprosy, vaccinia necrosum also developed. The smallpox vaccination with live virus also appeared as a provocative factor for the precipitation of lepra reaction in the lepromatous leprosy cases. After 3 weeks of vaccination, the frequency of the specific humoral antibody response was the same in the tuberculoid patients and controls while it was higher in the cases with lepromatous leprosy. The prevaccination titer of total hemagglutination inhibition antibody was significantly higher in the lepromatous leprosy cases. However, the postvaccinial, humoral antibody response of the lepromatous patients was of the same magnitude as that observed in the normal individuals, and it was mainly due to a 2-mercaptoethanol-resistant antibody.