86例异位妊娠的超声诊断价值

目的：探讨B超对异位妊娠的诊断价值。方法：对2004年1月～2009年1月的86例异位妊娠患者，采用超声诊断仪进行检查、分析。结果：超声检查的86例异位妊娠患者，诊断符合84例，确诊率为97．6％，误诊2例，误诊率为2．4％。结论：超声检查有着无创性、可重复性等不可比拟的优越性，为异位妊娠患者的诊断及治疗提供了可靠的依据。     

构筑健康教育工程实现社会医院双赢

介绍了四川大学华西医院10年来构筑普及医疗卫生保健知识系统工程的认识体会、经验和取得的成效,指出医院在普及卫生保健知识中的职责和优势。     

丙型肝炎传播途径的病例对照研究

本文按１１病例对照设计研究了丙型肝炎的传播途径。结果显示：无论单因素还是多因素条件Ｌｏｇｉｓｔｉｃ回归分析，输血及血制品都是丙型肝炎传播的一条重要途径。多因素条件Ｌｏｇｉｓ－ｔｉｃ回归分析的ＯＲ＝４．４８０，Ｐ＝０．００１。另外，肝炎家族史和外科手术史也可能与丙型肝炎的感染有关。本研究未发现注射、有创性检查以及外出饮食习惯与ＨＣＶ感染的关系     

基于经方解构新说“石膏配伍解肌法”

石膏解肌之说由来已久,但限于矿物药的溶出及研究手段有限等现实问题,其临床推广及应用不足,深入探讨亦不足。该文通过梳理解肌法的脉络,总结出解肌法所针对的病机为“津液不足,兼表不和”,而石膏解肌的核心内涵为“清火存液,兼透表邪”;通过梳理解肌法的古今运用,结合配位化学的现代研究,从配伍角度入手,主以《伤寒论》和《金匮要略》中的经方为例,拓展了石膏解肌之内涵,总结出石膏的解肌作用不仅可以治疗外感后的肌肉不适症状,还可能影响脏腑功能,进而治疗内伤杂病,并由此提出“石膏配伍解肌法”,认为石膏与麻黄、葛根、防己、知母、人参、芍药、竹茹、生地黄、麦冬和葳蕤等药物配伍后,通过调整透散和清热的力度来更好地发挥解肌作用。该文附临床验案一则予以阐发,以期为石膏的临床运用提供参考,为其配伍使用的药物机制研究提供方向。     

A nationwide post-marketing survey of knowledge,attitude and practice toward human papillomavirus vaccine in general population: Implications for vaccine roll-out in mainland China

BackgroundHuman papillomavirus (HPV) vaccine has been increasingly discussed in mainland China since its first approval in 2016. To date, nearly all studies assessing HPV vaccine perceptions and attitudes were implemented during pre-licensure period. Therefore, the nationwide post-marketing survey was conducted to update knowledge, attitudes and practice on HPV vaccine among general population in mainland China.MethodsParticipants aged 18–45 years living in mainland China were recruited in April 2019 by multi-stage non-randomized sampling. Sociodemographic factors, HPV and HPV vaccine related awareness, knowledge, attitudes, vaccine uptake and potential obstacles were assessed in questionnaires. Bivariate analysis and multivariate regression were used to identify disparity among subgroups with different sociodemographic characteristics.Results4,000 women (32.1 ± 7.81y) and 1,000 men (31.8 ± 7.96y) were included in final analysis. Less than one third of participants had heard of HPV (female: 31%; male: 22%) and HPV vaccine (female: 34%; male: 23%). Knowledge score was also unfavorable on HPV (female: 3 out of 13; male: 1.8 out of 13) and HPV vaccine (female: 3 out of 6; male: 2 out of 5). Only 3% females had been vaccinated three years after HPV licensure in China, although willingness to get vaccinated among those unvaccinated were high (mean willingness score ± SD: female: 3.3 ± 0.97; male: 3.0 ± 0.98). Industry of employment and household income were the major factors related to awareness and knowledge of vaccine, whereas HPV and HPV vaccine awareness were key influential factors for willingness. The main obstacles of vaccination were safety concerns, lack of knowledge, and high price of HPV vaccines.ConclusionsFindings highlight a lack of vaccine awareness, knowledge, and poor uptake in mainland China and underscore the necessity of health education campaigns. The identified priority groups, contents to be delivered and practical obstacles could furthermore provide insight into health education to reduce disparities and accelerate HPV vaccine roll-out in China.     

The role of sexual related Y gene detection in the diagnosis of patients with gonadal dysgenesis

Objective To clarify the role of sexual related Y (SRY) gene detection in the diagnosis of gonadal dysgenesis.Methods Sixteen cases of gonadal dysgenesis were included in this study: 5 with androgen insensitivity syndrome, 1 with 17-α-hydroxylase deficiency, 4 with true herm aphrodite, 2 with 45,X/46,XY gonadal dysgenesis, 1 with 45,X gonadal dysgenesis, 1 with XY pure gonadal dysgenesis, 1 with testicular regression, and 1 XY fema le who gave birth to a normal baby. SRY gene was detected by using polymerase c hain reaction (PCR) in blood and gonad samples and by direct sequencing of the S RY motif. Results Among the 16 cases, 15 were blood SRY positive, among which 13 (86.7%) showed t he presence of testicular tissue, and 2 showed ovaries without testicular tissue . One SRY negative case showed the presence of testicular tissue. In 3 cases, SRY detection in gonadal tissue correlated with pathological findings but not wi th blood karyotype. The correlation between peripheral blood SRY and the pathol ogy of the gonads was 81.25% and the correlation between the presence of periph eral blood Y chromosome and pathology of the gonads was 68.75%. Sequencing of the SRY motif in an XY female who gave birth to a normal baby showed no mutatio n.Conclusions SRY detection is more sensitive and specific than blood karyotype in the predic tion of the presence of testicular tissue. Peripheral blood karyotype does not necessarily reflect gonadal type. There may be testicular related factors other than the SRY gene.     

地塞米松和环孢菌素A对IL-4、IL-5合成的抑制作用

为研究淋巴细胞在哮喘发病中的作用及地塞米松（Ｄｅｘ）、环孢菌素Ａ（ＣｓＡ）治疗哮喘的机理,用ＥＬＩＳＡ法检测哮喘患者和对照组的外周血单个核细胞（ＰＢＭＣ）在植物血凝素刺激下合成白细胞介素４（ＩＬ－４）、白细胞介素５（ＩＬ－５）水平,以及Ｄｅｘ和ＣｓＡ对哮喘患者的ＰＢＭＣ合成ＩＬ－４、ＩＬ－５的抑制作用。结果表明,哮喘组的ＩＬ－４、ＩＬ－５水平较对照组高（Ｐ＜０．０５）;１０－６ｍｏｌ／Ｌ的Ｄｅｘ和ＣｓＡ均能抑制哮喘组ＰＢＭＣ合成ＩＬ－４、ＩＬ－５,增大药物浓度至２×１０－６、３×１０－６ｍｏｌ／Ｌ时,ＣｓＡ对ＩＬ－５合成的抑制作用逐步增强;Ｄｅｘ对ＩＬ－５合成的抑制作用较ＣｓＡ强（Ｐ＜０．０５）。提示糖皮质激素和ＣｓＡ抑制ＩＬ－４、ＩＬ－５的合成是其治疗哮喘的机理之一。     

颈动脉系统TIA脑血液动力学的研究

目的：探讨短暂性脑缺血发作（ＴＩＡ）的发病机制。方法：对３０例劲动脉系统ＴＩＡ进行三维经颅多普勒超声（３Ｄ－ＴＣＤ）、脑血管血液动力学参数（ＣＶＤＩ）及血液流变学检查分析。结果：绝大我数患者存在严重脑动脉硬化、脑动脉狭窄、脑内循环障碍;病灶侧平均脑血流量下降,血管自身调节功能减退;全血粘度、血浆粘度及血小板聚集率明显增高。结论：脑血液动力学障碍是ＴＩＡ发病机制之一。     

孤立型脉络膜血管瘤的超声诊断

目的 探讨孤立型脉络膜血管瘤的超声诊断价值。方法 使用标准化A超联合B超诊断6例脉络膜血管瘤。结果 脉络膜血管瘤B超显示实性占位病变，回声与正常脉络膜组织回声一致；A超表现为病变内高反射波。结论 超声检查是诊断脉络膜血管瘤有价值的辅助手段。     

鼻咽癌患者唾液中亚硝酸根含量的研究

目的研究鼻咽癌患者唾液中亚硝酸根含量。方法选择成人鼻咽癌患者26例为实验组,健康人27例为对照组,测定实验组和对照组所有人员唾液中亚硝酸根的含量。结果对照组唾液中亚硝酸根含量为(37.16±2.55)μmol/L,男女间无显著性差异。实验组唾液中亚硝酸根含量为(61.36±7.26)μmol/L,明显高于对照组。结论鼻咽癌患者唾液中亚硝酸根含量显著高于健康人。