急性乙型肝炎临床特征和病毒标志物动态变化分析

Objective To explore the dynamic change of viral marker and clinical features in acute hepatitis B (AHB)and distinguish AHB from chronic hepatitis B(CHB) in acute onset. Methods Viral marker, HBV DNA in serum and clinical features were analyzed in 105 patients with AHB (AHB group) and 102 patients with CHB in acute onset (CHB group) between 2005 and 2009. Results There was no statistical difference in the mean levels of ALT, TBil, HBsAg, HBeAg and HBV DNA between AHB and CHB group on admission. However, the titer of auti-HBc-IgM in AHB group was(26.34 ±3.74)S/CO, which was obviously higher than that in CHB group, which was( 14.46 ± 3.10)S/CO, there was a statistical difference between the two groups( P < 0.05). After 2 weeks treatment, the levels of ALT and TBil in AHB patients decreased (1540.50±225.54)IU/L and (103.60± 46.48) μmol/L respectively, the decreased levels in AHB group were high compared to CHB group; the levels of HBsAg, HBeAg and HBV DNA in AHB group decreased (2558.46 ±644.26) IU/mL, (420.20± 63.20) S/CO and (4.53± 1.42) log10copies/mL respectively, and the levels decreased obviously compared to CHB group (P < 0.05). The decreased level of anti-HBc-IgM in AHB group was no statistical difference to CHB group after 2 weeks treatment (P > 0.05). 19.04% of the AHB patients were HBV DNA negative seroconversion before they were hospitalized. The level of HBsAg and HBeAg in AHB group declined quickly. Separately, 90.47% and 94.24% of the AHB patients had HBsAg and HBeAg seroconversion at the end of follow-up in AHB group. The level of ALT in AHB decreased quickly but its normalization was slower than the clearance of HBV. Conclusions There is no difference in viral marker, HBV DNA and clinical features between AHB and CHB in acute onset patients on admission, but the recovery of liver function in AHB is obviously after treatment. Anti-HBc-IgM (≥20 S/CO), dynamic change and seroconversion viral marker, ALT ≥20×ULN and recovery can be used to differentiate AHB from CHB in acute onset.     

单味大黄保留灌肠治疗溃疡病急性穿孔13例体会

我科自1986～1989年间,用单味大黄末沸水冲调后直肠保留灌肠,治疗溃疡病急性穿孔一、二期患者,收到满意疗效。现总结如下。临床资料本组共13例,均为男性,年龄最大74岁,最小23岁,平均39岁;穿孔距就诊时间:最早2h,最晚24h,平均6 h;膈下有游离气体者7例,占49%;板状腹明显者10例,占79%;腹穿液多且有     

HCG酶免疫测定在辅助诊断滋养细胞疾患中的假阴性问题

HCG酶免疫测定应用于妇产科临床对诊断极早期妊娠、异位妊娠、滋养细胞疾患具有重要的辅助诊断价值。本文报善了应用本法诊断滋养细胞疾患时出现的假阴性现象,并讨论了其产生的原因及避免的方法。     

保留烧伤水疱腐皮的利弊

本院观察我院89年6月以来保留烧伤水疱腐皮治疗420例,其中暴露部位面、颈、手、足烧伤350例。临床资料:男342例,女78例,男女比例4.5:1,年龄3—57岁,其中18—30岁年龄组烧伤348例。烧伤面积最大50％,最小1％。治疗方法:简单清创,保留烧伤水疱腐皮,外涂速效烫伤膏治疗,对皮损创面外涂SD—Ag干燥疗法。伤后8—10天,可见一部分烧伤腐皮紧贴在创面上,干燥裂纹,脱皮治疗,另一部分烧伤水疱未被吸收,放出其液体,使其烧伤腐皮紧贴在创面上,逐     

110例急性颅脑损伤患者恢复期的整体护理

运用护理程序对 110例急性颅脑损伤恢复期患者实施整体护理 ,起到了良好效果。具体论述护理评估、诊断、实施、评价 4个程序 ,内容包括基础护理、心理护理、康复训练、营养支持等。指出优质整体护理有助于促进患者康复 ,减少并控制并发症     

克罗米酚对继发性不孕患者子宫内膜腺上皮细胞核仁管状系统的影响

本研究通过透射电镜观察及体视学分析, 发现继发性不孕患者经克罗米酚治疗后属分泌中期形态结构的子宫内膜腺上皮分泌细胞, 其核内核仁管状系统的出现较其自身用药前增多,差异具有显著意义(t 检验P< 0-05) 。在正常月经周期, 核仁管状系统常见于分泌早期, 偶见于分泌中期。上述结果说明克罗米酚可使子宫内膜腺上皮分泌细胞核仁管状系统延迟出现, 此时的子宫内膜腺上皮与“接收期”的形态结构特征不符, 造成正常受精的胚泡在“接收期”植入困难。这可能是克罗米酚诱发排卵治疗后低妊娠率的原因之一     

简便直肠脱垂悬吊术术式讨论

直肠脱垂病例,术前经过保守治疗无效（特别是小儿需总合治疗无效）,方可采用该手术治疗。１手术方法１１术前准备同肠道手术准备。病者取仰卧位。臀部垫高５～６ｃｍ,术中便于显露盆腔。１２手术操作取下腹部正中切口,开腹分离腹直肌前鞘时,游离腹直肌前鞘剪下５...     

MRP、LRP 在人大肠癌组织中的表达及临床意义

 目的 检测MRP、LRP在人大肠癌组织中的表达，探讨其与临床病理相关因素（患者的年龄、性别、肿瘤的大小、分化程度、浸润深度、及淋巴结转移）的关系。方法 采用免疫组化S-P法检测92例大肠癌组织中MRP、LRP的表达。结果 MRP、LRP在大肠癌中的阳性表达率分别为41．30％（38／92）、84．78％（78／92）且仅LRP与肿瘤的浸润深度相关。MRP、LRP的共表达率为39．13％，且两者具有关联性。结论 MRP、LRP在大肠癌组织中均高表达，与大肠癌的耐药性密切相关；且两者具有相关性，对其的深入了解有利于临床化疗方案的合理化，规范化，有助于化疗效果的提高。     

如何发挥全科医生“守门人”的作用

全科医生是全科医疗的主要执行者,能为基层医疗市场提供方便,及时、综合、有效、经济的医疗、急救和康复服务,可满足基层医疗市场的需求。因此,发挥全科医生的“守门人”作用,是我国开展初级卫生保健不可缺少的主要力量。