An etiological study on fulminant viral hepatitis]

Viral markers were studied in 79 cases of viral hepatitis with hepatic failure. The results were shown as follows: 8 cases were positive for anti-HAV IgM (10.12%); 76 cases positive for HBsAg or anti-HBc IgM (96.20%) and 41 cases positive for anti-HCV antibodies (51.89%). Among those with anti-HCV positive, 35 cases were co-infected with HBV, 5 cases with HAV and/or HCV, only one was infected with HCV alone 2 cases were HD-Ag positive (2.52%) and one not identified (1.27%). With the reference of clinical findings, patients co-infected with HBV/HCV or anti-HBc IgM positive were more critical and usually entail higher mortality. In cases with HCV co-infections, the positive HBV replication markers seems to be reduced. Hepatic failure without HBV replicative markers had a high rate of hepatic coma as well as poor outcome.     

Structure and promoter organization of the human monoamine oxidase A and B genes.

Monoamine oxidase (MAO) A and B play an important role in regulating levels of biogenic amines. MAO A and B cDNAs have been cloned and the deduced amino acids share 73% sequence identity. The genes for MAOA and B are comprised of 15 exons interspersed by 14 introns, span at least 60 kb and exhibit identical exon-intron organization. These findings suggest that the MAOA and MAOB genes are derived from the duplication of a common ancestral gene. The core promoter region of MAOA is comprised of two 90 bp repeats, each of which contains two Spl elements and lacks a TATA box. The MAOB core promoter region contains two sets of overlapping Spl sites which flank a CACCC element all upstream of a TATA box. The different organization of the MAOA and MAOB promoters may underlie their different cell and tissue specific expression.     

医技人员血源性疾病感染情况调查

医务人员的医院内感染逐渐被人们所关注，其中血源性疾病的感染更应引起大家的重视。为了了解医务人员中医师、检验人员的医院感染发生情况，笔者对某中心医院的医师和检验人员的2002年度体检结果进行了统计分析，现报告如下。     

显微内窥镜下治疗腰椎间盘突出症和腰椎管狭窄症

目的探讨显微内窥镜(MED)治疗腰椎间盘突出症和腰椎管狭窄症的临床效果。方法MED下切除增生内聚的关节突、肥厚的黄韧带及突出的椎间盘，彻底解除对硬膜、神经根的压迫。结果随访324例，按中华骨科学脊柱学组腰背痛手术评定标准，优297例，良14例，差13例，疗效优良率达96．0％，结论MED损伤小、恢复快、疗效好。     

EVALUATION OF IMMUNOHISTOCHEMICAL DIAGNOSIS OF RHABDOMYOSARCOMA

Objective To evaluate the sensitivity and specificity of regularly used immunohistochemical markers, including Vimentin (Vim), Desmin (Des), Myoglobin (MG), Myosin (MS), Smooth-muscle actin (SMA) and Sarcomeric actin ( Sr-A ) , in the diagnosis of rhabdomyosarcoma (RMS). Methods After resection, 24 RMSs and other childhood tumor specimens were fixed in 10% neutral-buffered formalin and embeded in paraffin. The immunohistochemical staining was performed by LSAB procedure. Heat-induced epitope retrieval of Des, MS, Sr-A was processed in order to enhence positive rate and positive strength. Results Vim, MG, MS, Des, Sr-A, SMA were arranged in the order of sensitivity from higher to lower. About specificity, Sr-A, Des, SMA, MG, Vim standed in a sequence from higher to lower ( the data of MS is insufficient) ; Des, MG, Sr-A possessedhigher experimental efficiency, followed by SMA, Vim in a succession. Conclusion Vim and MG are of the higher sensitivity but lower specificity. On the reverse, Sr-A and Des hoM the better specificity but lower sensitivity. So the combination of multiple antibody reactions shouM be considered to improve the diagnostic ability in poorly differentiated RMS. According to the result of experimental efficiency, we suggest that the combination of Des, MG and Sr-A can make it possible to diagnose the majority of RMS clearly.     

新生儿颅内出血的临床分析

目的 为探讨各种类型新生儿颅内出血的早期诊断方法，明确其临床特点与CT的关系。方法 对176例经CT证实有颅内出血新生儿的临床资料进行回顾性分析。结果 176例患儿中缺氧所致123例(72．6％)，产伤21例(11．9％)，新生儿出血症22例(12．5％)，早产儿10例。患儿有意识障碍者156例(88．6％)，惊厥98例(55．68％)，肌张力改变113例(64．2％)，原始反射减弱或消失104例(59％)，贫血16例。CT示：SAH121例。占68．75％，为NICH最常见类型；SDH17例，IPH13例，IVH5例，混合性出血20例。结论 根据临床表现考虑NICH者应做头颅CT或头颅B超检查。Cr是确诊的最佳手段，能正确显示出血部位、范围、程度及区分各种类型，头颅B超对早产儿、低出生体重儿的IVH、IPH检出率高。     

改良内侧上颌骨切除术治疗21例鼻息肉病

目的:探讨鼻息肉病的可行性手术方法,以提高治疗效果。方法:21例鼻息肉病患者一侧行唇龈沟径路,保留下鼻甲的改良内侧上颌骨切除术(modifiedmedialmaxillectomy,MMM);另侧行单纯鼻息肉摘除和鼻内筛窦切除术,并作为对照组。结果:术后随访12～34个月,平均20个月;改良内侧上颌骨切除术侧未见复发,另侧复发6例,两组复发率差异有显著性(P<0.05)。结论:改良内侧上颌骨切除术使鼻息肉病患者术后复发率显著降低,治疗效果显著,是一种可供选择的有效的治疗手段。