四川地区血吸虫及其他寄生虫病人血清库保存血清的质量探讨

目的　探讨四川地区血吸虫及其他寄生虫病人血清库的血清保存时间和效果。方法　分别于 1 994年、1 999年、2 0 0 3年抽取血清库内同一批慢性血吸虫病人和其它寄生虫病人血清以及非流行区的健康人血清 ,采用一步法 EIA-kit检测血吸虫病人血清循环抗原 ,用快速 ELISA、IHA检测血吸虫抗体。结果　三年测定血吸虫病人血清 EIA-kit阳性率分别为 1 0 0 .0 0 %、96.2 5 %、97.96% ,健康人血清的特异性均为 1 0 0 .0 0 %。 ELISA的阳性率分别为 1 0 0 .0 0 %、97.5 0 %、98.47% ;健康人血清的特异性为 99.44%、99.69%、99.62 % ;IHA的阳性率分别为 99.70 %、97.92 %、96.43 % ,健康人血清特异性为 98.61 %、98.44%、98.48%。用 ELISA对 3 69份其他寄生虫病人血清 (华支睾吸虫病 ,肺吸虫病 ,包虫病 ,囊尾蚴病 ,旋毛虫病 )检测抗体的特异性分别为 1 0 0 .0 0 %( 3 69/3 69)、97.67% ( 2 5 2 /2 5 8)、96.40 % ( 1 0 7/1 1 1 )。三次检测结果差异均无显著性 ( P>0 .0 5 )。结论　四川地区血吸虫及其它寄生虫病人血清库血清循环抗原、抗体效果 1 0年内无显著降低 ,有长期的应用价值     

Being 40 or younger is an independent risk factor for relapse in operable breast cancer patients: The Saudi Arabia experience

Background  

Breast cancer in young Saudi women is a crucial problem. According to the 2002 annual report of Saudi National Cancer Registry, breast cancers that developed before the age of 40 comprise 26.4% of all female breast cancers comparing to 6.5% in the USA. Breast cancer in young patients is often associated with a poorer prognosis, but there has been a scarcity of published data in the Middle East population.     

Knowledge and attitude regarding human immunodeficiency virus/acquired immunodeficiency syndrome in dermatological outpatients

Background  Dermatologists are often the first-line specialists who recognize and diagnose human immunodeficiency virus (HIV) infection because of pathognomic skin signs. It is therefore important to investigate attitudes and knowledge regarding HIV/acquired immunodeficiency syndrome (AIDS) amongst dermatological patients in order to provide information for dermatologists and to draw their attention to the issues.
Objectives  Awareness of HIV/AIDS, its prevention, and hypothetical behaviour were surveyed in dermatological outpatients.
Patients/method  The anonymous cross-sectional survey was conducted with consecutive German-speaking outpatients aged 18–65 years, who registered at the dermatological outpatient's clinic (excluding venereology, genitourinary or HIV medicine) of the University of Munich (Germany).
Results  Three hundred forty-seven (77.5%) questionnaires were accepted for analysis. Most of the patients knew about HIV incurability (89.4%), HIV transmissibility during needle sharing (95.3%), or vaginal (87.4%) and anal intercourse (79.5%), as well as about HIV prevention by condom use (97.8%), and use of single needles (76.2%). However, knowledge gaps and misconceptions were detected regarding the risk of HIV transmission during oral sex, and the efficacy of sexual fidelity and avoidance of blood transfusions in HIV prevention. The lowest knowledge level (< 50% correct answers) was detected in patients aged 50–59 years, in unemployed, divorced/widowed, and in those without or with incomplete school education.
Conclusions  Patient education about HIV/AIDS in dermatological ambulant settings should be performed differentially with regard to socio-demographic factors, and focused on the topic of oral sexual HIV transmission and on some other specific misconceptions.

Conflicts of interest

None declared.     

带蒂腹直肌瓣夹压悬吊球部尿道治疗获得性尿失禁的实验研究与临床应用

目的探讨采用带蒂腹直肌瓣夹压悬吊球部尿道治疗男性获得性尿失禁的可行性和有效性。方法取10只成年雄性比格犬带蒂腹直肌,长约8．0 cm,宽约2．5 cm,包绕球部尿道处阴茎1周,术前、术中、术后1个月、2个月分别测定尿道压力变化。临床采用带蒂腹直肌瓣悬吊球部尿道治疗2例男性复杂性尿道狭窄术后压力性尿失禁。结果犬使用腹直肌包绕阴茎后及术后2个月,最大尿道内压分别为(78．3±20．5)cm H2O(1 cm H2O=0,098 kPa)和(88．3±22．4)cm H2O,与术前(48．9±11．0)cm H2O相比差异均有统汁学意义(t=4．995,P=0．0007和t=6．058,P= 0．0002)。临床2例采用带蒂腹直肌瓣悬吊球部尿道术后7 d拔除导尿管,1例排尿通畅,另1例排尿困难,再次留管1周后排尿通畅。术后分别于10个月、1年随访,1例控尿较术前明显改善,另1例完全控尿,术后最大尿流率分别为25 ml／s和34 ml／s。结论采用带蒂腹直肌瓣夹压悬吊球部尿道能明显提高尿道压力,为治疗男性尿失禁增加了一种新的术式。     

Chronic kidney disease stage in renal transplantation classification using cystatin C and creatinine-based equations.

BACKGROUND: Current clinical guidelines recommend that renal transplant recipients (RTRs) be classified into chronic kidney disease (CKD) stage using a creatinine-based estimate of glomerular filtration rate (GFR). However, creatinine-based equations are inaccurate in RTRs leading to frequent CKD stage misclassification. It is not known whether the classification of CKD stage would be improved using a cystatin C-based estimate of GFR. METHODS: We measured (99m)Tc-DTPA GFR, cystatin C and creatinine in 198 stable RTRs. GFR was estimated using cystatin C-based equations (Filler, Le Bricon and Rule) and four creatinine-based equations. We determined the proportion, overall and by CKD stage, that were classified correctly by each equation as compared to the (99m)Tc-DTPA GFR. RESULTS: The Filler equation correctly classified 76% of patients compared to only 65% with the abbreviated modification of diet in renal disease (MDRD) equation and 69% with the Cockcroft-Gault equation. In CKD stages two and four, the Filler equation correctly classified 77% and 60% of patients whereas the abbreviated MDRD equation correctly classified 46% and 93% of patients. The area under the curve by receiver operating curve analysis for overall stage classification was uniformly poor for all equations (0.52-0.56). CONCLUSIONS: The cystatin C-based Filler and Le Bricon GFR estimates classified slightly more patients into the correct CKD stage than the standard creatinine-based equations in stable RTRs although the overall diagnostic accuracies were similar. The differences are modest and prospective studies will be needed to determine if the adoption of these equations for classification would lead to improved recognition of CKD complications or patient care.     

三种大鼠肾小管间质损伤模型的比较实验研究

目的　比较三种大鼠肾小管间质损伤模型。方法　采用庆大霉素腹腔注射、单侧输尿管梗阻、环孢素A(CsA)灌胃三种不同的方法 ,损伤大鼠的肾小管间质 ,测定尿液、血液各项生化指标 ,观察肾脏病理改变情况。结果　与对照组比较 ,三种模型的肾脏指数均明显增加 ,差异有极显著性 (P <0 0 1) ;庆大霉素模型尿蛋白和NAG酶在 7d时急剧增高 ,而在 15d时NAG酶差异已无显著性 ,单侧输尿管梗阻模型尿蛋白和NAG酶均显著增高 ,CsA模型的尿蛋白则呈下降趋势 ( 7dP <0 .0 5 ,15dP <0 0 1) ;三种模型的血清SCR、BUN均显著升高 ,TP、ALB均显著下降 ,15d时庆大霉素模型和单侧输尿管梗阻模型差异无显著性。镜下可见 :三种模型的肾间质均可见炎性细胞浸润 ,肾小管明显扩张 ,上皮空泡变性 ,仅单侧输尿管梗阻模型的间质趋向纤维化 ,CsA模型的病变相对轻微。结论　三种方法均可造成大鼠不同程度的肾小管间质损伤 ,单侧输尿管梗阻模型的肾小管间质纤维化病变明显 ,与临床肾脏病的表现相似 ,是一个较为理想可行的肾小管间质损伤模型 ,而庆大霉素模型 7d即能严重损伤肾小管间质 ,可作为急性的肾小管间质损伤模型 ,CsA模型则不如庆大霉素模型与单侧输尿管梗阻模型理想。     

长爪沙鼠毛色突变的类型及其遗传研究概况

长爪沙鼠毛色的突变迄今已有11种之多，本文综述了有详细特征描述的8种毛色及其遗传机制。这8种毛色分别是野生色，受A位点（刺鼠毛色）和a位点（非刺鼠型黑色）控制；白色，受c位点控制（白化型），等位基因包括ch基因（喜马拉雅型毛色）及cchm基因（中度青紫蓝）；白斑毛色，受Sp位点控制；灰色，受g位点控制；粉眼淡化色，受p位点控制。另外还有无毛突变、扩展位点的突变及淡化位点的突变等毛色出现。因长爪水鼠是一种多用途的实验动物，其毛色研究有着较广阔的前景。     

睾丸女性化综合症4例

目的：探讨睾丸女性化综合症的诊断和治疗。方法：回顾性分析1985-09/2001-10收治的4例睾丸女性化综合症患者的临床特征、影像学检查、治疗方法及随访资料。结果：术后随访0.5-1.5a，患者女性第二性征显著，有2例患者服用小剂量雌激素。结论：对睾丸女性化综合征患者应以预防未成熟睾丸发生恶变及维持女性特征为治疗原则。