病理借片会诊现象增多的伦理学分析

结合在临床病理科长期工作的具体实践经历,对当前病理会诊现象增多的原因、出现的问题进行简要分析,并对解决这些问题提出自己的建议。     

妇女乳腺疾病普查3667例分析

目的:探讨妇女病普查的工作质量,为妇女常见病防治工作重点提供可靠依据。方法:对湛江市霞山区2000~2002年3667例妇女乳腺病普查情况进行分析。结果:患病率39·2%,常见疾病前4位依次为乳腺增生症、乳腺纤维瘤、溢乳症、乳腺癌。结论:常见病发生率存在着明显的年龄和职业差异(P<0·01),妇女保健工作要有重点的针对这些高危人群采取相应保健内容,做到早期发现、早期诊断、早期治疗,降低妇女乳腺疾病的发生率,提高妇女的生存质量。     

康赛德止痛液中陈皮、白术和党参的薄层鉴别

采用薄层色谱法对康赛德止痛液中陈皮、白术和党参进行了鉴别试验。鉴别方法灵敏，干扰少，重现性好。为控制其质量提供了依据。     

TNF-α与IL-2诱导人多形性腺瘤细胞凋亡

目的 探讨肿瘤坏死因子—α(tumor necrosis factor—α，TNF—α)与白细胞介素Ⅱ(interleukn—2，IL—2)在体外对涎腺多形性腺瘤细胞凋亡的诱导作用。方法 取呈对数生长的第12代人多形性腺瘤细胞(SPA—02)，采用TNF—α与IL—2单独或联合用药。应用流式细胞术检测肿瘤细胞凋亡率及细胞周期分布情况，利用光镜观察凋亡细胞的形态学改变。结果 流式细胞术检测发现，采用TNF—a24h后凋亡峰开始形成，72h后细胞凋亡率最高。联合应用IL—2较单独应用TNF—α凋亡率显著增高；光镜观察发现用药后大量多形性腺瘤细胞胞浆皱缩，胞核染色质固缩，呈大小不等的点状。结论 TNF—α可诱导体外涎腺多形性腺瘤细胞发生凋亡，IL—2可增强TNF—α诱导涎腺多形性腺瘤细胞凋亡的效能。     

α-酸性糖蛋白在类风湿关节炎患者中的临床意义

目的研究α1-酸性糖蛋白在类风湿关节炎患者中的临床意义.方法应用速率散射比浊法测定72例类风湿关节炎患者(其中活动期43例,非活动期29例)血清α1-酸性糖蛋白.结果 72例类风湿关节炎患者α1-酸性糖蛋白的含量为(1247.4±386.5)mg/L,43例活动期类风湿关节炎患者为(1582.7±516.6)mg/L,29例非活动期类风湿关节炎患者为(831.4±306.5)mg/L,30例正常对照组AAG的水平为(436.5±278.3)mg/L,类风湿关节炎患者血清α1-酸性糖蛋白的水平高于正常对照组(P＜0.01).活动期类风湿关节炎血清α1-酸性糖蛋白高于非活动性类风湿关节炎(P＜0.01).结论α1-酸性糖蛋白检测对类风湿关节炎的活动期评价有一定的临床价值.     

白蛉的生态调查及灭蛉方法的探讨

1.在北京调查鳞喙白蛉占46.7%，中华白蛉占44.3%，许氏白蛉和蒙古白蛉较少。室内24小时观察白蛉在23时密度最高。观察到黑热病媒介中华白蛉的栖息性从家栖迁到野栖和半家栖，其白蛉季节为4个半月，高峰季节在六月中旬。北京平原地区白蛉基本消灭，而在山区、半山区白岭密度可高达230只/人工小时。
2.试验后证实了马拉硫磷及杀螟松灭白蛉效果好，持久效长，既经济又减少药物的用量。三年来在密云六个公社推广使用此两种药后，为国家节约了药费，降低了白蛉密度，并继续控制了黑热病新病人的发生。     

温针灸对膝骨性关节炎的作用机制研究进展

<正>膝关节骨关节炎(knee osteoarthritis,KOA)是OA中常见的一种,以关节软骨退变、破坏及伴有相邻软骨下骨板、关节边缘骨质增生、骨赘形成为特点的一种退行性疾病~([1])。本病为临床常见病、多发病,尤以中老年为主。临床上,膝关节骨关节炎可引起膝关节疼痛、肿胀、关节僵硬变形进而导致功能障碍,对患者的生活质量造成了严重的影响~([2])。流行     

健脾益肾养肝方联合聚乙二醇干扰素治疗HBeAg阳性慢性乙肝的临床研究

研究健脾益肾养肝方联合聚乙二醇干扰素治疗HBe Ag阳性慢性乙肝(HP-HBV)的临床疗效。选择2012年6月—2014年12月接受治疗的HP-HBV患者126例,给予聚乙二醇干扰素-α-2a(或α-2b)治疗24周,按照HBV-DNA水平分为应答组与应答不佳组,应答不佳组依据随机数字表法平均分为对照组与试验组,对照组继续单纯使用聚乙二醇干扰素-α-2a(或α-2b)治疗,试验组采用聚乙二醇干扰素-α-2a(或α-2b)联合健脾益肾养肝方治疗。观察各组治疗前,治疗24周HBe Ag,ALT及HBV-DNA水平变化;治疗48周病毒学应答、血清学应答及生化学应答,临床症状及体征积分,不良反应等指标。结果显示,治疗24周后,应答组HBe Ag,ALT,HBV-DNA水平显著优于应答不佳组(P0.05)。治疗48周,应答组、应答不佳组HBVDNA阴转率、HBe Ag阴转率存在统计学差异(P0.05)。试验组HBV-DNA阴转率、HBe Ag阴转率显著优于对照组(P0.05)。试验组治疗48周临床症状及体征积分显著低于对照组(P0.05),试验组不良反应发生率(0%)显著低于对照组(8.70%)(P0.05)。表明健脾益肾养肝方联合聚乙二醇干扰素治疗HP-HBV安全有效,值得应用于临床。     

泪道内镜下治疗泪道阻塞性疾病的初步观察

Objective To evaluate the therapeutic efficacy of lacrimal endoscope treatment for lacrimal passage obstruction, and to compare the effectiveness of endoscopically controlled laser surgery and micro-drill surgery for lacrimal passage obstruction. Methods It was a prospective random controlled trial. Eighty nine patients (104 eyes) with lacrimal passage obstruction, including presaccal canalicular obstruction (PSCO) and nasolacrimal duct obstruction (NLDO), were collected from September 2006 to December 2006 in Department of Ophthalmology, Union Hospital of Tongji Medical College, Huazhong University of Science and Technology. Patients were examined by endoscopy of the lacrimal drainage system under local anesthesia to detect the obstruction and changes of lacrimal mucous membrane. The obstructions were treated with laser or microdrill. Irrigation was performed to prove the recanalization of the lacrimal passage followed by injected ointment with 0.3% tobramycin and 0.1% dexamethasone into the lacrimal passage. All patients were followed up after the operation for 9-12 months. The difference between the laser and the microdrill treatment was observed. Chi-square test was used to evaluate the curative effect and complications differences between these two groups. Results The obstruction scene in the lacrimal passage of 89 patients could be observed effectively. All obstructions (104/104 eyes) were eliminated after the operation. Through the follow-up, the cure rate reached 78.85% (82/104 eyes). The cure rate of PSCO group and NLDO group, reached 77.78% (42/54 eyes) and 80.00% (40/50 eyes), respectively (χ2=0.077,P=0.782). The cure rate of laser group and micro-drill group, was 80.43% (37/46 eyes) and 77.59% (45/58 eyes), respectively (χ2=0.125,P=0.724). The cure rate of laser treatment was 89.66% (26/29 eyes) in the PSCO group and 64.71% (11/17 eyes) in the NLDO group (P=0.040). The cure rate of micro-drill treatment was 64.00% (16/25 eyes) in the PSCO group and 87.88% (29/33 eyes) in the NLDO group (χ2=4.664,P=0.031). Hemorrhage and palpebral edema occurred in 10.87% (5/46 eyes) and 4.35% (2/46 eyes) after laser treatment, respectively. Percentage of hemorrhage and palpebral edema after the micro-drill treatment was 55.17% (32/58 eyes) (compared to the laser group, χ2=21.969,P=0.000) and 6.90% (4/58 eyes) (compared to the laser group, χ2=0.017 ,P=0.896). Conclusions Lacrimal passage obstruction can be observed and treated directly through the endoscopy of lacrimal drainage system. Choosing an appropriate surgical procedure according to the locations of the obstruction can be helpful for improving the effectiveness of the operation.     

泪道内窥镜治疗泪道阻塞的初步应用体会

目的 探讨泪道内窥镜系统检查治疗泪道阻塞性疾病的方法,评价其临床应用价值.方法 47例(51眼)泪道阻塞于局麻下使用泪道内窥镜系统进行泪道检查,针对阻塞部位进行激光或钻孔处理,冲洗通畅后,泪道注入0.3%妥布霉素 0.1%地塞米松眼膏,术后随访观察疗效.结果 全部患眼的泪道均能被有效观察,术中再通率100.00%,术后随访治愈率90.20%.结论 泪道内窥镜系统能在直视下对泪道阻塞性疾病进行准确观察和针对性治疗,是一种治疗泪道阻塞的较有效方法.