系统性红斑狼疮合并隐球菌脑膜炎(附二例报道及文献复习)

目的 研究分析ＳＬＥ并发中枢神经系统隐球菌感染的特征、诊断及治疗。方法 报道经治疗的２例ＳＬＥ合并隐球菌脑膜炎病例，并加上文献复习的另２１例病人进行分析。结果 ＳＬＥ合并中枢神经系统隐球菌感染的特点为起病隐匿，进展较慢，临床和实验室表现非特异，易误诊为中枢狼疮或ＳＬＥ活动。脑脊液隐球菌培养是早期诊断ＳＬＥ合并中枢隐球菌感染的关键。结论 早期诊断和有效抗真菌药治疗有助于改善和提高ＳＬＥ合并隐球菌脑膜     

下丘脑错构瘤所致单纯性早熟的显微外科治疗

目的 探讨下丘脑错构瘤导致性早熟的手术治疗。方法 回顾分析１９９９年３月至２０００年７月收治的６例下丘脑错构瘤导致的单纯性早熟,男女各３例,平均发病年龄７．３个月,就诊年龄１３个月至５岁,平均为２岁６个月。均表现为生长发育快,骨龄明显大于实际年龄,性激素达到青春期水平;女孩表现为乳房发育,来月经;男孩表现为阴茎和睾丸增大,易勃起,面部痤疮等。ＭＲＩ显示垂体柄后上方灰结节部位皮质样信号肿物,注药无强     

系统性红斑狼疮合并隐球菌性脑膜炎临床分析

目的：探讨系统性红斑狼疮（SLE）合并隐球菌性脑膜炎的临床特点、诊断厦治疗，以提高对本病的认识和诊治水平。方法：时8例SLE合并隐球菌性脑膜炎（隐脑）病例的临床表现、脑脊液（cSF）特点和诊治经过进行回顾性分析。结果：SLE正患者出现隐脑时，病情隐匿，临床厦CSF系列生化检查呈非特异性，确诊所需时间2～16周，误诊率达50％，及时并重复进行CSF隐球菌乳胶凝集试验、涂片镜检厦培养是诊断的关键，以两性霉素B为主的抗真菌治疗效果较好，有效率100％。结论：SLE合并隐脑患者如能早期诊断并给予有效抗隐球菌治疗可显著改善预后。     

晚发系统性红斑狼疮的临床特点分析

目的分析晚发系统性红斑狼疮（SLE）患者的临床表现及治疗情况,并与早发SLE患者进行比较,以探讨晚发SLE的临床特点。方法收集2000～2004年于我院就诊的晚发SLE患者21例,并随机选取了同期40例发病时年龄〈50岁的患者作为早发SLE组,分析比较两组的临床表现、实验室指标、治疗情况。结果晚发SLE占所有SLE患者的6．18％。晚发SLE组性别比例女：男差异有统计学意义（3．2,P〈0．01）,且一些临床表现较少见：关节炎（P〈0．01）;蝶形红斑（P〈0．05）;肾脏受累（P〈0．01）。实验室指标中类风湿因子阳性率更高（P〈0．05）,而低补体C3血症较早发SLE组低（P〈0．01）。治疗方面,晚发SLE组较少使用大剂量皮质类固醇和免疫抑制剂。结论晚发SLE的临床表现多较轻,治疗上较少需要使用大剂量皮质类固醇和免疫抑制剂。     

泼尼松联合甲氨蝶呤氯喹治疗系统性红斑狼疮的研究

目的　回顾性研究 ,旨在探讨PMC治疗 (小剂量泼尼松合并甲氨蝶呤、氯喹 )对于轻、中度活动期SLE患者的疗效及副作用 ,以减少药物用量和副作用。方法　将入选的门诊患者按起始激素剂量 ,分为A (泼尼松剂量≤ 0 2mg·kg-1·d-1)和B (泼尼松 0 5～ 0 6mg·kg-1·d-1)两组 ,并联合应用甲氨蝶呤 7 5～ 10mg/周及氯喹 0 2 5g/d ,各 30例。观察疗效和副作用 ,为期 1年。结果　A组积分由治疗前的 2 1± 1 4降至 0 9± 0 7,B组感染多于A组 (2 2∶7,P <0 0 0 1) ,其中多为肺部感染 ,其次为皮肤感染。B组由 2 9± 2 3降至 1 3± 1 3。二组治疗前后相比疗效显著 ,但A、B两组间的疗效差异无显著性。B组中出现了库兴综合征及股骨头无菌性坏死 ,A组没有。结论　PMC方案对没有严重内脏累及的轻到中度的SLE患者有效。但在加大激素剂量的B组 ,感染问题比较突出     

Jo-1抗体综合征的临床研究

采用IBT法对2000余例结缔组织病患者进行了抗体的筛选,发现14例抗Jo-1阳性,通过与抗Jo-1阴性者对比研究,发现Jo-1抗体阳性者有如下临床特征:间质性肺炎和肌炎(100％),多关节炎(93％),雷诺现象(43％),发热及外周血白细胞升高(100％)。其中肌炎表现较轻,而关节炎表现较突出,易误诊为类风湿性关节炎。因此,对关节炎患者常规检测抗Jo-1抗体有助于肌炎及Jo-1综合征的诊断,并使患者得到合理的治疗。     

来氟米特治疗类风湿关节炎双盲随机对照研究

Objective　To study efficacy and safety of leflunomide to rheumatiod arthritis (RA) compared with MTX.Methods　Sixty patients with active RA were randomly allocated to leflunomide treatment (20 mg/week) or MTX treatment (15 mg/week).Clinical and laboratory parameters were analyzed at start,weeks 12 and 24 of both treatments.Results　The response rate in the leflunomide was 80.0% and 83.3% respectively at weeks 12 and 24,compared to 70.0% in MTX (P＞0.05).Leflunomide and MTX significantly improved clinical and laboratory parameters which were indications of disease activity.Most common side effects with leflunomide were digestive tract reaction.Conclusion　Leflunomide is effective in treatment of rheumatoid arthritis and is well tolerated.     

Enhanced response of titanium doped iron(ii) oxalate under electric field

Electrorheological (ER) fluid, containing polarized particles within an insulating liquid, represents a smart material, the mechanical properties of which can be altered mainly by an electric field. In this work, ER fluids based on cauliflower iron(ii) oxalate doped titanium particles show excellent rheological and wetting properties by the sample co-precipitation method. The morphology of the particles is observed by SEM and the molecular structure within the particles is obtained via XRD and FTIR. The distribution of elements within the particles is obtained by EDS. Owing to a lower current density than pure iron(ii) oxalate, the SEM and optical images show an obvious chain-like structure within the ER fluids with 2 wt% and 5 wt%, respectively, under 2 kV mm⁻¹. Then, the rheological properties of these ER fluids are tested up to 3 kV mm⁻¹ and the results show a gratifying property of resisting shear with different shear rates (0.1–100 s⁻¹), which is attributed to the appearance of a stable chain-like structure. At the same time, the ER efficiency and the switching performance are obtained and the static yield stress fits the relevant electric field strength well. Ultimately, an excellent sedimentation ratio is obtained from 0 h to 600 h.

Electrorheological (ER) fluid, containing polarized particles within an insulating liquid, represents a smart material, the mechanical properties of which can be altered mainly by an electric field.     

冰冻切片诊断甲状腺滤泡性癌的探讨

冰冻切片诊断甲状腺滤泡性癌是病理诊断工作的难点之一。我们对３６例有包膜浸润的甲状腺滤泡性癌的术中冰冻切片标本和术后石蜡切片，与随机找５０例甲状腺腺瘤的术中冰冻切片标本和术后石蜡切片标本进行了观察比较，总结出３个方面滤泡性癌不同于甲状腺腺瘤的组织学表现，作为除浸润标准外冰冻切片诊断甲状腺滤泡性癌的综合考虑依据，供进一步探讨此问题参考。