经颅多普勒频谱参数与急性颅脑损伤患者颅内压的关系

目的探讨急性颅脑损伤患者的经颅多普勒频谱参数与颅内压的关系。方法应用TCD检测20例急性中、重型颅脑损伤患者双侧大脑中动脉,同时行颅内压监测。结果经颅多普勒频谱参数cf、PI、af、RI、ae均和ICP正相关,Vd、ac和ICP负相关,其中cf与ICP的相关系数最大。建立TCD相关参数与ICP的多元线性回归方程:ICP=0.312MAP-1.531Vd+21.437PI-15.059ac+38.722cf(P<0.001,R2=0.920估计值的标准差=4.0972mmHg)。结论经颅多谱勒频谱参数可以反应颅脑损伤患者的颅内压的改变。综合研究经颅多谱勒频谱参数、血压与颅内压的关系是应用经颅多普勒无创监测颅内压的方向。     

不同剂量体外冲击波治疗肱骨外上髁炎的疗效对比

目的 比较不同能流密度的体外冲击波(extracorporeal shock wave, ESW)治疗肱骨外上髁炎(lateral epicondylitis, LE)的短期临床疗效,探索ESW的最佳治疗剂量。方法 将120例LE患者分为A、B、C和D 4组,均使用ESW治疗4周,各组的能流密度分别为0.06、0.08、0.10、0.12 mJ/mm²。分别在治疗前及治疗后4、24及48周,比较4组患者疼痛视觉模拟量表(visual analogue scale, VAS)评分、肱骨外上髁炎功能评估(patient-rated tennis elbow evaluation, PRTEE)评分及末次随访患者满意度和复发率。结果 按时间点比较,各组VAS评分治疗前最高,治疗后48周降至最低(P<0.05),4组患者满意度及复发率比较差异无统计学意义(P>0.05),但C组患者满意度(96.67%)明显高于A组(80%),差异具有统计学意义(P=0.04)。按组间比较观察,治疗前各组患肘VAS评分差异无统计学意义(P>0.05);治疗后4、24和48...     

Immune response to intraocular injection of retinal S-antigen in adjuvant

It has been proposed that the introduction of foreign material into the eye at the moment of a penetrating trauma provides an adjuvant effect which, coupled with the release of antigen, might be responsible for sensitizing the immune system to produce a contralateral sympathetic ophthalmia. We addressed that hypothesis by injecting S-antigen with complete Freund's adjuvant (CFA) into the anterior chamber (AC) of the eye of Lewis rats. The injection of an identical dose of antigen (30 g S-Ag in CFA in a total volume of 10 l) via the foodpad (FP) or under the conjunctiva (SC) could induce typical experimental autoimmune uveitis (EAU). By immunizing via the AC route, we could demonstrate a positive sensitization of the immune system, manifested by serum antibody production against S-Ag and by the presence of S-Ag-specific, responsive T-lymphocytes in the spleen. However, immunization via the AC route did not induce contralateral uveitis, and the animals did not produce a DTH skin response when challenged intradermally with S-Ag as they did after FP immunization. In the light of these results, we evaluated the possibility that a DTH suppressive response was elicited by intracameral (IC) injection as seen in anterior chamber-associated immune deviation (ACAID): we tested the effect of splenectomy and cyclophosphamide pretreatment before IC immunization and the effect of secondary footpad immunization as well as T-helper cell transfer after IC immunization. The results given by these approaches argue against the induction of suppressor cells by IC immunization. We believe that the absence of lymphatic drainage from the interior of the eye is probably responsible for the absence of EAU induction through the IC route and that extrusion of the antigen under the conjunctiva might be required for the activation of EAU effector cells.     

长期家庭氧疗对慢性阻塞性肺疾病患者心理情绪的影响

目的探讨长期家庭氧疗(LTOT)对慢性阻塞性肺疾病(COPD)低氧血症患者心理情绪的影响。方法31例COPD低氧血症患者用医院焦虑和抑郁情绪表(HAD)进行心理情绪评分。然后分为LTOT组17例和对照组14例。LTOT组的氧流量0.5～2.5L/min,每日吸氧时间≥15h(包括睡眠时间);对照组除未进行LTOT外,其余治疗与氧疗组相同。两组年龄、性别、肺功能和动脉血气无明显差别。1年后分别复查HAD评分。结果LTOT组焦虑评分由治疗前的14.35±3.81下降到1年后的9.65±3.83(P<0.01),抑郁评分由治疗前的13.18±4.50下降到1年后的9.06±2.79(P<0.01);对照组焦虑和抑郁评分均无明显变化。1年后LTOT组的焦虑及抑郁评分分别与对照组比较明显改善。1年后LTOT组除动脉血氧分压与对照组有显著差异外,动脉血二氧化碳分压、PH值及肺功能均无显著差异。结论LTOT能改善COPD低氧血症患者的心理情绪。     

牙周炎患者龈沟液白细胞介素—1β检测及意义

目的：检测牙周炎患者龈沟液（gingival crevicular fluid,GCF)中白细胞介素－1β(interleukin-1β,IL-1β)的含量,探讨IL－1β在牙周炎发病中的作用。方法：用滤纸条浸润法采集正常成年人及成年人牙周炎患者治疗前后GCF样本,用酶联免疫吸附法（ELISA）检测GCF中IL－1β含量变化,牙周炎患者龈沟液中IL－1β水平显著高于正常对照组（P＜0．01）,牙周炎治疗组患者龈沟液中IL－1β水平较牙周炎组显著降低（P＜0．01）,龈沟液中IL－1β水平分别与牙龈指数,探诊出血指数,牙周袋深呈显著正相关,结论：IL－1β参与牙周炎的发生和发展,GCF中IL－1β可作为检查牙周病活动情况的一项较为敏感的指标。     

三种感染性疾病降钙素原水平比较

目的探讨降钙素原(PCT)辅助细菌性脓毒症诊断的可靠性,以及在革兰阴性菌和革兰阳性菌感染鉴别中的意义。方法本项目收集的研究对象为2013年1月-2018年12月,深圳市龙岗中心医院感染科收治的细菌性脓毒症患者131例、登革热患者30例,流行性感冒患者30例。分别检测三组患者体内PCT水平。结果脓毒症组PCT为2.30(0.18,100)ng/ml高于登革热组0.27(0.09,0.54)ng/ml(P<0.001)及流感组0.04(0.01,0.35)ng/ml(P<0.001);而登革热组与流感组相比,PCT浓度则无统计学意义(P=0.128);其次,在脓毒症组中,革兰阴性菌感染者的PCT浓度高于革兰阳性菌感染者(P<0.001)。结论 PCT高浓度对细菌性脓毒症的诊断精确可靠。另外,革兰阴性菌和革兰阳性菌感染者体内降钙素原的浓度明显不同,这可作为两种细菌感染的鉴别依据。