狼疮抗凝物质45例临床分析

本文报道从1985年7月到1993年12月检出有狼疮抗凝物质患者45例,有血栓栓塞现象14例,占31.11％。我们就其病种、临床表现、实验室检查、治疗及预后进行分析。     

对－苯二甲酸衍生物的合成及其诱导分化HL－60细胞的活性

作者合成了１３个对－苯二甲酸衍生物，其中有９个化合物尚未见文献报道。通过对ＨＬ－６０细胞诱导分化活性试验，发现有两个化合物在浓度为５×１０￣（－６）ｍｏｌ／Ｌ时，可使细胞分化率达５５％，低于维Ａ酸的分化率（７９％，１０￣（－７）ｍｏｌ／Ｌ）。     

隐动脉筋膜蒂的交腿皮瓣修复小腿严重软组织缺损

目的探讨一种小腿严重软组织缺损的修复方法。方法以健侧隐动脉为蒂的顺行或逆行交腿皮瓣修复患侧小腿软组织缺损。结果本组8例均有效地覆盖受区创面,随访三个月,皮瓣全部成活。结论该皮瓣不牺牲小腿的重要血管,质地与受区相似,方法简单易行,血运可靠,血管蒂长,是修复小腿严重软组织缺损的较好方法。     

果胶酶治疗胃石症的临床研究

目的 探讨胃石症的发病机制。分析和总结果胶酶治疗胃石症的疗效。方法 在体外将山楂，柿子嚼碎后置入新鲜胃液，分为加白酒和不加白酒两组后放入37℃恒温箱内，观察胃石形成的经过及时间，再分别加入果胶酶，观察其解聚过程及时间，对54例胃石症患服用果胶酶治疗并观察疗效。结果 加白酒组形成胃石的速度较快，果胶酶能有效溶解胃石。54例患服用果胶酶6h后吞钡透视见胃石完全消失，症状，体征完全缓解。结论 果胶酶能有效溶解胃石。是治疗胃石症的有效方法。     

舰船员慢性荨麻疹与马拉色菌相关性研究

OBJECTIVE: To investigate the association of Malassezia furfur with chronic urticaria in the crew members of ships. METHODS: A comparative mycological study of 126 crew members of ships with chronic urticaria and 45 normal control subjects was carried out. The 82 urticaria patients identified as positive for Malassezia furfur were divided into groups A and B to receive treatment with antihistaminics (group A) and antihistaminics combined with 2% ketoconazole shampoo(group A). RESULTS: The carrier rates of Malassezia furfur were significantly higher in urticaria patients than in the normal control subjects (P<0.01), but in view of the case ratios of the final cure or improvement, no significant difference was observed between the two groups by the end of the treatment courses (P>0.05). But 6 to 8 weeks from the end of the treatment course, better therapeutic effect was noted in group B (P<0.01), with higher rate of negative Malassezia furfur findings (P<0.01). CONCLUSION: Malassezia furfur may play an important role in the prevalence of chronic urticaria among the crew members, and anti-fungal treatment may produce better long-term therapeutic effect.     

重症SARS的X线影像表现

目的探讨重症严重急性呼吸综合征(SARS)的X线表现.方法回顾性分析37例重症SARS患者的一系列X线胸片变化规律.结果重症SARS患者胸片表现为两肺阴影迅速进展,大部分区域受累.有3种表现类型:①19例表现为弥漫大片云雾状影,病灶无明显分界,肺纹理显示不清;②13例表现为弥漫棉团状密影,边缘模糊,肺纹理增粗;③5例表现为多发大团块密影,边缘模糊,可见支气管气相.如无合并症发生,对症治疗有效,1个月左右肺部阴影消失.6例肺部合并G-杆菌感染,5例合并纵隔气肿,出现合并症时,肺部阴影延迟吸收.结论重症SARS患者的X线影像为肺部密影快速进展至两肺大部分区域,易合并纵隔气肿及肺部感染.     

肝内HBcAg与血清学指标的关系及慢性乙型肝炎发病机理的探讨

We detected the presence and distribution of HBcAg in the liver by immunohistochemistry (ABC method) and the presence of HBV-DNA in serum (spot hybridization) and anti-HBe in serum (ELISA) from 59 cases of hepatitis B hospitalized in our hospital, including 47 cases of CAH, 5 cases of CPH, and 7 cases of subacute fulminant hepatitis. 1. HBcAg in the liver was detected in 25 out of 47 cases (53%) of CAH, in 2 out of 5 cases of CPH and in 4 out of 7 cases of subacute fulminant hepatitis. The total percentage was 53% (31/59). 2. There was no positive correlation between HBV replication activity and liver disease activity (P greater than 0.05). Our results did not support the hypothesis that suggests a direct cytopathic effect of HBV. Oppositely, the fact was that the presence, the amount and the patterns of HBcAg in the liver, and the presence of HBV-DNA in serum were predominant in mild CAH compared with those in severe CAH, predominant in CAH without cirrhosis compared with those in CAH with cirrhosis. There was a tendency of inverse correlation between HBV replication activity and liver disease activity. The results above were in line with the concept that HBcAg expressed on the surface of infected hepatocytes may be relevant target for T lymphocyte cytotoxicity. The results have suggested that an immune response to HBV is present, leading to the destruction of most infected cells. 3. There was a positive correlation between HBV-DNA in serum and HBcAg in the liver (P less than 0.005), indicating that HBV-DNA in serum can represent HBV replication.(ABSTRACT TRUNCATED AT 250 WORDS)     

直肠癌全直肠系膜切除术后直肠阴道瘘原因与防治

本文通过分析近5年来我院18例女性直肠癌全直肠系膜切除术后直肠阴道痿的临床资料。发现直肠阴道痿多发生于中低位直肠癌行全直肠系膜切除保肛手术的患者。痿的发生与肿瘤的位置、肿瘤的分期、肿瘤距肛门口的距离．以及手术技巧、手术难度、引流方法有关。而与是否进行预防性造口，以及是否采用腹腔镜手术无关。预防上强调应重视术中直肠前壁的锐性分离、结肠直肠吻合以及术后盆腔的负压引流。治疗上应首先进行保守治疗，即肠内营养，阴道冲洗。早期配合肠外营养、及全身或局部抗炎治疗，大部分直肠阴道痿通过保守治疗可以治愈。保守治疗无效时考虑结肠或回肠末端造口。若长期不愈应考虑吻合口肿瘤复发的可能。