MSM人群HIV感染状况及行为调查

[目的]了解深圳市男男性行为者(MSM)性行为特点、艾滋病知识水平及艾滋病、梅毒和丙肝感染状况,为在该人群中开展有针对性的健康教育和行为干预提供依据. [方法]采用同伴推动抽样方法对MSM进行匿名问卷调查,同时抽取血样进行HIV、梅毒和丙肝的检测. [结果]调查的161例MSM中,同性恋占46.0%,双性恋为46.0%.MSM艾滋病的知识知晓率为81.4%.最近6个月与男性商业性伴(MB)性行为占7.5%,为了得到钱与男性发生性行为占13%,有女性性接触占26.1%.在最近6个月内MSM与确立关系的男朋友、约会的情人、嫖客、一夜情、MB肛交时每次都使用安全套的比例分别为49.3%、53.5%、61.9%、60.9%、58.3%.HIV抗体阳性率为5.0%.梅毒阳性率为13.0%,丙肝阳性率为2.5%. [结论]深圳市MSM人群中存在艾滋病流行,应进一步加强该人群艾滋病防治相关知识的宣传教育和安全套推广使用工作,大力开展安全性行为促进活动,减少艾滋病感染的风险.     

深圳市罗湖区艾滋病患者生存时间影响因素分析

目的 探讨影响深圳市罗湖区艾滋病患者生存时间的因素.方法 从国家艾滋病综合防治信息系统,选取深圳罗湖区AIDS患者相关信息,按照病例入选标准,确定研究对象;应用Kaplan-Meier和Cox比例风险模型对可能影响AIDS患者生存时间的因素进行分析.结果 共选取88名患者,从首次确定HIV抗体阳性进展到AIDS阶段的平均时长27.73个月,中位时长27个月.Cox多因素分析结果提示,是否使用抗病毒药物治疗(P=0.004,RR=0.137),HIV抗体首次阳性进展到AIDS的时长(P=0.006,RR=0.951)、发现HIV感染时的年龄(P=0.052,RR=1.068)都是影响AIDS患者生存时间的因素.而性别、有无性病史、HIV感染途径,则无影响.使用抗病毒药治疗组的1、3、5年累积存活率分别为98％、91％、88％,明显高于未使用药物治疗组(分别为85％、68％、64％).结论 HIV感染的早期阶段,符合抗病毒药物治疗指征的,应尽早使用,可延长AIDS患者生存时间.     

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维拉帕米及尼卡地平对瘢痕成纤维细胞胶原合成的影响

目的:研究钙离子拮抗剂维拉帕米及尼卡地平对体外培养的瘢痕成纤维细胞胶原合成的影响,同时对两种药物疗效进行比较,讨论两种药物的作用特点.方法:向对数生长期的增生性瘢痕成纤维细胞及瘢痕疙瘩成纤维细胞中加入不同浓度的两种药液,培养48小时后进行羟脯氨酸比色试验,并将OD值依公式换算成羟脯氨酸含量,进行统计学比较.结果:维拉帕米及尼卡地平组随着用药浓度的提高,细胞形态变化越来越明显,两种成纤维细胞显示出类似的形态学特点;与对照组比较,两药均可以降低培养上清液中羟脯氨酸的含量,且随用药浓度增加,羟脯氨酸含量进一步下降,高(100μmol/L)低(10μmol/L)浓度组均有显著性差异(p<0.05),同时两药作用特点也有所不同.结论:维拉帕米和尼卡地平均可降低增生性瘢痕及瘢痕疙瘩的胶原含量,抑制胶原合成,对于增生性瘢痕,尼卡地平抑制作用略强于维拉帕米,而对于瘢痕疙瘩,则维拉帕米的抑制作用略强于尼卡地平.     

尿流式有形成分及干化学分析在尿路感染诊断中的应用评价

Objective To evaluate the clinical application of automated urine formed elements analyzer and/or urine dipstick analyzer for examination of urinary formed elements in screening urinary tract infection (UTI). Methods 148 fresh midstream clear-catch urine samples from the UTI patients and 284 fresh midstream clear-catch urine samples from non-UTI subjects were selected. Bacteria culture was performed for bacterial colony counting and identification. Bacteria counts ( BACT), yeast-like fungus and WBC were performed by UF-looOi automated urine formed elements analyzer. Leukocyte esterase test (LEU) and nitrite test (NIT) were performed by URISYS 2400 urine dipstick analyzer. We evaluated data obtained from urine dipstick analyzer, UF-1000i and combination of UF-1000i with urine dipstick analyzer and the results was compared with those obtained from quantitative bacterial culture. Then we evaluated the sensibility, specificity, positive predictive value (PPV), negative predictive value (NPV) and accuracy. Results Among the 148 patients with UTI, the positive rate of the quantitative bacterial culture was 73.6% (109/148), the positive rate of LEU and NIT detected by dipstick test 26. 4% (39/148).There was significantly statistical difference between bacterial culture and strip test(χ2 = 55.68 ,P < 0. 05 ). The positive rate of urine flow cytometry by UF-1000i with either positive of BACT and WBC was 91.2%(135/148), which was higher than the positive rate of the quantitative bacterial culture. There was significant difference between two methods (χ2 = 14. 70, P < 0. 05 ). The positive rate of anyone positive among BACT, WBC, LEU and NIT was 94. 6% (140/148) when detected with combination of dipstick test and UF-1000i, which was higher than the positive rate of the quantitative bacterial culture. And there was significant difference between two methods (χ2 = 20. 45, P < 0. 05 ). The sensitivity of dipstick test was low (26. 4% ,39/148 ), and specificity was high ( 99. 3%, 282/284 ) . The sensitivity, specificity, positive predictive value, negative predictive value of BACT detected by UF-1000i in diagnosing urinary tract infection were 92. 6% ( 137/148 ), 39. 8% ( 113/284 ). 44. 5% ( 137/308 ) and 91.1% ( 113/124 ), respectively. If the dipstick test was combined with UF-1000i, the sensitivity, negative predictive value, specificity, positive predictive value and accuracy were 98.0% ( 145/148 ), 97.1% ( 100/103 ). 35.2% (100/284) ,44. 1% (145/329) and 56. 7% (245/432), respectively. Conclusions The combination of urine dipstick test and automated urine formed elements analyzer UF-1000i plays an important role in early diagnosis of UTI. And it has significant value in diagnosis of UTI, especially for the patients with negative bacterial cultures of urine sample.     

咽后壁刀刺伤致高位颈髓损伤1例

患者 ,男 ,30岁。因酒后与他人发生口角 ,被人以尖刀刺伤右颊面及舌体 1小时于 2 0 0 2年 2月 2 7日急诊入院。入院时查体 :患者处于浅昏迷状态 ,四肢活动受限 (以为是醉酒所致而未引起注意 ) ,心率 80次 /分 ,呼吸 2 1次 /分 ,血压110 / 70mmHg ;右颊部可见长约 8cm创口 ,并贯     

尿流式有形成分及干化学分析在尿路感染诊断中的应用评价

Objective To evaluate the clinical application of automated urine formed elements analyzer and/or urine dipstick analyzer for examination of urinary formed elements in screening urinary tract infection (UTI). Methods 148 fresh midstream clear-catch urine samples from the UTI patients and 284 fresh midstream clear-catch urine samples from non-UTI subjects were selected. Bacteria culture was performed for bacterial colony counting and identification. Bacteria counts ( BACT), yeast-like fungus and WBC were performed by UF-looOi automated urine formed elements analyzer. Leukocyte esterase test (LEU) and nitrite test (NIT) were performed by URISYS 2400 urine dipstick analyzer. We evaluated data obtained from urine dipstick analyzer, UF-1000i and combination of UF-1000i with urine dipstick analyzer and the results was compared with those obtained from quantitative bacterial culture. Then we evaluated the sensibility, specificity, positive predictive value (PPV), negative predictive value (NPV) and accuracy. Results Among the 148 patients with UTI, the positive rate of the quantitative bacterial culture was 73.6% (109/148), the positive rate of LEU and NIT detected by dipstick test 26. 4% (39/148).There was significantly statistical difference between bacterial culture and strip test(χ2 = 55.68 ,P < 0. 05 ). The positive rate of urine flow cytometry by UF-1000i with either positive of BACT and WBC was 91.2%(135/148), which was higher than the positive rate of the quantitative bacterial culture. There was significant difference between two methods (χ2 = 14. 70, P < 0. 05 ). The positive rate of anyone positive among BACT, WBC, LEU and NIT was 94. 6% (140/148) when detected with combination of dipstick test and UF-1000i, which was higher than the positive rate of the quantitative bacterial culture. And there was significant difference between two methods (χ2 = 20. 45, P < 0. 05 ). The sensitivity of dipstick test was low (26. 4% ,39/148 ), and specificity was high ( 99. 3%, 282/284 ) . The sensitivity, specificity, positive predictive value, negative predictive value of BACT detected by UF-1000i in diagnosing urinary tract infection were 92. 6% ( 137/148 ), 39. 8% ( 113/284 ). 44. 5% ( 137/308 ) and 91.1% ( 113/124 ), respectively. If the dipstick test was combined with UF-1000i, the sensitivity, negative predictive value, specificity, positive predictive value and accuracy were 98.0% ( 145/148 ), 97.1% ( 100/103 ). 35.2% (100/284) ,44. 1% (145/329) and 56. 7% (245/432), respectively. Conclusions The combination of urine dipstick test and automated urine formed elements analyzer UF-1000i plays an important role in early diagnosis of UTI. And it has significant value in diagnosis of UTI, especially for the patients with negative bacterial cultures of urine sample.     

尿流式有形成分及干化学分析在尿路感染诊断中的应用评价

Objective To evaluate the clinical application of automated urine formed elements analyzer and/or urine dipstick analyzer for examination of urinary formed elements in screening urinary tract infection (UTI). Methods 148 fresh midstream clear-catch urine samples from the UTI patients and 284 fresh midstream clear-catch urine samples from non-UTI subjects were selected. Bacteria culture was performed for bacterial colony counting and identification. Bacteria counts ( BACT), yeast-like fungus and WBC were performed by UF-looOi automated urine formed elements analyzer. Leukocyte esterase test (LEU) and nitrite test (NIT) were performed by URISYS 2400 urine dipstick analyzer. We evaluated data obtained from urine dipstick analyzer, UF-1000i and combination of UF-1000i with urine dipstick analyzer and the results was compared with those obtained from quantitative bacterial culture. Then we evaluated the sensibility, specificity, positive predictive value (PPV), negative predictive value (NPV) and accuracy. Results Among the 148 patients with UTI, the positive rate of the quantitative bacterial culture was 73.6% (109/148), the positive rate of LEU and NIT detected by dipstick test 26. 4% (39/148).There was significantly statistical difference between bacterial culture and strip test(χ2 = 55.68 ,P < 0. 05 ). The positive rate of urine flow cytometry by UF-1000i with either positive of BACT and WBC was 91.2%(135/148), which was higher than the positive rate of the quantitative bacterial culture. There was significant difference between two methods (χ2 = 14. 70, P < 0. 05 ). The positive rate of anyone positive among BACT, WBC, LEU and NIT was 94. 6% (140/148) when detected with combination of dipstick test and UF-1000i, which was higher than the positive rate of the quantitative bacterial culture. And there was significant difference between two methods (χ2 = 20. 45, P < 0. 05 ). The sensitivity of dipstick test was low (26. 4% ,39/148 ), and specificity was high ( 99. 3%, 282/284 ) . The sensitivity, specificity, positive predictive value, negative predictive value of BACT detected by UF-1000i in diagnosing urinary tract infection were 92. 6% ( 137/148 ), 39. 8% ( 113/284 ). 44. 5% ( 137/308 ) and 91.1% ( 113/124 ), respectively. If the dipstick test was combined with UF-1000i, the sensitivity, negative predictive value, specificity, positive predictive value and accuracy were 98.0% ( 145/148 ), 97.1% ( 100/103 ). 35.2% (100/284) ,44. 1% (145/329) and 56. 7% (245/432), respectively. Conclusions The combination of urine dipstick test and automated urine formed elements analyzer UF-1000i plays an important role in early diagnosis of UTI. And it has significant value in diagnosis of UTI, especially for the patients with negative bacterial cultures of urine sample.     

四君子汤联合乌司他丁治疗重度烧伤临床研究

目的:观察四君子汤联合乌司他丁注射液治疗重度烧伤患者的临床疗效及对血清炎症因子及补体C3、C4、B因子的影响。方法:选取重度烧伤患者96例,按随机数字表法分组,对照组患者48例予以常规治疗,研究组患者48例予以四君子汤和乌司他丁注射液治疗,采肘静脉血测定两组治疗前后血清炎症因子及补体C3、C4、B因子,检测血常规状况,对比临床疗效及不良反应。结果:对照组有效率为72.92%,研究组有效率为89.58%,两组比较,差异有统计学意义(P0.05);与对照组比较,研究组治疗后血清肿瘤坏死因子、白细胞介素-6、白细胞、中性粒细胞水平降低,血清白细胞介素-2、白细胞介素-10、补体C3、C4、B因子及血小板水平升高,差异均具有统计学意义(P0.05);两组患者不良反应多为轻中度,患者能够耐受,对症处理后可缓解。结论:四君子汤联合乌司他丁注射液治疗重度烧伤患者疗效确切,能显著提高补体水平,降低炎症指标。