多孔义眼台植入手术围手术期用药的探讨

目的 探讨多孔义眼台植入手术的围手术期用药管理。方法 对116例患者(116眼)围手术期规范用药后，观察1个月。结果 仅1例凝血因子Ⅶ缺乏的患者出现重度出血和水肿，眼台取出；余均未发生术后严重的反应和并发症。结论 围手术期药物的合理使用可以有效地减轻手术的反应，减少手术的并发症。     

Molecular epidemiology of enterovirus 71 infection in the Western Pacific Region

BACKGROUND: Recently, there have been large outbreaks of hand, foot and mouth disease (HFMD) mainly caused by enterovirus 71 (EV71) associated with severe neurological diseases in the Western Pacific Region (WPR). To monitor the realtime trend of EV71 transmission throughout the WPR, the authors conducted a molecular epidemiological analysis of EV71 infection. METHODS: Viruses were isolated from clinical samples from patients with HFMD or those with neurological complications. The EV71 isolates were identified by microneutralization assay. The VP4 and/or VP1 regions of recent EV71 isolates were sequenced and subjected to phylogenetic analysis using reference EV71 strains. RESULTS: The phylogenetic analysis of EV71 isolates from the WPR revealed two major genogroups, B and C, based on the nucleotide sequence alignment of the VP1 or VP4 region. These two major genogroups were further divided into subgenogroups, B1, B2, B3, and B4 and C1, C2, C3 and C4, respectively. CONCLUSIONS: The molecular epidemiological analyses of recent and previous EV71 isolates in the WPR indicated that two major genogroups of EV71 are co-circulating in Australia, Malaysia, Singapore, Taiwan and Japan. Recent EV71 isolates in Mainland China constitute a new distinct genetic cluster, subgenogroup C4. Two major lineages of EV71 are the major causative agents of the present HFMD epidemics in the WPR and both are considered to be neurovirulent.     

彝族儿童幽门螺杆菌感染HLA-DQA1免疫遗传学特征分析

目的研究人类白细胞抗原(HLA)DQA1基因位点上是否存在H.pylori感染的易感基因或抵抗基因，探讨免疫遗传因素在H.pylori感染中的作用。方法用聚合酶链反应-序列特异性引物(PCR-SSP)技术对用血清学试验及^13C尿素呼气实验确诊的31例H．pylori感染的彝族儿童及39例无感染儿童进行HLA．DQA1基因分型。结果感染组HLA-DQA1*0102等位基因频率明显高于对照组(14．52％vs3．85％，P=0．025，Pc=0．35)，OR=4．245(95％CI：1．097～16．428)；感染组HLA-DQA1*0302等位基因频率低于对照组(0 vs12．82％，P=0．003，Pc=0．042)，OR=1．147(95％CI：1．053-1．249)。结论在HLA-DQA1位点上，H．pflori感染的彝族儿童与对照组儿童存在免疫遗传学差异，HLA-DQA1*0102基因可能是彝族H．pylori感染的易感基因，而HLA-DQA1*0302基因则可能是抵抗基因和具有免疫抵抗作用。     

卵巢无性细胞瘤PLAP、NSE和WT1检测的临床病理意义

目的 :评价胎盘碱性磷酸酶 (PLAP) ,神经元特异性烯醇化酶 (NSE)、催乳素(PRL)和肾母细胞瘤 (WT1)基因蛋白在卵巢无性细胞瘤中的表达及其临床病理意义。方法 :复查 1983年 1月至 2 0 0 2年 10月曾经在重庆医科大学临床学院治疗的卵巢无性细胞瘤 31例的临床及病理资料。对 31例的肿瘤组织进行PLAP、NSE、PRL和WT1免疫组织化学染色。结果 :患者年龄 12～ 4 2岁 ,平均 2 5岁。临床Ⅰ期 18例 (5 8.1% ) ,Ⅱ期 5例 (16 .1% ) ,Ⅲ期 6例 (19.4 % ) ,Ⅳ期 2例 (6 .4 % )。PLAP、NSE、PRL和WT1在无性细胞瘤组织中的阳性表达率分别为 10 0 %、70 .9%、3.2 %和 12 .9%。NSE表达与临床分期以及 5年生存率之间显著相关 (P <0 .0 5 )。WT1的阳性表达与组织学亚型明显相关 (P <0 .0 5 )。结论 :NSE阳性表达与晚期肿瘤密切相关。PLAP和NSE可看作是无性细胞瘤重要的组织标志物 ,肿瘤组织是血清PLAP和NSE的主要来源。WT1的表达与无性细胞瘤分化较差有关     

细胞周期素D1蛋白在卵巢上皮性肿瘤中的表达及其意义

目的　研究细胞周期素D1(cyclinD1)在卵巢上皮性肿瘤中的表达及意义。方法　 1997～ 2 0 0 0年采用免疫组织化学SP法 ,检测恶性卵巢上皮性肿瘤、交界性肿瘤、良性肿瘤、正常卵巢组织cyclinD1的表达。结果　在恶性卵巢上皮性肿瘤 ,良性肿瘤 ,正常卵巢组织之间cyclinD1的表达差异有显著性 (P <0 0 1)。cyclinD1的表达率与组织分化程度和临床分期有显著相关性 (P <0 0 5 ) ,cyclinD1的过度表达见于组织分化差 ,肿瘤发病的晚期。结论　cyclinD1在卵巢癌组织中广泛存在 ,并与组织分化 ,临床分期有一定相关性 ,提示该基因在卵巢癌的发生、发展中起一定作用     

儿童过敏性紫癜不同时期凝血功能状态检测及分析

目的　研究儿童过敏性紫癜 (HSP)发作期及缓解期凝血状态的改变情况及其机制。方法　 2 0 0 1～2 0 0 3年深圳市儿童医院收治的HSP患儿共 6 0例 ,根据发病期和缓解期的不同 ,相应分为HSP发作组 (30例 )和HSP缓解组 (30例 ) ,检测凝血酶原时间比 (PTR)、血浆D 二聚体 (D dimer)及组织因子途径抑制物 (TFPI)水平 ,并与对照组 35例健康体检儿童比较。结果　两组HSP患儿的PTR与对照组比较差异无显著性 (均P >0 0 5 ) ;HSP发作组血浆D dimer明显升高 (P <0 0 5 ) ,而HSP缓解组血浆D dimer浓度下降 ,与对照组差异无显著性(P >0 0 5 ) ;HSP发作组血浆TFPI含量高于对照组 (P <0 0 5 ) ,HSP缓解组降至正常水平 ,和对照组比较差异无显著性 (P >0 0 5 )。结论　HSP患儿发作期凝血解溶状态处于高活动状态 ,随着病情进入缓解期高凝状态可恢复正常 ;TFPI在HSP患儿发作期可能具有防止血管内凝血活动过度和扩散的重要作用。     

监测血清尿酸值预测妊高征的临床意义(附562例临床分析)

目的　探讨血清尿酸预测妊高征的临床意义。方法　 1998年 8月至 2 0 0 2年 8月检测 562例孕妇在孕 2 8、3 2、3 6、3 8周及临产时肾功能。结果　临产时妊高征患者血清尿酸显著高于正常孕妇 (P <0 0 0 1) ,并从妊娠 3 2周开始其含量逐渐升高 ,妊娠 3 4周以后轻、中、重度妊高征间差异有显著性 (P <0 0 5)。结论　血清尿酸含量的测定对了解妊高征的病情具有重要意义 ,监测晚孕血清尿酸值可预测妊高征的发生     

第一产程异常胎心监护图形与新生儿结局的关系

目的　探讨第一产程异常胎心监护图形与新生儿结局的关系。方法　回顾分析 2 0 0 2年 8月至 2 0 0 3年 6月在我院足月单胎头位分娩产妇 ,第一产程中胎心率 (FHR)异常图形 2 1 7例 (观察组 )和FHR正常图形的2 6 9例 (对照组 )的临床资料。结果　第一产程异常FHR图形的发生率为 4 4 7% ,常见类型为轻度变异减速(6 4 5 % )、基线变异减弱 (2 1 6 % )和轻度心动过速 (1 2 0 % )。晚期减速、基线变异减弱和重度变异减速是导致新生儿窒息的危险因素。观察组羊水过少 (5 1 % )、脐带缠绕 (2 2 6 % )、羊水粪染 (1 0 6 % )、新生儿窒息 (6 5 % )、新生儿转入NICU(1 0 1 % )的发生率和剖宫产率 (31 8% )明显高于对照组 (P <0 0 5 )。结论　第一产程异常FHR图形的发生率较高 ,其中晚期减速、基线变异减弱、重度变异减速与新生儿窒息的发生相关 ,其他图形可在严密监护下继续试产     

Low-dose oral combination of 17beta-estradiol and norethisterone acetate in postmenopausal women decreases factor VII, fibrinogen, antithrombin and plasminogen activator inhibitor-1.

OBJECTIVE: Controversies still persist concerning hormone replacement therapy (HRT) and its effects upon blood coagulation and fibrinolysis. This study was carried out to evaluate possible effects of continuously administered low-dose 17beta-estradiol (E2) and norethisterone acetate (NETA) on coagulation and fibrinolytic factors. METHODS: We conducted a randomized double-blind, placebo-controlled, 1-year study in 120 healthy postmenopausal women. The three groups consisted of a placebo group (n = 40), a group receiving oral continuous combined E2 1 mg and NETA 0.25 mg (n = 40) and a group receiving oral continuous combined E2 1 mg and NETA 0.5 mg (n = 40). RESULTS: The two low doses of E2-NETA induced significantly lower plasma levels of factor VII, fibrinogen, antithrombin and plasminogen activator inhibitor-1 (PAI-1), compared with placebo treatmen CONCLUSIONS: Low-dose E2 (1 mg) in combination with NETA resulted in favorable changes of factor VII activity and fibrinogen, compared with placebo. The lower plasma levels of PAI-1 may lead to increased fibrinolytic activity. These findings suggest a decreased risk of developing coronary heart disease. Antithrombin activity was also reduced, which may increase the risk of developing venous thromboembolism. The clinical significance of the lower levels of these factors remains to be clarified.