口腔门诊患者HSV-1抗体的检测

单纯疱疹病毒 (ＨＳＶ)对人体的感染比较常见 ,它可经口—呼吸道传播 ,也可经皮肤、粘膜接触传播。口腔科医生在为患者治疗疾病的过程中 ,难免要接触患者口唇等易患处 ,容易造成交叉感染。作者对 1485例门诊患者进行Ⅰ型单纯疱疹病毒 (ＨＳＶ 1)抗体检测 ,现报告如下 ,希望能引起口腔医务工作者的重视。1　材料与方法选择 1996年 5月至 1998年 5月门诊患者共 1485例 ,其中男性 6 38例 ,女性 847例。年龄 15～ 35岁 ,平均 2 8岁。ＨＳＶ 1抗体检查采用ＥＬＩＳＡ法。2　结果本组 1485例标本中 ,ＨＳＶ 1抗体阳性 96 2人 ,检出率6 4 87%。3　…     

滤纸尿半乳糖醇气相色谱/质谱分析在筛查希特林蛋白缺陷致新生儿肝内胆汁淤积症中的应用

目的观察不同大小及不同放置时间的滤纸洗脱尿半乳糖醇气相色谱/质谱(GC/MS)检测结果与原尿液半乳糖醇GC/MS检测结果之间差异,探讨滤纸尿送检筛查希特林蛋白缺陷所致新生儿肝内胆汁淤积症(NICCD)的可行性。方法选择既往GC/MS分析提示含有半乳糖醇的原尿液10份,每份制成3种大小不同的滤纸吸附,晾干,在室温下放置1～7 d,然后洗脱。取原尿液和洗脱尿100μL,用生化分析仪测定尿肌酐水平。取原尿液和洗脱尿100μL,原尿液先采用尿素酶处理后进行尿液代谢产物GC/MS检测。用质谱仪检索NIST图谱库定性检测到的尿液代谢产物。用正十七烷酸作为内标物质,应用内标法以内生肌酐定量代谢产物。结果同一份含有半乳糖醇的尿液,制成3种大小不同的滤纸尿,放置第1、3、5、7天的大小不同滤纸洗脱尿与其原尿液均经GC/MS检测,并进行比较,发现不同时间/不同大小的滤纸洗脱尿与其原尿液半乳糖醇的出峰时间及水平,均无统计学差异,不同时间/不同大小的滤纸洗脱尿半乳糖醇的出峰时间及水平均无统计学差异。结论在常温下,7 d内当洗涤滤纸的液体与滤纸吸收的尿液量一致时,滤纸尿可代替-80℃储存的原尿。建议使用的滤纸片规格是5 cm×8 cm,可吸收1.0 mL尿液。     

消化内镜在伴有消化道症状的儿童过敏性紫癜中的诊断价值

过敏性紫癜是一种毛细血管变态反应性炎症,在儿童中常见.除最常见的皮肤损害外,若累及胃肠黏膜的毛细血管可出现各种消化道症状:如腹痛、呕吐、消化道出血等症状.其中有部分患儿以剧烈腹痛和消化道出血为首发症状,在并不伴有典型的皮肤紫癜时临床诊断难以确立,有时还易误诊为外科急腹症如阑尾炎等.     

超声内镜医师诊断胰腺囊性病变的一致性分析

目的 探讨胰腺囊性病变超声内镜（EUS）形态学特点在不同EUS医师之间的一致性。方法 回顾性分析安徽医科大学第一附属医院2011年11月至2014年12月诊治的24例胰腺囊性病变患者EUS图像,2位EUS医师分析图像中是否存在间隔、固体成分和淋巴结肿大等特点。结果 2位EUS医师分析是否有固体成分的一致性较好（Kappa=0.647）。分析间隔、壁结节、边缘钙化、主胰管扩张、淋巴结肿大以及囊性病变数量方面一致性中等。结论 不同EUS医师分析胰腺囊性病变EUS图像,存在主观差异。     

显微镜下喉返神经解剖在甲状腺手术中的应用

目的:探讨显微镜下解剖喉返神经(RLN)在甲状腺手术中的应用.方法:回顾性分析292例不同类型的甲状腺手术,术前均经喉镜检查声带运动正常,术中均常规显微镜下解剖RLN.结果:共显露RLN 402根,暂时性RLN损伤3例(0.75%),无一例发生永久性RLN损伤.结论:甲状腺手术中应常规显露RLN,显微镜下解剖RLN及其分支可有效避免RLN的损伤,尤其适用于多次手术后复发或甲状腺癌的患者.     

运动性软组织损伤的MR表现

目的 评价MRI对运动性软组织损伤的诊断价值和临床意义.方法 58例不同部位运动性损伤患者接受MR检查,但X线平片未显示骨折.MR检查时间为外伤后1～14 d,常规包括T1WI,T2WI以及T2WI脂肪抑制序列和短时间反转恢复序列(STIR).观察软组织和骨损伤的MR表现.结果 58例中发现髋肌损伤8例,腘绳肌损伤6例,股四头肌损伤5例,小腿三头肌损伤15例,胫侧副韧带损伤6例,前交叉韧带损伤5例,后交叉韧带损伤4例,髌韧带损伤3例,跟腱损伤4例,腓短肌键损伤2例.MR表现分为3度,Ⅰ度为牵拉伤,共31例,Ⅱ度为部分撕裂,共19例,Ⅲ度为完全断裂,共8例.损伤肌肉肌腱邻近的骨髓水肿23例,主要为Ⅱ度及Ⅲ度损伤的病例,其中1例可见骨骺骨折,X线片显示可疑.结论 肌肉肌腱韧带损伤具有特征性的MR表现.     

低频电刺激与康复训练对脑卒中患者运动功能恢复的影响

目的探讨低频电刺激对脑卒中偏瘫患者神经功能恢复的影响。方法50例脑卒中患者随机分为治疗组和对照组各25例；对照组予以神经内科常规药物治疗和Bobath技术治疗；治疗组在上述治疗基础上加用低频电刺激治疗20d。采用简易Fugl—Meyer评定法和临床神经功能缺损程度评分评定两组患者的疗效。结果治疗后，两组患者的神经功能均有恢复，但治疗组的Fugl—Meyer评分高于对照组（P〈0．05）。结论低频电刺激治疗有助于促进脑卒中患者神经功能的恢复。     

不同液体复苏对颅脑外伤并发急性失血性休克大鼠脑保护作用比较

目的比较不同种类液体复苏对大鼠颅脑外伤并发急性失血性休克模型的局部脑血流（rCBF）、脑水肿和血脑屏障（BBB）的影响.方法SD大鼠60只随机分为5组：①假手术组（Ⅰ组）;②脑外伤＋休克组（Ⅱ组）;③生理盐水组（Ⅲ组）;④10%羟乙基淀粉（HES）组（Ⅳ组）;⑤小容量高晶体-高胶体渗透压混合液（HHS,7.5%NaCl与10%HES按1：1混合）（Ⅴ组）.记录外伤、休克和复苏前后平均动脉压（MAP）和rCBF的变化,测定复苏后3 h脑组织含水量以及脑组织伊文思蓝（EB）含量.结果在复苏后即刻,Ⅲ、Ⅳ、Ⅴ组MAP和rCBF均恢复正常,分别在15 min、30 min和45 min后开始下降,至120 min时,Ⅴ组显著高于Ⅲ、Ⅳ组（P＜0.05）.复苏后3 h,Ⅴ组脑组织含水量双侧正常,Ⅲ组双侧均显著高于Ⅰ、Ⅴ组（P＜0.05）;Ⅱ、Ⅲ组损伤侧脑组织EB含量显著高于Ⅳ、Ⅴ组（P＜0.05）.结论小容量HHS复苏能够有效、持久地恢复颅脑外伤并发失血性休克大鼠的MAP和rCBF,减轻脑水肿,改善BBB.NS恢复MAP和rCBF的时间较短,加重脑水肿和BBB破坏.10%HES的作用介于小容量HHS和NS之间.     

Adipose tissue compartments and insulin resistance in overweight-obese Caucasian men

We examined the association between insulin resistance and adipose tissue compartments in overweight/obese men. Total intra-abdominal, intraperitoneal, retroperitoneal, total subcutaneous, anterior subcutaneous and posterior subcutaneous abdominal adipose tissue (PSAAT) masses (total intra-abdominal fat TIAATM, IPATM, RPATM, TSAATM, ASAATM and PSAATM, respectively) were quantified in 51 overweight/obese men using magnetic resonance imaging (MRI). Total adipose tissue mass (TATM) was also determined using bioelectrical impedance. Insulin resistance was estimated by homeostasis model assessment (HOMA) score. In univariate regression analysis, all fat compartments, with the exception of RPATM, were significantly and positively correlated with the HOMA score. The positive correlation between HOMA score and both IPATM and anterior subcutaneous adipose tissue mass was independent of obesity status. After adjusting total for TATM, only IPATM was significantly correlated with HOMA score (partial r=0.38, P<0.01). In stepwise regression, IPATM was the best predictor of HOMA score. In multivariate regression models including age, obesity status, non-esterified fatty acid (NEFAs) levels, triglycerides and energy expenditure, IPATM remained a significant positive predictor (P<0.05) of HOMA score. In overweight/obese men intraperitoneal AT is the fat compartment that best predicts the degree of insulin resistance. This association appears to be independent of age, total body fat mass and obesity status.     

Diagnosis of diabetic peripheral neuropathy among patients with type 1 and type 2 diabetes in France, Italy, Spain, and the United Kingdom

AIMS: The objective of this study was to describe the proportion and characteristics of patients with type 1 and type 2 diabetes diagnosed with diabetic peripheral neuropathy (DPN) in France, Italy, Spain, and the United Kingdom (UK). METHODS: A cross-sectional survey was administered to general practitioners and diabetes specialists. Existing physicians' records were used to quantify the frequency of DPN diagnoses, and notes from patients' medical charts were used to characterize symptoms. RESULTS: The average number of physicians per country was 41 (range of 34-49). The proportion of diabetes patients diagnosed with DPN ranged from 9.6% (95% CI, 7.1-12.2) in Spain to 23.1% (95% CI, 15.4-30.7) in Italy. Of 913 DPN study patients, 55.0% were male, and 78.5% had type 2 diabetes. Mean age was 64.5+/-12.5 years. A DPN diagnosis was based primarily on symptoms. Approximately 27% of patients had no documented neurological examination. "Prickling" was the most common DPN symptom recorded in France, Italy, and Spain, and "numbness" was the most common in the UK. CONCLUSIONS: Country-specific estimates of DPN diagnosis may reflect clinical management of diabetes and DPN. A substantial number of diagnoses were not associated with a record of a neurological examination.