肾病综合征合并乳糜性腹水3例报告

原发性肾病综合征是临床常见的一种疾病，常合并胸、腹水，腹水一般为漏出液，并发乳糜性腹水较为少见，至2002年国内仅报道3例。本院2002-06～2004-06收治3例，治疗效果良好。报道如下。     

重庆地区肺炎链球菌耐药性和分子流行病学调查

目的调查重庆地区肺炎链球菌在社区获得性感染患者中的分离率及对抗生素的敏感性。方法采集社区获得性感染患者的痰、鼻咽拭子标本,培养、分离和鉴定肺炎链球菌。琼脂二倍稀释法测定肺炎链球菌对11种抗生素的耐药性。通过聚合酶链反应(PCR)扩增肺炎链球菌BOX重复元件对其进行分子流行病学分型。结果680份临床标本中,分离出39株肺炎链球菌,阳性率为5.7%。34株(有5株在保存过程中死亡)肺炎链球菌中有2株对青霉素低度耐药(MIC为0.125mg/L),1株青霉素敏感株对左氧氟沙星耐药(MIC为8mg/L)。肺炎链球菌对大环内酯类抗生素和克林霉素表现出较高的耐药率,且均为高度耐药(MIC≥64mg/L),对所测其他β内酰胺类和万古霉素均呈敏感。盒式PCR显示了较高的分辨率,能快速、可靠地检测菌株间的亲缘关系。35株肺炎链球菌共分为25个型,29个亚型,最多见的为A型图谱(3株),2株青霉素低度耐药株分属不同的型。结论重庆地区分离的临床肺炎链球菌对青霉素耐药率较低,但对大环内酯类抗生素和克林霉素耐药却非常普遍。盒式PCR能快速、可靠地对肺炎链球菌进行分子流行病学分型,重庆地区耐药克隆没有明显的优势株。     

制约医院发展的因素与解决办法

“以病人为中心”指的是医疗服务活动要以病人的需要为中心，以病人的需求、身心健康作为服务的出发点和落脚点。面对不断变化的医疗环境，有些医院缺乏清醒认识，部分职工仍认为医院是打不破的铁饭碗，无视病人需求、无视价值规律的作用、无视竞争的无情，躺在计划经济体制下旧经营模式的摇篮中，     

吸脂减肥术的风险

吸脂手术,是六大医疗美容项目之一,据说减肥效率快、不反弹,很快被人们广泛接受。“人造美女”热潮中的“南京第一魔女”葛莹、中国“第一人造美女”郝璐璐、 “中原第一人造美女”22岁的洛阳姑娘曹媛,都进行过身体多部位的吸脂整形手术。目前吸脂减肥术常见有以下几种:超声吸脂术、电子吸脂术和最常见的快速负压吸脂术。超声吸引术 是通过超声发生器产生一定频率的超声波,将之对准减肥部位,通过超声震荡将脂肪细胞或脂肪颗粒击碎,然后再挤出或吸出,理论上不损伤血管神经,但实际应用起来产生效果慢,仍有血管神经的损伤。电子吸脂术 是通过电…     

中西医结合治疗小儿功能性消化不良疗效观察

目的 观察中西医结合治疗小儿功能性消化不良的临床疗效。方法 将60例患儿随机分为两组，治疗组30例予健脾益气汤加吗丁啉口服，对照组30例单服吗丁啉，2周为1个疗程；比较两组疗效。结果 治疗组临床治愈17例，显效10例，有效3例，总有效率为100％；对照组临床治愈7例，显效14例，有效7例，无效2例，总有效率为93．33％。结论 健脾益气汤配合吗丁啉治疗小儿功能性消化不良较单用吗丁啉疗效为佳。     

正交实验法优选枇杷叶药渣中乌索酸提取工艺

目的确定枇杷叶药渣中乌索酸的最佳超声提取工艺条件。方法采用正交设计L9(34)方法,考察乙醇浓度、料液比、超声时间和提取次数对乌索酸提取率的影响,用高效液相色谱法测定含量,并与常规提取法进行了对比。结果所考察的因素对枇杷叶药渣中乌索酸提取的影响程度为:乙醇浓度>提取次数>料液比>超声时间;超声提取的最佳条件为:A3B1C1D2。结论与常规的提取方法相比,超声提取具有提取时间短、操作简单、提取率高、无需加热等优点。     

EFFECT OF ELECTROACUPUNCTURE ON THE IMMUNOREACTIVITY OF FOCAL CUTANEOUS μ-OPIOID RECEPTOR IMMUNOREACTION-POSITIVE FIBERS IN ADJUVANT ARTHRITIC RATS

Objective: To study the effect of μ-opioid receptor (MOR) expression in the inflammatory skin tissue and the effect of electroacupuncture (EA) on the topical immunoreaction (IR) of MOR positive fibers in adjuvant arthritic (AA) rats. Methods: A total of 48 SD rats were randomized into control (n = 8), model (n = 10), focus-side-EA (n = 10), non-acupoint-EA (n = 10), and healthy-side-EA (n = 10) groups. AA model was established by subcutaneous injection of complete Freund's adjuvant (CFA, 50 μL) into the left hind paw. EA (4-16 Hz, 0.5-1.5 V) was applied to "Huantiao" (环跳 GB 30) and "Yanglingquan" (阳陵泉 GB 34) on the focus or healthy side and non-acupoints for 30 min. Non-acupoints used were the two sites 5 mm to GB 30 and GB 34 on the healthy side. The topical MOR IR-positive fibers in the dermal and subcutaneous tissues of the focus was stained with immunohistochemical method. The severity of pain was detected by foot (ankle-joint)-bending test. Results: Compared with model group, the "foot-bending test" score decreased significantly in focus-side-EA group on the 9th and 11th day (P<0.05) and in non-acupoint-EA group on the 8th, 9th and 11th d after injection of CFA (P < 0.05), indicating that EA of bilateral GB 30 and GB 34 and non-acupoints all can relieve pain. From the 13th day on, no significant differences were found in "foot-bending test" scores among the 3 EA groups and model group (P >0.05). In comparison with control group, the area values of MOR IR-positive nerve fibers in the focus tissue were significantly higher in 3 EA groups (P<0.05). The area values of MOR IR-positive nerve fibers in the focus in model group and 3 EA groups were significant higher than that in control group (P<0.05). Compared with model group, the area values of MOR IR-positive fibers in focus-side-EA group and healthy-side-EA group increased significantly (P<0.05); while those of MOR IR-positive fibers in non-acupoint-EA group and healthy-side-EA group were significantly lower than that in focus-side-EA group (P<0.05), and no significant differences were found among model group, healthy-side-EA group and non-acupoint-EA group in the area of MOR IR-positive fibers (P>0.05), indicating a stronger effect of EA of acupoints on the focus side. Conclusion: EA of GB 30 and GB 34 can relieve inflammatory pain and up-regulate the expression of MOR IR-positive fibers in the focal skin tissues in AA rats, exerting anti-inflammatory and analgesic effects.     

软肝冲剂抗免疫损伤性肝纤维化的实验研究（2）

目的：探讨软肝冲剂治疗肝纤维化的作用机理。方法：制备免疫损伤性肝纤维化模型。以软肝冲剂作治疗组，促肝细胞生长素及秋水仙碱作对照组，观测肝组织Ⅲ型胶原（Collagen）、转化生长因子β1（TCFβ1）的免疫组化以及肝细胞生长因子（HGF）mRNA的原位杂交表达等。结果：肝脏组织TCFβ1、CollagenⅢ的免疫组化显示软肝冲剂组阳性表达显著减少；原位杂交及RT-PCR电泳图谱示软肝冲剂能明显抑制HGFmRNA的表达。结论：软肝冲剂具有明显的抗肝纤维化作用。     

抓住机遇,促实验室建设与管理

本文从首都医科大学公共卫生与家庭医学学院的成立,结合新建实验室的特点,改建旧实验室模式,创建教学实验中心新体系;对实验室管理的规范化、科学化和现代化的探讨。     

经内镜金属夹钳夹术治疗非静脉曲张性上消化道出血

非静脉曲张性上消化道出血是内科的急症之一，及时胃镜检查和镜下治疗是关键。我院2001年7月至2006年7月经胃镜下使用金属钛夹止血67例，疗效满意，现报告如下。