钩端螺旋体病的血清学诊断

钩端螺旋体病是一种世界范围的人畜共患病,血清学试验是其重要的诊断方法之一,聚合酶链反应的应用加速了其分子水平的研究。为适应广大发展中国家的国情,一些简便、快速、价廉的血清学诊断方法应运而生,或在原有基础上加以改进。本文就目前开展的钩端螺旋体病血清学诊断方法作了综述。     

IFAT和RPHI检测EHF病毒抗体的比较观察

<正> 我们用间接免疫荧光法(IFAT)和反向间接血凝抑制试验(RPHI)对流行性出血热(EHF)病毒抗体的诊断做了比较,结果报告如下。 材料和方法 一、标本来源 1986年4月采自宁乡县病人血清,用无菌试管保存在-20℃冰箱中备用。 二、药盒 羊抗人IgG 荧光血清系上海生物制品研究所产品(批号 8501-3);抗原系湖南株R_(45)细胞培养片;RPHI法药盒由南京军区后勤部军事医学研     

重型肝炎患者肝组织Ⅰ型胶原和血小板衍生生长因子-1mRNA的表达及Ⅰ、Ⅳ型胶原蛋白表达的研究

目的：了解重型病毒性肝炎患者肝组织Ⅰ型胶原mRNA、血小板衍生生长因子-1(PDGF-1)mRAN及Ⅰ、Ⅳ型胶原蛋白的表达情况，探讨重型病毒性肝炎肝纤维化发生的分子机制。方法：重型病毒性肝炎肝组织标本20例，正常肝组织6人份，用原位杂交检测肝组织Ⅰ型胶原和PDGF-1mRNA的表达，用免疫组化法观察肝组织Ⅰ、Ⅳ型胶原蛋白的沉积、分布和含量，用天狼红染色观察肝组织总的胶原含量。结果：与正常肝组织相比，重肝患者的肝组织Ⅰ型肢原和PDGF-1mRNA的表达显著增加，Ⅰ、Ⅳ型肢原蛋白大量沉积，PDGF-1mRNA的表达与Ⅰ型肢原mRNA的表达呈显著正相关，和总的胶原含量，Ⅰ、Ⅳ型胶原蛋白的表达也呈显著性正相关，Ⅰ型胶原mRNA的表达和Ⅰ型胶原蛋白的表达呈显著正相关。结论：重型肝炎患者PDGF-1mRNA与Ⅰ型胶原mRNA表达的增加是导致肝组织胶原蛋白合成增加，重型肝炎发展成肝纤维化乃至肝硬化的原因之一。     

平平淡淡才是真——与“南京小姐”栾晓华聊天

栾晓华:18岁,身高约1.7米,建筑中专毕业,喜欢体育、做手工、绘画、读书、看电视…… “我来自校园,小时侯住在海边。在赶海的时侯,奶奶告诉我:在天与海交界的地方,也就是梦幻成真的地方。此后,我常常坐在海边,看着天与海的尽头,幻想梦幻成为现实。日子一天天过去,我发现这并不是一个童话。于是,我常常告诫自己,只有付出努力,只有坚定不移,只有永不放弃,你才能成功,你才无愧于自己。”     

游离肩胛皮瓣在深度烧伤创面上的应用(附三例报告)

肩胛皮瓣1980年首先应用于临床以来,因其解剖清楚,可取皮面积大,隐蔽而又不损伤供皮区功能,因而它已成为游离皮瓣首选供区。我科采用肩胛皮瓣游离移植修复深度烧伤创面三例,疗效满意。现报道如下:1　临床资料1)　一般资料:2000年1月以来,我科采用肩胛破瓣游离移植修复深度烧伤创面三例。均为男性。年龄各为23、21、44岁。两例为电烧伤,各在伤后第50天、3天手术;另一例为碳火烧伤,伤后193天手术。手术部位各为:右侧头颅颅骨外露(创面11cm×7cm,右手腕部(腕环形电烧伤),右尺动脉栓塞,旋前方肌坏死等),左小腿及右足部(胫骨远端,跖骨外露,创面14…     

Rh血型遮断现象1例

红细胞表面血型抗原完全被某种抗体结合后，进行血型鉴定时发生遮断现象，易导致血型定型错误。笔者遇见一例，现报告如下。     

保留变性真皮与薄自体皮移植治疗深度手烧伤

目的探讨一种治疗深度手烧伤的新手术方法。方法选择手部深Ⅱ度和混合度烧伤病例，削痂手术时保留创面变性真皮，取大张薄自体中厚皮片移植覆盖创面，加压包扎7～8天，手术争取在烧伤后72h进行。结果16例(27只手)，24只植皮成活好，手功能恢复满意。供皮区愈合快，不留瘢痕。结论 保留变性真皮与薄自体皮复合移植是治疗深度手烧伤的一种可行的手术方法。     

强化精氨酸肠内营养对烧伤患者营养状况和细胞免疫的影响

Objective To investigate the effects of arginine enriched enteral nutrition (EN) on nu-tritional status and cellular immunity of severely burned patients. Methods Randomized, single blind, parallel and positive control investigation was employed in the study. Thirty severely burned patients were di-vided into enteral immune nutrition (EIN) group and EN group. Sixteen patients in EIN group received en-teral nutrition enriched with arginine, while the other 14 patients in EN group received standard enteral nu-trition. Nutritional support was continued for 14 days. Gastrointestinal reaction of patients in 2 groups was observed. Fasting venous blood was drawn from patients of both groups before receiving nutrition treatment and on the morning of 7th, 14th day of treatment. Level of serum protein, hepatic function parameters, renal function parameters, fasting-blood glucose, and subpopulations of T lymphocytes in peripheral blood were determined. Results (1) Incidence of gastrointestinal side effect in EIN group (25.0%) was close to that of EN group (21.4% , P>0.05). (2) Compared with pre-treatment days, levels of prealbumin and transferrin in serum of patients in 2 groups on 7th and 14th post-treatment days were significantly increased (P<0.05 or P<0.01), but there was no significant difference between 2 groups. The level of total serum protein on 14th day of treatment of patients was significantly increased in both groups, and that of EIN group (66±7 g/L)was significantly higher compared with that in EN group (64 ± 11 g/L, P<0.05). The level of serum albumin (29±5, 32±5 g/L, respectively) of patients in EIN group on 7th and 14th day of treat-ment were significantly higher than that (26±4 g/L, P <0.05) in pre-treatment days, however there was no significant difference in EN group. (3) There was no significant difference in respect of hepatic function, renal function, and fasting-blood glucose between pre-treatment and post-treatment periods in both groups (P>0.05). (4) The ratio of CD4+ , CD8+ on 14th day of treatment in EIN group was close to that of pre-treatment level. In EN group, cell percentage of CD4+ significantly decreased, while that of CD8+ significantly increased (P<0.05), and CD4+ was significantly higher [(56±8) %] in EIN group than that in EN group [(55±12) % , P <0.05]. In both groups, cell percentage of CD3+ was significantly higher than that in pre-treatment days (P<0.05), while there was no obvious change in CD4+/CD8+. Conclusions Arginine enriched enteral nutrition can effectively improve nutritional status and cellular immune function of burn patients.     

四种逆行岛状皮瓣坏死的原因与防治

目的 探讨逆行岛状皮瓣在移植过程中坏死的原因与防治措施. 方法 选取因修复四肢创面所施行的62例逆行岛状皮瓣,对皮瓣的设计、手术方法、皮瓣危象、皮瓣下感染、皮瓣下血肿形成及术后皮瓣撕脱等因素进行分析. 结果 小腿前外侧逆行岛状皮瓣8例,其中1例因肌腱炎发生皮瓣下感染,1例因静脉危象出现部分坏死;远端蒂腓肠神经营养血管皮瓣31例,其中2例因静脉危象部分坏死,3例发生皮瓣下感染,6例出现皮瓣下血肿;前臂骨间背侧动脉逆行岛状皮瓣9例,其中1例因动脉危象全部坏死,1例因静脉危象全部坏死,1例出现皮瓣下血肿;前臂链式血供逆行岛状筋膜皮瓣14例,其中1例因皮瓣撕脱坏死,4例出现皮瓣下感染. 结论 动脉供血不足与静脉回流障碍是本文4种逆行岛状皮瓣坏死的主要原因;蒂部处理是手术成功的关键;皮瓣下感染与血肿形成严重影响皮瓣的存活质量和愈合时间.