2006～2007年桐乡市不同人群HIV监测检测结果分析

目的:分析不同人群HIV监测结果及感染者特征,制定有效的防控措施。方法:采用EXECL数据库对2006~2007年桐乡市各艾滋病实验室检测数据和网络直报个案资料进行整理、分析。结果:2006年检测38674份血清,确认HIV抗体阳性为10例,占0.03%,2007年检测37287份,确认HIV抗体阳性为6例,占0.02%,HIV阳性者的家属的检测确认阳性率都最高,分别为14.29%和16.67%。感染者特征中21~25岁为感染主要年龄段,以无业为主,以性行为为HIV传播的高危行为,住在城镇较多。结论:桐乡市的艾滋病处于低流行水平,且以特定人群为主,有向一般人群扩散的趋势,故要继续加强监测并采取以开展健康教育为主的干预,特别是面向农村和农民,提高自我防范意识,以遏制艾滋病在我市的流行和蔓延。     

尿毒症血液透析合并急性左心衰患者心肌酶的变化

目的探讨尿毒症血液透析合并急性左心衰患者心肌酶升高的临床意义。方法尿毒症并急性心力衰竭患者38例为心衰组,同期未发生心衰的尿毒症患者40例为对照组,检测两组肌酸磷酸激酶(CK)、肌酸磷酸激酶同功酶(CK-MB)、乳酸脱氢酶(LDH)、羟丁酸脱氢酶(HBDH)、谷草转氨酶(AST)、肌钙蛋白(cTnT)的变化。结果心衰组出现了不同程度的心肌酶谱的升高,以CK、CK-MB及HBDH升高最为显著(P<0.01),LDH及AST未见明显升高(P>0.05)。对照组仅个别患者出现CK、CK-MB及HBDH升高。但两组患者均有cTnT的升高,心衰组出现率为34.2%,对照组为30%。结论尿毒症合并急性左心衰患者的心肌酶出现明显升高,检测心肌酶的变化对于尿毒症患者的预后有重要意义。     

腹膜透析患者出院后延续护理需求与生活质量调查

目的:探讨腹膜透析患者出院后不同阶段的延续护理需求及生活质量的变化。方法:采用纵向调查法,于患者出院后第1、3、6及12个月分别使用自行设计的一般资料调查表、腹膜透析患者延续护理需求量表、肾脏病专用生活质量简表(KDQOL-36TM)开展4次调查。结果:腹膜透析患者出院后12个月内延续护理需求总分呈先上升后下降趋势,分别为(121.17±8.57)、(121.54±7.75)、(125.88±8.07)和(123.15±8.10)分,患者生活质量总分呈逐渐下降趋势,分别为(45.57±5.03)、(45.52±4.93)、(44.89±5.05)和(44.58±5.07)分。结论:腹膜透析患者不同阶段的延续护理需求及生活质量不同,医护人员应针对患者不同阶段的护理需求提供个性化的护理干预,提高患者生活质量。     

核素心肌灌注显像定量分析技术诊断本地人群冠心病的价值

Objective To evaluate the accuracy of automated quantification of myocardial perfusion imaging (MPI) using a method based on a Western normal database for the detection of coronary artery disease (CAD) in a group of Chinese patients. Methods Seventy-two Chinese patients who underwent coronary angiography (CAG) and MPI within 3 months were recruited into this study. Eighty selected from 140 Chinese patients with low probability of CAD ( ＜ 5% ) were enrolled into local normal database of 99Tcm-methoxyisobutylisonitrile (MIBI) MPI using Cedars quantitative perfusion SPECT (QPS) database. Two Western MPI normal databases (CSMC MibiMbiAuto and Mibimibi) were used for processing the Chinese CAD patients recruited in this study, and the results were compared with those using local normal database and visual interpretation. T-test and z-test were used for statistical analysis. Results The extent (EXT)measurement obtained from Mibimibi and local database was ( 10.73 ± 14.54)% and ( 14.22 ± 16.51 )%,respectively ( t = 7.87, P ＜ 0.001 ); the severity (SEV) was 1.07 ± 0.93 and 1.34 ± 1.20, respectively ( t =7.45, P＜0.001). The area under curve(AUC) by using EXT measurement for local database (0.85 ±0.05) was larger than that for CSMC MibiMbiAuto ( AUC = 0.72 ± 0.06, z = 2.50, P ＜ 0.01 ) and Mibimibi ( AUC = 0.77 ± 0.06, z = 2.47, P = 0.014). The AUC of local database showed no significant difference from that of visual interpretation (AUC=0.83 ±0.05, z=0.05, P＞0.05). Conclusion Quantification of MPI of our Chinese patients using Western normal database would decrease the accuracy for the detection of CAD.     

局限性胸膜纤维瘤的影像表现

目的：探讨胸膜局限性纤维瘤的影像特点,以提高对它的认识。方法：回顾性分析了2002年～2008年经穿刺及手术病理证实的12例局限性纤维瘤的影像表现。结果：12例均为单发性病灶,右侧7例,左侧5例。其中最小1例直径约3cm,3～10cm的4例,10～15cm的3例,4例大于15cm。12例X线平片均见病灶密度均匀,边界清楚,无肋骨及椎体的骨质破坏征象。CT平扫见病灶与胸壁紧密相连。较小病灶密度均匀,境界清楚,大病灶内可见斑点状低密度坏死区,但其边界光滑,相邻组织受压移位。CT平扫中12例病灶的CT值平均为33.4±5.7HU,而周边肌肉的CT值平均为52.9±6.2 HU,经两样本均数的t检验,P=0.0367（P〈0.05）。3例增强扫描见病灶中等度强化,坏死区不强化。2例行MRI检查,T1WI见病灶呈类似肌肉的稍低信号,T2WI为与肌肉相似的等信号,坏死区为高信号。结论：局限性纤维瘤具有相对特征性的影像表现,CT、MRI均可显示其病变的范围及其性质。     

多囊卵巢综合征患者子宫内膜组织中同源框基因A10蛋白的表达

目的:检测多囊卵巢综合征(PCOS)患者子宫内膜组织中同源框基因(HOX)A10的表达.方法:采集20例已婚PCOS患者和26例已婚正常育龄妇女子宫内膜组织标本,HE染色判定内膜分期,采用免疫组化SP法检测不同患者子宫内膜HOXA10的表达.结果:PCOS患者子宫内膜间质反应不良和PCOS分泌中期组的子宫内膜分泌反应欠...     

The effect of estrogen replacement therapy on novel-object recognition and extinction of conditioned fear memory in ovariectomized rats

OBJECTIVE To investigate the effect of estrogen replacement therapy on novel-object recognition and extinction of conditioned fear memory in ovariectomized(OVX) rats.METHODS Sixty sexually mature(>90 d) female SD rats weighing 250-350 g were used as subjects.The rats were randomly divided into 7 groups as follows: OVX with low dose of estrogen replacement(OVX+LD,0.1 mg·kg-1,n=9),medium dose(OVX+MD,0.3 mg·kg-1,n=9) and high dose(OVX+HD,0.9 mg·kg-1,n=9),estrogen replacement with medium dose at 2 weeks after OVX(MD+2W,n=9) and 4 weeks after OVX(MD+4W,n=8),OVX group(n=8) and Sham group(SH,n=8).One week after arrival,all rats underwent surgery,and after at least 1 week of recovery from surgery,rats were allowed to experiment.According to the different dose and time schedules,each group was administrated estrogen or vehicle via subcutaneous injection on the dorsal side of the rat.Estrogen maintenance one month after ovariectomized surgery,then,the Novel-object recognition and extinction of conditioned fear memory were tested.RESULTS The rats after OVX showed access-dependent impairments on novel-object recognition and the estrogen replacement therapy can reversal this phenomenon,but not the HD group.Simultaneously,the effect is associated with the time schedules of estrogen,the earlier the better.On extinction of conditioned fear memory,the OVX rats produced significantly less freezing by fear context than that of SH rats,after chronic administration with estrogen one month exhibited the enhanced acquisition of context fear,except HD group.Estrogen replacement therapy also increased the speed of extinction of conditioned fear memory.CONCLUSION These results indicate that estrogen may have an effect on the central nervous system,and it plays an important role for improving emotional learning and memory during deprive of sex hormone.     

一种新的手术方式:声带外展下移术治疗双侧神经麻痹

目的探讨一种新的手术方式:声带外展下移术治疗双侧神经麻痹临床优势及特点。方法回顾性分析15例使用声带外展下移术治疗双侧神经麻痹的临床效果。结果所有患者术后伤口一期愈合。9例患者术后10天拔管,6例患者术后半月至1月时拔管。复查时间1年至2年不等,患者正常生活,均未见呼吸不畅情况发生。结论声带外展下移术疗效确切,具有能同时照顾到呼吸通畅度、发声及避免呛咳的作用。     

踝关节骨折的治疗进展

尽管对旋转暴力型踝关节骨折的研究已经相当深入并且基本治疗策略已较为成熟,但向纵深和细微发展,还存在较多的争议,有进一步研究的必要。如某些骨折类型的手术指征并未获得广泛的认同,如何精准评估下胫腓联合的损伤还值得深入探讨,在下胫腓联合固定和后踝固定方面也还存在不同意见。随着技术的进步,可吸收内固定及微创技术的应用可望在骨折治疗中取得更好的结果,但对其手术经验和远期治疗效果还需更多的观察与总结。     

脑血肿动物模型的建立及MRI表现

本文详细介绍了脑血肿动物模型的建立方法，其成功的关键是，选择适当的钻孔点和注入的深度及血肿量，此外掌握好注入的速度也很重要，同时了各期龄脑血肿模型的ＭＲＩ表现，还有血肿模型的价值评价。