海口地区2000年临床分离菌耐药性监测

目的：监测海口地区临床分离菌对抗菌药物的耐药状况。方法：采用VITEK微生物自动分析仪测定药敏。结果：2000年共收集临床分离菌1399株，革兰阳性球菌426株（30．5％），革兰阴性杆菌973株（69．5％），以铜绿假单胞菌、大肠杆菌、金黄色葡萄球菌、肺炎克雷伯杆菌最多见，所监测的细菌总体耐药率比国内其他地区偏高，且出现万古霉素耐药的表皮葡萄球菌和粪肠球菌。结论：海口地区的细菌耐药严重，控制细菌耐药成为当务之急。     

50岁以上肾移植的临床分析

自１９８９年１月～１９９５年１２月共施行同种异体尸肾移植术５５６例次，其中５０岁以上患者１８２例（３２７％），对这些患者的临床资料进行比较分析。结果显示：５０岁以上组１、３、５年的人／肾存活率分别为８３４％／７９３％、７７１％／７１１％和５４５％／４５５％，与４９岁以下组比较差异无显著性（Ｐ＞００５），急性排斥发生率并不比４９岁以下组高，并发症发生率尤其是感染发生率及致死率均高于４９岁以下组（Ｐ＜００５）。本资料说明，年龄不是肾移植的主要影响因素，感染和心血管并发症是主要的死亡原因和影响长期存活的因素。适应证的选择和术前充分透析，术后合理应用免疫抑制剂，定期复查及心、肝、肺功能的监护，是提高高龄肾移植患者长期存活的主要因素。     

Detection ofHelicobacter pylori in gastric biopsy tissue by polymerase chain reaction

To evaluate the sensitivity of a polymerase chain reaction (PCR) assay using nested primers in detectingHelicobacter pylori, gastric tissue biopsy specimens were collected on endoscopy from 17 patients with a duodenal ulcer. DNA was extracted by phenol/chloroform treatment or boiling in water, and then subjected to a nested PCR using two primer pairs from the urease gene ofHelicobacter pylori. Fourteen of the 17 patients were positive forHelicobacter pylori using DNA samples extracted by either method. The PCR results correlated well with the results of an enzyme immunoassay to detect IgG antibody. However, there were two culture negative patients. The three PCR negative patients were both culture negative and serologically negative. DNA from 9 of the 14 patients was randomly selected and subjected to semiquantification by serial dilutions, and then PCR. The results showed that phenol/chloroform extraction yielded 10–1000 times more DNA than the boiling method. It is concluded that the PCR assay is a rapid and sensitive method for detectingHelicobacter pylori, and that phenol/chloroform extraction is superior to simple boiling in obtaining DNA samples for PCR.     

血清LSA测定在恶性肿瘤临床诊断中的初步应用

本文根据Svennerholm和蒋谷人等的方法略加改良,测定了蚌埠地区113例正常人,71例恶性肿瘤患者和82例非肿瘤疾病患者血清脂质结合唾液酸(LSA)的含量。正常值为12.4mg/dl(SD=±3.6mg/dl),71例不同肿瘤患者的平均值为28.2mg/dl(SD=±9.7mg/dl),阳性率为88.7％,82例非肿瘤疾病患者的平均值为16.82mg/dl(SD=±5.4mg/dl),假阳性率为17％。方法的灵敏度,重复性(平均CV=3.6％)和回收率(平均回收率=101.4％)测定结果是满意的。本研究的初步结果表明,血清LSA测定对肺癌、白血病、胃癌和食管癌具有一定的临床诊断价值。     

Osteoporosis and Coronary Atherosclerosis in Asymptomatic Postmenopausal Women

Estrogen deficiency is a risk factor for osteoporosis and coronary artery disease. Osteoporosis can be evaluated by measuring bone mineral density (BMD). Coronary atherosclerotic burden can be evaluated by measuring coronary calcium using electron beam computed tomography (EBT) of the heart. We compared coronary calcium scores in 45 asymptomatic postmenopausal women with normal and low BMD. BMD of the lumbar spine and proximal femur was measured by dual X-ray absorptiometry (DXA), and coronary calcium was measured quantitatively by EBT. Women were divided into control, osteopenia, and osteoporosis groups based on the T score of the lumbar spine. Women were similar in age, years since menopause, height, weight, and body mass index (BMI). BMD ± SD (g/cm²) of L1–L4 was 0.96 ± 0.11, 0.83 ± 0.03, and 0.73 ± 0.05, in control, osteopenia, and osteoporosis group, respectively. The total coronary calcium score ± SD (relative units) was 41.9 ± 83.1, 115.1 ± 181.9, and 221.7 ± 355.4 for control, osteopenia, and osteoporosis group, respectively; the score was significantly higher in the osteoporosis than in the control group. This study provides initial data suggesting that women with osteoporosis may have a higher risk of developing coronary atherosclerosis.     

紫胡皂甙的高效液相色谱分离与测定

建立了高效液相色谱法，应用反相柱，以甲醇－水（６６∶３４）为流动相，分离了柴胡中的主要有效成分柴胡皂甙ａ、ｃ、ｄ（Ｓａｉｋｏｓａｐｏｎｉｎａ，ｃ，ｄ）并用紫外法进行含量测定。     

The bioavailability and nonlinear pharmacokinetics of MK-679 in humans

MK-679 (R(?)-3-((3-(2-(7-chloro-2-quinolinyl)ethenyl)phenyl)(3-(dimethylamino)-3-oxopropyl)thio)methyl)thio(propanoic acid) is a potent and specific LTD₄-receptor antagonist. The disposition of MK-679 was investigated in a three-way crossover study in 12 healthy males receiving single intravenous doses of 75, 250, and 500 mg of MK-679. A greater than proportional increase in the area under the plasma concentration—time curve of MK-679 was observed with increase in dose. The plasma concentration data for each subject fitted well to the differential equations for a two-compartment model with linear tissue distribution and Michaelis-Menten elimination from the central compartment, indicating that the elimination of MK-679 in humans is saturable. In a previous study, the disposition of MK-679 in humans was also dose-dependent when given together with its S(+)-isomer, L-668,018. Thus, the disposition of MK-679 in humans is dose-dependent regardless of the presence of its stereoisomer. Also, the bioavailability of MK-679 was determined in six healthy males receiving simultaneously an oral dose of 250 mg of MK-679 and intravenous infusion of 1 mg ¹⁴C-MK-679. Results of this study indicate that the oral bioavailability of MK-679 is nearly quantitative.     

角膜地形图与角膜曲率计在白内障手术前后评价

本文应用计算机辅助的角膜地形图系统TMS-1和角膜曲率计TOPCONOM-4同时测定了200例(278眼)的角膜地形图和中央角膜屈光状态。比较了角膜地形图的模拟角膜曲率SIMK值和角膜曲率计的垂直和水平屈光度。结果显示,白内障术前组116例150眼的SIMK平均值分别为44.22D(垂直轴)和44.26D(水平轴),角膜曲率计的中央屈光度垂直轴平均为44.16D,水平轴为44.23D。统计学处理表明,2种组方法的结果之间差异无显著性(P>0.05),第2种术后组67例90眼的SIMK平均值分别为46.37D(垂直轴)和43.06D(水平轴),角膜曲率计的中央屈光度垂直轴平均为46.09D,水平轴平均为42.88D,统计学处理二种方法的结果之间差异无显著性(P>0.05)。研究提示,角膜地形图系统的模拟角膜曲率SIMK值和角膜曲率计的屈光度无论在白内障手术前还是在手术后其结果是一致的,临床应用具有同等的价值。但是,当角膜中央屈光度异常范围小于3毫米,角膜混浊,角膜严重不规则散光时,角膜曲率计不能满足临床需要。而计算机辅助的角膜地形图系统则具有极大的诊断及检测价值。眼科学报 1994;10:85—89。     

人工晶体植入术后继发青光眼的临床分析

报告14例后房型人工晶体植入术后继发青光眼患者，男性8例，女性6例。均为单眼发病，其中10例发生在术后1个月以内，另4例发生在1～3年以后。其中开角型8例，闭用型6例。7例经抗青光眼药物治疗可控制眼压，4例用激光治疗，另3例需行抗青光眼手术。治疗前矫正视力达0．5以上者为28％，治疗后矫止视力达0．5以上增加至50％。所有病例均眼压控制良好、视力不良原因为青光眼世视神经萎缩，提示早期发现的重要性。     

复治矽肺结核化疗效果观察

我们自１９８０～１９８８年对７９例复治矽肺结核进行化疗。其中绝大多数为慢性纤维化空洞性病例，均经细菌学证实，并由尘肺诊断组认定为矽肺合并结核。本组病例分别以ＫＭ、ＩＮＨ、ＲＦＰ、ＰＺＡ，或ＳＭ、ＩＮＨ、ＲＦＰ、ＥＢ联合，分两阶段治疗１８个月，获痰菌阴转７９．２％，其中ＫＨＲＺ与ＳＨＲＥ组分别为９３．９％与６８．２％（Ｐ＜０．０５）。自疗程结束追踪２～８年，其细菌复阳率分别为６．４５％和１０．０％（Ｐ＞０．１）。并对影响其过去治疗失败的原因及对策进行了讨论。