舰船员慢性荨麻疹与马拉色菌相关性研究

目的研究舰船员慢性荨麻疹发病与马拉色菌的关系。方法对126例舰船员慢性荨麻疹患者及45例健康者进行真菌学比较研究。将马拉色菌阳性的82例慢性荨麻疹患者分为A、B两组,A组单用抗组胺药,B组用抗组胺药联合2%酮康唑洗剂治疗。结果舰船员慢性荨麻疹患者皮肤马拉色菌带菌率高于正常对照组(P<0.01),两治疗观察组于治疗结束时,疗效无显著性差异(P>0.05);治疗结束6~8周后,B组疗效高于A组,有显著性差异(P<0.01),且B组真菌学检查马拉色菌转阴率高于A组(P<0.01)。结论舰船员慢性荨麻疹与皮肤马拉色菌有一定相关性,联合抗真菌治疗能提高其远期疗效。     

医院感染常见细菌分布与耐药性分析

目的了解细菌分布及常见细菌的耐药性。方法回顾性分析某院2000—2004年临床标本分离的细菌及其耐药性监测结果。结果1439株细菌中，革兰阳性菌456株（31．69％），以凝固酶阴性表皮葡萄球菌为多，达206株（45．18％），其次为金黄色葡萄球菌92株（20．18％）；两种葡萄球菌的耐药率相似，对万古霉素耐药率均为0。革兰阴性菌983株，前5位依次为肠杆菌属346株（35．20％），克雷伯菌属164株（16，68％），铜绿假单胞菌155株（15．77％），埃希菌属101株（10．27％），变形杆菌属94株（9．56％）；前5位革兰阴性菌对常用抗菌药物的耐药性以半合成青霉索较明显，铜绿假单胞菌的耐药性较突出。结论应高度重视细菌变迁和耐药性监测，提高抗菌药物合理应用水平。     

新生儿白细胞介素2、γ干扰素水平的研究

通过检测15例正常新生儿、8例早产儿和33例患病新生儿(13例患非感染性疾病,20例患感染性疾病)的白细胞介素2(IL-2)和γ干扰素(IFNγ)水平。并比较两者间的关系。结果发现新生儿IL-2、IFNγ的产生能力较正常成人降低,早产儿降低更明显;感染性疾病能使新生儿IL-2、IFNγ的产生减少,而非感染性疾病对之无明显影响;各组的IL-2和IFNγ同有明显的相关关系。提示评价新生儿的免疫状态应结合淋巴因子水平的测定,临床上对严重感染性疾病的治疗试用IL-2和IFNγ有潜在的重要作用。     

晕得宁毒性的实验研究

晕得宁为复方中药制剂,济宁市第一人民医院耳科用于治疗美尼尔氏病疗效良好,我室对此方剂进行了毒理学研究。急性毒性实验表明,小鼠一次灌胃量达人用量的200倍(n=10),观察72小时,未见异常表现及死亡。亚急性毒性实验:实验组12只家兔(分成大、中、小剂量三组),连续给药三周,其观察指标包括体重、血常规、肝功(GPT)和肾功(BUN),与对照组(n=4)相比,均无异常(P>0.05);病理检查10兔正常,另2兔患有肺炎。其中1只病兔属大剂量组,于给药第20～21天出现腹泻并死亡,可能与方剂组成中半夏的毒性有关。作者认为晕得宁的毒性较小;鉴于半夏有毒,临床用药宜避免大剂量、长期应用。     

丁二酸酐交联羟基超支化聚(胺-酯)的反应及其交联膜的性质

以丁二酸酐(SA)为交联剂研究了端羟基超支化聚(胺-酯)(HPAE)的交联反应和交联膜的制备。结果表明:SA与HPAE的交联反应分为两个阶段,可以采用溶液法低温涂膜及高温交联得到HPAE/SA交联膜;改变SA的用量可控制膜的交联度,HPAE/SA交联膜的拉伸强度随SA用量的增大而提高,最高可达59.60 M Pa,膜表面的水接触角小于74.3°。     

正常人在静态和运动状态下"死腔/潮气"估测值和实测值的比较

目的研究正常人静态及运动状态下死腔/潮气(VD/VT)估测值和实测值的关系.方法23名受试者行心肺运动试验,同步实时测定摄氧量和二氧化碳排出量,分别在运动前及运动高峰时抽取动脉血,根据Bohr的公式,得出VD/VT实测值,同时再用呼气末CO2分压(PetCO2)代替PaCO2,计算VD/VT,得出VD/VT估测值.结果根据病史、体检、肺功能和运动前后的心电图判断23名受试者均为正常受试者.静态时的VD/VT估测值和VD/VT实测值分别为0.359±0.109和0.354±O.106,两者无显著性差异(P=0.710),相关分析显示两者高度相关(r=0.911,P＜0.001).运动高峰时的VD/VT估测值和VD/VT实测值分别为0.234±0.070和0.248±0.094,两者无显著性差异(P=0.748),相关分析表明两者显著相关(r=0.783,P＜0.001).与静态时比较,运动时估测和实测VD/VT均明显下降.结论对于正常成人,无论是在静态或最大运动状态下,可用无创方法计算VD/VT代替VD/VT实测值.     

The adverse effect of treatment prolongation in cervical cancer by high-dose-rate intracavitary brachytherapy.

BACKGROUND AND PURPOSE: The potential risk of prolongation of treatment time in cervical cancer has been reported for many low-dose rate (LDR) studies, with an estimated loss of local control ranging from 0.3 to 1.6% per day of treatment prolongation. Since the treatment schedule for fractionated high-dose rate intracavitary brachytherapy (HDRICB) is not directly comparable with that for low-dose rate studies, this report aims to evaluate the adverse effect of treatment prolongation specifically for cervical cancer treated with HDRICB. MATERIAL AND METHODS: From September 1992 to December 1997, 257 patients diagnosed with uterine cervical cancer (35 Ib, 26 IIa, 122 IIb, 10 IIIa, 57 IIIb, 7 IVa), who underwent external radiotherapy combined with between two and four courses of HDRICB and a minimum of 3 years of follow-up (median 57 months), were analyzed. Treatment consisted of irradiation of the whole pelvis with 44-45 Gy consisting of 22-25 fractions by 5 weeks, with the dose boosted to 54-58 Gy (with central shielding) for patients diagnosed as FIGO stage IIb-IVa bilateral parametrial disease. HDRICB was performed using an Ir-192 remote afterloading technique at 1-week intervals. The standard prescribed dose for each course of HDRICB was 7.2 Gy to point A for three insertions (before July 1995), or 6.0 Gy to point A for four insertions (after July 1995). Total prescribed point A doses (external beam radiotherapy+HDRICB) ranged from 58 to 71.6 Gy (median, 65.6 Gy) for stage IB-IIA, while analogous dosage for larger lesions (stage IIb-IVa) ranged from 59 to 75.6 Gy (median, 65.6 Gy). Kaplan-Meier and multivariate analyses were used to test the effect of treatment time on pelvic control rate (PCR) and cause-specific survival (CSS) at 5 years. RESULTS: Median treatment time was 63 days. For all stages of disease, the 5-year CSS and PCR were significantly different comparing treatment times of less than and greater than or equal to 63 days [83% and 65% (P=0.004], 93% and 83% (P=0.02), respectively]. These associations were also significant for stage Ib/IIa [97% and 79% (P=0.01), and 100% and 87% (P=0.02), respectively), but not for stage IIb [75% and 72% (P=0.79), and 93% and 87% (P=0.83), respectively] or stage III [66% and 49% (P=0.2), and 83% and 72% (P=0.21), respectively]. Multivariate analysis identified three prognostic factors for CSS, stage (P<0.001), tumor response to external RT (P=0.001), and overall treatment time (OTT; P=0.006). Prognostic factors for pelvic failure were stage (P<0.001), tumor response to external RT (P=0.001), and OTT (P=0.03). Prolongation of treatment time resulted in a daily decrease in pelvic control rate of 0.67% overall, and 0.43% for stage Ib-IIa, 0.57% for stage IIb, and 0.73% for stage III patients. CONCLUSION: Analysis of the data from the current study demonstrates that the adverse effect of treatment prolongation was observed later in the treatment course for the high-dose rate (HDR) series compared to the LDR analog, however, treatment-time prolongation still negatively influenced the cause-specific survival and pelvic control rate for both dosage groups.     

严重烧伤后肠道损伤与肠源性高代谢的关系

目的　探讨烧伤后肠道损害与“肠源性高代谢”的关系。方法　在建立严重烧伤加清洁肠道动物模型的基础上 ,将 96只Wistar大鼠随机分为烧伤对照 (B)组和烧伤加清洁肠道 (SDD)组。观察了伤后 0～ 10d大鼠静息能量代谢率(REE)的变化 ,同时检测了伤后 0、1、3、5、7、10d血中内毒素 (LPS)、肿瘤坏死因子 (TNF)和二胺氧化酶 (DAO)的含量 ,并进行相关分析。结果　烧伤后两组大鼠的REE、TNF、LPS和DAO均明显高于伤前 ,两组相比 ,SDD组的REE、TNF和LPS较B组均有不同程度的降低 ,而DAO则明显高于B组。相关分析显示 ,REE同LPS和TNF呈显著正相关 (r1 =0 .77,P <0 .0 5 ,r2 =0 .81,P <0 .0 5 ) ,与DAO相关不显著 (r >0 .0 5 )。结论　烧伤后肠源性高代谢与血中炎症介质含量呈正比 ,但肠道损伤程度加重并不引起代谢率相应增加 ,二者不存在线性关系     

硝苯地平控释片对原发性高血压患者血管内皮功能的影响

目的 :探讨钙拮抗剂硝苯地平控释片 (商品名 :拜新同 )对原发性高血压 (EH)患者血管内皮功能的影响。方法 :观察34例EH(EH组 )患者用硝苯地平控释片治疗前后的抗氧化能力、白细胞黏附血管壁功能及血管内皮舒张功能等方面的变化 ,并与 2 1例正常对照组对比分析。结果 :硝苯地平控释片治疗前 ,EH组血清可溶性细胞间黏附分子 1(SICAM 1)、丙二醛(MDA)的含量均明显高于对照组 (P <0 .0 1) ;血清超氧化物歧化酶 (SOD)活性、一氧化氮 (NO)及血浆C 型利钠肽 (CNP)的含量均明显降低 (P <0 .0 1) ;硝地平控释片治疗 4周后 ,EH组SICAM 1、MDA的含量均较治疗前明显降低 (P <0 .0 1) ,SOD活性及CNP含量均较治疗前明显升高 (P <0 .0 1) ;硝苯地平控释片降压总有效率 82 .35 %。结论 :硝苯地平控释片在有效降压的同时 ,不仅能抑制白细胞在血管内皮细胞的黏附、增加机体抗氧化能力 ,而且可改善内皮功能障碍 ,因而对EH患者的靶器官具有保护作用。     

小型猪在异种移植中的应用前景

目的 建立狂犬病病毒感染动物疾病模型.方法 狂犬病病毒CVS-B2C毒株以10LD50剂量腿部肌肉注射接种4～6周龄的BALB/c小鼠,0.2 mL/只,于BSL2实验室负压IVC设备内饲养观察,并对其模型进行评价.结果 小鼠接种狂犬病病毒后一周左右就出现临床症状,表现为饮食量下降,毛皮慢慢失去原先的光泽,体重下降,并出现麻痹等症状,进而死亡,部分小鼠出现躁狂的症状或抽搐性和强直性痉挛,而对照组小鼠则表现正常.DFA法检测结果:感染上狂犬病毒的小鼠脑组织涂片中出现特异性荧光抗体染色反应,而对照组动物的小鼠脑组织涂片未出现荧光抗体染色反应.RT-PCR法检测结果:从感染小鼠脑组织标本中提取病毒RNA,引物扩增出的目的 基因片段,大小约为1kb,为N蛋白.免疫组化法检测结果:感染狂犬病毒的小鼠脑切片显示出棕色阳性颗粒,对照组小鼠脑切片染色阴性.病理检测结果:HE染色可见感染小鼠脑组织炎性细胞浸润.神经细胞胞质内出现内基体以及神经细胞退行性病变.结论 成功的复制出小鼠狂犬病病毒感染模型,为研究和控制狂犬病奠定了基础.