脂肪栓塞综合征治疗体会(附12例报告)

脂肪栓塞综合征（Fat Embolisim Syndrome,简称FES）是骨折早期最严重的并发症之一,临床上常常误诊误治。我院1988年至1998年共收治12例,经积极治疗,11例救治成功,1例抢救无效死亡。本文对FES的发病机制、诊断、治疗、预防等进行了进一步的讨论。     

山西省1992年—1999年临床细菌检验质量评价活动总结

本文报告了山西省92—99年细菌室间质评的鉴定情况,结果表明,肠菌科鉴定正确率为62.9％;非发酵菌鉴定正确率为54.1％;革兰氏阳性球菌鉴定正确率为77％;弧菌科鉴定正确率为61—85％。     

整合素血小板膜糖蛋白IIb、IIIa在系膜增殖性肾炎中的表达

目的 :观察整合素血小板膜糖蛋白Ⅱb、Ⅲa(GPⅡb、GPⅢa)在人类系膜增殖肾炎 (MsPGN)中肾内表达 ,探讨GPⅡb Ⅲa在MsPGN的作用。方法 :18例肾活检标本均行光镜HE、PAS、PASM Masson染色 ,电镜及免疫荧光检查 ,以SABC法测定肾组织中GPⅡb、GPⅢa、P 选择素 (P 140 )、纤维连接蛋白 (FN)、粘连蛋白 (LN)表达与正常对照组分别比较 ,并行计算机图像分析。结果 :PAS阳性物 (PAS+ )、PASM阳性物 (PASM+ )及FN、LN明显增生 ;GPⅡb、GPⅢa、P 140表达上调 ;肾小球细胞数 (n)、平均肾小球体积 (AVG)及肾小球硬化指数显著增加 ;肾小管、间质轻度受损。结论 :GPⅡb、GPⅢa在肾小球及肾小管间质表达上调与系膜细胞基质增生、细胞浸润、肾小球硬化相关 ;可能与肾小球疾病中凝血功能紊乱、血小板在肾脏的致病作用相关     

鼻咽癌患者心理社会因素多变量分析

目的 :探讨心理社会因素对鼻咽癌患者影响的作用规律和早期识别方法 ,为早期发现、早期诊断和早期治疗服务。方法 :通过 1∶1配对临床流行病学调查方法收集资料建立数据库文件 ,在PTMMX 2 0 0 0型微机上完成配对Logistic回归和判别分析。结果 :在α =0 .0 5水准 ,发现X2 (嗜烟习惯 )、X8(家用燃料种类 )、X12 (爱生闷气 )、X13(病后情绪低落恐惧 )和X15(病后得不到亲人关照和心理满足 )计 5个差异有显著性的变量 (P <0 .0 5 )进入方程 :LogitP=ai- 66.7362X15+ 91.386 6X13 - 3.7985X12 - 4.0 142X8- 5 .6 0 6 3X2 ;在此基础上建立了鼻咽癌和非鼻咽癌判别诊断模型。判别诊断与临床诊断总的符合率高达 93 .33% ,其中对鼻咽癌和非鼻咽癌判别符合率分别为 95 .0 0 %和 91.6 7% ,总的误判率为 6 .6 7%。结论 :所建数学模型具有一定临床意义 ,从是否患肿瘤角度提出的健康模式假设 ,尚待进一步研究。     

胃癌中P16与MDM2的免疫组化研究

目的 :检测胃肿瘤及正常胃组织中P16与MDM2的表达 ,探讨其在肿瘤凋亡中的相互关系。方法 :采用免疫组织化学方法 (SABC法 )。结果 :胃癌中P16阳性率为 69% ,MDM2阳性率为 75 % ,它们与正常胃组织及良性胃肿瘤相比差异均有显著性 (P <0 .0 5 )。结论 :在胃癌的细胞凋亡中 ,P16与MDM2均发挥了其各自对细胞凋亡的作用 ,为临床胃癌的组织学检测提供了理论依据 ,同时也支持胃癌的发生是多基因协同作用的过程     

Clinical significance and assessment of cytokines in various stages of ulcerative colitis

Summary In order to study the clinical significance and change of interleukin (IL)-1β and IL-10 concentration in intestinal mucosal tissues in various stage of ulcerative colitis (UC), IL-1β and IL10 levels were measured by enzyme linked immunosorbent assays (ELISA). Our results showed that IL-β level caused by spontaneous secretion in the intestinal mucous tissues in active stage of ulcerative colitis was significantly higher than that in normal controls and in remission stage of ulcerative colitis (P <0. 01,P<0. 001). IL-10 level in various stage of UC was relatively lower in controls, but there was no significantly difference between the two groups. Our study suggested that higher IL-1β level in active might play an important role in pathogenesis of UC, and IL-10, as an anti-inflammatory cytokine, was low in active UC, suggesting that it may be a important factor contributing to the development of higher IL-1β level. This project was supported by the grant of the Scientific Research Fund of the Ministry of Health (No. 98-2-387).     

Osteogenic potential of cultured bone marrow stromal cells transfected with transforming growth factor β1 genein vitro

Summary To study the osteogenic potential of cultured bone marrow stromal cells (BMSCs) transfected with transforming growth factor β₁ (TGF-β₁) genein vitro, cultured BMSCs were transfected with the complexes of pcDNA₃-TGF-β₁ and Lipofectamine Reagentin vitro. The cell proliferation was detected by MTT method and the morphological features of transfected BMSCs was observed. ALP stains and PNP method were used to measure ALP activity. In addition, the collagen type I propeptides and mineralized matrixes were examined by immunohistochemical staining and tetracycline fluorescence labeling respectively. The morphological and biological characters of the transfected BMSCs were similar to those of osteoblasts and the cell proliferation was promoted. The cell layer displayed strong positive reaction for ALP stains and immunohistochemical staining. ALP activity and collagen type I expression increased remarkably after transfection. Mineralized matrixes formed earlier and more in transfected BMSCs as compared with control group. It is concluded that transfecting with TGF-β₁ gene could promote the osteogenic potential of cultured BMSCs.     

Analysis of the factors influencing the therapeutic effects of onychomycosis

From July 1 994to June 1 999,5 4 5 onychomyco-sis patients were treated with Itraconazole and com-pleted their treatment courses with complete follow-up in out- patientdepartment.The recovery rate was83.1 4% and 79.2 3% in fingernail and toenail dis-eases respectively.But following phenomena werefound:( 1 ) Some new nails stopped growing in cer-tain length,even if the treatment continued;( 2 )Some damaged nails reappeared soon after the treat-ment ceased;( 3) Some damaged nails with deep- co…     

意外跌落伤住院儿童转归的影响因素分析

为探讨影响意外跌落伤住院儿童转归的有关因素,提高患儿的住院治疗质量,促进医院建立有效的院内医疗系统,利用多项有序分类反应变量的逐步Logistic回归对3035例0～14岁意外跌落伤住院患儿的转归进行影响因素分析.发现影响转归的因素有住院时间、确诊时间、院前时间、病情程度、受伤部位、并发症、生活环境、手术及术前住院天数、住院费用.结果表明医院要正确处理缩短住院时间与提高治疗效果之间的关系,并通过缩短院前时间、及时确诊、降低并发症、控制病情、降低住院费用、尽量减少术前住院天数,强化和贯彻整体医疗观念等综合措施即可有效地提高意外跌落伤住院儿童的治疗效果.