液基超薄细胞检测结合TBS系统检测1583例宫颈涂片的临床分析

目的:对液基超薄细胞检测技术(thinprep cytologic test,TCT)和Bethesda系统(The Bethesda System,TBS)在宫颈病变诊断中的临床应用价值进行评价。方法:1583例门诊患者行TCT检查和TBS细胞学分类诊断,对TCT检查发现异常的患者进行阴道镜病理检查和PCR检测HPV-DNA。结果:1583例涂片中检出异常涂片241例,占15·22%。其中不典型鳞状细胞(ASCUS)88例(5·56%),低度鳞状上皮内病变(LSIL)45例(2·84%),高度鳞状上皮内病变(HSIL)8例(0·51%),鳞状细胞癌(SCC)1例(0·06%),子宫内膜腺癌1例(0·06%),HPV感染42例(2·65%)。TCT与阴道镜病理检查和PCR检测的符合率分别为83·82%、61·90%。结论:TCT技术应用于宫颈细胞涂片筛查,能明显提高涂片满意率及宫颈异常细胞检出率,减少漏诊率,TBS报告方法客观、准确、详尽,能及早发现宫颈早期病变。     

我国60岁以上女性眼病患者调查分析

目的:了解老年女性眼病患者发病情况和病因顺位。方法:各地防盲办公室将《眼病登记表》发至县、地市、省级医院和眼科专科医院,由眼科医生出诊时依照患者病历填写。结果:1997年1月1日～1998年12月31日60岁以上女性眼病患者共计74448例,其中白内障患者占64.32%,双盲与单盲两者共23983例,双眼低视力与单眼低视力两者共12469例,视力在各年龄组之间有显著性差异(P<0.001)。结论:60岁以上女性眼病患者中白内障占第1位,政府应正视老年性白内障高发病率的严重性,及早采取预防措施。     

消炎痛对白色念珠菌菌丝形成的影响

目的:探讨环氧化酶抑制剂消炎痛对白色念珠菌形态发育的影响。方法:分别用含不同浓度消炎痛的RPM I1 640加10%小牛血清的液体培养基和玉米-吐温80固体培养基培养3株白色念珠菌,观察白色念珠菌形态发育变化。结果:消炎痛对白色念珠菌芽管和菌丝形成的抑制作用与其剂量相关。在液体培养基中,消炎痛浓度为0.75 mM时可抑制50%芽管形成,浓度为2.0mM时可完全抑制芽管和菌丝形成;而在固体培养基中,消炎痛浓度为1.0mM时可抑制菌丝和厚壁孢子的形成,浓度为2.0 mM时,几乎没有菌丝形成。结论:消炎痛可以抑制白色念珠菌芽管、菌丝的形成,阴道内给予消炎痛将有助于治疗念珠菌性阴道炎。     

机械通气在新生儿麻醉中的应用

目的:评价机械通气在新生儿麻醉应用中的安全性和有效性。方法:47例新生儿手术,在全身麻醉气管插管后,行机械定压模式呼吸通气30 m in,监测通气前后动脉血气值、血氧饱和度(SpO2)、体温、呼气末CO2浓度(PetCO2)、气道压(Paw)、呼吸频率(f)、心电等参数。结果:新生儿手术全身麻醉控制呼吸,根据PetCO2适当调节呼吸参数,采用定压呼吸模式,能够维持动脉血氧分压(PaO2)、动脉血CO2分压(PaCO2)于正常范围。结论:机械通气能安全有效地应用于新生儿手术。     

Risk Factors of Gastric Cancer in Wuwei City- an Endemic Region of Gastric Cancer

OBJECTIVE Studies have shown that risk factors of gastric cancer include living habits, eating moldy pickled food, dystrophy, lack of nutrients, and genetics, etc. This study explores the prevalence of these factors in Wuwei, a city in northwest China with a high incidence of gastric cancer.METHODS Family histories of the residents in Wuwei City were investigated with a case-control method. Segregation ratio and heredity degree of gastric cancer were calculated using theLi-Mantel-Cart and Falconer's regression methods. Chronic gastritis patients were followed-up by home visits, gastroscopy, and pathology. Carcinogenic fungi and volatilile N-nitroso compounds were noted in the residents' meals. Helicobactor pylori (Hp) was assessed in their gastric mucosa and the total content of serum vitamin C in 293 healthy adults was determined.RESULTS In Wuwei City, the segregation ratio of gastric cancer was 0.077. The heredity degree of first-degree relatives was 22.91%. The incidence rate of cancer per year in people in an atrophic gastritis group was 1.09%. Eight kinds of nitrosamines and 14 kinds of carcinogenic fungi were detected in the residents' food. Total average vitamin C in the serum of the 293 healthy adults in the summer was 5.74±2.79 mg/L. The positive rate of Hp in gastric mucosa of the residents was 67%.CONCLUSION The majorextrinsic factors include infection of Hp, atrophic gastritis (especially atrophic hyperplasia), and genetic susceptibility.     

壳聚糖纳米载体提高抗乙肝免疫核糖核酸免疫活性的研究

目的:通过制备抗乙肝免疫核糖核酸(iRNA)的壳聚糖纳米载体,提高其免疫活性.方法:复凝聚方法制备壳聚糖-免疫核糖核酸纳米粒,扫描电镜、原子力显微镜、Zeta电位/粒度分析仪观察测定壳聚糖-免疫核糖核酸纳米粒形态、粒径和表面电位;核糖核酸酶(RNase)保护试验观察壳聚糖对包裹的iRNA的保护作用;白细胞黏附抑制(LAI)试验测定壳聚糖-免疫核糖核酸纳米粒免疫活性.结果:壳聚糖与iRNA形成表面带正电荷的纳米粒,iRNA未被RNase的降解,白细胞黏附抑制率增高.结论:壳聚糖纳米载体提高了抗乙肝免疫核糖核酸的免疫活性.     

反向高效液相色谱法测定盐酸伊托必利颗粒血药浓度及其人体药动学和生物等效性分析

目的:测定人血浆中盐酸伊托必利颗粒的血药浓度并对其在健康人体内的药代动力学及生物等效性进行分析.方法:采用反相高效液相色谱法(RP-HPLC)测定20名男性健康志愿者单剂量口服100mg盐酸伊托必利颗粒剂(受试药)和盐酸伊托必利片(参比药)后,血浆中伊托必利浓度变化情况,用3P97程序进行药代动力学分析.结果:测得受试药和参比药Cmax分别为594.8±152.3和628.6±261.4μg·L-1,Tmax分别为0.766±0.213和0.900±0.392 h,T1/2ke分别为3.21±0.86和3.49±0.77 h,AUC0-15分别为2266.0±1340.9和2339.4 ±1831.7μg·L-1·h-1,AUC0-∞分别为2472.1±1800.3和2496.9±1952.3μg·L-1·h-1.结论:盐酸伊托必利颗粒的相对生物利用度为106.9%±27.3%:选择Cmax、AUC0-15和AUC0-∞进行三因素方差分析与双单侧t检验,结果表明受试药与参比药具有生物等效性.     

特异性p38蛋白激酶抑制剂SB203580对哮喘小鼠气道炎症和Th1/Th2类细胞因子变化的影响

目的:探讨特异性p38蛋白激酶(p38MAPK)抑制剂SB203580对哮喘小鼠气道炎症和Th1／Th2类细胞因子(IFN-γ／IL-4)变化的影响。方法:BALB／c小鼠30只随机分成3组:正常对照组、哮喘模型组和SB203580干预组。采用酶联免疫吸附法(ELISA)检测支气管肺泡灌洗液(BALF)中IL-4和IFN-γ含量,并观察BALF中炎症细胞和肺组织病理学改变。结果:与正常对照组比较,哮喘模型组小鼠BALF中炎症细胞计数和IL-4水平升高而IFN-γ水平降低(P<0.01);与哮喘模型组比较,SB203580干预组小鼠BALF中炎症细胞计数和IL-4水平明显降低,IFN-γ水平明显上升(P<0.01),肺组织病理学改变显著减轻。结论:SB203580能抑制哮喘小鼠的气道炎症反应,纠正IFN-γ／IL-4平衡的失调。     

持续高眼压对急性大发作期原发性闭角型青光眼行白内障手术的影响

目的：研究持续高眼压对原发性闭角型青光眼急性大发作期行白内障手术的影响与其相关因素分析,并探讨持续高眼压状态下的治疗方案。

方法：选取武汉同济医院眼科收治的284例293眼接受白内障手术治疗的原发性闭角型青光眼急性大发作期的病历资料。根据术前眼压,将病人分为三组,术前用全身及局部药物眼压可基本控制在正常范围内的(组1),共188例; 术前眼压不能用药控制在正常范围,但行一次前房穿刺治疗后,眼压在用药物或不用药下可控制在正常范围的(组2),共61例; 术前多次前房穿刺放液仍不能维持正常眼压(组3),共44例。组1行白内障摘除联合人工晶体植入术,组2和组3行白内障摘除和房角分离联合人工晶体植入术。分析手术前后视力、眼压、中央前房深度、黄斑中心凹下脉络膜厚度以及房角镜检查结果。术前及术后测量数据采用非参数检验。

结果：各组术后一周眼压控制率分别为：组1(100%),组2(95%),组3(82%)(组2眼压控制率高于组3, χ²=4.795,P<0.05)。视力提高率分别为：组1(92%),组2(84%); 组3(52%)。各组术后中央前房深度均较术前明显加深,但组3中术后房角粘连范围显著高于组1和组2。组1和组2未出现术后前房积血,而组3中18%患者术后出现前房积血。

结论：对于持续高眼压的原发性闭角型青光眼急性大发作术前各种措施将眼压降至正常后再行白内障手术有较好的疗效,但是术前多次前房穿刺放液仍不能维持正常眼压眼,术后存在较大的房角粘连和前房出血风险。     

Scleral buckling combined with internal cyclopexy for severe traumatic cyclodialysis cleft in open globe injuries

This study aimed to evaluate the effect of scleral buckling combined with internal cyclopexy on the treatment of severe traumatic cyclodialysis cleft in open globe injuries (OGIS). This retrospective study recruited 10 patients of 10 eyes. With our surgical intervention, all the 10 eyes achieved retinal and ciliary body anatomic re-attachment. The choroidal ruptures in nine eyes were closed with complete choroidal reattachment. Postoperative best-corrected visual acuity of nine eyes had various improvements. The mean intraocular pressure was increased from 8.9±2.6 mm Hg to 13.4±4.4 mm Hg. Eventually, six eyes underwent silicone oil (SO) removal without complications, two eyes still had SO tamponade and two eyes became SO-dependent eyes. The result shows that internal direct cyclopexy combined with scleral buckling is an effective treatment for severe traumatic cyclodialysis cleft in OGIS.