四川省2005年霍乱分子流行病学特征

目的：分析四川省2005年霍乱弧菌分子特征,以及霍乱暴发疫情分离的菌株与菌株之间,疫情分离的菌株与海、水产品监测分离的霍乱弧菌之间的遗传相关性,查找霍乱传染来源,为预测疫情和制定防治措施提供依据.方法：利用聚合酶链反应（PCR）检测O139群霍乱弧菌特异性编码脂多糖基因（LPS）和霍乱毒力基因（ctxAB）;脉冲场凝胶电泳对菌株进行分子分型,所得结果以BioNumerics V4.0软件UPGMA方法进行聚类分析.结果：所试16株霍乱弧菌14株LPS阳性,为O139群霍乱弧菌;另2株为O1群稻叶型霍乱弧菌.2株稻叶型霍乱弧菌和1株O139群霍乱弧菌ctxAB阴性,其余13株菌均具有ctxAB,为产毒株.对16株菌以NotⅠ酶切后PFGE可分为5个型别.O139群霍乱弧菌优势流行株与从甲鱼分离的O139群霍乱弧菌PFGE型别一致,且同为产毒株.结论：甲鱼等海、水产品被O139群霍乱弧菌污染情况严重,甲鱼中分离的O139群霍乱弧菌与霍乱疫情分离菌株之间高度同源,被污染的甲鱼可能是本年度食源性霍乱暴发的主要传染来源之一,海、水产品的监测是近期霍乱防控的重点.     

范永升教授诊治系统性红斑狼疮经验

范永升教授认为系统性红斑狼疮的病因病机以肾虚为本,热毒、瘀血为标;在辨病辨证基础上,以解毒祛瘀滋肾为大法并结合西药综合治疗,取得了较好疗效。     

A型肉毒毒素治疗面肌、眼睑痉挛59例临床观察

目的探讨A型肉毒毒素治疗面肌、眼睑痉挛的疗效。方法采用A型肉毒毒素局部注射治疗偏侧面肌痉挛51例、眼睑痉挛8例,并使用Cohen和Albert量表进行评估。结果症状完全缓解占51.45%,明显改善占37.5%,部分改善占11.2%,疗效平均持续约3～6个月,复发者重复注射仍有效,出现眼睑闭合不全、面肌无力、眼睑下垂共18例,均恢复。结论局部注射A型肉毒毒素确为一种安全有效、简便易行的治疗面肌、眼睑痉挛的方法。     

The undesirable wink

Background:Marin-Amat syndrome is a rare acquired oculofacial synkinesis first reported in 1918. It manifests as involuntary eyelid closure on jaw opening or on lateral movement of the jaw following a peripheral facial nerve palsy. The increased orbicularis tone due to aberrant connections between the cranial nerve (CN) V and CN VII results in an undesirable wink with major psychosocial impact.Purpose:Most cases in literature were either observed or administered botulinum toxin injection to the orbicularis muscle. There are few sporadic reports of surgical interventions with successful outcomes.Hence there was a need to generate awareness regarding various modes of management of this rare entity.Synopsis:We present a video on the clinical presentation and management of six such patients, of whom one was bilateral. Five patients were females. Traumatic facial nerve paralysis and Bell’s palsy was previously diagnosed in one and five patients respectively. The mean age was 52 ± 9.48 years. The mean MRD (margin reflex distance) 1 and MRD 2 was 3.17 ± 0.60 and 5.33± 0.65 mm respectively. On smiling or on movement of the jaw the MRD 1 and 2 was reduced by 2. 50±0.40 and 1.50+/-0.40 mm respectively. Of the six patients four patients opted for nil intervention.Highlights:Botulinum toxin injection and preseptal orbicularis resection in the upper and lower eyelid along with blepharoplasty was performed in 1 patient each. Satisfactory reduction in the synkinetic movement was achieved in both. Marin-Amat syndrome is a rare often underdiagnosed synkinetic disorder following peripheral facial nerve palsy. Botulinum toxin injection and preseptal orbicularis resection are viable management options.Video link: https://youtu.be/YQbRecp449w     

结直肠癌前病变中医病机探讨

在癌毒病机理论的指导下,提出结直肠癌前病变的共性病机为湿热毒蕴,脾气亏虚.湿、热之邪在脾虚的基础上产生并相互胶结于肠腑,日久内生癌毒.脾气亏虚是结直肠癌前病变发生的根本病机,湿热蕴结是其发展条件,癌毒内生是癌变的关键所在.结合内镜下病理分级,根据癌毒内生与否可将结直肠癌前病变的演变过程分为无癌毒期及癌毒期.癌毒致病的过...     

Botulinum Toxin Injection for the Treatment of Upper Esophageal Sphincter Dysfunction

Dysphagia associated with upper esophageal sphincter (UES) dysfunction remarkably affects the quality of life of patients. UES injection of botulinum toxin is an effective treatment for dysphagia. In comparison with skeletal muscles of the limb and trunk, the UES is a special therapeutic target of botulinum toxin injection, owing to its several anatomical, physiological, and pathophysiological features. This review focuses on (1) the anatomy and function of the UES and the pathophysiology of UES dysfunction in dysphagia and why the entire UES rather than the cricopharyngeal muscle before/during botulinum toxin injection should be examined and targeted; (2) the therapeutic mechanisms of botulinum toxin for UES dysfunction, including the choice of injection sites, dose, and volume; (3) the strengths and weaknesses of guiding techniques, including electromyography, ultrasound, computed tomography, and balloon catheter dilation for botulinum toxin injection of the UES.     

精制E型肉毒类毒素免疫原不同配制比例实验

目的为获得高效价的马血浆,选择最佳E型肉毒类毒素免疫原配制比例。方法用3种不同配制比例配制E型肉毒类毒素免疫原,免疫原1、2、3分别为V（羊毛脂）：V（液体石蜡）：V（精制E型肉毒类毒素抗原）=1：2：6,1：2：3,1：2：2。将24匹马分为3组,分别用3种免疫原按常规法免疫,采用小鼠中和试验方法检测马血浆效价。结果用免疫原2免疫的马匹,马血浆平均效价比用免疫原1、3平均效价提高了36．3％,且马匹表现状况好于免疫原1、3。结论免疫原2的配制比例使用安全、稳定性良好、马匹免疫效果较好,为目前抗毒素生产用免疫原最佳配制比例。     

抗重组志贺样毒素ⅡA亚单位单链抗体的构建及表达

目的 构建重组志贺样毒素ⅡA亚单位（SLT2A）单链抗体基因（scFv）,并在大肠杆菌中进行分泌表达。方法 通过连接肽（Gly4Ser）,将已成功扩增的抗SLT2A单克隆抗体（mAb）5F3的VL和Va连接成scFv基因VH-Linker-VL并在Va基因5′端和VL基因3′端引入Sfi Ⅰ和Not Ⅰ的酶切位点,克隆至经改造的分泌性表达载体pCANTAB6His中,转化Ecoli HB2151,IPTG诱导表达。表达产物经亲和层析纯化后,SDS-PAGE和Westem blot分析鉴定。结果 经限制性酶切鉴定及DNA测序分析证实,基因构建正确。SDS-PAGE和Westem blot分析表明scFv基因在大肠杆菌中得到表达,表达产物的相对分子质量为27000,与理论预期值相符,且可与相应抗原特异结合。结论 成功地实现了抗SLT2A scFv基因的原核分泌表达,为探讨0157菌感染的机制及防治研究奠定了基础。     

胃癌的病机演变与治疗初探

论述了胃癌的病因病机及治疗,认为癌毒留滞胃腑,易于搏结痰瘀,阻遏气机,耗伤正气,治疗宜抗癌解毒、化痰软坚、调理脏腑、扶正补虚。     

浅析“存津液”思想在急性白血病治疗中的重要性

探讨"存津液"思想在急性白血病治疗中的地位和作用。认为急性白血病多见热毒炽盛、阴虚血热等,属于"温病""急劳"等范畴。治疗应重视养阴救津。并附验案1则。