中西医结合疗法治疗肛周尖锐湿疣56例

肛周尖锐湿疣是一种上皮增生性疾病,本病易反复发作,易感染,难治愈。单纯用一种疗法治疗疗效较差,我们采用综合疗法治疗,效果满意。     

尖锐湿疣人乳头瘤病毒颗粒、核酸及抗原检测

42例尖锐湿疣进行了HPV-DNA序列,HPV抗原和电镜检查。36例(85.7%)HPV-DNA序列检测阳性。其中单一型感染9例,混合型感染27例。以HPV_(11)阳性最多,计32例,HPV_(6b)26例,HPV_(16)19例,HPV_(18)6例。HPV抗原阳性28例(66.7%)。15例查见病毒颗拉(35.7%)。总计阳性率为90.5%(38/42例)。文中对三项检查结果作了比较和分析。     

外阴、阴道和宫颈尖锐湿疣组织中HPV感染的对比研究

目的研讨外阴、阴道和宫颈尖锐湿疣(CA)组织中人乳头瘤病毒(HPV)感染型别的分布状况以及临床意义。方法应用基因芯片结合PCR技术对63例外阴尖锐湿疣、61例阴道尖锐湿疣和65例宫颈尖锐湿疣组织行23种HPV基因型检测,并分析患者的临床病理资料。结果 63例外阴尖锐湿疣组织中检出HPV阳性者56例,HPV感染率为88.89%(56/63);61例阴道尖锐湿疣组织中检出HPV阳性者55例,HPV感染率为90.16%(55/61);65例宫颈尖锐湿疣组织中检出HPV阳性者62例,HPV感染率为95.39%(62/65)。结论 HPV感染与外阴、阴道和宫颈尖锐湿疣的发病密切相关,HPV6和11是主流型别,以外阴尖锐湿疣最为常见。基因芯片结合PCR技术是适合应用于临床行HPV分型诊断的一种方法,具有敏感性好、特异性高的特点。对女性外阴、阴道和宫颈尖锐湿疣的临床诊断、治疗及其疫苗的研究具有重要的意义。     

人乳头瘤病毒感染与女性生殖器尖锐湿疣发病的相关性

为探讨人乳头瘤病毒（HPV）感染与女性生殖器尖锐湿疣的相关性，随机选择协和医院性病专科门诊有临床疣者30例（A组），无临床疣者53例（B组），采用PCR技术检测HPV。另从HPV阳性者中选择36例，采用PCR技术检测淋球菌（NG）、沙眼衣原体（CT）及解脲支原体（UU）。结果A组HPV阳性率显著高于B组（P＜0．01）。36例HPV阳性者16例为NG或CT或UU感染，而非尖锐湿疣，6例为尖锐湿疣与NG或CT或UU混合感染。提示为了提高尖锐湿疣的正确诊断率，须将传统的病理组织学检查与现代的PCR技术结合运用。     

卡介菌多糖核酸对尖锐湿疣患者血清IL-4和IL-12水平的影响

目的：研究卡介菌多糖核酸对尖锐湿疣患者血清IL-12和IL-4水平的影响,探讨卡介菌多糖核酸对尖锐湿疣Th1/Th2的免疫调节作用的机制。方法：将60例尖锐湿疣患者随机分为治疗组和对照组。采用双抗体夹心ELISA法分别检测治疗前后患者血清IL-12和IL-4水平,并与健康对照者比较。同时比较治疗组与对照组的临床复发率。结果：尖锐湿疣患者血清IL-12水平降低,IL-4水平增高,二者呈负相关（r＝-0.287,P<0.05）,与健康对照者比较均有显著性差异（P<0.05）;治疗组治疗后IL-12水平增高,而IL-4水平降低,与治疗前水平比较均有显著差异（P<0.05）,对照组治疗前后IL-12水平和IL-4水平无显著差异（P>0.05）;治疗组复发率低于对照组,有显著差异（χ2＝4.356,P<0.05）。结论：尖锐湿疣患者存在Th1/Th2细胞因子失衡;卡介菌多糖核酸能提高患者血清IL-12水平,降低IL-4水平;其降低尖锐湿疣临床复发率的机制可能是通过调节和改善尖锐湿疣的Th1/Th2细胞因子免疫失衡,从而增强机体的细胞免疫功能。     

Development and validation of a continuous measure of patient condition using the Electronic Medical Record

Patient condition is a key element in communication between clinicians. However, there is no generally accepted definition of patient condition that is independent of diagnosis and that spans acuity levels. We report the development and validation of a continuous measure of general patient condition that is independent of diagnosis, and that can be used for medical-surgical as well as critical care patients.A survey of Electronic Medical Record data identified common, frequently collected non-static candidate variables as the basis for a general, continuously updated patient condition score. We used a new methodology to estimate in-hospital risk associated with each of these variables. A risk function for each candidate input was computed by comparing the final pre-discharge measurements with 1-year post-discharge mortality. Step-wise logistic regression of the variables against 1-year mortality was used to determine the importance of each variable. The final set of selected variables consisted of 26 clinical measurements from four categories: nursing assessments, vital signs, laboratory results and cardiac rhythms. We then constructed a heuristic model quantifying patient condition (overall risk) by summing the single-variable risks. The model’s validity was assessed against outcomes from 170,000 medical-surgical and critical care patients, using data from three US hospitals.Outcome validation across hospitals yields an area under the receiver operating characteristic curve (AUC) of ⩾0.92 when separating hospice/deceased from all other discharge categories, an AUC of ⩾0.93 when predicting 24-h mortality and an AUC of 0.62 when predicting 30-day readmissions. Correspondence with outcomes reflective of patient condition across the acuity spectrum indicates utility in both medical-surgical units and critical care units. The model output, which we call the Rothman Index, may provide clinicians with a longitudinal view of patient condition to help address known challenges in caregiver communication, continuity of care, and earlier detection of acuity trends.     

CONSTRUCTION AND IMMUNOGENICITY OF HUMAN PAPILLOMAVIRUS TYPE 6B L1 RECOMBINANT PLASMID

Objective To construct a DNA vaccine as a prophylactic model to prevent condyloma acuminatum and detect its immunogenicity in mice. Methods The major capsid protein (L1) gene of human papillomavirus (HPV) 6b was inserted into an eukaryotic expression plasmid (pcDNA3.1). The recombinant plasmid was transfected into COS-7 cells. Western blot were performed to detect whether L1 protein can be expressed in eukaryotic cells. Eighteen female BALB/c mice were tested for immunogenicity study. Results The recombinant plasmid (pcDNA3. 1-HPV6bL1) was verified as HPV6b L1 gene by sequencing. Western blot showed specific strip. Anti-L1 protein antibodies could be detected in the mice‘s sera inoculated with pcDNA3.1-HPV6bL1. Similarly, IL-4, IL-2, and IFN-γ were increased in the same mice. Conclusion HPV6b L1 recombinant plasmid was constructed successfully which had immunogenicity for BALB/c mice. It provided experimental evidence for the research of DNA vaccine of condyloma acuminata.     

子宫颈尖锐湿疣组织中HPV感染基因型别分布

目的：探讨子宫颈尖锐湿疣( condyloma acuminatum, CA)组织中人乳头瘤病毒( human papillomavirus, HPV)感染的基因型别分布及临床意义。方法采用PCR和基因芯片技术对120例子宫颈CA组织进行23种HPV基因分型检测,并对患者的临床病理资料进行分析。结果120例子宫颈CA组织中检出HPV阳性感染115例,HPV感染率为95．83%(115/120)。其中一重HPV感染者85例,感染率为70.83%(85/120),多重HPV感染者30例,感染率为25．00%(30/120)。一重HPV感染中HPV11型阳性检出率为45．00%(54/120),是最主要的感染型别;其次是HPV6型(27例),阳性检出率为22．50%(27/120)。多重HPV感染中,HPV6+11型6例,占多重感染的20．00%(6/30),是多重感染的主要型别;其次是HPV11+16型(3例),占多重感染的10．00%(3/30)。结论 HPV6型、11型、6+11型、11+16型感染是子宫颈CA的主要致病类型。基因扩增结合基因芯片技术是一种比较适合临床进行HPV分型检测的诊断方法,其敏感性高,特异性好。对子宫颈CA及子宫颈癌/瘤的防治及其疫苗的研究具有十分重要意义。     

尖锐湿疣HPV的分型及宫颈阴道脱落细胞和疣组织中HPV检测的比较

目的:比较阴道脱落细胞和尖锐湿疣(CA)疣组织中HPV的基因型分布和差异.方法:采用液相芯片技术对116例CA的疣组织以及48例女性患者的宫颈阴道脱落细胞进行HPV分型.结果:116例疣组织中有114例HPV阳性,阳性检出率为98.3%,其中主要的基因型是HPV6型(61.4%),HPV11型(42.9%),HPV16型(5.3%),HPV52型(4.39%),HPV18型(3.51%).宫颈阴道脱落细胞和疣组织标本中HPV亚型的阳性检出率无显著性差异(P0.05).结论:上海地区CA患者HPV感染常见的基因型是HPV6、11、16、52和18型.应用宫颈阴道脱落细胞标本可以替代疣组织对HPV感染进行检测.