门静脉高压症胃病与幽门螺杆菌感染关系的临床研究

目的 :探讨门静脉高压症胃病与幽门螺杆菌感染的关系。方法 :对 68例门静脉高压症胃病患者的上消化道粘膜病理改变、出血状况及与幽门螺杆菌感染之间的关系进行分析。结果 :肝功能受损越重 ,门静脉高压症胃病患者的病理改变越明显。在重度门静脉高压症胃病患者中 ,幽门螺杆菌的检出率为 69.44% ,而在轻度患者中 ,幽门螺杆菌的检出率为 43.75% ,两者比较有显著性差异 (χ2 =4.57,P<0 .0 5)。结论 :门静脉高压症胃病与幽门螺杆菌感染有一定的关系 ,病症越重 ,幽门螺杆菌的检出率越高     

机械通气致下呼吸道黄杆菌感染的临床分析

目的:探讨黄杆菌属致下呼吸道感染的临床特点及对常用抗生素的耐药情况。方法:分析我院六年来机械通气致下呼吸道黄杆菌感染的11例临床资料,平板稀释法测定常用抗菌药物对该菌株的最低抑菌浓度,采用法国生物梅里埃公司API系统进行细菌学鉴定,以美国国家实验室标准化委员会NCCLS的标准判定结果。结果:全部应用广谱抗生素,年龄>60岁者8例,机械通气到发生黄杆菌感染的平均时间为18天,死亡4例;耐药率高,仅对头孢哌酮/舒巴坦、复方磺胺甲恶唑、哌拉西林、左氧氟沙星等较敏感。结论:机械通气致下呼吸道黄杆菌感染常发生在基础状态较差,机械通气时间较长,且长期应用广谱抗生素的老年患者,临床表现常无特征性,细菌耐药严重,病死率高     

Abdominal ultrasonography in the diagnostic work-up in children with recurrent abdominal pain

We report on our experience with routine abdominal ultrasonography in 120 children (aged 3–15 years) with recurrent abdominal pain, in order to determine the diagnostic value of this investigation. Eight children (7%) revealed sonographic abnormalities: gallbladder stone (n = 2), splenomegaly (n = 1) and urogenital abnormalities (n = 5). The recurrent abdominal pain could be explained by these findings in only two (may be three) cases. Conclusion The diagnostic value of abdominal ultra‐sonography in unselected children with recurrent abdominal pain is low. However, the direct visualization of the abdominal structures as being normal may be helpful to the parents and the child in their understanding and acceptance of the benign nature of recurrent abdominal pain. Received: 19 March 1996 / Accepted: 29 January 1997     

Mycetoma of the calf

 Actinomycetous infections typically involve either the head and neck or the extremities following a traumatic implantation. Classic clinical associations are draining sinus tracts. This case report describes the pathologic and MR findings of a relatively acute mycetomatous process involving the soft tissues. Pathologic findings in this case included an occasional granule composed of gram positive, thin branching elements. These and other findings were consistent with actinomycetes bacterium infection. The discussion centers around the use of MR, both with and without gadolinium, in evaluating this type of granulomatous infection. Infiltration of the adjacent subcutaneous tissues was easier to appreciate on both the T1-weighted images without gadolinium and the T1-weighted images with gadolinium when compared to the T2-weighted images. Signal characteristics as described in this case report may suggest a granulomatous process.     

泌尿系感染病原菌的变迁及耐药性分析

目的了解近年来泌尿系感染病原菌的变迁及耐药现状. 方法应用回顾性调查分析方法,对我院1997至2000年间泌尿系感染检测的1 026株病原菌的分布及耐药性进行统计分析. 结果在泌尿系感染的病原菌中,G+球菌上升,G-杆菌下降,真菌上升,其中粪肠球菌上升和变形菌属下降差异有显著性(P<0.05),药敏实验结果对以往常用的抗菌药物青霉素类、复方新诺明、红霉素、诺氟沙星及一代头孢显示较高的耐药性,2000年耐药率>81.6%,对三代头孢、环丙沙星、庆大霉素呈中度耐药,耐药率在42.9%～78.3%,对阿米卡星及头孢哌酮/舒巴坦呈轻度耐药,耐药率<36.7%. 结论随着抗生素的更新换代、人口老龄化及医院感染等因素的变化,泌尿系感染病原菌的分布及耐药性均发生了变迁.     

骨感染病人TNF-α、IL-6和C反应蛋白的检测及临床意义

①目的　探讨骨感染病人肿瘤坏死因子α(TNF α)、白细胞介素 6 (IL 6 )和C反应蛋白 (CRP)水平的变化及意义。②方法　采用双抗体夹心ELISA法测定 30例骨感染病人及 2 5例正常人的血清TNF α、IL 6水平 ,采用散射比浊法测定CRP水平。③结果　骨感染病人血清中TNF α、IL 6及CRP含量均处于高水平状态 ,与健康人比较 ,差异有显著性 (t=2 .2 6～ 10 .6 7,P <0 .0 5、0 .0 1)。④结论　TNF α、IL 6及CRP是预测骨感染病人病情危重的重要指标之一 ,对临床有一定指导意义     

Abdominal distension after colonic lactulose fermentation recorded by a new extensometer

Colonic lactulose fermentation induces bloating, but whether it also causes abdominal distension is not known. The aim of this study was to assess the effect of colonic lactulose fermentation on abdominal girth using a new extensometer. We recorded abdominal girth in 24 healthy subjects by means of an extensometer that measures the phase shift of an ultrasound wave propagating in a tube encircling the abdomen. The recordings were continuously made for 3 h after the ingestion of 100 mL of tap water with (16 subjects) or without (eight subjects) 10 g of lactulose. Every 10 min, H2 in the breath was analysed and the intensity of bloating was recorded. Bloating was never reported after water ingestion, whereas it was reported by 10 subjects after lactulose ingestion (P = 0.002). The mean +/- SD changes in abdominal girth in comparison with resting conditions were statistically significant after lactulose ingestion (3 +/- 2.9 mm; P = 0.002) but not after water ingestion (-0.2 +/- 2.7 mm; P = 0.82). The area under the curve of the changes in abdominal girth after lactulose were significantly greater than after water ingestion (P = 0.03). In conclusion, colonic lactulose fermentation induces bloating and abdominal distension. The new extensometer is useful for continuously recording changes in abdominal girth.     

Urine as an alternative to urethral swabs for the diagnosis of Chlamydia trachomatis in infertile males

Swabbing the urethrae of men has been the traditional approach for collecting specimens for detection of Chlamydia trachomatis . Recently, however, urine testing using enzyme immunoassay has yielded promising results. A total of 105 patients attending the Andrology Clinic at Ga Rankuwa Hospital, Medunsa were included in the study. These patients were asymptomatic and had no urethral discharge. Three endo-urethral swabs and first-catch urine were collected fiom each patient. The urethral swabs were used for enzyme immunoassay (EIA) (IDEIA 111), tissue culture and direct immonufluorescent antibody (DFA) test (IMAGEN) to detect C. trachomatis . In addition about 15–30 ml of first-catch urine, or urine collected at least 2h after the previous micturition, was collected for each patient for EIA testing. Fifteen (14.3%) of 105 patients were positive on urethral swab EIA, in comparison with the DFA test in which 14 (13.3%) were positive. Eight (7.8%) were positive in tissue culture. Urine EIA was positive in 17 (16.2%) patients, of whom five (4.8%) were positive in urine EIA only. All EIA positive urines were confirmed by DFA. We recommend that first-catch urine or urine collected at least 2h after the previous micturition in infertile males may be considered a suitable alternative to urethral swab for chlamydial diagnosis because it is noninvasive and nontraumatic.     

单项抗HBc阳性的临床分析

临床上对于乙型肝炎的诊断主要是依据病人的 HBV- M结果进行判断 ,对于单项抗 HBc阳性的临床意义 ,目前有不同的争议。通过在临床工作中搜集整理的有关资料进行总结分析 ,认为单项抗 HBc阳性的意义与其在血清中的滴度有关。     

Chronic cryptococcal meningitis in an intravenous drug addict without evidence of infection by HIV-1,2 in southern Italy

Before the emergence of AIDS, extra-pulmonary cryptococcosis was very rare. By contrast, meningeal cryptococcosis is a very common opportunistic infection in AIDS patients. We report an intravenous drug addict with cryptococcal meningitis, who was not infected with HIV and had no apparent predisposing conditions. This case, as those elsewhere described, supports the potential existence of viral agents, other than HIV-1,2, capable of encouraging the occurrence of unusual infections as have emerged during the AIDS pandemic.