肾综合征出血热特异性抗体的检测与中西医结合治疗的研究

目的探索一种更为简便、快速、特异、灵敏的肾综合征出血热(hemorrhagic fever with renal syndrome, HFRS)抗体的检测方法及更为有效的中西医结合治疗手段.方法559例HFRS患者血清同时采用免疫滴金法(colloidal gold immuno-dot assay,CGIDA)与酶联免疫吸附法(enzyme linked immunosorbent assay,ELISA)对比检测特异性免疫球蛋白M抗体(抗HFRS-IgM),间接免疫荧光法(indirect fluorescent antibody test,IFAT)对比检测特异性免疫球蛋白G抗体(抗HFRS-IgG).101例HFRS患者分组进行中西医结合治疗,治疗组50例用苦黄注射液、参麦注射液联合黄芪口服液,对照组51例用利巴韦林注射液联合甘利欣注射液,针对老年患者的临床特点,及早采用综合性防治措施.结果559例HFRS患者血清,以CGIDA法检测抗HFRS-IgM,阳性396例(70.8%);以CGIDA法检测抗HFRS-IgG,阳性489例(87.5%).治疗组与对照组用药后退热天数、主要症状和体征缓解天数相似(P＞0.05);肾功能恢复天数,对照组优于治疗组(P<0.01);在越期方面,治疗组越休克期数明显高于对照组(P<0.01). 结论CGIDA法检测HFRS特异性抗体分别与ELISA法及IFAT法对照,均有简便、快速、特异、灵敏之优点,检测抗HFRS-IgM,CGIDA法敏感性差于ELISA法,但是无假阳性;检测抗HFRS-IgG,CGIDA法的灵敏度高于IFAT法.苦黄注射液、参麦注射液联合黄芪口服液与利巴韦林注射液联合甘利欣注射液相比较,疗效无明显差别,但前者优于改善休克情况,后者强于改善肾功能.     

非痉挛型脑瘫的立体定向手术治疗(附16例报告)

目的探讨立体定向核团毁损术及脑深部电刺激术治疗非痉挛型脑瘫的疗效。方法将16例非痉挛型脑瘫病人分成三组：A组为肌张力障碍型，11例；B组为肌张力障碍合并震颤型，3例；C组为共济失调合并震颤型，2例。采用通用DT评分量表（GPS）评估病肢功能。分别采用立体定向核团毁损术及脑深部电刺激术治疗。术后随访1年，评估症状改善情况。结果A组肌张力障碍改善率为0—58．3％，平均17．1％；B组肌张力障碍改善率6．7％～25．0％，震颤改善率66．7％～75．0％；C组共济失调无明显变化，震颤改善率12．5％～25.0％。结论立体定向手术是治疗肌张力障碍型及震颤型脑瘫的可选择手段。     

Diagnostic imaging of orofacial malformations

Summary Two-dimensional conventional X-rays and computer tomographic imaging systems contribute to the diagnosis and surgical planning of patients with orofacial malformations. The ability to reformat CT scans into three-dimensional osseous and soft tissue surface images has a significant impact on the diagnosis and management of orofacial malformations. Cephalometric evaluation with teleradiography provides precise insight into both the skeletal structures and the soft parts, enabling the radiologist to assess the relationship among the different parts in a given subject, at any given time and in relation to the normal.      

胚胎种植前遗传学检测助孕妊娠结局的影响因素研究

背景 育龄期女性胚胎着床失败及流产的最常见原因是胚胎异常,但移植经胚胎种植前遗传学检测(PGT)筛选后的正常胚胎后,仍出现种植失败或流产的原因目前并没有形成统一的结论。目的 分析PGT助孕后种植失败及流产的影响因素。方法 回顾性分析2018年12月至2021年2月在安徽医科大学第一附属医院生殖中心行PGT助孕的329例患者的临床资料,根据患者是否临床妊娠分为临床妊娠组(n=218)和种植失败组(n=111),并将临床妊娠组患者根据妊娠结局分为活产亚组(n=175)和流产亚组(n=43)。比较临床妊娠组和种植失败组,活产亚组和流产亚组的一般情况、促排卵及体外胚胎发育情况。采用多因素Logistic回归分析探讨PGT患者种植失败及流产的影响因素。绘制受试者工作特征(ROC)曲线分析多因素Logistic回归分析筛选出的影响因素对PGT患者发生种植失败及流产的预测价值。结果 多因素Logistic回归分析显示,既往流产次数≥2次〔OR=4.032 0,95%CI(2.423 0,6.710 0)〕、高密度脂蛋白胆固醇(HDL-C)水平低〔OR=3.890 0,95%CI(1.455 0,10...     

Effects of epidural bupivacaine and epidural morphine on bowel function and pain after hysterectomy

A comparison was made of the effects of continuous epidural analgesia with bupivacaine and intermittent epidural morphine on bowel function after abdominal hysterectomy. The duration of postoperative ileus was assessed as the time from the end of operation to the first postoperative passage of flatus and feces. Twenty-two patients were randomly allocated to two equal groups. An "epidural morphine" group received general anesthesia and epidural morphine for postoperative pain relief, and an "epidural bupivacaine" group was given combined general anesthesia and epidural anesthesia with 0.5% bupivacaine intraoperatively and epidural analgesia with 0.25% bupivacaine postoperatively. Epidural morphine or bupivacaine was given for 42 h postoperatively. Pain intensity (visual analog scale) was low in both groups, but lower (P less than 0.05) in the epidural bupivacaine group. The time to first passage of flatus was 22 +/- 16 h in the epidural bupivacaine group and 56 +/- 22 h in the epidural morphine group (P less than 0.001). The time to first postoperative passage of feces was shorter (P less than 0.05) in the former than in the latter 57 +/- 44 h vs 92 +/- 22 h). The patients of the epidural bupivacaine group started intake of oral fluids earlier (P less than 0.01) and to a greater extent (P less than 0.05) than those in the epidural morphine group. It is concluded that the duration of postoperative ileus after hysterectomy is shorter when epidural bupivacaine is given for postoperative pain relief than when this is achieved by epidural morphine.     

Human smooth pursuit during transient perturbations of predictable and unpredictable target movement

Summary The predictive component of human smooth pursuit was studied by perturbing sinusoidal target motion at unpredictable instants. The disturbances consisted of either a brief period of stabilization of the target on the fovea or a replacement of the sine by a ramp displacement for half a period. To minimize the effects of a possible change of the tracking strategy by the subject the transitions were masked and only the initial part of the response to the disturbance was analyzed. After stabilization on the fovea the eye oscillation continued at the frequency of the preceding target movement for about one half-cycle, whereupon the oscillation was rapidly damped. The mean unidirectional smooth eye acceleration was 70% of the mean unidirectional target acceleration prior to the stabilization. This suggests that during pursuit of a sinusoidal target movement about 75% of the oculomotor response is generated by predictive processes. When the sine was replaced by a ramp, starting at the velocity zero-crossing, the eye accelerated away from the target for ca. 180 ms irrespective of the frequency of prior tracking. In contrast, when the ramp started at the peak velocity of the sinusoidal target motion the eye accelerated away from the target for more than a quarter period. After foveal stabilization during pursuit of a pseudorandom stimulus, the eye continued to oscillate for less than one period at approximately the highest frequency present in the stimulus. The frequency characteristics of human smooth pursuit of predictable as well as unpredictable target motion were correctly simulated by a model, which derived its predictive properties from a lead element, tuned to the current frequency of the target motion.     

Multidimensional Chromatographic and Hyphenated Techniques for Hydrophilic Copolymers, 1

Summary: The chromatographic analysis of hydrophilic copolymers is complicated due to the fact that in most cases aqueous eluents must be used. In aqueous eluents different polar and ionic effects may disturb the selective interactions between the macromolecules and the stationary phase making it impossible to separate such copolymers with regard to chemical composition. Therefore, 2D chromatography combining a separation according to composition with a separation according to molar mass has been applied mostly to polymers that are soluble in organic solvents. The present contribution describes experimental approaches to analyze such hydrophilic copolymers by 2D‐chromatography. For a model polymer system resulting from the copolymerization of methacrylic acid and a poly(ethylene glycol) macromonomer, it is shown that different analytical techniques including SEC, LC‐CC, MALDI‐TOF MS and 2D chromatography can be used to analyze the different parameters of molecular heterogeneity of such copolymers.

2D separation of poly(MPEG‐MM 2), 1^st dimension: LC‐CC, 2^nd dimension: SEC.     

Direct blood-pressure measurements: risks,technological evolution and some current problems

The direct measurement of blood pressure has found widespread use in intensive care units, operating rooms, and in emergency departments. Infection, air embolism and thrombosis are some of the risks to patients associated with both the cannulation procedure and with the apparatus used in the blood-pressure measuring process. Although there is constant revision in an attempt to reduce these risks, they cannot be completely eliminated. The need for direct blood-pressure measurements and the physiological effects of air embolism and thrombosis are reviewed. Infection and problems related to the techniques used to insert the catheters are not discussed.