亚胺培南/西司他丁与头孢他啶治疗中、重度细菌感染疗效费用分析比较研究

对我院４５例确诊为中、重度细菌感染住院患者进行了亚胺培南／西司他丁与头孢他啶疗效费用分析比较研究。结果表明：２组病例有效率、死亡率无显著性差异；头孢他啶组较亚胺培南／西司他丁组疗程明显延长。亚胺培南／西司他丁每日所需费用明显高于头孢他啶；治疗结束时，前者全部费用并未超过后者；全部住院费用无明显差异。作者认为：决定２种药物全部费用的因素，除与药物单价和每日费用有关，还与药物疗程密切相关。选用药物抗菌作用越强，用药时间即相应缩短，住院时间必然缩短；最终患者住院费用降低     

Oxidative breakdown of octanoic acid is maintained in patients with cirrhosis despite advanced disease

As an octanoic acid 13CO2 breath test is frequently used to test gastric emptying of solid food, the purpose of the present study was to study whether oxidative breakdown of octanoic acid is affected by severe liver disease. The design of our study was twofold. First, cirrhotic patients (n = 82) of varying severity were compared with healthy controls (n = 17). Values of half-time, time point of maximal expiration and cumulative recovery of octanoic acid breath tests (OBT) were not significantly different between them. Secondly, cirrhotic patients (n = 10) were studied before placement of transjugular intrahepatic portosystemic shunt, 4-7 days later and 1-2 months later. Values of half-time, time point of maximal expiration and cumulative recovery of consecutive OBTs did not change significantly. The OBT may therefore be a suitable test in the future to detect delayed gastric emptying of solids in cirrhotic patients with reduced liver function and portal hypertension.     

反坦克武器击中坦克时舱室内有害气体测试方法的探讨

为探讨在模拟实验条件下，坦克受到反我武器攻击后舱室内有害气体的取样方法和分析方法，用3种武器发射3种弹药攻击坦克，在远距离控制取样设备，取样后在实验室进行坦克舱室内有害气体浓度分析，结果取样成功，坦克被击中后，一氧化碳气体含量有明显的增高，氮氧化物、二氧化硫增高幅度不大，氧含量无明显变化，说明对坦克舱室进行远距离现场控制气体采样是可行的；坦克的受反坦克武器打击后，除弹片和冲击波等致伤因素外，还会造成坦克内乘员一氧化碳中毒。     

Controversies in tuberculosis

Tuberculous infection among children continues to be a significant cause of morbidity. The symptom complex are so variable among children that the final diagnosis often rests on the laboratory tests. Proper interpretation of the tests, specially tuberculin test and radiographic studies, are necessary for establishing correct diagnosis. The usefulness of tuberculin test in both unimmunized and BCG vaccinated children is highlighted. BCG accelerated response as a test should be reserved for identifying serious form of pulmonary disease or CNS tuberculosis when the tuberculin test is negative. Radiographic assessment may be sensitive in some instances but not always specific and hence needs cautious interpretation. Tuberculosis among BCG vaccinated children though not uncommon, needs proper documentation. Current trends in the management of tuberculosis including CNS forms are briefly outlined.     

LCT联合阴道镜检查对宫颈病变筛查的临床分析

目的:评价液基细胞学检查(liquid-based cytologic test,LCT)配合阴道镜检查对子宫颈病变的诊断价值。方法:收集2006年1月~2007年8月在我院妇科门诊就诊患者,采用LCT检测,对细胞学检查异常的1116例进行阴道镜检查及活检。结果:LCT异常者占10.15%,LCT和阴道镜对低度鳞状上皮内瘤变(LSIL)的检出率分别为65.45%和71.01%,高度鳞状上皮内瘤变(HSIL)为70.54%和84.50%,宫颈浸润癌(CC)为89.55%和92.53%。结论:细胞学筛查是诊断宫颈病变的重要方法,配合阴道镜下活检,能提高子宫颈癌前病变和宫颈早期浸润癌检出率,具有重要的临床意义。     

Prolactin responses to haloperidol in drug-free and treated schizophrenic patients

Summary The prolactin response to 5 mg haloperidol i.m. was studied in 12 schizophrenic patients in a drug-free state and after a month treatment with haloperidol, as a possible index of dopamine receptor sensitivity and occupancy. Blood samples were taken at times 0, 60, 90 and 120 minutes. The increase in PRL observed in the drug-free state disappeared after drug treatment. The PRL plasma levels after treatment with 60 mg haloperidol per os were higher than the maximal PRL responses after 5 mg i.m. The increases in baseline PRL caused by the treatment correlated positively to the reduction in the BPRS score. The test was also performed in a group of 11 patients chronically treated with haloperidol during a daily dose of 60 mg, and 15 days after reduction of the dose to 30 mg. PRL increases after 5 mg haloperidol i.m. were observed only after reduction of the dose. It is suggested that the prolactin response to haloperidol is an index of the occupancy of receptors that are involved in the PRL releasing mechanisms, and could be used to verify their blockade by the neuroleptics, especially in patients that do not respond positively to drug treatment.     

Gram-negative bacterial pneumonia with secondary aspergillosis in an AIDS patient

Summary A 40-year-old, HIV-infected female patient received antibiotic treatment for a urinary tract infection. After the initial success of therapy and a symptom-free period, she developed pneumonia with septic shock and adult respiratory distress syndrome (ARDS). In spite of intensive care and respirator therapy with positive end-expiratory pressure (PEEP), she died of infectious toxic shock. Autopsy findings showed relapsing, gramnegative, bacterial pneumonia (morphologically compatible with Klebsiella pneumonia) and secondary, invasive aspergillosis. The pathogenesis and epidemiology of these unusual complications of AIDS are discussed.Abbreviations AIDS acquired immunodeficiency syndrome - ARDS adult respiratory distress syndrome - CDC Centers for Disease Control - HIV human immunodeficiency virus - PEEP positive end-expiratory pressure     

关节液检查的临床意义

检查30例关节炎患者的关节液,结果示类风湿性关节炎患者关节液中白细胞数为330～72600/mm~3,粒细胞为9～97％,结合关节液的其它物理性质,对类风湿关节炎的诊断有一定参考价值。并观察到类风湿关节炎患者血清中IgG、IgA、IgM和关节液中IgG高于其它类型关节炎。     

再论妊娠期糖尿病与胎儿生长发育

目的 研究妊娠期糖尿病与胎儿生长发育中糖代谢特点的关系。方法 选择妊娠期糖尿病25例（GDM组），正常孕妇20例（对照组），分别测孕妇空腹血糖、糖耐量、C肽、IGF－I、新生儿出生2h内空腹血糖，并依据新生儿出生体重分为大于胎龄儿组（LGA组，≥4000g），适于胎龄儿组（AGA组，2500－3999g)。结果 C肽及新生儿出生2h内空腹血糖GDM组与对照组差异有显著性；糖耐量各时点血糖值餐后2h血糖值LGA和AGA组差异有显著性。结论 血糖始终是影响胎儿生长发育的重要因素，孕妇餐后2h血糖水平与巨大儿的发生呈正相关。     

应用3H-TdR掺入法对SMMC-7721细胞株药敏试验条件的探讨与应用

目的探讨3H-TdR掺入法在进行SMMC-7721系细胞肿瘤药敏试验实验时的最佳实验条件.方法确定出3H-TdR掺入法药敏实验时的最适细胞浓度、最适实验药物浓度、3H-TdR掺入最适时间;在最适条件下采用3H-TdR掺入法测定肝癌SMMC-7721细胞株对临床常用的9种抗癌药物的敏感性.结果应用3H-TdR掺入法检测肝癌SMMC-7721细胞株药敏试验的最适实验细胞浓度为1×104个/孔,最适试验药物浓度为1×PPC,3H-TdR最适掺入时间为收集细胞前8 h;肝癌SMMC-7721细胞株对DDP、ADM、5-FU、CPT高度敏感,对MTX、VP-16、MMC、NVB低度敏感,对PYM不敏感.结论 3H-TdR掺入法可用于肿瘤药物敏感性测定并确定出它的最适实验条件.