中医五联疗法治疗肝性脑病临床研究

目的观察中医五联疗法治疗肝性脑病的,临床疗效。方法将肝性脑病患者65例随机分为治疗组34例与对照组31例,均予常规西药和中药汤剂口服治疗,治疗组加中药静脉滴注、中药灌肠、中药肝区热敷、中药穴位敷贴五联疗法。比较两组患者精神意识、智力及扑翼样震颤的改善情况,治疗前后总胆红素、血氨及凝血酶原时间变化情况。结果治疗组和对照组总有效率分别为76．47％、51．61％,治疗组疗效显著优于对照组（P〈0．05）;两组患者治疗后总胆红素、血氨及凝血酶原时间均显著下降（P〈0．05）,且治疗组在降低凝血酶原时间、血氨方面显著优于对照组（P〈0．05）。结论中医五联疗法发挥了中药综合治疗的优势,疗效显著,值得推广。     

An Autopsy Case of Fulminant,Suppurative Bacterial Myocarditis Caused by Group B Streptococcus

A 61-year-old woman was admitted to our hospital with a fever, nausea, diarrhea, and back pain. Her condition rapidly deteriorated, and she was transferred to the intensive-care unit for mechanical circulatory support and antibiotics, but she died 40 hours after admission. Autopsy findings showed necrotic and suppurative myocardial changes due to group B Streptococcus (GBS). To date, only one case of bacterial myocarditis caused by GBS has been reported. We herein report a case of GBS myocarditis, the etiology of which is poorly understood due to the limited number of cases. Bacterial myocarditis should be considered in patients with sepsis and myocardial dysfunction.     

磷酸肌酸钠联合果糖二磷酸钠治疗病毒性心肌炎的疗效观察

目的 探讨磷酸肌酸钠联合果糖二磷酸钠治疗病毒性心肌炎的疗效.方法 选取2010年9月至2012年8月在新疆自治区人民医院北院就诊的病毒性心肌炎患者99例,按照随机数字表法将患儿分成联合用药组（50例）和基础治疗组（49例）.两组患儿均实施常规治疗,治疗组在常规治疗的基础上加用果糖二磷酸钠,每次150剂mg/kg,每日2次,静脉滴注;联合用药组在治疗组的基础上加用磷酸肌酸钠,50 mg/kg,静脉滴注.两组疗程均为2周.结果 联合用药组治疗后的总有效率为92.0%,显著高于治疗组的67.3%（Z=2.484,P＜0.05）,联合用药组经治疗后心电图及心肌酶谱各有1例未发生变化,治疗组经治疗后心电图无变化4例,心肌酶谱无变化7例,联合用药组经治疗后心电图及心肌酶谱改变均较治疗组显著.结论 磷酸肌酸钠联合果糖二磷酸钠治疗病毒性心肌炎疗效显著,不良反应轻微,安全可行,值得临床推广.     

L－HSA－Ara－AMP识别的去唾液酸糖蛋白受体在大鼠肝细胞及HepG－2细胞表面的定位

以胶体金标记抗病毒交联物Ｌ－ＨＳＡ－Ａｒａ－ＡＭＰ，做直接胶体金银染色，光镜观察该交联物识别的去唾液酸糖蛋白受体在大鼠肝细胞及ＨｅｐＧ－２细胞表面的定位，同时分别用大鼠脾组织，金标ＨＳＡ做对照。结果：去唾液酸糖蛋白受体多分布在大鼠肝细胞的血窦面，侧面亦有少量分布。ＨｅｐＧ－２细胞表面受体呈阳性。而两组对照组受体标记均呈阴性。     

心脏MRI诊断儿童急性心肌炎

目的 观察心脏MRI(CMRI)诊断儿童急性心肌炎(AMC)的价值。方法 回顾性分析36例临床诊断AMC(AMC组)和22例非心肌炎(对照组)患儿心脏黑血脂肪抑制双反转恢复T2WI、初始T1 mapping及钆对比剂延迟强化成像(LGE),记录其心肌T2信号比、初始T1值,判断LGE阳性与否;比较组间一般资料及CMR参数的差异,绘制受试者工作特征(ROC)曲线,评估单一CMR参数、T2信号比及初始T1值及其联合诊断儿童AMC的效能。结果 组间患儿年龄、性别及临床表现、心电图、超声心动图表现差异均无统计学意义(P均>0.05)。AMC组肌酸激酶同工酶[19.00(16.25,24.00)U/L vs.14.00(12.00,16.25)U/L]、N末端B型钠尿肽前体[58.47(30.85,113.75)pg/ml vs.32.94(12.56,84.25)pg/ml]、T2比[2.08(1.57,2.39)vs. 1.58(1.36,1.86)]及初始T1值[1 326.00(1 308.75,1 376.50)ms vs.1 213.50(1 192.75,1 243.00)m...     

急性心肌炎多模态影像学诊疗进展

急性心肌炎(AM)临床表现多变,早期明确诊断对临床决策与预后评估具有重要意义。作为无创诊断AM的主要工具,超声心动图、MRI及PET可从形态、功能及分子水平显示心肌损伤,在其风险分层和临床管理中发挥关键作用。本文就多模态影像学用于诊断与治疗AM进展进行综述。     

Development of suspension adapted Vero cell culture process technology for production of viral vaccines

Vero cells are considered as the most widely accepted continuous cell line by the regulatory authorities (such as WHO) for the manufacture of viral vaccines for human use. The growth of Vero cells is anchorage-dependent. Scale-up and manufacturing in adherent cultures are labor intensive and complicated. Adaptation of Vero cells to grow in suspension will simplify subcultivation and process scale-up significantly, and therefore reduce the production cost.Here we report on a successful adaptation of adherent Vero cells to grow in suspension in a serum-free and animal component-free medium (IHM03) developed in-house. The suspension adapted Vero cell cultures in IHM03 grew to similar or better maximum cell density as what was observed for the adherent Vero cells grown in commercial serum-free media and with a cell doubling time of 40–44 h. Much higher cell density (8 × 10⁶ cells/mL) was achieved in a batch culture when three volume of the culture medium was replaced during the batch culture process.Both adherent and suspension Vero cells from various stages were tested for their authenticity using short tandem repeat analysis. Testing result indicates that all Vero cell samples had 100% concordance with the Vero DNA control sample, indicating the suspension cells maintained their genetic stability. Furthermore, suspension Vero cells at a passage number of 163 were assayed for tumorigenicity, and were not found to be tumorigenic.The viral productivity of suspension Vero cells was evaluated by using vesicular stomatitis virus (VSV) as a model. The suspension cell culture showed a better productivity of VSV than the adherent Vero cell culture. In addition, the suspension culture could be infected at higher cell densities, thus improving the volumetric virus productivity. More than one log of increase in the VSV productivity was achieved in a 3L bioreactor perfusion culture infected at a cell density of 6.8 × 10⁶ cells/mL.     

Virología: diagnóstico sindrómico de meningitis y encefalitis

Viral infections of the nervous system represent a major health problem. It is estimated that the incidence of viral meningitis in the general population ranges from 5-17 cases per 100,000 inhabitants per year in developed countries. This heading encompasses highly varied clinical pictures, ranging from meningitis to encephalitis. This article presents the agents involved in our environment and discusses their expressiveness. In immunocompetent patients, the course of these infections is usually benign. Nucleic acid amplification techniques are the gold standard for their etiological diagnosis. The introduction of polymerase chain reaction and serological diagnosis of the main arboviruses has increased the diagnostic capabilities in a wide spectrum of these clinical entities.     

17例人微小病毒B19肝炎患者临床特点分析

目的：探讨人微小病毒B19肝炎患者的临床特征。方法对17例感染人微小病毒B19患者的病历资料进行回顾性分析,总结肝损害的特点和临床特征。结果17例人微小病毒B19肝炎患者均有发热（100%）,有全身乏力14例（82.4%）、关节、肌肉痛9例（52.9%）、咽痛6例（35.3%）、食欲减退11例（64.7%）、皮疹5例（29.4%）、脾肿大12例（70.6%）,肝肿大7例（41.2%）、淋巴结肿大3例（17.6%）、黄疸5例（29.4%）;除血ALT和AST升高外,伴有羟丁酸脱氢酶、乳酸脱氢酶、腺苷脱氨酶升高和淋巴细胞百分比升高;起病急,临床表现复杂,但多呈急性自限性过程,肝功能恢复较快,预后较好。结论对不明原因肝损害同时伴有上述特征者,除常规筛查常见的嗜肝病毒外,及时检测血清抗人微小病毒B19抗体IgM,能帮助明确一部分患者的病因。