三叉神经痛合并根区蛛网膜粘连的病毒病因学研究

Objective To assess the relationship that trigeminal neuralgia combining arachnoids' adhesions and herpes simplex virus type 1. Methods There are fifty nine patients with trigeminal neuralgia their trigeminal nerve root area combined arachnoids' adhesion, cutting their arachnoids as the experimental group. There are twenty four patients with trigeminal neuralgia their trigeminal nerve root area is not combined significant arachnoids' adhesion, cutting their arachnoids as the case - control group. Using polymerase chain reaction and Western blot technique to detecting the HSV - 1 specific DNA fragments and specific antigen,and cutting twenty arachnoids of the patients with Brain Trauma as the normal control group. Results The positive ratio of DNA fragments in the three group is 69% 、58% and 25% respectively. The positive ratio of DNA fragments in the experiment group and case -control group were higher than the normal control group,with statistical difference ( P ＜ 0. 05 ), but the experimental group and case -control group compared with no significant difference ( P ＞ 0. 05 ). The positive ratio of virus - specific antigen is 51%、 25 % and 15 %respectively. The positive ratio of virus - specific antigen was higher than the case - control group, also higher than the normal control group, were significantly different ( P ＜ 0. 05 ), while the case - control group and the normal control group compared with no significant differences ( P ＞ 0. 05 ). Conclusion HSV - 1 proliferating infected patients with trigeminal neuralgia may result in the arachnoids adhesion of trigeminal nerve root zone; arachnoids tissue may be another latent base of HSV - 1; HSV - 1 infection may be another pathogenic factor of trigeminal neuralgia.     

助产士应对医院感染的防护措施及体会

目的：分析助产士工作中所面临医院感染的风险因素，加强防护措施，提高自我防护意识，减少职业暴露危险，将危害降至最低，最大限度的保护助产士的安全，进而提高护理工作质量。     

三叉神经痛合并根区蛛网膜粘连的病毒病因学研究

Objective To assess the relationship that trigeminal neuralgia combining arachnoids' adhesions and herpes simplex virus type 1. Methods There are fifty nine patients with trigeminal neuralgia their trigeminal nerve root area combined arachnoids' adhesion, cutting their arachnoids as the experimental group. There are twenty four patients with trigeminal neuralgia their trigeminal nerve root area is not combined significant arachnoids' adhesion, cutting their arachnoids as the case - control group. Using polymerase chain reaction and Western blot technique to detecting the HSV - 1 specific DNA fragments and specific antigen,and cutting twenty arachnoids of the patients with Brain Trauma as the normal control group. Results The positive ratio of DNA fragments in the three group is 69% 、58% and 25% respectively. The positive ratio of DNA fragments in the experiment group and case -control group were higher than the normal control group,with statistical difference ( P ＜ 0. 05 ), but the experimental group and case -control group compared with no significant difference ( P ＞ 0. 05 ). The positive ratio of virus - specific antigen is 51%、 25 % and 15 %respectively. The positive ratio of virus - specific antigen was higher than the case - control group, also higher than the normal control group, were significantly different ( P ＜ 0. 05 ), while the case - control group and the normal control group compared with no significant differences ( P ＞ 0. 05 ). Conclusion HSV - 1 proliferating infected patients with trigeminal neuralgia may result in the arachnoids adhesion of trigeminal nerve root zone; arachnoids tissue may be another latent base of HSV - 1; HSV - 1 infection may be another pathogenic factor of trigeminal neuralgia.     

反义重组腺病毒质粒pAdxsi-GFP-hVEGF的构建与鉴定

目的构建反义重组腺病毒质粒pAdxsi-GFP-hVEGF。方法从人外周血细胞中提取总RNA,RT-PCR法反转录合成人cDNA文库。设计带有酶切位点的引物,调取VEGF目的基因,插入pShuttle-GFP-CMV穿梭载体。经鉴定序列正确后,将VEGF目的基因构建至亚克隆重组腺病毒质粒pAdxsi中。结果成功构建反义重组腺病毒质粒pAdxsi-GFP-hVEGF,经酶切鉴定,目的基因分子量与预计的相同,测序插入载体部位正确。结论反义重组腺病毒质粒pAdxsi-GFP-hVEGF构建正确、稳定,为进一步抑制人VEGF基因的表达和体内外实验打下了良好的基础。     

三叉神经痛合并根区蛛网膜粘连的病毒病因学研究

目的 探讨原发性三叉神经痛(TN)合并根区蛛网膜粘连与HSV-1感染的关系.方法 对TN患者于显微血管减压术中见其三叉神经根区合并蛛网膜粘连者59例,取其蛛网膜作为实验组;未合并根区明显蛛网膜粘连的TN患者24例,取其蛛网膜作为病例对照组;采用PCR和Western Blot方法分别检测其HSV-1特异性DNA片段、特异性抗原,并以20例外伤患者蛛网膜做正常对照.结果 三组资料中DNA片段阳性率分别为:69%、58%和25%;实验组和病例对照组的DNA片段阳性率均高于正常对照组,且差异有统计学意义(P＜0.05),但实验组和病例对照组相比差异无统计学意义(P＞0.05);病毒特异性抗原阳性率分别为:51%、25%和15%,实验组病毒抗原阳性率高于病例对照组,也高于正常对照组,差异有统计学意义(P＜0.05),而病例对照组和正常对照组相比差异无统计学意义(P＞0.05).结论 HSV-1病毒增殖性感染可能促使TN患者三叉神经根区蛛网膜的粘连,蛛网膜组织可能是HSV-1潜伏感染的另一基地;HSV-1病毒感染可能是TN又一致病因素.

Abstract：

Objective To assess the relationship that trigeminal neuralgia combining arachnoids' adhesions and herpes simplex virus type 1. Methods There are fifty nine patients with trigeminal neuralgia their trigeminal nerve root area combined arachnoids' adhesion, cutting their arachnoids as the experimental group. There are twenty four patients with trigeminal neuralgia their trigeminal nerve root area is not combined significant arachnoids' adhesion, cutting their arachnoids as the case - control group. Using polymerase chain reaction and Western blot technique to detecting the HSV - 1 specific DNA fragments and specific antigen,and cutting twenty arachnoids of the patients with Brain Trauma as the normal control group. Results The positive ratio of DNA fragments in the three group is 69% 、58% and 25% respectively. The positive ratio of DNA fragments in the experiment group and case -control group were higher than the normal control group,with statistical difference ( P ＜ 0. 05 ), but the experimental group and case -control group compared with no significant difference ( P ＞ 0. 05 ). The positive ratio of virus - specific antigen is 51%、 25 % and 15 %respectively. The positive ratio of virus - specific antigen was higher than the case - control group, also higher than the normal control group, were significantly different ( P ＜ 0. 05 ), while the case - control group and the normal control group compared with no significant differences ( P ＞ 0. 05 ). Conclusion HSV - 1 proliferating infected patients with trigeminal neuralgia may result in the arachnoids adhesion of trigeminal nerve root zone; arachnoids tissue may be another latent base of HSV - 1; HSV - 1 infection may be another pathogenic factor of trigeminal neuralgia.     

脑胶质瘤术后超选介入化疗联合系统化疗的临床研究

目的 探讨术后超选择介入化疗联合系统化疗治疗脑胶质瘤的优势.方法 2006年至2009年山东济宁市第一人民医院介入科收治46例腩胶质瘤的患者.据患者自愿入组的原则分为两组.治疗组:25例患者手术后先行常规放疗,然后行超选介入化疗,同期进行系统化疗.对照组:21例患者手术后先行常规放疗,然后只进行系统化疗.定期随访,复查颅脑CT,测量肿瘤的体积,并进行Karnofsky预后评分.比较肿瘤体积变化及两组间Karnofsky预后评分的差异.结果 平均随访2.3年,两组均无死亡病例.化疗前两组肿瘤的体积差异无统计学意义,(P>0.05).化疗1年后介入化疗联合系统化疗组肿瘤缩小率为67.11%,系统化疗组肿瘤缩小率为45.79%,两组肿瘤体积经独立样本t检验显示肿瘤体积差异有统计学意义(P<0.05).治疗组在化疗期间出现癫痫3例,眼痛5例,头痛9例,恶心呕吐8例,血小板下降1例.对照组出现癫痫1例,头痛7例,血小板下降3例,恶心呕吐6例.Wilcoxon秩和检验Karnofsky预后评分显示介入化疗结合系统化疗组的预后优于单纯系统化疗组.(P<0.05).结论 术后放疗结合介入化疗联合系统化疗的治疗方法,与术后放疗结合系统化疗的治疗方法相比,可以更有效的控制肿瘤的生长,改善临床症状,提高生活质量,是值得进一步探讨的化疗方法.     

依达拉奉治疗急性重型颅脑损伤的疗效观察

目的观察依达拉奉对重型颅脑损伤的治疗效果。方法 80例急性重型颅脑损伤病人按随机数字表随机分成依达拉奉全量治疗组32例,依达拉奉减量治疗组28例,对照组20例。治疗14d后,观察分析GCS评分及不良反应。结果与对照组相比,依达拉奉全量治疗组和减量治疗组GCS评分明显升高(P0.05),但两组间GCS评分差异无显著性。结论早期应用依达拉奉治疗急性重型颅脑损伤有较好的效果,且副作用少,安全可靠。     

三叉神经痛病毒病因学及其发病机制研究进展

病毒感染学说在三叉神经痛的病因中,一直占有举足轻重的地位。单纯疱疹病毒存在潜伏性及嗜神经性,并且在某些因素作用下,潜伏的病毒可再激活,进而引起各种疾病。而三叉神经痛的发病机制与其病因的发展有着不可分割的联系。近些年学者在基础与临床方面对单纯疱疹病毒1型(HSV-1)进行了大量研究。本文结合国内外相关文献,就其病毒病因、发病机制及其相关研究进展做一综述。     

三叉神经根区粘连蛛网膜组织中IL-6的表达及意义

目的探讨原发性三叉神经痛(TN)患者三叉神经根区粘连的蛛网膜组织中白细胞介素-6(IL-6)表达对单纯疱疹病毒Ⅰ型(HSV-1)的影响,并进一步探讨HSV-1感染与TN的关系。方法首先采用PCR方法检测TN患者三叉神经根区粘连的蛛网膜、无粘连的蛛网膜组织中HSV-1特异性基因片段,再用免疫印迹法分别检测上述组织中抗原的表达,从而确定病毒感染状态,将其重新划分为HSV-1潜伏感染组、增殖感染组、未感染组,再用酶联免疫吸附测定法分别定量检测三组蛛网膜标本组织和患者血清中IL-6水平。结果 HSV-1增殖感染组的蛛网膜组织中IL-6水平[(324.64±14.28)pg/g]高于潜伏感染组[(232.75±19.17)pg/g],潜伏感染组也高于未感染组[(93.54±14.08)pg/g],且均有统计学差异(P<0.01);血清中IL-6水平三组之间无明显差异(P>0.05)。结论 IL-6是HSV-1增殖感染过程中的重要介质。HSV-1的增殖感染可能诱发或加重三叉神经根区蛛网膜的粘连,蛛网膜组织可能也是HSV-1的潜伏基地。HSV-1感染可能是继血管压迫之外造成三叉神经根区蛛网膜粘连继而引发TN的另一重要因素。     

剖宫产后产妇院内感染情况及影响因素和预防措施研究

目的探讨剖宫产后产妇院内感染情况及影响因素和预防措施,以进一步降低产后感染率。方法选取2015年1月至2018年8月于我院进行剖宫产术的128例产妇作为研究对象,记录所有产妇年龄、孕况等资料及院内感染情况,分析剖宫产后产妇院内感染的相关因素和影响因素。结果 128例剖宫产产妇产后发生院内感染者14例,感染率为10.94%;经非条件单因素Logistic回归模型分析显示,年龄较大、住院时间较长、合并疾病存在、手术时间过长、导尿管的使用以及未能使用预防抗菌药物的剖宫产产妇产后院内感染率均显著升高(P0.05);住院时间较长、合并疾病存在、手术时间过长、导尿管的使用以及未能使用预防抗菌药物均为导致剖宫产产妇产后院内感染的独立危险因素(P0.05)。结论剖宫产产妇产后院内感染主要以手术切口感染为主,而住院时间较长、合并疾病存在、手术时间过长、导尿管的使用以及未能使用预防抗菌药物均为导致剖宫产产妇产后院内感染的独立危险因素,故因采取相应的措施降低产妇产后感染率,促进产妇产后恢复和提高新生儿质量。