气传致敏真菌与支气管哮喘相关性研究

目的 研究气传致敏真菌与过敏性哮喘的关系.方法 采用空气中暴片调查法和暴皿调查法,了解本地区气传真菌的品种和数量.应用5组多价真菌变应原对346例支气管哮喘患者进行了皮内试验.应用放射变应原吸附试验方法 对真菌皮试阳性哮喘患者89例和50例健康者进行血清特异性IgE测定.结果 346例支气管哮喘患者真菌变应原皮内试验阳性89例(25.75%).89例真菌变应原皮内试验阳性患者中特异性IgE阳性78例,真菌变应原皮内试验与sIgE两种检测方法 一致率87.64%(78/89),两种检测方法 经一致性卡方检验,χ2=9.09 ,P＜0.01.对照组50例中仅2例阳性反应(4.0%),余均为阴性.两组结果 经卡方检验,χ2= 89.98,P＜0.001.结论 气传致敏真菌是过敏性哮喘的重要致敏原,采用体内外检测方法 联合测定真菌过敏原具有良好的相关性.     

儿童哮喘患者180例常见变应原检测分析

目的:探讨西安地区哮喘儿童常见变应原,为预防和治疗哮喘儿童变应性疾病提供科学依据。方法:选择西安地区近1年哮喘儿童首次症状的病人180例进行临床检测。所有对象均进行皮肤变应原(SPT)点刺试验。结果:180例患儿中SPT(≥1个变应原阳性)154例占84.8%,各变应原阳性率为5.3%～74.2%,变应原中以粉尘螨致敏的阳性率最高达78.6%,其次为蒿属花粉46.1,其余阳性率依次为狗毛36.6%,猫毛20.2%,律艹属花粉15.8%,蟑螂17.4%,牛奶11.6%,海虾16.5%,蛋清12.4%,草莓7.2%,芒果10.2%,大豆9.8%。螨过敏阳性率患儿有142例,常合并其它一种或多种变应原阳性(144例78.2%),而螨阴性患儿(35例28.6%)中仅有10例(28.9%)合并其它一种或多种变应原阳性,差异有统计学意义。各年龄组发病率特点:高龄组(>7岁)SPT阳性率为81.1%,高于低龄组(≤7岁)78.1%,两组间SPT阳性率的差异有统计学意义。在吸入变应原种类的比较中,高龄组螨过敏的阳性率、蒿属花粉阳性率、狗毛与猫毛的阳性率、蟑螂阳性率均高于低龄组,差异有统计学意义。结论:西安地区儿童哮喘常见的变应原是粉尘螨、蒿属花粉。随着年龄增长,呼吸道变态反应性疾病的患儿对吸入性变应原更为敏感,研究不同区域不同年龄变态反应性疾病患儿的变应原特征,有助于对疾病早期诊断和早期干预。     

哮喘斜纹天蛾及蛱蝶致敏原的临床研究

应用自己研制的斜纹天蛾及蛱蝶变应原给３１例哮喘患者做皮肤试验及ＢＳＡＥＬＩＳＡ特异性ＩｇＥ测定，研究两种常见昆虫的致敏性。结果发现哮喘患者斜纹天蛾及蛱蝶的皮肤试验及特异性ＩｇＥ阳性率均明显高于正常人，其ＯＤ指数均亦明显高于对照组。提示斜纹天蛾及蛱蝶可能系哮喘致敏原，建议将这两种新发现的昆虫变庆原用于这诊断有 性免疫治疗中，研究还显示哮喘皮肤试验与特民性ＩｇＥ阳性符合率７０％以上，正常对照组无１例特     

真菌相关性变应性鼻炎283例分析

目的探讨真菌相关性变应性鼻炎（AR）的变应原分布、临床特征及其与当地气传真菌变应原谱的关系。方法回顾分析283例真菌变应原皮肤点刺试验（SPT）阳性AR患者的临床资料，同时分析同期当地气传真菌变应原分布。结果1632例具有AR症状进行SPT的患者中，SPT真菌阳性282例，阴性者中同期特异性鼻黏膜激发试验56例，1例真菌阳性，共检出真菌致敏原283例，检出率17．34％。其中单纯真菌阳性92例，合并其他变应原阳性191例；合并支气管哮喘21例，伴鼻窦真菌病2例，有哮喘史或AR家族史35例。全部研究对象都有AR临床表现，发病时区在5～8月（57．09％）较多。致敏真菌有交链孢霉、曲菌、白色念珠菌、特异青霉、串珠镰他菌、蠕孢菌、黑粉菌、总状毛霉菌、新月弯他菌等。结论气传真菌是变应性鼻炎的重要致敏原；根据当地真菌变应原谱针对性选择变应原种类进行变应原筛查能提高致敏原检出率，降低费用并减少皮肤点刺痛苦。     

西安地区支气管哮喘鳞翅目昆虫致敏的的研究

调查了西安地区鳞翅目昆虫动态及哮喘蝶，蛾致敏原种类结果发现，于１９９５年的４－１１月份可捕捉到这类昆虫，７－８月份的捕捉 量最大；全年的７１个捕虫日中，蛾１２５只，属１４科，５２种。其中、夜蛾科居首位，天蛾科次之，余依次为眼蝶科，尺蛾科，粉蝶科等。将上述优势鳞翅目昆虫翅制成单价变压原，给当地哮喘患者作皮试，发现夜蛾科，天蛾科及粉蝶科３＾＋以上皮试阳性反应率３０％以上，提示它们可能为西安地区哮喘鳞翅     

皮肤点刺试验阴性患者的血清特异性IgE检测结果分析

目的分析皮肤点刺试验(SPT)阴性患者的血清特异性IgE(sIgE)检测结果,探讨血清sIgE检测的临床意义。方法使用德国默克公司的阿罗格(NHD)24种标准变应原试剂对就诊于本院的211例患者行SPT检测。变应原点刺液与阳性对照所致丘疹直径之比,即皮肤指数(SI),根据SI将阳性结果分为"+"、"++"、"+++"、"++++",皮肤反应与阴性对照相似则标以阴性(-)。用德国欧蒙EUROIMMUN公司产的Euroline中国特应性组合20种标准试剂对SPT阴性患者行血清sIgE和总IgE检测,血清IgE结果分0~6级。结果 SPT检测阴性的83例患者中49例(59.0%)患者血清sIgE检测结果阳性。血清sIgE浓度1级患者30例,2级患者8例,3级患者5例,4级患者5例,5级患者1例,6级患者0例。1种血清sIgE阳性患者19例,2种血清sIgE阳性患者11例,3种血清sIgE阳性患者5例,4种血清sIgE阳性患者2例,5种血清sIgE阳性患者7例,6种血清sIgE阳性患者3例,7种血清sIgE阳性患者2例。血清sIgE阳性的吸入性变应原主要为:螨虫组合(18例),屋尘(15例),树木组合3(13例),动物毛发组合1(13例);血清sIgE阳性的食入性变应原主要为:淡水鱼组合1(21例),海洋组合2(15例),花生/黄豆/小麦/玉米(11例)。83例SPT阴性患者中34例(41.0%)患者血清sIgE检测结果阴性。其中血清sIgE阴性但总IgE阳性患者14例,血清sIgE和总IgE均阴性的患者20例(24.1%)。结论近60%SPT阴性患者血清sIgE呈阳性,SPT检测阴性患者仍需行血清sIgE检测。     

宁夏银北地区常见气传变应原谱分析

目的研究宁夏银北地区常见气传变应原的种类、分布特征及其与过敏性疾病的关系。方法选择就诊的624例患者中疑似过敏性疾病患者461例,进行皮肤点刺试验（SPT）,以明确过敏原。结果检测中阳性率SPT为45.53%,至少一种变应原呈SPT阳性为20%（42/210）,2种以上占80%（160/210）。其阳性率分布前4位的变应原分别为艾蒿、粉尘螨、屋尘螨、热带螨,男女阳性率差异无统计学意义（P﹥0.05）。变应原阳性率主要集中在20~50岁。结论宁夏银北地区主要吸入致敏原,对本地区过敏性疾病的防治具有指导意义。     

淮南地区常年性变应性鼻炎对尘螨过敏情况的调查

目的:了解淮南地区不同职业人群中常年性变应性鼻炎患者对尘螨的过敏情况。方法:选取不同的职业人群采用问卷调查方法,选择118名符合常年性变应性鼻炎症状的志愿者,利用皮肤点刺试验(SPT)及血清特异性IgE(sIgE)检测其对尘螨变应原的过敏情况。结果:工作中密切接触中药材的常年性变应性鼻炎患者其SPT阳性率达77.5%,sIgE阳性率为75.0%;工作中密切接触粮食的常年性变应性鼻炎患者其SPT阳性率达60.9%,sIgE阳性率为56.5%;而纺织车间工人中常年性变应性鼻炎患者的SPT阳性率为31.2%,sIgE阳性率为15.6%;差异均有统计学意义(P<0.01)。结论:淮南地区不同职业中常年性变应性鼻炎患者对尘螨的过敏情况与职业环境有关,应加强对特定职业人群的劳动保护。     

霜天蛾昆虫变应原的变应原性及免疫原性分析

目的 分析霜天蛾主要变应原的变应原性和免疫原性,为进一步制备霜天蛾标准化变应原疫苗和基因工程重组霜天蛾昆虫变应原奠定基础.方法 应用不连续聚丙烯酰胺凝胶电泳对霜天蛾变应原蛋白成分进行分离,对9例霜天蛾过敏患者血清分别进行IgE、IgG免疫印记分析,并对比分析IgE、IgG反应变应原成分.结果 霜天蛾提取液经SDS-PAGE染色后显示出20余种蛋白质成分,相对分子质量12 000～128 000.免疫印迹分析结果显示具有变应原性的蛋白相对分子质量及反应率分别为:74 000(88.9%),66 000(22.2%),49 000(22.2%),36 000(77.8%),25 000(33.3%),具有免疫原性的蛋白相对分子质量及反应率分别为:79 000(33.3%),74 000(66.7%),66 000(22.2%),49 000(22.2%),36 000(44.4%),25 000(55.6%).结论 霜天蛾变应原中具有较强变应原活性的蛋白质相对分子质量为74000和36000,具有较强免疫原活性的蛋白质相对分子质量为74 000和25 000的蛋白质,是霜天蛾过敏患者特异性过敏诊断和治疗的主要成分.     

Value of D-Dimers in patients with acute aortic dissection

Objective: To evaluatel the value of D-dimers in patients with acute aortic dissection (AAD). Methods: This study consisted of 16 patients with AAD and 27 non-AAD patients. Serum D-dimets were measured by Sta-Liatest D-DI immunoturbidimetric assay. Results: D-dimer level was higher (P ＜ 0.001) in patients with AAD(7.91 ± 5.52 μg/ml) than that in non- AAD group(1.57±1.24 μg/ml). D-dimer was positive (＞0.4 μg/ml) in all patients with AAD and in 10 control group patients (37%). Among patients with acute AAD, D-dimers tended to be higher in Stanford A than in Stanford B (8.67 ± 4.31 μg/ml vs. 3.24±1.27 μg/ml, P ＜0.01). D-dimer values tended to be higher in more extended disease(3.84 ± 1.65 μg/ml, 8.57 ± 3.58 μg/ml and 11.87 ± 5.69 μg/ml in thoracic aorta, thoracic and abdominal aorta, thoracic and abdominal aorta and iliacal arteries, respectively, P ＜ 0.05 for both 8.57 ± 3.58 and 11.87 ± 5.69 vs. 3.84 ± 1.65 ). Including the control group into the analysis, we found a sensitivity of 100%, a negative predictive value of 100%, and a specificity of 66% and a positive predictive value of 64% for D-dimer in diagnosis of AAD in our patients with suspected AAD. Conclusion: D-dimer was elevated in patients with AAD. A negative D-dimer test result could be useful in excluding AAD.     

Research of combined liver-kidney transplantation model in rats

Objective： To set up a simple and reliable rat model of combined liver-kidney transplantation. Methods： SD rats served as both donors and recipients. 4℃ sodium lactate Ringer＇s was infused from portal veins to donated livers,and from abdominal aorta to donated kidneys, respectively. Anastomosis of the portal vein and the inferior vena cava （IVC） inferior to the right kidney between the graft and the recipient was performed by a double cuff method, then the superior hepatic vena cava with suture. A patch of donated renal artery was anastomosed to the recipient abdominal aorta. The urethra and bile duct were reconstructed with a simple inside bracket. Results： Among 65 cases of combined liver-kidney transplantation, the success rate in the late 40 cases was 77.5%. The function of the grafted liver and kidney remained normal. Conclusion： This rat model of combined liver-kidney transplantation can be established in common laboratory conditions with high success rate and meet the needs of renal transplantation experiment.     

APPLICATION OF LORNOXICAM TO PATIENT-CONTROLLED ANALGESIA IN PATIENTS UNDERGOING ABDOMINAL SURGERIES

FOR anesthesiologis s ,treatingpostoperativepainhas alwaysbeen a problem.Althoughopioidshave been provedtobe effective,theirsideeffectscouldnotbeignored.With thedevelopmentofscienceand pharmacology,many drugs with aspectsof satisfactoryanalgesicefficacyand couldbe welltoleratedby patientshave been developed.And lornoxicamisone of them, which isa non-steroidalanti-inflammatorydrug (NSAID ), with analgesic, anti-infl-ammatory,andantipyreticproperties.Itseliminationhalf-time(3 to 5 hours) isle…     

BLOOD PRESSURE CHANGE WITH AGE IN SALT-SENSITIVE TEENAGERS

Objective To observe blood pressure change with age in salt-sensitive teenagers whose salt sensitivity were determined by repeated testing.Methods Salt sensitivity was determined through intravenous infusion of normal saline combined with volume-depletion by oral diuretic furosemide in 55 teenagers. After five years, salt sensitivity was re-examined and subject blood pressure was followed up. Blood pressure changes in salt-sensitive teenagers were compared to that of non-salt sensitive teenagers over five years.Results After 5 years, the repetition rate of salt sensitivity determined by intravenous saline loading is 92.7%. In teenagers with salt sensitivity on the baseline, both the systolic blood pressure increments and increment rates were much higher than non-salt sensitive teenagers (12.7±12.1 mmHg vs. 2.8±5.2 mmHg, P＜ 0.01; 12.2%± 12.0% vs. 2.5% ±4.4%, P＜ 0.001,respectively). There was a similar trend for diastolic blood pressure (8.4 ± 6.4 mmHg vs. 3.7 ± 6.4 mmHg, P = 0.052; 13.2% ±10.6 % vs. 6.8%± 10.1%, P = 0.053, respectively).Conclusions Salt sensitivity determined by intravenous saline loading showed good reproducibility. Blood pressure increments with age were much higher in salt-sensitive teenagers than non-salt sensitive teenagers, especially in terms of systolic blood pressure.     

Acupuncture Combined with Spinal Tui Na for Treatment of Primary Dysmenorrhea in 30 Cases

Objective: To observe the therapeutic effects in acupunture treatment of primary dysmenorrhea combined with spinal Tui Na, and study its mechanism. Methods: Thirty cases of the treatment group were treated by acupuncture combined with spinal Tui Na, and thirty cases in the control group were treated by routine acupuncture. Results: The total effective rate was 93.3% in the treatment group, and 73.3% in the control group, with a significant difference between the two groups (P<0.05). Conclusions: Acupuncture combined with spinal Tui Na has good prospects for treatment of primary dysmenorrhea.     

Luo Lingjie's Experience in Treating Chronic Nephropathy

In treating chronic nephropathy,Luo Lingjie,a chief physician,pays attention to regulating the balance between yin and yang,treating infection if present,and removing pathogenic factors.He prescribes gentle drugs and uses carefully strongly warming-tonifying ones,emphasizes the importance of persuading the patient to persist in treatment with medication and nurse one's health for recuperation,and is good at combined use of TCM and western medicine therapy and brings the merits of various therapies into full play,with obvious theraoeutic effects.     

Dr.Zhang Ren's Experience in the Acupuncture Treatment of Different Diseases with the Same Therapeutic Principle

Dr.Zhang Ren,the chief physician,is the chairman of Shanghai Acupuncture and Moxibustion Association.Having been engaged in medicine for about 40 years,he is experienced in treating various intractable diseases.In his long years of clinical practice,he advocates taking the TCM differentiation as the basis to seek for the acupuncture method for treatment of modern intractable diseases.The author of this essay had the fortune to follow Dr.Zhang in study.The following is a summary of Dr.Zhang's experience in the acupuncture treatment for different intractable diseases with the same therapeutic principle.     

安心颗粒对急诊经皮冠状动脉介入术后生活质量影响的研究

目的：评价使用安心颗粒对急诊经皮冠状动脉介入术（PPCI）术后生活质量的影响.方法：将160例接受PPCI的急性ST段抬高型心肌梗死患者随机分为安心颗粒组（术前顿服安心颗粒8.8g,术后安心颗粒4.4 g/次,每日2次）和对照组（仅接受基础药物治疗）.所有患者均服用阿司匹林、氯吡格雷和阿托伐他汀.分别在入院时、出院前1d、出院后180 d时,应用心肌梗死多维度量表（MIDAS）、中文版SF-36评价量表对患者生活质量评分.并观察术后30 d以内的出血并发症、血小板减少症发生情况.结果：入院时和出院前1d,两组患者的心肌梗死MIDAS、SF-36量表评分比较无差异（P＞0.05）;出院后180 d时,与对照组比较,安心颗粒组MIDAS、SF-36评分明显减低（P＜0.05）;组内与入院时比较,两组出院前1d、出院后180 d时,MIDAS、SF-36评分均降低（P＜0.05）.两组患者在随访期间均无大量出血、少量出血、重度和极重度血小板减少症发生,安心颗粒组有4例、对照组有7例发生不明显出血（P＞0.05）.两组发生轻度血小板减少症的患者数比较无差异（P＞0.05）.结论：PPCI使用安心颗粒,能改善急性ST段抬高型心肌梗死患者的生活质量,且不增加出血风险.     

The comparative studies of the influences of Urapidil and Nicardipine on sino-atrial node function, atrio-ventricular node function and hemodynamics

Objective:To investigate the influences of urapidil and nicardipine on rabbit sinus function,atrio-ventricular node function and hemodynamics.Methods:Thirty-two Angora's rabbits were selected and randomly divided into four groups.U1 group:urapidil 0.25 mg/kg;U2 group:urapidil 0.5 mg/kg;N1 group:nicardipine 10 μg/kg;N2 group:nicardipine 20 μg/kg.All these medicine were administrated within 30 seconds.Measurements were taken before and after the administration of urapidil or nicardipine for the following data:mean blood pressure(MAP),heart rate(HR),sino-atrial conduction time(SACT),maximal sinoatrial recovery time(SNRTmax)corrected sinus node recovery time(CSNRT),index of sinus node recovery time(SNRTI),Wenckebach A-V conduction frequency (WB),and P-R interval.Results:Significant MAP and HR changes were identified in all of the four groups before and after administration of both urapidil and nicardipine.No significant changes could be found in the rest of the parameters.Intergroup analysis showed that SACT and CSNRT of N1 and N2 groups were shorter than those of the U2 group(P＜0.01);the MAP decreased(P＜0.01)and the HR increased drastically(P＜0.01).Conclusions:Neither urapidil(0.25 mg/kg,0.5 mg/kg)nor nicardipine(10μg/kg,20μg/kg)has any significant influence on rabbit sinus function or rabbit atrio-ventricular node function.Nicardipine could be a better choice than urapidil for parafunctional sinus node patients.