2005～2010年石家庄市布鲁杆菌病疫情监测情况分析

石家庄市位于河北省中南部,辖区内有平原、山区和半山区,畜牧养殖范围较广且分散。据记载,1957年平山县开始有布鲁杆菌病(简称布病)病羊查出,1970年以前共查出流产羊8 620只,自1967年开始,畜牧部门和卫生部门协作开展了布病防治工作,落实     

2009年石家庄市省级布病监测点监测情况分析

目的为探索我市布病流行规律,为卫生行政采取防控措施提供可靠科学依据。方法通过选择4个固定监测乡和1个非固定监测乡进行人间布病流行病学和血清学调查。结果调查5个乡(镇)的10个自然村,流行病学调查1 339人,血清学检测189份,血检凝集试验阳性率7.94%,感染率1.12%。结论被监测乡村布病感染病较高,针对重点人群,及时做好预防布病知识的教育和普及工作,提高广大群众的自我防范能力,降低发病率。     

阻塞性睡眠呼吸暂停综合征对肝脏酶谱影响的配对研究

目的:评价阻塞性睡眠呼吸暂停综合征(obstructive sleep apnea syndrome,OSAS)对肝脏酶学的影响。方法:选择30例按照体重指数配对的不同程度OSAS男性患者,进行睡眠呼吸暂停监测,并于清晨空腹抽血测定空腹血糖,空腹胰岛素水平,血清丙氨酸氨基转移酶、天门冬氨酸氨基转氨酶及乳酸脱氢酶水平。结果:按照体重指数配对的AHI<15/h与AHI>15/h的两组患者体重指数、年龄、腰臀比、颈围均无统计学差异。两组患者AHI水平有统计学差异(6.67±5.16/h vs 31.69±22.91/h,p=0.001);夜间最低血氧饱和度有统计学差异(88.07±6.69%vs 79.47±11.31%,p=-0.019)。AHI>15/h组患者胰岛素抵抗指数较AHI<15/h组患者升高并有统计学差异(1.47±0.58 vs 0.94±0.49,p=0.001)。AHI>15/h组患者空腹血清丙氨酸氨基转移酶水平较AHI<15/h组患者升高并有统计学差异(33.82±33.37 IU/L vs 20.06±13.64IU/L,p=0.040);乳酸脱氢酶水平升高并有统计学差异(165.83±37.50IU/Lvs144.93±21.28IU/L,p=0.047)。结论:随着OSAS严重程度增加,胰岛素抵抗程度增加,血清丙氨酸氨基转移酶及乳酸脱氢酶升高;提示OSAS可能通过间断缺氧途径及胰岛素抵抗途径导致肝功能损伤,引起非酒精性肝病。     

Activation of TLRs/NF-κB signal pathway and occurrence of different functional cytokines during invasive pulmonary aspergillosis

Objective To study the activation of TLRs/NF-κB signal pathway and production of different functional cytokines during invasive pulmonary aspergillosis( IPA) , in order to probe the pathogene-sis of IPA. Methods Mouse were randomly divided into normal, normal + inoculated with Aspergillus fumigatus( normal inoculation group), and immune suppression + inoculation with Aspergillus fumigatus (IPAmodel group) , the mouse were killed at different time points after inhaling Aspergillus fumigatus spores by nose. Removing the lung tissue in a sterile manner and making pathological section respectively, counting Aspergillus fumigatus colony, dynamiclly detecting the expression of TLR2, TLR4 mRNA, variation of NF-κB p65 protein, pro-inflammatory cytokines TNF-α, IL-1β and anti-inflammatory cytokines IL-10 levels in the lung tissue by RT-PCR and Western blot method during Aspergillus fumigatus infection in mouse. Results (1) When it's 72 h after inhaling Aspergillus fumigatus by nose, IPA model emerged severe lung tissue inflammation, and generated a large number of hyphae, meanwhile, burthen of Aspergillus fumigatus was higher than normal inoculation group at each time point. (2)Compared with the normal inoculation group, IPA group whose TLR2 mRNA was low expression at early stage of infection (24 h), and emerged high expression at late stage of infection (120 h, 144 h); and TLR4 mRNA has been at a state of low expression in the infection process; NF-κB p65 suddenly increased at early stage of infection(24 h) and then continued to decline. (3) After infected by Aspergillus fumigatus in normal mouse, proinflammatory cytokine TNF-α, IL-1β in lung exhibited high expression at the early stages of infection, and the highest expression levels appeared at 48 h or 72 h, then decreased and recovered to normal level. And the expression level of anti-inflammatory cytokine IL-10 rised at late stage of infection; The IP A mouse released a lot of anti-inflammatory cytokine IL-10 at early stage of infection, which significantly reduced at late stage, and released pro-inflammatory cyto-kines TNF-α, IL-1β at slow and low level. Conclusion The abnormal activation of TLRs/NF-β signaling pathway caused the loss of dynamic balance between pro-inflammatory cytokines and anti-inflammatory cytokines, leading to the occurrence and development of IPA.     

改良式颈内静脉阻断法在神经外科昏迷患者PICC置管中的应用效果观察

目的 探讨神经外科昏迷患者在行经外周静脉穿刺中心静脉置管术（PICC）过程中运用改良式颈内静脉阻断法阻断颈内静脉对减少导管异位的效果。 方法 回顾分析2015年1月至2018年6月徐州医科大学附属医院神经外科行PICC穿刺的136例昏迷患者的临床资料，其中2015年1月至2016年5月住院的68例患者为对照组，2016年6月至2018年6月的68例患者为观察组。对照组PICC穿刺过程中颈内静脉阻断采用常规方法；观察组采用了改良式颈内静脉阻断法。对比两组患者术后导管初次异位情况以及导管相关性感染发生情况。结果 观察组无导管误入颈内静脉及导管相关性感染发生病例，对照组中有6例（8.8%）发生导管误入颈内静脉，与观察组比较差异有统计学意义（P=0.037），1例（1.5%）发生导管相关性感染，与观察组比较差异无统计学意义（P=1.000）。结论 在神经外科昏迷患者PICC置管过程中采用改良式颈内静脉阻断法对避免导管误入颈内静脉效果肯定，值得推广。     

低能量氦-氖激光血管内照射对颅脑损伤31例康复疗效观察

低能量氦-氖融光血管内照射方法对颅脑损伤后的脑细胞功能恢复确有一定的疗效。使颅脑损伤引起的头痛、头晕、呕吐、肢体瘫痪、大小便失禁、耳鸣、失眠等主要症状得到不同程度的改善。     

宫颈癌根治术后患者不同导尿方式的效果观察

宫颈癌是常见的妇科恶性肿瘤之一,宫颈癌根治术为宫颈浸润癌手术治疗的基本方式[1],由于手术范围较大,膀胱功能障碍是宫颈癌根治术后最常见、最难治的并发症,常表现为膀胱麻痹、排尿困难、尿潴留、残尿过多、尿感消失及张力性尿失禁等[2].长期留置尿管是解决以上问题的重要护理措施.2006年12月-2007年7月我科对188例宫颈癌根治术患者分别采用耻骨上膀胱造瘘引流带管法与传统经尿道留置尿管法进行比较,对照观察2组在尿路感染、拔管时间、膀胱刺激征及尿管重插率的差异,现报道如下.     

自身免疫溶血性贫血伴同种抗-S抗体一例

正1资料与方法1.1资料患者,男,36岁,汉族,4年前确诊为自身免疫性溶血性贫血。在患者生病的4年时间里每次发病均以血色素低入院。在住院期间,患者先后输血4次,临床给予激素等支持对症治疗,每次均好转出院。近期患者病情再次加重,以头晕、乏力、心慌气短入院。实验室检查:Hb为46 g/L、RBC为3.03×10~(12)/L、WBC为3.5×10~9/L、Hct为0.20、Plt为78×10~9/L。为进一步明确病情,家属送患者标本至本中