5例神经型布氏杆菌病患者的调查分析

目的提高对神经型布氏杆菌病的认识。方法对5例神经型布氏杆菌病患者的流行病学资料、临床表现、实验室检查等进行回顾性分析。结果男4例、女1例,年龄30~60岁之间,5例患者中有4例病前有与羊的密切接触史,1例有经常进食涮羊肉史。5例患者均有不同程度的发热、头疼、关节疼痛,2例恶心、呕吐伴脑膜刺激征,2例手足麻木,1例双下肢无力。5例患者确诊后除一般治疗及对症治疗外,均应用米诺环素、利福平及头孢曲松3种药物联合治疗,预后良好。结论神经型布氏杆菌病传播途径复杂,临床表现多样,影像学又无特异性改变,故易漏诊、误诊。当遇到患者出现不明原因的神经症状时,应特别注意有无布氏杆菌流行病学史。患者脑脊液布氏杆菌抗体及血清凝集试验检测应作为常规检查,做到早诊断、早治疗,改善预后。     

6例神经型布氏杆菌病临床特点与分析

目的:分析探讨神经型布氏杆菌病的临床特点.方法:回顾性分析本院自2009年1月～2012年1月收治的6例神经型布氏杆菌病病例.结果:经临床对症治疗,4例治愈,2例好转.结论:神经型布氏杆菌病传播途径复杂,临床表现多样,易导致误诊;治疗需早期、联合用药、足够疗程治疗方可改善预后.     

神经型布氏杆菌感染脑膜炎的研究进展

神经型布氏杆菌病(NB)是布氏杆菌累及中枢神经系统后出现的罕见且严重并发症，其临床表现复杂多样。脑膜炎是神经型布氏杆菌病最常见的临床表现，在疾病早期即可出现。神经型布氏杆菌病所致脑膜炎的研究尚处于初级阶段，致病机制及代谢通路尚不明确，为提高临床工作者对神经型布氏杆菌感染脑膜炎的认识，本文将对神经型布氏杆菌病患者常见临床表现脑膜炎进行讨论，现将其发病机制、临床特点、辅助检查、诊断及治疗综述，希望通过利用代谢组学、宏基因二代测序等技术明确诊断，在疾病早期进行治疗干预，改善患者病情及预后，提高患者生活质量。     

布氏杆菌病合并脑膜炎27例临床分析

目的 探讨布氏杆菌病合并脑膜炎的临床表现、诊断及治疗、预后情况.方法 采用回顾性随机抽样的方法,描述、总结、分析了我院2007-2011年收治的27例布氏杆菌病合并脑膜炎病人的临床资料.结论 布氏杆菌病病人临床表现多种多样,诊断主要依据流行病学史、临床表现及实验室检查.经过规范化治疗后,预后良好.     

神经型布氏杆菌病1例报告及相关文献资料复习

目的报告1例神经型布氏杆菌病病例,复习相关资料,以提高对其认识.方法通过对病例的回顾,分析其发病机制,总结神经型布氏杆菌病的多种临床表现.结果神经型布氏杆菌病临床表现多种多样,极易误诊.结论神经型布氏杆菌病临床少见,遇到反复波动性发热,合并有神经系统症状、体征者,要详细询问牧区居住史以及牛羊制品食用史,并进行必要的血清学、病原学检查,以排除或确诊神经型布氏杆菌病.     

神经型布氏杆菌病1例报告及相关文献资料复习

目的：报告1例神经型布氏杆菌病病例，复习相关资料，以提高对其认识。方法：通过对病例的回顾，分析其发病机制，总结神经型布氏杆菌病的多种临床表现。结果：神经型布氏杆菌病临床表现多种多样，极易误诊。结论：神经型布氏杆菌病临床少见，遇到反复波动性发热，合并有神经系统症状、体征者，要详细询问牧区居住史以及牛羊制品食用史，并进行必要的血清学、病原学检查，以排除或确诊神经型布氏杆菌病。     

不典型布氏杆菌病诊疗体会

目的 总结不典型布氏杆菌病临床症状及治疗效果,提高布氏杆菌病的诊治水平.方法 回顾性分析33例布氏杆菌病患者的临床资料,并对其临床表现及治疗方法和效果进行分析.结果 典型临床表现者为76％,初诊确诊者72.7％,复诊确诊者24.2％,多次复诊确诊者3％.33例患者全部治愈出院,6个月内复查无复发.结论 布氏杆菌病临床表现复杂,临床医生要熟悉其发病机理、临床表现及实验室检查,早诊断,早治疗.     

广州地区布氏杆菌病的临床分析

目的 探讨广州市布氏杆菌病的流行情况、诊断及治疗.方法 对2例布氏杆菌病的流行病学、临床资料、治疗经过行系统分析.结果 2例布氏杆菌病患者均为广州市人,本地发病,以不规则低热为主要表现,因血培养阳性确诊,利福平、强力霉素治疗效果佳.结论 布氏杆菌病广州市多年已未发现,且可因临床表现不典型,极易误诊,临床医生应提高警惕,对抗生素治疗效果欠佳的低热患者,血培养为简单、易行的方法.     

以脊髓压迫症起病的布氏杆菌病1例报道并文献复习

<正>当今神经系统感染性疾病发病呈现散发趋势,但神经型布氏杆菌病有增多趋势。其表现多样,以脑膜炎、脑膜脑炎、脊髓炎和脊髓病多见,而以脊髓压迫症发病的还未见报道。回顾性分析保定市第一医院2013年3日诊断明确的1例神经布氏杆菌病的临床表现、辅助检查结果以及诊断与治疗经过,并结合文献分析其发病特点。1临床资料患者,男性,39岁,主因发热20 d伴颈部疼痛向双上肢放射15 d入院。既往体健,否认结核等传染病     

布氏杆菌脑膜炎临床及脑脊液特点

目的 探讨布氏杆菌脑膜炎的临床表现及脑脊液特点,加深对该病的临床认识,减少误诊误治.方法 对我院近几年确诊的布氏杆菌脑膜炎进行回顾性分析,探讨其临床表现及脑脊液特点,检索国内文献,进行总结分析.结果 患者均有发热及明显头痛,伴有不同程度关节、肌肉疼痛,颅压明显增高,且持续时间较长;患者均出现脑膜刺激征.血布氏凝集实验（＋）;脑脊液细胞数增高,蛋白轻-中度增高,糖低于正常,氯化物正常或稍低于正常.结论 布氏杆菌脑膜炎临床表现及脑脊液检查均无特异性,但颅内压增高持续时间较长,高颅压症状相对较轻,易被误诊为病毒性脑膜炎或结核性脑膜炎而延误甚至错误治疗.对病史较长的脑膜炎患者,需行流行病学调查,尽早行血布氏凝集试验,早发现、早治疗.     

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.     

Development on Adjustable Calibration Marker for Shock Wave Focus

Shock wave lithotripsy （SWL） is a treatment of choice for upper urinary stones. However, this procedure is inappropriate for obese patients because the focus is often unable to reach the target owing to the limited focal distance in shock wave source. Although treating such patients in a blast path may increase the application length of shock wave source, it＇s difficult to find this path on the lithotripter monitor. For this reason, we invented an adjustable calibration marker in order to set an effective focus in the shock wave hath.     

Study on the TCM Pathogenesis of Angiopathic Complications of Type II Diabetes

Excess production of reactive oxygen species(ROS)of mitochondrion mediated by hyperglycemia is the common pathogenesis of angiopathic complications of diabetes.TCM holds that the damp from the dysfunction of spleen.kidney and liver is the causative factor of complications of diabetes.This is similar to the mechanism of Ros resulting in angiopathic complications of diabetes.When the angiopathic complications of type II diabetes mellitus(T2DM)are difierentiated as caused by turbid damp in TCM can be explained as ROS.Since the obstruction of pathogenic damp in channels and collaterals is said to be the main pathogenesis,the treating principle should be dissolving the damp to remove the obstruction.     

Leptin, Ghrelin and TNF-α before and after Hypo-caloric Traditional Chinese Diet and Auricular Acupuncture

INTRODUCTION Obesity is a complex emergent problem, which can be possibly solved not only by the diet but also by the life style and promotion of a constant physical exercise. 1, 2 No doubt careful attentions must be given to the nutritional condition of obese people, the dietary habits, the somatic build (i.e. distribution of fat mass) and the organic functions linked to formation of the fat mass. All the parameters should be constantly monitored before, during and after a diet treatment. 3, 4, 5     

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.     

Relationship between Dysglycemia and Carotid Atherosclerosis in Tibetan Population

People with dysglycemia are at high risk for atherosclerotic diseases. This study aims at investigating the atherosclerotic vascular damage in dysglycemia and its metabolic origin in Tibetan population.     

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…     

CLINICAL SIGNIFICANCE OF SERUM CYTOKINES IL-1β,sIL-2R,IL-6,TNF-α,AND IFN-v IN ACUTE CORONARY SYNDROME

Objectives To explore serum cytokines levels (including IL-1 β, sIL-2R, IL-6, TNF-α, and IFN-v) and their significance in patients with acute coronary syndrome (ACS) and the subsequent follow-ups, with attempt to estimate the role of various serum inflammatory markers in the diagnosis and assessment of ACS.Methods The study population include 40 patients with acute myocardial infarction (AMI), 40 patients with unstable angina pectoris (UAP), and 40 controls. Among the 80 patients, 60 patients attended a follow up 4 months later. Serum inflammatory markers including IL-1 β, sIL-2R, IL-6, TNF-α, and IFN-v were measured by enzyme linked immunosorbent assay.Results Serum IL- 1 β, sIL-2R, IL-6, TNF-α were significantly higher in AMI group or UAP group compared to the control group and became significantly lower 4 months later in the follow-up patients. Serum levels of IFN-v shows no significant difference between AMI group or UAP group and controls, also showing no significant change when measured in follow up patients. There was no correlation between serum creatine kinase-MB isoenzyme levels and serum inflammatory markers either in UAP or AMI group. Furthermore, when divided into two subgroups using Wagner's QRS scoring system in the AMI group, there is no difference of each serum inflammatory marker between ≤ 6 scores group and ＞ 6 scores group.Conclusion Serum levels of certain inflammatory markers may have some diagnostic value for ACS, and can be a useful marker reflecting disease stability.     

Possible Spread of adenovirus type 3 from poultry to humans ：indirect evidence from an outbreak in China

Objective:To explore the epidemiology and etiology for an outbreak of acute respiratory tract infection that occurred in one county of Jiangsu Province, China 2004. Methods: Only cases meeting the case definition were included in the study. We reviewed the medical records of the cases who were admitted to the local hospitals, interviewed cases by a standard questionnaire, and then described the epidemiotogic features and analyzed risk factors by means of a case-control study. We collected pharyngeal swab specimens and sent them to different laboratories for isolation and culture. The laboratory used different detection methods such as DIP, PCR, electron microscope examination and microneutralization assay, to identify and then type the positive specimens. Results:A total of 871 cases were reported during the period from April 18 to July 4,2004. The distribution of onset times presented two peaks, one in late May and another in middle June. The epidemic occurred mainly in the elementary and junior high schools in ten townships of one county, and the mean age of the cases was 12 years (range 7 months to 18 years). The course of the disease was acute, and was characterized by fever accompanied with sore throat and tonsillitis. The WBC count of cases was normal or elevated. The mean duration of illness was 5 days (range 2 to 12 days). No fatalities from illness were reported. A case-control study indicated that the possible risk factors were close contact with a case and/or poultry before onset and sharing of towels among members of the family. The typical CPE was observed through inoculating pharyngeal swab specimens into the HEP-2 cell cultures in different laboratories. An infection of adenovirus type 3 was verified by detecting positive specimens in different methods. Conclusion:This investigation demonstrated that the acute respiratory infection in cases was caused by adenovirus type 3. Cases occurred in over 70 schools in ten townships in 2004, and the route of transmission was possibly close contact with cases or droplet transmission.