单扩溶血技术在禽H5N1流感诊断中的应用

目的 了解单扩溶血技术对禽H5N1流感病毒抗原测定的最佳条件,以便使禽H5N1病毒抗体测定能在普通实验室内进行.方法 比较不同浓度,不同品种红细胞,琼脂糖种类和浓度对测定敏感性的影响,以及对该法的敏感性和特异性与微量中和试验进行了比较.结果 单扩溶血技术测定最佳条件为：病毒浓度为：1000 HA单位/0.1 ml浓鸡红细胞;琼脂糖浓度为：1.0%;补体采用后加法.该法的敏感性和特异性不亚于微量中和试验,同时未发现H1N1,尤其N1抗体对H5N1抗体测定有影响.结论 单扩溶血技术对禽H5N1病毒抗体测定的敏感性和特异性不亚于微量中和试验,并能在普通实验室对大量血清样本进行测定.     

Characterization of hemagglutinin gene of influenza A virus subtype H9N2

Objective　To determine the origin of human influenza A (H9N2) virus and the relationship among H9N2 strains isolated from different hosts, on the basis of molecular biology. Methods　Viruses were passed in embryonated hen eggs, and virion RNA was extracted from allantoic fluid and reverse transcribed to synthesize cDNA. cDNA was amplified by PCR and the PCR product was purified with a purification kit. Afterwards RNA sequence analysis was performed by dideoxynucleotide chain termination and a cloning method. Finally, phylogenetic analysis of the sequencing data was performed with MegAlign (version 1.03) and Editseg (version 3.69) softwares. Results　The amino acid sequences at the cleavage site between HA1 and HA2 domains of H9N2 viruses isolated in China are R-S-S-R. One pigeon strain contains seven potential glycosylation sites on the HA protein molecule, while all others have eight. There are 2 to 15 differences of amino acid sequences distributed at 24 different positions on the HA protein molecules among six H9N2 viruses. The H9N2 viruses with multiple lineages of HA genes were co-circulating in China recently. Conclusion　The highest possibility is that human influenza A (H9N2) virus was derived from Chicken H9N2 virus, and not derived from pigeon H9N2 virus. However, it is still unknown whether the H9N2 virus could transmit from person to person. The H9N2 viruses with multiple lineages of HA genes are co-circulating in China.     

牵张成骨技术治疗小下颌畸形伴阻塞性睡眠呼吸暂停综合征患者的护理

中国人民解放军第252医院口腔科开展1例牵张成骨技术治疗小下颌畸形伴睡眠呼吸暂停综合征患者,取得良好效果。在护理工作中,对患者手术前后可能出现的问题进行了综合分析并采取了有计划、有针对性的护理措施,患者顺利完成了手术,术后未发生并发症。通过此例患者的护理,积累了一些经验,为今后的护理工作提供了参考。     

依非韦仑为主的方案治疗人类免疫缺陷病毒/丙型肝炎病毒感染患者的安全性和有效性

目的 评价以依非韦仑为主的方案治疗HIV/HCV合并感染患者的安全性和有效性.方法 以依非韦仑为主的方案治疗53例HIV/HCV合并感染患者7年,观察CD4+T淋巴细胞计数、HIV RNA、肝功能、肝纤维化指标、血脂、血糖、血尿酸、血常规的变化.治疗前、后均数的比较采用t检验.结果 53例患者治疗前、后HIV RNA分别为(4.56±0.88)lg拷贝/mL和(1.70±1.10)lg拷贝/mL(t=14.781,P＜0.01);CD4+T淋巴细胞分别为(188.37±151.14)×106/L和(445.18±314.25)×106/L(t=5.362,P＜0.01);ALT分别为(36.6±16.3)和(57.2±9.9)U/L(t=7.864,P＜0.01);甘胆酸(CG)分别为(444.22±476.74)和(556.88±733.05)mg/L(t=0.938,P＜0.05);ⅣC分别为(45.13±8.25)和(47.88±4.51)ng/mL(t=2.129,P＜0.05);三酰甘油分别为(1.57±0.65)和(2.51±1.29)mmol/L(t=4.737,P＜0.01);血尿酸分别为(298.5±48.2)和(495.1±89.4)mmo1/L(t=14.092,P＜0.01).结论 以依非韦仑为主的方案治疗HIV/HCV合并感染患者是有效的,但可引起肝脏功能损害和代谢异常.

Abstract：

Objective To evaluate the efficacy and safety of efavirenz-based therapy in patients with human immunodeficiency virus (HIV)/hepatitis C virus (HCV) co-infection. Methods Fiftythree HIV/HCV co-infected patients received efavirenz-based therapy were followed up for 7 years.The changes of CD4+ T lymphocyte count, HIV virus load, hepatic function, hepatic fibrosis index,blood lipid, blood glucose, blood uric acid and blood routine were observed. The comparison of means before and after treatment was performed by t-test. Results The HIV RNA levels at baseline and endpoint were (4. 56±0. 88) lg copy/mL and (1.70±1.10) lg copy/mL, respectively (t=14. 781, P＜0.01). The peripheral blood CD4+ T lymphocyte counts were ( 188.37±151.14)×106/L and (445.18±314.25)×106/L, respectively (t=5.362, P＜0.01).The alanine aminotransferase (ALT) levels were (36.6±16.3) U/L and (57.2±9.9) U/L, respectively (t=7.864, P＜0. 01).The glycocholic acid levels were (444.22±476.74) mg/L and (556.88±733.05) mg/L, respectively (t=0.938, P＜0.05). The Ⅳ-collagen(Ⅳ-C) levels were (45.13±8.25) ng/mL and (47.88±4.51) ng/mL, respectively (t= 2.129, P＜0.05). The riacylglycerol levels were (1.57±0.65)mmol/L and (2.51±1.29) mmol/L, respectively (t=4.737, P＜0.01). The blood uric acid levels were (298.5±48.2) mmol/L and (495.1±89.4) mmol/L, respectively (t= 14.092, P＜0.01).Conclusions The efavirenz-based therapy is efficacious in HIV/HCV co-infected patients, but it could cause liver injury and metabolic disorder.     

开腹术后再次腹腔镜手术248例临床分析

目的探讨下腹部开腹术后再次腹腔镜手术的可行性。方法回顾性分析下腹部手术后行腹腔镜再次手术248例患者的临床资料。结果除11例因盆腔严重粘连,1例卵巢癌中转开腹外,余均在腹腔镜下完成手术。2例出现粘连性肠梗阻经保守治疗治愈。其余无严重并发症发生。结论对术前选择合适病例及有熟练操作的妇科内镜医师前提下,下腹部有手术史再次手术行腹腔镜手术是安全、可行的。     

妇科腹腔镜手术中转开腹24例原因分析

近年来腹腔镜手术在妇科手术中应用越来越广。为探讨妇科腹腔镜手术的安全性和可行性，对本院2003年1月至2007年12月中转开腹的24例病例进行回顾性分析总结。现报道如下。     

中国流感监测网络发展概况

流行性感冒（Influenza,流感）是一种由流感病毒引起的急性呼吸道传染病,临床表现为起病急、高热、肌痛、头痛伴有严重不适、干咳、咽喉痛或鼻炎,多数患者可在一到两周内恢复。流感潜伏期短、经呼吸道飞沫传播,传播迅速,抗原易变异。人群对变异株普遍易感,控制难度大。流感流行呈一定季节性,     

产妇抑郁诸因素探讨

妇女在妊娠期、分娩期和产褥期,承受着躯体上和精神上的巨大压力,可以引起产后精神障碍,最常见为抑郁。现就1998年1～3月在我院分娩的产妇随机抽取236名,对产妇抑郁情况及相关因素进行调查。1 资料与方法1·1 资料 选择1998年1～3月在我院分娩的产妇随机抽取236名,排除既往精神病史,无不良社会因素刺激,调查时间为产后42天内。1·2 方法 用问卷调查形式,采用抑郁自评量表(SDS),此表共有反映抑郁症状的20个条目,每一条目按1～4分记(最     

结合晨会形式提高护理交接班质量

“抓制度促质量，以管理促服务”是我院今年“制度质量年”的主题，在工作中落实各项规章制度促进了医院的全面质量建设。交接班四看五查一巡视制度是护士每天上岗后要执行的第一项制度，认真执行这一制度，提高交接班质量有助于提高当班护士对病区情况的整体把握，便于有重点，有步骤的安排本班工作，保证了护理工作的严谨性、有序性和安全性。我们结合护理晨会的形式，将四看五查一巡视的内容贯穿于展会中，进行口头交班，促进了交接班制度的落实，提高交接班质量，现将我们的做法介绍如下：     

腹腔镜与开腹行子宫肌瘤剔除术的疗效分析

目的比较腹腔镜与开腹子宫肌瘤剔除术的疗效。方法回顾性分析38例行腹腔镜子宫肌瘤剔除术（腹腔镜组）的临床资料,与同期行开腹子宫肌瘤剔除术34例（开腹组）对比,比较两组手术时间、术中出血量、术后体温、术后疼痛情况、住院时间、住院费用。结果腹腔镜组的手术时间、术中出血量、住院时间显著小于开腹组,差异有统计学意义（t分别=3．10、9．17、11．28,P均〈0．05）;术后体温〉38℃和术后需镇痛例数显著小于开腹组,差异有统计学意义（x^2分别=5．58、5．76,P均〈0．05）;住院费用显著高于开腹组,差异有统计学意义（t=-12．38,P〈0．05）。结论腹腔镜子宫肌瘤剔除术与开腹手术相比具有手术时间短、术中出血少、术后发热少、住院时间短和术后疼痛轻等优点。