纳洛酮与地塞米松治疗肾综合征出血热原发性休克的研究

目的　研究纳洛酮和地塞米松治疗肾综合征出血热 (HFRS)原发性休克的疗效。方法　将 110例原发性休克患者随机分为治疗组与对照组。治疗组 5 6例予以纳洛酮 0 .8～ 1.2mg、静脉缓慢注射 ,之后 1.2～ 1.6mg加入 2 5 0ml液体中滴注 ,每分钟 2 0～ 3 0滴 ;地塞米松 2 0mg、静脉注射。对照组 5 4例予以阿拉明 2 0～ 3 0mg与多巴胺 40～ 60mg加入2 5 0ml液体中滴入 ,每分钟 15～ 3 0滴。结果　治疗后 1h休克纠正率治疗组与对照组分别为 89 2 9% ( 5 0 /5 6)和 68.5 2 %( 3 7/5 4) ,P <0 0 0 5 ;越过少尿期率分别为 14 .2 9% ( 8/5 6)与 3 .70 % ( 2 /5 4) ,P <0 0 5 ;肾功能恢复正常天数分别为 12 .96±1.76天和 14 .75± 1.92天 ,P <0 0 0 1;病死率分别为 3 .5 7% ( 2 /5 6)和 12 .96% ( 7/5 4) ,P <0 0 5。结论　纳洛酮与地塞米松治疗HFRS原发性休克疗效明显优于阿拉明与多巴胺     

应用输尿管镜放置双J管早期治疗输尿管阴道瘘

Objective To evaluate the clinical effect of placing double J stent using a ureteroscope in early managing ureterovaginal fistula.Methods Twenty-eight patients cases with ureterovaginal fistula from 2002 to 2008 were treated early with placing double J stent using a ureteroscope and the clinical data were reviewed.Results Twenty-two of 28 cases were treated and double J stent was placed in them by a uretero-scope and 75% (21/28)of cases were cured.Four of 21 cases were treated twice by a ureteroscope and were cured finally.7 cases with failure ureterovaginal treatment underwent ureterocystostomy and were cured.The follow-up from 6 months to 33 months (average 10.1±6.4 months)showed that all of the 28 cases had been cured and had no urinary fistula.Conclusion Placing double J stent using a ureteroscope is the first choice of operative procedure for the early treatment of ureterovaginal fistula.     

血浆同型半胱氨酸水平与Alzheimer病的关系

本研究探讨血浆同型半胱氨酸(Hcy)水平在Alzheimer(AD)发病中的可能意义.     

双平面经食管超声心动图诊断心血管病的临床价值

本总结用双平面经食管越声心动图(TEE)对57例心血管病进行检查的结果，井与经胸超声心动图(TTE)结果对比．57例中，风湿性心脏病18例，先天性心脏病39例．结果表明，57例中TEE确诊56例，TTE确诊46例．本对TEE诊断心血管病的主要价值进行了讨论。     

调Q倍频Nd：YAG激光治疗太田痣的副反应及相关因素的探讨

观察调Q倍频Nd：YAG激光治疗太田痣的副反应及其相关因素。方法回顾性分析750例患者经调Q倍频Nd：YAG激光治疗后的副反应及其与治疗次数、治疗能量的关系。结果750例接受治疗的患者中发生副反应者76例(10．1％)，其中暂时性色素沉着55例(7.3％)，暂时性色素减退18例(2.4％)，永久性色素减退1例(0.1％)，萎缩性瘢痕2例(0.3％)。出现副反应与治疗次数无关，与治疗能量有关。结论副反应的出现与激光治疗本身没有特异性关系，随治疗能量的增加副反应发生率上升。调Q倍频Nd：YAG激光治疗太田痣无连续激光治疗后所致的增生性瘢痕、持续性色素沉着等副反应，用于治疗太田痣是安全的。     

用ROC曲线法分析99Tcm-HL91肺肿瘤阳性显像的诊断效能

目的探讨半定量分析及接受器工作特性(ROC)曲线法在99Tcm-4,9-二氮-3,3,10,10-四甲基十二烷-2,11-二酮肟(HL91)肿瘤阳性显像鉴别肺部良恶性肿块中的价值.方法经CT检查发现肺部肿块的患者50例,均经活组织检查或手术病理检查证实.根据病理检查结果分为恶性组37例和良性组13例.术前行99Tcm-HL91 2 h、4 h平面显像及4 h断层显像,分别使用视觉判断法、半定量分析及ROC曲线法分析显像结果.结果①视觉判断法99Tcm-HL91显像的灵敏度、特异性和准确性分别为97.3%、69.2%和90.0%.②肿瘤/正常肺组织(T/N)比值半定量分析及ROC曲线法恶性组2 h、4 h平面显像及4 h断层显像T/N比值分别为1.52±0.19、1.73±0.28及2.84±0.97;良性组分别为1.20±0.16、1.24±0.20及1.52±0.40.各个时相的曲线下面积分别为0.909±0.056、0.945±0.039、0.953±0.034.从99Tcm-HL91断层显像ROC曲线的界值点找到1个界点(T/N=1.76),以其作为判断良、恶性的诊断阈值,灵敏度、特异性和准确性分别为100%、84.6%和96.0%.③视觉判断法与半定量分析法比较T/N比值半定量分析及ROC曲线法使诊断的灵敏度、特异性和准确性都有提高,尤其特异性.但两种方法间差异无显著性(P均＞0.05).结论半定量分析及ROC曲线法的诊断阈值可进一步提高99Tcm-HL91肺部肿瘤阳性显像的诊断效能.     

曲线拟合中的几个问题

曲线拟合中的几个问题第四军医大学徐勇勇，陈长生，张成岗间近几期《中国卫生统计》杂志，觉得曲线拟合在基层卫生统计工作中用途很广，是总结经验、发现规律的一个有力工具。但从目前的应用现状看，笔者觉得尚存在一定问题值得商榷。归纳起来，主要有以下几点。（一）拟...     

细胞荧光素酶报告基因试验受CpG岛甲基化状态影响

Objective To investigate the effects of methylation status of CpG islands of endogenous E-cadherin (CDH1) gene on the promoter activity of corresponding genes in reporter assays. Methods The methylation statuses of CpG island of CDHI in 8 different cell lines were detected by methylation-specific PCR. CDH1 protein was analyzed by Western blotting. Two sets of pGL3 reporter vectors with different genotypes/haplotypes of the CDH1 promoter were constructed [pGI3-A(-73)/-C(-73)pGL3-H1/-H4]and used to transfect these cell lines. The differences between these promoter reporter vectors were analyzed by t-test. Results (1) CDH1 CpG island was unmethylated in AGS, MCF7, MKN74, and PC-3 cell lines,expressed in MCF7, MKN74, and PC-3 ,but not in AGS. Expression of CDH1 was silenced by methylation in HeLa, BGC823, A549, and RKO cell lines. (2) In the four CDH1 -unmethylated MCFT, M KN74, PC-3, and AGS cell lines ,the promoter activities of pGI3-C(-73)(as 0. 78±0. 10,0. 17±0.01,0. 11±0. 01,1.19±0. 18)were significantly higher than those of pGL3-A(-73)(as 0. 30±0. 08,0. 07±0. 01,0. 07±0. 01,0. 39±0. 04) (t values are -6. 298, -12. 349, -8. 128, -7.388, and P<0. 01). However, in the four C DH1 -methylated HeLa, BGC823, A549, and RKO cell lines, the promoter activity of pGL3-C(-73)(as 0. 09±0. 02,0. 13±0. 02,0. 05±0. 01,0. 01±0. 00) was significantly lower than that of pGL3-A(-73)(as 0. 16±0. 01,0.25±0.01,0. 11±0.03,0.03±0.00) (t valued at 5.958,11. 189,3. 661,13. 866,and P<0.05). (3) In the unmethylated MKN74 and methylated RKO cell lines, the promoter activities of pGI3-H1/-H4 were obviously and contrarily different(as 1.57±0. 23/0. 94±0. 06 and 0. 38±0. 02/0. 50±0. 04 ,t values were 4. 577 and -4. 915 ,P values were 0. 010 and 0. 003). Conclusion The methylation status of CpG island of the target gene in the tested cell lines affects the promoter activity in Reporter Assay significantly. The most active one may be the most suppressive one.     

100例鼻咽癌患者心理社会因素配对调查与多变量分析

为探讨心理社会因素对恶性肿瘤的影响规律，本文按多因素１：１病例－配对对照设计法，对１００例鼻咽癌及其配对对照了临床流行病学调查。资料经ＱＵＩＣＫ ＢＡＳＩＣ语言支持下完成了配对Ｌｏｇｉｓｔｉｃ回归分析。在α＝０．１０的水准，分别有Ｘ１，Ｘ２，Ｘ３，Ｘ４，Ｘ６，Ｘ１０，及Ｘ１１共７个入选的变量最终进入了方程：Ｌｏｇｉｔ Ｐ＝ａｉ＋０．２８８Ｘ１＋０．５６０Ｘ２－１．０１５Ｘ３－１．６９５Ｘ４＋０．９