合成肽库及其应用

合成肽库由含特定长度的肽片段所组成，它包含了该长度短肽的各种可能序列或绝大部分序列。合成肽库家族包括随机合成肽库、合成肽组合文库（SPCL）、多用途肽库（MUPL）、位置扫描合成肽组合文库（PS．SPCL）、寡核苷酸编码的合成肽库等。肽库技术除可用于蛋白质研究及分子识别，也开始应用于免疫学领域，如抗原表位分析、药物设计及疫苗研制等方面。     

ERG和VEP在视网膜色素变性早期诊断中的应用

视网膜色素变性(RP)是临床上较为常见的一种遗传性致盲眼病,发病率约1/3000～1/5000。临床特点为夜盲,进行性视野缩窄,渐进性视力下降,眼底视     

全手指皮肤撕脱原位缝合成活2例

全手指碾压、皮肤撕脱在手外伤中比较常见，一般的治疗方法与手指脱套伤治疗方法相同。2002年2—10月，我院对5例全手指碾压伴皮肤撕脱伤的患者行细致清创、撕脱皮肤原位缝合，术后配合扩血管药物的治疗，撕脱皮肤大部分成活，小片未成活处经局部换药后痊愈，手指外观及功能均较满意。现将其中2例资料报道如下。     

尿流式有形成分及干化学分析在尿路感染诊断中的应用评价

Objective To evaluate the clinical application of automated urine formed elements analyzer and/or urine dipstick analyzer for examination of urinary formed elements in screening urinary tract infection (UTI). Methods 148 fresh midstream clear-catch urine samples from the UTI patients and 284 fresh midstream clear-catch urine samples from non-UTI subjects were selected. Bacteria culture was performed for bacterial colony counting and identification. Bacteria counts ( BACT), yeast-like fungus and WBC were performed by UF-looOi automated urine formed elements analyzer. Leukocyte esterase test (LEU) and nitrite test (NIT) were performed by URISYS 2400 urine dipstick analyzer. We evaluated data obtained from urine dipstick analyzer, UF-1000i and combination of UF-1000i with urine dipstick analyzer and the results was compared with those obtained from quantitative bacterial culture. Then we evaluated the sensibility, specificity, positive predictive value (PPV), negative predictive value (NPV) and accuracy. Results Among the 148 patients with UTI, the positive rate of the quantitative bacterial culture was 73.6% (109/148), the positive rate of LEU and NIT detected by dipstick test 26. 4% (39/148).There was significantly statistical difference between bacterial culture and strip test(χ2 = 55.68 ,P < 0. 05 ). The positive rate of urine flow cytometry by UF-1000i with either positive of BACT and WBC was 91.2%(135/148), which was higher than the positive rate of the quantitative bacterial culture. There was significant difference between two methods (χ2 = 14. 70, P < 0. 05 ). The positive rate of anyone positive among BACT, WBC, LEU and NIT was 94. 6% (140/148) when detected with combination of dipstick test and UF-1000i, which was higher than the positive rate of the quantitative bacterial culture. And there was significant difference between two methods (χ2 = 20. 45, P < 0. 05 ). The sensitivity of dipstick test was low (26. 4% ,39/148 ), and specificity was high ( 99. 3%, 282/284 ) . The sensitivity, specificity, positive predictive value, negative predictive value of BACT detected by UF-1000i in diagnosing urinary tract infection were 92. 6% ( 137/148 ), 39. 8% ( 113/284 ). 44. 5% ( 137/308 ) and 91.1% ( 113/124 ), respectively. If the dipstick test was combined with UF-1000i, the sensitivity, negative predictive value, specificity, positive predictive value and accuracy were 98.0% ( 145/148 ), 97.1% ( 100/103 ). 35.2% (100/284) ,44. 1% (145/329) and 56. 7% (245/432), respectively. Conclusions The combination of urine dipstick test and automated urine formed elements analyzer UF-1000i plays an important role in early diagnosis of UTI. And it has significant value in diagnosis of UTI, especially for the patients with negative bacterial cultures of urine sample.     

尿流式有形成分及干化学分析在尿路感染诊断中的应用评价

Objective To evaluate the clinical application of automated urine formed elements analyzer and/or urine dipstick analyzer for examination of urinary formed elements in screening urinary tract infection (UTI). Methods 148 fresh midstream clear-catch urine samples from the UTI patients and 284 fresh midstream clear-catch urine samples from non-UTI subjects were selected. Bacteria culture was performed for bacterial colony counting and identification. Bacteria counts ( BACT), yeast-like fungus and WBC were performed by UF-looOi automated urine formed elements analyzer. Leukocyte esterase test (LEU) and nitrite test (NIT) were performed by URISYS 2400 urine dipstick analyzer. We evaluated data obtained from urine dipstick analyzer, UF-1000i and combination of UF-1000i with urine dipstick analyzer and the results was compared with those obtained from quantitative bacterial culture. Then we evaluated the sensibility, specificity, positive predictive value (PPV), negative predictive value (NPV) and accuracy. Results Among the 148 patients with UTI, the positive rate of the quantitative bacterial culture was 73.6% (109/148), the positive rate of LEU and NIT detected by dipstick test 26. 4% (39/148).There was significantly statistical difference between bacterial culture and strip test(χ2 = 55.68 ,P < 0. 05 ). The positive rate of urine flow cytometry by UF-1000i with either positive of BACT and WBC was 91.2%(135/148), which was higher than the positive rate of the quantitative bacterial culture. There was significant difference between two methods (χ2 = 14. 70, P < 0. 05 ). The positive rate of anyone positive among BACT, WBC, LEU and NIT was 94. 6% (140/148) when detected with combination of dipstick test and UF-1000i, which was higher than the positive rate of the quantitative bacterial culture. And there was significant difference between two methods (χ2 = 20. 45, P < 0. 05 ). The sensitivity of dipstick test was low (26. 4% ,39/148 ), and specificity was high ( 99. 3%, 282/284 ) . The sensitivity, specificity, positive predictive value, negative predictive value of BACT detected by UF-1000i in diagnosing urinary tract infection were 92. 6% ( 137/148 ), 39. 8% ( 113/284 ). 44. 5% ( 137/308 ) and 91.1% ( 113/124 ), respectively. If the dipstick test was combined with UF-1000i, the sensitivity, negative predictive value, specificity, positive predictive value and accuracy were 98.0% ( 145/148 ), 97.1% ( 100/103 ). 35.2% (100/284) ,44. 1% (145/329) and 56. 7% (245/432), respectively. Conclusions The combination of urine dipstick test and automated urine formed elements analyzer UF-1000i plays an important role in early diagnosis of UTI. And it has significant value in diagnosis of UTI, especially for the patients with negative bacterial cultures of urine sample.     

冠状动脉慢血流临床相关因素研究

目的：探讨可能造成冠状动脉慢血流现象（ coronary slow flow phenomenon,CSF）的临床相关因素。方法：入选2011年8月-2013年12月因疑似冠心病行冠状动脉造影检查,结果显示冠状动脉无明显狭窄但存在CSF的患者97例,作为CSF组,同期冠状动脉正常而且血流也正常的患者100例作为对照组。所有入选患者均在入院后第1天晨空腹抽血检测总胆固醇（ Tc ）、低密度脂蛋白胆固醇（ LDL-c ）、甘油三酯（ TG ）、同型半胱氨酸（ Hcy）、超敏-C反应蛋白（ hs-CRP）、血红蛋白（ Hb）、红细胞分布宽度（ RDW）和血小板计数（ PLT）。结果：两组吸烟患者的构成比有统计学差异（ P﹤0．05）;与对照组比较,CSF组的Hcy、hs-CRP和RDW均升高,差异有统计学意义（P均﹤0．05）。结论：吸烟、高同型半胱氨酸血症和炎症导致的内皮损害及血液中的有形成分增多可能是造成CSF的因素。     

维拉帕米及尼卡地平对瘢痕组织抑制作用的体外实验

目的研究钙离子拮抗剂维拉帕米及尼卡地平对体外培养的瘢痕组织的成纤维细胞增殖的抑制作用,同时对两药药效进行比较,观测两药的作用特点。方法四甲基偶氮唑（MTT）比色法检测两药对瘢痕组织的成纤维细胞增殖的影响：向对数生长期的患者病理性瘢痕组织的成纤维细胞中分别加入不同浓度维拉帕米及尼卡地平（150、100、50、10、0μmol／L）,分别在用药后24、72、120h进行MTT法检测,将吸光度值（A值）换算为生长抑制率,根据直线回归法计算出各时间点的半数有效抑制浓度（IC50）并进行统计学比较。结果维拉帕米及尼卡地平均显示很强的对瘢痕组织成纤维细胞增殖的抑制作用。但作用特点各有不同,维拉帕米在早期作用强于尼卡地平（P〈0．05）。而随时间延长,在3～5d时反而减弱,而尼卡地平则显示出较好的时间依赖性,在5d时其抑制作用明显强于维拉帕米（P〈0．05）。结论维拉帕米及尼卡地平对瘢痕组织成纤维细胞增殖抑制作用的时效不同,为两药联合应用治疗瘢痕提供了理论依据。     

咽后壁刀刺伤致高位颈髓损伤1例

患者 ,男 ,30岁。因酒后与他人发生口角 ,被人以尖刀刺伤右颊面及舌体 1小时于 2 0 0 2年 2月 2 7日急诊入院。入院时查体 :患者处于浅昏迷状态 ,四肢活动受限 (以为是醉酒所致而未引起注意 ) ,心率 80次 /分 ,呼吸 2 1次 /分 ,血压110 / 70mmHg ;右颊部可见长约 8cm创口 ,并贯     

尿流式有形成分及干化学分析在尿路感染诊断中的应用评价

Objective To evaluate the clinical application of automated urine formed elements analyzer and/or urine dipstick analyzer for examination of urinary formed elements in screening urinary tract infection (UTI). Methods 148 fresh midstream clear-catch urine samples from the UTI patients and 284 fresh midstream clear-catch urine samples from non-UTI subjects were selected. Bacteria culture was performed for bacterial colony counting and identification. Bacteria counts ( BACT), yeast-like fungus and WBC were performed by UF-looOi automated urine formed elements analyzer. Leukocyte esterase test (LEU) and nitrite test (NIT) were performed by URISYS 2400 urine dipstick analyzer. We evaluated data obtained from urine dipstick analyzer, UF-1000i and combination of UF-1000i with urine dipstick analyzer and the results was compared with those obtained from quantitative bacterial culture. Then we evaluated the sensibility, specificity, positive predictive value (PPV), negative predictive value (NPV) and accuracy. Results Among the 148 patients with UTI, the positive rate of the quantitative bacterial culture was 73.6% (109/148), the positive rate of LEU and NIT detected by dipstick test 26. 4% (39/148).There was significantly statistical difference between bacterial culture and strip test(χ2 = 55.68 ,P < 0. 05 ). The positive rate of urine flow cytometry by UF-1000i with either positive of BACT and WBC was 91.2%(135/148), which was higher than the positive rate of the quantitative bacterial culture. There was significant difference between two methods (χ2 = 14. 70, P < 0. 05 ). The positive rate of anyone positive among BACT, WBC, LEU and NIT was 94. 6% (140/148) when detected with combination of dipstick test and UF-1000i, which was higher than the positive rate of the quantitative bacterial culture. And there was significant difference between two methods (χ2 = 20. 45, P < 0. 05 ). The sensitivity of dipstick test was low (26. 4% ,39/148 ), and specificity was high ( 99. 3%, 282/284 ) . The sensitivity, specificity, positive predictive value, negative predictive value of BACT detected by UF-1000i in diagnosing urinary tract infection were 92. 6% ( 137/148 ), 39. 8% ( 113/284 ). 44. 5% ( 137/308 ) and 91.1% ( 113/124 ), respectively. If the dipstick test was combined with UF-1000i, the sensitivity, negative predictive value, specificity, positive predictive value and accuracy were 98.0% ( 145/148 ), 97.1% ( 100/103 ). 35.2% (100/284) ,44. 1% (145/329) and 56. 7% (245/432), respectively. Conclusions The combination of urine dipstick test and automated urine formed elements analyzer UF-1000i plays an important role in early diagnosis of UTI. And it has significant value in diagnosis of UTI, especially for the patients with negative bacterial cultures of urine sample.     

主动脉夹层分离并急性心肌梗死的观察与护理7例

1999年12月-2003年10月，我科收治了7例主动脉夹层分离并急性心肌梗死患者，效果明显，现将护理体会介绍如下。