Comparison on the Treatments of Three Methods for Knee Osteoarthritis

目的 探讨膝关节骨性关节炎（knee osteoarthritis,KOA）的较佳治疗方案。方法 从双氯芬酸钠治疗组（A组）、正清风痛宁口服治疗组（B组）、正清风痛宁关节腔注射与片剂序贯疗法组（C组）各随机抽取60例病例,比较3组治疗前后疗效、不良反应等指标。结果 3组患者治疗后的Lequesne指数均较治疗前下降（P均〈0.01）;A组治疗后的Lequesne指数与B组差异无统计学意义（P〉0.05）;C组治疗后的Lequesne指数均低于A组与B组（P均〈0.01）。A、B、C 3组治疗总有效率分别为73.3%、75.0%、93.3%,A组疗效与B组比较差异无统计学意义（P〉0.05）,C组疗效优于A组与B组（P均〈0.01）。A、B、C 3组不良反应发生率分别为26.7%、10.0%、11.7%,A组不良反应发生率高于B组与C组（P均〈0.05）;B组与C组的不良反应发生率差异无统计学意义（P〉0.05）。结论 正清风痛宁关节腔注射与片剂序贯疗法治疗KOA疗效好,不良反应较少。Objective To investigate the better treatments of knee osteoarthritis.Methods Randomly selected 60 case from each of the following groups：diclofenac sodium treatment group（A）,zhengqingfengtongning oral treatment group（B）,zhengqingfengtongning articular cavity injection with tablet sequential therapy group（C）.Comparative analysis of the curative effect before and after treament,effective rate and the incidence of adverse reactions between each group.Results The lequesne index of all the 3 groups dropped significantly before and after treament（P〈0.01）.Compared each group after treatment,A and B had no statistical difference（P〉0.05）,C was significantly lower than A and B（P〈0.01）.The total effective rate of A,B and C were 73.3%,75.0% and 93.3%,A and B had no statistical difference（P〉0.05）,C was better than A and B（P〈0.01）.The incidence of adverse reactions of A,B and C were 26.7%,10.0% and 11.7%;A higher than B and C（P〈0.05）,but B and C had no significant difference（P〉0.05）.Conclusion Zhengqingfengtongning articular cavity injection with tablet sequential therapy have good curative effect and less adverse in treatment of KOA,worthy of clinical recommendations

Necessity of treating subclinical hypothyroidism in early pregnant women

目的评估早孕妇女亚临床甲状腺功能减退症(subclinical hypothyroidism,SCH)对妊娠结局的影响及药物治疗的必要性。方法收集18 243例在厦门大学附属第一医院产前检查直至分娩的病例,诊断标准为妊娠10~12周产前检查时TT4与FT4正常而TSH≥2.5 m IU/L为SCH,甲状腺过氧化物酶抗体(thyroid peroxidase antibody,TPOAb)≥34 U/L为阳性。根据TSH的升高程度不同、TPOAb情况、能否遵医嘱按时按量服用L-T4使TSH控制在正常范围内进行分组:2.5 m IU/L≤TSH≤5.0 m IU/L且TPOAb阳性且能遵医嘱者为A组,不能遵医嘱者为B组;TSH>5 m IU/L且TPOAb阳性且能遵医嘱者为C组,不能遵医嘱者为D组;2.5 m IU/L≤TSH≤5.0 m IU/L且TPOAb阴性且能遵医嘱者为F组,不能遵医嘱者为G组;TSH>5 m IU/L且TPOAb阴性且能遵医嘱者为H组,不能遵医嘱者为K组。并随机抽取200例同期甲状腺功能正常的病例作为对照组(E组),回顾分析早孕妇女甲状腺功能异常的发生率、SCH对妊娠结局的影响、早孕妇女SCH行左旋甲状腺素片(L-T4)替代治疗的剂量及影响因素。结果早孕妇女SCH检出率为5.20%,甲状腺功能正常率为79.00%。A组早产3.31%(8/242)、妊娠期高血压7.02%(17/242)、胎儿生长受限7.02%(17/242)、出生低体质量儿6.61%(16/242)的发生率均低于B组的8.79%(8/91)、14.29%(13/91)、15.38(14/91)、14.29(13/91)(P均 5 m IU / L,TPOAb was positive and had good compliance; Group D: TSH and TPOAb as Group C but not have good compliance; Group F: 2. 5 m IU / L≤TSH≤5. 0 m IU / L,TPOAb was negative and had good compliance; Group G: as Group F,but not have good compliance; Group H: TSH > 5 m IU / L,TPOAb was negative and had good compliance; Group K: as Group H,but not have good compliance. Randomly selected 200 cases with normal thyroid function at the same period as the control group( Group E). Retrospective analysis the occurrence rate of thyroid gland dysfunction,the influence of SCH to pregnancy outcome,the doses and influencing factors of replacement therapy by L-T4 to SCH of early pregnant women. Results Relevance ratio of SCH in early pregnant women was5. 20%,the ratio of normal thyroid function was 79. 00%. In group A,premature birth 3. 31%( 8 /242),gestational hypertension 7. 02%( 17 /242),fetal growth restriction 7. 02%( 17 /242),low birth weight infant 6. 61%( 16 /242),were lower than that in group B 8. 79%( 8 /91),14. 29%( 13 /91),15. 38( 14 /91),14. 29( 13 /91) respectively( P < 0. 05). In group C,spontaneous abortion 3. 31%( 6 /181),premature birth 3. 89%( 7 /181),gestational hypertension 8. 29%( 15 /181),gestational diabetes mellitus 3. 89%( 7 /181),fetal growth restriction 7. 73%( 14 /181),low birth weight infant 6. 63%( 12 /181),were lower than that in group D 11. 54%( 6 /52),11. 54%( 6 /52),19. 23%( 10 /52),11. 54%( 6 /52),17. 31( 9 /52),15. 38( 8 /52)( P < 0. 05). No significant statistical difference were found in multiple comparison of the above six indexes of group A,B,C. And just the same as the multiple comparison of group F,G,H,K,E. When TSH reach the standard,the dosage of L-T4 in group A and C had significant difference [( 0. 757 ± 0. 378 vs. 1. 106 ± 0. 454) μg / kg,t = 8. 39,P < 0. 001]. There were also significant differences of group F compared with group H[( 0. 443 ± 0. 198 vs. 0. 813 ± 0. 378) μg/kg,t = 8. 22,P < 0. 001],group( A + F) compared with group( C + H) [( 0. 634 ± 0. 358 and 1. 017 ±0. 427) μg / kg,t = 11. 77,P < 0. 001],group A compared with group F [( 0. 757 ± 0. 378 vs. 0. 443 ± 0. 198) μg / kg,t = 9. 85,P < 0. 001 ],group C compared with group H [( 1. 106 ± 0. 45 vs. 0. 813 ± 0. 378) μg / kg,t = 5. 59,P < 0. 001],group( A + C) compared with group( F + H) [( 0. 932 ±0. 463 vs. 0. 693 ± 0. 388) μg / kg,t = 6. 53,P < 0. 001]. Conclusion The early pregnant women with SCH and TPOAb positive could increase the occurrence rate of spontaneous abortion,premature birth,gestational hypertension,gestational diabetes mellitus,fetal growth restriction and low birth weight infant. The early intervening treatment of L-T4 could efficiently decrease the adverse event occurrence ratio of pregnant woman with SCH and positive TPOAb,but no effect for that with SCH and TPOAb negative. The TSH level and condition of TPOAb could affect the replacement therapy dosage of early pregnancy with SCH

系膜增生性肾小球肾炎的病理特征与治疗

目的探讨系膜增生性肾小球肾炎的病理特征与中西医结合治疗的疗效和安全性。方法收集186例MsPGN患者的临床病例资料,回顾分析其病理特征,根据治疗方法的不同分为西药治疗组、雷公藤多苷组与正清风痛宁组,每组各62例。西药治疗组用贝那普利(ACEI)及双嘧达莫,雷公藤多苷组西药加雷公藤多苷,正清风痛宁组西药加正清风痛宁。结果 MsPGN的免疫病理和电镜病理特征突出;西药结合中药雷公藤多苷与西药结合正清风痛宁治疗MsPGN的总缓解率与总有效率分别为32.3%、67.7%、37.1%、71.0%,均高于单纯西药治疗的16.1%、35.5%(均P0.05);西药治疗组治疗前后除Scr水平显著下降外(P0.05);雷公藤多苷组与正清风痛宁组治疗前后除WBC外,其余5项指标均有明显改善(均P<0.05);正清风痛宁组治疗后Scr水平改善程度优于雷公藤多苷组(P<0.05);正清风痛宁组不良反应发生率为9.7%,显著低于雷公藤多苷组的25.8%(P<0.05)。结论 MsPGN的免疫病理和电镜病理特征突出,是本病诊断与鉴别诊断的可靠方法;西药结合雷公藤多苷或西药结合正清风痛宁治疗MsPGN的疗效明显优于单用西药;正清风痛宁的不良反应发生率显著低于雷公藤多苷,更值得临床推广

Clinical efficacy of the fine needle aspiration of the cell block in the diagnosis of parotid gland masses

目的探讨超声引导下细针穿刺制作细胞块在诊断腮腺区肿块方面的应用价值。方法在彩色超声仪引导下,对285个腮腺区肿块进行细针穿刺,将穿刺标本制成细胞块,以进行病理学诊断。对非肿瘤性肿块采取保守治疗,囊肿与肿瘤性肿块采取手术治疗。对术后病理确诊为腺样囊性癌(ACC)与多形性腺瘤(PA)对应的细胞块行干细胞因子受体CD117免疫组织化学检测。结果标本制作满意率为95.1%(271/285),诊断准确率为94.5%(256/271);诊断敏感度为87.0%(67/77),特异度为98.1%(157/160)。CD117在ACC中的阳性表达率为95.2%(20/21),在PA中为20.3%(25/123),ACC中阳性表达率明显高于PA,二者差异有统计学意义(P<0.01)。结论超声引导下腮腺区肿块细针穿刺制作细胞块结合分子标志物检测,对腮腺区肿块的诊断具有重要意义。Objective To investigate the clinical significance of cell blocks obtained by ultrasound-guided fine needle aspiration in diagnosing parotid gland masses. Methods Cell blocks were made in 285 parotid gland masses by ultrasoundguided fine needle aspiration. Diagnosis was conducted using the cell blocks. Non-tumor masses were subjected to conservative treatment, and cysts and tumors were treated with surgery. The cell block sections from masses with the diagnosis of adenoid cystic carcinoma(ACC) and pleomorphic adenoma(PA) were applied to the detection of immunocytochemical staining for the stem cell factor receptor CD117. Results The satisfaction rate of the specimen was 95.1%(271/285). The accuracy rate of the diagnosis was 94.5%(256/271), the sensitivity was 87.0%(67/77), and the specificity was 98.1%(157/160). The positive rate of CD117 in ACC was 95.2%(20/21), whereas that in PA was 20.3%(25/123). The positive rate of CD117 in ACC was higher than that in PA(P<0.01). Conclusion The use of cell blocks obtained from ultrasound-guided fine needle aspiration, together with molecular marker detection, has great significance in diagnosing parotid gland masses

分泌AFP的胃肝样腺癌(光镜、电镜和免疫组化观察)

分泌AfP的胃肝样腺癌（光镜、电镜和免疫组化观察）江显毅1杨善民2张思宇1方庆全1关键词胃癌；肝癌细胞样分化；电镜；免疫组化1.厦门市第一医院（厦门361003）2.厦门大学抗癌研究中心自1982年PrATH［1］等首次在卵巢的卵黄囊肿瘤发现肝癌细胞..

分泌AFP的胃肝样腺癌1例─附光镜、电镜和免疫组化观察

分泌AfP的胃肝样腺癌1例─附光镜、电镜和免疫组化观察江显毅，杨善民，张思宇，方庆全（厦门市第一医院病理科3610032厦门大学抗癌研究中心）自1982年PrATH［1］等首次在卵巢的卵黄囊肿瘤发现肝癌细胞样细胞特3征以来，在胃、肺、子宫内膜、结肠和..

Transfer of drug resistance plasmids from Escherichia coli to pathogenic vibrio

用混合培养法进行耐药质粒从大肠杆菌 (Escherichiacoli)向病原弧菌转移研究 ,结果表明 ,耐药质粒 pBR322和 pBR325可以从大肠杆菌向病原弧菌转移。在混合培养30min后 ,部分弧菌获得耐药质粒 ,质粒的转化率随着培养时间的延长而增大 ;混合培养24h后 ,转化率分别提高至4.62×10-6～1.18×10-5。耐药质粒 pBR322和 pBR325在2株病原弧菌细胞内能较为稳定地遗传 ,在培养初期 (0～1h) ,均未出现质粒丢失 ,随着培养时间的延长 ,有少量细胞因丢失耐药质粒而表现出对药物的敏感性 ;培养72h后 ,质粒 pBR322和 pBR325在副溶血弧菌(Vibrioparahaemolyticus)中的丢失率分别为10 %和9% ,溶藻弧菌(Vibrioalginolyticus)中2种质粒的丢失率分别为22%和19 %。细菌的药敏试验表明不同菌株在获得耐药质粒后对特定药物的抗性大大增强 ,但不同菌株的耐药水平有所不同 ,说明耐药质粒在不同菌株中的表达水平有所不同。The transfer of drug-resistant plasmid from Escherichia coli to pathogenic vibrios was studied by mixed culturing.Results showed that plasmid pBR322and pBR325could be transferred from E.coli to pathogenic vibrios.Some tested vibrio could be obtained plasmid within30min of mixed culturing.The transfer rate of plasmid increased with inˉcreasing culture time at24h the transfer rate was4.62×10 -6 ～1.18×10 -5 .Drug-resistant plasmid pBR322and pBR325were in pathogenic vibrio.In the initial stages of culture,no plasmid was lost,but as the culture time increased,some vibrio would lose plasmid and became sensitive to antibiotic.72h after culture,plasmids pBR322and pBR325lost in V.parahaemolyticus were10%and9%respectively,while in V.alginolyticus,22%and19%was lost.Bacterial drug-resistance level increased significantly after plasmid was obtained,but variety was seen between different bacteria indicating the expression level of drug-resistant plasmid varied.国家高技术研究发展计划 (863计划 )(819-02-12

Detection of the Vibrio alginolyticus LPS of Pseudosciaena crocea by indirect ELISA

用酚 水法从20dm3溶藻弧菌培养液中分离得到脂多糖(LPS)97.6mg,以0.5mg cm3的LPS溶液通过耳缘静脉注射免疫实验兔,经过3次加强注射后从颈动脉放血制备抗血清.该抗血清的效价为1∶2560,对副溶血弧菌等10株细菌的交叉反应效价都较低.用免疫吸附过滤法去除血清中的非特异性成分.用吸附后的抗血清进行溶藻弧菌间接ELISA检测,其检测限为97×104个 cm3.以ELISA进行大黄鱼体内溶藻弧菌检测.结果表明:用LPS抗血清可以较为灵敏地检测大黄鱼体内的溶藻弧菌,该方法不仅可以用于诊断大黄鱼的溶藻弧菌病,也可以检测无病症带菌大黄鱼.97.6mg lipopolysaccharide(LPS) were obtained by phenol-watermethod from 20dm~3 suspension of Vibrio alginolyticus. 0.5mg/cm~3 LPS were injected into rabbits for the sake of making anti-serum. The titer of anti-serum was 1∶2 560. The non-special component in the serum was removed by absorption. Serum after absorption was used for indirect ELISA detection. The detecting limit of V.alginolyticus was 9.7×10~4ind/cm~3. By using indirect ELISA of anti-LPS serum to detect V.alginolyticus in Pseudosciaena crocea, the results indicated that ELISA method could beused not only to diagnose the clinically diseased P.crocea, but also to recognize pathogenic bacteria carrying P.crocea.国家高技术研究发展计划(863计划)资助(863 819 02 12;2001AA635070

一个奇异核反应总截面的探测系统及其应用

评述了现有的奇异核反应总截面测量方法，介绍了一套简单可行的测量中能区奇异核反应总截面的探测装置，并对实验的能量刻度、粒子鉴别以及实验结果进行了阐述和讨论．The present status of experimental studies of the total reaction cross sections of exotic nuclei are reviewed. A detector system used for measuring the total reaction cross section of radioactive ions is described. The energy calibration of detectors, particle identification and possible experimental results are discussed.国家杰出青年科学研究基

F同位素的反应总截面测量和~(17)F可能的质子皮结构

应用透射法对中能区F同位素与C靶的反应总截面进行了测量 .发现17F的反应总截面比其邻近同位素的反应总截面稍有增强 .用Glauber模型和BUU模型对F同位素进行了差异因子d的分析 .17F的差异因子d比其附近同位素稍有增强 .分析结果表明17F可能存在质子皮结构