近年来由支原体所引起的女性泌尿生殖系统感染增多,尤其是非淋球菌性尿道(宫颈)炎(NGU)发病率呈上升趋势[1,2].目前很多实验室根据文献推荐的方法,用支原体检测试剂盒培养24h再观察结果[3,4].但笔者在实际工作中发现,部分支原体生长缓慢,培养24 h报告结果,易引起部分菌株漏检,药敏反应不明显.为此,对笔者所在医院妇科就诊的395例疑有宫颈炎、盆腔炎患者宫颈分泌物进行支原体培养鉴定及药敏试验,分别于培养24、48、72 h后观察结果,以了解培养时间对支原体检出率的影响及其耐药变迁情况,现报告如下.

目的了解临床感染标本中的铜绿假单胞菌的血清分型及耐药性。方法常规分离培养细菌,获纯培养后用VITEK微生物全自动分析仪或API系统鉴定到种;血清分型按试剂盒操作说明进行;药敏实验采用K-B纸片扩散法,按NCCLS规定的标准进行;ESBLs检测采用表型确认法,AmpC酶检测采用三维实验确认法。结果 100株铜绿假单胞菌来自呼吸道的占78%,分型率为83%,B型占50%,次为G型和E型分别为9%和6%;对11种抗菌药物的耐药率为:头孢曲松71%,阿乐欣64%,特美汀56%,左氧氟沙星51%,哌拉西林50%,丁胺卡那48%,先锋必47%,泰能38%,马斯平33%,头孢他啶20%,舒普深18%;产ESBLs的阳性率为37%,产AmpC的阳性率为15%;产酶菌对舒普深、头孢他啶耐药率最高为29.7%。结论铜绿假单胞菌血清型以B型为主,其次为G型和E型;该菌耐药现象日趋严重,对非产酶菌的治疗根据药敏实验结果可选用马斯平、头孢他啶、舒普深、泰能,对产酶菌应与丁胺卡那、左养氟沙星等抗菌药物联用。

目的探讨糖化血红蛋白(GHb)及血小板参数联合检测在糖尿病微血管病变时的意义。方法采用XE-2100型全自动五分类血细胞分析仪对100例糖尿病患者(其中有微血管病变58例,无微血管病变42例)和50例健康对照组进行血小板计数(PLT)、血小板平均体积(MPV)、血小板分布宽度(PDW)、血小板压积(PCT)、大血小板比率(P-LCR)测定;采用日立7170A全自动生化分析仪测空腹血糖(FPG);糖化血红蛋白(GHb)采用D-10全自动糖化血红蛋白分析仪应用高效液相色谱法。结果糖尿病患者GHb、MPV、PDW、PCT、P-LCR均明显高于正常对照组(P<0.01);微血管病变者明显高于无微血管病变者(P<0.01),正常组和糖尿病患者的PLT无显著变化(P>0.05)。结论 GHb、MPV、PDW、PCT、P-LCR联合检测对糖尿病患者微血管病变的早期诊断与治疗具有重要临床价值。

[目的]探讨血浆中纤维蛋白原及D-二聚体的检测对膝关节镜手术患者并发深静脉血栓(DVT)的早期诊断价值。[方法]对796例膝关节镜手术患者术前及术后第3~5 d进行血浆中纤维蛋白原、D-二聚体的水平检测,并与正常对照组(30例)比较。[结果]30例并发DVT组术后与术前及正常对照组血浆中纤维蛋白原、D-二聚体的检测结果差异有统计学意义(P<0.05);未并发DVT组术前、术后与正常对照组血浆中纤维蛋白原、D-二聚体的检测结果均无统计学意义(P>0.05)。[结论]血浆中纤维蛋白原及D-二聚体的动态检测对膝关节镜手术患者并发深静脉血栓具有早期的诊断价值。

Objective To study the significance of quantitation of serum HBV DNA and prealbumin(PA) in patients with hepatitis B,and to compare their clinical values in hepatitis B.Method A lotal of 312 patients with chronic hepatitis B was divided into 5 groups based on their different virus markers.HBV DNA and PA were measured by fluorescence quantitative PCR and immune turbidimetry.Results The level of PA decreased in all groups of patients with hepatitis B,and the differences among 5 groups were significant(F=63.97,P0.05).The level of PA decreased gradually along with the exacerbation of chronic hepatitis B,and the decreasing extent was parallel to the severity of liver lesion.No correlation was found between the positive rate of HBV DNA and the severity of chronic hepatitis B.There was no difference in PA level and their abnormal rate between HBV DNA positive group and negative group in patients with hepatitis B(F=0.86,P0.05;χ2=2.14,P0.05).There was no difference in PA level between replication group and nonreplication group of HBV(t=0.236,P0.05).Conclusions The quantitation of HBV DNA is a reliable item to identify the replication and infection of HBV in patients with hepatitis B,but it cannot reflect the severity of hepatitis B.Serum PA is a sensitive index to reflect the lesior of liver cells and is useful to identify and predict the outcome of hepatitis B.PA level isn't obviously related to the replication of HBV and the concentration of HBV DNA.

血细胞分析仪计数血小板准确性与血小板本身具有易粘附、凝集、破坏和变形等特点,所用器材的准确性、清洁度,操作者的熟练程度直接相关联.

Objective To observe the relationship between mark models(HBsAg,HBsAb,HBeAg,HBeAb and HBcAb) of hepatitis B virus(HBV) and condition of chronic hepatitis B. Methods The 582 patients with chronic hepatitis B and or with cirrhosis divided into 5 groups. HBV marks were detected by enzyme-linked immunosorbent assay(ELISA); serum levels of total bilirubin(TBIL), albumin(ALB), aminotransferase(ALT) and prealbumin(PA) were measured by Olympus AU2700 auto-biochemical analyzer. Then the patients were divided into 6 groups based on positive status of HBV marks: group A comprised 173 patients whose HBV marks of HBsAg, HBeAg and HBcAb were positive; group B comprised 218 patients whose HBV marks of HBsAg, HBeAb and HBcAb were positive; group C comprised 161 patients whose HBV marks of HBsAg and HBcAb were positive; group D comprised 13 patients whose HBV marks of HBeAb and HBcAb were positive; group E comprised 6 patients whose HBV marks of HBsAb, HBeAb and HBcAb were positive; group F comprised 11 patients whose HBV marks of HBsAb and HBcAb were positive. Results The positive rates of group A, B, C, D, E and F in 582 patients were 29.7%, 37.4%, 27.7%, 2.2%, 1.0% and 1.9% respectively. The differences of positive rates were significant among group A, B and C(χ2=14.75, P0.01) and the positive rates of group B was the highest. In 5 groups of chronic hepatitis, the difference of positive rate of group A was significant(χ2=23.17, P0.01), which of group B was not significant(χ2=3.72, P0.05) and which of group C was significant(χ2=25.74, P0.01). The differences of serum levels of TBIL, ALB, ALT, PA and their abnormal rates were not significant between group A which HBV mark of HBeAg was positive and group B,C which HBV mark of HBeAg was negative(F=1.91,2.48,0.58,1.37,P0.05; χ2=2.09,5.97,2.35,2.26,P0.05).Conclusion No positive correlation is shown between HBV marks model and condition of chronic hepatitis B, which is not useful to diagnosis and prognosis for hepatitis B based on HBV marks model.

患者男,18岁.2006-01-07诊断为"粘连性肠梗阻"入住本院普通外科.予葡萄糖氯化钠注射液500ml、25%葡萄糖注射液600ml、10%kcl针40ml、30%脂肪乳注射液250ml、18-复方氨基酸注射液500ml、欣维针1支、中性胰岛素针18U静脉滴注1次/d,13日复查血WBC、PLT结果均正常.16日下午患者体温达39.5℃,并伴有鼻塞、咽部不适,无寒战,无咳嗽、咳痰不适,考虑为上呼吸道感染,加用小儿退热栓一枚,病毒唑针300mg、5%葡萄糖注射液250ml、西迪林针3g、

近几年前列腺炎在成年男性中的感染比例越来越高,且抗菌药物的治疗效果不佳,随着病原菌的耐药性发生越来越多,给临床治疗带来了极大困难.为了解前列腺炎病原菌的分布及耐药性,我们对门诊前列腺感染患者的标本进行了病原菌的分离鉴定和耐药性检测,以期为临床治疗提供帮助.

目的了解临床下呼吸道感染标本中的铜绿假单胞菌的血清分型及耐药性.方法常规分离培养细菌,获纯培养后用VITEK微生物全自动分析仪或API系统鉴定到种;血清分型按试剂盒操作说明进行;药敏实验采用K-B纸片扩散法,按NCCLS规定的标准进行;ESBLs检测采用表型确认法,AmpC酶检测采用三维实验确认法.结果 75株铜绿假单胞菌分型率为89.3%,B型占57.3%,次为G型和E型分别为6.7%和5.3%;对11种抗菌药物的耐药率为:头孢曲松74.7% 、阿洛西林45.5%、替卡西林-克拉维酸58.7%、左氧氟沙星53.3%、哌拉西林56.6%、阿米卡星54.7%、头孢哌酮46.7%、亚胺培南-西拉司丁42.6%、头孢吡肟33.3%、头孢他啶22.7%、头孢哌酮-舒巴坦9.3%;产ESBLs的阳性率为38.7%,产AmpC的阳性率为14.7%. 结论铜绿假单胞菌血清型以B型为主,次为G型和E型;该菌耐药现象日趋严重,对非产酶菌的治疗根据药敏实验结果可选用头孢吡肟、头孢他啶、头孢哌酮-舒巴坦、亚胺培南-西拉司丁,对产酶菌应与阿米卡星、左氧氟沙星等抗菌药物联用 .

<正> 鼻腔填塞术是目前治疗鼻出血的主要方法,广泛应用于鼻部手术后及鼻出血病人。由于鼻腔部位特殊、鼻腔填塞后除直接影响病人的呼吸方式外,对病人的睡眠、饮食等有较明显的影响,术后可出现许多护理问题。因此通过对鼻部术后鼻腔填塞者进行全面的健康指导,提高病人对鼻部术后鼻腔填塞的认知,自觉配合治疗,有效控制