儿科医院院内感染相关因素分析

目的:了解儿科院内感染发病情况、发病诱因及病程特点,为临床防治提供依据.方法:对1998年1月～2002年12月儿科住院患儿进行回顾分析.结果:院内感染发生率5.28%,医院感染与年龄、住院时间、基础病、抗生素相关.主要致病菌金黄色葡萄球菌占42.5%,其次变形杆菌占28.4%,发生感染部位主要为呼吸道和消化道.结论:医院感染与年龄、住院时间、基础病、抗生素密切相关.主要致病菌是金黄色葡萄球菌.     

血府逐瘀汤治疗黄褐斑46例

黄褐斑在祖国医学中称为“黧黑斑”,主要是发生在颜面部位的黄褐色色素沉着斑片,是临床上常见而又难以治愈的皮肤病之一。近３年来笔者采用血府逐瘀汤治疗黄褐斑４６例,取得较好疗效,现报告如下。１临床资料１．１病例选择４６例患者均为１９９５年１月至１９９８年３...     

软刺裸裂尻鱼耳石日轮及年轮沉积规律研究

研究利用软刺裸裂尻鱼(Schizopygopsis malacanthus)确证了耳石生长轮沉积规律,并在此基础上,探究了其生长轮与年轮关系,推算了第一年轮形成时间。研究结果表明:仔鱼微耳石第一轮纹在出膜后第二天形成,在实验条件下,轮纹沉积具有日周期性,生长轮为日轮;成鱼轮纹沉积具有年周期性,生长轮每年增加1轮。基于耳石日轮技术推算养殖和野生软刺裸裂尻鱼第一年轮形成时间分别为2021年1月28日至3月13日(n=40)和2017年3月8日至5月10日(n=75)。养殖和野生样本耳石轮纹数年际间的分析结果发现,软刺裸裂尻鱼耳石轮纹数和耳石年生长宽度随着年龄增加逐渐降低,耳石年生长面积随着年龄增加逐渐增加。这些结果揭示了软刺裸裂尻鱼耳石轮纹沉积规律,有助于增加年龄鉴定的准确性,进而为种群动态研究和渔业管理政策制定等提供参考。     

生肌纱布条治疗蛇伤溃疡56例临床分析

被毒蛇咬伤的患者经抢救脱离危险后 ,常留下局部软组织坏死 ,形成溃烂不愈 ,往往导致截肢 ;即使溃疡愈合后也常留疤痕增生及挛缩 ,严重者可致畸形或终身残废。我所自 1 995年 6月至 2 0 0 0年1 0月共收治蛇伤溃疡患者 56例 ,采用生肌纱布条 ,配合对症治疗 ,均获良效。现报道如下。1　临床资料　　本组 56例 ,男 45例 ,女 1 1例 ;年龄 7～ 68岁 ,平均 33岁。56例均发生在 4～ 1 1月间。致伤部位 :手 32例 ,足 2 2例 ,其它部位 2例。伤后至我所诊治的时间 :1～ 52天 ,平均 1 2天。溃疡创面情况 :局部组织破坏严重 ,皮肤缺损最大 1 4cm× 2 6cm…     

马拉色菌引起乳房垢着病1例并文献分析

皮肤垢着病(cutaneous dirt-adherent disease,CDAD)是一种临床少见皮肤病,其中单独发生在乳房部位的,临床称之为"乳房垢着病",更是罕见。目前,国内外文献报道约15例,但均为个案报道,对该病的临床特点及诊疗方案缺乏系统性分析。     

皮肤软组织扩张Ⅰ期术后血肿危险因素研究

目的:皮肤软组织扩张术一个令人头疼的问题是其高并发症,其中血肿的发生往往意味着二次手术,本研究希望寻找皮肤软组织扩张Ⅰ期术后血肿发生的独立危险因素,为临床工作提供指导.方法:回顾性分析西京医院整形外科2003年1月至2012年12月间行扩张器置入术患者的临床资料,应用单因素Logistic回归法进行比较,寻找潜在危险因素,将单因素分析差异P＜0.1的变量引入多因素Logistic回归分析模型,采用Backward Conditional法行逐步回归分析,以P＜0.05筛选出独立危险因素.结果:2003年1月至2012年12月西京医院整形科行皮肤软组织置入术患者,共2056人次3382例扩张器入选研究,Ⅰ期术后发生血肿的共100例,发生率为3.0％,经过统计分析最终发现术前APTT值、单次手术埋置扩张器数、性别及扩张器埋置部位是血肿的独立危险因素.结论:血肿的独立危险因素为术前APTT值、单次手术埋置扩张器数、性别及扩张器埋置部位,术前APTT值越高、单次手术扩张器埋置数越多、患者为男性及手术部位为面颈部时,软组织扩张术后发生血肿的可能性越大,本研究对指导临床工作降低血肿发生具有重要的参考意义.     

皮肌炎合并感染的特点与危险因素分析

目的探讨皮肌炎患者合并感染的特点及相关危险因素。方法回顾性分析107例患者的临床资料和感染情况,并填入自制表格,内容包括性别、年龄、住院时间、患者的感染率、感染部位、基础疾病、病原菌等,并采用流行病学方法进行统计分析。结果皮肌炎患者发生医院感染41例,感染率38.32%,感染部位以呼吸道居多,占41.46%,其次为皮肤粘膜感染,占24.39%,泌尿道占14.63%;检出病原菌38株,检出率为92.69%,其中,革兰阳性菌17株占44.74%,革兰阴性菌13株占34.21%,真菌5株占13.16%;通过对感染的相关因素进行分析,其中年龄、住院时间、低蛋白血症和侵入性操作等是导致皮肌炎患者发生感染的主要因素,差异有统计学意义(P0.05)。结论皮肌炎患者感染的发生率高,应当针对相关因素采取合理措施,以有效预防其感染的发生,促进患者早日康复。     

早期宫颈癌患者围手术期外周血淋巴细胞数与其预后的关系

目的:探讨早期宫颈癌患者围手术期外周血淋巴细胞数与其预后之间的关系。方法:回顾性分析2006年1月至2012年12年就诊于解放军总医院,根据2009年最新宫颈癌FIGO指南诊断为Ⅰb~ⅡA期宫颈癌进行阴式宫颈癌根治术患者的临床病历资料。分析患者的围手术期淋巴细胞数和其无瘤生存期、总生存期间的关系。结果:共143例阴式早期宫颈癌根治术患者纳入研究,随访时间为6~87个月,中位随访时间为53个月。术后,宫颈癌患者外周血淋巴细胞数显著下降。术前外周血淋巴细胞数较高的患者无瘤生存期及总生存期均较外周血淋巴细胞数低于平均水平的患者显著延长(P0.05);术后第三天淋巴细胞数恢复或高于术前水平的患者无瘤生存期较术后第三天淋巴细胞数低于术前水平的患者显著延长(P0.05),但总生存期无明显差异(P0.05)。COX回归分析显示术前淋巴细胞数高于平均水平及术后第三天淋巴细胞数高于或等于术前水平的宫颈癌患者的预后相对较好。结论:术前淋巴细胞数和术后第三天淋巴细胞数的变化均可作为评估宫颈癌术后患者预后的重要参考指标。     

胸外科手术术后神经病理性疼痛的发生情况及相关因素分析

目的:探讨胸外科手术术后神经病理性疼痛的发生情况及相关危险因素。方法:回顾性分析2015年至2016年就诊于我院行胸外科手术的患者的临床资料,包括患者的年龄、性别、吸烟史、BMI、术前是否使用催眠药物、术前诊断、手术侧别、手术方式、是否为微创、硬膜外自控镇痛泵使用情况、术中失血量、手术持续时间、引流管引流时间及是否发生神经病理性疼痛,对比分析是否发生神经病理性疼痛患者的临床资料,对有差异的临床资料进行多因素Logistic回归分析探讨发生神经病理性疼痛的危险因素。结果:共有123例患者纳入研究,33例(26.8%)患者的患者术后出现神经病理性疼痛,6例(4.9%)患者在术后一年仍有持续性神经性病理疼痛,术后出现神经病理性疼痛的平均时间为术后第7天,平均持续时间为75天,发生神经病理性疼痛的患者吸烟比例(81.8%)、术前使用催眠药比例(57.6%)、开胸手术比例(81.8%)、术中失血量(185 mL)、手术时间(196分钟)、术后引流时间(2.5天)均高于没有发生神经病理性疼痛的患者。多因素分析显示术前使用催眠药(OR=2.322,P<0.001)、手术时间延长(OR=3.703,P<0.001)和术后引流时间延长(OR=2.675,P=0.002)均是神经病理性疼痛发生的危险因素,电视辅助胸腔镜手术方式是保护性因素(OR=0.453,P=0.002)。结论:术前使用催眠药物、延长的手术时间及术后引流时间增加了神经病理性疼痛发生的风险,电视辅助胸腔镜技术可减少其发生率。     

结直肠疾病临床特点的趋势分析

目的:通过分析患者的临床资料,探讨结直肠疾病的临床特点,为临床诊断和治疗提供参考。方法:回顾性分析我院肠镜室2012年5月-2013年4月(A)及2005年5月-2006年4月(B)两个时间段经电子肠镜检查的人群的性别、年龄及结直肠疾病的检出、息肉及癌的病变部位及病理类型情况。结果:两时间段结直肠器质性疾病发病率均较高,且A时间段比B时间段结直肠器质性疾病发病率升高(57.68%:45.13%),结直肠息肉及炎发病率升高(35.09%:19.76%和21.90%:14.45%),腺瘤性息肉比率升高(76.84%:68.33%),左半结肠息肉及癌的比率降低(60.88%:72.27%和60.00%:77.55%)。结论:结直肠疾病的发病人群分布发生改变,发病率呈逐年升高趋势。结直肠息肉的病理分型、发生部位及结直肠癌的发生部位有显著变化。     

6-[2-(adamantylidene)-hydroxybenzoxazole]-O-sulfamate, a steroid sulfatase inhibitor for the treatment of androgen- and estrogen-dependent diseases

Steroid sulfatase (STS) offers a new target for the treatment of steroid hormone-dependent diseases, such as breast and prostate cancer and androgen-dependent skin diseases. We here characterize a novel non-estrogenic inhibitor of the enzyme, namely 6-[2-(adamantylidene)-hydroxybenzoxazole]-O-sulfamate (AHBS), with special attention to its potential use in the treatment of acne. The compound blocks STS activity in homogenates of human skin with IC(50)=16 nM. Following a single oral dose (5 mg/kg) in rats, the compound blocks STS in the skin by 95% at 8 h, followed by recovery of activity over 5 days. Following topical application to the skin, both in vitro and in vivo, AHBS passes through the stratum corneum leading to inhibition of STS activity in the dermal compartment with rapid onset and long duration. Topical application of AHBS to G?ttingen minipigs for a period of 2 weeks does not induce symptoms of ichthyosis as seen in STS-deficient human subjects, but leads to a reduction of sebum secretion to the skin surface. Based on these data, clinical studies with AHBS in acne patients are warranted, in order to verify the hypothesis on the importance of the sulfatase pathway in androgen-dependent skin diseases.     

Differential cytokine activity and morphology during wound healing in the neonatal and adult rat skin

Wound-healing mechanisms change during transition from prenatal to postnatal stage. Cytokines are known to play a key role in this process. The current study investigated the differential cytokine activity and healing morphology during healing of incisional skin wounds in rats of the ages neonatal (p0), 3 days old (p3) and adult, after six different healing times (2 hrs to 30 days). All seven tested cytokines (Transforming Growth Factor (TGF) alpha, TGFbeta1, -beta2 and -beta3, IGF 1, Platelet Derived Growth Factor A (PDGF A), basic Fibroblast Growth Factor (bFGF) exhibited higher expression in the adult wounds than at the ages p0 and p3. Expression typically peaked between 12 hrs and 3 days post-wounding, and was not detectable any more at days 10 and 30. The neonate specimen showed more rapid re-epithelialization, far less inflammation and scarring, and larger restitution of original tissue architecture than their adult counterparts, resembling a prenatal healing pattern. The results may encourage the use of neonatal rat skin as a wound-healing model for further studies, instead of the more complicated prenatal animal models. Secondly, the data may recommend inhibition of PDGF A, basic FGF or TGF-beta1 as therapeutic targets in efforts to optimize wound healing in the adult organism.     

Drug-induced skin reactions and acute cutaneous graft-versus-host reaction: a comparative immunohistochemical study

Skin biopsies from eight patients with drug-induced dermatitis have been compared with skin biopsies from 16 patients developing skin lesions (acute graft versus host-reaction and/or drug-induced reaction) after bone marrow transplantation. Biopsies were investigated using immunohistochemistry and several monoclonal antibodies. Morphological and immunohistochemical patterns in skin biopsies of both groups were very similar. The only difference seen was a reduced number of epidermal Langerhans cells with poorly developed dendrites in skin biopsies taken from patients who underwent bone marrow transplantation. If the latter finding is due to the cytotoxic drug regimen administered before bone marrow transplantation, as previously stated, we doubt the usefulness of skin biopsies in the differential diagnosis of acute graft-versus-host reaction and drug-induced skin lesions.     

Perhexiline maleate-induced lipidosis in cultured human fibroblasts: cell kinetics, ultrastructural and biochemical studies

Perhexiline maleate reduced the growth of human skin fibroblasts in cell culture at a concentration range of 0.3-3 micrograms/ml. At the highest concentration, the cells survived only four days. Pleomorphic inclusions characteristic of drug-induced phospholipidoses appeared in cultured cells. Analysis of the major lipid classes was performed on cells exposed to 3 micrograms/ml at four days. Gangliosides, phospholipids and cholesterol levels four to six times above controls were found. No major qualitative abnormalities were detected in phospholipids. On the contrary, an abnormal pattern of gangliosides was seen by densitometry of silica gel thin-layer plates with increases of GD3 and of an unknown ganglioside. Drug induced lipidosis may involve other lipids than phospholipids, particularly gangliosides.     

Clinical and laboratory characteristics of drug-induced vasculitic syndromes

Clinical recognition of drug-induced vasculitic and lupus-like syndromes is very important because continued use of the offending drug can lead to irreversible and life-threatening vasculitic organ damage (e.g. end-stage renal disease or pulmonary haemorrhage). Withdrawal of the drug often leads to spontaneous recovery, meaning that immunosuppressive therapy can be avoided. The presence of myeloperoxidase–antineutrophil cytoplasmic antibodies, IgM anticardiolipin antibody, and antihistone antibodies in combination was found to be characteristic of drug-induced vasculitic syndromes caused by the antithyroid drugs propylthiouracil and methimazol. Clinically, skin vasculitis and arthralgias predominated and renal vasculitis was rare.     

Gamma frailty model for linkage analysis with application to interval-censored migraine data

For many diseases, it seems that the age at onset is geneticallyinfluenced. Therefore, the age-at-onset data are often collectedin order to map the disease gene(s). The ages are often (right)censored or truncated, and therefore, many standard techniquesfor linkage analysis cannot be used. In this paper, we presenta correlated frailty model for censored survival data of siblings.The model is used for testing heritability for the age at onsetand linkage between the loci and the gene(s) that influence(s)the survival time. The model is applied to interval-censoredmigraine twin data. Heritability (obtained from the frailtiesrather than actual onset times) was estimated as 0.42; thisvalue was highly significant. The highest lod score, a scoreof 1.9, was found at the end of chromosome 19.     

Most common skin tumours in correlation with solar ultraviolet radiation in the area of West Herzegovina

Incidence rate of skin tumours, both, non-melanoma and melanoma, is increasing nowadays. Various etiological factors are of relevance for the occurrence of the diseases. The solar radiation, as well, long-term exposure to ultraviolet (UV) radiation, have the greatest impact on development of these skin tumours. Non-melanoma skin tumours, Basal Cell Carcinoma (BCC) and Squamous Cell Carcinoma (SCC), are the most common skin tumours in humans, and usually develop on the chronically photo-exposed areas. As for the Malignant Melanoma (MM), one of the most aggressive skin tumours, the exposure to solar radiation also plays an important role. This study investigates the correlation between the skin tumours and UV radiation in the area of West Herzegovina, on the sample of 1676 patients. It presents the occurrence of skin tumours in the period from 1997 to 2003. The study investigates the incidence and the risk factors separately for every skin tumour which can be etiologically related to the occurrence of skin tumours and UV radiation: occupation, exposure to UV radiation, skin type, and family history on malignan tumours within the patient's family. The exact incidence rate of non-melanoma and melanoma skin tumours in Bosnia and Herzegovina is still unknown, for the reason that the united National Cancer Register does not exist yet.     

Availability of vitamin D photoconversion weighted UV radiation in southern South America

Ultraviolet radiation (UVR) plays a key role in several biological functions, including human health. Skin exposure to UVR is the main factor in vitamin D photoconversion. There is also evidence relating low levels of vitamin D with certain internal cancers, mainly colon, breast and prostate, as well as other diseases. Several epidemiological studies have shown an inverse relationship between the above-mentioned diseases and latitude, in accordance with the ultraviolet radiation latitudinal gradient. The aim of this study is to determine whether UV irradiance levels in the southern South America are sufficient to produce suitable levels of vitamin D year around. For this purpose, vitamin D photoconversion weighted-irradiance was analyzed between S.S. de Jujuy (24.17°S, 65.02°W) and Ushuaia (54° 50'S, 68° 18'W). In addition to irradiance, skin type and area of body exposed to sunlight are critical factors in vitamin D epidemiology. Due to a broad ethnic variability, it was assumed that the skin type in this region varies between II and V (from the most to the less sensitive). All sites except South Patagonia indicate that skin II under any condition of body area exposure and skin V when exposing head, hands, arms and legs, would produce suitable levels of vitamin D year round (except for some days in winter at North Patagonian sites). At South Patagonian sites, minimum healthy levels of vitamin D year round can be reached only by the more sensitive skin II type, if exposing head, hands, arms and legs, which is not a realistic scenario during winter. At these southern latitudes, healthy vitamin D levels would not be obtained between mid May and beginning of August if exposing only the head. Skin V with head exposure is the most critical situation; with the exception of the tropics, sun exposure would not produce suitable levels of vitamin D around winter, during a time period that varies with latitude. Analyzing the best exposure time during the day in order to obtain a suitable level of vitamin D without risk of sunburn, it was concluded that noon is best during winter, as determined previously. For skin type II when exposing head, exposure period in winter varies between 30 and 130 min, according to latitude, except for South Patagonian sites. During summer, noon seems to be a good time of day for short periods of exposure, while during leisure times, longer periods of exposure without risk of sunburn are possible at mid-morning and mid-afternoon. At 3 h from noon, solar zenith angles are almost the same for sites between the tropics and North Patagonia, and at 4 h from noon, for all sites. Then, in these cases, the necessary exposure periods varied slightly between sites, only due to meteorological differences.     

Potential dermatological application on Asian plants

Skin diseases are among some of the most common types of health problems faced in Malaysia, as reported by the World Health Organization (WHO). Correspondingly, research into the use of medicinal plants for skin disease treatment has become important. Through the ages, medicinal plants have been used widely to treat a variety of skin diseases. The demand for plant-based medicines is growing, as they are generally considered to be safer and less harmful than conventional allopathic drugs. This article reviews the potential of Asian plants to be epidermal protecting agents. There are eleven remarkable Asian plants that are known for their skin barrier protecting agent properties. Important studies have shown that natural products offer a rich potential source of epidermal protecting agents. Nevertheless, further surveys and clinical evidence are needed to establish the potential of identified species in contributing to the treatment of skin disease, especially atopic eczema.