阴道加德纳菌生物型与细菌性阴道病的关系

对１２０例细菌性阴道病患者和９０例正常对照组进行阴道加德纳菌的分离鉴定,同时采用Ｐｉｏｔ分型法对分离出的９３株Ｇｖ进行生物分型,结果显示ＢＶ患者Ｇｖ的检出率（５９．２％）明显高于正常对照组（２４．４％）,Ｐ〈０．０１。９３株Ｇｖ中,８个生物型全检测到,其中１型２３．７％,２型１８．３％,４型３２．３％,６型１０．８％,３型和５型均为５．４％,７型和８型为２．２％。ＢＶ患者主要为１、２、４型,显著高于正常对照组（８７．３％和３１．８％,Ｐ〈０．０１）。     

恶性肿瘤中抗酸菌L型检出意义的研究

本文用改良抗酸染色法和卡介苗抗体免疫组化染色法对４２０例恶性肿瘤（乳腺癌１１２例肠腺癌１００例、恶性淋巴病５４例、子宫颈癌７０例、绒毛膜癌８４例）进行了研究。结果发现４２０例恶性肿瘤中４７例（１１．２％）,１Ｋ抗酸染色阳性和４９例（１１．６％）免疫组化染色阳性,其中以恶性淋巴瘤抗酸菌Ｌ型检出率最高（４４．４％）绒毛膜癌最低（２．４％）,抗酸菌Ｌ型主要（８５％）分布于癌巢或肿瘤实质内该区５１．１％癌细胞呈增生活跃状态,３４％癌细胞呈空泡样变性,颇似病毒感染的凹空细胞,２．１％的瘤细胞发生坏死。结合文献复习,提示抗酸菌Ｌ型感染可能与肿瘤发生有关。     

细菌L型败血症312例15例随访

本文随访１５年中细菌Ｌ型败血症３１２例,首次治愈２８７例（９１．９８％）,复发２４例（７．７０％）,死亡１例（０．３２％）。复发１、２及３交者,分别为１５、７及２例。复发原因依次为：（１）未适时做细菌Ｌ型检测,迁延不愈后就医;（２）未按细菌Ｌ型特点治疗或疗程不足;（３）存在慢性炎症病灶或迁延病灶未清除;（４）有使机体免疫力降低的基础病存在。文中提出增进对细菌Ｌ型及其诊断方法的了解、减少医源性失误、     

脓毒血症大鼠心肌II型磷脂酶A_2活性变化及其调控

观察了脓毒血症大鼠心肌ＩＩ型ＰＬＡ２ 活性、蛋白质含量及其ｍ ＲＮＡ 的变化。结果发现, 脓毒血症早期与晚期心肌ＩＩ型ＰＬＡ２ 活性较对照组分别降低２５ ．０ ％ （Ｐ ＜ ０ ．０５）及增高４７．６ ％ （Ｐ ＜ ０ ．０１）,ＩＩ型ＰＬＡ２ 蛋白质含量分别降低２７．０％ 及增高４８ ．０ ％（ 均Ｐ ＜ ０ ．０１）; 心肌ＩＩ型ＰＬＡ２ ｍ ＲＮＡ合成率与含量呈现类似的双相变化, 在脓毒血症早、晚期ｍＲＮＡ 合成率分别降低４５．０％ 和升高７０．０ ％ （均Ｐ ＜ ０ ．０１）,ｍＲＮＡ含量分别降低３４．１ ％ 和增加１５７ ．０％ （均Ｐ＜ ０ ．０１） 。脓毒血症早、晚期心脏ＩＩ型ＰＬＡ２ ｍ ＲＮＡ半衰期无显著变化（Ｐ ＞ ０．０５） 。实验结果表明大鼠脓毒血症发生过程中心肌ＩＩ型ＰＬＡ２ 活性呈现出先下降后升高的变化, 这一变化受其ｍＲＮＡ 转录水平的调节。     

上海交通大学附属第一人民医院中心实验室

目的：研究内蒙古地区汉族非吸烟人群和吸烟人群中,细胞色素P4501A1（cytochromc P4501A1,CYP1A1）基因MspI酶切位点多态性与慢性重度牙周炎（chronic severe periodontitis,CP）易感性的关系。方法：对50例CP患者和51例正常对照者按吸烟情况进行分组。用聚合酶链反应-限制性片段长度多态性技术（PCR-RFLP）,检测研究人群中CYP1A1基因3’端MspI酶切位点的3种基因型（A,B,C）的分布频率。结果：不考虑吸烟情况下,MspI基因型C在病例组和对照组中各占20％和13．7％,基因型A在两组中分别占42％和47．1％,基因型B在两组中分别占38％和39．2％,各基因型在两组间比较差异无显著性（P〉0．05）。但在吸烟组MspI C型者患慢性重度牙周是的危险性（OR）是其他基因型的5倍（95％可信限：1．34218．62）。结论：MspI C型可能是吸烟者慢性重度牙周炎易感性的遗传标志。     

干扰素治疗丙型肝炎—病例对照研究

应用兰州生物制品研究所生产之精制人白细胞干扰素治疗丙型肝炎的病例对照研究结果表明,治疗组５５．６％（１５／２７例）呈完全反应,４４．４％（１２／２７例）呈部分反应,对照组２２．２％（６／２７例）完全反应,７４．１％（２０／２７例）部分反应,１例无反应。治疗组ＨＣＶＲＮＡ转阴率（５５．６％）明显高于对照组（２２．２％）,Ｐ＜０．０５。     

GSTT1 、GSTM1 基因多态性与重度慢性牙周炎 易感性关系的研究

目的：研究GSTTI＋／0和GSTM1＋／0基因型及其联合基因型与重度慢性牙周（chronic pefiodontitis,cp）易感性的关系。方法：用聚合酶链反应检测50例重度慢性牙周炎患者和51例正常对照者的GSIT1＋／0、GSTM1＋／0的基因型。结果：GSTM1（0／0）和GSTT1（0／0）基因型及GSTMI（0／0）与GSTT1（0／0）联合基因型对重度慢性牙周炎相对危险度（OR）分别为9．56（95％CI．3．88—23．59）,8．68（95％CI,3．50—21．51）,36．83（95％CI,10．42—130．13）。结论：在内蒙古汉族人群中,基因型GSTT1（0／0）和GSTM1（0／0）增加了个体对重度慢性牙周炎易感性,且上述两种基因型间存在协同作用。     

多聚酶链反应检测宫颈HPV感染及分型的研究

本文应用ＰＣＲ技术检测２ｌ２例临床宫颈标本的ＨＰＶ－６、ｌｌ、１６、１８型特异性核酸序列。结果发现ＨＰＶ－ＤＮＡ的阳性率：宫颈癌组为６２．５％（２５／４０）．慢性宫颈炎为５７％（８１／１４２）,正常宫颈对照组为２０％（６／３０）,Ｐ＜０．００１,提示ＨＰＶ的感染与宫颈炎、宫颈癌有关。同时分型结果显示：ＨＰＶ－６、１６、１８型与宫颈炎相关,１６型与宫颈癌密切相关,且ＨＰＶ不同型别的混合感染在宫颈中普遍存在（３１．３％）。成年女性各年龄组间ＨＰＶ的感染率并无明显差异（Ｐ＞０．０５）。     

鼻咽癌细菌L型感染与P^53基因突变的研究

用免疫组化和革兰染色等技术,对６９例鼻咽癌进行细菌Ｌ型和突变型Ｐ５３蛋白检测,并以２０例鼻咽粘膜慢性炎作为对照。结果发现,革兰染色鼻咽癌细菌Ｌ型检出率为７９．７％,与免疫组化Ｌ型抗原表达阳性率（６９．６％）具有一致性（Ｐ＞０．０５）。鼻咽癌Ｐ５３蛋白表达阳性率为６５．２％,与粘膜慢性炎的Ｐ５３蛋白表达（１／２０）有显著性差异（Ｐ＜０．００５）,且Ｌ型阳性病人的Ｐ５３蛋白表达阳性率（７８．２％）明显高于Ｌ型阴性病人（１４．３％）,两者有显著性差异（Ｐ＜０．００５）。结果表明,细菌Ｌ型感染与突变型Ｐ５３蛋白过度表达存在着明显相关性。提示,细菌Ｌ型感染参与了Ｐ５３抑癌基因的失活,基因突变可能是细菌Ｌ型致鼻咽癌作用的机制之一。     

乙肝患者病变程度与病毒基因分型的相关性分析

目的探讨乙型肝炎（乙肝）病毒（HBV）基因分型与病变程度之间的关系。方法对165例经肝组织切片证实的急性轻型肝炎、轻度慢性肝炎（CHB）、中度慢性肝炎和重度慢性肝炎及肝硬化的乙肝患者血清进行基因分型。结果基因型以B型和C型为主,分别为12．1％和86．7％。C型中度慢性肝炎所占的百分比显著高于B型,而重度慢性肝炎在B型和C型中所占百分比差异无统计学意义;基因C型感染者HBeAg阳性率显著高于基因B型感染者,而基因C型感染者中HBeAb阳性率显著低于基因B型感染者。结论C型HBV感染和乙肝病情加重有一定关系,而B型HBV感染者预后相对较好。     

CO_2激光联合胸腺五肽治疗尖锐湿疣的临床效果分析

目的：探讨CO2激光联合胸腺五肽治疗尖锐湿疣的临床疗效。方法：将我院2010年2月-2011年8月期间收治的82例尖锐湿疣患者随机分为两组,治疗组50例采用CO2激光器治疗联合胸腺五肽肌注;对照组32例单纯采用CO2激光器治疗;两组治疗疗程结束后观察临床疗效。结果：治疗组50例,一次治愈者46例,占92%;二次治愈者4例,占8%。对照组32例,一次治愈者19例,占59.4%;二次治愈者13例,占40.6%。两组一次治愈率比较差异明显,具有统计学意义（P〈0.05）。两组术后局部轻度水肿和疼痛,无需处理1~3天缓解或痊愈。结论：CO2激光联合胸腺五肽治疗尖锐湿疣临床疗效好,并具有治疗简便,术后不良反应少,治愈率高等特点。     

CO2 激光联合胸腺五肽治疗尖锐湿疣的临床效果分析

目的:探讨CO2激光联合胸腺五肽治疗尖锐湿疣的临床疗效。方法:将我院2010年2月-2011年8月期间收治的82例尖锐湿疣患者随机分为两组,治疗组50例采用CO2激光器治疗联合胸腺五肽肌注;对照组32例单纯采用CO2激光器治疗;两组治疗疗程结束后观察临床疗效。结果:治疗组50例,一次治愈者46例,占92%;二次治愈者4例,占8%。对照组32例,一次治愈者19例,占59.4%;二次治愈者13例,占40.6%。两组一次治愈率比较差异明显,具有统计学意义(P<0.05)。两组术后局部轻度水肿和疼痛,无需处理1~3天缓解或痊愈。结论:CO2激光联合胸腺五肽治疗尖锐湿疣临床疗效好,并具有治疗简便,术后不良反应少,治愈率高等特点。     

消糜栓联合波姆仪治疗宫颈糜烂的疗效观察

目的探讨消糜栓联合波姆光治疗宫颈糜烂的疗效。方法90例病例随机分为单纯波姆光照射组（对照组）和波姆光联合消糜栓治疗组（治疗组）,每组各45例。对照组单纯用波姆光照射。治疗组术前每晚阴道置消糜栓1枚,共用7d,月经干净3～7d后用波姆光治疗,再用药14d结果对照组阴道内分泌物异常持续天数为24.5d,显著长于治疗组的15.5d（P〈0.01）,且前者伴有明显的腥臭味。术后1个疗程内对照组1次治愈39例（86.7%）,治疗组治愈45例（100%）,治疗组明显优于对照组（P〈0.05）。结论采用波姆光联合消糜栓治疗宫颈糜烂效果显著,能明显地改善单纯波姆光照射治疗后阴道分泌物异常,缩短持续时间,提高治愈率。     

CO2激光对女性外生殖系疾病的审美修复作用

应用ＣＯ２激光对５６例女性外生殖系疾患的７４个病灶地汽化治疗,效果显著,治愈率达１００％,同时对处女膜发育异常,阴唇肥大及外有黑色素痣等进行了审美修复,并对术后伤口愈合及其功能恢复进行了随访,作者对ＣＯ２激光治疗外阴疾患和审美修复的有关问题提出了见解。     

Cytophotometric studies in suspicious cervical smears.

Papanicolaou stained smears of various cervical lesions diagnosed as "suspicious" by routine cytology were reviewed with regard to different cell types leading to this diagnosis. The smears were then submitted to Feulgen hydrolysis and redyed by Acriflavin-SO2 for fluorescence-cytophotometry. In nine of 14 cases measured, the DNA content of all types of "suspicious" cells was increased with DNA modes at euploid levels of 2 n, 4 n and 8 n indicating that the "suspicious" cells in those cases are polyploid. However, in five cases aneuploid DNA-distribution patterns were found similar to those observed in carcinoma in situ or severe dysplasia. Since polyploidization may be considered as a cellular response to higher functional requirement (i.e. inflammation or regeneration) a "suspicious" cervical smear with a polyploid DNA-distribution pattern may reverse to normal cervical epithelium after normal conditions are restored. However, a "suspicious" smear with an aneuploid DNA-distribution pattern should be considered more seriously as being related to a precancerous lesion requiring immediate surgical treatment.     

AgNOR counts in cervical smears under normal and other cytopathologic conditions

OBJECTIVE: To investigate the diagnostic value of AgNOR counts in cervical smears in the process of cervical carcinogenesis and in discriminating the different grades of squamous intraepithelial lesion (SIL). STUDY DESIGN: Silver nitrate staining for AgNOR counts was performed in 50 cervical smears of cytologically diagnosed normal, inflammatory, low grade SIL (LSIL) (mild dysplasia), high grade SIL (HSIL) (moderate and severe dysplasia) and squamous cell carcinoma. The smears were derived from the ongoing routine outpatient cytology screening at Queen Mary's Hospital, Lucknow, India. RESULTS: In normal and inflammatory smears, the number of AgNOR dots varied from 1 to 2, in mild dysplasia from 2 to 4, in moderate dysplasia from 4 to 6 and in severe dysplasia from 6 to 8. Frank cervical carcinoma cases revealed 8-10 dots. Thus, a progressive increase in AgNOR counts was observed when the severity of pathologic lesions increased. Statistical analysis revealed a significant difference in AgNOR counts between normal and inflammatory smears, but it was highly significant between inflammatory and LSIL cases, between LSIL and HSIL, and between severe dysplasia and frank malignancy. CONCLUSION: This study underscored the diagnostic importance of AgNOR counts, especially in discriminating between LSIL and HSIL of the cervix. Another study is under way to assess the potentiality of AgNOR counts as tumor markers in cervical carcinogenesis.     

HLA DOA1 and DOB1 loci in Honduran women with cervical dysplasia and invasive cervical carcinoma and their relationship to human papillomavirus infection.

Molecular and epidemiological studies have demonstrated that certain types of human papillomavirus (HPV), mainly HPV-16 and HPV-18, are the primary causes of cervical cancer and its precursor lesions; there is now evidence for a clear association with specific HLA class I and class II loci contributing independently to the expression of cervical cancer. Among Honduran women carcinoma of the cervix is the most common type of cancer, and infections with high-risk HPV types are highly prevalent. To study the interactive role of viral-host genetics, we performed PCR amplification of DNA and sequence-specific oligonucleotide probe typing on cervical scrapes from 49 women [24 with cervical intraepithelial neoplasia stage III or cervical cancer (severe cases) and 25 with stage I or II cervical intraepithelial neoplasia (mild cases)] and 75 control subjects to look for possible associations between HPV and HLA class II DQA1 and DQB1 alleles in the development of dysplasias and invasive cancer. This analysis revealed a predominance of HLA-DQA1*0301 among severe-case patients [relative risk (RR) = 3.45, p = 0.008), whereas DQA1*0501 was negatively associated (RR = 0.30, p = 0.03), suggesting a protective effect of this allele. HPV typing showed a decreased relative risk among the HPV-16 or HPV-18 carrying patients and other HPV-related positive patients in the presence of DQB1*0602 compared with positive control subjects (p = 0.04). No statistically significant allele frequency difference was observed between mild dysplasia cases and control subjects. The results suggest that DQA1*03011, which is in linkage desequilibrium with all HLA-DR4 alleles, confers an increased risk for severe cervical dysplasia and invasive cancer, whereas DQA1*0501, which is in several DR52 haplotypes, has a protective effect. Furthermore, specific HLA-DQB1 sequences may be important in determining the immune response to HPV peptides and may affect the risk for cervical cancer after HPV infection in mestizo Honduran women.     

激光在喉狭窄治疗中的应用：附13例报告

采用支撑喉镜、喉造口以激光治疗喉狭窄１３例,均观察１年４个月以上。包括先天性喉蹼,声带粘连,双侧喉返神经麻痹,多发性复发性喉乳头状瘤多次手术无效,喉外伤后甲状软骨及其内结构严重破坏,继发感染伴喉腔大是一肉芽生产及瘢痕形成者。     

Presence of human papillomavirus genome in human tumor cell lines and cultured cells.

A series of 47 human carcinoma cell lines and their cultured cells were examined for human papillomavirus (HPV) genomes with the use of an HPV detection kit (DNA-RNA hybridization, mixed HPV DNA probe of types 6, 11, 16, 18, 31, 33 and 35). Four of 8 cases of mild dysplasia, 3 of 9 cases of severe dysplasia, 3 of 7 cases of carcinoma in situ, 3 of 15 cases of uterine carcinoma and 5 of 6 cases of condyloma acuminatum were shown to contain the HPV DNA genome in primary cultured cells, while HPV was not detected in the third-passage cells except for the three cases of large cell, nonkeratinizing squamous cell carcinoma. HPV was also not detected in such normal tissues as uterine cervical squamous epithelium, uterine cervical columnar epithelium and endometrium. The presence of HPV DNA genomes was detected consistently in the passages of three lines (SKG-II, HKMUS and HKTUS; large cell nonkeratinizing squamous cell carcinomas of the uterine cervix) with the use of the Southern Blot method (DNA-DNA hybridization, mixed HPV probe of types 6, 11, 16 and 18). HPV type 16 DNA was detected in HKTUS, and HPV type 18 DNA was found in SKG-II and HKMUS. The other 44 cell lines, including ovarian carcinoma, endometrial carcinoma, sarcoma, gastric cancer, pancreatic cancer and rectal cancer, were negative for the HPV-6, HPV-11, HPV-16, HPV-18, HPV-31, HPV-33 and HPV-35 genomes under stringent hybridization conditions.     

Natural history of precancerous and early cancerous lesions of the uterine cervix

A prospective study of cervical dysplasia cases and control cases matched for age and parity was undertaken in search of factors related to cervical carcinogenesis. Cytologic examination of 66,736 women revealed negative findings in 28.5%, inflammation in 70.3%, dysplasia in 1.4% and carcinoma in 0.1% of the cases. Data on epidemiologic features, cytomorphologic characteristics and serologic findings of antibodies to herpes simplex virus (HSV) were collected for proven cancer patients, dysplasia cases and control subjects. Cancer patients revealed significantly elevated antibodies to HSV as compared to the controls. The analysis revealed a higher proportion of dysplasia cases with an age at consummation of marriage of less than or equal to 15 years as compared to controls, with a relative risk of 1.5 (P less than .05). Similarly, a higher proportion of women with dysplasia had HSV-II-specific antibodies as compared to control women. The relative risk was found to be 1.3, which was not statistically significant (P greater than .05). The Mantel-Haenszel summary relative risk between antibodies to HSV and the two groups (dysplasia cases and controls), adjusted for the age at consummation of marriage, worked out to be 1.38, which was also statistically not significant (P greater than .05). The overall progression rate of dysplasia to malignancy was found to be 11.7% at the end of 54 months (during a total follow-up period of 84 months). Progression to cancer was highest in severe dysplasia cases and less in mild dysplasia cases. The progression rates were also significantly higher in the group of women who revealed antibodies to HSV II. Similar differences in the progression rates were observed with regard to the age at consummation of marriage.