简介:临床资料患者,男,46岁。主因右侧鼻腔外侧缘赘生物15d,于2010年8月就诊。患者15d前右侧鼻腔外侧缘出现赘生物,逐渐增大,无明显自觉症状。1个月前双足跖曾出现红斑、脱屑,自行外用抗真菌制剂治疗无明显好转。随后双手出现类似皮损,未消退。患者既往体健,否认输血史、介入治疗史等,有数次冶游史。其配偶未来我科就诊。各系统检查未见异常。皮肤科检查:右侧鼻腔外侧边缘见一蚕豆大小扁平丘疹(图1a),双手掌、双足跖可见铜红色圆形、弧形斑疹,边缘附黏着性鳞屑,似领圈样(图1b,1c)。肛周可见2枚黄豆大小粉红色扁平丘疹,边界清晰,基底无明显红晕,表面湿润呈细颗粒状,无糜烂、渗液,质地较柔软(图1d)。鼻部及肛周皮损行醋酸白试验颜色改变不明显。实验室检查:梅毒螺旋体明胶凝集试验(TPPA)阳性,快速血浆反应素环状卡片试验(RPR)1∶32;血清人免疫缺陷病毒(HIV)检测阴性;钳取右侧鼻翼及肛周皮损行聚合酶链反应检测人乳头瘤病毒(HPV)阴性。患者拒行组织病理检查。诊断:二期梅毒。治疗:长效青霉素240万U分两侧臀部肌内注射,每周1次,连续3次。3个月后复诊,RPR滴度1∶4,临床症状基本消退。随访至2012年9月,复查RPR阴性,TPPA阳性。
简介:Objective:Todetectandquantitategenitalherpessimplexvirus(HSV)DNAinspecimensfrom100patientsclinicallydiagnosedwithgenitalherpes.Methods:PolymeraseChainReaction(PCR)andenzyme-linkedimmunosorbentassay(ELISA)wereusedwithastandardcurveofDNAcopiesofHSVasquantitativecontrast.Results:Ninety-threecaseswereconfirmedHSVpositiveand7caseswerefoundtobenegative.Therewere58casesofHSV-2(62.4%)and35casesofHSV-1(37.6%)amongthe93positivecases.ThenumberofDNAplasmidsrangedfrom115to1.1×l0^5per250pLamongthe93positivesamples(mean=7.1×10^4/250μL).ThenumberofHSVDNAplasmidsrangedfrom136to1.1×l0^5copiesper250pL(mean=7.6×10^4)amongthosewithHSV-2,and115to9.4×10^4per250pL(mean=6.3×10^4)amongthosewithHSV-1.Meanwhile10μLofextractedanddissolvedDNArandomlytakenfrom8eachofHSV-2andHSV-1samplesweretested.ThenumberofHSV-2DNAplasmidsrangedfrom35copiesto2.7×10^4(Mean=l.8×10^4)andthenumberofHSV-1DNArangedfrom29to2.5×10^4(Mean=1.6×10^4).Inthe7negativecases,thequantityofHSVplasmidswaszero.Conclusion:ThesensitivityofELISAquantitation(93%)isequaltothatofSouthernblot.ThesensitivityofPCRfordiagnosisis91%,and88%forPCRtyping.
简介:目的:探讨雌激素与二甲双胍联合治疗青春期多囊卵巢综合征(PCOS)的临床疗效。方法:选取2014年1月至2015年11月于我院诊治的青春期PCOS患者共95例进行研究,按照随机原则分为观察组(n=48)和对照组(n=47),对照组实施雌激素单药治疗、观察组采用雌激素与二甲双胍联合治疗。比较两组患者治疗前后性激素指标、代谢指标变化情况,评价临床疗效、药物不良反应。结果:两组患者治疗后的性激素指标(T、FSH、LH、DHEAS)均较治疗前降低,SHBG水平较治疗前升高,且观察组各项指标均较对照组改善更明显(P均〈0.05);治疗后,观察组代谢指标(FBS、TG、FIN)均较治疗前、对照组明显降低,而HDL-C水平明显升高(P〈0.05);观察组和对照组的治疗总有效率分别为91.67%和72.24%,观察组高于对照组(P〈0.05);两组不良反应发生情况无明显差异(P〉0.05)。结论:对青春期PCOS患者行雌激素与二甲双胍联合治疗,患者性激素、代谢激素水平得到有效控制,临床症状明显改善,效果显著,值得推广。
简介:Objective:ToexploretherelationshipbetweenquantitativeTreponemapallidumDNA(TP-DNA)PCRtestingandtheToludineRedUnheatedSerumTest(TRUST)inpatientswithsyphilisbeforeandaftertreatment,andevaluatetheclinicalvalueofquantitativeTP-DNAtestinginthediagnosisandtreatmentevaluationofsyphilis.Methods:29patientswithprimary(12cases)orsecondary(17cases)syphilis,whometthecriteriasetforthisstudywererecruitedassubjects.Allpatientsweretreatedwith2.4millionunitsbenzathinepenicillinIMweeklyfor3weeks.QuantitativetestsofTP-DNAinthepatients'plasmawereperformedusingFQ-PCRbeforeandafterthetreatment.SerologictestsincludingTRUSTandTPPAwerealsoperformed.Results:Beforethetreatment,9outof12primarysyphilispatients(75%)andallsecondarysyphilispatients(17/17)testedpositiveforTreponemapallidum(TP)byTP-DNAtesting.TheaveragequantitativetestvaluesofTP-DNAinprimaryandsecondarysyphilispatientswere(3.38±2.34)×10^4and(5.73±1.33)×10^6copies/ml,respectively.Afterthreemonthsoftreatment,1ofthe9primaryand5outof17secondarysyphilispatientswerepositiveuponTP-DNAtesting,respectively.TheaveragequantitiesofTP-DNAwere2.01×10^2copies/mlinprimaryand5.87×10^2copies/mlinsecondarysyphilispatientswithpositiveTRUSTandTP-DNAtests,and3.09×10^2copies/mlforthosewithnegativeTRUST,respectively.Afterninemonthsoftreatment,alltheprimaryandsecondarysyphilispatientswerenegativeuponTP-DNAtesting,whileallprimaryand14of17(82.35%)secondarysyphilispatientsshowednegativeTRUSTresults.Conclusion:ThattheresultsofTP-DNAtestsarenotconsistentwiththoseofTRUSTbeforeandaftertreatmentindicatesthatquantitativeTP-DNAtestingmayhavevaluableclinicalsignificanceintheearlydiagnosisandevaluationoftreatmentregimensforsyphilis.
简介:Objectives:Todevelopamulti-nestedpolymerasechainreactioninanassaytodetectearlyTreponemapallidumandHaemophilusducreyiDNAintheswabsofgenitalulcers.Methods:Fourpairsofouterandinnerprimers,specifictothebasicmembraneproteingeneofTreponemapallidumandtothe16srRNAgeneofHducreyiweresynthesized.Themulti-nestedPCRwasdevelopedandappliedtodetectTreponemapallidumandHaemophilusdicreyiinclinicalswabs.Result:ThetwosamplesofstandardstrainsofHaemophilusducreyiandoneTreponemapallidumwereamplifiedandshowed309-bprRNAgeneofHaemophilusducreyiand506-bpDNAofTreponemapalidum,respectively.Outof51samplesofgenitalulcerdetected,29showedTreponemapallidumpositiveproductandnoHaemophilusducreyiDNAwasfound.Conclusion:Themulti-nestedPCRforTreponemapallidumandHaemophilusducreyicouldbeusefulforearlydetectionanddistinguishingdiagnosisbetweensyphilisandchancroid.
简介:目的:研究雌激素联合二甲双胍治疗青春期多囊卵巢综合症的临床效果。方法:选取2010年3月至2014年5月共120例于我院就诊的青春期多囊卵巢综合征患者,将其半随机分为研究组和对照组,其中研究组患者采用雌激素联合二甲双胍治疗,对照组患者采用雌激素补充治疗。对比两组患者空腹胰岛素变化、空腹血糖、血浆性激素变化情况。结果:两组患者FIN、FBS在治疗3个月后均有明显改善,且研究组改善明显,具有统计学差异(P<0.05);两组患者血浆性激素T、LH、FSH、LH/FSH在治疗3个月后均有下降,且研究组下降明显,具有统计学差异(P<0.05)。结论:雌激素联合二甲双胍治疗青春期多囊卵巢综合征可有效降低雄激素水平,改善患者胰岛素抵抗、卵巢功能、临床症状,效果满意。
简介:(接上期)梅毒的广泛流行和传播已成为世界各国的公共卫生问题,因此梅毒的规范化治疗也受到高度重视。2003年世界卫生组织推荐的梅毒治疗方案和2006年美国疾病控制中心梅毒治疗指南是我国在制定梅毒
简介:Objective:Todevelopasensitive,specificandsimplemethodfordetectionofextremelylownumbersofT.palliduminclinicalspecimens,asasignificantadditiontotheserologictestsforsyphilisdiagnosis.Methods:Double-tubenestedPCR(DN-PCR)andsingle-tubenestedPCR(SN-PCR)assayswereperformedtoamplifyspecificfragmentsoftheDNApolymeraseIgene(polA)ofT.pallidum.SensitivityandspecificityofthetwoPCRassaysweretested.EightysixwholebloodspecimensfrompersonswithsuspectedsyphilisweredetectedbythetwonestedPCRmethods.TheTPPAtestwasusedasacomparisonfordetectingsyphilisinserafromcorrespondingpatients.Results:OnlyspecificampliconscouldbeobtainedduringamplificationoftheT.pallidumpolAgeneandthedetectionlimitwasapproximately1organismwhenanalyzedongelbythetwoPCRmethods.Of86clinicalspecimens,62werepositivebyTPPA.Ofthese,54and51werepositivebytheDN-PCRandSN-PCR,respectively,whichdoesnotrepresentastatisticallysignificantdifferencebetweenthetwoPCRtests.Of24TPPA-negativespecimens,5werepositivebybothDN-PCRassayandSN-PCRassay.Conclusion:TheSN-polAPCRmethodisextremelysensitive,specificandeasytoperformfordetectinglownumbersofT.palliduminclinicalbloodspecimensasacomplementarytoserologyforsyphilisdiagnosis.
简介:54岁男性患者.胡蜂蛰伤9h后入院,总计蛰伤约43处.患者病情危重,出现横纹肌溶解及多脏器功能障碍综合征,给予积极抗炎、控制感染、补液及血液净化等治疗,患者康复出院.