不同厂家结晶紫中性红胆盐琼脂培养基的质量比较

结晶紫中性红胆盐琼脂(VRBA)培养基用于食品大肠菌群检验中的平板计数法。为了选出质量较好的VRBA培养基用于日常检验,对实验室中常用的三个厂家的培养基从一般性状、pH值、生长率、选择性、菌落生长情况等方面进行比较。实验结果表明,三个厂家的VRBA培养基中,VRBA-1质量最优。

总胆红素、总胆汁酸、前白蛋白三项检测在肝脏疾病诊断中的价值

目的探讨总胆红素、总胆汁酸、前白蛋白三项检测在肝脏疾病诊断中的价值。方法选择不同肝病患者142例,其中急性肝炎患者41例(急性肝炎组);慢性肝炎患者63例(慢性肝炎组);肝硬化患者38例(肝硬化组);并选取50例体检健康者进行研究(健康者组)。对患者的前白蛋白(prealbumin,PA)、总胆汁酸(total bile acid,TBA)及总红胆素(total red bile pigment,TB)对于肝脏疾病的诊断阳性率进行判定。结果 PA值在慢性肝炎组的阳性率为86%,肝硬化组为92%,与健康组比较,差异有统计学意义(P<0.05);TBA在急性肝炎组的阳性率为93%,在慢性肝炎组、肝硬化组与健康组的比较,差异有统计学意义(P<0.05);TB在急性肝炎组与健康组比较,差异有统计学意义(P<0.05)。结论 PA、TBA、TB的测定在各种肝脏疾病的诊断和鉴别中起着显著作用,具有很高的临床价值。

中药对急性重症胆管炎血清铁蛋白和总胆红质的影响

目的 :探讨中药对急性重症胆管炎血清铁蛋白和总胆红质的影响。方法 :将 3 2只 Wistar大鼠分为对照组、造模组、减压组、中药组 ,每组 8只。分别测定各组中血清铁蛋白和总胆红质的浓度。结果 :减压组和中药组的血清铁蛋白和总胆红质的浓度明显下降。结论 :中药治疗能明显降低血清铁蛋白和总胆红质的浓度。

大肠埃希氏菌平板计数法存在的技术性问题探讨

本文综述了大肠埃希氏菌结晶紫中性红胆盐-4-甲基伞形酮葡萄糖醛酸苷琼脂平板计数法的建立背景、原理、优缺点,以期对该方法有更全面深入的认识,在此基础上对该方法存在的技术性问题进行了探讨,并提出了改进策略,以期为方法修订提供参考,从而更准确地进行食品中大肠埃希氏菌的计数。

酷似病毒性肝炎的胆源性肝损害102例临床分析

笔者在２０年的临床工作中，发现诊断为病毒性肝炎的一部分病例虽具备肝炎的一般症状、体征，甚至部分实验室依据，但经仔细询问病史、观察肝脏体征与肝功能的动态变化、Ｂ超检查等，确认并非病毒性肝炎，而是胆道感染所致的胆源性肝损害。经抗感染与中药治疗获得显著疗效...

超高压与微酸性电解水结合对鲜切果蔬的杀菌效果研究

鲜切果蔬由于切割等操作,表面遭到破坏,极易受到微生物的侵染,引起品质劣变。为了延长鲜切果蔬的货架期,通过单因素实验探究微酸性电解水的有效氯浓度、用量,超高压处理的压力、保压时间等对鲜切胡萝卜的杀菌效果,从而得到二者结合处理的工艺条件:微酸性电解水有效氯质量浓度为30 mg/L,用量200 m L;超高压压力范围为100~400 MPa,保压时间5 min,总处理时间为15 min。实验以鲜切胡萝卜、鲜切苹果为研究对象,采用脑心浸液琼脂培养基和结晶紫中性红胆盐琼脂培养基对大肠杆菌进行检测,以微酸性电解水替代高压过程中无菌水的方式,探究超高压与微酸性电解水结合的杀菌效果,结果表明结合处理能提高其杀菌效率,但在低压下,增强效果并不显著,400 MPa增强效果最为显著。超高压400 MPa与微酸性电解水结合处理时,鲜切胡萝卜在2种培养基中均没有检出大肠杆菌,而鲜切苹果在脑心浸液琼脂培养基中仍有少量大肠杆菌检出。同时对比BHIA和VRBA的实验结果发现:微酸性电解水有明显的致死效应;而超高压处理则同时存在亚致死和致死效应。

应用茜素-β-D-半乳糖苷快速检验食品中的大肠菌群

用茜素 β D 半乳糖苷琼脂和行标SNO16 9- 1992指定的结晶紫中性红胆盐琼脂 (VRBA)对比检测 13种相关标准菌株和 70份食物样品。二者对标准菌株的检测结果完全一致 ,对食物样品检测结果的符合率也较接近。大肠菌群在茜素 β D 半乳糖苷琼脂中 2 4h内可长成较大的鲜明红色 ,轮廓清晰 ,易于辨认 。

晚期血吸虫病鉴别诊断计量法应用的进一步研究

计量诊断法诊断晚期血吸虫病,是具临床实用价值的辅助诊断方法。我们的初步研究已作报道,为进一步评价其敏感性、特异性,现又以肝活检病理诊断肝硬变的黄金标准为依据,进行对比验证。

天门冬氨酸鸟氨酸治疗中、重度黄疸型慢性肝炎的临床疗效观察

目的观察天门冬氨酸鸟氨酸治疗黄疸型慢性肝炎的临床疗效。方法将148例黄疸型慢性肝炎患者随机分为两组,分别接受4周的天门冬氨酸鸟氨酸、天门冬氨酸钾镁治疗,并检测治疗前后的血清总胆红素(TBIL)、丙氨酸氨基转移酶(ALT)及天门冬氨酸氨基转移酶(AST)。结果天门冬氨酸鸟氨酸组降低血清TBIL的有效率为74.3%,天门冬氨酸钾镁组为31.1%,差异有统计学意义(P<0.01)。结论注射用天门冬氨酸鸟氨酸粉针剂能有效降低黄疸型慢性肝炎患者的血清TBIL、ALT及AST。

VRBA 和3M Petrifilm^(TM)快速测试片定量检测 大肠菌群的性能比较研究

为补充结晶紫中性红胆盐琼脂(violet red bile agar,VRBA)和3M Petrifilm^(TM)大肠菌群快速测试片定量检测大肠菌群的性能数据,文中比较了VRBA和测试片对大肠菌群4种目标菌的分离与定量效果,观察目标菌菌落特征及生长率;同时对4种非目标菌进行选择性试验;以及进行质控样品和能力验证样品的检测。结果表明,VRBA和测试片的检测性能均可满足大肠菌群的定量检测要求。VRBA定量检测大肠菌群应严格按照国标方法进行,有助于提高检验结果的准确性,避免漏检。基于测试片的快速简便性,建议作为日常检验的辅助手段。

乙胺丁醇致肝损害1例报告

乙胺丁醇(Ethambutol)引起肝损害,国内外文献尚少报道,笔者近来遇见1例,报告如下。刘××,女,48岁,农民。因咳嗽、潮热,盗汗1月,咯血2天,于1988年3月中旬到某院就诊。X线胸片示右肺上浸润型肺结核,痰抗酸杆菌涂片(+),肝功能及血尿常规均正常。

哪些情况会出现皮肤黄染和眼黄

皮肤黄染和眼黄通常是由黄疸引起，也可因其他原因造成。

Prognostic factors in patients with advanced cholangiocarcinoma: Role of surgery, chemotherapy and body mass index

AIM： To study the factors that may affect survival of cholangiocarcinoma in Lebanon. METHODS： A retrospective review of the medical records of 55 patients diagnosed with cholangio- carcinoma at the American University of Beirut between 1990 and 2005 was conducted. Univariate and multivariate analyses were performed to determine the impact of surgery, chemotherapy, body mass index, bilirubin level and other factors on survival. RJ^SULTS： The median survival of all patients was 8.57 mo （0.03-105.2）. Univariate analysis showed that low bilirubin level （〈 10 mg/dL）, radical surgery and chemotherapy administration were significantly associated with better survival （P = 0.012, 0.038 and 0.038, respectively）, in subgroup analysis on patients who had no surgery, chemotherapy administration prolonged median survival significantly （17.0 mo vs 3.5 mo, P = 0.001）. Multivariate analysis identified only low bilirubin level 〈 10 mg/dL and chemotherapy administration as independent predictors associated with better survival （P 〈 0.05）. CONCLUSION： Our data show that palliative and postoperative chemotherapy as well as a bilirubin level 〈 10 mg/dL are independent predictors of a significant increase in survival in patients with cholangiocarcinoma.

Effect of preoperative biliary drainage on surgical results after pancreaticoduodenectomy in patients with distal common bile duct cancer:Focused on the rate of decrease in serum bilirubin

AIM: To examine if the rate of decrease in serum bilirubin after preoperative biliary drainagecan be used as a predicting factor for surgical complications and postoperative recovery after pancreaticoduodenectomy in patients with distal common bile duct cancer.METHODS: A retrospective study was performed in 49 consecutive patients who underwent pancrea-ticoduodenectomy for distal common bile duct cancer. Potential risk factors were compared between the complicated and uncomplicated groups. Also, the rates of decrease in serum bilirubin were compared pre- and postoperatively. RESULTS: Preoperative biliary drainage (PBD) was performed in 40 patients (81.6%). Postoperative morbidity and mortality rates were 46.9% (23/49) and 6.1% (3/49), respectively. The presence or absence of PBD was not different between the complicated and uncomplicated groups. In patients with PBD, neither the absolute level nor the rate of decrease in serum bilirubin was significantly different. Patients with rapid decrease preoperatively showed faster decrease during the first postoperative week (5.5 ± 4.4 μmol/L vs -1.7 ± 9.9 μmol/L, P = 0.004).CONCLUSION: PBD does not affect the surgical outcome of pancreaticoduodenectomy in patients with distal common bile duct cancer. There is a certain group of patients with a compromised hepatic excretory function, which is represented by the slow rate of decrease in serum bilirubin after PBD.

Gilbert's syndrome: High frequency of the (TA)_7 TAA allele in India and its interaction with a novel CAT insertion in promoter of the gene for bilirubin UDP-glucuronosyltransferase 1 gene

AIM： To identify the variants in U rase 1 （UGT1A1） gene in Gilbert＇s syndrome （GS） and to estimate the association between homozygosity for TA insertion and GS in India, as well as the frequency of TA insertion and its impact among normal controls in India. METHODS： Ninety-five GS cases and 95 normal controls were selected. Liver function and other tests were done. The promoter and all 5 exons of UGT1A1 gene were resequenced. Functional assessment of a novel trinucleotide insertion was done by in silico analysis and by estimating UGT1A1 promoter activity carried out by ludferase reporter assay of appropriate constructs in Hep G2 cell line. RESULTS： Among the GS patients, 80% were homozygous for the TA insertion, which was several-fold higher than reports from other ethnic groups. The mean UCB level was elevated among individuals with only one copy of this insertion, which was not significantly different from those with two copies. Many new DNA variants in UGT1A1 gene were discovered, including a trinucleotide （CAT） insertion in the promoter found in a subset （10%） of GS patients, but not among normal controls. In-silico analysis showed marked changes in the DNA-folding of the promoter and functional analysis showed a 20-fold reduction in transcription efficiency of UGT1A1 gene resulting from this insertion, thereby significantly elevating the UCB level. CONCLUSION： The genetic epidemiology of GS is variable across ethnic interactions among UGT1A1 groups and the epistatic promoter variants modulate bilirubin glucuronidation.

Evaluation of prognostic markers in severe drug-induced liver disease

AIM: To analyze the outcome of patients with severe drug-induced liver disease (DILD) associated with jaundice classified as hepatocellular, cholestatic or mixed liver injury and to evaluate the validity of Hy’s rule and the most important predictors for outcome. METHODS: The Adverse Drug Reaction Advisory Committee was set up in 1997 in our hospital to identify all suspicions of DILD following a structured prospective report form. Liver damage was divided into hepatocellular, cholestatic, and mixed types according to laboratory and histologic criteria when available. Further evaluation of causality assessment was performed. RESULTS: From January 1997 to December 2004, 265 patients were diagnosed with DILD,and 140 (52.8%) of them were female. hepatocellular damage was the most common (72.1%), the incidence of death was 9.9% in patients with hepatocellular damage and 9.5% in patients with cholestatic/mixed damage (P < 0.05). There was no difference in age of dead and recovered patients. The proportion of females and males was similar in recovered and dead patients, no difference was observed in duration of treatment between the two groups. The serum total bilirubin (P < 0.001), direct bilirubin (P < 0.001) and aspartate transaminase (AST) (P = 0.013) values were higher in dead patients than in recovered patients. Chinese herbal medicine was the most frequently prescribed, accounting for 24.2% of the whole series. However, antitubercular drugs (3.4%) were found to be the primary etiological factor for fetal DILD. Factors associated with the development of fulminanthepatic failure were hepatic encephalopathy (OR = 43.66, 95% CI = 8.47-224.95, P < 0.0001), ascite (OR = 28.48, 95% CI = 9.26-87.58, P < 0.0001), jaundice (OR = 11.43, 95% CI = 1.52-85.96, P = 0.003), alcohol abuse (OR = 3.83, 95% CI = 1.26-11.67, P = 0.035) and direct bilirubin (OR = 1.93, 95% CI = 1.25-2.58, P = 0.012). CONCLUSION: Death occurs in 9.8% of patients with DILD. Chinese herbal medicine stands out as the most common drug for DILD. While antitubercular drugs are found to be the primary etiological factor for fetal DILD, hepatic encephalopathy, ascites, jaundice, alcohol abuse and direct bilirubin levels are associated with the death of DILD patients.