结核

Between them 56 cases （85%） had TB of cervical lymph nodes, 4 patients had laryngeal TB, 2 patients had TB of cervical vertebrae, 2 patients had TB of middle ear, and there was l patient each of oropharynx and retropharyngeal abscess.

结果：66例病人，56例（85％）为颈淋巴结结核，4例（6％）为喉结核，2例（3％）颈椎结核，2例（3％）中耳结核，口咽结核和咽后脓肿各1例（3％）。30％的病人伴有肺或其它器官的结核；9％的病人有结核病史或为继发的结核。

Of the 8 cases, 2 cases showed blood Tb-Ab positive, 1 case was positive to antiacid bacillus of sputum, the rest cases with negative TBAb. 3 patients with 2 showed organs infection, 6 patients passed the tissue biopsy diagnose, body temperature of 6 cases fall to normal after 3-7 days of antituberculotic treatment, mild liver dysfunction appeared in 2 patients, hyperuricemia occurred in 7 patients, in addition, 1 patient developed reject reaction. Among all the cases, 7 cases healed, 1 died of pulmonary fungal infection.

其中2例血Tb-Ab，1例腹水结核抗体阳性，1例痰抗酸杆菌阳性，其余结核抗体阴性，3例患者表现为2个脏器感染，6例通过病理组织活检诊断，6例发热者在抗结核治疗3~7d体温降至正常，2例患者在治疗过程中出现轻度肝功能异常，7例出现高尿酸血症，1例出现移植肾排斥反应。8例患者7例痊愈，1例肺结核患者死于肺部真菌感染。6例发热者在抗结核治疗3~7d体温降至正常。

The results demonstrated that 22 of 50 were positive by PCR-ELISA method while only 7/50 and 18/50 by antiacid staining and culture respectively, and no positive result was found in 20 sputum specimens without Mycobacterium tuberculosis by the methods; Conclusion The pCR-ELISA method can objectively detect Mycobacterium tuberculosis from clinical specimens with high specificity and sensitivity.

对50份来自结核病人高度怀疑有结核分枝杆菌的标本检测表明，PCR-ELISA检出22份阳性，比抗酸染色法(7/50)、培养法(13/50)和PCR-电泳法(18/50)检出率高，而20份证实无结核分枝杆菌的标本，几种方法检查均为阴性。结论该法可敏感、特异和客观地检测临床标本中的结核分枝杆菌。

The inflammation reaction hyperplactic stage and lymphatic nodular stage are of nonspecific morphological changes and should be diagnosed with the help of positive tuberculin test and obvious increase of adenosine deaninase ; tuberculous nodular stage has a great number of epithelioid cells,and Langhans cells, caseous necrosis stage is characterized by a great deal of necrotic tissue and debris,a small number of fragmented epithelioid cells, and mainly by antiacid bacteria fibrinous hyperplastic stage is featured by a few fibrous tissue, cells and mucous oweing to hardness to get puncture, neans tuberculous restoration,and scar formation.

结核初期-炎性增殖期60例，占5.5%；结核早期-淋巴结节期130例，占11.9%；结核中期-结核性结节期有590例，占54.1%；结核晚期-干酪样脓样坏死期有280例，占25.7%；结核恢复期-纤维素增殖期30例，占2.8%。炎性增殖反应期非特异性形态学变化，需要结合结核抗体阳性和腺苷酸脱氨酶明显增高有助于诊断，结核结节期主要可有较多类上皮样细胞及郎罕氏细胞；而干酪样脓样坏死主要见大量坏死组织及碎屑、少数残碎不全类上皮样细胞，此期主要能查到抗酸菌为特点；纤维增殖期，抽出物难取，仅见少数纤维组织、纤维细胞和黏液间质为其特征，提示结核恢复、瘢痕形成所致。

In order to investigate new methods to the detection of Mycobacterium tuberculosis and diagnostic value of FQ-PCR in the detection of DNA in Mycobacterium tuberculosis, FQ-PCR was used to detect DNA of Mycobacterium tuberculosis in body fluid from 68 patients with tuberculosis and 68 patients without tuberculosis and it was also compared with the two methods of smear acid-fast stainning and antituberculotic antibody.

为探讨结核分枝杆菌检测的新途径及其FQ-PCR技术在结核分枝杆菌DNA诊断中的实用价值，运用FQ-PCR技术对68例结核病患者和68例非结核病患者体液进行结核分枝杆菌DNA测定，并与涂片抗酸染色及ELISA—抗结核抗体法进行比较。

Results Of this series of 25 patients, 16 cases were pathologically diagnosed as tuberculous lymphadenopathy, representing 64%( hyperplastic tuberculosis 14 cases; caseous tuberculosis 2 cases); 8 cases were sarcoidosis, representing 32%; one case was difficult to tell tuberculosis from sarcoidosis microscopically, representing 4%.

结果 本组25例患者接受纵隔镜检查，其中16例被病理诊断为纵隔淋巴结结核，占64%(其中增殖性结核14例，占88%；干酪性结核2例，占12%)；8例诊为结节病，占32%；1例难于确定为淋巴结结核或结节病，占4%。

For a classic spondylodiscitis when surgery is required for débridement and decompression, an anterior approach through an extrapleural anterolateral route or through transpleural route is recommended. Healthy posterior elements should not be jeopardized by surgery. The real control of tuberculous disease requires a serious and sustained global effort to eliminate immunocompromised states, poverty, malnutrition, and overcrowding.

述评：现在，结核有死灰复燃的趋势，在2000年前，我院治疗的脊椎结核大约80多例每年，但是到2007年，我科收治的脊椎结核病人就达200多例，分析这些患者，大部分都来自边远山区，有少不分来自城市，为什么现在结核患者这么多，个人认为与目前抗生素滥用，导致结核菌变种有一定的关系。

Results: Cultures for Mycobacterium were positive in a total of 2657 people, among them 1848 strains (69.55%) were Mycobacterium tuberculosis, and 809 strains (30.45%) were Nontuberculous Mycobacterium. Among the 1848 strains of Mycobacterium tuberculosis, 337 strains (18.24%) were drug resistant, and 75 strains (4.06%) of them were resistant to both Isoniazid and Rifampin which made them multi-drug resistant. Among the 548 strains of Nontuberculous Mycobacterium, 453 strains (82.66%) were drug resistant. There were a total of 261 rapidly growing mycobacteria, and 242 (92.72%) of them were drug resistant.

结果：分枝杆菌培养阳性共2657菌株/人，其中1848株(69.55%)为结核分枝杆菌，809株(30.45%)为非典型结核分枝杆菌感染。1848株结核分枝杆菌中，337株(18.24%)有抗药性问题，其中75株(4.06%)同时对Isoniazid和Rifampin有抗药性为多重性抗药菌。548株非典型结核分枝杆菌中453株(82.66%)有抗药性问题；快速生长菌群共261株，其中242株(92.72%)有抗药性问题。

Type-B Nodule: The source of elements in the nodules comes from slow deposition of the overlying water and the diffusion of the pore water, which comes mainly from the double decomposition reaction of Fe, Mn oxides caused by the oxidation diagenesis of organic material in sediment and its forming process and distribution is controlled by pH in the pore water. There is no corrlation between distribution of the nodules and water depth, topograph.

A型结核主要分布于深海火山沉积环境区，受上覆水Mn〓和Eh制约；B型结核一方面由于在深海火山沉积环境区，受生物作用影响，另一方面在生物沉积环境区，又受火山作用影响，使此类结核的分布与大洋地貌和沉积物的关系不明显；C型结核主要分布在太平洋CCD范围内，受沉积环境上生物和活性有机碳的制约。

Treatment of spinal tuberculosis1methods between february 1998 and august 2000 , 12 patients with spinal tuberculosis were operated with anterior vertebrectomy , bone grafting and plating1 evaluation including bone fusionrate , correction of deformity and status of spinal lesion was carried out1results in an average of ten months ,spinal tuberculosis was completely cured and solid bone fusion had taken place in all 12 patients1 the time for bone fusion averaged 518 months and the average angle of correction of kyphosis was 16°1conclusions anterior plating following vertebrectomy and bone grafting offers a complete removal of lesion and decompression of the spinal canal as well as reconstruction of spinal stability1 early rehabilitation and an increased curative rate can be expected through this procedure1

目的 探讨经脊柱前路结核病灶清除的同时植骨内固定的可行性和必要性，以及对脊柱结核的治疗效果。方法1998 年2月~2000 年8 月采用脊柱前路病椎切除加植骨，并采用orion或z-plate 钢板进行椎体固定。共治疗12 例脊柱结核，观察植骨融合及矫正畸形情况和结核病灶愈合情况。结果经平均10 个月的随访，12 例患者脊柱结核均治愈，植骨与受骨区全部骨性融合，融合时间平均为518 个月，后凸矫正角度平均16°。全组病例切口均一期愈合。无手术并发症。结论本方法可经脊柱前路作较彻底的病灶清除，并较好地进行脊柱矫形和椎管减压，完成脊柱稳定性重建，有利于患者早期离床活动和脊柱结核治愈率的提高。

The split between the two groups can hardly be papered over.

这两个团体间的分歧难以掩饰。

This approach not only encourages a greater number of responses, but minimizes the likelihood of stale groupthink.

这种做法不仅鼓励了更多的反应，而且减少跟风的可能性。