血miR-24表达与重症肺炎患儿病情及预后的关系

目的 探讨血miR-24表达与重症肺炎患儿病情及预后的关系。方法 选取2017年3月至2020年3月苏州高新区人民医院收治的72例重症肺炎患儿为重症组，120例普通肺炎患儿为轻症组；本院同期健康体检的150名健康儿童为对照组。采用qRT-PCR法检测3组对象外周静脉血miR-24表达水平，采用急性生理与慢性健康状况评价Ⅱ（APACHEⅡ）、序贯器官衰竭（SOFA）评分评价肺炎患儿病情，根据治疗后1周疗效（显效和有效均归为有效）评估重症肺炎患儿预后。比较3组对象血miR-24表达水平及APACHEⅡ、SOFA评分，分析重症肺炎患儿3项指标的相关性，比较重症组不同预后患儿3项指标，采用ROC曲线分析3项指标单独及联合检测对重症组患儿预后的预测效能。结果 3组对象血miR-24表达水平及APACHEⅡ、SOFA评分比较，差异均有统计学意义（均P<0.05）。重症组患儿血miR-24表达水平与APACHEⅡ、SOFA评分均呈负相关（r=-0.785、-0.315，均P<0.05）。重症组有效患儿血miR-24表达水平明显高于无效患儿（P<0.05），而APACHEⅡ、SOFA...     

血清淀粉样蛋白A、白细胞介素-35及可溶性髓样细胞触发受体-1诊断脓毒症患者中的价值

目的:探讨血清淀粉样蛋白A(SAA)、白细胞介素-35(IL-35)、可溶性髓样细胞触发受体-1(sTREM-1)诊断脓毒症患者的价值.方法:选取确诊的脓毒症患者110例(脓毒症组),全身炎症性反应综合征(SIRS)患者110作为对照组;检测两组的SAA、IL-35及sTREM-1水平,采用受试者工作曲线(ROC)分析三项指标鉴别诊断脓毒症与SIRS患者价值.结果:脓毒症组患者的SAA、IL-35及sTREM-1测定值及APACHEⅡ评分、SOFA评分均高于对照组,差异有统计学意义(P<0.05);严重脓毒症患者的SAA、IL-35及sTREM-1测定值及APACHEⅡ评分、SOFA评分均高于脓毒症患者,差异有统计学意义(P<0.05);SAA鉴别诊断脓毒症与SIRS患者的灵敏度为78.56％、特异度为85.29％、ROC曲线下面积AUC值为0.821;IL-35鉴别诊断脓毒症与SIRS患者的灵敏度为68.34％、特异度为78.09％、ROC曲线下面积AUC值为0.742;sTREM-1鉴别诊断脓毒症与SIRS患者的灵敏度为91.17％、特异度为80.66％、ROC曲线下面积AUC值为0.875;SAA、IL-35及sTREM-1联合应用诊断脓毒症与SIRS患者的灵敏度为96.44％、特异度为87.18％、ROC曲线下面积AUC值为0.926.结论:脓毒症组患者的SAA、IL-35及sTREM-1水平较SIRS患者升高显著,病情与患者病情程度有关,早期检测这三项指标对于鉴别诊断脓毒症与SIRS患者有一定的价值.     

血清SP-D、IL-17、IL-33与重症肺炎患儿肺损伤程度的关系及判断预后的价值

目的 探讨血清肺泡表面活性物质蛋白D(surfactant protein D,SP-D)、白细胞介素-17(inteleukin-17,IL-17)、白细胞介素-33(inteleukin-33,IL-33)水平与重症肺炎患儿肺损伤程度及预后的关系。方法 选取笔者医院2018年4月～2021年2月收治的148例重症肺炎患儿作为病例组,70例健康儿童作为对照组进行临床研究。比较两组儿童血清SP-D、IL-17、IL-33水平,并分析3项指标与病例组患儿急性肺损伤评分、急性生理与慢性健康评分(APACHE Ⅱ)的相关性,以及在重症肺炎患儿治疗结局中的预测价值。结果 病例组血清SP-D、IL-17、IL-33水平显著高于对照组(P<0.05)。病例组儿童治愈出院121例,死亡27例。治愈组患儿的血清SP-D、IL-17、IL-33水平,APACHEⅡ、LPS评分均低于死亡组患儿(P<0.05)。重症肺炎患儿血清SP-D、IL-17、IL-33水平与APACHEⅡ、LPS评分均呈正相关(P<0.05)。血清SP-D、IL-17、IL-33预测患儿的治疗结局的AUC值分别为0.712、0.803、0.877。结论 血清SP-D、IL-17、IL-33水平能在一定程度上反映重症肺炎患儿肺损伤及病情的严重程度,对于患儿治疗结局有一定的预测价值。     

血清25羟维生素D与新生儿感染性肺炎的关系研究

目的　探讨血清25羟维生素D〔25-（OH）D〕水平与新生儿感染性肺炎的关系。方法　选取2015年8月—2017年7月在郑州大学第二附属医院入住新生儿重症监护室的患有感染性肺炎的新生儿65例,根据病情严重程度分为轻症肺炎组34例、重症肺炎组31例;另于同期在本院收集健康新生儿60例为对照组。比较3组血清25-（OH）D、钙离子（Ca2+）、降钙素原（PCT）、C反应蛋白（CRP）、白介素6（IL-6）水平;采用Spearman秩相关分析感染性肺炎患儿血清25-（OH）D水平与血清Ca2+、PCT、CRP、IL-6水平的相关性。结果　3组血清Ca2+水平比较,差异无统计学意义（P>0.05）;3组血清25-（OH）D、PCT、CRP、IL-6水平比较,差异有统计学意义（P<0.05）。其中,轻症肺炎组、重症肺炎组血清25-（OH）D水平低于对照组,血清PCT、CRP、IL-6水平高于对照组,差异有统计学意义（P<0.05）;重症肺炎组血清25-（OH）D水平低于轻症肺炎组,血清PCT、CRP、IL-6水平高于轻症肺炎组,差异有统计学意义（P<0.05）。感染性肺炎患儿的血清PCT、IL-6水平与血清25-（OH）D水平呈负相关（rs值分别为-0.434、-0.315,P<0.05）;血清Ca2+、CRP水平与血清25-（OH）D水平无相关关系（rs值分别为-0.053、-0.184,P>0.05）。结论　感染性肺炎患儿的血清25-（OH）D水平较低,且病情较重者的水平更低,监测血清25-（OH）D水平在新生儿感染性肺炎的病情评估中具有一定临床价值。     

学龄前支原体肺炎患儿病情严重程度与白介素-4、白介素-6、白介素-8、肿瘤坏死因子-α水平相关性分析

目的分析支原体肺炎患儿病情严重程度与白介素-4(IL-4)、白介素-6(IL-6)、白介素-8(IL-8)、肿瘤坏死因子-α(TNF-α)水平相关性。方法选取2020年1月至2021年6月郑州大学附属儿童医院接收的94例支原体肺炎学龄前患儿进行分析。根据肺炎严重指数(PSI)程度评分为普通支原体肺炎58例(普通组),重症支原体肺炎36例(重症组)。另选取94名健康体检的学龄前儿童作为对照组。检验三组儿童血清IL-4、IL-6、IL-8、TNF-α水平。对学龄前支原体肺炎患儿采用PSI评估病情严重程度,分析IL-4、IL-6、IL-8、TNF-α水平与学龄前支原体肺炎患儿病情严重程度的相关性及诊断价值。结果普通组儿童PSI评分(78.45±9.57)分低于重症组儿童的(103.84±9.75)分(P<0.05)。三组儿童血清IL-4、IL-6、IL-8、TNF-α水平比较差异有统计学意义(P<0.05)。IL-4、IL-6、IL-8、TNF-α水平与支原体肺炎患儿PSI评分均呈正相关(P<0.05)。受试者工作特征曲线(ROC)曲线分析可知,IL-4的曲线下面积(AUC)值为0.753,IL-6的AUC值为0.736,IL-8的AUC值为0.747,TNF-α的AUC值为0.711(P<0.05)。结论IL-4、IL-6、IL-8、TNF-α水平与支原体肺炎患儿病情严重程度具有相关性,可用于学龄前支原体肺炎患儿病情的辅助诊断。     

结缔组织病间质性肺病患者血清25(OH)D和IL-32水平变化及其检测价值分析

目的 检测结缔组织病间质性肺病（CTD-ILD）患者血清25-羟维生素D[25(OH)D]、白细胞介素-32(IL-32)水平,并分析其与患者病情活动、肺功能关系。方法 选取2019年6月-2020年12月三二〇一医院风湿免疫科或呼吸与危重症学科收治的200例初发CTD患者,根据是否合并ILD分为CTD-ILD组73例、单纯CTD组127例;另选取同期50名健康体检者为对照组。采用荧光免疫层析法检测血清25(OH)D水平,酶联免疫吸附试验法检测IL-32水平。比较3组血清指标[类风湿因子（RF）阳性率、抗核抗体（ANA）阳性率、C反应蛋白（CRP）、红细胞沉降率（ESR）、25(OH)D、IL-32]及肺功能;分析不同病情活动CTD-ILD患者血清25(OH)D、IL-32表达情况;采用Spearman相关分析法探究CTD-ILD患者血清25(OH)D、IL-32与临床指标及肺功能相关性;绘制受试者工作特征（ROC）曲线探究血清25(OH)D、IL-32对CTD-ILD诊断价值。结果 CTD-ILD组、单纯CTD组、对照组血清CRP分别为（22.08±7.71）、（15.79±5.86...     

老年危重症患者血清维生素D水平与APACHEⅡ评分和预后的相关性分析

目的 探讨老年危重患者血清1,25羟-维生素D3[1,25（OH）2D3]水平与急性生理功能和慢性健康状态Ⅱ（APACHE Ⅱ）评分及预后的相关性.方法 将196例老年危重患者按APACHE Ⅱ评分分为A组（APAC HE Ⅱ≤15）、B组（16≤APACHE Ⅱ≤25）和C组（APACHEⅡ＞25）,根据转归分为死亡组与存活组,分析APACHEⅡ评分与血清1,25（OH）2D3及院内死亡率的相关性.结果 A组血清1,25（OH）2D3水平和院内病死率与B组和C组差异均有统计学意义（均P＜ 0.05）;B组血清1,25（OHhD3水平和院内病死率与C组差异均有统计学意义（均P＜ 0.05）.存活组血清1,25（OH）2D3水平明显高于死亡组（P＜0.01）,血清1,25（OH）2D3水平与APACHE Ⅱ评分呈负相关（r=-0.458,P＜0.05）,与院内病死率呈负相关（r=-0.871,P＜0.05）.结论 老年危重患者血清1,25（OH）2D3水平低下提示病情危重且不良预后可能性增加.     

下呼吸道感染儿童血清25-羟基维生素D水平的变化及意义

目的:探究血清25-羟基维生素D[25-(OH)D]水平变化在下呼吸道感染患儿中的意义,为今后婴幼儿下呼吸道感染的防治提供依据。方法:选取下呼吸道感染患儿310例,按病情分为重症肺炎组、普通肺炎组,另选取健康婴幼儿100例为健康组,对比三组血清25-(OH)D水平。结果:治疗前,重症肺炎组婴幼儿平均血清25-(OH)D为(51.47±16.98)nmol/L,为三组最低,其次为普通肺炎组(63.47±18.26)nmol/L,三组比较差异有统计学意义(P<0.05);重症肺炎组中36.67%患儿血清25-(OH)D水平<50 nmol/L,Vit D缺乏率为三组最高,其次为普通肺炎组(26.88%),三组比较差异有统计学意义(P<0.05)。结论:血清25-(OH)D水平可用于儿童下呼吸道感染风险评估,患儿血清25-(OH)D水平越低,病情越重。     

25-（OH）D3 和IL-17 在不同严重程度哮喘 患儿血清中的表达及其临床意义

目的 探讨25-（OH）D3 和白细胞介素-17（IL-17）在不同严重程度哮喘患儿血清中的表达及 其临床意义。方法 选取2016 年10 月—2018 年12 月海口市人民医院收治的哮喘患儿224 例作为研究组,根 据研究组患儿不同病情分为轻度间歇组68 例、轻度持续组52 例、中度持续组59 例和重度持续组45 例。选 取该院同期健康体检儿童50 例作为对照组。分别检测各组血清25-（OH）D3 和IL-17 水平;同时采用儿童 哮喘控制测试评分系统（C-ACT）进行哮喘病情评分。比较各组血清25-（OH）D3 和IL-17 水平,分析血清 25-（OH）D3、IL-17 水平与C-ACT 评分的相关性。结果 观察组血清IL-17 水平高于对照组（P <0.05）, 而血清25-（OH）D3 水平低于对照组（P <0.05）。轻度间歇组、轻度持续组、中度持续组和重度持续组血清 IL-17、25-（OH）D3 水平和C-CAT 评分比较,经方差分析,差异有统计学意义（P <0.05）;从轻度间歇组、 轻度持续组、中度持续组到重度持续组,血清IL-17 水平呈上升趋势（P <0.05）,而血清25-（OH）D3 水平 和C-CAT 评分呈下降趋势（P <0.05）。Pearson 相关性分析显示,观察组患儿血清IL-17 与C-CAT 评分呈 负相关（r =-0.825,P =0.006）,而血清25-（OH）D3 水平与C-CAT 评分呈正相关（r =0.917,P =0.008）。 结论 哮喘患儿血清25-（OH）D3 水平降低,血清IL-17 水平升高,且指标变化情况与病情有相关性。早期 检测25-（OH）D3 和IL-17 水平,对哮喘早期诊断、病情及预后评估具有重要临床意义。     

血清淀粉样蛋白A和白细胞介素-6对脓毒症诊断及病情严重程度评估的临床价值

  目的  探究血清淀粉样蛋白A(SAA)、白细胞介素-6(IL-6)对脓毒症诊断及病情严重程度评估的意义。  方法  选取2020年10月1日—2021年5月31日蚌埠医学院第一附属医院重症医学科的患者80例,观察患者入科24 h内的SAA、IL-6、降钙素原(PCT)、C反应蛋白(CRP)、急性生理学和慢性健康状况评价Ⅱ(APACHEⅡ)评分及序贯性器官功能衰竭估计(SOFA)评分。根据脓毒症诊断标准将80例患者分为非脓毒症组(25例)和脓毒症组(55例),通过ROC曲线评估SAA、IL-6对脓毒症的诊断效能,利用Spearman分析探究SAA、IL-6与APACHEⅡ评分、SOFA评分的相关性。根据脓毒性休克诊断标准将55例脓毒症患者分为普通脓毒症组(25例)和脓毒性休克组(30例),评估SAA、IL-6对病情严重程度的判断价值。  结果  诊断脓毒症的ROC曲线示,IL-6的灵敏度和特异度(94.4%、63.4%)较高;联合应用时, SAA联合PCT的特异度(95.8%)最高;IL-6联合CRP的灵敏度(100.0%)最高。SAA、IL-6与APACHEⅡ评分、SOFA评分均呈正相关。评估病情程度的ROC结果示,SAA单独应用以及IL-6联合PCT的特异度(均为80.0%)最高,SAA联合PCT的灵敏度(96.0%)最高。  结论  SAA、IL-6可作为评估脓毒症病情严重程度的有效标志物,IL-6也可以辅助脓毒症的早期诊断,两者与PCT、CRP联合应用后可提高临床价值。      

Value of D-Dimers in patients with acute aortic dissection

Objective: To evaluatel the value of D-dimers in patients with acute aortic dissection (AAD). Methods: This study consisted of 16 patients with AAD and 27 non-AAD patients. Serum D-dimets were measured by Sta-Liatest D-DI immunoturbidimetric assay. Results: D-dimer level was higher (P ＜ 0.001) in patients with AAD(7.91 ± 5.52 μg/ml) than that in non- AAD group(1.57±1.24 μg/ml). D-dimer was positive (＞0.4 μg/ml) in all patients with AAD and in 10 control group patients (37%). Among patients with acute AAD, D-dimers tended to be higher in Stanford A than in Stanford B (8.67 ± 4.31 μg/ml vs. 3.24±1.27 μg/ml, P ＜0.01). D-dimer values tended to be higher in more extended disease(3.84 ± 1.65 μg/ml, 8.57 ± 3.58 μg/ml and 11.87 ± 5.69 μg/ml in thoracic aorta, thoracic and abdominal aorta, thoracic and abdominal aorta and iliacal arteries, respectively, P ＜ 0.05 for both 8.57 ± 3.58 and 11.87 ± 5.69 vs. 3.84 ± 1.65 ). Including the control group into the analysis, we found a sensitivity of 100%, a negative predictive value of 100%, and a specificity of 66% and a positive predictive value of 64% for D-dimer in diagnosis of AAD in our patients with suspected AAD. Conclusion: D-dimer was elevated in patients with AAD. A negative D-dimer test result could be useful in excluding AAD.     

Research of combined liver-kidney transplantation model in rats

Objective： To set up a simple and reliable rat model of combined liver-kidney transplantation. Methods： SD rats served as both donors and recipients. 4℃ sodium lactate Ringer＇s was infused from portal veins to donated livers,and from abdominal aorta to donated kidneys, respectively. Anastomosis of the portal vein and the inferior vena cava （IVC） inferior to the right kidney between the graft and the recipient was performed by a double cuff method, then the superior hepatic vena cava with suture. A patch of donated renal artery was anastomosed to the recipient abdominal aorta. The urethra and bile duct were reconstructed with a simple inside bracket. Results： Among 65 cases of combined liver-kidney transplantation, the success rate in the late 40 cases was 77.5%. The function of the grafted liver and kidney remained normal. Conclusion： This rat model of combined liver-kidney transplantation can be established in common laboratory conditions with high success rate and meet the needs of renal transplantation experiment.     

BLOOD PRESSURE CHANGE WITH AGE IN SALT-SENSITIVE TEENAGERS

Objective To observe blood pressure change with age in salt-sensitive teenagers whose salt sensitivity were determined by repeated testing.Methods Salt sensitivity was determined through intravenous infusion of normal saline combined with volume-depletion by oral diuretic furosemide in 55 teenagers. After five years, salt sensitivity was re-examined and subject blood pressure was followed up. Blood pressure changes in salt-sensitive teenagers were compared to that of non-salt sensitive teenagers over five years.Results After 5 years, the repetition rate of salt sensitivity determined by intravenous saline loading is 92.7%. In teenagers with salt sensitivity on the baseline, both the systolic blood pressure increments and increment rates were much higher than non-salt sensitive teenagers (12.7±12.1 mmHg vs. 2.8±5.2 mmHg, P＜ 0.01; 12.2%± 12.0% vs. 2.5% ±4.4%, P＜ 0.001,respectively). There was a similar trend for diastolic blood pressure (8.4 ± 6.4 mmHg vs. 3.7 ± 6.4 mmHg, P = 0.052; 13.2% ±10.6 % vs. 6.8%± 10.1%, P = 0.053, respectively).Conclusions Salt sensitivity determined by intravenous saline loading showed good reproducibility. Blood pressure increments with age were much higher in salt-sensitive teenagers than non-salt sensitive teenagers, especially in terms of systolic blood pressure.     

Development on Adjustable Calibration Marker for Shock Wave Focus

Shock wave lithotripsy （SWL） is a treatment of choice for upper urinary stones. However, this procedure is inappropriate for obese patients because the focus is often unable to reach the target owing to the limited focal distance in shock wave source. Although treating such patients in a blast path may increase the application length of shock wave source, it＇s difficult to find this path on the lithotripter monitor. For this reason, we invented an adjustable calibration marker in order to set an effective focus in the shock wave hath.     

Study on the TCM Pathogenesis of Angiopathic Complications of Type II Diabetes

Excess production of reactive oxygen species(ROS)of mitochondrion mediated by hyperglycemia is the common pathogenesis of angiopathic complications of diabetes.TCM holds that the damp from the dysfunction of spleen.kidney and liver is the causative factor of complications of diabetes.This is similar to the mechanism of Ros resulting in angiopathic complications of diabetes.When the angiopathic complications of type II diabetes mellitus(T2DM)are difierentiated as caused by turbid damp in TCM can be explained as ROS.Since the obstruction of pathogenic damp in channels and collaterals is said to be the main pathogenesis,the treating principle should be dissolving the damp to remove the obstruction.     

Leptin, Ghrelin and TNF-α before and after Hypo-caloric Traditional Chinese Diet and Auricular Acupuncture

INTRODUCTION Obesity is a complex emergent problem, which can be possibly solved not only by the diet but also by the life style and promotion of a constant physical exercise. 1, 2 No doubt careful attentions must be given to the nutritional condition of obese people, the dietary habits, the somatic build (i.e. distribution of fat mass) and the organic functions linked to formation of the fat mass. All the parameters should be constantly monitored before, during and after a diet treatment. 3, 4, 5     

Relationship between Dysglycemia and Carotid Atherosclerosis in Tibetan Population

People with dysglycemia are at high risk for atherosclerotic diseases. This study aims at investigating the atherosclerotic vascular damage in dysglycemia and its metabolic origin in Tibetan population.     

APPLICATION OF LORNOXICAM TO PATIENT-CONTROLLED ANALGESIA IN PATIENTS UNDERGOING ABDOMINAL SURGERIES

FOR anesthesiologis s ,treatingpostoperativepainhas alwaysbeen a problem.Althoughopioidshave been provedtobe effective,theirsideeffectscouldnotbeignored.With thedevelopmentofscienceand pharmacology,many drugs with aspectsof satisfactoryanalgesicefficacyand couldbe welltoleratedby patientshave been developed.And lornoxicamisone of them, which isa non-steroidalanti-inflammatorydrug (NSAID ), with analgesic, anti-infl-ammatory,andantipyreticproperties.Itseliminationhalf-time(3 to 5 hours) isle…     

安心颗粒对急诊经皮冠状动脉介入术后生活质量影响的研究

目的：评价使用安心颗粒对急诊经皮冠状动脉介入术（PPCI）术后生活质量的影响.方法：将160例接受PPCI的急性ST段抬高型心肌梗死患者随机分为安心颗粒组（术前顿服安心颗粒8.8g,术后安心颗粒4.4 g/次,每日2次）和对照组（仅接受基础药物治疗）.所有患者均服用阿司匹林、氯吡格雷和阿托伐他汀.分别在入院时、出院前1d、出院后180 d时,应用心肌梗死多维度量表（MIDAS）、中文版SF-36评价量表对患者生活质量评分.并观察术后30 d以内的出血并发症、血小板减少症发生情况.结果：入院时和出院前1d,两组患者的心肌梗死MIDAS、SF-36量表评分比较无差异（P＞0.05）;出院后180 d时,与对照组比较,安心颗粒组MIDAS、SF-36评分明显减低（P＜0.05）;组内与入院时比较,两组出院前1d、出院后180 d时,MIDAS、SF-36评分均降低（P＜0.05）.两组患者在随访期间均无大量出血、少量出血、重度和极重度血小板减少症发生,安心颗粒组有4例、对照组有7例发生不明显出血（P＞0.05）.两组发生轻度血小板减少症的患者数比较无差异（P＞0.05）.结论：PPCI使用安心颗粒,能改善急性ST段抬高型心肌梗死患者的生活质量,且不增加出血风险.     

CLINICAL SIGNIFICANCE OF SERUM CYTOKINES IL-1β,sIL-2R,IL-6,TNF-α,AND IFN-v IN ACUTE CORONARY SYNDROME

Objectives To explore serum cytokines levels (including IL-1 β, sIL-2R, IL-6, TNF-α, and IFN-v) and their significance in patients with acute coronary syndrome (ACS) and the subsequent follow-ups, with attempt to estimate the role of various serum inflammatory markers in the diagnosis and assessment of ACS.Methods The study population include 40 patients with acute myocardial infarction (AMI), 40 patients with unstable angina pectoris (UAP), and 40 controls. Among the 80 patients, 60 patients attended a follow up 4 months later. Serum inflammatory markers including IL-1 β, sIL-2R, IL-6, TNF-α, and IFN-v were measured by enzyme linked immunosorbent assay.Results Serum IL- 1 β, sIL-2R, IL-6, TNF-α were significantly higher in AMI group or UAP group compared to the control group and became significantly lower 4 months later in the follow-up patients. Serum levels of IFN-v shows no significant difference between AMI group or UAP group and controls, also showing no significant change when measured in follow up patients. There was no correlation between serum creatine kinase-MB isoenzyme levels and serum inflammatory markers either in UAP or AMI group. Furthermore, when divided into two subgroups using Wagner's QRS scoring system in the AMI group, there is no difference of each serum inflammatory marker between ≤ 6 scores group and ＞ 6 scores group.Conclusion Serum levels of certain inflammatory markers may have some diagnostic value for ACS, and can be a useful marker reflecting disease stability.