D-二聚体、抗凝血酶Ⅲ、凝血因子Ⅷ、凝血因子Ⅸ检测对肝脏疾病诊断的意义

目的 研究凝血因子、抗凝血酶Ⅲ（AT-Ⅲ）活性和D-二聚体（D-D）含量测定对肝脏疾病的诊断意义.方法 对126例肝脏疾病患者和30例健康体检者的血浆样本用免疫比浊法测定D-二聚体含量,用凝固法测定凝血因子Ⅷ和Ⅸ活性;用发色底物法检测抗凝血酶Ⅲ活性.结果肝癌组和肝硬化组血浆D-二聚体含量与健康对照组比较显著升高（P＜0.05）,而肝炎组与健康对照组比较差异无统计学意义（P＞0.05）;不同类型肝病患者凝血因子Ⅷ活性与健康对照组相比较显著升高（P＜0.05）,肝癌组凝血因子Ⅸ活性与健康对照组比较有显著升高（P＜0.01）,肝炎组和肝硬化组凝血因子Ⅸ活性与健康对照组比较差异无统计学意义（P＞0.05）,抗凝血酶Ⅲ与健康对照组相比均显著降低（P＜0.01）.结论 D-二聚体含量、凝血因子Ⅷ活性增加和抗凝血酶Ⅲ活性降低是肝病患者疾病发展的敏感性指标,而凝血因子Ⅸ活性可能只是反映肝癌疾病的敏感指标.     

中重度烧伤合并脓毒血症患者TFPI、TF、TNF-α的变化

目的通过测定中重烧伤合并脓毒血症患者组织因子途径抑制物（TFPI）、组织因子（TF）和肿瘤坏死因子-α（TNF-α）的水平,了解TFPI、TF、TNF-α与感染及其严重程度的关系。方法选取中重度烧伤合并脓毒血症患者30例（烧伤组）,按病程的前后分为：感染前期组（烧伤后72 h～7 d内）;感染后期组（感染后期组,烧伤后10～14 d）。选取同期健康献血员20例（对照组）。用酶联免疫吸附法测定各组TFPI、TF、TNF-α水平。结果与对照组比较,感染前期组TFPI、TF及TNF-α抗原含量明显升高（P〈0.0...     

疼痛护理干预对ICU重症患者谵妄发生情况、疼痛因子、应激因子的影响

目的研究疼痛护理干预对ICU重症患者谵妄发生情况、疼痛因子、应激因子的影响。方法选择2018年7月—2021年6月本院ICU收治的80例患者为研究对象,按照随机数字表法分为试验组与对照组,每组各40例。对照组采用常规疼痛干预,试验组采用疼痛护理干预,观察两组的谵妄发生情况及疼痛控制情况,比较两组入ICU时、出ICU时的疼痛因子水平(血清去甲肾上腺素、多巴胺、5-羟色胺)和应激因子水平(丙二醛、超氧化物歧化酶、谷胱甘肽过氧化物酶)。结果试验组的谵妄发生率小于对照组,谵妄持续时间短于对照组(P<0.05);试验组的疼痛控制优良率大于对照组(P<0.05);出ICU时,试验组的血清去甲肾上腺素、多巴胺、5-羟色胺水平均低于对照组,试验组的血清丙二醛水平低于对照组,超氧化物歧化酶和谷胱甘肽过氧化物酶的水平高于对照组(P<0.05);结论疼痛护理干预可有效缓解ICU重症患者的疼痛,抑制疼痛因子的分泌,改善应激因子水平,预防谵妄的发生。     

肺癌与转录因子cJun、cFos、AP-1

cJun、cFos、AP－1作为转录因子,与细胞的增殖与分化密切相关。在肿瘤的促癌和演进过程中起关键的调节作用。深入研究AP－1、cJun、cFos在肺癌中的表达,有助于探索肺癌的诊断和防治都有极大的进步,但效果不能令人满意,因此,进一步探索肺癌的发病机理,为肺癌的防治提供一些科学依据。     

胃癌患者血浆组织因子、组织因子途径抑制物的检测及其临床意义

近年来研究发现，组织因子（TF）和组织因子途径抑制物（TFPI）与恶性肿瘤的发生、发展有重要关系，TF在体内许多细胞均能表达，多种癌细胞亦能表达和分泌，与肿瘤的血管生长和转移有关。我们报道胃癌患者血浆中TF和TFPI的水平变化，并对其临床意义进行探讨：     

血清TNF-α、cTn I、MIF在病毒性心肌炎的诊断效果评估

目的探究血清肿瘤坏死因子-α(TNF-α)、心肌肌钙蛋白I(cTn I)、巨噬细胞游走抑制因子(MIF)在病毒性心肌炎(VMC)中的诊断效果评估价值。方法分析乌鲁木齐第一人医院2018年5月至2020年5月收治的136例VMC患者临床资料,纳入研究组;选取同期来本院进行健康体检的120例患者作为健康对照组,对比两组患者血清TNF-α、cTnI、MIF水平,采用受试者工作特征(ROC)曲线分析 TNF-α、cTnI、MIF 水平诊断 VMC 的价值。结果观察组患者 TNF-α(113.41±15.69)、cTnI(0.60±0.15)、MIF(68.38±14.49)水平均显著高于健康对照组(67.28±10.36、0.15±0.04、33.15±5.74)差异有统计学意义(P<0.05);TNF-α、cTnI、MIF 诊断 VMC 的 AUC 依次为 0.918、0.920、0.931,敏感度依次为 86.8%、91.9%、86.8%,特异度依次为93.3%、90.8%、92.5%,cTnI水平诊断价值最高(P<0.05)。结论 TNF-α、cTnI、MIF水平对VMC均具有较高的诊断价值且cTnI诊断价值最高,三者联合诊断病毒性心肌炎具有较高准确度,可为病毒性心肌炎的临床诊断提供科学依据。     

右美托咪定对缺血缺氧性脑损伤新生大鼠脑组织中TNF-α、IL-1β、NGF、BDNF表达的影响

目的观察右美托咪定对缺血缺氧性脑损伤(HIBD)新生大鼠皮层和海马组织中损伤因子肿瘤坏死因子(TNF-α)、白细胞介素-1β(IL-1β)及抗损伤因子神经生长因子(NGF)、脑源性神经营养因子(BDNF)表达的影响,初步探讨右美托咪定的神经保护机制。方法将45只7日龄SD大鼠,随机分为3组:假手术组,缺血缺氧组和右美托咪定组。缺血缺氧组和右美托咪定组新生大鼠建立HIBD动物模型,假手术组仅分离左侧颈总动脉,不结扎也不做缺氧处理。右美托咪定组于建立模型后立即按100μg/kg腹腔注射右美托咪定,假手术组和缺血缺氧组注射等量生理盐水。24 h后全部处死,采用ELISA法检测脑组织中TNF-α、IL-1β、NGF、BDNF水平。结果缺血缺氧组新生大鼠皮层和海马组织中TNF-α、IL-1β、NGF、BDNF水平高于假手术组;右美托咪定组的TNF-α、IL-1β水平低于缺血缺氧组,而NGF、BDN水平则高于缺血缺氧组,差异均具有统计学意义(P<0.05或P<0.01)。结论右美托咪定可保护新生大鼠缺血缺氧后引起的皮层和海马损伤,其作用机制可能与抑制损伤因子TNF-α、IL-1β表达和促进抗损伤因子NGF、BDNF表达相关。     

川崎病患儿血清chemerin、omentin-1、APN、IL-1β、TNF-α水平检测及其意义

目的:探讨川崎病(KD)患儿血清脂肪因子chemerin、网膜素-1(omentin-1)、脂联素(APN)、白细胞介素1β(IL-1β)、肿瘤坏死因子α(TNF-α)水平检测及其意义。方法:选取2015-06—2018-06期间收治的KD患儿98例作为KD组,同期选取体检中心健康儿童30例作为健康组,检测所有儿童血清chemerin、omentin-1、APN、IL-1β、TNF-α水平并分析其与意义。结果:KD组血清chemerin、IL-1β、TNF-α水平明显高于健康组,KD组血清omentin-1、APN水平明显低于健康组,差异有统计学意义(P0.05);KD组中,急性期患儿血清chemerin、IL-1β、TNF-α水平明显高于亚急性期患儿,急性期患儿血清omentin-1、APN水平明显低于亚急性期患儿,冠脉损伤(CAL)患儿血清chemerin、IL-1β、TNF-α水平明显高于无CAL患儿,CAL患儿血清omentin-1、APN水平明显低于无CAL患儿,差异有统计学意义(P0.05);Logistic分析结果显示,血清chemerin、omentin-1、APN、IL-1β、TNF-α水平是KD患儿急性期及CAL发生的独立影响因素(P0.05)。结论:KD患儿存在较为严重的脂质代谢紊乱及炎症反应,且急性期及CAL患儿的脂质代谢紊乱及炎症反应更严重,提示chemerin、omentin-1、APN、IL-1β、TNF-α可作为评估KD发生发展的重要指标。     

CHD-PAH患儿CFHR2、T-bet mRNA、CF6的变化及其意义

目的探讨先天性心脏病(CHD)相关的肺动脉高压(PAH)患儿血清补体因子H相关蛋白2(CFHR2)、偶联因子-6(CF6)及外周血单核细胞转录因子T-bet mRNA的变化及其意义。方法选取我院2014年2月-2017年5月收集的CHDPAH患儿60例(CHD-PAH组)、CHD未合并PAH患儿70例(CHD组),检测并比较两组患儿的血清CFHR2、CF6及T-bet mRNA,并按照PAH程度将患儿分为轻度组、中度组及重度组进行亚组分析,并分析上述指标CHD-PAH患儿手术前后的变化。结果 CHD-PAH患儿的血清CFHR2、T-bet mRNA水平显著的低于CHD组患儿(P0.05);血清CFHR2、CF6及T-bet mRNA水平鉴别诊断CHD-PAH患儿与CHD患儿的ROC曲线下面积AUC值分别为0.837、0.747、0.706;CHD-PAH患儿的CF6水平显著的高于CHD组患儿(P0.05);轻度、中度CHD-PAH患儿的血清CFHR2、T-bet m RNA水平显著的高于重度CHD-PAH组患儿(P0.05);轻度、中度CHD-PAH患儿的CF6水平显著的低于重度CHD-PAH组患儿(P0.05);手术后1周,CHD-PAH患儿的血清CFHR2、T-bet mRNA水平显著的较术前升高(P0.05);CF6水平较手术前显著的降低(P0.05)。结论 CHD-PAH患儿血清CFHR2、T-bet mRNA低于单纯CHD患儿,CF6水平高于单纯CHD患儿,并且与肺动脉高压严重程度具有一定的关系。     

Effect of 5-fluorouracil, mitoxantrone, methotrexate, and vincristine on the antibacterial activity of ceftriaxone, ceftazidime, cefotiam, piperacillin, and netilmicin

Using the checkerboard agar dilution technique, antibacterial activity and in vitro interactions of 4 antineoplastic agents and 5 antimicrobial drugs were examined against 56 strains of 7 bacterial species. 5-fluorouracil was found to inhibit all strains of Staphylococcus aureus and of Staphylococcus epidermidis at a concentration of 0.8 micrograms/ml or less. 84% of all gram-negative strains were inhibited synergistically when 5-fluorouracil was combined with beta-lactam antibiotics. Methotrexate and cefotiam were antagonistic in 42% of all combinations, especially when tested against Escherichia coli and Klebsiella pneumoniae.     

Aluminum, iron, lead, cadmium, copper, zinc, chromium, magnesium, strontium, and calcium content in bone of end-stage renal failure patients.

BACKGROUND: Little is known about trace metal alterations in the bones of dialysis patients or whether particular types of renal osteodystrophy are associated with either increased or decreased skeletal concentrations of trace elements. Because these patients are at risk for alterations of trace elements as well as for morbidity from skeletal disorders, we measured trace elements in bone of patients with end-stage renal disease. METHODS: We analyzed bone biopsies of 100 end-stage renal failure patients enrolled in a hemodialysis program. The trace metal contents of bone biopsies with histological features of either osteomalacia, adynamic bone disease, mixed lesion, normal histology, or hyperparathyroidism were compared with each other and with the trace metal contents of bone of subjects with normal renal function. Trace metals were measured by atomic absorption spectrometry. RESULTS: The concentrations of aluminum, chromium, and cadmium were increased in bone of end-stage renal failure patients. Comparing the trace metal/calcium ratio, significantly higher values were found for the bone chromium/calcium, aluminum/calcium, zinc/calcium, magnesium/calcium, and strontium/calcium ratios. Among types of renal osteodystrophy, increased bone aluminum, lead, and strontium concentrations and strontium/calcium and aluminum/calcium ratios were found in dialysis patients with osteomalacia vs the other types of renal osteodystrophy considered as one group. Moreover, the concentrations of several trace elements in bone were significantly correlated with each other. Bone aluminum was correlated with the time on dialysis, whereas bone iron, aluminum, magnesium, and strontium tended to be associated with patient age. Bone trace metal concentrations did not depend on vitamin D intake nor on the patients' gender. CONCLUSIONS: The concentration of several trace elements in bone of end-stage renal failure patients is disturbed, and some of the trace metals under study might share pathways of absorption, distribution, and accumulation. The clinical significance of the increased/decreased concentrations of several trace elements other than aluminum in bone of dialysis patients deserves further investigation.     

Comparative in vitro activities of XRP 2868, pristinamycin, quinupristin-dalfopristin, vancomycin, daptomycin, linezolid, clarithromycin, telithromycin, clindamycin, and ampicillin against anaerobic gram-positive species, actinomycetes, and lactobacilli

A comparative study of the in vitro activities of XRP 2868, a new oral streptogramin, against 266 anaerobic gram-positive clinical isolates using the agar dilution method showed that the XRP 2868 MICs for 95% (254 of 266) of isolates were < or =0.5 microg/ml. XRP 2868 MICs for only two strains, one being Clostridium clostridioforme (MIC, 16 microg/ml) and the other being Clostridium difficile (MIC, 32 microg/ml), were >2 microg/ml. Depending on its pharmacokinetics and pharmacodynamics, XRP 2868 has potential for use against infections with gram-positive anaerobes and deserves further clinical evaluation.     

Susceptibilities of non-Pseudomonas aeruginosa gram-negative nonfermentative rods to ciprofloxacin, ofloxacin, levofloxacin, D-ofloxacin, sparfloxacin, ceftazidime, piperacillin, piperacillin-tazobactam, trimethoprim-sulfamethoxazole, and imipenem.

Agar dilution MICs of 10 agents against 410 non-Pseudomonas aeruginosa gram-negative nonfermentative rods were determined. MICs at which 50 and 90% of the isolates were inhibited, respectively, were as follows (in micrograms per milliliter): sparfloxacin, 0.5 and 8.0; levofloxacin, 1.0 and 8.0; ciprofloxacin, 2.0 and 32.0; ofloxacin, 2.0 and 32.0; D-ofloxacin, 32.0 and > 64.0; ceftazidime, 8.0 and 64.0; piperacillin with or without tazobactam, 16.0 and > 64.0; trimethoprim-sulfamethoxazole, 0.5 and > 64.0; imipenem, 2.0 and > 64.0. With the exception of those for Stenotrophomonas maltophilia, Burkholderia cepacia, and Alcaligenes faecalis-A. odorans, agar dilution MICs for all strains tested were within 1 dilution of inhibitory (bacteriostatic) levels as determined by time-kill methodology.     

In vitro activity of piperacillin, ticarcillin, mezlocillin, ticarcillin-clavulanic acid, aztreonam, ceftazidime, azlocillin, cefoperazone, and thienamycin against Pseudomonas aeruginosa

The in vitro susceptibility of 103 well-characterized strains of Pseudomonas aeruginosa to nine antimicrobial agents was assessed by means of the Kirby-Bauer disk diffusion assay and the microtiter minimal inhibitory concentration assay. The antimicrobials, from the most to the least active against P aeruginosa, were thienamycin greater than ceftazidime greater than piperacillin greater than azlocillin greater than cefoperazone greater than aztreonam greater than ticarcillin greater than ticarcillin-clavulanic acid greater than mezlocillin. The resistance patterns of the antimicrobial agents suggest that P aeruginosa resistant to a penicillin, cephalosporin, or aztreonam may be susceptible to thienamycin.