VEGF和孕酮联合检测在早期异位妊娠诊断中的价值

目的分析VEGF和孕酮联合检测对于早期妊娠患者诊断的临床价值 。方法选取2013年5月至2016年5月在本院妇产科就诊的的宫外孕患者256例作为研究组、同期在本院确诊的正常妊娠妇女260例作为对照组。联合检测两组研究对象的VEGF和孕酮含量，采用ROC曲线计算VEGF、孕酮相对值及曲线下面积，进一步分析联合检测的特异度、敏感度、准确度。结果对照组孕酮值显著高于研究组，VEGF值显著低于研究，数据的差异存在统计学意义（P<0.05）；孕酮的参考值为15.8 nmol/l，ROC曲线下面积为0.82；VEGF的参考值为238.6pg/ml，ROC曲线下面积为0.87；孕酮 VEGF的曲线下面积为0.96。研究组与对照组患者联合使用VEGF和孕酮检测的特异度、敏感度及准确度都比单独使用VEGF或孕酮高，数据的差异存在统计学意义（P<0.05）。结论联合使用VEGF和孕酮检测早期异位妊娠的特异度、敏感度及准确度都比单独使用VEGF或孕酮高，可增加早期异位妊娠患者的检出率,提高治愈率。     

VEGF和孕酮联合检测在早期妊娠诊断中的临床价值

目的研究讨论VEGF和孕酮联合检测对于早期妊娠患者诊断的临床价值。方法选取2014年6月~2016年5月在我院妇产科就诊的256例宫外孕患者(研究组)及同期在260例正常妊娠妇女(对照组)检测值进行对比分析。结果对照组孕酮值显著高于研究组,差异有统计学意义(P0.05);对照组的VEGF值则低于研究组,差异有统计学意义(P0.05)。孕酮的参考值为15.8 nmol/L,ROC曲线下面积为0.82;VEGF的参考值为238.6 pg/m L,ROC曲线下面积为0.87;孕酮+VEGF的曲线下面积为0.96。研究组与对照组患者联合使用VEGF和孕酮检测的特异度、敏感度及准确度都比单独使用VEGF或孕酮高,差异有统计学意义(P0.05)。结论联合使用VEGF和孕酮检测早期异位妊娠的特异度、敏感度及准确度都比单独使用VEGF或孕酮高,因此,在临床上,可以推广此二种检测联合的方式,以期增加早期异位妊娠患者的检出率,使患者能够及时住院治疗及终止妊娠,降低异位妊娠患者的死亡率,提高治愈率。     

血清标记物对早期异位妊娠的诊断价值

目的研究血清孕酮（P）、β-人绒毛膜促性腺激素（13-HCG）及血清激活素A（ACTA）联合检测对早期异位妊娠的诊断价值。方法回顾性分析住院及门诊就诊的83例患者,根据妊娠结局将研究对象分为宫内早孕组（45例）和异位妊娠组（38例）,通过电化学发光法检测所有患者血清P、β-HCG及ACTA,计算48h／0h β-HCG比值,ROC曲线下面积（AUC）,确定各检查指标的最佳工作点（OOP）,并评价单一或联合指标检测对异位妊娠诊断的准确性。结果异位妊娠组P（16．83±15．71）nmol／L、48h／0h β-HCG比值（1．02±0．77）和ACTA（0．26±0．15）μg/L均明显低于于正常早孕组[分别为（75．74±9．76）nmol／L,（2．53±0．34）,（0．49±0．43）μg/L]（P〈0．05）。ROC工作曲线显示,血48h／0h β-HCG比值的诊断准确度最高（AUC为0．94）,其次为P（AUC为0．91）,ACTA的诊断准确度最低（AUC为0．56）;通过ROC曲线确定各指标OOP：孕酮以31．30nmol／L,48h／0h β-HCG比值以1．25,ACTA以0．43μg/L为临界值时对诊断早期异位妊娠有较好准确度;P和β-HCG联合检测对异位妊娠诊断的敏感度（98．4％）和特异度（66．7％）均明显高于其它检测组（均P〈0．05）。结论联合检测P和48h／0hB．HCG比值可进一步提高异位妊娠诊断准确率,而ACTA对异位妊娠诊断意义不大。     

血清β-HCG和孕酮联合动态检测在异位妊娠早期诊断中的应用

目的探讨血清β—人绒毛膜促性腺激素（β—HCG）和孕酮联合检测在异位妊娠早期诊断中的应用。方法采用微粒子化学发光法分别检测84例正常妊娠（对照组）和62例异位妊娠（观察组）妇女血清β-HCG和孕酮的水平,比较两组间血清β-HCG及孕酮水平的变化。结果妊娠第4周β—HCG两组问差异无统计学意义,孕酮水平显著低于对照组（P〈0．05）;观察组第5、6周β-HCG和孕酮均显著低于对照组（P〈0．05）;观察组B—HCG和孕酮检联合检测诊断符合率明显高于单独检测β-HCG,联合检测确诊时间显著早于单独检测β-HCG（P〈0．05）。结论血清β—HCG和孕酮联合检测有助于异位妊娠的早期诊断,可提高早期异位妊娠诊断的符合率,值得临床推广应用。     

血清β-HCG及孕酮检测在异位妊娠早期诊断中的价值

目的探讨血清β-人绒毛膜促性激素（β-HCG）及孕酮检测在异位妊娠早期诊断中的价值。方法分别检测46例异位妊娠患者和48例同期宫内早期妊娠妇女的血清β-HCG和孕酮的浓度值。结果异位妊娠组血清β-HCG和孕酮低于宫内妊娠组,差异有统计学意义（P〈0.01）。以孕酮〈15ng/ml作为诊断异位妊娠的临界点,其敏感度为91.3%,特异度为93.75%,阳性预测值为93.3%,阴性预测值为91.8%。结论血清β-HCG与孕酮联合测定可提高异位妊娠早期诊断的敏感性和特异性。     

异位妊娠患者血管内皮生长因子含量变化及临床价值

目的：研究分析血管内皮生长因子（VEGF）在异位妊娠患者早期诊断中的价值。方法选取黄石市中心医院妇产科门诊2014年1月—2015年1月收集的67例异位妊娠患者（孕周﹤7周）作为异位妊娠组、同期正常妊娠者80例作为正常妊娠组,检测两组外周血 VEGF 及黄体酮（P）、人绒毛膜促性腺激素（β-hCG）的水平并进行比较,绘制受试者工作曲线（ ROC）,选取最大诊断指数时 VEGF 的临界值作为最佳诊断临界值。结果异位妊娠组血VEGF 水平显著高于正常妊娠组（P ﹤0.05）,血β-hCG、黄体酮（P）水平显著低于正常妊娠组（P ﹤0.05）。不同妊娠部位及胚胎类型异位妊娠患者 VEGF、P、β-hCG 水平存在差异（ P ﹤0.05,P ﹤0.01）。通过绘制 ROC 曲线,发现在 VEGF为50 pg / ml 的情况下,诊断异位妊娠的灵敏度为0.826、特异度为0.927,同时具有最大的 ROC 曲线下面积（ AUC）（0.918）及诊断指数（1.753）。结论外周血 VEGF 在异位妊娠患者中的表达明显上调,其检测值的变化可在一定程度上协助确诊。     

β-HCG、孕酮联合B超诊断早期异位妊娠效果

探讨血清β-HCG、孕酮检测联合阴道B超检查对于早期诊断异位妊娠的临床价值。以我院2012年1月至2016年3月收治的90例早期异位妊娠患者为观察组,另随机选择同期90例正常早孕妇女为对照组。分别对2组进行血清β-HCG、孕酮检测联合B超检查。比较2组β-HCG、孕酮值、子宫内膜厚度、诊断符合情况。观察组β-HCG、孕酮值都显著低于对照组（P＜0.05）,超声检查观察组的子宫内膜厚度显著薄于对照组（P＜0.05）。2组3项联合检测的诊断符合率显著高于单独进行一项检测（P＜0.05）。β-HCG、孕酮联合B超检测能显著提升早期异位妊娠诊断的符合率,值得在临床上推广应用。     

血清人绒毛膜促性腺激素和孕酮检测在异位妊娠早期诊断中的研究

目的探讨人绒毛膜促性腺激素和孕酮检测在异位妊娠早期诊断中的价值。方法选取2006年2月至2010年2月在淄博市妇幼保健院就诊的临床诊断为异位妊娠患者60例作为研究组;同期就诊的正常早孕患者60例作为对照1组;稽留流产患者60例作为对照2组。三组患者临床资料无差异。进行血β-HCG和孕酮检测并分析。结果血β-HCG和孕酮检测值对照1组高于研究组和对照2组（P〈0.05）,研究组和对照2组无显著差异（P〉0.05）。以异位妊娠组孕酮≤9.33ng/ml作为临界值,诊断异位妊娠的灵敏度、特异度、阳性预测价值和阴性预测价值分别为87.51%、78.92%、81.23%和71.34%。以异位妊娠组血清孕酮水平的第90百分位数9.33ng/ml联合血β-HCG2916.12mIU/ml作为临界值诊断异位妊娠,它的灵敏度、特异度、阳性预测价值和阴性预测价值分别为93.75%、63.04%、89.94%和67.06%。结论血清孕酮对异位妊娠的诊断有一定价值,联合血β-HCG和孕酮检测可以提高异位妊娠诊断的敏感性和特异性。     

降钙素原联合超敏C反应蛋白检测在新生儿细菌感染诊断中的价值

目的 探讨降钙素原（PCT）联合超敏C反应蛋白（hs-CRP）在新生儿细菌感染中的诊断价值。方法 选取2015年1月至2015年12月蚌埠医学院第二附属医院儿科确诊为新生儿感染的51例患儿为感染组,其中新生儿败血症22例,新生儿肺炎29例,另选取同期非感染性疾病新生儿60例为对照组,检测两组对象PCT及hs-CRP水平,采用SPSS 18.0统计软件分析PCT和hs-CRP浓度水平和新生儿细菌感染的关系。结果 感染组的PCT及hs-CRP水平高于对照组,差异有统计学意义（P<0.05）;PCT和hs-CRP联合诊断新生儿细菌感染的ROC曲线下面积为0.954,敏感度为94.12%,特异度为96.67%。PCT单独诊断新生儿细菌感染的ROC曲线下面积为0.871,敏感度为76.47%,特异度为91.67%。hs-CRP单独诊断新生儿细菌感染的ROC曲线下面积（AUC）为0.858,敏感度为80.39%,特异度为76.67%。结论 PCT联合hs-CRP检测对新生儿细菌感染的诊断价值较高。     

腹腔血与静脉血β-HCG与孕酮比值在诊断异位妊娠中的价值

目的探讨腹腔血与静脉血人绒毛膜促性腺激素(β-HCG)与孕酮比值在异位妊娠预测中的临床价值。方法对2013年1月-2013年12月可疑异位妊娠患者72例,应用放射免疫分析法72例异位妊娠患者静脉血和腹腔血β-HCG及孕酮进行测定对比,其中明确妊娠28例h IUP,34例所有患者均同时取腹腔积血后穹窿穿刺或术中抽取和静脉血送检,双盲测定并计算RPh CG/Vh CG以RPh CG/Vh CG>1.0为标准,诊断异位妊娠的敏感度特异度及准确度。结果异位妊娠敏感度95.7%,特异度100%,阴性预测值93.3%阳性预测值100%,腹腔血β-HCG与孕酮分别高于静脉血β-HCG与孕酮。结论可疑宫外孕患者进行静脉血和腹腔血的同时检测发现腹腔血与静脉血人绒毛膜促性腺激素(β-HCG)与孕酮比值大于1时阳性预测值可达100%。     

Synthesis,Cytotoxicity and Antileishmanial Activity of Some N-(2-(indol-3-yl)ethyl)-7-chloroquinolin-4-amines

We report herein the condensation of 4,7-dichloroquinoline (1) with tryptamine (2) and D-tryptophan methyl ester (3) . Hydrolysis of the methyl ester adduct (5) yielded the free acid (6) . The compounds were evaluated in vitro for activity against four different species of Leishmania promastigote forms and for cytotoxic activity against Kb and Vero cells. Compound (5) showed good activity against the Leishmania species tested, while all three compounds displayed moderate activity in both Kb and Vero cells.     

Lung disease and PKCs

The lung offers a rich opportunity for development of therapeutic strategies focused on isozymes of protein kinase C (PKCs). PKCs are important in many cellular responses in the lung, and existing therapies for pulmonary disorders are inadequate. The lung poses unique challenges as it interfaces with air and blood, contains a pulmonary and systemic circulation, and consists of many cell types. Key structures are bronchial and pulmonary vessels, branching airways, and distal air sacs defined by alveolar walls containing capillaries and interstitial space. The cellular composition of each vessel, airway, and alveolar wall is heterogeneous. Injurious environmental stimuli signal through PKCs and cause a variety of disorders. Edema formation and pulmonary hypertension (PHTN) result from derangements in endothelial, smooth muscle (SM), and/or adventitial fibroblast cell phenotype. Asthma, chronic obstructive pulmonary disease (COPD), and lung cancer are characterized by distinctive pathological changes in airway epithelial, SM, and mucous-generating cells. Acute and chronic pneumonitis and fibrosis occur in the alveolar space and interstitium with type 2 pneumocytes and interstitial fibroblasts/myofibroblasts playing a prominent role. At each site, inflammatory, immune, and vascular progenitor cells contribute to the injury and repair process. Many strategies have been used to investigate PKCs in lung injury. Isolated organ preparations and whole animal studies are powerful approaches especially when genetically engineered mice are used. More analysis of PKC isozymes in normal and diseased human lung tissue and cells is needed to complement this work. Since opposing or counter-regulatory effects of selected PKCs in the same cell or tissue have been found, it may be desirable to target more than one PKC isozyme and potentially in different directions. Because multiple signaling pathways contribute to the key cellular responses important in lung biology, therapeutic strategies targeting PKCs may be more effective if combined with inhibitors of other pathways for additive or synergistic effect. Mechanisms that regulate PKC activity, including phosphorylation and interaction with isozyme-specific binding proteins, are also potential therapeutic targets. Key isotypes of PKC involved in lung pathophysiology are summarized and current and evolving therapeutic approaches to target them are identified.     

Gender-related symptoms and correlates of alcohol dependence among men and women with a lifetime diagnosis of alcohol use disorders

This study explored gender-related symptoms and correlates of alcohol dependence in a crosssectional study of 150 men and 150 women with a lifetime diagnosis of alcohol use disorders (AUD). Participants were recruited in equal numbers from treatment settings, correctional centres and the general community. Standardized measures were used to determine participants' use of substances, history of psychiatric disorders and psychosocial stress, their sensation seeking and family history of substance use and mental health disorders. Multivariate analyses were used to detect patterns of variables associated with gender and the lifetime severity of AUD. Men had a longer history of severe AUD than women. Women had similar levels of alcohol dependence and medical and psychological sequelae as men, despite 6 fewer years of AUD. More women than men had a history of severe psychosocial stress, severe dependence on other substances and antecedent mental health problems, especially mood and anxiety disorders. There were differences in family history of alcohol-related problems approximating same-gender aggregation. The severity of a lifetime AUD was predicted by its earlier age at onset and the occurrence of other disorders, especially anxiety, among both men and women. The limitations in the generalizability of these findings due to sample idiosyncrasies are discussed.     

Biochemical and molecular characterisation of cubozoan protein toxins

Class Cubozoa includes several species of box jellyfish that are harmful to humans. The venoms of box jellyfish are stored and discharged by nematocysts and contain a variety of bioactive proteins that are cytolytic, cytotoxic, inflammatory or lethal. Although cubozoan venoms generally share similar biological activities, the diverse range and severity of effects caused by different species indicate that their venoms vary in protein composition, activity and potency. To date, few individual venom proteins have been thoroughly characterised, however, accumulating evidence suggests that cubozoan jellyfish produce at least one group of homologous bioactive proteins that are labile, basic, haemolytic and similar in molecular mass (42-46 kDa). The novel box jellyfish toxins are also potentially lethal and the cause of cutaneous pain, inflammation and necrosis, similar to that observed in envenomed humans. Secondary structure analysis and remote protein homology predictions suggest that the box jellyfish toxins may act as α-pore-forming toxins. However, more research is required to elucidate their structures and investigate their mechanism(s) of action. The biological, biochemical and molecular characteristics of cubozoan venoms and their bioactive protein components are reviewed, with particular focus on cubozoan cytolysins and the newly emerging family of box jellyfish toxins.     

Dose tolerability of chronically inhaled voriconazole solution in rodents

Invasive pulmonary aspergillosis (IPA) is a fungal disease of the lung associated with high mortality rates in immunosuppressed patients despite treatment. Targeted drug delivery of aqueous voriconazole solutions has been shown in previous studies to produce high tissue and plasma drug concentrations as well as improved survival in a murine model of IPA. In the present study, rats were exposed to 20 min nebulizations of normal saline (control group) or aerosolized aqueous solutions of voriconazole at 15.625 mg (low dose group) or 31.25 mg (high dose group). Peak voriconazole concentrations in rat lung tissue and plasma after 3 days of twice daily dosing in the high dose group were 0.85 ± 0.63 μg/g wet lung weight and 0.58 ± 0.30 μg/mL, with low dose group lung and plasma concentrations of 0.38 ± 0.01 μg/g wet lung weight and 0.09 ± 0.06 μg/mL, respectively. Trough plasma concentrations were low but demonstrated some drug accumulation over 21 days of inhaled voriconazole administered twice daily. Following multiple inhaled doses, statistically significant but clinically irrelevant abnormalities in laboratory values were observed. Histopathology also revealed an increase in the number of alveolar macrophages but without inflammation or ulceration of the airway, interstitial changes, or edema. Inhaled voriconazole was well tolerated in a rat model of drug inhalation.