实验家兔莱姆病血液学研究

本实验复制了莱姆病实验家兔模型，对血液生化23项进行了动态观察。结果表明，血液中谷丙转氨酶、γ-谷氨酰转肽酶、乳酸脱氢酶、谷草转氨酶、β-羟丁酸脱氢酶、磷酸肌酸激酶、胆固醇、尿素氮随病情加重而升高。葡萄糖、尿酸、磷随病情加重而减低。     

Multivariate modelling of responses to conditional items: New possibilities for latent class analysis

Questionnaire data may contain missing values because certain questions do not apply to all respondents. For instance, questions addressing particular attributes of a symptom, such as frequency, triggers or seasonality, are only applicable to those who have experienced the symptom, while for those who have not, responses to these items will be missing. This missing information does not fall into the category ‘missing by design’, rather the features of interest do not exist and cannot be measured regardless of survey design. Analysis of responses to such conditional items is therefore typically restricted to the subpopulation in which they apply. This article is concerned with joint multivariate modelling of responses to both unconditional and conditional items without restricting the analysis to this subpopulation. Such an approach is of interest when the distributions of both types of responses are thought to be determined by common parameters affecting the whole population. By integrating the conditional item structure into the model, inference can be based both on unconditional data from the entire population and on conditional data from subjects for whom they exist. This approach opens new possibilities for multivariate analysis of such data. We apply this approach to latent class modelling and provide an example using data on respiratory symptoms (wheeze and cough) in children. Conditional data structures such as that considered here are common in medical research settings and, although our focus is on latent class models, the approach can be applied to other multivariate models. Copyright © 2009 John Wiley & Sons, Ltd.     

不同孕期阶段孕妇凝血四项及FDP和D-二聚体的变化及临床意义

目的:研究不同孕期阶段(早、中、晚)孕妇凝血四项、血浆纤维蛋白(原)降解产物[plasma fibrin/fibrinogen degradation products, FDP]、D-二聚体的变化及临床意义,为临床诊疗提供理论支持。方法:回顾性分析2021年1月至2021年12月200例孕妇就诊资料中的凝血四项,纤维蛋白原(fibrinogen, FIB)、凝血酶原时间(prothrombin time, PT)、凝血酶时间(thrombin time, TT)、活化部分凝血活酶时间(activated partial thromboplastin time, APTT)。并对FDP与D-二聚体的检测结果进行统计分析,比较孕早期、中期、晚期三个阶段凝血四项、FDP和D-二聚体水平的变化。结果:孕早期、孕中期与孕晚期PT水平比较,差异有统计学意义(P<0.05);孕早期、孕中期与孕晚期三个阶段的TT相比,差异无统计学意义(P>0.05);孕早期的APTT明显长于中期、晚期孕妇,差异有统计学意义(P<0.05);孕早期、中期、晚期孕妇,随着孕周的增加,FIB水平逐渐升高...     

Multiple Copies of the Upstream Regulatory Region of the Major Capsid Protein Gene of Bacteriophage MB78 Inhibit Phage Morphogenesis

The 2.311 kb EcoRI F fragment of bacteriophage MB78 has been cloned in multicopy vectors pUC19 and pCR90. Salmonella typhimurium strains carrying such plasmids cannot support development of phage MB78 while other Salmonella phages like P22 and 9NA grow normally. Most of the phage MB78 induced functions are normal in such transformed hosts but proper maturation of the phage particles does not take place. Deletion of 138 bp from the 3 end of the cloned fragment reverses the inhibitory effect. Analysis of nucleotide and the deduced amino acid sequence of a 1.2 kb HindIII-SalI fragment of the phage genome which overlaps the 138 bp confirms that this part contains the upstream regulatory region of the major structural protein gene. It seems that in presence of multiple copies of the upstream regulatory region (which includes a number of promoter like sequence) of the coat protein gene, the maturase gene is down regulated and this is effective only in cis, a situation quite similar to that of Q RNA phages.     

Isolation and characterisation of a defective measles virus from a subacute sclerosing panencephalitis patient.

A cytopathic measles virus was isolated from a brain biopsy of a subacute sclerosing panencephalitis (SSPE) patient. The agent could be transferred to Vero cells by cocultivation, but the infectivity always remained cell-associated -ie, a defective virus infection. The cell-associated nature of the virus was retained through 25 passages in Vero cells. Intracerebral inoculation of hamsters (2-6 days old) with the cocultured Vero cells gave rise to 100% mortality in 5-7 days. The virus retained its cell-associated nature after passage in hamsters. Electron microscopy of the brain and Vero cocultures showed the presence of virus-like ribonucleoparticles mainly in the nucleus. The presence of viral antigens in the nucleus, cytoplasm, and on the plasma membranes was confirmed by immunofluorescence. Using a combination of immunological and biochemical techniques, it was shown that all the viral proteins were synthesized with the exception of the haemagglutinin. Inclusion of the fusion inhibitor SV4814 (CBZ-D phenylalanine-L-phenylalanine-L-arginine-NO2) in the culture medium led to the elimination of the SSPE infection.     

部分手术类项目标准成本分析

对6个手术类医疗服务项目进行了标准成本测算,分析了其成本构成,并与全国的实际成本平均水平进行了比较。建议政府以标准成本作为调整医疗服务价格的依据,同时,建议医院在加强手术室成本管理时应着重加强医用材料的管理。     

ABC分类法在医疗用品库存管理中的应用

结合医院库存用品的特点和特殊的经营性质,在阐述重点库存控制-ABC分类法的思想和操作步骤的基础上,提出了该方法在医院实际应用中应该注意的问题.     

Peroperative scoring systems for predicting the outcome of cytoreductive surgery in advanced-stage ovarian cancer – A systematic review

The extent of peritoneal metastases (PM) largely determines the possibility of complete or optimal cytoreductive surgery in advanced ovarian cancer. An objective scoring system to quantify the extent of PM can help clinicians to decide whether or not to embark on CRS. Therefore several scoring systems have been developed by different research teams and this review summarizes their performance in predicting a complete or optimal cytoreduction in patients with advanced ovarian cancer. A systematic search in the MEDLINE database revealed 19 articles that described a total of five main scoring systems to predict the completeness of CRS in patients with FIGO stage III-IV ovarian cancer based on the surgical exploration of the abdominal cavity; PCI, PIV, Eisenkop, Espada, and Kasper. The Peritoneal Cancer Index (PCI) and the Predictive Index Value (PIV) were mentioned most frequently and showed AUCs of 0.69–0.92 and 0.66–0.98, respectively. Due to the use of different cut-offs sensitivities and specificities greatly varied. Therefore with the current data, no scoring system could be identified as best. An objective measure of the extent of disease can be of great clinical use for identifying ovarian cancer patients for which a complete (or optimal) CRS is achievable, however due to local differences in treatment strategies and surgical policy a widely adopted objective scoring system with a standard cut-off value is not feasible. Nevertheless, objective scoring systems can play an important role to guide treatment decisions.     

有丝分裂阻滞缺陷基因异常在肿瘤中的研究进展

纺锤体组装检验点（ Spindle assembly checkpoint ，SAC）是机体有丝分裂的重要监控机制，能够监控着丝点与微管之间的连接，确保染色体正确分离。有丝分裂阻滞缺陷家族蛋白（ Mitotic arrest defi-cient protein，Mad）作为SAC的重要组成部分，其主要在正常有丝分裂过程中发挥作用。 Mad家族基因突变或蛋白表达异常可能导致染色体异常分离，在促使肿瘤发生、预示肿瘤预后不良、化疗药物耐药等方面都起到一定作用。     

慢性乙型肝炎患者病毒复制与肝纤维化五项联合检测的临床应用

目的探讨慢性乙型肝炎患者乙型肝炎病毒(HBV)DNA复制与肝纤维化五项指标:透明质酸(HA)、Ⅲ型前胶原N端肽(PⅢPN)、Ⅳ型胶原(CⅣ)、层粘连蛋白(LN)、甘胆酸(CG)联合检测的临床意义。方法选取2018年7月至2019年9月在汉川市人民医院确诊的慢性乙型肝炎患者109例为研究对象,选取40例健康体检者为对照组,按HBV DNA的载量,将研究对象分为低载量组(104copy/mL)39例,中载量组[(104～106)copy/mL]33例,高载量组(106copy/mL)37例,对照组(500 copy/mL)40例。分别检测HBV DNA和肝纤维化五项,采用SPSS 19.0统计学软件对数据进行统计分析。结果低载量组和中载量组肝纤五项检测结果与对照组比较,差异无统计学意义(P0.05);高载量组肝纤五项检测结果与对照组比较,差异有统计学意义(P0.05)。随着HBV DNA载量的增加,肝纤五项各检测指标的数值也在增加。肝纤五项(HA、PⅢPN、CⅣ、LN、CG)的ROC曲线下面积(AUC)分别为0.556、0.763、0.742、0.420、0.695,其中PⅢPN的AUC最大,表明PⅢPN比其他指标对肝脏疾病的诊断准确率最高;LN的AUC最小,0.5,表明其单独诊断的准确率低。结论 HBV DNA载量与血清肝纤维化五项指标联合检测是慢性乙型肝炎患者病情监测的一个良好指标,临床应及时关注慢性乙型肝炎患者病毒复制与肝纤维化水平,延缓肝硬化的发生。