脓毒血症并发急性肾损伤早期诊断标志物的研究

Objective To investigate the accuracy of NGAL in prediction of acute kidney injury (AKI) complicated by sepsis. Methods Blood and urine samples were collected at different time points in 74 sepsis patients, and 17 AKI patients were got from them.Cysteine Cys C levels were detected with Latex enhanced turbidimetric immunoassay (LETIA). Urine NGAL and Scr levels were detected with solid-phase sandwich enzyme-linked immunosorbent assay and creatinine enzymatic assay respectively. At the same time, 57 non-AKI patients were set as controls. Dynamic changes of urine NGAL and Scr were observed in sepsis patients in test and control group. ROC curve was used to evaluate the performance of AKI diagnosis by urinary NGAL.Results The Scr base line was (59. 38 ±16. 72) μmol/L.The median time of diagnose of AKI was 24 (12, 48) h past-sepsis diagnosis, while the Scr was(100. 35± 28. 26) μmol/L. Of the group, 17 cases of sepsis were diagnosed with AKI, accounting for 23% (17/74) prevalence. In sepsis group, base line value[(0. 61 ± 0. 15) mg/L] of serum Cys C was not upregulated at 2, 4 and 6 h, which was (0. 63 ± 0. 14) mg/L, (0. 68 ± 0. 16) mg/L and (0.65±0. 14) mg/L respectively. As to 8 h [(0. 85 ± 0. 22) mg/L], a slight upregulation was found with no significant difference (t = 1.63, P ＞ 0. 05).A trend of gradual increase of serum Cys C levels was found in sepsis AKI group at 12, 18, 24, 36, 48 and 72 h. A significant difference was found compared with base line (t = 2. 81, 2.98, 3.05, 3.11, 3. 38,3. 17,P ＜0.01). NGAL level[(96.21 ±45.32) μg/L] was significantly higher than base line value [(4. 98 ± 1.65) μg/L]. Subsequently, in each time point from the 2 h to 48 h, a trend of gradual increase in urinary NGAL levels was showed. The differences were significant compared with the baseline values (t =2. 74,2. 83,2. 91,3.04,3.15,3.22,3. 31,3.45,3.57 ,P ＜0. 01). Urinary NGAL levels of sepsis AKI group were significantly higher than those in non-AKI group at different time points with significant difference (t =2. 69,2. 73,2. 84,2. 96,3.02,3. 13,3.29,3.43,3.54,3.22,P ＜0. 01). ROC curve was selected to analyze diagnostic performance of urinary NGAL levels in AKI patients 2 h post-sepsis. Area under ROC curve was obtained as 0. 935, 95% confidence interval was 0. 683-0. 971. When cut-off value of urinary NGAL for patients 2 h post-sepsis was 50 μg/L, the sensitivity, specificity and accuracy were 94. 4%, 87. 5% and 96. 8% in AKI diagnosis respectively. Conclusions The occurrence of AKi can be accurately predicted by urinary NGAL levels 2 h post-sepsis , and its AKI diagnosis time is earlier than that of Scr. Urine NGAL can be used as early marker of AKI complicated by sepsis.     

PTEN基因蛋白在恶性黑素瘤中的表达及意义

目的探讨PTEN基因蛋白在恶性黑素瘤中的表达及其意义.方法采用免疫组化EnVision检测PTEN基因蛋白在51例恶性黑素瘤以及30例皮内痣组织中的表达情况.结果恶性黑素瘤组织中PTEN表达强度低,总体阳性率52.9%(27/51),其中Ⅰ、Ⅱ、Ⅲ各期阳性率分别为59.4%(17/32)、38.5%(5/13)、33.3%(2/6);而皮内痣中PTEN均呈强阳性,表达阳性率为100%(30/30),二者差异具有显著性(P＜0.01).结论恶性黑素瘤的发生可能与PTEN基因蛋白的低表达有关,PTEN基因蛋白表达缺失或低下者更易发生远处转移,标记PTEN可作为判断黑素瘤预后的一项指标.     

护理人员基础理论考核试卷分析

通过对护士１２９７人次基础理论考核试卷进行分析，结果记忆性试卷的平均成绩明显优于理解性试卷，毕业７年以上的护士基础理论考核成绩高于毕业７年以下的护士。提示应注重在职护士的教育和培训，以提高其分析及解决护理问题的能力。     

我国东部与中西部医药产业差距分析及其对策

进入90年代以来，地区发展不平衡问题日益成为我国经济、社会和政治生活中的热点和焦点。这一问题的产生，是中国渐进式改革开放道路的内在逻辑规定的，也是一个大国在经济起飞特定阶段所表现出来的非均衡发展的客观形态。特别是近年来．发展差距不断加大，如不及时加以解决，地区间过分悬殊的差距势必影响社会稳定，引发矛盾，由此带来的“移民潮”有可能引发经济、社会的严重失衡，因此，我们有必要对中国目前日益突出的地区发展问题进行认真的科学的研究与探讨。作为国家经济有机组成部分的医药产业，也同样存在着地区发展不平衡问题，特…     

臀上皮神经卡压综合征的诊治 (附38例报告)

臀上皮神经卡压综合征又称臀上皮神经炎,是腰背疼痛的好发病因之一[1],是指臀上皮神经在其走行的各固定点受牵拉和卡压而引起的一系列症状。腰背部骶棘肌处脂肪球通过腰背筋膜疝出,使脂肪受到嵌顿,发生变性,并压迫穿过该处的臀上皮神经而引起相应的腰腿疼痛等症状。我院从1995年到2000年收治38例此病患者,结合有关文献报道如下。     

动静脉内瘘术125例治疗体会

<正>我院自1986～1994年为125例慢性肾功能衰竭患者行上肢动静脉内瘘术130例次,现将治疗报告如下。 1.临床资料 1.一般资料 125例中男106例,女19     

HE+PAS+改良 Warthin-Starry染色技术联合诊断放线菌病

放线菌病(actinomycosis)是由以色列放线菌、牛放线菌或赖氏放线菌感染引起的慢性化脓性肉芽肿病变，可发生于身体任何部位，主要侵犯颌颈部和胸腹部。正常人口腔中的牙垢、龋齿、牙周袋、扁桃体陷窝等处均可找到放线菌，一般情况下不引起疾病，属于内源性条件致病菌。本病散在发生，发病率极低，易误诊为肿瘤，因而寻找一个简便而有效的     

免疫检验质量控制在临床样本检测中应用研究

目的探讨临床检测样本实施严格免疫检验质量控制的效果。方法将2016年11月—2017年4月九江学院附属医院收治的实施常规免疫质量控制的55例免疫检验患者作为对照组;将2017年5—10月该院收治的实施严格免疫检验质量控制的55例免疫检验患者作为观察组,根据临床检验结果分别对两组患者采取有针对性的治疗方案,比较两组检验效果及患者满意度。结果观察组检验有效率及患者对检验满意度均高于对照组,差异有统计学意义(P<0.05)。结论严格免疫检验质量控制在临床检测样本中应用效果显著,可在提高样本检验准确性的同时,进一步提高患者对检验满意度。     

某磷化铝生产车间职业病危害因素现状分析

为了识别和评价某磷化铝生产车间在生产过程中产生和存在的职业病危害种类和存在的部位,分析职业病危害控制措施及其控制效果,提出合理的控制改善措施,提高该车间的职业病危害防护水平,我们对该车间的工艺过程进行了全面的分析,对车间存在的危害因素进行了监测。结果表明,该车间在生产过程中产生的铝粉尘、磷化氢气体、五氧化二磷(P2O5)气体严重超标,职业病危害控制措施很不完善。