血栓前状态分子标志物的变化在不稳定型心绞痛合并高血压患者中的价值

目的探讨血栓前状态(PTS)分子标志物变化在不稳定型心绞痛(UAP)合并高血压(HBP)患者中的价值。方法选取我院2012年1月~2015年12月心脏中心重症监护室收治的120例UAP患者按照随机对照原则分为UAP组50例,UAP合并HBP组70例,另选50例无器质性心脏病的在院老年患者作为对照组,用酶联免疫吸附双抗体夹心法(ELLSA)、发色底物法、免疫浊度法等检测方法分别对3组患者PTS分子标志物进行测定分析,包括:血管性血友病因子抗原(v WF:Ag)、血小板α颗粒膜蛋白-140(GMP-140)、组织型纤溶酶原激活剂(t-PA)、血浆纤维蛋白原(Fbg)、纤溶酶原激活抑制物-1(PAI-1)、抗凝血酶(AT)及血液流变学等指标。结果 UAP组的血浆v WF、GMP-140、Fbg含量、PAI-1含量及活性均明显高于对照组、低于UAP合并HBP组,UAP组的AT含量、t-PA活性均明显低于对照组,高于UAP合并HBP组,差异具有统计学意义(P0.05);血压越高,PTS标志物变化越显著(P0.05)。结论 1UAP合并HBP者存在PTS;2UAP合并HBP者的PTS变化较单纯UAP者更为明显;3PTS分子标志物变化可加速血栓形成。     

新疆维吾尔自治区2004-2014年细菌性痢疾流行概况及耐药分析

目的 了解新疆维吾尔自治区（新疆）细菌性痢疾（菌痢）的流行概况及病原特征。方法 采用描述性流行病学方法,对2004-2014年新疆菌痢的发病资料、菌型监测、药敏试验等进行分析。结果 2004-2014年新疆共报告菌痢123 238例,年发病率波动在25.91/10万～76.04/10万之间,年病死率在0.00～46.90/10万之间。东疆地区的发病率高于其他地区。7-9月为发病高峰。男性发病率高于女性。各年龄组中以<5岁组发病率最高。职业分布中以散居儿童最高,其次是农民和学生。福氏志贺菌是优势菌群,其中F2a最多。流行菌株对链霉素、青霉素、强力霉素及四环素等抗生素等高度耐药,对青霉素、四环素、强力霉素和链霉素耐药率逐年上升,且多重耐药现象严重,耐5种抗生素的菌株达71.43%。结论 2004-2014年新疆菌痢发病率保持平稳下降的趋势,但是个别地区的发病率仍然高于全国平均水平,应该对重点地区、重点人群、高发季节采取有针对性的措施。耐药及多重耐药现象严重,给防治工作带来了一定难度,该疾病仍然是新疆传染病防治的重点。     

Analysis of the cause of increased measles incidence in Xinjiang, China in 2004

BACKGROUND: Increased number of measles cases were reported from Xinjiang province of China in 2004, relative to previous years. This study aimed to identify the direct cause for this increase in measles morbidity and the major reason for the relatively high measles incidence rate in Xinjiang. METHODS: The epidemiologic and laboratory surveillance data for measles cases of 2004 were analyzed and a seroepidemiologic investigation involving 1024 subjects, mainly children aged less than 15 years, was conducted in Xinjiang. A questionnaire including demographic and vaccination data was completed by interview and blood samples drawn from surveillance subjects. Sera were analyzed for measles IgM (cases) and IgG (cases and surveillance). Data were assessed for their relationship with high measles incidence rate. RESULTS: 6271 measles cases were reported from Xinjiang in 2004 with a morbidity of 33.7 cases per 100,000 population. 83% of the cases were children less than 12-year-old. 50% of the serum samples were measles IgM positive and 69% were measles IgG positive. 2014 serum samples were collected in the seroepidemiologic survey. The overall IgG antibody seropositivity rate was 89%, preschool children having the lowest seropositivity rate (86%). There was a significant difference in IgG positive rates as well as IgG titers between unvaccinated and vaccinated subjects with each subsequent dose leading to further increase in titer. CONCLUSIONS: Low routine measles vaccine coverage was the major probable cause contributing to the increased measles cases in 2004 in Xinjiang and the high measles infection rate overall. The national 2-dose measles vaccination regimen is effective if delivered appropriately.     

Klotho基因沉默对肾小管上皮细胞草酸钙晶体粘附的影响

目的 探讨短发夹RNA(shRNA)稳定转染方法沉默Klotho基因对草酸钙晶体诱导人肾小管上皮细胞氧化应激及粘附的影响。方法 肾小管上皮细胞分为Ctrl、shRNA-NC、shRNA-Klotho、COM、shRNA-Klotho+COM组。ELISA检测5组氧化应激指标谷胱甘肽(GSH)、超氧化物歧化酶(SOD)、血红素氧合酶1(HO-1)、过氧化氢酶(CAT)、丙二醛(MDA)水平。Western blot检测5组Klotho蛋白水平。AlexaFluor-488-标记钙检测草酸钙晶体的黏附。结果 与Ctrl组相比,shRNA-Klotho组GSH、SOD、HO-1含量均显著降低(P<0.05),而MDA及ROS含量显著增高(P<0.05)。与Ctrl组相比,shRNA-Klotho组Klotho蛋白表达水下调(P<0.05);与其他组相比,shRNA-Klotho+COM组Klotho蛋白表达水平下调最为明显(P<0.05)。与COM组相比,shRNA-Klotho+COM组草酸钙晶体黏附增加了123.47%(P<0.05)。结论 沉默Klotho...     

沙疗对股骨力学性能的影响及其有限元分析

目的 探讨在维医沙疗中,沙疗前后股骨力学性能的变化.方法 把兔子随机分为沙疗组、对照组两组,沙疗组和对照组的兔子都有退化犁关节炎,对照组兔子不进行任何形式的治疗,仅对沙疗组兔子进行沙疗实验,在沙疗完成后,取出兔子股骨做成试件并进行分组.采用NJ-100B型实验机对股骨进行拉伸和压缩强度的测定,将实验数据有限元进行分析.结果 沙疗组的平均拉伸强度比对照组的平均拉伸强度要高4.54 MPa,沙疗组的平均压缩强度比对照组的平均压缩强度要高22.76 MPa,有关节炎病变的兔子通过沙疗其骨骼的综合强度有一定的改善(23.21 MPa).有限元分析显示,在载荷从0-924 kg·m·s~(-2)之间变化时,长半轴的应力值总比短半轴应力值大(6.08MPα).结论 在体外不同温度加热后对骨组织的生物力学性能无明显影响.股骨离体静拉伸强度无明显下降,压缩强度比正常组有所提高.     

Hepatitis A outbreaks in China during 2006: application of molecular epidemiology

Background  In China, hepatitis is a huge public health problem. Outbreaks of hepatitis A are the most frequent cause of acute hepatitis, and to date, few epidemiologic investigations or molecular surveillance studies have been performed. Materials and methods  In 2006, two major outbreaks of hepatitis A occurred, one in Guigang City, southern China, and the other in Hetian City, northwestern China. Field and molecular epidemiologic investigations were conducted. Results  In Guigang, a single outbreak occurred in a school; 35 patients and 25 asymptomatic individuals were infected with 1 strain of hepatitis A virus (HAV). A case-control study showed that contaminated water was the likely transmission source. In Hetian, the epidemic of hepatitis A consisted of sporadic, small outbreaks involving as many as 20 wild HAV strains. A molecular epidemiology approach allowed us to identify two groups infected by individual HAV strains. Further fieldwork and a case-control study showed that ice cream was the suspected transmission source in one group. Our molecular epidemiology study showed that genetic variability between the HAV strains isolated from Guigang and Hetian and previously reported HAV strains was at least 4.3%. Conclusion  Contaminated water and suspected ice cream were associated with outbreaks of hepatitis A. Viral genetic analysis may advance field investigations in complex situations.     

MTHFR 基因多态性及同型半胱氨酸与维吾尔族人群静脉血栓栓塞症的相关性研究

目的：探讨亚甲基四氢叶酸还原酶（MTHFR）基因 C677T 位点突变及同型半胱氨酸（Hcy）水平与维吾尔族静脉血栓栓塞症（VTE）发生的关系。方法选择2008年1月-2012年12月在新疆医科大学第一附属医院住院的维吾尔族 VTE 患者94例（VTE 组）,健康对照组86例;采用聚合酶链反应-限制性片段长度多态性（PCR-PFLP）技术检测 MTHFR 基因 C677T 多态性,应用酶循环法检测血浆 Hcy 水平,分析 Hcy 及 MTHFR 基因C677T 多态性与 VTE 的关联性。结果VTE 组与健康对照组 MTHFR 基因 C677T 突变位点基因型分布和各等位基因频率比较差异均有统计学意义（P 均＜0．05）;VTE 组血浆 Hcy 水平高于健康对照组,差异有统计学意义（P ＜0．05）。VTE 组677TT 基因型者血浆 Hcy 水平高于 CC 和 CT 基因型,差异有统计学意义（P 均＜0．05）。结论MTHFR 基因 C677T 基因多态性及血浆 Hcy 水平可能与维吾尔族人群 VTE 的发生有关。     

384例维汉不同民族肾癌患者临床特点对比研究

目的对比分析新疆地区维汉不同民族肾癌患者的临床特征。方法回顾性分析2000年1月至2012年12月新疆医科大学第一附属医院和新疆医科大学第二附属医院诊治的384例新发肾癌患者的临床资料,对其中维汉不同民族患者的发病情况、临床特点进行分析。结果汉族肾癌患者以右侧为主(52.4%),而维吾尔族肾癌患者以左侧为主(56.7%)。汉族肾癌患者中无症状者所占比例明显地高于维吾尔族肾癌患者(41.7%vs 20.0%)(P<0.05)。维汉民族肾癌患者病理类型及分布差异无统计学意义(P>0.05)。汉族肾癌患者肿瘤T1a比例显著地高于维吾尔族肾癌患者(50.1%vs 16.7%),T1b肿瘤汉族比例显著地低于维吾尔族肾癌患者(19.4%vs 70.8%)(均P<0.05)。两组主要的病理类型均为透明细胞癌。结论与汉族肾癌患者相比,维吾尔族肾癌患者有症状者明显多于无症状者,肿瘤的病理分期也高于汉族,提示可能与维吾尔族人群的健康体检意识不强有关。     

两种教学方式在呼吸内科临床实习中的比较

目的：探讨PBL教学法在呼吸内科临床实习教学中的应用效果。方法将52名预防医学本科生在入科实习前随机分成实验组和对照组。实验组采用PBL教学法,对照组采用传统教学法,实习前进行入科考试,实习结束后进行出科考试及学习效果问卷调查。结果实验组出科时考试成绩明显优于对照组（P＜0.01）,尤其是病案分析类试题更显优势。实验组学生对教学效果的评价优于对照组。结论 PBL教学法应用于呼吸内科临床实习中可以提高学生分析和解决问题的能力,为今后工作提供更好的帮助。     

经皮冠状动脉介入术中止血活性的早期改变及与纤溶酶原激活剂抑制物-1基因多态性的相关性

目的探讨经皮冠状动脉介入(PCI)术中冠状动脉内血浆纤溶酶原激活剂抑制物-1(PAI-1)、D-二聚体(D-D)、凝血因子Ⅶ(FⅦa)及可溶性P选择素(CD62P)活性在球囊扩张和支架植入前后的早期改变及其与PAI-1基因多态性的相关性,评估其对急性支架血栓形成的预测价值。方法选择稳定型心绞痛患者20例,按标准方法行冠状动脉造影且证实冠状动脉狭窄均在70%以上。术中冠状动脉内血样采集顺序依次为:球囊扩张前冠状动脉入口处(Ostium)用引导导管,球囊扩张15min以后及支架植入后15min通过血栓吸引器穿过病灶在病变远端采血。结果PAI-1基因多态性在本组中分布为4G/5G型最多(12例,60%),4G/4G型其次(6例,30%),5G/5G型最少(2例,10%)。4G和5G等位基因频率分别为60%和40%。具有PAI-14G/5G基因型患者冠状动脉内血浆PAI-1、D-D以及FⅦ活性在球囊扩张后较球囊扩张前明显升高且有统计学意义(P均为0.01),然而这些指标在球囊扩张前与支架植入后比较无显著性差异。结论球囊扩张较支架植入更易损伤血管内皮并导致冠状动脉内局部、早期止血活性的一过性增高,具有PAI-14G/5G基因型患者对这种反应较为敏感。PCI术前双联抗血小板药物可以有效抑制血小板活性。