新型冠状病毒肺炎防控科室管理的文献综述

本文综述了2019新型冠状病毒爆发期间,收治确诊及疑似患者医院应急处理中科室管理情况。分析了科室管理中病区布局及环境控制、人力资源的使用、人员防护规范、医疗废弃物的管理及探视制度的落实等5个方面,确保切断传播途径,为临床实践提供参考借鉴。     

骨保护素在血管钙化中的作用

骨保护素(OPG)是近年来发现的一种分泌型糖蛋白,属于肿瘤坏死因子受体超家族成员,在体内可以抑制破骨细胞的活性.近年研究发现血管钙化是一种类似于骨和软骨形成的主动调节过程.OPG的发现揭开了骨质疏松和血管钙化之间的分子联系.本文将对近年来OPG在血管钙化中作用的研究进展进行综述.     

肺炎衣原体通过上调酰基辅酶A:胆固醇酰基转移酶1诱导人单核细胞株THP-1源性泡沫细胞形成的实验研究

Objective To investigate the expression changes of acyl-coenzyme A: cholesterol acyhransferase 1 (ACAT1) on Chlamydia pneumoniae (C. pn) induced foam cell formation. Methods Human monocytic cell line (THP-1) was induced into macrophages by 160 nmol/L phorbol myristate acetate (PMA)for 48 h, and were randomly allocated into four groups: negative control group (50 μg/ml LDL for 48 h) ; positive control group (50 μg/ml ox-LDL for48 h) ; C. pn infection group (50 μg/ml LDL plus 1× 105,4×105,5×105and 1×106 IFU C.pn for 48 h or 1×106 IFU C.pn for 0,24,48 and 72h); ACAT inhibitor 58-035 plus C. pn infection group (1, 5, 10 μg/ml ACAT inhibitor 58-035 pretreatment for 1 h,50 μg/ml LDL and 1 × 106 IFU C. pn for 48 h). The mRNA and protein expressions of ACATI were determined by RT-PCR and Western blot, respectively. Lipid droplets in cytoplasm were observed by oil red 0 staining. The contents of intracellular cholesteryl esters were detected by enzyme-fluorescence. Results The mRNA and protein expressions of ACATI were significantly up-regulated in positive control cells compared those in negative control cells and further upregulated by C. pn infection in a time-dependent and concentration-dependent manner (all P ＜ 0.05). There were significantly increases in the accumulation of lipid droplets and the ratio of cholesteryl ester to total cholesterol in positive control cells as compared with negative control cells and these were further aggravated by C. pn (at the concentrations of 5× 105 and 1×106IFU for 48 h) and C. pn infection induced increases in the accumulation of lipid droplets and the ratio of cholesteryl ester to total cholesterol could he significantly attenuated by ACAT inhibitor 58-035 (all P ＜ 0.05). Conclusion Chlamydia pneumoniae induces THP-1-derived foam cell formation by up-regulating the expression of ACATI.     

老年人群血清谷氨酰转移酶与代谢综合征的相关性研究

目的探讨老年人群血清谷氨酰转移酶（GGT）水平与代谢综合征（MS）的关系。方法调查在华中科技大学同济医学院附属协和医院进行常规体检的1444例老年人群,检测体质量指数（BMI）、收缩压（SBP）、舒张压（DBP）、空腹血糖（FBG）、甘油三酯（TG）、总胆固醇（TC）、低密度脂蛋白胆固醇（LDL-C）、高密度脂蛋白胆固醇（HDL-C）、谷氨酰转移酶（GGT）、丙氨酸转氨酶（ALT）、尿酸（UA）等。结果与非MS组相比,MS组GGT、BMI、SBP、DBP、TG、ALT、UA均明显升高（P〈0．01）,HDL-C显著减低（P〈0．01）;随着GGT四分位间距的递增,MS发生率、MS各组分（肥胖、血压异常、血糖异常、血脂异常）的发生率均显著增加,差异具有统计学意义（P〈0．01）;多元线性回归分析提示,GGT与DBP、TG、ALT、uA、MS组分个数呈正相关（P〈0．01）,而与HDL-C呈负相关（P〈0．05）：多因素Logistic回归分析表明GGT是MS发生的危险因素之一（OR=1．008,95％CI1．0001．024,P=0．046）。结论老年人群血清GGT水平与MS关系密切,其水平的升高能够反映MS的发生风险;在排除肝脏疾病以后GGT可以作为MS发生风险的筛选指标。     

ACS经皮冠状动脉介入治疗后P2Y12受体抑制剂应用策略

P2Y12受体抑制剂是急性冠状动脉综合征(ACS)患者经皮冠状动脉介入治疗(PCI)术后双联抗血小板治疗(DAPT)的重要组成部分。本文介绍了P2Y12受体抑制剂在ACS患者PCI术后应用的最新指南推荐,并结合最新临床试验比较了从静脉坎格瑞洛过渡至不同口服P2Y12受体抑制剂方案的优劣,以及PCI术后新型P2Y12受体抑制剂的转换策略,评估了药物基因型检测对P2Y12受体抑制剂方案转换的指导价值。