部队中老年干部体质指数对心血管疾病的影响

目的探讨部队中老年干部体质指数(BM I)对心血管病的影响。方法选择741名中老年[平均年龄(55.9±10.3)岁]军官体检资料,对BM I与高胆固醇(TC)、高血压、糖尿病和低高密度脂蛋白胆固醇(HDL-C)的患病率及收缩压、舒张压、空腹血糖(FPG)、TC、HDL-C水平进行相关与回归分析。结果随着BM I的增加,高血压、糖尿病和低HDL-G的患病率呈线性增高趋势,与高三酯甘油(TG)患病率无相关性。控制年龄因素后,BM I与收缩压、舒张压、FPG水平呈线性正相关(r’=0.1 7 4 8～0.2 2 7 1),与HDL-C水平呈线性负相关(r’=-0.333 3)。BM I增加1个单位,收缩压、舒张压和FPG将分别增加1.34 mmHg(1 mmHg=0.133 kPa)、1.08 mmHg和0.10 mmol/L,HDL-C降低0.05 mmol/L。结论部队中老年干部BM I与心血管疾病因素相关。控制体质量可全面降低心血管疾病的发生。     

An irreducible variant of femoral neck fracture: A minimally traumatic reduction technique

We present 25 cases of irreducible variant femoral neck fractures that require surgical management after routine manipulative manoeuvre attempts have failed. In our study, an irreducible variant of femoral neck fractures is defined as a reduction that cannot be achieved after multiple attempts at closed reduction. This was evident radiographically, as seen in displaced-impacted femoral neck fractures when the proximal femur compacts and rotates along with the distal part, and anatomical reduction cannot be achieved with manipulative manoeuvres. Another rare situation also included is when the proximal fragment disconnects from the femur and dislocates as a ‘floating’ component, consequently resulting in failure of alignment of the distal fragment to the proximal femur.Here, we describe a technique, applied as a minimally traumatic procedure to achieve anatomic reduction in such cases. With the patient placed in supine position on the fracture table under general anaesthesia, the injury site is exposed and the procedure performed under intra-operative radiographic control. Location of the femoral artery is done first by palpation. The insertion site of the K-wires or Steinman pins on the proximal thigh is 1.5-3 cm lateral to the femoral artery. The K-wires or Steinman pins are inserted vertically into the middle 1/2-2/3 of the femoral head and more than 1 cm inferior to the sub-chondral bone of the femoral head to a depth of approximately, 1/2 diameter of the femoral head. The pins are then used as a joystick to control the movement of the proximal femur. With the help of the K-wires, surgeons can manually control the movement of the proximal femur and ensure anatomic reduction with the distal fragment using routine-closed reduction. Three cannulated screws are used to stabilise the fracture after anatomic reduction is achieved and maintained in a stable position. All cases were treated with this minimally invasive procedure and internal fixation, 25 fractures united, uneventfully, whilst two of them developed femoral head necrosis at 10 months and 4.5 years postoperatively, respectively.     

制药洁净厂房设备设施表面甲醛残留的测定

目前制药厂房仍普遍使用甲醛作为环境的消毒方式,但在厂房设施及设备表面的甲醛残留会对产品质量及人员安全造成危害。通过比较确定使用紫外吸光光度法进行检测,并对取样过程进行验证。     

The Saharan antelope addax (Addax nasomaculatus) as a host for Hyalomma marginatum,tick vector of Crimean-Congo hemorrhagic fever virus

Tick infestation and pathogen prevalence in ticks infesting the Saharan antelope addax (Addax nasomaculatus) are factors that may constitute a risk for both human and animal health. In this study we describe season distribution of adult Hyalomma marginatum and analyzed the tick-borne pathogens and their seroprevalence in natural-living addax in Morocco. The results showed that addax is an important host species for H. marginatum adults. The seroprevalence of Bluetongue virus (BTV; 61.5–92.3%, n = 8/13-84/91), Coxiella burnetii (36.3–69.2%, n = 33/91-9/13) and Brucella spp. (0.0–4.8%, n = 0/50-2/42) was characterized in addax during various years (sampled animals per year, n = 13–91). Presence of Aigai virus (AIGV), a recent taxonomic differentiation of Crimean-Congo hemorrhagic fever virus (CCHFV) of 100% (4/4, years 2016 and 2017) together with Babesia ovis (75%, 3/4, year 2014), Anaplasma spp. (75%, 3/4, year 2014), Rickettsia spp. (50%, 2/4, year 2014) and Theileria spp. (25%, 1/4, year 2014) was observed in H. marginatum collected from the addax (4 pools of 10 adult ticks each). The results support the role of addax host in H. marginatum life cycle and exposure to AIGV and other tick-borne pathogens. The development of control interventions including anti-tick vaccines for wildlife species will contribute to the implementation of effective measures for the prevention and control of tick-borne diseases and might be relevant for the preservation of this threatened species and others such as Arabian oryx (Oryx leucoryx) and African elk (Taurotragus oryx) that share habitat.     

环丝氨酸联合抗结核药物对耐多药肺结核患者在肺功能、痰菌阴转率、X-pert MTBRIF以及肺CT的影响研究

目的探讨环丝氨酸联合抗结核药物对耐多药肺结核患者肺功能、痰菌阴转率及X-pert MTBRIF的影响。方法回顾性选取我院2017年7月至2019年6月收治的224例耐多药肺结核患者的病例资料,依据治疗方案不同分为对照组与观察组各112例,对照组患者给予常规抗结核药物方案(丙硫异烟胺+盐酸乙胺丁醇+利奈唑胺+吡嗪酰胺)治疗;观察组患者在对照组基础上联合环丝氨酸胶囊(250mg/次,2次/日),对比两组患者治疗前后肺功能、不同阶段痰菌阴转率及治疗后X-pert MTBRIF检测结果,评价临床治疗效果。结果治疗前两组患者FVC、FEV1%、FEV1/FVC等呼吸功能指标差异无统计学意义(P>0.05),治疗后FVC、FEV1%、FEV1/FVC均高于治疗前,呼吸功能改善显著,且观察组患者各指标较对照组升高显著(P<0.05);LPA检测阳性率与X-pert MTB/RIF检测结果差异无统计学意义,P>0.05;观察组患者治疗1个月后X-pert MTB/RIF与线性探针技术(LPA)患者阳性率均低于对照组(P<0.05);两组患者治疗后1周痰转阴率差异无统计学意义(P>0.05);观察组患者治疗后1个月、3个月患者痰转阴率均低于对照组,差异有统计学意义(P<0.05);观察组患者治疗后有效率92.0%(103/112)显著高于对照组76.8%(86/112)(P<0.05);两组患者不良反应发生率无明显差异(P>0.05)。观察组患者治疗后胸部CT效果明显优于对照组。结论环丝氨酸联合常规抗结核药物治疗耐多药肺结核可显著改善患者肺功能,提高患者痰菌转阴率,治疗后患者痰标本结核杆菌含量减少,且未增加治疗后不良反应,临床治疗显著,更适用于耐多药结核患者应用。     

升麻苷H-1对脑缺血大鼠纹状体氨基酸类神经递质含量的影响

 目的:研究脑缺血大鼠脑纹状体区域细胞外液中氨基酸类神经递质的表达变化,以探讨升麻苷H-1神经保护作用的机制。方法:SD 大鼠随机分为假手术组、脑缺血组、升麻苷H-1高、中、低剂量组和金纳多组。用线栓法造成右侧大脑中动脉闭塞(MCAO),建立局灶脑缺血模型,假手术组和脑缺血组分别给予生理盐水腹腔注射,升麻苷H-1高、中、低剂量组和金纳多组分别给予不同剂量的药物腹腔注射,每天1 次,连续7 d。采用脑微透析技术在大鼠脑纹状体区域内进行微透析活体采样,将微透析液注入高效液相-电化学检测器,检测样品中谷氨酸(Glu)、天门冬氨酸(Asp)、甘氨酸(Gly)和γ-氨基丁酸(GABA)的含量。结果:与假手术组相比,脑缺血组的兴奋性氨基酸Glu和Asp在脑缺血后2 h浓度升高(P<0.05)。升麻苷H-1高剂量组、金纳多组分别与脑缺血组相比,Glu和Asp在脑缺血后2 h显著降低(P<0.05);升麻苷H-1低、中剂量组分别与脑缺血组相比,Glu和Asp在脑缺血后2 h 没有显著降低(P>0.05)。与假手术组相比,脑缺血组的抑制性氨基酸神经递质GABA 和Gly在脑缺血后3 h浓度降低(P<0.05)。升麻苷H-1高剂量组、金纳多组分别与脑缺血组相比,GABA 和Gly在脑缺血后3 h显著升高(P<0.05);升麻苷H-1低、中剂量组分别与脑缺血组相比,GABA 和Gly在脑缺血后3 h 没有显著升高。结论:升麻苷H-1可以抑制脑缺血时兴奋性氨基酸的过度释放,并增加抑制性氨基酸的浓度。升麻苷H-1不仅能透过血脑屏障,同时可调节脑缺血兴奋性氨基酸神经递质的功能紊乱,可能对缺血脑组织神经元有一定的保护作用。     

细胞块石蜡包埋切片和细胞涂片鉴别诊断良、恶性胸腹腔积液的临床效果比较

［摘要］目的　对比细胞块石蜡包埋切片和细胞涂片鉴别诊断良、恶性胸腹腔积液的临床效果．方法　随机选取安康市中医医院2012年5月至2015年5月收治的胸腹腔积液患者80例,每1例送检标本分为2份,1份应用细胞块石蜡包埋切片法检测,另1份应用细胞涂片法检测．结果　细胞块石蜡包埋切片的细胞学诊断阳性率28.8%（23/80）显著高于细胞涂片22.5%（18/80）,P＜0.05,细胞病理学诊断的腺癌检出率32.5%（26/80）显著高于细胞涂片20.0%（16/80）,P＜0.05;80例标本中,31例为血性胸腹腔积液,其中13例为恶性,阳性率为41.9%;49例为非血性胸腹腔积液,其中11例为恶性,阳性率为22.5%．血性胸腹腔积液细胞病理学诊断的阳性率显著高于非血性胸腹腔积液（P＜0.05）．结论　细胞块石蜡包埋切片比细胞涂片鉴别诊断良、恶性胸腹腔积液的临床效果好．     

中西医结合治疗结核性脑膜炎37例

目的 观察中西医结合疗法治疗结核性脑膜炎（ＴＢＭ）的临床疗效。方法 ７５例结核性脑膜炎患者随机分为２组,治疗组３７例在常规西医抗疲治疗基础上加用中药抗疲清脑汤治疗,对照组３８例采用常规西医抗痨治疗。３０日为１个疗程,２个疗程后比较疗效。结果治疗组显效率５１．４％,总有效率８６．５％;对照组分别为２８．９％、６５．８％,差异均有显著性（Ｐ〈０．０５）。结论 以抗痨清离脑汤为主的中西医结合疗法治疗ＴＢ     

银杏叶提取物对大鼠肺纤维化的影响及其机制的研究

目的:观察银杏叶提取物(GbE)对博莱霉素(BLM)所致大鼠肺纤维化的影响,并探讨其作用机制。方法:将SD大鼠随机分对照组、BLM+NS组和BLM+GbE组,每个时间点每组6只。各组分别于给药后14,30 d处死动物。光镜下观察肺组织损伤(HE染色)和肺组织纤维化(M asson染色)的程度;采用生化法测定肺组织中胶原蛋白含量及血浆MDA含量;采用免疫组织化学法和免疫细胞化学法观察肺组织和支气管肺泡灌洗液细胞(BALF)中TGF-β1蛋白表达的变化。结果:与对照组大鼠相比,BLM+NS组大鼠各时间点各指标呈明显变化,提示模型制作成功。与BLM+NS(14 d)组大鼠相比,BLM+GbE(14 d)组大鼠血浆MDA含量,支气管肺泡灌洗液(BALF)细胞TGF-β1蛋白表达显著减少;与BLM+NS(30 d)组大鼠相比,BLM+GbE(30 d)组大鼠肺组织损伤、肺组织纤维化显著减轻,肺胶原含量和血浆MDA含量显著减少,肺组织TGF-1β蛋白表达显著减少,但BALF细胞TGF-β1蛋白表达无明显变化。结论:银杏叶提取物具有抗BLM诱导的大鼠肺纤维化作用,其机制可能与减少纤维化早期(14 d)肺泡巨噬细胞和纤维化期(30 d)肺非炎症细胞TGF-β1蛋白表达及减轻BLM所致的氧化应激有关。