A novel nutritional index and adverse outcomes in ischemic stroke: Results from the third China National Stroke Registry

Background and aimsFew studies have applied the triglyceride, cholesterol, body weight index (TCBI) in acute ischemic stroke (AIS). We investigated the association between the TCBI and adverse clinical outcomes in patients with AIS.Methods and resultsBased on the Third China National Stroke Registry (CNSR-III) data from August 2015 to March 2018, we evaluated the nutritional status of patients with AIS using the TCBI. Patients were categorized according to quartile levels of the TCBI. The main outcomes were poor functional outcomes and recurrent stroke at 1-year and secondary outcomes were adverse outcomes at 3 and 6 months after stroke onset. Poor functional outcomes consisted of all-cause mortality and major disabilities. Multivariate analyses with logistic or Cox regression analysis and restricted cubic splines determined the association between the TCBI and adverse outcomes. We included 9708 patients. At the 1-year follow-up, 1323 patients (13.6%) had died or experienced major disability. The adjusted odds ratios/hazard ratios and 95% confidence intervals of the lowest quartile at 1-year were 1.47 (1.22–1.78) for poor functional outcomes, 1.46 (1.18–1.81) for major disability, and 1.34 (0.94–1.86) for all-cause mortality. Kaplan–Meier analysis demonstrated an inverse relationship between all-cause mortality and the TCBI (log-rank p < 0.05). An approximately L-shaped relationship between TCBI levels and poor functional outcomes and major disability was observed at 1-year.ConclusionThe novel TCBI was associated with short- and long-term adverse outcomes in AIS. Thus, it may be useful for predicting adverse outcomes in patients with AIS.     

丙型病毒性肝炎患者疾病防治知识知晓情况及相关因素

目的  了解丙型病毒性肝炎(丙肝)患者的丙肝防治知识知晓情况并分析相关因素, 为丙肝防治工作提供参考。方法  2022年7-9月, 对云南省文山壮族苗族自治州(文山州)和江苏省徐州市的丙肝患者进行调查, 收集调查对象的人口学特征、丙肝防治知识等信息。采用χ²检验比较不同特征患者丙肝防治知识知晓情况的差异, 并采用多元线性回归模型分析患者丙肝防治知识知晓情况的相关因素。结果  共收集486份问卷, 有效问卷483份。其中男性占65.22%(315名), 女性占34.78%(168名), 平均知晓率为62.66%, 单题知晓率最低为32.71%, 最高为81.37%。多元线性回归模型分析结果显示, 女性[β=-0.729 (95% CI: -1.311~-0.147), P=0.014]、年龄≥50岁[β=-0.635 (95% CI: -1.205~-0.065), P=0.029]、农民或民工[β=-1.139(95% CI: -1.992~-0.286), P=0.009]、不清楚自身感染途径者[β=-0.970(95% CI: -1.577~-0.362), P=0.002]、未接受丙肝宣传教育者[β=-1.648(95% CI: -2.224~-1.073), P < 0 001]和不知道自己患有丙肝者[β=-1.097(95% CI: -2.094~-0.010), P=0.031]的知晓率更低。结论  丙肝患者的丙肝防治知识知晓率不高, 且与性别、年龄、职业、感染途径、是否接受过丙肝宣传教育和是否知道自身患病有关联, 需加强宣传教育提高该人群的知识知晓状况。     

Association of interleukin-6 promoter polymorphism with knee osteoarthritis: a meta-analysis

Background Osteoarthritis （OA） is the most common form of human polyarthritis.Many genetic factors have been implicated in OA.It was reported that a polymorphism in the gene of interleukin-6 （IL-6） was associated with OA of knee.The aim of this study was to determine whether functional IL-6 promoter-174G/C （rs1800795） polymorphisms confer susceptibility to knee OA.Methods A meta-analysis was conducted on the association between the IL-6 polymorphism and knee OA.Electronic search at PubMed,EMBASE,Weipu database,and Wanfang database was conducted to select studies.Case-control studies containing available genotype frequencies of IL-6-174G/C were chosen,and odds ratio （OR） with 95％ confidence interval （C/） was used to assess the strength of this association.Results A total of seven studies involving 6 464 subjects （knee OA 3 331 and controls 3 133） were considered in this study.The results suggested that the variant genotypes were not associated with knee OA risk in all genetic models （additive model：OR=1.144,95％ CI 0.934-1.402,P=0.194; recessive model：OR=1.113,95％ CI 0.799-1.550,P=0.526;dominant model：OR=1.186,95％ CI 0.918-1.531,P=0.191）.A symmetric funnel plot,the Begg＇s test （P ＞0.05）,suggested that the data lacked publication bias.Conclusions This meta-analysis does not support the idea that rs1800795 genotype is associated with increased risk of knee OA.However,to draw comprehensive and more reliable conclusions,further prospective studies with larger numbers of participants worldwide are needed to examine the association between rs1800795 polymorphism and knee OA.     

滇南小耳猪正常胆道和胆道瘢痕来源成纤维细胞核转录因子κB和凋亡调控蛋白FLICE样抑制蛋白的表达

背景：胆道瘢痕形成存在细胞的增殖和凋亡的平衡被破坏,尤其是成纤维细胞大量增殖并过度分泌胶原等基质成分。目的：对比核转录因子κB及其下游抗凋亡caspase-8同源结构FLICE抑制蛋白在胆道瘢痕及正常胆道来源的成纤维细胞系中的表达情况。方法：8只滇南小耳猪随机等分为胆道损伤修复组和正常对照组,分别通过建立胆道损伤修复模型和不损伤胆道方法培养胆道瘢痕及正常胆道来源的成纤维细胞。结果与结论：与正常胆道来源的成纤维细胞相比,胆道瘢痕来源的成纤维细胞中核转录因子κB及凋亡调控蛋白FLICE样抑制蛋白表达的范围更广,表达更强。提示胆道损伤后核转录因子κB激活增加,并导致caspase-8同源结构FLICE抑制蛋白过表达,从而导致胆道成纤维细胞凋亡减少致胆道瘢痕的形成。     

七氟烷复合顺式阿曲库铵在新生儿剖腹探查术中的应用

目的回顾总结七氟烷复合顺式阿曲库铵在新生儿剖腹探查术中应用的效果。方法就诊于本院的新生儿50例,ASAⅡ或Ⅲ级,年龄1~28d,体重1.9~3.5 kg,分为2组:七氟烷组(Q组)(n=22)和七氟烷顺阿曲库铵组(QA组)(n=24)。Q组七氟烷吸入麻醉诱导;QA组吸入七氟烷复合静脉注射顺阿曲库铵0.1 mg/kg行麻醉诱导。两组均吸入七氟烷(1.0~1.2 MAC)维持麻醉。结果术前患儿出生天数、体重、性别构成情况的比较,差异无统计学意义(P>0.05)。两组间术毕后拔管和术毕后带管的患儿比较,差异无统计学意义(P>0.05)。结论新生儿剖腹探查术中应用七氟烷复合顺式阿曲库铵不影响术毕拔管。     

营养不良儿童血清锌、铜、钙的变化及临床意义

目的了解营养不良儿童血清锌（Zn）、铜（Cu）、钙（Ca）元素的变化。方法对营养不良儿童6月～5.6岁89例、健康儿童10月～5.9岁93例应用美国PE-300全自动原子吸收光谱仪和日立7060生化分析仪进行血清锌、铜、钙的定量测定,并作包括一般情况、饮食、喂养、患病情况等的问卷调查,对两组儿童各元素水平进行分析比较。结果营养不良组儿童血清锌、钙平均值分别是0.81μg/ml、2.03 mmol/L,均低于健康组儿童的0.97μg/ml和2.2 5 mmol/L,比较差异有统计学意义（P〈0.05）,营养不良组、健康组血清铜平均值分别是1.03μg/ml和1.09μg/ml,比较差异无统计学意义（P〉0.05）;不同类型营养不良患儿的血清锌、铜、钙含量平均值比较差异无统计学意义（P〉0.05）;治疗后的血清锌、钙含量平均值分别是0.95μg/ml、2.11 mmol/L,与治疗前比较差异有统计学意义（P〈0.05）,各阳性症状治疗前后比较差异有统计学意义（P〈0.05）。结论营养不良组儿童和健康组儿童元素水平存在差异;营养不良组儿童治疗前后元素水平存在差异。     

酚妥拉明治疗危重型手足口病的临床疗效观察

目的观察酚妥拉明治疗危重型手足口病的临床疗效．方法对收治的62例危重型手足口病患者,在常规治疗基础上加用酚妥拉明,严密监测血压,调整酚妥拉明用量,观察治疗前后临床症状及相关指标变化．结果应用酚妥拉明治疗后患儿血压、心率均有显著改善,差异有统计学意义（P〈O．05）．结论酚妥拉明治疗危重型手足口病患者临床疗效显著．     

儿童急性淋巴细胞白血病化疗后院内感染24例报道

目的探讨儿童急性淋巴细胞白血病(acute lymphoblastic leukemia,ALL)化疗后院内感染特点及药物选择.方法回顾性分析24例儿童ALL接受CCLG-2008ALL方案化疗院内感染的临床资料.结果院内感染率高达95.8%,呼吸系统为最常见感染部位,91.3%有发热临床感染症状.结论急性淋巴细胞白血病患儿接受CCLG-2008ALL方案化疗,骨髓缓解率高,但感染发生率高,感染程度重,及时而强有力的抗感染能有效提高患儿的生存率.     

昆明地区新生儿听力及聋病易感基因联合筛查

目的探讨新生儿的听力及聋病易感基因联合筛查的临床价值.方法对748例新生儿进行听力及聋病易感基因联合筛查,听力筛查采用丹麦(MADSEN公司)生产的AccuScreen全功能自动耳声发射听力筛查仪进行诱发瞬态耳声发射法(transient evoked otoacoustic eission,TEOAE)筛查,聋病易感基因筛查3个最为常见的聋病基因,即mtDNAA1555G、GJB2、SLC26A4.结果 748例新生儿听力初次筛查(初筛)未通过222例;623例进行了第2次筛查(复筛),未通过27例;744例做了聋病易感基因筛查,聋病易感基因筛查阳性率15‰.结论新生儿的听力筛查联合聋病易感基因筛查,可早期发现听力损失及聋病基因的携带者.     

心脏急症与稳定性冠心病患者临床治疗探析

目的对比心脏急症与稳定性冠心病的治疗效果,为提高心脏急症患者与稳定性冠心病患者的生活与生存质量提供可靠的临床依据。方法急症组患者给予盐酸替罗非班、阿司匹林、低分子肝素以及氯吡格雷治疗,稳定组患者给予阿托伐他汀、阿司匹林、低分子肝素以及氯吡格雷治疗。比较两组患者的治疗结果。结果两组患者经治疗后心绞痛发作次数与发作持续时间均有所下降,但稳定组患者下降幅度更大,治疗效果更好,差异有统计学意义(P<0.05)。结论心脏急症患者的病情较稳定性冠心病难以控制,故在临床治疗过程中应根据患者实际情况选用药物或手术治疗,以免死亡现象发生。