4110例肝炎分型分析

[目的]探讨各型肝炎的感染率。[方法]研究对象为我院住院及门诊患者，共计4110例。采用微粒子酶免分析法（MEIA）及酶联免疫吸附法（ELISA）进行肝炎分型（甲、乙、丙、丁、戊、庚肝）检测。[结果]4110例受检者中，单纯乙肝感染者133例，占3．24％；单纯丙肝感染者134例，占3．26％；单纯戊肝感染者2例，占0．05％；乙肝合并丙肝感染者3例，占0．07％；丙肝合并戊肝感染者1例，占0．02％；HAV、HDV、HGV无一例感染，感染率为0。另外，男性受检者2088人，乙肝感染者88人，占4．21％；丙肝感染者48人，占2．30％；女性受检者2022人，乙肝感染45人，占2．23％；丙肝感染86人，占4．25％。[结论]除丙肝外，各型感染率均低于全国平均感染率，与相关资料报道相差甚远。乙肝及丙肝仍以单纯感染多见。另，本组资料还显示，男性较女性更易感染乙肝病毒，而女性感染丙肝者远远高于男性，对于丙肝感染的性别差异，尚无报道，需进一步探讨。     

A Clinical and Economic Evaluation of Endoscopic Ultrasound for Patients at Risk for Familial Pancreatic Adenocarcinoma

Background and Aims: Approximately 10% of pancreatic adenocarcinoma is familial. Approximately 50% of Ist-degree relatives (FDRs) have endoscopic ultrasound (EUS) findings of chronic pancreatitis. We modeled the natural history of these patients to compare 4 management strategies. Methods: We performed a systematic review, and created a Markov model for 45-year-old male FDRs, with findings of chronic pancreatitis on screening EUS. We compared 4 strategies: doing nothing, prophylactic total pancreatectomy (PTP), annual surveillance by EUS, and annual surveillance with EUS and fine needle aspiration (EUS/FNA). Outcomes incorporated mortality, quality of life, procedural complications, and costs. Results: In the Do Nothing strategy, the lifetime risk of cancer was 20%. Doing nothing provided the greatest remaining years of life, the lowest cost, and the greatest remaining quality-adjusted life years (QALYs). PTP provided the fewest remaining years of life, and the fewest remaining QALYs. Screening with EUS provided nearly identical results to PTP, and screening with EUS/FNA provided intermediate results between PTP and doing nothing. PTP provided the longest life expectancy if the lifetime risk of pancreatic cancer was at least 46%, and provided the most QALYs if the risk was at least 68%. Conclusions: FDRs from familial pancreatic cancer kindreds, who have EUS findings of chronic pancreatitis, have increased risk for cancer, but their precise risk is unknown. Without the ability to further quantify that risk, the most effective strategy is to do nothing.     

超声造影技术在腹腔镜T1期肝细胞癌切除术中的应用价值

目的：探讨超声造影(CEUS)技术在腹腔镜T1期肝细胞癌(HCC)切除术中的应用价值。方法：选择2018年1月—2020年12月于天津医科大学第二医院行腹腔镜T1期HCC切除术的患者80例,根据是否行术前CEUS将患者分为造影组和对照组(每组40例)。均在距肿瘤边缘0.5 cm处切开患者肝脏实质并完整切除肿瘤,然后在切缘3个不同位置取组织活检。采用免疫组化检测癌组织中增殖细胞核抗原(PCNA)及Bcl-2相关X蛋白(Bax)的表达水平。记录患者手术时间、术中出血量、住院时间、肿瘤直径、切缘长度、术后进食时间、拔除引流管时间、术后最高丙氨酸氨基转移酶(ALT)和总胆红素(TBIL)及其恢复正常时间。术后均行规律随访观察。结果：与对照组相比,造影组手术时间(t=11.69,P<0.001)及住院时间更短(t=9.40,P<0.001),术中出血量更少(t=14.86,P<0.001);而两组患者在肿瘤直径(t=0.28,P=0.78)、切缘长度(t=0.18,P=0.86)、术后进食时间(t=0.44,P=0.66)及拔除引流管时间(t=1.16,P=0.25)方面差异均...     

健康人动脉结构及功能改变与室间隔厚度的相关性研究

目的 研究健康人中动脉结构和功能改变与心室间隔厚度的关系.方法 以颈动脉内膜中层厚度( IMT)和肱动脉血流介导的血管舒张反应(FMD)二指标反应动脉结构和功能改变.采用超声多普勒测定68例健康人(男16人,女52人)的IMT、FMD和室间隔厚度( IVST).结果 健康人中IVST与IMT呈正相关(r=0.394,P=-0.001),与FMD呈负相关(r=0.337,P＜ 0.01),IVST也与年龄和收缩压呈正相关.以IVST为因变量的多因素回归分析显示,IMT和FMD是其独立影响因素.结论 健康人中IMT、FMD和IVST相关,动脉结构和功能改变影响心室间隔厚度.     

标准大骨瓣开颅减压术治疗重型颅脑损伤伴脑疝术后护理方法的效果评价

目的探讨标准大骨瓣开颅减压术治疗重型颅脑损伤伴脑疝患者术后护理方法。方法将本院96例重型颅脑损伤伴脑疝患者随机分成2组,2组患者均运用标准大骨瓣开颅减压术干预治疗,其中给予常规组(48例)患者实施临床常规护理,术后护理组(48例)患者则运用术后综合护理措施干预,观察2种护理方法,并对比2组患者取得的护理满意度和并发症发生率情况。结果术后护理组取得的满意度结果,并发症发生率均明显低于常规组,2组差异有统计学意义(P<0.05)。结论给予重型颅脑损伤伴脑疝患者实施术后综合护理,可显著提高患者的临床护理满意度,同时改善并发症发生率情况,临床疗效显著,是临床护理重型颅脑损伤伴脑疝患者的理想方法。     

Pacifiplex: an ancestry-informative SNP panel centred on Australia and the Pacific region

The analysis of human population variation is an area of considerable interest in the forensic, medical genetics and anthropological fields. Several forensic single nucleotide polymorphism (SNP) assays provide ancestry-informative genotypes in sensitive tests designed to work with limited DNA samples, including a 34-SNP multiplex differentiating African, European and East Asian ancestries. Although assays capable of differentiating Oceanian ancestry at a global scale have become available, this study describes markers compiled specifically for differentiation of Oceanian populations. A sensitive multiplex assay, termed Pacifiplex, was developed and optimized in a small-scale test applicable to forensic analyses. The Pacifiplex assay comprises 29 ancestry-informative marker SNPs (AIM-SNPs) selected to complement the 34-plex test, that in a combined set distinguish Africans, Europeans, East Asians and Oceanians. Nine Pacific region study populations were genotyped with both SNP assays, then compared to four reference population groups from the HGDP-CEPH human diversity panel. STRUCTURE analyses estimated population cluster membership proportions that aligned with the patterns of variation suggested for each study population’s currently inferred demographic histories. Aboriginal Taiwanese and Philippine samples indicated high East Asian ancestry components, Papua New Guinean and Aboriginal Australians samples were predominantly Oceanian, while other populations displayed cluster patterns explained by the distribution of divergence amongst Melanesians, Polynesians and Micronesians. Genotype data from Pacifiplex and 34-plex tests is particularly well suited to analysis of Australian Aboriginal populations and when combined with Y and mitochondrial DNA variation will provide a powerful set of markers for ancestry inference applied to modern Australian demographic profiles. On a broader geographic scale, Pacifiplex adds highly informative data for inferring the ancestry of individuals from Oceanian populations. The sensitivity of Pacifiplex enabled successful genotyping of population samples from 50-year-old serum samples obtained from several Oceanian regions that would otherwise be unlikely to produce useful population data. This indicates tests primarily developed for forensic ancestry analysis also provide an important contribution to studies of populations where useful samples are in limited supply.