大豆异黄酮对阿茨海默病大鼠ChAT和caspase-3活性影响

目的 :探讨大豆异黄酮(soybean isoflavones,SIF)改善阿茨海默病(Alzheimer’s disease,AD)大鼠学习记忆能力的作用机制。方法 :采用右侧杏仁核注射β-淀粉样肽(β-amyloid peptide,Aβ)制备AD大鼠模型,给予不同剂量的SIF,观察其对大鼠海马胆碱乙酰转移酶(choline acetyltransferase,ChAT)活性和半胱天冬氨酸特异性蛋白酶3(cysteinyl aspartate-specific protease3,caspase-3)活性的影响。结果 :大豆异黄酮显著升高AD大鼠海马ChAT活性,降低AD大鼠海马caspase-3活性。结论 :大豆异黄酮对中枢胆碱能神经细胞损伤及脑细胞凋亡具有保护作用,能改善AD大鼠学习记忆能力。     

186例哮喘儿童皮肤点刺实验结果分析及其意义

目的分析哮喘儿童皮肤点刺试验结果,了解儿童哮喘的过敏原种类及其在各年龄段的分布特点。方法选取2009年3月～2010年11月来本院哮喘门诊就诊的186例患儿临床资料进行回顾性分析。采用德国默克公司生产的变应原试液以生理盐水作阴性对照,组胺作阳性对照。结果186例患儿中SPT阳性150例,其中,i～3岁组56例,4～6岁组48例,7～14岁组46例,7～14岁组SPT阳性率最高,4～6岁组次之,1～3岁组最低,3组变应原阳性率比较,差异有统计学意义。在不同年龄组所有变应原中,以尘螨阳性率最高,屋尘螨达37．6％,粉尘螨36．6％;其次为室外霉菌34．4％。随着年龄的增长,患儿致敏的变应原阳性种类相对增多,10种以上变应原阳性者7～14岁组明显高于其他两组。结论所有变应原阳性率中以尘螨阳性率最高且受年龄影响,所以指导家长避免和减少与尘螨的接触是治疗和护理儿童哮喘的最基本措施。     

中药参附黄蒲汤治疗脾胃虚寒证胃痛临床观察

目的探讨中药参附黄蒲汤的临床治疗效果。方法将确诊为脾胃虚寒证胃痛的患者随机分为两组,治疗组给予中药参附黄蒲汤口服治疗,对照组给予黄芪建中汤口服,治疗1个月后观察其临床治疗效果。结果治疗组治愈率为60．59％,总有效率为98．56％;对照组治愈率为51．82％,总有效率为83．94％,两组比较,在治愈率：总有效率上治疗组明显高于对照组,差异有统计学意义（P〈0．05）。治疗过程中未发生不良反应。结论中药参附黄蒲汤治疗脾胃虚寒证胃痛疗效确切、安全可靠,值得临床推广应用。     

北京市通州区痰涂片阳性肺结核病人实施全面监督化学疗法的研究

目的 探讨通州区长期实施全监化疗的可行性?方法 对全区涂阳肺结核病人实施不住院全监化疗 ,建立健全三级防痨网 ,区?乡?村各级医生明确职责分工 ,区卫生局实施行政管理 ,各项工作实行质量控制监测?结果 1.979～1.997年对 1.648例涂阳病人中的 1.42.1例进行全监化疗 ,全监化疗率 86.2 % ,坚持监化率 90.4 % ,一年痰菌阴转率 95.3 % ,二年复发率 3.2 % ,人口传染源率从 1.980年的 81 /1.0万下降到1 997年的 2 3 /1.0万 ,下降 97.2 % ,使 1.3万健康人避免了结核菌感染 ,保护劳动力创造产值 659万元 ,节约医药费 2 557万元?结论 通过制定统一的化疗方案和建立三级防痨网 ,以卫生行政管理手段保证三级防痨网稳定?高效地工作 ,可在通州区长期对涂阳病人实施全监化疗 ,并取得预期效果?     

超声引导下导丝定位切除术治疗触诊阴性乳腺病灶的价值

目的探讨超声引导下导丝定位切除术治疗触诊阴性乳腺病灶的临床应用价值。方法选择133例超声探及但临床触诊阴性的乳腺病灶,在超声引导下将定位导丝置入乳腺病灶内,根据定位导丝的位置切除病变及其周围部分正常组织,并送检病理检查。结果133例患者共136个结节,导管内乳头状瘤9例,乳腺增生症伴纤维腺瘤样结构形成25例,非典型增生4例,乳腺增生症35例,纤维腺瘤53例,乳腺浸润性癌8例,导管原位癌2例。结论超声引导下导丝定位切除术治疗触诊阴性乳腺病灶具有定位准确、操作简单、微创等优点,该技术的应用对于乳腺癌的早期诊断及早期治疗具有重要价值。     

康复新液联合利多卡因及庆大霉素治疗口腔溃疡的临床疗效观察

目的 探讨康复新液联合利多卡因及庆大霉素治疗口腔溃疡的临床疗效。方法 选取2019年5月至2021年7月在北京市通州区妇幼保健院收治的120例口腔溃疡患者,按照随机表法分为观察组和对照组,对照组58例采用利多卡因治疗,观察组62例采用康复新液联合利多卡因及庆大霉素治疗,观察对比两组治疗前后的临床疗效,包括口腔溃疡情况、治疗3 d、治疗5 d后视觉模拟评分（VAS评分）、炎症因子水平及不良反应等。结果 治疗后观察组总有效率（95.12%）高于对照组总有效率（74.36%）,差异有统计学意义（P<0.05）;溃疡面积、溃疡愈合时间、进食改善时间显著短于对照组（P<0.05）;观察组治疗3 d、5 d后VAS评分、肿瘤坏死因子-α（TNF-α）、C反应蛋白（CRP）、细胞白介素-6（IL-6）水平均较对照组显著降低（P<0.05）;观察组不良反应发生率（3.22%）与对照组不良反应发生率（6.90%）相比,差异无统计学意义（P>0.05）。结论 康复新液联合利多卡因及庆大霉素治疗口腔溃疡的疗效更好,能有效改善患者各项临床症状,降低患者疼痛感,降低炎症因子水平,有助于患者恢复,并且安全性高。     

Association between body mass index and mortality in atrial fibrillation patients with and without diabetes mellitus: Insights from a multicenter registry study in China

Background and aimsThe aim of this study was to evaluate the association between body mass index (BMI) and mortality in atrial fibrillation (AF) patients with and without diabetes mellitus (DM).Methods and resultsA total of 1991 AF patients were enrolled and divided into two groups according to whether they have DM at recruitment. Baseline information was collected and a mean follow-up of 1 year was carried out. The primary outcome was defined as all-cause mortality with the secondary outcomes including cardiovascular mortality, stroke and major adverse events (MAEs). Univariable and multivariable Cox regression were performed to estimate the association between BMI and 1-year outcomes in AF patients with and without DM. 309 patients with AF (15.5%) had comorbid DM at baseline. Patients with DM were more likely to have cardiovascular comorbidities, receive relevant medications but carry worse 1-year outcomes. Multivariable Cox regressions indicated that elevated BMI was related with reduced risk of all-cause mortality, cardiovascular mortality and major adverse events. Compared to normal weight, overweight [HR (95% CI): 0.548 (0.405–0.741), p < 0.001] and obesity [HR (95% CI): 0.541 (0.326–0.898), p = 0.018] were significantly related with decreased all-cause mortality for the entire cohort. Remarkably reduced all-cause mortality in the overweight [HR (95% CI): 0.497 (0.347–0.711), p < 0.001] and obesity groups [HR (95% CI): 0.405 (0.205–0.800), p = 0.009] could also be detected in AF patients without DM, but not in those with DM.ConclusionElevated BMI was associated with reduced mortality in patients with AF. This association was modified by DM. The obesity paradox confined to AF patients without DM, but could not be generalized to those with DM.     

The limited value of routine chest X-ray in the follow-up of stage II breast cancer

In 280 patients with stage II breast cancer, chest X-ray was performed at 6 and 12 months and yearly thereafter to the 6th year or until recurrence, another cancer was detected, the patient refused further follow-up or died. Among 1289 scheduled chest X-rays, malignant changes were found in 20 patients, of which only 3 had pulmonary symptoms. In a further 14 patients malignant changes were suspected, but follow-up examinations could not prove malignancy. 26 patients presented within 12 months after the last scheduled X-ray with pulmonary symptoms and a work-up chest X-ray revealed malignant changes. Thus, in only 1.3% of the scheduled X-rays were unsuspected malignant changes diagnosed. Median survival of patients with malignant chest X-rays found at scheduled controls versus between scheduled controls did not differ significantly (P = 0.26). It is concluded that routine chest X-ray is not indicated in patients with stage II breast cancer.     

Associations between genetic variants of HSD17B13 and fasting plasma glucose in Chinese children

Background and aimsGenetic variants in 17-β hydroxysteroid dehydrogenase 13 (HSD17B13) were demonstrated to protect against NAFLD, which is highly related with insulin resistance and dyslipidemia. However, the effects of NAFLD associated HSD17B13 variants on circulating glucose and lipids have not been adequately investigated in children. This study aimed to investigate associations between single nucleotide polymorphisms (SNPs) of HSD17B13 and NAFLD or its related phenotypes, such as blood glucose and serum lipids in Chinese children.Methods and resultsWe studied 1027 Chinese Han children aged 7–18 years old, which included 162 NAFLD children and 865 controls without NAFLD. Three SNPs (rs13112695, rs7692397, rs6834314) in HSD17B13 were genotyped. The multivariable logistic and linear regression models were applied to detect the associations between three SNPs and NAFLD or its related phenotypes [alanine transaminase (ALT), fasting plasma glucose (FPG) and serum lipids]. The effect allele A of rs7692397 was negatively associated with FPG [β (SE) = −0.088 (0.027) mmol/L, P = 0.001], whereas the effect allele G of rs6834314 was positively associated with FPG (β (SE) = 0.060 (0.019) mmol/L, P = 0.002). After Bonferroni correction, the significant associations still remained (both P < 0.0024). No significant associations were found for NAFLD or serum lipids.ConclusionThe study firstly revealed the association between two HSD17B13 variants and FPG in Chinese children, providing evidence for HSD17B13 variants and abnormal glucose metabolism.     

胰岛素样生长因子-1、肝细胞生长因子、肿瘤间质比值诊断乳腺癌患者淋巴结转移的价值及与预后的关系

目的：探讨血清胰岛素样生长因子-1(IGF-1)、肝细胞生长因子（HGF）、肿瘤间质比值（TSR）诊断乳腺癌发生淋巴结转移的价值及与患者预后的关系。方法：采取回顾性研究方法，选取2015年6月—2017年8月北京市通州区妇幼保健院乳腺科收治的120例乳腺癌患者作为研究对象，根据手术后病理学结果患者是否发生淋巴结转移将其分为复发转移组24例、未复发转移组96例，对比两组患者的血清IGF-1、HGF、TSR值，采用受试者工作特组（ROC）曲线分析三项指标诊断乳腺癌患者发生淋巴结转移的价值；采用Logistic回归模型分析乳腺癌病理学特征、治疗方法及IGF-1、HGF、TSR与乳腺癌患者预后结局的关系。结果：乳腺癌淋巴结转移组患者的IGF-1、HGF测定值高于未转移组，TSR水平低于未转移组，差异均有统计学意义（P <0.05）;IGF-1、HGF、TSR测定值诊断乳腺癌发生淋巴结转移的ROC曲线下面积值分别为0.837 (0.766～0.907)、0.842(0.773～0.911)、0.880(0.821～0.938);Logistic回归分析结果显示：TNM分期≥Ⅱ期、发生淋巴结...