青少年代谢综合征因子分析

【目的】 通过青少年代谢综合征(metabolic syndrome, MS)相关组分的因子分析,探索青少年MS病理生理机制。 【方法】 以哈尔滨市某校130名高一学生为研究对象。测量身高、体重、腰围、臀围、收缩压、舒张压,计算体质指数、腰臀比和腰围身高比;测定空腹血糖、血清总胆固醇、甘油三酯、高密度脂蛋白胆固醇、低密度脂蛋白胆固醇及血清超敏C反应蛋白(high sensitivity C reactive protein, hs-CRP)含量。 【结果】 未引入hs-CRP变量时,提取三个公因子:肥胖因子、脂代谢因子和血压血糖因子,分别解释10个原始变量的31.730%、22.287%和16.767%,累计方差贡献率为70.784%。引入hs-CRP变量后,青少年MS相关组分共提取3个因子,分别为肥胖因子、脂代谢因子和血压血糖因子,分别解释10个原始变量的32.697%、20.275%、15.454%,累计方差贡献率为68.427%。 【结论】 肥胖因子在青少年MS发病机制中起主要作用;腰围身高比较腰围更适于评价青春期MS的中心性肥胖;hs-CRP可能参与青春期MS的发病。     

数字化三维立体导丝定位穿刺技术在乳腺微小病灶中的应用

目的:探讨数字化三维立体导丝定位穿刺术对乳腺微小病灶的诊断价值。方法:回顾性分析临床触诊阴性而影像学表现异常的患者41例(乳腺微小病灶43处),41例均行乳腺数字化三维立体导丝定位穿刺切除并进行病理学检查。结果:43处微小病灶均定位成功,病变完全切除。病理检查:恶性病变8处,其中原位癌3处,浸润性导管癌Ⅰ～Ⅱ级3处,导管内癌伴早期浸润1处,浸润性导管癌伴腋下淋巴结转移1处;良性病变35处。结论:乳腺数字化三维立体导丝定位穿刺技术定位准确、损伤小、诊断符合率高,是治疗乳腺微小病变的重要手段,也是发现早期乳腺癌的重要方法。     

孕早期和待产孕妇血清蛋白质含量分析

目的调查分析孕妇孕早期和待产时血清蛋白质含量，探讨建立孕妇血清蛋白参考范围的必要性。方法奥林巴斯全自动生化分析仪定量检测1082例孕早期孕妇和963例待产孕妇血清中总蛋白（双缩脲法）、清蛋白含量（溴甲酚绿法）。统计各组均值伍）与标准差（S），以2s建立相应的参考范围。单一样本t检验与健康成人血清蛋白含量进行统计学比较。结果孕早期总蛋白x为73．90g／L，S为4．60，参考范围为64．90～82．90g／L；清蛋白x为42．30g／L，s为4．39，参考范围为33．70～50．00g／L。待产时总蛋白x为64．90g／L，5为6．06，参考范围为53．00～76．80g／L；清蛋白x为34．20g／L，s为4．29，参考范围为25．80～42．60g／L。与健康成人血清总蛋白（63．00～83．00g／L）、清蛋白（35．00～50．00g／L）进行单一样本t检验，孕早期清蛋白与健康成人清蛋白含量差异无统计学意义，孕早期总蛋白以及待产时血清总蛋白和清蛋白与健康成人血清蛋白含量差异均有统计学意义。结论在孕早期，清蛋白含量与健康成人清蛋白差异无统计学意义，总蛋白含量统计学上虽有差异，但数值上相差不大，无实际临床价值，可以通用健康成人参考范围。待产时，孕妇血清蛋白含量与健康成人血清蛋白含量在统计学和临床上差异有统计学意义，有必要另行建立其相应的参考范围。     

Prognostic Markers in Resected Non–Small-Cell Lung Cancer: An Patients with 5 Year Follow-Up

We performed a retrospective analysis of potential prognostic markers in 260 patients with surgically resected stage I and II non–small-cell lung cancer (NSCLC) with a minimum 5-year follow-up. Cox proportional hazard models and Wilcoxon tests were employed to analyze the effect of patient characteristics on survival and disease-free survival (DFS). In the univariate analysis, the following were significant predictors of shorter overall survival: N-stage (N1 vs N0) (p < 0.001); T-stage (T2 vs T1) (p < 0.001); antigen A (loss vs presence) (p < 0.01); cough (present vs absent) (p= 0.01); bcl-2 expression (positive vs negative) (p= 0.03); age (> 63.5 vs < 63.5) (p= 0.03); mucin (positive vs negative) (p < 0.03). The following were significant predictors of shorter DFS: N-stage (p < 0.001); T-stage (p=0.001); loss of antigen A (p=0.01); mucin expression (p < 0.01); cough (p=0.02); Ki-67 expression (p=0.02) and negative bcl-2 expression (p=0.03). Analysis of survival difference for histologic subtype, degree of differentiation, aneuploidy, %S-phase, codon 12 K-ras mutation, and immunohistochemistry staining for Lewis^y, p53, Rb, microvessel count, HER2, E-cadherin and neuroendocrine markers did not reach statistical significance. In multivariate analysis, the following predicted for shorter overall survival: N-stage (p < 0.01), antigen A (p=0.01), age (p < 0.01), and bcl-2 (p = 0.05); and for DFS, N-stage (p < 0.01), antigen A (p < 0.01), Ki-67 (p = 0.03), mucin (p = 0.04) and T-stage (p = 0.05). Of all the clinical-pathological, proliferative, and biological markers studied, only a few carried independent prognostic significance.     

苏中苏南地区高脂血症人群ApoE基因多态性分析研究

目的 为了了解江苏省苏中苏南地区汉族人群高脂血症患者中载脂蛋白E(apolipoprotein E，ApoE)不同基因型的分布差异，从而对他汀类药物在高脂血症患者中的使用提供数据支持，为临床用药提供参考。方法 分别选择2019年8月1日-2022年1月1日在江苏省苏北人民医院和苏州大学第一附属医院诊断为高脂血症患者676例，对患者的ApoE388T＞C（rs429358）、526C＞T（rs7412）相关基因位点的多态性进行了检测，并根据基因分型分为ApoE2、ApoE3和ApoE4三组，搜集纳入各组患者的相关病历数据资料进行回顾性分析，分析总体及不同性别ApoE基因多态性和基因型分布情况，χ2检验分析ApoE基因突变符合 Hardy-weinberg 遗传平衡和进行组间比较，SPSS26.0统计软件分析数据。结果对入选的676例高脂血症病人，三组间患者基本资料中无显著差异（P>0.05），共检出6种ApoE基因表型，由多到少分别为E3/E3 458例(67.75%)，E3/E4 109例（16.12%)，E2/E3 86例（12.72%），E4/E4 11例（1.63%），E2/E4 10例（1.48%），E2/E2 2例（0.30%）。ApoE基因突变符合 Hardy-weinberg 遗传平衡（P>0.05），所有纳入患者来源于同一个孟德尔遗传。ApoE基因型分布在不同性别之间不具有统计学差异(P>0.05)。结论 苏中苏南地区高脂血症人群ApoE的基因多态性分布不均匀，在不同性别中不存在差异，ApoE基因多态性发布特点对临床精准调脂治疗具有一定的参考价值。     

Efficacy and safety of PCSK9 inhibitors in patients with diabetes: A systematic review and meta-analysis

AimsIndividuals with diabetes have increased cardiovascular risk. Although PCSK9 inhibitors bring about a wide reduction in lipids, there is uncertainty about the effects for diabetic patients. We conducted a systematic review and meta-analysis to assess the efficacy and safety of PCSK9 inhibitors for diabetes.Data synthesisWe performed a meta-analysis comparing treatment with PCSK9 inhibitors versus controls up to July 2022. Primary efficacy endpoints were percentage changes in lipid profile parameters. We used random effects meta-analyses to combine data. Subgroups of diabetic patients (by diabetes type, baseline LDL-C, baseline HbA1c and follow-up time) were also compared. We included 12 RCTs comprising 14,702 patients. Mean reductions in LDL-C were 48.20% (95% CI: 35.23%, 61.17%) in patients with diabetes. Reductions observed with PCSK9 inhibitors were 45.23% (95% CI: 39.43%, 51.02%) for non-HDL-cholesterol, 30.39% (95% CI: 24.61%, 36.17%) for total cholesterol, 11.96% (95% CI: 6.73%, 17.19%) for triglycerides, 27.87% (95% CI: 22.500%, 33.17%) for lipoprotein(a), 42.43% (95% CI: 36.81%, 48.06%) for apolipoprotein B; increases in HDL-C of 5.97% (95% CI: 4.59%, 7.35%) were also observed. There was no significant difference in fasting plasma glucose (FPG) (WMD: 2.02 mg/mL; 95% CI: −1.83, 5.87) and HbA1c (WMD: 1.82%; 95% CI: −0.63, 4.27). Use of a PCSK9 inhibitor was not associated with increased risk of treatment-emergent adverse event (TEAE) (p = 0.542), serious adverse event (SAE) (p = 0.529) and discontinuations due to AEs (p = 0.897).ConclusionsPCSK9 inhibitor therapy should be considered for all diabetic individuals at high risk of atherosclerotic cardiovascular disease.Registration code in prosperoCRD42022339785.