小儿肺咳颗粒联合头孢西丁钠治疗小儿支气管肺炎的临床研究

目的 探讨小儿肺咳颗粒联合头孢西丁钠治疗小儿支气管肺炎的临床疗效。方法 选取2020年11月-2022年11月上海健康医学院附属崇明医院儿科收治的136例支气管肺炎患儿,按照随机数字表法分为对照组和治疗组,每组各68例。对照组患者静脉滴注注射用头孢西丁钠,1 g加于0.9%氯化钠注射液100 mL,1次/d。治疗组在对照组基础上口服小儿肺咳颗粒,3 g/次,3次/d。两组用药7 d。观察两组的临床疗效和临床症状好转时间,比较两组患儿白细胞（WBC）、中性粒细胞（NEUT）、白细胞介素-8（IL-8）、血清样淀粉蛋白A （SAA）、血清降钙素原（PCT）、C反应蛋白（CRP）水平。结果 治疗后,治疗组总有效率97.06%,显著高于对照组的85.29%（P<0.05）。治疗后,治疗组发烧、咳嗽、气喘、肺部啰音等症状好转时间均显著短于对照组（P<0.05）。治疗后,两组WBC、NEUT水平均显著低于治疗前（P<0.05）;治疗后,治疗组WBC、NEUT水平低于对照组（P<0.05）。治疗后,两组IL-8、PCT、SAA、CRP水平均较治疗前显著降低（P<0.05）;治疗后,治疗组IL-8、PCT、SAA、CRP水平显著低于对照组（P<0.05）。结论 小儿肺咳颗粒联合头孢西丁钠治疗小儿支气管肺炎效果确切,能有效降低肺炎相关症状,增强患儿的免疫能力,降低机体炎性反应,值得临床借鉴应用。     

老年重症肺部感染患者血清降钙素原表达水平及对机械通气撤机结局的预测价值

目的观察老年重症肺部感染患者血清降钙素原(PCT)表达水平,探讨其对机械通气撤机结局的预测价值。方法选取重症肺部感染老年患者50例为重症组,轻中重度肺部感染老年患者30例为非重症组,另选取同期体检健康患者30例为对照组。对比3组入院24 h内血清PCT、超敏C反应蛋白(hs-CRP)水平,以及重症组不同病原体感染患者上述指标差异。观察重症组48 h内的撤机结局,分析撤机前血清PCT、hs-CRP和白细胞计数(WBC)水平对撤机结局的预测价值。结果1重症组血清PCT显著高于非重症组和对照组(P0.05)。2重症组细菌性感染30例,病毒性感染13例,支原体感染7例,重症组细菌性感染患者血清PCT和WBC显著高于病毒性感染和支原体感染患者(P0.05),hs-CRP比较差异无统计学意义(P0.05)。3重症组撤机成功39例,撤机失败11例;撤机前血清PCT的ROC曲线下面积为0.812,最佳截点值为0.80 ng/m L,敏感度为82.0%,特异度为76.0%。结论血清PCT可以作为老年重症肺部感染患者的辅助诊断指标,且对患者撤机结局有一定的预测价值。     

Unilateral lower lung field opacities on chest radiography: a comparison of the clinical manifestations of tuberculosis and pneumonia

Background

The radiological manifestations of lower lung field (LLF) tuberculosis (LLFTB) are similar to those of LLF pneumonia (LLFP), making diagnosis challenging. The aim of this study was to determine if there are differences in the clinical manifestations of LLFTB and LLFP in patients with unilateral LLF opacities.

Methods

We performed a retrospective review of patient records to identify those with unilateral LLF opacities who were subsequently diagnosed with LLFTB or LLFP. We compared demographics, clinical manifestations, hematological data, and radiographic findings between the groups of patients.

Results

We identified 22 and 72 patients diagnosed with LLFTB and LLFP, respectively. Multivariate analysis revealed that age (odds ratio [OR] = 1.05, 95% confidence interval [CI] = 0.99–1.11, P = 0.072), lack of fever > 38 °C (OR = 9.04, 95% CI = 1.69–48.40, P = 0.001), duration of symptoms ≥ 7 days (OR = 4.57, 95% CI = 1.09–19.26, P = 0.038), and the lack of air bronchograms upon radiography (OR = 12.08, 95% CI = 1.98–73.64, P = 0.007) were significant predictors of LLFTB in patients with LLF opacities. We used these predictors to construct a mathematical model for predicting LLFTB in patients with LLF opacities.

Conclusions

Our findings suggest that older age, prolonged duration of symptoms, lack of fever > 38°C, and the absence of air bronchograms are more common in patients with LLFTB than patients with LLFP. These findings may help clinicians differentiate between LLFTB and LLFP and thus initiate timely and appropriate treatment.     

Toxicology of 3-epi-deoxynivalenol,a deoxynivalenol-transformation product by Devosia mutans 17-2-E-8

Microbial detoxification of deoxynivalenol (DON) represents a new approach to treating DON-contaminated grains. A bacterium Devosia mutans 17-2-E-8 was capable of completely transforming DON into a major product 3-epi-DON and a minor product 3-keto-DON. Evaluation of toxicities of these DON-transformation products is an important part of hazard characterization prior to commercialization of the biotransformation application. Cytotoxicities of the products were demonstrated by two assays: a MTT bioassay assessing cell viability and a BrdU assay assessing DNA synthesis. Compared with DON, the IC₅₀ values of 3-epi-DON and 3-keto-DON were respectively 357 and 3.03 times higher in the MTT bioassay, and were respectively 1181 and 4.54 times higher in the BrdU bioassay. Toxicological effects of 14-day oral exposure of the B6C3F₁ mouse to DON and 3-epi-DON were also investigated. Overall, there were no differences between the control (free of toxin) and the 25 mg/kg bw/day or 100 mg/kg bw/day 3-epi-DON treatments in body and organ weights, hematology and organ histopathology. However, in mice exposed to DON (2 mg/kg bw/day), white blood cell numbers and serum immunoglobulin levels were altered relative to controls, and lesions were observed in adrenals, thymus, stomach, spleen and colon. Taken together, in vitro and in vivo studies indicate that 3-epi-DON is substantially less toxic than DON.     

血细胞计数影响因素分析

本文分析血细胞计数的影响因素,发现血细胞检测结果受环境温度、放置时间、采血方式等因素的影响,检验人员在采血和检测过程中应尽可能排除各种影响因素,为临床提供真实可靠的检验结果。     

急性胰腺炎血感染指标的研究进展

急性胰腺炎(acute pancreatitis, AP)的发病率呈现快速上升的趋势,重症急性胰腺炎(severe acute pancreatitis, SAP)发病快、病情复杂多变、并发症多,死亡率高。AP发病上升与生活水平的提高和饮食结构的改变密切相关。急性胰腺炎感染的早期识别及指导合理应用抗生素对患者治疗及预后十分重要。目前血感染指标包括外周血白细胞(WBC),中性粒细胞率(NR)以及C反应蛋白(CRP)等,该研究做相关的研究报道。     

XN-1000希森美康对孕妇外周静脉血分析提示与细胞涂片染色分析的相关性

目的探讨XN-1000希森美康细胞分析仪对孕妇外周静脉血白细胞分类计数、有核红细胞计数分析提示与相关细胞涂片染色人工分析结果相关性及意义。方法采用XN-1000型希森美康细胞分析仪对妇产科采集的280份外周静脉血进行白细胞分类计数、有核红细胞计数分析,同时对应外周静脉血标本进行细胞涂片染色分析,比较仪器分析和细胞染色人工分析结果。结果仪器分析重复性良好,仪器分析和细胞染色人工分析具有较高的相关性,报警提示结果和细胞染色人工分析阳性结果特异性大于95%,灵敏度100%,阳性预测值大于90%,阴性预测值100.00%。结论 XN-1000希森美康细胞分析仪分析报警提示可以有效筛选阳性标本,同时对阳性标本需要细胞染色人工分析,避免假阳性结果。