中国少数民族中小学生视力不良特征分析

了解中国26个少数民族7~18岁学生视力不良现状及特征,为少数民族学生制定具有针对性的视力防控与治理措施提供依据.方法 使用2014年中国学生体质健康调研中26个少数民族的80 766名中小学生视力不良数据,采用x2检验进行组间比较.结果 少数民族中小学生视力不良率为39.17%,各学段女生视力不良率均高于男生,性别间差异有统计学意义(x2=1 127.28,P<0.01).高中(16~18岁)女生视力不良率最高,达63.13%;小学低年级(7~9岁)男生视力不良率最低,为20.50%.各民族视力不良检出率在14.68%~62.94%之间,其中视力不良检出率最高的前5个民族分别为藏族(62.94%)、壮族(62.39%)、朝鲜族(57.92%)、回族(56.48%)、纳西族(51.35%),最低的前5个民族为水族(14.68%)、佤族(17.96)、柯尔克孜族(18.30%)、黎族(19.22%)、哈尼族(22.30%),民族间差异有统计学意义(x2=7 910.34,P<0.01).结论 中国26个少数民族中小学生视力水平民族间差异明显.在针对藏、壮等重点民族学生干预的同时,应注重性别差异,加强全民族学生的视力防控与治理.     

Hh信号通路因子Shh、Ptch1和Gli1在大黄蛰虫丸抗大鼠肝纤维化中的表达及调节作用

目的探讨大黄蛰虫丸(DZP)对CCl4诱导肝纤维化大鼠肝脏Hedgehog(Hh)信号通路因子Shh、Gli1、Ptch1的影响及其机制。方法选SD雄性大鼠30只,体质量180～200 g,随机分为对照组(N组)、模型组(M组)和灌药组(D组)。后2组行CCl_4诱导肝纤维化造模,8周后D组、C组大鼠分别给予DZP药液灌胃,NG组大鼠给予等量生理盐水。连续灌胃4周后,断头处死各组大鼠,摘取肝脏,应用HE和Masson染色法检测各组别大鼠肝组织纤维化程度;应用Western blot和RT-PCR法分别检测各组大鼠肝组织Hh信号通路因子Shh、Ptch1、Gli1的蛋白及基因表达水平,用Quantity One图像分析软件进行条带光密度分析,计算光密度值(A值)。结果 M组大鼠肝纤维化明显,而D组大鼠肝的纤维化程度显著改善。Hh信号通路因子Shh、Ptch1、Gli1的基因和蛋白表达水平检测结果显示:与N组相比,M组大鼠肝组织中三者的A值均显著上调(P<0.05);而与M组相比,D组大鼠肝组织中三者的A出现显著下调(P<0.05),数据表明大鼠肝纤维化造模成功后,给予DZP干扰,后者可能通过抑制Shh、Gli1、Ptch1的基因和蛋白表达,从而抑制了肝纤维化过程中异常激活的Hh信号通路。结论 DZP可能通过抑制异常激活的Hh信号通路来逆转大鼠肝纤维化。     

腹部内生场热疗联合化疗治疗恶性腹水的临床研究

目的:评价腹部内生场热疗联合化疗治疗恶性腹水的近期疗效及毒副反应。方法:将2015年1月至2016年12月期间江门市人民医院收治的98例恶性腹水的患者按随机分为两组,观察组(50例),采用化疗结合腹部内生场热疗;对照组(48例),采用单纯化疗,比较两组近期效果、毒副反应以及卡氏百分法(KPS)评分的情况。结果:与对照组比较,观察组腹水控制有效率以及KPS评分提高率明显高于对照组,差异具有统计学意义(P0.05);肢端感觉异常及面部感觉异常的发生率低于对照组,差异具有统计学意义(P0.05)。结论:腹部内生场热疗联合化疗治疗恶性腹水近期效果显著,不良反应少,是晚期肿瘤姑息治疗的一种好手段。     

尿流式有形成分及干化学分析在尿路感染诊断中的应用评价

Objective To evaluate the clinical application of automated urine formed elements analyzer and/or urine dipstick analyzer for examination of urinary formed elements in screening urinary tract infection (UTI). Methods 148 fresh midstream clear-catch urine samples from the UTI patients and 284 fresh midstream clear-catch urine samples from non-UTI subjects were selected. Bacteria culture was performed for bacterial colony counting and identification. Bacteria counts ( BACT), yeast-like fungus and WBC were performed by UF-looOi automated urine formed elements analyzer. Leukocyte esterase test (LEU) and nitrite test (NIT) were performed by URISYS 2400 urine dipstick analyzer. We evaluated data obtained from urine dipstick analyzer, UF-1000i and combination of UF-1000i with urine dipstick analyzer and the results was compared with those obtained from quantitative bacterial culture. Then we evaluated the sensibility, specificity, positive predictive value (PPV), negative predictive value (NPV) and accuracy. Results Among the 148 patients with UTI, the positive rate of the quantitative bacterial culture was 73.6% (109/148), the positive rate of LEU and NIT detected by dipstick test 26. 4% (39/148).There was significantly statistical difference between bacterial culture and strip test(χ2 = 55.68 ,P < 0. 05 ). The positive rate of urine flow cytometry by UF-1000i with either positive of BACT and WBC was 91.2%(135/148), which was higher than the positive rate of the quantitative bacterial culture. There was significant difference between two methods (χ2 = 14. 70, P < 0. 05 ). The positive rate of anyone positive among BACT, WBC, LEU and NIT was 94. 6% (140/148) when detected with combination of dipstick test and UF-1000i, which was higher than the positive rate of the quantitative bacterial culture. And there was significant difference between two methods (χ2 = 20. 45, P < 0. 05 ). The sensitivity of dipstick test was low (26. 4% ,39/148 ), and specificity was high ( 99. 3%, 282/284 ) . The sensitivity, specificity, positive predictive value, negative predictive value of BACT detected by UF-1000i in diagnosing urinary tract infection were 92. 6% ( 137/148 ), 39. 8% ( 113/284 ). 44. 5% ( 137/308 ) and 91.1% ( 113/124 ), respectively. If the dipstick test was combined with UF-1000i, the sensitivity, negative predictive value, specificity, positive predictive value and accuracy were 98.0% ( 145/148 ), 97.1% ( 100/103 ). 35.2% (100/284) ,44. 1% (145/329) and 56. 7% (245/432), respectively. Conclusions The combination of urine dipstick test and automated urine formed elements analyzer UF-1000i plays an important role in early diagnosis of UTI. And it has significant value in diagnosis of UTI, especially for the patients with negative bacterial cultures of urine sample.     

14例B细胞淋巴瘤患者131I-美罗华放免显像前用药的观察与护理

目的 探讨B细胞淋巴瘤131I-美罗华放免显像前用药的护理.方法 对14例患者进行放免显像前用药后的观察与护理.结果 2例患者出现寒颤、高热,其中1例伴有心慌、胸闷.结论 此方法比较安全.在护理上要做好放免显像前的准备工作,注意观察患者服药后的不良反应,并且做好心理护理,为B细胞淋巴瘤患者131I-美罗华放免显像的顺利进行奠定良好的基础.     

2014年北京市一起成人麻疹病例暴发的调查

2014年7月15日,北京市朝阳区某房产中介公司发生一起麻疹暴发疫情,共确诊64例病例,均为公司员工,罹患率7.62%(64/840)。发病时间分布在6月30日至7月18日,该公司23个门店内有19个发现病例,经实验室检测感染毒株为H1型。调查结果显示暴发原因可能为首例病例通过公司会议共同暴露。提示易感人群聚集易造成麻疹暴发,综合防控措施是控制成人麻疹暴发疫情的有效方式。     

IVF周期中高雌、孕激素水平对着床期子宫整合素αvβ3表达及子宫内膜容受性的影响

目的 探讨IVF超促排卵过程中,超生理剂量的雌、孕激素对着床期整合素αvβ3表达的影响,从而推测IVF超促排卵所致的高雌、孕激素对子宫内膜容受性的影响.方法 2012年5月至2013年10月于云南省第一人民医院生殖—科行IVF的33例因卵巢过度刺激综合征或过高孕酮水平取消新鲜周期胚胎移植的不孕症妇女为研究组,根据HCG日雌孕激素水平将研究对象分为3组:高E2组(E2≥5 210 pg/mL、P＜ 1.05 ng/mL);高P组(P≥1.05 ng/mL、E2＜5 210 pg/mL);高E2并高P组(P≥1.05 ng/mL、E2≥5 210 pg/mL),于取卵后7～8d用宫腔负压吸管(Pipe11e管)取内膜组织.对照组为11例正常妇女,于超声监测排卵后7～8 d同法取内膜,采用免疫组化SP法和组织学积分H-score法对整合素α v β 3在种植窗期子宫内膜中的表达进行定位和半定量分析,比较不同雌孕激素水平在着床期对整合素αvβ3表达的影响,从而推测IVF超促排卵中高雌、孕激素对子宫内膜容受性的影响.结果 种植窗期高E2组、高P组、高E2并高P组患者与对照组比较整合素α vβ 3的表达差异没有统计学意义(P＞0.05).结论 仅仅依靠整合素αvβ3的表达来推测子宫内膜的容受性是不可靠的.     

尿流式有形成分及干化学分析在尿路感染诊断中的应用评价

Objective To evaluate the clinical application of automated urine formed elements analyzer and/or urine dipstick analyzer for examination of urinary formed elements in screening urinary tract infection (UTI). Methods 148 fresh midstream clear-catch urine samples from the UTI patients and 284 fresh midstream clear-catch urine samples from non-UTI subjects were selected. Bacteria culture was performed for bacterial colony counting and identification. Bacteria counts ( BACT), yeast-like fungus and WBC were performed by UF-looOi automated urine formed elements analyzer. Leukocyte esterase test (LEU) and nitrite test (NIT) were performed by URISYS 2400 urine dipstick analyzer. We evaluated data obtained from urine dipstick analyzer, UF-1000i and combination of UF-1000i with urine dipstick analyzer and the results was compared with those obtained from quantitative bacterial culture. Then we evaluated the sensibility, specificity, positive predictive value (PPV), negative predictive value (NPV) and accuracy. Results Among the 148 patients with UTI, the positive rate of the quantitative bacterial culture was 73.6% (109/148), the positive rate of LEU and NIT detected by dipstick test 26. 4% (39/148).There was significantly statistical difference between bacterial culture and strip test(χ2 = 55.68 ,P < 0. 05 ). The positive rate of urine flow cytometry by UF-1000i with either positive of BACT and WBC was 91.2%(135/148), which was higher than the positive rate of the quantitative bacterial culture. There was significant difference between two methods (χ2 = 14. 70, P < 0. 05 ). The positive rate of anyone positive among BACT, WBC, LEU and NIT was 94. 6% (140/148) when detected with combination of dipstick test and UF-1000i, which was higher than the positive rate of the quantitative bacterial culture. And there was significant difference between two methods (χ2 = 20. 45, P < 0. 05 ). The sensitivity of dipstick test was low (26. 4% ,39/148 ), and specificity was high ( 99. 3%, 282/284 ) . The sensitivity, specificity, positive predictive value, negative predictive value of BACT detected by UF-1000i in diagnosing urinary tract infection were 92. 6% ( 137/148 ), 39. 8% ( 113/284 ). 44. 5% ( 137/308 ) and 91.1% ( 113/124 ), respectively. If the dipstick test was combined with UF-1000i, the sensitivity, negative predictive value, specificity, positive predictive value and accuracy were 98.0% ( 145/148 ), 97.1% ( 100/103 ). 35.2% (100/284) ,44. 1% (145/329) and 56. 7% (245/432), respectively. Conclusions The combination of urine dipstick test and automated urine formed elements analyzer UF-1000i plays an important role in early diagnosis of UTI. And it has significant value in diagnosis of UTI, especially for the patients with negative bacterial cultures of urine sample.