努力推进军队卫生系统的计算机应用

系统地介绍了军队卫生系统计算机应用的概况，总结了军队卫生系统自动化建设的主要经验，并提出了加强军队卫生系统计算机应用的设想。     

不同给药途径时抗核抗体独特型多肽对狼疮样肾炎小鼠作用的探讨

目的应用抗核抗体独特型多肽免疫治疗狼疮肾炎小鼠,观察其对狼疮肾炎模型小鼠肾脏的保护作用。方法将35只雌性GVHD狼疮样肾炎小鼠(C57BL/10×DBA/2)F1分为3组,肾炎模型对照组(10只),口服多肽实验组(10只),皮下注射多肽实验组(15只)。3组小鼠均于24周龄处死,观察3组小鼠体质量、尿蛋白、肾脏组织学及血清IL-6水平的变化。结果在给予多肽12周时,皮下注射组和口服多肽组小鼠肾脏损害较对照组明显减轻;血清IL-6水平也较对照组明显降低。在给予多肽10周时,皮下注射组小鼠体质量明显高于对照组小鼠,12周时口服组体质量也明显高于对照组。给予多肽4周时,皮下注射组小鼠尿蛋白明显少于对照组,8周时口服组尿蛋白也明显少于对照组。结论口服独特型多肽对GVHD狼疮样肾炎小鼠肾脏同样有保护作用。     

雷公藤氯内酯醇对大鼠异位心脏移植免疫抑制作用的实验研究

本研究应用纯系大鼠（Ｌｏｕ→Ｆ３４４）心脏移植模型，比较分析了ＣｓＡ和不同剂量Ｔ４治疗组的移植心脏存活时间、病理损害计分以及移植受体大鼠脾单个核细胞ＩＬ－２生成活性和血清ｓＩＬ－２Ｒ水平，证实Ｔ４可明显延长移植心脏存活时间和减少移植排异反应程度。此研究结果表明Ｔ４具有较强的抗移植排异作用。     

同种异体原位心脏移植2例报告

目的 总结2例原位心脏移植成功的治疗经验，探讨手术方式及术后围手术期处理。方法 2003年5月和2003年12月先后为2例终末期心肌病患者施行原位心脏移植手术。术后免疫抑制剂应用“环孢素A 强的松 骁患”三联疗法。结果 2例手术均获成功，术后无并发症发生，心功能良好，生活质量好。结论 经典法原位心脏移植操作方便、缝合牢固确实，但存在术后心房偏大的不足；围手术期处理中应重视右心功能不全、肾功能不全的防治和胃肠道营养的应用。     

Phylogenetic and pathogenic analyses of two virulent Newcastle disease viruses isolated from Crested Ibis (Nipponia nippon) in China

The crested ibis is one of the most endangered birds in the world, found only in Shaanxi Province in Central China, and it has been reintroduced in Sadogashima in Japan. Two Newcastle disease virus (NDV) isolates were collected from sick crested ibises, and their pathogenic and phylogenetic characteristics were investigated. The results showed that they are virulent, with intracerebral pathogenicity indices of 1.46–1.83 and a mean time of death of 54.4–84.4 h. They shared the same virulent motif ¹¹²-R-R-Q-K-R-F-¹¹⁷ at the F protein cleavage site. The phylogenetic analysis revealed that both isolates were clustered with class II NDVs, with one in genotype VIId and another in a novel genotype (provisionally designated as VIi). The two isolates shared high homology with the strains isolated from poultry flocks in the same region from 2006 to 2010. We first isolated and characterised the NDV isolates from crested ibises, one of which showed new genetic characteristics and formed a new subgenotype with isolates from pigeons and ostriches in the same area. These data are useful for further epidemiological studies on NDV and the protection of crested ibises.     

Clinical cohort study on renal pathological features and prognosis of type 2 diabetic kidney disease patients

Objective To analyze the relationship between renal pathological characteristics and clinical prognosis in type 2 diabetic kidney disease patients, and discuss predictive value of pathological type and indexes for renal function declining rate and related outcome events. Methods Ninety-two type 2 diabetes patients from PUMC Hospital (with macroalbuminuria and followed up no less than 6 months, excluding patients with non-diabetic renal disease) were divided into typical diabetic glomerulopathy group (DG, n=51) and atypical diabetes-related renal disease group(ADRD, n=41) according to renal pathological findings. A retrospective cohort study was performed to investigate renal pathological features and prognosis. Results Total of 29 renal outcome events and 12 death events occurred in DG group and none in ADRD group; the survival rate and kidney survival rate are different between two groups (P＜0.05); DG group, thick GBM, severe vascular and tubular lesion are predicative indicators for renal outcome event; mesangial volume fraction is predicative indicator for renal outcome events independent of age and serum creatinine. Conclusions DG and ADRD patients have different prognosis and might undergo different pathophysiological mechanisms; renal pathological type and mesangial volume fraction could help predicting outcomes of type 2 diabetic nephropathy patients.     

Human leucocyte antigen‐G 14‐bp InDel polymorphism and oral squamous cell carcinoma risk in Chinese Han population: A case–control study

Human leucocyte antigen‐G (HLA‐G) is a nonclassical HLA class I molecule involved in tumour immune escape. The purpose of this study was to investigate the association between the 14‐bp insertion/deletion (InDel) polymorphism in the 3′ untranslated region (3′‐UTR) of HLA‐G gene and oral squamous cell carcinoma (OSCC) risk in Chinese Han population (216 cases and 193 healthy controls), and furthermore, to evaluate serum soluble HLA‐G (sHLA‐G) levels in the OSCC patients. Our results demonstrated that the Ins allele was significantly less frequent in the OSCC patients than that in the healthy controls (odds ratio [OR] = 0.75; 95% confidence interval [CI]: 0.57–0.99; p = 0.040). Distribution of the 14‐bp genotypes in the OSCC patients and the healthy controls revealed that the Ins/Ins genotype was associated with decreased OSCC risk in both the codominant model (Ins/Ins versus Del/Del; OR = 0.57; 95% CI = 0.33–0.99; p = 0.044) and the log‐additive model (OR = 0.76; 95% CI: 0.58–0.99; p = 0.044). The serum sHLA‐G level was significantly higher in the OSCC patients than those in the healthy controls (p < 0.001). Receiver operating characteristic (ROC) curve revealed the valuable diagnostic value of sHLA‐G for OSCC detection, with an area under the ROC curve (AUC) of 0.891 (95% CI: 0.856–0.925, p < 0.001). The OSCC patients with Ins/Ins genotype had lower serum sHLA‐G levels than those with Ins/Del and Del/Del genotypes (p = 0.015). Furthermore, serum sHLA‐G levels were significantly increased with the increasing TNM stages of the OSCC patients (p = 0.017). Our findings revealed that the HLA‐G 14‐bp InDel polymorphism might be a genetic risk factor for OSCC susceptibility, and the serum sHLA‐G may act as a promising biomarker for noninvasive diagnosis of OSCC.     

不同型别银屑病炎症相关临床特征及实验室指标的比较

 目的 探讨寻常型银屑病（PV）、红皮病型银屑病（EP）和泛发性脓疱型银屑病（GPP）患者的4种常见炎症相关临床特征及实验室指标，包括发热、白细胞计数、C反应蛋白（CRP）和红细胞沉降率（ESR）等方面的差异。方法 单中心回顾性研究近10年我科163例银屑病住院患者。比较PV(58例)、EP(48例）、GPP(57例）三组间体温、血细胞计数等资料的差异。结果 GPP组年龄低于30岁患者比例显著高于EP组和PV组。EP组和GPP组患者入院首日发热比例分别为66.67%和77.19%，显著高于PV组（10.34%）。EP组和GPP组患者出现白细胞升高的比例分别为43.75%、73.68%，出现中性粒细胞升高（>7.5×109/L）的比例分别为33.33%、66.67%，均显著高于PV组（分别为12.07%、3.45%），而GPP组相应比例显著高于EP组，差异均有统计学意义（均P<0.05）。EP组和GPP组患者出现单核细胞升高的比例分别为20.83%、36.84%，存在CRP升高的比例分别为81.52%、87.72%，存在ESR升高的比例分别为83.33%、84.21%，均显著高于PV组（分别17.24%、15.52%），差异均有统计学意义（均P<0.05）。 结论 与PV患者比较，EP和GPP患者临床更容易出现发热症状，以及白细胞、中性粒细胞、单核细胞、CRP和ESR升高等炎症标志异常。GPP患者白细胞和中性粒细胞升高比例高于EP患者。不同型别的银屑病在以上常见炎症相关临床特征及实验室指标方面存在明显差异，提示其发病机制可能不同，临床治疗方案理应有别。     

心脏移植术后肺部真菌球2例

目的 总结心脏移植术后肺部真菌球的诊断及处理方法。方法 30例同种异体原位心脏移植患者中,2例术后早期并发肺部严重真菌感染(毛霉菌和曲霉菌)伴真菌球形成,主要依靠胸片、痰培养或组织培养确诊,均给予行手术切除病灶及二性霉素B治疗。结果 2例真菌感染得到控制,但均存在肝功能损害。1例长期存活,1例于移植后第17周因药物性肝损害并发暴发性肝炎致肝功能衰竭而死亡。结论 心脏移植后肺部真菌球较少见,死亡率高,外科切除病灶及二性霉素B联合处理效果较佳,应重在预防。