不同类别细菌感染患儿血清降钙素原水平变化

目的了解不同类别细菌感染患儿血清降钙素原（PCT）水平的变化,探讨血清PCT区分革兰阳性(G＋)菌和革兰阴性(G－) 菌感染的价值。方法以重症监护室收治的266例全身重症细菌感染患儿为研究对象,根据细菌培养结果分为G＋菌组和G－菌组,分别检测2组患儿血清PCT、C反应蛋白（CRP）水平和白细胞（WBC）计数、中性粒细胞百分比(Neu%),并对2组资料进行统计分析。结果全身重症细菌感染患儿血清PCT水平明显升高,以PCT≥2.0 ng/mL为阳性,G－菌组阳性率（92.36%）显著高于G＋菌组（76.23%）(χ2=13.45,P＜0.001);当PCT≥10.0 ng/mL时,G－菌感染可能性更大。而常规感染指标CRP、WBC计数及Neu%,G＋菌组阳性率与G－菌组差异无统计学意义(均P＞0.05)。结论血清PCT水平作为区分G＋菌和G－菌感染指标有一定价值,能为重症感染患儿早期使用相应抗菌药物治疗提供参考依据。     

胃癌及胃癌前疾病患者血清及组织癌胚抗原检测的意义

目的 检测胃癌、胃癌前疾病患者血清与胃组织癌胚抗原(CEA),为胃癌及胃癌前疾病的诊断、监测提供参考指标.方法 采用放射免疫法测定胃癌(111例)、胃癌前疾病(167例,其中慢性萎缩性胃炎104例,胃溃疡31例,胃黏膜肠上皮化生32例)患者血清CEA,免疫组化SP法测定胃组织CEA,并与浅表性胃炎(31例)对照.结果 胃癌组织中CEA阳性率(89.2%,99/111)明显高于胃癌前疾病[慢性萎缩性胃炎52.9%(55/104),胃黏膜肠上皮化生53.1%(17,32),胃溃疡48.4%(15/31)]及浅表性胃炎组织(19.4%,6/31),P＜0.01;胃癌与胃癌前疾病及浅表性胃炎的血清CEA阳性率比较差异有统计学意义(分别为19.8%、1.9%、0),P＜0.01;胃癌前疾病与浅表性胃炎的血清CEA阳性率比较差异无统计学意义,P＞0.05.结论 胃组织中CEA阳性有助于胃癌的诊断.并可作为监测胃癌前疾病的指标之一;血清CEA水平对胃癌有一定的诊断价值,对胃癌前疾病的诊断价值不大.     

血清钙离子水平与肝硬化发病风险相关性研究

目的探讨成年人血清钙离子水平与肝硬化发病风险间的关系。方法在河南省林县食管癌营养干预试验队列中开展巢式病例对照研究。利用全自动生物化学分析仪和酶联免疫法检测281名肝硬化病例和562名对照个体的基线血清钙浓度以及HBsAg、抗一HBc、抗一HCV,采用调查问卷收集研究对象相关基线特征信息。研究对象血钙水平以三分位分组并使用多因素logistic回归模型计算各组肝硬化发病OR值及其95％C／。结果病例组血清钙离子水平为(1．81±0．84)mmol／L,高于对照组(1．65±0．79)mmol／L,f=一2．640,P=0．008。血清钙的不同取值水平与肝硬化发病率有关(X²=6．888,P=0．0319)。血钙浓度最高组患肝硬化的风险约为最低组的2倍(OR=2．261,95％CI：1．497～3．416,P=0．002),且血钙水平与肝硬化风险呈正相关(X²=6．842,P=0．0089)。结论 中国人群中高血清钙水平可能作为肝硬化发生一项独立的危险因素,其机制尚需进一步研究。     

Intakes of calcium and vitamin D and risk of colorectal cancer in women

In vivo and in vitro studies have suggested a protective role of calcium and vitamin D in the development of colorectal cancer. However, epidemiologic data have been inconclusive. The authors prospectively assessed intakes of calcium and vitamin D in relation to risk of colorectal cancer in a large, prospective, female cohort from the US Women's Health Study. In 1993, 39,876 women aged > or = 45 years and free of cardiovascular disease and cancer were enrolled in the study. During an average follow-up of 10 years, 223 of 36,976 women eligible for the present study developed colorectal cancer. Intakes of calcium and vitamin D from dietary sources and supplements were assessed with a baseline food frequency questionnaire. Cox proportional hazards regression was used to estimate relative risks and 95% confidence intervals. Intakes of total calcium and vitamin D were not associated with risk of colorectal cancer; multivariate relative risks comparing the highest with the lowest quintile were 1.20 (95% confidence interval: 0.79, 1.85; p for trend = 0.21) for total calcium and 1.34 (95% confidence interval: 0.84, 2.13; p for trend = 0.08) for total vitamin D. Intakes of both nutrients from specific types of sources, including diet and supplements, were also not significantly associated with colorectal cancer risk. Data provide little support for an association of calcium and vitamin D intake with colorectal cancer risk.     

Basic and clinical investigations of dietary calcium in the prevention of colorectal cancer

Long-standing investigations into the role of diet in colon cancer have generally supported the notion that some aspect of dietary fats acts to promote cancer at this site. Understanding of the chemical behavior of lipids in the colon led to a hypothesis suggesting that depletion of calcium could partly explain the tumor-promoting effects of dietary fat. Calcium levels may control critical intracellular events in the course of proliferation. Lack of availability or loss of calcium may result in abnormalities in the regulation of colonic proliferation. Basic and clinical studies suggest that calcium supplementation reduces colonic proliferation implying a potential reduction in cancer risk. The current evidence supporting calcium as a cancer chemoprevention agent is reviewed.     

苏州成人血清维生素D、甲状旁腺激素、钙与血糖升高的关系

目的探讨血清25-羟基维生素D(25-OH-D)、甲状旁腺激素(PTH)及血清钙与血糖升高之间的关系。方法于2013年按照整群随机抽样的方法从苏州市4个社区抽取621名40～75岁成年居民,收集人口统计学等资料,测量身高、体重和血压,检测空腹血糖、25-OH-D、PTH、钙、磷等指标。结果与25-OH-D10.0μg/L者相比,25-OH-D介于10.0～19.9μg/L及≥20.0μg/L者的空腹血糖水平及血糖升高发生率均偏低(P0.001)。PTH≥65.0 ng/L者与65.0 ng/L者的血糖水平及血糖升高发生率差异无统计学意义。与血清钙为2.03～2.54 mmol/L者相比,血清钙≥2.54 mmol/L者的血糖水平均较高(P0.001),而血糖升高者比例却随着血清钙浓度的增加而增加。多因素Logistic回归分析发现,25-OH-D为10.0～19.9μg/L组及≥20.0μg/L组血糖升高的危险性分别为10.0μg/L组的0.467倍(95%CI 0.311～0.703,P0.001)和0.402倍(95%CI 0.205～0.790,P=0.008);血清钙≥2.54 mmol/L组血糖升高的危险性是2.03～2.54 mmol/L组的1.884倍(95%CI 1.272～2.791,P=0.001)。结论维生素D缺乏、血清钙浓度的升高会增加血糖升高的危险性。     

血清降钙素原水平测定对老年患者下呼吸道感染的诊断价值

目的探讨血清降钙素原(PCT)水平测定对老年患者下呼吸道感染的诊断意义,从而对患者进行全面的评估。方法选择2011年1月-2015年6月医院收治的老年下呼吸道感染患者102例为研究对象,按感染类型将其分为两组,68例细菌性感染患者为观察组,34例非细菌性感染患者为对照组,分析两组患者的PCT和C-反应蛋白(CRP)水平,两组患者在PCT和CRP的灵敏度、特异度比较,观察组不同时间的PCT和APACHEⅡ评分。结果观察组患者PCT和CRP的水平分别为(7.2±2.6)μg/L和(11.2±3.5)mg/L,均明显高于对照组的(3.8±1.3)μg/L和(8.7±2.9)mg/L,差异均有统计学意义(P0.05);观察组中PCT的敏感度和特异度分别为98.5%和91.2%,均高于对照组的79.4%和64.7%,两组差异有统计学意义(P0.05),而观察组中CRP的敏感度相对较高,但是与对照组间差异无统计学意义,且特异度较低,与对照组相比差异有统计学意义(P0.05);随着对患者的治疗,PCT的水平得到下降,使患者的APACHEⅡ评分下降,且第1天和第8天的PCT水平及APACHEⅡ评分差异有统计学意义(P0.05)。结论老年患者下呼吸道细菌性感染的病情可通过PCT水平的测定对病情的严重程度及预后进行全面的评估,是一个较好的诊断指标。     

Detection of aberrant p16 methylation in the serum of colorectal cancer patients

OBJECTIVES: To detect aberrant p16 promoter methylation in serum of patients with colorectal cancer (CRC), and to explore the possibility of using this assay in early detection or as a prognostic marker. METHODS: Methylation-specific PCR was used to detect p16 methylation in DNA extracted from 52 CRCs and corresponding serum samples. Serum samples from 34 patients with adenomatous polyps and 10 healthy individuals were used as controls. The association of p16 hypermethylation in serum DNA of CRC patients with clinicopathological characteristics was analyzed. RESULTS: p16 methylation was found in 38% (20 of 52) of CRC tissues. Among the 20 patients with aberrant methylation in the tumor tissues, similar changes were also detected in the serum of 14 (70%) patients. No methylated p16 sequences were detected in the peripheral serum of the 32 CRC patients without these changes in the tumor, in 34 paitents with adenomatous polyps, or in 10 healthy controls. Clinicopathological analysis revealed that p16 methylation in serum was significantly associated with later Dukes' stage (chi(2) = 5.7, P = 0.03). CONCLUSION: This assay offers a potential means for the serum-based detection and/or monitoring of CRC patients.     

肿瘤患者及健康人血清硒水平研究

对２０３例肿瘤患者和４０例健康对照组血清硒研究表明，肿瘤患者血清硒显著低于健康组（Ｐ＜０．０１～０．００１），而不同肿瘤患者之间无差异，肺癌患者不同分期之间也无统计学意义，结果认为低硒水平可能是肿瘤患者的固有特性。     

血清TPSA、PSAD对前列腺癌的诊断价值

目的探讨血清总前列腺特异抗原（TPSA）、前列腺特异抗原密度（PSAD）对前列腺癌的诊断价值。方法检测经病理诊断的39例前列腺癌、68例前列腺增生患者的血清TPSA,通过经直肠超声测定其前列腺的体积（PV）并计算PSAD。结果（1）前列腺癌组患者的TPSA、PSAD明显高于前列腺增生组;（2）TPSA、PSAD在工作特征曲线（ROC曲线）下的面积大小分别为0．652、0．852：由ROC曲线确定的诊断前列腺癌的最佳临床判断值为TPSA〉8．35ng／ml、PSAD〉0．1885ng／（ml·cm^3）;据此临界值诊断前列腺癌的敏感度、特异度分别为：TPSA为61．5％、69．1％,PSAD为82．1％、83．8％。结论PSAD是TPSA对前列腺癌诊断的有益补充。     

血清TPSA、PSAD对前列腺癌的诊断价值

目的 探讨血清总前列腺特异抗原(TPSA)、前列腺特异抗原密度(PSAD)对前列腺癌的诊断价值.方法 检测经病理诊断的39例前列腺癌、68例前列腺增生患者的血清TPSA,通过经直肠超声测定其前列腺的体积(PV)并计算PSAD.结果 (1)前列腺癌组患者的TPSA、PSAD明显高于前列腺增生组;(2)TPSA、PSAD 在工作特征曲线(ROC曲线)下的面积大小分别为0.652、0.852;由ROC曲线确定的诊断前列腺癌的最佳临床判断值为TPSA>8.35 ng/ml、PSAD>0.1885 ng/(ml·cm3);据此临界值诊断前列腺癌的敏感度、特异度分别为: TPSA 为61.5%、69.1%,PSAD 为82.1%、83.8%.结论 PSAD是TPSA对前列腺癌诊断的有益补充.