SLIPA喉罩对无痛纤维支气管镜检查患者应激反应及血流动力学的影响

目的探讨流线型气道(streamlined liner of the pharynx airway,SLIPA)喉罩对无痛纤维支气管镜检查患者应激反应及血流动力学的影响。方法选择2015年1月-2017年1月收治的无痛纤维支气管镜检查患者124例为研究对象,采用前瞻性研究的方法,将患者随机分为干预组和对照组各62例。对照组使用内镜面罩,干预组使用SLIPA喉罩。比较两组患者应激反应、血流动力学、不良反应。结果纤维支气管镜插入后3min(T2)、取出纤维支气管镜后1min(T3),干预组患者血清肾上腺素(E)、去甲肾上腺素(NE)、多巴胺(DA)含量明显低于对照组[(0. 80±0. 16 vs 1. 25±0. 21,0. 72±0. 15 vs 0. 98±0. 24) mmol/L,(1. 36±0. 27 vs 1. 62±0. 27,1. 30±0. 16 vs 1. 48±0. 13) mmol/L,(1. 15±0. 22 vs 1. 58±0. 20,0. 98±0. 17 vs 1. 32±0. 21) mmol/L](t=13. 421,7. 234,5. 667,6. 875,11. 388,9. 909,P 0. 05,P 0. 01),心率(HR)、舒张压(SBP)、收缩压(DBP)均明显低于对照组[(78. 23±6. 65 vs 82. 10±6. 10,76. 32±8. 45 vs 76. 05±8. 32)次/min,(138. 12±8. 36 vs 146. 32±10. 20,135. 12±9. 20 vs 135. 24±11. 36) mm Hg,(82. 12±8. 45 vs 84. 45±7. 24,78. 15±8. 34 vs 79. 12±8. 35) mm Hg](t=3. 377,2. 127,10. 167,6. 420,6. 472,4. 962,P 0. 05,P 0. 01);干预组恶心呕吐、呛咳、咽痛不适等发生率明显低于对照组(3. 23%vs 12. 90%,4. 84%vs 27. 42%,1. 61%vs 11. 29%)(χ~2=3. 916,11. 685,4. 810,P 0. 05,P 0. 01)。结论 SLIPA喉罩有助于缓解无痛纤维支气管镜检查患者应激反应,维护血流动力学相对稳定,减少不良反应发生率。     

先天性肝纤维化伴血铜蓝蛋白降低1例

患者,男,22岁.因肝区隐痛不适2年来诊.无呕血、腹痛、黑便等症状.曾用保肝药物.既往史无殊,无毒物接触史和肝病家族史.查体体型瘦长.肝掌阴性,蜘蛛痣阴性,巩膜无黄染.心肺听诊未及异常.腹软,肝脾肋下未触及,移动性浊音阴性,下肢无水肿.     

隐孢子虫基因组学研究进展

隐孢子虫为人兽共患性原虫,呈世界性分布,经水源和食物源途径传播,为人腹泻性疾病的一个重要致病因素.共有7个种(Cryptosporidium hominis, C.parvum, C.meleagridis, C.felis, C.canis, C.muris,C.suis,C.andersoni, C.baileyi)以及一个基因型(cervine genotype,skunk genotype)可以感染人类.而目前尚无有效的治疗性药物,因此研究隐孢子虫具有公共卫生重要性.     

穿孔素和颗粒酶B基因多态性与幼年特发性关节炎相关性分析

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非酒精性脂肪性肝病与血清维生素D及骨密度的关系

目的探讨非酒精性脂肪性肝病(NAFLD)与维生素D及骨密度的关系。方法选取2018年5月-2019年3月于大连大学附属中山医院住院及门诊就诊的NAFLD患者180例为NAFLD组,另选取年龄及性别相匹配的健康体检者180例为对照组。比较2组维生素D、骨密度、骨代谢生化标志物[β胶原降解产物(β-CTX)、Ⅰ型胶原氨基端延长肽(P1NP)、骨钙素(OC)]的差异。正态分布的计量资料2组间比较采用独立样本t检验,非正态分布采用Mann-Whitney U检验;计数资料2组间比较采用χ2检验。相关性采用Spearman秩相关分析;采用二项分类logistic回归分析NAFLD的相关危险因素。结果 NAFLD组25(OH) D[13. 06(10. 73～19. 77) ng/ml vs 19. 88(12. 56～22. 60) ng/ml,Z=-1. 37,P=0. 041]、L1-4骨密度[0. 87(0. 83～1. 05) g/cm2vs1. 05(0. 92～1. 21) g/cm2,Z=-2. 17,P=0. 034]、股骨颈骨密度[(0. 76±0. 21) g/cm2vs(0. 84±0. 51) g/cm2,t=2. 02,P=0. 015]、P1NP[45. 40(33. 35～58. 02) ng/ml vs 67. 39 (48. 09～87. 49) ng/ml,Z=-0. 83,P=0. 044]和OC[14. 79 (11. 64～18. 87) ng/ml vs17. 29(15. 16～21. 04) ng/ml,Z=-2. 09,P=0. 037]水平均明显低于对照组;β-CTX[354. 75(186. 32～526. 57) pg/ml vs 287. 67(164. 10～497. 76) pg/ml,Z=-1. 04,P=0. 027]水平明显高于对照组。NAFLD患者25(OH) D[(13. 51±3. 20) ng/ml vs(18. 86±3. 70) ng/ml,t=3. 02,P=0. 038]及L1-4骨密度[(0. 75±0. 24) g/cm2vs(1. 05±0. 31) g/cm2,t=2. 17,P=0. 035]、股骨颈骨密度[(0. 71±0. 18) g/cm2vs(0. 82±0. 21) g/cm2,t=2. 25,P=0. 042]在ALT2倍正常值上限(ULN)组明显低于≤2×ULN组; 25(OH) D、L1-4骨密度、股骨颈骨密度在CT诊断不同程度脂肪肝组间比较差异均无统计学意义(P值均 0. 05)。骨密度与HDL-C(r=0. 232,P 0. 05)呈正相关,与BMI(r=-0. 271,P 0. 05)、GLU(r=-0. 242,P 0. 05)、ALT(r=-0. 375,P 0. 05)、AST(r=-0. 312,P 0. 05)、LDL-C(r=-0. 247,P 0. 05)呈负相关。logistic回归分析结果显示,25(OH) D[比值比(OR)=1. 113,95%可信区间(95%CI):1. 023～1. 210,P=0. 013]、BMI(OR=0. 676,95%CI:0. 522～0. 877,P=0. 003)、GLU(OR=0. 350,95%CI:0. 139～0. 882,P=0. 026)是NAFLD的影响因素。结论 NAFLD患者血清维生素D及骨密度明显低于正常人,通过血清维生素D及骨密度的分析可进一步阐明NAFLD的骨代谢特征,对NAFLD并发骨质疏松症进行合理的早期筛查,以提高NAFLD患者的预后及生活质量。     

My Hobbies

Hi! My name is Chu Chenyao.I’m twelve years old.I live in Fenhu,a small town near Shanghai.I’m a student.I study at Luxu Experimental Primary School.I like English,but I cannot speak English very well.I like watching TV.I often watch TV at weekends.I like watching"Where are you going,Dad?"very much.I like reading,too.I read a nice storybook yesterday.What do you like?Tell me your hobbies please.     

3种预测工具评估住院高血压患者脑卒中风险

目的采用3种预测工具评估住院高血压患者脑卒中风险。方法选择高血压患者356例,采用脑卒中风险初筛量表、改良Framingham卒中风险评估量表(M-FSP)和汇集队列风险方程(PCE)评估脑卒中风险,并比较M-FSP和PCE在脑卒中风险评估应用中的一致性。结果脑卒中风险初筛量表评估男性脑卒中高危风险明显高于女性(28. 8%vs 17. 2%,P 0. 05);≥60岁脑卒中高危风险明显高于60岁(30. 1%vs 15. 3%,P 0. 01)。M-FSP评估患者10年脑卒中风险(12. 6±7. 1)%,男性脑卒中风险明显高于女性[(14. 5±9. 6)%vs (10. 1±8. 9)%,P 0. 01];≥60岁脑卒中风险明显高于60岁[(18. 8±12. 1)%vs (9. 4±7. 6)%,P 0. 01]。PCE评估患者10年脑卒中风险(13. 3±9. 2)%,男性脑卒中风险明显高于女性[(16. 5±11. 9)%vs (8. 9±7. 8)%,P 0. 01];≥60岁脑卒中风险明显高于60岁[(29. 9±19. 5)%vs (11. 2±9. 3)%,P 0. 01]。相关性分析显示,男性和女性的r值分别为0. 647和0. 609,≥60岁和60岁的r值分别为0. 577和0. 702(P 0. 01)。结论脑卒中风险初筛量表可以对个体脑卒中风险进行初筛和归类,M-FSP和PCE均能预测脑卒中发生风险。     

支气管镜局部灌注联合全身化疗 对耐多药肺结核患者血清炎性因子及免疫功能的影响

目的探讨支气管镜局部灌注联合全身化疗对耐多药肺结核患者血清炎性因子及免疫功能的影响。方法选择2013年10月-2015年10月收治的耐多药肺结核患者124例为研究对象,采用随机数字表法分为观察组和对照组各62例。对照组给予3DThZVAK+M/15DThZV+M标准化耐多药肺结核化疗方案,观察组联合应用支气管镜局部灌注治疗,比较两组痰菌转阴率、血清炎性因子、免疫功能、不良反应。结果治疗3个月、6个月,随访12个月,观察组痰菌转阴率明显高于对照组(59. 68%vs 35. 48%,74. 19%vs48. 39%,88. 71%vs 67. 74%),(χ~2=7. 725,8. 702,8. 002,P 0. 05);治疗6个月,观察组患者血清肿瘤坏死因子-α(TNF-α)、C反应蛋白(CRP)、降钙素原(PCT)含量降低值明显高于对照组[(17. 77±3. 12 vs 11. 00±1. 45) pg/m L、(45. 65±5. 42 vs 37. 96±4. 36) mg/L、(0. 31±0. 08 vs 0. 23±0. 05) ng/L](t=15. 494,8. 705,6. 677,P 0. 05,P 0. 01);免疫球蛋白Ig A、Ig G、Ig M增加值明显高于对照组[(0. 86±0. 15 vs 0. 48±0. 10)g/L、(4. 22±0. 56 vs 2. 12±0. 36) g/L、(0. 29±0. 08 vs 0. 14±0. 05) g/L](t=16. 597,24. 838,12. 520,P 0. 01);两组发热、咳血痰、肝功能损害等不良反应比较,无统计学意义(24. 19%vs 20. 97%)(χ~2=0. 185,P0. 05);随访2年,观察组复发率3. 23%明显低于对照组14. 52%(χ~2=4. 888,P 0. 05)。结论支气管镜局部灌注联合全身化疗有助于提高耐多药肺结核患者痰菌转阴率,减少复发率,可能与抑制患者炎症反应、改善免疫功能等因素有关。     

骨细胞密度对骨生物力学性能的影响

Objective To investigate osteocyte density as a potential index of bone biomechanical property. Methods Forty 7-month-old female Sprague-Dawley rats were randomly group (EST) and sham operation group (SHAM). At 15 weeks postoperation, the compression test was performed on L5 vertebral body and micro-computed tomography (μ-CT) was used to estimate the three-dimensional bone mineral density (BMD) and three-dimensional microstructure parameters of L6 vertebral body. After fatigue damage testing, the L6 vertebral body was bulk-stained in 1% basic fuchsin and embedded in methylmethacrylate. Mounted bone slices were used to measure microcrack parameters and osteocyte density. Results At 15 weeks postoperation, osteocyte density (Ot. N/T. area) was significantly decreased in OVX group compared with SHAM group and EST group [(1268. 1 ±191.2)/mm2 vs. (1760. 8 ± 376.6)/mm2 and (1550. 9± 202.2)/mm2, F = 3.513,P<0. 05]. Maximum load (ML) was significantly decreased and the length of microcrack (Cr. Le) was significantly increased in OVX group compared with SHAM group, EST group and GEN group [(84. 4±16.9)N vs. (110.3±25.6),(103. 9±15. 8)and(110.1±4. 9)N; (58. 1±6.8) μm vs. (24.2±8. 1), (36. 5±9. 7)and(28.5±7. 5)μm, F=9. 561,3. 179, all P<0. 05]. Compared with SHAM group and EST group, bone trabecula connection density (Conn. D) was significantly decreased and trabecular separation (Tb. Sp) was significantly increased in OVX group [(47.4±7.4) m-3 vs. (71.8±16.0)and (74.0±12.7)m-3;(315.0±32.7)μm vs. (222. 5±21.7)and (273.3± 50.0)μm, F=7. 635,7. 007, all P<0. 05]. Bone mineral content (BMC) was lower in OVX group than that in SHAM group[(6.5±2. 2)g vs. (7. 9±1.2)g, P<0. 05]. When data in four groups were overall analyzed, Ot. N/T. Ar was positively correlated with ML, Conn. D and BMC (R2 = 0. 7874, 0. 1153, 0. 1309, all P<0. 05), but was negatively correlated with Cr. Le and Tb. Sp (R2 =0. 5738, 0. 3964, both P < 0.05). Conclusions Osteocyte plays a crucial role in maintaining bone biomechanical property and osteocyte density may be considered as a useful indicator for assessing bone biomechanical property.     

骨细胞密度对骨生物力学性能的影响

Objective To investigate osteocyte density as a potential index of bone biomechanical property. Methods Forty 7-month-old female Sprague-Dawley rats were randomly group (EST) and sham operation group (SHAM). At 15 weeks postoperation, the compression test was performed on L5 vertebral body and micro-computed tomography (μ-CT) was used to estimate the three-dimensional bone mineral density (BMD) and three-dimensional microstructure parameters of L6 vertebral body. After fatigue damage testing, the L6 vertebral body was bulk-stained in 1% basic fuchsin and embedded in methylmethacrylate. Mounted bone slices were used to measure microcrack parameters and osteocyte density. Results At 15 weeks postoperation, osteocyte density (Ot. N/T. area) was significantly decreased in OVX group compared with SHAM group and EST group [(1268. 1 ±191.2)/mm2 vs. (1760. 8 ± 376.6)/mm2 and (1550. 9± 202.2)/mm2, F = 3.513,P<0. 05]. Maximum load (ML) was significantly decreased and the length of microcrack (Cr. Le) was significantly increased in OVX group compared with SHAM group, EST group and GEN group [(84. 4±16.9)N vs. (110.3±25.6),(103. 9±15. 8)and(110.1±4. 9)N; (58. 1±6.8) μm vs. (24.2±8. 1), (36. 5±9. 7)and(28.5±7. 5)μm, F=9. 561,3. 179, all P<0. 05]. Compared with SHAM group and EST group, bone trabecula connection density (Conn. D) was significantly decreased and trabecular separation (Tb. Sp) was significantly increased in OVX group [(47.4±7.4) m-3 vs. (71.8±16.0)and (74.0±12.7)m-3;(315.0±32.7)μm vs. (222. 5±21.7)and (273.3± 50.0)μm, F=7. 635,7. 007, all P<0. 05]. Bone mineral content (BMC) was lower in OVX group than that in SHAM group[(6.5±2. 2)g vs. (7. 9±1.2)g, P<0. 05]. When data in four groups were overall analyzed, Ot. N/T. Ar was positively correlated with ML, Conn. D and BMC (R2 = 0. 7874, 0. 1153, 0. 1309, all P<0. 05), but was negatively correlated with Cr. Le and Tb. Sp (R2 =0. 5738, 0. 3964, both P < 0.05). Conclusions Osteocyte plays a crucial role in maintaining bone biomechanical property and osteocyte density may be considered as a useful indicator for assessing bone biomechanical property.     

骨细胞密度对骨生物力学性能的影响

Objective To investigate osteocyte density as a potential index of bone biomechanical property. Methods Forty 7-month-old female Sprague-Dawley rats were randomly group (EST) and sham operation group (SHAM). At 15 weeks postoperation, the compression test was performed on L5 vertebral body and micro-computed tomography (μ-CT) was used to estimate the three-dimensional bone mineral density (BMD) and three-dimensional microstructure parameters of L6 vertebral body. After fatigue damage testing, the L6 vertebral body was bulk-stained in 1% basic fuchsin and embedded in methylmethacrylate. Mounted bone slices were used to measure microcrack parameters and osteocyte density. Results At 15 weeks postoperation, osteocyte density (Ot. N/T. area) was significantly decreased in OVX group compared with SHAM group and EST group [(1268. 1 ±191.2)/mm2 vs. (1760. 8 ± 376.6)/mm2 and (1550. 9± 202.2)/mm2, F = 3.513,P<0. 05]. Maximum load (ML) was significantly decreased and the length of microcrack (Cr. Le) was significantly increased in OVX group compared with SHAM group, EST group and GEN group [(84. 4±16.9)N vs. (110.3±25.6),(103. 9±15. 8)and(110.1±4. 9)N; (58. 1±6.8) μm vs. (24.2±8. 1), (36. 5±9. 7)and(28.5±7. 5)μm, F=9. 561,3. 179, all P<0. 05]. Compared with SHAM group and EST group, bone trabecula connection density (Conn. D) was significantly decreased and trabecular separation (Tb. Sp) was significantly increased in OVX group [(47.4±7.4) m-3 vs. (71.8±16.0)and (74.0±12.7)m-3;(315.0±32.7)μm vs. (222. 5±21.7)and (273.3± 50.0)μm, F=7. 635,7. 007, all P<0. 05]. Bone mineral content (BMC) was lower in OVX group than that in SHAM group[(6.5±2. 2)g vs. (7. 9±1.2)g, P<0. 05]. When data in four groups were overall analyzed, Ot. N/T. Ar was positively correlated with ML, Conn. D and BMC (R2 = 0. 7874, 0. 1153, 0. 1309, all P<0. 05), but was negatively correlated with Cr. Le and Tb. Sp (R2 =0. 5738, 0. 3964, both P < 0.05). Conclusions Osteocyte plays a crucial role in maintaining bone biomechanical property and osteocyte density may be considered as a useful indicator for assessing bone biomechanical property.     

异甘草酸镁治疗自身免疫样药物性肝损伤的效果和安全性

目的探索异甘草酸镁治疗自身免疫样药物性肝损伤的临床疗效和安全性。方法选取首都医科大学附属北京佑安医院2016年7月-2019年1月住院的自身免疫样药物性肝损伤患者53例为观察组,另选不伴有自身免疫现象的药物性肝损伤患者50例为对照组。所有患者给予异甘草酸镁200 mg/d,治疗4周。观察治疗前后患者肝功能情况,观察治疗前后观察组患者的免疫学指标,记录两组患者的不良反应。治疗结束后每月随访肝功能,随访时间6个月。正态分布计量资料组间比较采用t检验,非正态分布的计量资料采用Mann-Whitney U检验,计数资料组间比较采用χ~2检验或Fisher精确概率检验。结果观察组治疗后与治疗前比较,ALT[35. 4(29. 2～42. 0) U/L vs 289. 0(226. 6～460. 3) U/L,Z=-8. 661,P 0. 001]、AST[46. 3(15. 6～183. 5) U/L vs306. 3(32. 2～589. 8) U/L,Z=-5. 271,P 0. 001]、GGT[77. 0(53. 2～183. 2) U/L vs 129. 0(77. 8～232. 5) U/L,Z=-3. 437,P=0. 001)]、ALP[83. 1(64. 9～83. 1U/L vs 119. 4 (104. 9～146. 9) U/L,Z=-3. 485,P 0. 001]和TBil[(27. 5±10. 3)μmol/L vs(59. 7±18. 6)μmol/L,t=6. 673,P 0. 001]水平均明显降低;对照组患者治疗后与治疗前比较,ALT[33. 1(14. 9～106. 4) U/L vs300. 6(206. 8～679. 5) U/L,Z=-8. 232,P 0. 001]、AST[44. 1(20. 8～151. 6) U/L vs 321. 7(36. 2～553. 2) U/L,Z=-3. 549,P 0. 001]、GGT[82. 7(50. 6～168. 5) U/L vs 133. 5 (72. 2～254. 2) U/L,Z=-2. 364,P=0. 018]、ALP[87. 6 (74. 3～139. 4) U/L vs128. 0(106. 3～201. 4) U/L,Z=-4. 303,P 0. 001]和TBil[(23. 8±10. 9)μmol/L vs (58. 3±19. 8)μmol/L,t=-8. 450,P 0. 001]水平也明显降低。但治疗后两组间比较差异均无统计学意义(P值均 0. 05)。治疗后观察组患者IgG水平由(15. 8±3. 2) g/L降至(14. 2±2. 0) g/L,治疗前Ig G水平升高(16 g/L)患者22例中18例(81. 8%)恢复正常。36例ANA阳性患者19例(52. 7%)阴转。两组患者均无严重不良反应。行肝穿病理检查患者中,观察组患者中性粒细胞和(或)嗜酸性粒细胞浸润(17/32,53. 1%)明显高于对照组(3/17,17. 5%)(χ~2=5. 785,P=0. 016)。结论异甘草酸镁用于治疗自身免疫样药物性肝损伤安全有效,是临床治疗的可选择方案。     

直接抗病毒药物治疗慢性丙型肝炎的效果及对肝硬度、APRI的影响

目的探讨目前直接抗病毒药物(DAA)治疗方案下,慢性丙型肝炎患者真实世界病毒应答情况及对肝硬度值和天门冬氨酸/血小板比值指数(APRI)的影响。方法连续性纳入2018年4月1日-2018年11月30日在天津市第三中心医院接受DAA治疗的慢性丙型肝炎患者,应用无干扰素方案的DAA治疗12～24周,评估治疗结束后第12周病毒学应答情况,对比基线及治疗结束后12周肝硬度值和APRI的变化。计量资料两组间比较采用Wilcoxon秩和检验。结果共纳入212例慢性丙型肝炎患者,其中肝硬化患者占35. 4%,基因1b、2a、3a、6a型分别占75. 0%、18. 4%、4. 2%及2. 4%。174例患者完成了DAA治疗疗程及治疗后12周随访。在DAA治疗结束和治疗结束后12周获得持续病毒学应答(SVR)的比例分别为98. 3%及95. 4%。基因1b型、2a型、3a型及6a型患者的SVR12分别为96. 3%、93. 1%、80. 0%及100%。治疗结束后12周肝硬度值较基线[9. 8(6. 9～16. 3) kPa vs 11. 4(7. 7～19. 1) kPa,Z=-2. 5,P=0. 012]及APRI[0. 34(0. 25～0. 64) vs 0. 76(0. 56～2. 25),Z=-6. 6,P 0. 001]均明显下降。根据基线是否存在肝硬化进行分组,结果显示治疗结束12周非肝硬化组患者肝硬度值较基线显著降低[7. 6(6. 6～10. 7) k Pa vs 8. 8(7. 2～13. 0) kPa,Z=-2. 7,P=0. 007];而肝硬化组患者治疗前后肝硬度值无明显差异[17. 4(12. 7～22. 1) k Pa vs 19. 8(12. 8～24. 9) kPa,Z=-1. 4,P=0. 152]。肝硬化组和非肝硬化组患者APRI在治疗后12周较基线均明显下降[0. 73 (0. 52～1. 34) vs1. 37(0. 80～2. 11),Z=-3. 4,P 0. 001; 0. 29(0. 21～0. 36) vs 0. 54(0. 31～0. 95),Z=-6. 8,P 0. 001]。结论在该真实世界研究中,应用DAA治疗的慢性丙型肝炎患者总体病毒学应答率较高,治疗结束后12周肝硬度及APRI明显改善。     

关于《中国老年学杂志》投稿及收取版面制作费的郑重声明

中国老年学杂志唯一投稿方式为网站投稿,网址为:lnx.jlsyxqks.org或lnx.jlsyxqks.cn.投稿不收取审稿费.唯一咨询电话:0431-88923384.目前,某些编辑部发现网络上有人假借编辑部名义骗取作者的版面制作费.鉴于此情况, 中国老年学杂志 编辑部提醒广大读者提高警惕,谨防上当受骗,本刊绝无以个人账户名义收款.     

肝细胞癌中microRNA-888基因家族的表达特征及临床意义

目的初步探讨microRNA-888(miRNA-888)基因家族成员在肝细胞癌中的表达特征及其意义。方法选取湖南中医药大学第一附属医院在2012年1月-2017年12月病理确诊为肝细胞癌的患者72例,另收集72例健康自愿者的肝组织作为正常对照组。运用实时定量PCR和原位杂交分析肝癌组织中miRNA-888家族中miRNA-888、miRNA-891a、miRNA-891b、miRNA-892a和miRNA-892b的表达情况,初步探讨miRNA-888、miRNA-891b和miRNA-892a的表达与肝癌临床病理特征的关系。计量资料2组间比较采用t检验;计数资料组间比较采用χ2检验。结果 miRNA-888、miRNA-891b、miRNA-892a在肝癌组织中的表达明显高于正常肝组织(2. 53±0. 75 vs 0. 46±0. 08,t=14. 02,P 0. 001; 2. 26±0. 38 vs 1. 19±0. 21,t=7. 75,P 0. 001; 5. 44±1. 01 vs 1. 06±0. 30,t=35. 27,P 0. 001);原位杂交分析进一步验证了miRNA-888、miRNA-891b和miRNA-892a 3种miRNAs主要表达定位于肝癌组织中的细胞核,与正常肝组织表达水平比较差异均有统计学意义(3. 91±0. 92 vs 1. 21±0. 42,t=22. 65,P 0. 001; 2. 92±0. 76 vs 0. 83±0. 21,t=22. 92,P 0. 001; 3. 81±0. 99 vs 1. 30±0. 32,t=20. 47,P 0. 001)。miRNA-888和miRNA-891b高表达在组织学分级和临床分期的比较中差异有统计学意义(χ2值分别为6. 25、4. 44、4. 76、6. 05,P值均0. 05),而miRNA-892a高表达在Ⅲ、Ⅳ期肿瘤中表达更明显(χ2=8. 50,P 0. 001)。结论 miRNA-888、miRNA-891b及miRNA-892a在肝癌组织中表达明显增加; miRNA-888,miRNA-891b和miRNA-892a表达升高与肝癌恶性程度更高密切相关。     

骨细胞密度对骨生物力学性能的影响

Objective To investigate osteocyte density as a potential index of bone biomechanical property. Methods Forty 7-month-old female Sprague-Dawley rats were randomly group (EST) and sham operation group (SHAM). At 15 weeks postoperation, the compression test was performed on L5 vertebral body and micro-computed tomography (μ-CT) was used to estimate the three-dimensional bone mineral density (BMD) and three-dimensional microstructure parameters of L6 vertebral body. After fatigue damage testing, the L6 vertebral body was bulk-stained in 1% basic fuchsin and embedded in methylmethacrylate. Mounted bone slices were used to measure microcrack parameters and osteocyte density. Results At 15 weeks postoperation, osteocyte density (Ot. N/T. area) was significantly decreased in OVX group compared with SHAM group and EST group [(1268. 1 ±191.2)/mm2 vs. (1760. 8 ± 376.6)/mm2 and (1550. 9± 202.2)/mm2, F = 3.513,P<0. 05]. Maximum load (ML) was significantly decreased and the length of microcrack (Cr. Le) was significantly increased in OVX group compared with SHAM group, EST group and GEN group [(84. 4±16.9)N vs. (110.3±25.6),(103. 9±15. 8)and(110.1±4. 9)N; (58. 1±6.8) μm vs. (24.2±8. 1), (36. 5±9. 7)and(28.5±7. 5)μm, F=9. 561,3. 179, all P<0. 05]. Compared with SHAM group and EST group, bone trabecula connection density (Conn. D) was significantly decreased and trabecular separation (Tb. Sp) was significantly increased in OVX group [(47.4±7.4) m-3 vs. (71.8±16.0)and (74.0±12.7)m-3;(315.0±32.7)μm vs. (222. 5±21.7)and (273.3± 50.0)μm, F=7. 635,7. 007, all P<0. 05]. Bone mineral content (BMC) was lower in OVX group than that in SHAM group[(6.5±2. 2)g vs. (7. 9±1.2)g, P<0. 05]. When data in four groups were overall analyzed, Ot. N/T. Ar was positively correlated with ML, Conn. D and BMC (R2 = 0. 7874, 0. 1153, 0. 1309, all P<0. 05), but was negatively correlated with Cr. Le and Tb. Sp (R2 =0. 5738, 0. 3964, both P < 0.05). Conclusions Osteocyte plays a crucial role in maintaining bone biomechanical property and osteocyte density may be considered as a useful indicator for assessing bone biomechanical property.     

骨细胞密度对骨生物力学性能的影响

Objective To investigate osteocyte density as a potential index of bone biomechanical property. Methods Forty 7-month-old female Sprague-Dawley rats were randomly group (EST) and sham operation group (SHAM). At 15 weeks postoperation, the compression test was performed on L5 vertebral body and micro-computed tomography (μ-CT) was used to estimate the three-dimensional bone mineral density (BMD) and three-dimensional microstructure parameters of L6 vertebral body. After fatigue damage testing, the L6 vertebral body was bulk-stained in 1% basic fuchsin and embedded in methylmethacrylate. Mounted bone slices were used to measure microcrack parameters and osteocyte density. Results At 15 weeks postoperation, osteocyte density (Ot. N/T. area) was significantly decreased in OVX group compared with SHAM group and EST group [(1268. 1 ±191.2)/mm2 vs. (1760. 8 ± 376.6)/mm2 and (1550. 9± 202.2)/mm2, F = 3.513,P<0. 05]. Maximum load (ML) was significantly decreased and the length of microcrack (Cr. Le) was significantly increased in OVX group compared with SHAM group, EST group and GEN group [(84. 4±16.9)N vs. (110.3±25.6),(103. 9±15. 8)and(110.1±4. 9)N; (58. 1±6.8) μm vs. (24.2±8. 1), (36. 5±9. 7)and(28.5±7. 5)μm, F=9. 561,3. 179, all P<0. 05]. Compared with SHAM group and EST group, bone trabecula connection density (Conn. D) was significantly decreased and trabecular separation (Tb. Sp) was significantly increased in OVX group [(47.4±7.4) m-3 vs. (71.8±16.0)and (74.0±12.7)m-3;(315.0±32.7)μm vs. (222. 5±21.7)and (273.3± 50.0)μm, F=7. 635,7. 007, all P<0. 05]. Bone mineral content (BMC) was lower in OVX group than that in SHAM group[(6.5±2. 2)g vs. (7. 9±1.2)g, P<0. 05]. When data in four groups were overall analyzed, Ot. N/T. Ar was positively correlated with ML, Conn. D and BMC (R2 = 0. 7874, 0. 1153, 0. 1309, all P<0. 05), but was negatively correlated with Cr. Le and Tb. Sp (R2 =0. 5738, 0. 3964, both P < 0.05). Conclusions Osteocyte plays a crucial role in maintaining bone biomechanical property and osteocyte density may be considered as a useful indicator for assessing bone biomechanical property.     

棘球蚴感染长爪沙鼠诱发过敏反应的实验观察

[目的 ]观察棘球蚴感染长爪沙鼠诱发的过敏反应。 [方法 ]取 5 6只及 48只长爪沙鼠 ,分别腹腔接种感染细粒棘球蚴 E.g.及泡状棘球蚴 E.m.,3个月后分别用羊源新鲜囊液、羊源 E.g.粗制囊液抗原及沙鼠 E.m.抗原经腹腔注射攻击 ,观察其过敏反应。在攻击发敏前后 ,检测 Ig E抗体水平和嗜酸性粒细胞直接计数 (directeosinophilic leukocyte count,DEL C)。 [结果 ]沙鼠 E.g.和 E.m.感染率分别为 89.3%和 97.9%。各组过敏反应发生率最低为 6 2 .5 % ,最高为 10 0 %。过敏性休克发生率最低为 12 .5 % ,最高为 12 .7%。沙鼠感染 E.g.和 E.m.后 ,Ig E抗体和 DEL C水平逐渐增高 ,但攻击发敏后 Ig E抗体水平显著降低 ,DEL C显著增多。 [结论 ]E.g.和 E.m.感染沙鼠后 ,采用不同抗原攻击均可出现过敏反应或休克 ;不同抗原引起过敏反应的发生率和程度不同 ,但在感染E.g.与 E.m.沙鼠之间无显著性差异。     

环状RNA FLI1在肝细胞癌患者中的表达及其与预后的关系

目的探讨环状RNA FLI1(circ FLI1)在肝细胞癌(HCC)患者中的表达及意义。方法收集2013年1月-2018年1月于西南医科大学附属医院经手术切除的45例HCC患者的癌组织及配对癌旁组织和血清样本(HCC组)。同时收集45例健康体检者的血清标本(对照组)。人肝癌细胞株HepG2、SMMC7721、HB611均来自中国科学院生物化学与细胞生物学研究所。real-time PCR法检测circ FLI1在肝癌细胞及45例肝癌组织、血清标本中的表达。计量资料2组间比较采用t检验。采用Kaplan-Meier法分析circ FLI1表达与患者生存时间的关系,采用受试者工作特征曲线(ROC曲线)分析血清circ FLI1 E2-4及circ FLI1 E2-5作为诊断HCC生物标志物的潜能,应用单因素及多因素Cox比例风险模型分析影响HCC预后的因素。结果 circ FLI1 E2-5及circ FLI1 E2-4在3种肝癌细胞中高表达。circ FLI1 E2-4(7. 09±0. 26 vs 1. 14±0. 20,t=19. 970,P 0. 001)及circ FLI1 E2-5(7. 50±0. 25 vs 1. 29±0. 30,t=16. 640,P 0. 001)在HCC患者血清中的表达明显高于对照组;在HCC患者癌组织中的表达明显高于癌旁组织(7. 62±1. 33 vs 1. 55±0. 32,t=15. 560,P 0. 001; 7. 92±0. 35 vs 1. 42±0. 39,t=21. 170,P 0. 001)。高表达circ FLI1 E2-5的患者中位无进展生存时间[(11. 17±0. 49)个月vs (23. 35±1. 27)个月,χ2=28. 480,P 0. 001]及总生存时间[(19. 75±0. 76)个月vs(37. 44±1. 57)个月,χ2=21. 750,P 0. 001]均较低表达者明显缩短;高表达circ FLI1 E2-4的患者中位无进展生存时间[(10. 29±0. 42)个月vs(24. 65±1. 58)个月,χ2=19. 620,P 0. 001]及总生存时间[(21. 32±0. 55)个月vs(35. 69±1. 74)个月,χ2=19. 730,P 0. 001]亦较低表达者明显缩短。血清circ FLI1 E2-4作为诊断HCC血清标志物的ROC曲线下面积为0. 910[95%可信区间(95%CI):0. 621～0. 970,P 0. 001],灵敏度和特异度分别为84. 3%和90. 5%。血清circ FLI1 E2-5作为诊断HCC血清标志物的ROC曲线下面积为0. 760(95%CI:0. 650～0. 860,P 0. 001),灵敏度和特异度分别为80. 5%和87. 3%。Cox多因素回归模型分析提示,血清circ FLI1 E2-4(风险比=3. 060,95%CI:1. 630～5. 870,P=0. 001)及circ FLI1 E2-5(风险比=2. 560,95%CI:1. 250～6. 460,P=0. 008)表达是HCC患者预后的独立影响因素。结论 circ FLI1在HCC患者组织及血清中高表达,与患者的预后相关,可能是潜在的HCC患者预后标志物和治疗靶点。     

2型糖尿病家系发病特征与危险因素初步调查

Objective To explore the characteristics and risk factors of type 2 diabetes mellitus (T2DM) onset in pedigrees. Methods A total of 865 subjects were screened and diagnosed by oral glucose tolerance test (OGTT) based on American Diabetes Association (ADA) criteria. Type 1 diabetes mellitus (T1DM) , maturity onset diabetes of the young (MODY) and chondriosome diabetes were excluded by clinical features and laboratory test of insulin and autoantibodies including glutamic acid decarboxylase antibody, insular cellular antibody and insulin autoantibody. A total of 182 pedigrees of T2DM were obtained. Results No gender difference was found in the prevalence of T2DM (42. 59% in male and 48. 18% in female respectively, P ＞0. 05) , nor was the newly diagnosed rate(9. 89% in male and 11. 82%in female, P ＞ 0. 05). The onset age was (63. 3 ± 12. 4) years old in the first generation [(64. 4 ± 12. 5)years in male and (62. 3 ± 10. 3) years in female] , (47. 1 ± 8. 7) years old in the second generation [(48. 2 ±9. 3)years in male and (46. 1 ± 8. 1) years in female] , (29. 6 ± 10. 2) years old in the third generation [(28. 9 ±9. 5)years in male and (30. 0 ± 10. 4)years in female]. Compared with normal glucose tolerance (NGT) subjects , newly diagnosed T2DM and impaired glucose regulation (IGR) subjects had higher prevalence of hypertension, hyperlipidemia and smoking but less physical activities. Statistical differences were shown in body weight five years before diagnosis, one years before diagnosis and at diagnosis in newly diagnosed T2DM[(68. 4 ±12. 4)kg, (69. 5 ± 11. 0)kg and (69. 1 ±9. 6)kg] and IGR[(66. 1 ±10.7)kg, (65.9 ± 10.7) kg and(65.7 ± 10.4) kg] , when compared with NGT [(61.0 ± 10.2) kg,(59. 5 ±11.0) kg and (60. 1 ± 10. 4) kg, all P ＜ 0. 05] . The same results were obtained with waist circumference and waist-hip ratio [(4. 1 ± 12. 5) cm and 0. 92 ± 0. 36 in newly diagnosed T2DM while (89. 1 ± 10. 7) cm and 0. 90 ± 0. 64 in IGR] , when compared with NGT[(82. 5 ± 10. 1) cm and 0. 82 ±0. 25] , all P ＜0. 05. Conclusions No gender difference was found in the onset characteristics of T2DM.High prevalence of obesity, hypertension, hyperlipidemia and smoking with less physical activities were associated with T2DM.