CT灌注成像联合血清microRNA-493预测急性脑梗死患者预后的价值

目的 分析CT灌注成像联合血清microRNA-493(miR-493)预测急性脑梗死（ACI）患者预后的价值。方法 选取2019年6月—2022年11月湖北文理学院附属医院收治的149例ACI患者,所有患者治疗前行CT灌注成像及血清miR-493测定,溶栓治疗后均随访3个月,评估其预后情况。分析影响ACI患者预后的因素,分析CT灌注成像参数联合血清miR-493预测ACI患者预后的价值。结果 149例ACI患者中20例预后不良。多因素逐步Logistic回归分析结果显示,美国国立卫生研究院卒中量表评分[■=5.743(95%CI:2.363,13.958)]、脑血流量（CBF）[■=3.931(95%CI:1.618,9.555)]、脑血容量（CBV）[■=3.827(95%CI:1.575,9.301)]、灌注对比剂平均通过时间（MTT）[■=3.615(95%CI:1.487,8.785)]、miR-493 [■=3.873(95%CI:1.594,9.412)]是影响ACI患者预后的因素（P <0.05）。受试者工作特征曲线结果分析结果显示,CBF、CBV、MTT、miR...     

血小板微粒对大动脉粥样硬化型脑梗死近期预后的预测价值分析

目的 探讨血小板微粒与大动脉粥样硬化型脑梗死患者近期预后的关系及其预测价值。方法 选取2015年7月—2020年11月在青岛市中医医院诊断为大动脉粥样硬化型脑梗死患者152例，均经治疗后好转出院。根据患者出院后30 d的预后情况，分为预后不良组（37例）和预后良好组（115例）。比较两组患者的临床资料、血小板微粒、NIHSS及mRS评分；采用多因素Logistic回归分析预后的影响因素；采用受试者工作特征（ROC）曲线评估血小板微粒对预后的预测效能；绘制Kaplan-Meier曲线，分析血小板微粒与生存时间的关系。结果 预后不良组患者的血小板微粒水平、NIHSS评分及mRS评分高于预后良好组；多因素Logistic回归分析结果显示，血小板微粒[■=2.204(95%CI:1.547,3.128)]、NIHSS评分[■=1.784(95%CI:1.295,2.436)]及mRS评分[■=1.133(95%CI:1.057,1.206)]与预后不良有关（P <0.05）;ROC曲线分析结果显示，血小板微粒预测预后不良的曲线下面积为0.854(95%CI:0.792,0.906)，敏感...     

局部晚期宫颈癌患者新辅助化疗疗效的影响因素及预测模型研究

目的 探讨局部晚期宫颈癌患者新辅助化疗疗效的影响因素并建立预测模型。方法 回顾性分析2021年8月—2023年6月在徐州医科大学附属徐州市妇幼保健院接受治疗的136例局部晚期宫颈癌患者的临床资料，根据新辅助化疗疗效分为有效组（96例）和无效组（40例）。比较两组患者的临床资料。多因素逐步Logistic回归分析局部晚期宫颈癌患者新辅助化疗疗效的影响因素；绘制受试者工作特征（ROC）曲线分析局部晚期宫颈癌患者新辅助化疗疗效预测模型预测新辅助化疗疗效的价值。结果 有效组鳞癌、病灶大小≤6 cm、化疗疗程2～3周期、无贫血、淋巴结转移阴性、血流丰富占比高于无效组（P <0.05）。多因素逐步Logistic回归分析结果显示：鳞癌[■=2.044(95%CI:1.211,3.450)]、病灶大小≤6 cm [■=2.563(95%CI:1.305,5.034)]、化疗疗程2～3周期[■=1.845(95%CI:1.118,3.045)]、无贫血[■=1.229(95%CI:1.003,1.506)]、淋巴结转移阴性[■=3.174(95%CI:1.678,6.004)]、血流丰富[■=2...     

良性前列腺增生微创术后尿道狭窄的危险因素分析

目的 基于列线图分析良性前列腺增生（BPH）微创术后尿道狭窄（US）的危险因素。方法 选取2019年1月—2022年1月在天水市第二人民医院行微创术的BPH患者162例，术后随访6个月，统计US发生情况，分为US组、无US组。比较两组患者一般资料；采用多因素Logistic逐步回归模型分析BPH微创术后US的危险因素；建立BPH微创术后US的列线图风险模型，并评估其效能及预测价值。结果 随访6个月后，BPH行微创术患者US发生率为18.52%(30/162)。US组与无US组患者尿路感染、手术操作不规范、术中行尿道扩张、术后导尿管留置时间> 14 d构成比比较，差异均有统计学意义（P <0.05）。多因素Logistic逐步回归分析结果显示，尿路感染[■=6.521(95%CI:4.568,8.474)]、手术操作不规范[■=3.789(95%CI:1.254,6.323)]、术中行尿道扩张[■=2.818(95%CI:1.986,3.650)]、术后导尿管留置时间> 14 d [■=2.683(95%CI:1.365,4.001)]为BPH微创术后US的危险因素（P...     

多普勒超声、声触诊组织定量技术联合血清胱抑素C在早期糖尿病肾病中的应用价值

目的 探讨多普勒超声、声触诊组织定量（VTQ）技术联合血清胱抑素C(CysC)在早期糖尿病肾病（DN）中的应用价值。方法 选取2020年9月—2022年9月南京中医药大学连云港附属医院收治的138例2型糖尿病（T2DM）患者为研究对象。其中,单纯T2DM患者56例,早期DN 48例,临床DN 34例。所有患者均行多普勒超声、VTQ技术诊断,并检测血清CysC水平。采用多因素Logistic逐步回归分析影响DN诊断的因素,绘制受试者工作特征（ROC）曲线分析多普勒超声、VTQ检查定量指标及CysC诊断DN及早期DN的价值。结果 多因素Logistic逐步回归分析结果显示,血肌酐[■=3.438(95%CI:1.415,8.356)]、肾动脉（肾门处主肾动脉）舒张末期最低血流速度（EDV）[■=4.121(95%CI:1.695,10.014)]、肾动脉阻力指数（RI）[■=4.358(95%CI:1.793,10.591)]、肾皮质剪切波速度（SWV）[■=4.323(95%CI:1.779,10.507)]、CysC[■=4.229(95%CI:1.740,10.278)]是影响DN诊...     

外周血PD-L1分子表达联合LDH对晚期非小细胞肺癌免疫治疗效果的预测价值

目的 探讨外周血程序性死亡配体1(PD-L1)分子表达联合乳酸脱氢酶(LDH)对晚期非小细胞肺癌(NSCLC)免疫治疗效果的预测价值。方法 回顾性分析2018年1月—2021年8月马鞍山市人民医院收治的88例晚期NSCLC免疫治疗患者的临床资料。治疗3个疗程后根据疗效分为无效组和有效组。采用单因素分析影响晚期NSCLC免疫治疗无效的因素,对影响晚期NSCLC免疫治疗无效的因素进行多因素一般Logistic回归分析,绘制受试者工作特征(ROC)曲线分析外周血PD-L1分子表达联合LDH水平预测晚期NSCLC免疫治疗效果的价值。结果 无效组患者低分化构成比、PD-L1、LDH高于有效组患者(P <0.05)。一般多因素Logistic回归分析结果显示,分化程度[■=3.114(95%CI:1.281,7.569)]、PD-L1[■=3.951(95%CI:1.583,9.860)]、LDH[■=3.432(95%CI:1.375,8.564)]是导致晚期NSCLC免疫治疗无效的危险因素(P <0.05)。ROC曲线分析结果显示,PD-L1敏感性最高,为82.98%;PD-L1和...     

血清Sema7A、CD163预测颈动脉粥样硬化斑块易损性的价值研究

目的 分析血清Sema7A、CD163预测颈动脉粥样硬化斑块易损性的价值。方法 选取2019年4月—2022年4月徐州医科大学附属连云港医院收治的108例脑梗死患者，采用酶联免疫吸附试验检测患者血清Sema7A、CD163水平。根据彩色多普勒超声诊断仪检测患者颈动脉斑粥样硬化块性质分为稳定斑块组、不稳定斑块组，分析影响患者颈动脉粥样硬化斑块易损性的影响因素。绘制受试者工作特征（ROC）曲线，分析血清Sema7A、CD163预测颈动脉粥样硬化斑块易损性的价值。结果 不稳定斑块组LDL-C、脂蛋白a、中性粒细胞计数、Hcy、Sema7A、CD163水平高于稳定斑块组（P <0.05），不稳定斑块组淋巴细胞计数、颈动脉狭窄率低于稳定斑块组（P <0.05）。多因素Logistic逐步回归分析结果显示：LDL-C [■=6.341(95%CI:2.609,15.410)]、脂蛋白a [■=5.078(95%CI:2.090,12.342)]、Sema7A [■=4.495(95%CI:1.850,10.925)]、CD163 [■=3.927(95%CI:1.616,9.545)]...     

血清嗜酸性粒细胞阳离子蛋白与白三烯B4联合预测支气管哮喘患儿预后的临床价值

目的 探究血清嗜酸性粒细胞阳离子蛋白（ECP）与白三烯B4(LTB4)联合预测支气管哮喘患儿预后的临床价值。方法 选取2020年12月—2022年12月江南大学附属儿童医院收治的支气管哮喘患儿80例作为研究对象。给予患儿对症治疗,治疗28 d后,依据肺功能指标改善状况及儿童哮喘控制测试（C-ACT）结果将患儿分为病情控制良好组和控制不佳组。检测两组患儿入院时血清ECP、LTB4水平;采用多因素逐步Logistic回归模型分析影响患儿支气管哮喘病情控制的危险因素;绘制受试者工作特征（ROC）曲线评估血清ECP、LTB4对支气管哮喘患儿预后的预测效能。结果 80例支气管哮喘患儿中控制不佳17例,63例患儿病情控制良好且未见复发。控制不佳组过敏史、呼吸道反复感染史占比及血清ECP、LTB4水平均高于控制良好组（P <0.05）。过敏史[■=3.557(95%CI:1.053,12.023)]、呼吸道反复感染史[■=4.923(95%CI:1.289,18.806)]、血清ECP水平升高[■=3.770(95%CI:1.115,12.741)]、血清LTB4水平升高[■=4.212(95...     

脑电双频指数联合血清Ghrelin对脓毒症相关性脑病的早期诊断价值分析

目的 探讨脑电双频指数（BIS）联合血清生长激素释放肽（Ghrelin）对脓毒症相关性脑病（SAE）的早期诊断价值。方法 选取2015年4月—2020年1月武汉市第一医院收治的109例脓毒症患者的临床资料。分析影响SAE早期诊断的因素,BIS、Ghrelin早期诊断SAE的价值,不同病情严重程度SAE患者BIS、Ghrelin水平。结果 109例脓毒症患者中42例诊断为SAE,其余67例未发生SAE。逐步多因素Logistic回归分析结果显示,急性生理与慢性健康状况Ⅱ（APACHEⅡ）评分■=5.254(95%CI:2.162,12.769)]、S100β[■=3.831(95%CI:1.576,9.309)]、BIS[■=5.859(95%CI:2.411,14.240)]、Ghrelin[■=4.477(95%CI:1.842,10.881)]是影响SAE早期诊断的独立因素（P <0.05）。ROC曲线结果显示,BIS、Ghrelin及两者联合诊断SAE的敏感性分别为73.81%(95%CI:0.577,0.856)、78.57%(95%CI:0.628,0.892)和73....     

原发性肝癌组织中溴结构域蛋白4的表达及与临床病理特征和预后的关系

目的 探讨原发性肝癌（PHC）组织中溴结构域蛋白4(BRD4)的表达及与患者临床病理特征及预后的关系。方法 选取2015年7月—2018年7月青海省人民医院收治的PHC患者83例作为研究对象,均行手术切除,术后随访3年。采用免疫组织化学法检测BRD4蛋白的表达,对比癌组织、癌旁组织中BRD4蛋白的表达,分析PHC癌组织中BRD4蛋白表达与患者临床病理特征的关系,影响PHC患者预后的因素,癌组织中BRD4蛋白表达与PHC患者预后的关系。结果 PHC患者癌组织中BRD4阳性表达率高于癌旁组织（P <0.05）。有微血管侵犯、肿瘤包膜不完整、临床分期Ⅲ期、低分化癌组织BRD4蛋白阳性表达率较高（P <0.05）。多因素Cox回归分析结果显示,微血管侵犯[■=5.379(95%CI:3.487,13.005)]、肿瘤包膜[■=5.614(95%CI:3.986,16.115)]、临床分期[■=5.312(95%CI:3.307,12.413)]、分化程度[■=4.187(95%CI:2.893,10.006)]、BRD4蛋白表达[■=5.799(95%CI:4.156,17.235...     

Value of D-Dimers in patients with acute aortic dissection

Objective: To evaluatel the value of D-dimers in patients with acute aortic dissection (AAD). Methods: This study consisted of 16 patients with AAD and 27 non-AAD patients. Serum D-dimets were measured by Sta-Liatest D-DI immunoturbidimetric assay. Results: D-dimer level was higher (P ＜ 0.001) in patients with AAD(7.91 ± 5.52 μg/ml) than that in non- AAD group(1.57±1.24 μg/ml). D-dimer was positive (＞0.4 μg/ml) in all patients with AAD and in 10 control group patients (37%). Among patients with acute AAD, D-dimers tended to be higher in Stanford A than in Stanford B (8.67 ± 4.31 μg/ml vs. 3.24±1.27 μg/ml, P ＜0.01). D-dimer values tended to be higher in more extended disease(3.84 ± 1.65 μg/ml, 8.57 ± 3.58 μg/ml and 11.87 ± 5.69 μg/ml in thoracic aorta, thoracic and abdominal aorta, thoracic and abdominal aorta and iliacal arteries, respectively, P ＜ 0.05 for both 8.57 ± 3.58 and 11.87 ± 5.69 vs. 3.84 ± 1.65 ). Including the control group into the analysis, we found a sensitivity of 100%, a negative predictive value of 100%, and a specificity of 66% and a positive predictive value of 64% for D-dimer in diagnosis of AAD in our patients with suspected AAD. Conclusion: D-dimer was elevated in patients with AAD. A negative D-dimer test result could be useful in excluding AAD.     

Research of combined liver-kidney transplantation model in rats

Objective： To set up a simple and reliable rat model of combined liver-kidney transplantation. Methods： SD rats served as both donors and recipients. 4℃ sodium lactate Ringer＇s was infused from portal veins to donated livers,and from abdominal aorta to donated kidneys, respectively. Anastomosis of the portal vein and the inferior vena cava （IVC） inferior to the right kidney between the graft and the recipient was performed by a double cuff method, then the superior hepatic vena cava with suture. A patch of donated renal artery was anastomosed to the recipient abdominal aorta. The urethra and bile duct were reconstructed with a simple inside bracket. Results： Among 65 cases of combined liver-kidney transplantation, the success rate in the late 40 cases was 77.5%. The function of the grafted liver and kidney remained normal. Conclusion： This rat model of combined liver-kidney transplantation can be established in common laboratory conditions with high success rate and meet the needs of renal transplantation experiment.     

BLOOD PRESSURE CHANGE WITH AGE IN SALT-SENSITIVE TEENAGERS

Objective To observe blood pressure change with age in salt-sensitive teenagers whose salt sensitivity were determined by repeated testing.Methods Salt sensitivity was determined through intravenous infusion of normal saline combined with volume-depletion by oral diuretic furosemide in 55 teenagers. After five years, salt sensitivity was re-examined and subject blood pressure was followed up. Blood pressure changes in salt-sensitive teenagers were compared to that of non-salt sensitive teenagers over five years.Results After 5 years, the repetition rate of salt sensitivity determined by intravenous saline loading is 92.7%. In teenagers with salt sensitivity on the baseline, both the systolic blood pressure increments and increment rates were much higher than non-salt sensitive teenagers (12.7±12.1 mmHg vs. 2.8±5.2 mmHg, P＜ 0.01; 12.2%± 12.0% vs. 2.5% ±4.4%, P＜ 0.001,respectively). There was a similar trend for diastolic blood pressure (8.4 ± 6.4 mmHg vs. 3.7 ± 6.4 mmHg, P = 0.052; 13.2% ±10.6 % vs. 6.8%± 10.1%, P = 0.053, respectively).Conclusions Salt sensitivity determined by intravenous saline loading showed good reproducibility. Blood pressure increments with age were much higher in salt-sensitive teenagers than non-salt sensitive teenagers, especially in terms of systolic blood pressure.     

安心颗粒对急诊经皮冠状动脉介入术后生活质量影响的研究

目的：评价使用安心颗粒对急诊经皮冠状动脉介入术（PPCI）术后生活质量的影响.方法：将160例接受PPCI的急性ST段抬高型心肌梗死患者随机分为安心颗粒组（术前顿服安心颗粒8.8g,术后安心颗粒4.4 g/次,每日2次）和对照组（仅接受基础药物治疗）.所有患者均服用阿司匹林、氯吡格雷和阿托伐他汀.分别在入院时、出院前1d、出院后180 d时,应用心肌梗死多维度量表（MIDAS）、中文版SF-36评价量表对患者生活质量评分.并观察术后30 d以内的出血并发症、血小板减少症发生情况.结果：入院时和出院前1d,两组患者的心肌梗死MIDAS、SF-36量表评分比较无差异（P＞0.05）;出院后180 d时,与对照组比较,安心颗粒组MIDAS、SF-36评分明显减低（P＜0.05）;组内与入院时比较,两组出院前1d、出院后180 d时,MIDAS、SF-36评分均降低（P＜0.05）.两组患者在随访期间均无大量出血、少量出血、重度和极重度血小板减少症发生,安心颗粒组有4例、对照组有7例发生不明显出血（P＞0.05）.两组发生轻度血小板减少症的患者数比较无差异（P＞0.05）.结论：PPCI使用安心颗粒,能改善急性ST段抬高型心肌梗死患者的生活质量,且不增加出血风险.     

The comparative studies of the influences of Urapidil and Nicardipine on sino-atrial node function, atrio-ventricular node function and hemodynamics

Objective:To investigate the influences of urapidil and nicardipine on rabbit sinus function,atrio-ventricular node function and hemodynamics.Methods:Thirty-two Angora's rabbits were selected and randomly divided into four groups.U1 group:urapidil 0.25 mg/kg;U2 group:urapidil 0.5 mg/kg;N1 group:nicardipine 10 μg/kg;N2 group:nicardipine 20 μg/kg.All these medicine were administrated within 30 seconds.Measurements were taken before and after the administration of urapidil or nicardipine for the following data:mean blood pressure(MAP),heart rate(HR),sino-atrial conduction time(SACT),maximal sinoatrial recovery time(SNRTmax)corrected sinus node recovery time(CSNRT),index of sinus node recovery time(SNRTI),Wenckebach A-V conduction frequency (WB),and P-R interval.Results:Significant MAP and HR changes were identified in all of the four groups before and after administration of both urapidil and nicardipine.No significant changes could be found in the rest of the parameters.Intergroup analysis showed that SACT and CSNRT of N1 and N2 groups were shorter than those of the U2 group(P＜0.01);the MAP decreased(P＜0.01)and the HR increased drastically(P＜0.01).Conclusions:Neither urapidil(0.25 mg/kg,0.5 mg/kg)nor nicardipine(10μg/kg,20μg/kg)has any significant influence on rabbit sinus function or rabbit atrio-ventricular node function.Nicardipine could be a better choice than urapidil for parafunctional sinus node patients.     

Expression of OPGmRNA and ODFmRNA in the patients of hip fracture due to osteoporosis

Objective：To investigate the gene expression of osteoprotegerin（OPG） and osteoclast differentiation factor（ODF） in the bone tissue of patients with hip fracture due to osteoporosis. Methods：OPGmRNA and ODFmRNA in the bone tissue in 50 cases of osteoporosis sufferers（over 50 years old） with hip fracture（Observer Group） and 30 cases of hip facture sufferers with no osteoporosis（Control group） were analyzed with the Semi-Quantitative RT-PCR method. Results：The mRNA expressed of ODF, OPG were both high in the patients with hip fracture. In the control group, the expression of OPG mRNA was observed, while the expression of ODF mRNA was very slight. Conclusion：Aged patients contained all signals including OPG, ODF that are essential for inducing osteoclastogenesis and promoting bone resorption.     

The clinicopathological and immuohistochemical analysis of solid-pseudopapillary tumor of the pancreas： report of 9 cases

Objective：To investigate the clinical features, pathological characteristics and immunophenotype of solid-pseudopapillary tumor of the pancreas（SPTP）. Methods：Nine surgically treated cases of SPTP were retrospectively reviewed. Hematoxylin and Eosin（HE） staining and immunohistochemical staining were used to analyze all cases, and the general clinical data was collected. Results：Six patients were asymptomatic except for a palpable mass. Two patients complained of vague-epigastric pain. One patient appeared jaundice. The tumor was encapsulated and solid tissues alternately with cystic tissues. Histologically, the histological structure of solid portion was pseudopapillary with a fibrovascular core. Tumor cells were uniform and medium-sized which were arranged in sheets ets or nests or pseudopapillary patterns. Immunohistochemical studies demonstrated that SPTP proved positive in vimentin（9/9 cases）, AAT（9/9 cases）, NSE（9/9 cases）, ACT（7/9 cases）, CK20（2/9 cases）, CgA（1/9 cases）, S-100（3/gcases）, PR（4/gcases）, Syn（3/9 cases） and CD56（5/9cases）, negative in CEA and ER. Conclusion：SPTP is a tumor predominantly occurring in young women frequently without special symptoms. This tumor has various characteristical histological patterns with different immunophenotype.     

Dynamic Changes in Serum Estradiol and Progesterone levels in Patients of Premenstrual Syndrome with Adverse Flow of Liver-qi

Objective:To probe into the influence of changes of ovarian hormones on the pathogenesis of the specific sub-type premenstrual syndrome(PMS)and reveal partial microcosmic mechanisms of adverse flow of liver-qi.Methods:Estradiol(E2)and progesterone(P)levels in serum were determined at different phases of menstrual cycle by radioimmunoassay.Results:In the group of PMS with adverse flow of liver-qi.the secretive peak value Of E2 and P at the follicular phase significantly decreased,and the secretive peak value at the luteal phase did not come into being.Conclusions:Low E2 and P secretive peak at the follicular phase and absence of secretive peak at the luteal phase is one of the microcosmic mechanisms of PMS with adverse flow of liver-qi.One of the pathophysiologic mechanisms of specific sub-type PMS is probably the continuous low level of E2and P.     

Real-time Three-dimensional Echocardiography in Assessment of Left Ventricular and Right Ventricular Volumes

Real-time three-dimensional echocardiography (RT3DE)is a new ultrasound technique that enables dynamic threedimensional visualization and quantification of the heart in real time. Investigation of feasibility and methodology of RT3DE in determining left ventricular (LV) and right ventricular (RV) volumes, RT3DE was performed in 35 normal adults using Philips SONOS 7500 system with a 2-4 MHz matrix array transducer. The 60°×60° "pyramid" volume database was obtained and analyzed on a TomTec echo workstation. Both LV and RV volumes were calculated with four 3DE methods (i.e. apical 2, 4, 8, and 16-plane) through manually tracing ventricular endocardial borders in end diastole and end systole. Stroke volumes were then calculated. LV volume was also measured by 2DE Simpson's rule using GE VIVID 7 ultrasound machine.     

SCREENING FOR A 21-CHROMOSOME ABNORMALITY IN PREIMPLANTED EMBRYOS OF ELDERLY WOMEN

Increasing maternal age is the only etiological factor unequivocally linked to Down's syndrome in humans. The occurrence rate of newborns with Down's syndrome is about 1/220 in women over 35 years old. However, the occurrence rate in embryos fertilized in vitro, of the elder woman is unclear. Using FISH we screened the number of chromosome 21 in preimplanted embryos of 5 elderly women (average age, 38.4 years) to study the feasibility and necessity of screening trisomy 21 in embryos in patients over 35 years old at the in vitro fertilization (IVF) center.