PCT用于胎膜早破新生儿感染早期诊断临床价值探讨

目的:探讨PCT用于胎膜早破新生儿感染早期诊断临床价值。方法:回顾性分析我院近期收治胎膜早破新生儿共110例,依据感染情况分为A组、B组及C组,其中A组21例合并败血症,B组45例合并局部感染,C组44例未合并感染;比较三组新生儿PCT和hs CRP指标检出阳性率、敏感度及特异度等。结果:A组新生儿PCT检出阳性率显著高于B组,差异有统计学意义(p0.05);A组新生儿PCT和hs CRP检出阳性率显著高于C组,差异有统计学意义(p0.05);B组新生儿PCT和hs CRP检出阳性率显著高于C组,差异有统计学意义(p0.05);胎膜早破新生儿感染PCT检测诊断灵敏度和特异度明显高于hs CRP检测。结论:PCT用于胎膜早破新生儿感染早期诊断可有效提高灵敏度和特异度,临床价值优于hs CRP。     

血清降钙素原在老年脑出血并发肺部感染的早期诊断价值

目的探讨血清降钙素原(PCT)对老年脑卒中并肺部感染的早期诊断价值。方法选取2014年12月‐2017年12月收治的40例老年脑出血合并肺部感染患者为观察组,另选同期40例老年脑出血未合并肺部感染者为对照组,两组患者入院1～7 d连续抽空腹静脉晨血检测PCT与白细胞计数(WBC)、C-反应蛋白(CRP)。结果观察组PCT与WBC及CRP水平均较对照组高,两组差异有统计学意义(P 0.05);PCT特异度与灵敏度分别为100.00%、95.00%,WBC特异度与灵敏度分别为85.00%、82.50%,CRP特异度与灵敏度分别为77.50%、87.50%,PCT的特异度与灵敏度均较WBC、CRP高,差异有统计学意义(P 0.05)。结论 PCT诊断老年脑出血并发肺部感染特异度与灵敏度高,可为临床制定治疗方案提供参考依据。     

血清降钙素原对骨折术后感染的诊断价值

目的 探讨在骨折术后感染中血清降钙素原(PCT)水平检测的诊断价值.方法 2008年9月至2011年9月骨折术后感染患者30例为感染组,同期未发生感染者30例为非感染组.检测2组血清PCT和C-反应蛋白(CRP)的水平,对比两指标在诊断骨折术后感染诊断中的敏感度和特异度.结果 PCT水平在感染组明显高于非感染组[(8.68±2.73)vs(0.18±0.09)ng/ml,P＜0.01].PCT和CRP对骨折术后并发感染诊断的敏感度分别是93.3％、100.0％,特异度分别是90.0％、10.0％,阳性预测值分别为90.3％、52.6％,阴性预测值分别为93.1％、100.0％.PCT对骨折术后并发感染的特异度和阳性预测值高于CRP(P均＜0.01).结论 PCT可用于诊断骨折术后感染,不易受创伤及手术因素干扰,具有较高敏感度和特异度.     

检测血清降钙素原对诊断重症感染临床价值分析

目的探讨检测血清降钙素原(PCT)对早期诊断重症细菌感染的临床价值。方法纳入重症监护病房(ICU)中58例感染患者,按感染轻重及病原体类型划分为A组(重症细菌感染组)21例,B组(一般细菌感染组)37例,另纳入30例非感染患者为C组。检测血清PCT、外周血白细胞计数(WBC)、C反应蛋白(CRP)水平。结果 PCT、CRP、WBC均呈A组B组C组趋势,组间差异有统计学意义(P0.05);A组PCT阳性率明显高于B、C组,B组明显高于C组,A组CRP阳性率明显高于B、C组,上述差异均有统计学意义(P0.05),WBC阳性率各组间无明显差异(P0.05);PCT对重症细菌感染的检测约登指数最高。结论血清PCT有助于早期诊断重症细菌感染,值得临床重视。     

降钙素原与C反应蛋白对肺部感染病原体价值的讨论

目的:讨论降钙素原(PCT)与C反应蛋白(CRP)对肺部感染病原体的鉴别价值。方法:我院收治的88例肺部感染患者依据临床诊断分为病毒感染组(A组28例)、细菌感染组(B组36例)和真菌感染组(C组24例),检测CRP和PCT水平,比较CRP和PCT检测阳性率。结果:B组PCT水平高于A组和C组(P0.05),A组与C组CRP和PCT水平无明显差异(P0.05);B组CRP和PCT检测阳性率高于A组和B组(P0.05),A组与C组CRP和PCT检测阳性率无明显差异(P0.05)。结论:PCT检测鉴别肺部感染病原体较CRP检测更具优越性。     

血清B型利钠肽、C-反应蛋白和降钙素原检测对心力衰竭患者并发肺部感染的诊断价值

目的:探讨血清B型利钠肽(BNP)和外周血炎症介质对心力衰竭(HF)并发肺部感染的检测价值.方法:将82例HF患者依据是否并发肺部感染分为感染组(n=39)和未感染组(n=43),另选取同期体检15名健康志愿者为健康组.比较三组血清BNP和C反应蛋白(CRP)、降钙素原(PCT)水平,分析感染组血清BNP与CRP、PCT水平的相关性,并用受试者工作特征(ROC)曲线评估上述指标对HF患者并发肺部感染的诊断价值.结果:感染组血清BNP、CRP、PCT高于未感染组和健康组(P<0.05),且未感染组高于健康组(P<0.05).感染组血清BNP与CRP、PCT水平呈正相关(P<0.05).血清BNP、CRP、PCT诊断HF并发肺部感染敏感性分别为73.25％、66.47％、82.51％,特异性分别为65.38％、78.25％、75.36％.结论:HF并发肺部感染与血清BNP、CRP、PCT水平密切相关,加强上述指标的检测有助于HF并发肺部感染的诊断.     

血清降钙素原与C反应蛋白在创伤感染中诊断价值

目的 评价血清降钙素原(PCT)与C反应蛋白(CRP)在创伤感染中的诊断价值.方法 选取102例创伤感染的患者作为感染组,并以101例非感染患者作为对照组,测定并比较分析两组患者血清的PCT与CRP结果.结果 感染组血清PCT、CRP明显高于对照组(P＜0.05),感染组检测的阳性率PCT为90.19％,CRP为96.08％,PCT、CRP检测对创伤感染诊断的灵敏度、特异度、阳性预测值、阴性预测值、诊断符合率均较高.结论 血清PCT、CRP可作为诊断创伤感染的有效指标,对临床诊治具有指导意义.     

降钙素原在哮喘-慢阻肺重叠综合征应用性研究

目的：探讨降钙素原在哮喘-慢阻肺重叠综合征中的临床应用价值。方法整群选取2014年1月—2015年12月该院收治的52例ACOS急性加重患者作为ACOS组,选取同期治疗的86例单纯慢性阻塞性肺疾病患者作为对照组,分析比较两组患者血清PCT及CRP水平,并评价ACOS组PCT检测的敏感度及特异度。结果ACOS组患者血清PCT及CRP水平均高于对照组,差异有统计学意义(P<0.05);PCT和CRP对ACOS急性加重患者细菌感染进行诊断, PCT诊断敏感度和特异度分别为95.65%、83.33%,均高于CRP诊断(83.33%、60.00%),PCT诊断阳性预测值、阴性预测值均高于CRP检测。结论PCT检查能够及时准确判断ACOS患者细菌感染情况,具有较好的灵敏度及特异度,为判断细菌感染的程度提供依据,有助于抗菌药物的合理应用,对于规范化治疗ACOS有明确的应用价值。     

降钙素原与C反应蛋白联合检测在肺部感染的临床意义

目的探讨降钙素原(PCT)、C反应蛋白(CRP)联合检测在肺部感染患者中的临床意义。方法选取肺部感染患者68例,其中细菌感染组40例、非细菌感染组28例;同期体检健康者32例纳入对照组。检测血清PCT和CRP水平,并进行分析。结果细菌感染组PCT和CRP水平明显高于非细菌感染组和对照组(P0.05);PCT、CRP及二者联合检测对肺部感染细菌感染的诊断特异度分别为89.1%、73.3%、95.7%,灵敏度分别为79.3%、89.4%、88.7%,联合检测的诊断特异度和灵敏度均高于PCT、CRP单独检测;细菌感染组经抗菌药物积极治疗后,PCT和CRP水平较治疗前均呈下降趋势(*P0.05),炎症控制后,PCT和CRP水平恢复正常。结论血清PCT、CRP联合检测对肺部感染患者具有较高的诊断价值,可有效预测治疗效果及预后。     

血清C反应蛋白和降钙素原检测在恶性肿瘤合并细菌感染的应用评价

目的 探讨C反应蛋白(CRP)、降钙素原(PCT)在恶性肿瘤合并细菌感染的应用价值.方法 分别采用散射免疫比浊法和化学发光法检测恶性肿瘤合并细菌感染(感染组)和不伴感染(非感染组)患者的CRP和PCT,比较两组患者CRP、PCT水平,诊断细菌感染的灵敏度和特异度差异.利用相对工作特征曲线(ROC)对CRP和PCT诊断细菌感染的效能进行分析.结果 感染组100例,非感染组60例,感染组的中位CRP、PCT水平均明显高于非感染组,差异均有统计学意义(P=0.000).感染组CRP的阳性率高于非感染组(97%vs 40%,P=0.000).感染组PCT的阳性率高于非感染组(55%vs 1.7%,P=0.000).CRP诊断恶性肿瘤合并细菌感染的灵敏度、特异度分别为97%和60%;PCT诊断恶性肿瘤合并细菌感染的灵敏度、特异度分别为55%和98.3%.ROC曲线分析CRP的AUC=0.905,PCT的AUC=0.882.CRP以31.9 mg/L为诊断界值时诊断价值最大,PCT以0.1 ng/mL为诊断界值时诊断价值最大.结论 CRP、PCT联合检测有助于早期快速诊断恶性肿瘤合并感染.     

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.