三项检测在急性心梗急诊PCI术后预后不良中的预测应用

目的 探讨同型半胱氨酸（homocysteine,Hcy）、分泌型卷曲相关蛋白5(secreted frizzled related protein 5,SFRP5)及尿酸（uric acid,UA）三项检测在急性心梗急诊PCI术后预后不良的预测价值。方法 选取2017年1月～2018年12月在资阳市第一人民医院治疗的96例急性心肌梗死患者,根据2年随访数据划分为预后良好组（n=63）和预后不良组（n=33）。分析不同预后的患者Hcy、SFRP5、UA水平;Logistic回归分析影响患者预后不良的相关因素;绘制ROC曲线,分析三者联合（Hcy、SFRP5及UA）检测对PCI术后预后不良的预测价值。结果 (1)两组性别、年龄、体质量、高血压史、糖尿病史比较差异无统计学意义;两组心脑血管家族遗传史、吸烟史、饮酒史、冠脉病支数比较差异有统计学意义（均P<0.01）;(2)预后不良组患者Hcy、UA水平明显高于预后良好组,SFRP5水平明显低于预后良好组（均P<0.01）;(3)心脑血管家族遗传史、吸烟史、饮酒史、冠脉病支数、Hcy、SFRP5、UA是影响急性心肌梗死患者PCI术...     

巨细胞病毒脑炎临床分析

巨细胞病毒（CMV）在人群中感染非常普遍，多为亚临床不显性感染和潜伏感染。当机体免疫功能低下时CMV感染可累及多器官系统出现临床症状，以肺部最常见，其次为肝脏，肾脏等组织，脑组织少见。国外报道的CMV脑炎的病人多为接受器官移植或HIV感染等免疫缺陷患者，国内有关的研究报道很少，有关CMV脑炎诊断标准尚不明确，诊断水平有待提高。现对我院近2年收治的6例诊断为CMV脑炎患者的病例资料进行回顾性分析。     

卵巢癌患者CD4+T细胞中调节性T细胞相关分子标志物的表达特点及临床意义

目的:探讨卵巢癌患者外周血和肿瘤组织CD4+调节T细胞中性T细胞相关分子标志物(Foxp3、CD25、CD127、CTLA-4及GITR)的表达特点及其临床意义。方法 :流式细胞术检测31例卵巢癌患者,26例卵巢良性肿瘤患者和20例健康对照者的外周血,以及14例卵巢癌组织和12例卵巢良性肿瘤组织CD4+T细胞中Foxp3、CD25、CD127、CTLA-4及GITR的表达水平。结果:卵巢癌组织CD4+T细胞中的Foxp3、CD25、CTLA-4及GITR的表达水平显著高于卵巢良性肿瘤组织(P<0.05);CD127在卵巢癌组织CD4+T细胞中所占的比例显著低于卵巢良性肿瘤组织(P<0.01);卵巢癌患者外周血CD4+T细胞中Foxp3、CD25、CTLA-4及GITR的表达水平均显著高于卵巢良性肿瘤患者和健康对照者(P<0.01),CD127的表达水平显著低于卵巢良性肿瘤患者和健康对照者(P<0.01);Ⅲ/Ⅳ期卵巢癌患者外周血CD4+T细胞中Foxp3的表达水平显著高于Ⅰ/Ⅱ期患者(P<0.05);Ⅲ/Ⅳ期卵巢癌患者外周血CD4+T细胞中CD127的表达水平显著低于Ⅰ/Ⅱ期患者(P<0.05)。结论:卵巢癌患者外周血及肿瘤组织中CD4+Treg细胞的表达水平显著高于卵巢良性肿瘤组和健康对照组,Foxp3和CD127的表达水平与肿瘤分期有关,提示这两种标志物可作为判断卵巢癌疾病进展的重要指标。     

耳穴压豆联合中医艾灸护理在维持性血液透析伴便秘病人中的应用

[目的]探讨耳穴压豆联合中医艾灸护理在维持性血液透析(MHD)伴便秘病人中的应用效果。[方法]选取本院收治的96例MHD伴便秘病人,根据随机数字表将病人分为观察组及对照组各48例,对照组行常规饮食指导,观察组在对照组基础上实施耳穴压豆联合中医艾灸护理,比较两组病人治疗效果、临床症状改善及生活质量情况。[结果]观察组病人治疗总有效率高于对照组(P0.05)。观察组干预后排便困难、腹胀/下坠感、腹痛、排便时间、粪便性状、排便频率等症状评分较对照组显著下降(P0.05)。观察组干预后生活质量及各维度评分较对照组显著升高(P0.05)。[结论]耳穴压豆联合中医艾灸能有效改善MHD病人便秘症状,提高病人生活质量。     

少阳生骨方对大鼠在体软骨损伤关节液IL-1β及软骨修复组织Ⅱ型胶原影响的实验研究

目的应用少阳生骨方对大鼠在体软骨损伤进行干预,观察其对大鼠在体软骨损伤关节液中IL-1β水平及和修复组织中Ⅱ型胶原的影响。方法选用在相同条件下喂养的6～8周清洁级SD大鼠,制作成关节软骨损伤动物模型,按照组内均衡一致原则随机编为3组,即少阳生骨方组实验组（S组）、盐酸氨基葡萄糖胶囊组对照组（A组）和生理盐水空白对照组（K组）,每组9只。于造模完成后的第二天,开始灌胃药物,S组少阳生骨方灌胃,A组盐酸氨基葡萄糖胶囊灌胃,K组生理盐水灌胃。对比观察少阳生骨方及盐酸氨基葡萄糖胶囊对大鼠关节软骨损伤后不同时期（4周、8周、12周）关节液中IL-1β水平和修复组织中Ⅱ型胶原的影响。结果三组关节液中IL-1β水平检测,S组和A比较：第4、8、12周A组高于S组（P〈0．05）;第4、8、12周K组高于S组（P〈0．05）;第4、8、12周K组高于A组（P〈0．05）。治疗前后自身比较：S组第8周、第12周均低于第4周（P〈0．05）;A组第8周、第12周均低于第4周（P〈O．05）;K组第4周〉第8周〉第12周（P〈0．05）。组织学观察显示S、A组软骨缺损修复组织的数量及质量均优于K组,S组的修复效果强于A组。结论通过和解少阳的方法可显著降低关节液中导致软骨细胞损伤的炎性介质IL-1β水平,提高软骨损伤后修复组织中Ⅱ型胶原的表达,从而有助于软骨损伤的修复。     

肺癌细胞促进单核吞噬细胞MAPK相关通路活化诱导炎性细胞因子表达上调的研究

目的：通过建立人单核吞噬细胞系（THP‐1）和人肺腺癌细胞系（SPC‐A1）共培养体系,检测共培养体系中THP‐1的炎性细胞因子mRNA表达水平和丝裂原活化蛋白激酶通路（MAPK）的表达情况,初步阐明肺癌微环境对THP‐1中炎性细胞因子表达的影响。方法体外培养SPC‐A1细胞系、THP‐1细胞系,并建立二者共培养体系,设置THP‐1单独培养组为对照组。24h后,收集各组THP‐1细胞,实时荧光定量聚合酶链式反应（Real‐TimePCR）检测白细胞介素（IL）‐1β、‐6、‐8及肿瘤坏死因子‐α（TNF‐α）的mRNA表达水平;Westernblot检测MAPK通路蛋白c‐Jun氨基末端激酶及其磷酸化形式（JNK／p‐JNK）、丝裂原活化蛋白激酶p38亚单位及其磷酸化形式（p38MAPK／p‐p38MAPK）、细胞外调节蛋白激酶及其磷酸化形式（ERK／p‐ERK）的表达。结果共培养24h后,共培养组THP‐1的IL‐1β、IL‐8mRNA表达水平均明显高于对照组（P＜0．05）,分别为对照组的5．81、4．21倍;Westernblot结果显示共培养组p38MAPK、p‐p38MAPK的表达水平均明显高于对照组（P＜0．05）。结论肺癌细胞可引起肺癌环境中单核吞噬细胞中p38MAPK通路的活化,进而诱导IL‐1β、IL‐8mRNA表达上调,有利于肿瘤炎症微环境的维持和促进肿瘤的进展。     

Clinicopathological significance and prognostic value of LRP16 expression in colorectal carcinoma

AIM: To explore the expression of leukemia related protein 16 (LRP16) in colorectal carcinoma, and analyze its correlation with clinicopathologic features and prognosis. METHODS: Immunohistochemistry for LRP16 was performed in 201 cases of colorectal carcinoma and 60 cases of distal normal mucosa. Medical records were reviewed and clinicopathological analysis was performed. RESULTS: LRP16 expression was detected in 117 of 201 cases of the colorectal carcinoma and in 21 cases of 60 distal normal mucosa. The ...     

Unusual cause of gastrointestinal bleeding in a cirrhotic patient:hepatocellular carcinoma with gastric invasion

BACKGROUND:Upper gastrointestinal(GI)bleeding is a common complication of portal hypertension in cirrhotic patients,and hepatocellular carcinoma(HCC)is the most common tumor in cirrhotic livers.Bleeding from tumor erosion into the GI tract is very rare.A patient with HCC and gastric tumor invasion was described and the previously reported cases were reviewed. METHOD:A patient with upper GI bleeding was treated in a tertiary hospital. RESULTS:A cirrhotic patient with a HCC invading the stomach leading to upp...     

阿托伐他汀对急性缺血性脑卒中患者血浆溶血磷脂酸的影响

目的：探讨阿托伐他汀对急性缺血性脑卒中患者血浆溶血磷脂酸（lysophosphatidi cacid,LPA）的干预作用。方法：110例脑梗塞患者,被随机分为阿托伐他汀组（57例）和常规治疗组（53例）。两组均给予钙拮抗剂、脑细胞活化剂、银杏达莫注射液及对症治疗。阿托伐他汀组加用阿托伐他汀20～40mg／d。两组病人人院后第二天清晨空腹静脉采血查血浆LPA和血脂水平,治疗14d后复查。结果：阿托伐他汀组和对照组治疗后LPA较治疗前均显著下降（P〈0．05～〈0．01）。且阿托伐他汀组下降更显著[（2．53±0．75）μmol／L：（1．01±0．56）μmol／L.P〈0．01）。两组治疗前后总胆固醇（TC）与低密度脂蛋白一胆固醇（LDL-C）均有显著下降（P〈0．01,〈0．05）．但两组比较无显著性差异（P〉0．05）。结论：阿托伐他汀能显著降低急性脑梗塞患者血浆LPA水平,其作用与调脂作用似无明显相关。     

Effect of alcohol consumption on liver stiffness measured by transient elastography

AIM:To determine the evolution of transient elastography(TE) in patients with alcoholic liver disease according to alcohol cessation or continuation.METHODS:We retrospectively selected in our local database all patients who had two TE between June 2005 and November 2010 with chronic alcohol excessive consumption and excluded those with associated cause of liver disease.TE was performed at least one week apart by senior operator.TE examinations with less than ten successful measures or with an interquartile range above 30% were excluded.We retrospectively reviewed file of all patients to include only patient followed up by trained addictologist and for which definite information on alcohol consumption was available.Concomitant biological parameters [aspartate amino transferase(AST),alanine amino transferase and gamma-glutamyl transpeptidase(GGT)] within 4 wk of initial and final TE were recorded.Putative fibrosis score according to initial and final TE were determined with available cut-off for alcoholic liver disease and hepatitis C.Initial and final putative fibrosis score were compared according to alcohol consumption during follow-up.RESULTS:During the study period 572 patients had TE examination for alcoholic liver disease and 79 of them had at least two examinations.Thirty-seven patients met our criteria with a median follow-up of 32.5 wk.At the end of the study,13(35%) were abstinent,and 24(65%) relapsers.Eight patients had liver biopsy during follow-up.TE decreased significantly during follow-up in 85% of abstinent patients [median(range):-4.9(-6.1,-1.9)],leading to a modification of the putative fibrosis stage in 28%-71% of patient according to different cut-off value.In relapsers TE increased in 45% and decreased in 54% of patient.There was no statistical difference between initial and final TE in relapsers.In the overall population,using 22.6 kPa as cut-off for cirrhosis,4 patients had cirrhosis at initial TE and 3 patients had cirrhosis at final TE.Using 19.5 kPa as cut-off for cirrhosis,7 patients ha