263例儿童介入手术的辐射剂量研究

目的 评估现阶段不同疾病类型的儿童介入手术患儿的受照剂量,并对临床中与辐射剂量相关的因素进行分析,以降低患儿的辐射剂量。方法 回顾性的收集2019年7—9月济南某儿科三甲医院导管室手术间所进行的所有介入手术病例,记录患儿的个人情况及辐射剂量报告。结果 纳入263例患儿中,血管瘤所占比例为27%、脉管畸形49%、母细胞瘤14%、先天性心脏病8%、其他疾病2%,剂量面积乘积（DAP）的中位数最大的为毛细血管畸形66.0 mGy·m²、最小的为视网膜母细胞瘤 0.6 mGy·m²和淋巴管畸形0.02 mGy·m²。累积剂量中位数最大的为毛细血管畸形4132.0 mGy、最小的为淋巴管畸形1.2 mGy。对具有分析意义的血管瘤、视网膜母细胞瘤和静脉畸形组进行组间比较,结果静脉畸形组和血管瘤组的DAP值表现均显著高于视网膜母细胞瘤组(P < 0.05),静脉畸形组和血管瘤组间无显著差异性(P > 0.05);血管瘤组的CD值表现均显著高于视网膜母细胞瘤组和静脉畸形组(P < 0.05),视网膜母细胞瘤组和静脉畸形组间无显著差异性(P > 0.05)。多因素回归分析手术中年龄(β = 0.188,P < 0.05)、体重(β = -0.185,P < 0.05)、球管电压(β = 0.565,P < 0.05)、球管电流(β = -0.061,P < 0.05)和光野大小(β = 0.335,P < 0.05)因素均会对患儿的受照剂量产生影响,脉冲时间和铜过滤与患儿受照剂量之间无统计学意义（P > 0.05）。结论 本研究总结了儿童介入手术的类型和比例,评估了每种介入手术的患儿受照剂量水平,患儿本体特性、设备的曝光参数与患儿辐射剂量相关,可用于儿童介入手术辐射剂量与防护的初步评估。     

Improved detection of dengue-1 virus from IgM-positive serum samples using C6/36 cell cultures in association with RT-PCR

Dengue is the most important arboviral disease in the world, and its diagnosis is primarily made by serology. Virus isolation has been successful mainly in clinical samples obtained during the acute phase of illness, and is carried out through inoculation of clinical samples into C6/36 cell monolayers followed by the detection of infection by indirect immunofluorescence assay (IFA). We compared the efficiency of RT-PCR and IFA in the detection of dengue-1 virus after inoculation of C6/36 cells with samples obtained in the convalescent period of dengue infection. Out of 75 IgM-positive samples inoculated into C6/36 cells, 2 were positive by IFA while 17 were positive by RT-PCR. The 2 IFA-positive samples were collected during the acute phase of the illness; 17 positive samples were found by RT-PCR, including the 2 detected by IFA. For both methods, we also investigated the time necessary for viral detection using a fixed dose of 1 x 10(4) viruses/ml. RT-PCR and IFA detected the dengue virus 1 and 4 days after virus inoculation, respectively. The results obtained here indicate that RT-PCR is the most sensitive method in the detection of dengue viruses using C6/36 cells for viral isolation.     

Variation of Serum Monocyte Chemoattractant Protein-1 in Patients with Diabetes and Metabolic Syndrome

This study investigated the variation of serum monocyte chemoattractant protein-1 (MCP-1)in patients with both diabetes mellitus (DM) and metabolic syndrome (MS).Based on the International Diabetes Federation (IDF) diagnostic criteria,93 patients enrolled in this study were divided into four groups:normal control (NC),simple DM,simple MS,and DM plus MS (DM-MS) groups.The main measures included height,weight,waist circumference (WC),hip circumference,blood pressure,fasting blood glucose,insulin resistance index (HOMA-IR),serum triglyceride (TG),HDL-ch,LDL-ch,and MCP-1.The results showed that the serum levels of MCP-1 in the DM-MS group were significantly increased as compared with those in the DM and MS groups (P＜0.05),and the increase in the MCP-1 level in the DM group was much higher than in the MS group (P＜0.05).The DM-MS group had the highest HOMA-IR levels,followed by MS,DM and NC groups (P＜0.05).Correlation tests showed that the association of MCP-1 with age,HDL-ch,or LDL-ch was insignificant,whereas that of MCP-1 with body mass index (BMI),waist hip rate (WHR),WC,systolic blood pressure (SBP),diastolic blood pressure (DBP),TG,and HOMA-IR was significantly positive.It was concluded that circulating MCP-1 was substantially increased in patients with both DM and MS as compared with that in the patients with DM or MS alone,and the central obese state may contribute to a more vicious proinflammatory condition and insulin resistance in patients with diabetes.     

基于因子分析法的弱、少精子症中医证候分型研究

目的：研究弱、少精子症的证候分型及量化诊断规律。方法：采集507 例弱、少精子症患者的临床四诊信息,对常见症状按4 级赋予分值,以因子分析方法进行证候分型及量化分析。结果：因子分析从弱、少精子症临床四诊信息中提取5 个代表性因子,分别代表湿热下注、肾精不足、肾阳虚、肝郁气滞、肾阴虚等证候,同时对各个证候进行量化。结论：以大样本为基础,应用因子分析方法所得的弱、少精子症常见证候分型及量化诊断规律符合临床实际情况,为临床辨证提供客观依据。     

Overlap between molecular markers expressed by naturally occurring CD4+CD25+ regulatory T cells and antigen specific CD4+CD25+ and CD8+CD28- T suppressor cells

Alloantigen specific CD8+CD28- T suppressor (TS) cells differ from naturally occurring CD4+CD25+ T-regulatory (natural TR) cells not only by their phenotype but also by their mechanism of action. Natural TR have been extensively studied, leading to the identification of characteristic "molecular markers" such as Forkhead box P3 (FOXP3), glucocorticoid-induced tumor necrosis factor receptor-related protein (GITR) and cytotoxic T lymphocyte-associated antigen 4 (CTLA-4). We have investigated the expression of these genes in alloantigen specific TS and CD4+CD25+ T regulatory (TR) cells and found that they are expressed at levels similar to those observed in natural TR. Furthermore, similar to natural CD4+CD25+ TR, antigen-specific CD8+CD28-CD62L+ TS cells have more suppressive capacity than CD8+CD28-CD62L- TS cells. In spite of these similarities, natural TR are not antigen-specific and inhibit other T cells by T cell-to-T cell interaction, whereas TS are antigen-specific and exert their inhibitory function by interacting with antigen-presenting cells and render them tolerogenic to other T cells. The molecular characterization of TS cells may contribute to a better understanding of mechanisms involved in inhibition of immune responses in autoimmunity, transplantation, and chronic viral infection.     

认知行为干预对首发精神分裂症远期疗效的对照研究

目的 :探讨认知行为干预 (心理治疗 )对首发精神分裂症患者疗效的影响。方法 :对 1998年6月以来 2 5 1例首次住院治疗的精神分裂症患者 ,于治疗的第三个阶段随机分为抗精神病药物合并心理治疗组 (研究组 ,12 6例 )及单用抗精神病药物组 (对照组 ,12 5例 ) ,两组均采用同样的药物维持治疗。研究组服氯氮平 (12 7 5± 73 1)mg/d (4 5例 ) ,利培酮 (2 4± 1 4)mg/d (81例 ) ;对照组服氯氮平 (12 3 2± 77 3 )mg/d (4 7例 ) ,利培酮 (2 3± 1 6)mg/d (78例 )。经 2年的随访观察 ,分别对两组的复发率 ,自知力评分 ,服药依从性 ,和阴阳性症状评定量表 (PANSS)总分进行比较。结果 :研究组复发率低于对照组 (P <0 0 1) ;研究组的自知力好于对照组 (P <0 0 1) ;研究组的PANSS总分及因子分均低于对照组 (P <0 0 1～ 0 0 5 )。结论 :对首发精神分裂症患者进行认知行为干预 ,可提高患者的疗效及服药依从性 ,减少疾病的复发率。     

幽门螺杆菌依赖蛋白酪氨酸激酶途径诱导胃上皮细胞分泌IL-8

目的 分析中国临床分离的幽门螺杆菌的cag致病岛的差异和不同激酶抑制剂对幽门螺杆菌诱导中国人胃上皮细胞IL-8分泌的影响。方法 在体外分别用中国临床分离的cagA^ cagE^ ,cagA^ cagE^-0、cagA^-cagE^ 、cagA^-cagE^-的幽门螺杆菌与中国人胃上皮细胞MGC-803共培养,分泌的IL-8用ELISA进行检测,比较蛋白激酶A、C、G和蛋白酪氨酸激酶的抑制剂对幽门螺杆菌诱导分泌的IL-8用ELISA进行检测,比较蛋白激酶A、C、G和蛋白酪氨酸激酶的抑制剂对幽门螺杆菌诱导胃上皮细胞IL-8分泌的影响。结果 cagA^ cagE^ 幽门螺杆菌显著增加了胃上皮细胞IL-8的分泌,cagA^ cagE^-,cagA^-cagE^ 幽门螺杆菌作用次之,而cagA^-cagE^-幽门螺杆菌不能增加胃上皮细胞IL-8的分泌,蛋白激酶A、C、G的抑制剂不能阻断幽门螺杆菌增加胃上皮细胞IL-8的分泌,而蛋白酪氨酸激酶的抑制剂阻断了幽门螺杆菌增加胃上皮细胞IL-8的分泌。结论 cagA^ cagE^ 幽门螺杆菌显著增加了胃上皮细胞IL-8的分泌并且依赖于蛋白酪氨酸激酶的活性。     

Combined effects of polyfluorinated and perfluorinated compounds on primary cultured hepatocytes from rare minnow (Gobiocypris rarus) using toxicogenomic analysis

Polyfluorinated and perfluorinated compounds (PFCs) are used in numerous commercial products and have been ubiquitously detected in the environment as well as in the blood of humans and wildlife. To assess the combined effects caused by PFCs in mixtures, gene expression profiles were generated using a custom cDNA microarray to detect changes in primary cultured hepatocytes of rare minnows exposed to six individual PFCs (perfluorooctanoic acid, perfluorononanoic acid, perfluorodecanoic acid, perfluorododecanoic acid, perfluorooctane sulfonate, and 8:2 fluorotelomer alcohol) and four formulations of the PFCs mixtures. Mixtures as well as individual compounds consistently regulated a particular gene set, which suggests that these conserved genes may play a central role in the toxicity mediated by PFCs. Specifically, a number of genes regulated by the mixtures were identified in this study, which were not affected by exposure to any single component. These genes are implicated in multiple biological functions and processes, including fatty acid metabolism and transport, xenobiotic metabolism, immune responses, and oxidative stress. More than 80% of the altered genes in the PFOA- and PFOS-dominant mixture groups were of the same gene set, while the gene expression profiles from single PFOA and PFOS exposures were not as similar. This work contributes to the development of toxicogenomic approaches in combined toxicity assessment and allows for comprehensive insights into the combined action of PFCs mixtures in multiple environmental matrices.     

自发性蛛网膜下腔出血全脑DSA阴性的原因与对策

目的 探讨蛛网膜下腔出血(SAH)患者全脑数字减影血管造影(DSA)阴性的原因和对策.方法 对120例自发性SAH患者中DSA阴性的30例资料进行回顾性分析.结果 30例中,有13例(43.3%)重新获得明确诊断.其中,5例行重复造影检查,发现1例左侧前交通动脉瘤,1例右颈内动脉C2段动脉瘤,1例出血处手术探查发现为隐匿性血管畸形,另2例重复造影仍为阴性.头颅MRI检查发现2例海绵状血管瘤,其余8例患者CT符合中脑周围非动脉瘤性SAH(PNSH).结论 对在首次造影中有颅内血管痉挛,部分血管不显形或有再出血的患者必须行重复造影.     

Impact of Liver Functions by Repurposed Drugs for COVID-19 Treatment

Liver injury is an important complication that may arise in patients suffering from coronavirus disease 2019 (COVID-19) and is accompanied by a transient increase of transaminases and/or other liver enzymes. Liver function test (LFT) abnormalities generally disappear when the COVID-19 resolves or hepatotoxic drugs are discontinued. The LFT abnormalities are associated with drug-induced liver injury (DILI), due to the overuse of antimalarials, antivirals, and antimicrobials. Studies have reported varying levels of these liver injuries in COVID-19 patients; however, most involve elevated serum aminotransferases. Hepatic dysfunction is significantly high in patients with severe illness and has poor outcome. Normally, the liver is involved in the metabolism of many drugs, including nucleoside analogs and protease inhibitors, which are currently repurposed to treat COVID-19. In addition to the manifestation of COVID-19, drugs implemented in its treatment may aggravate liver injuries. Thus, DILI should be considered especially in those COVID-19 patients with underlying liver disease. It was unclear whether the elevated liver enzymes have originated from the underlying disease or DILI in this population. Furthermore, it is difficult to establish a direct relationship between a specific drug and liver injury. Another possible effect of liver damage may due to inflammatory cytokine storm in severe COVID-19. Liver injury can change metabolism, excretion, dosing, and expected concentrations of the drugs, which may make it difficult to achieve a therapeutic dose of the drug or increase the risk of adverse effects. These repurposed drugs have shown limited efficacy against the virus and the disease itself; however, they still pose risk of adverse effects. Careful and close monitoring of LFTs in COVID-19 patients can provide early diagnosis of liver injury, and the risk of DILI could be reduced. Also, drug interactions in liver-transplanted patients should always be kept in mind for certain immunosuppressive therapies and their known signs of DILI. Altogether, abnormal LFTs should not be regarded as a contraindication to use COVID-19 experimental therapies if needed under emergent status.