GPBB、cTnI、CK、CKMB在急性心肌梗死伴糖尿病早期诊断中的临床应用价值

分析心肌梗死伴糖尿病患者血清中糖原磷酸化酶同工酶BB(GPBB)、肌钙蛋白I (cTnI)、肌酸激酶(CK)、肌酸激酶同工酶(CKMB)水平的变化。结果显示糖尿病组、单纯急性心肌梗死组及急性心肌梗死伴糖尿病组患者血清中GPBB、cTnI、CK、CKMB、BNP及超敏C反应蛋白(Hs-CRP)水平明显升高(P<0.05),且急性心肌梗死伴糖尿病组患者与其他组相比差异均有显著性(P<0.05);与GPBB、cTnI、CK、CKMB单独检测相比,各项目联合检测急性心肌梗死伴糖尿病敏感度和特异性均明显升高(P<0.05)。因此, GPBB、cTnI、CK、CKMB联合检测在急性心肌梗死伴糖尿病早期诊断中具有重要的参考价值。     

小剂量阿司匹林治疗早发型子痫前期的疗效及对母婴结局的影响

【摘要】 目的 探讨小剂量阿司匹林治疗早发型子痫前期的疗效及对母婴结局的影响。方法 选取2016年1月~2018年1月期间我院收治的94例早发型子痫前期患者,分为对照组（常规治疗组）和观察组（阿司匹林抗凝组）,每组各47例。对照组予以常规治疗,观察组在常规治疗基础上予以小剂量阿司匹林治疗。观察并记录两组患者疗程结束后的临床总有效率、凝血功能指标［血浆凝血酶原时间（PT）、活化部分凝血活酶时间（APTT）、凝血酶时间（TT）、纤维蛋白原（Fib）］、不良妊娠结局（肝肾功能异常、子痫、早产、剖宫产、产后出血）的发生率、围生儿结局［新生儿体质量、1min新生儿评分（Apgar）］以及治疗期间血小板计数异常、胃肠道症状等不良反应发生情况。结果 疗程结束后,观察组治疗总有效率明显高于对照组（P＜0.05）;观察组患者PT、APTT、TT均较对照组更长（P＜0.05）,血清Fbg水平则明显更低（P＜0.05）;两组剖宫产率、产后出血率差异无统计学意义（P＞0.05）;观察组肝肾功能损害、子痫、早产发生率均低于对照组（P＜0.05）;观察组新生儿体质量、1min Apgar评分均高于对照组（P＜0.05）;两组治疗期间均未出现血小板计数异常或明显的胃肠道症状(P＞0.05)。结论 小剂量阿司匹林用于治疗早发型子痫前期是安全有效的,可保护患者肝肾功能,减少并发症,改善母婴结局。     

联合激光周边虹膜切除术治疗原发性闭角型青光眼

目的：探讨联合激光周边虹膜切除术治疗原发性闭角型青光眼的临床疗效。

方法：收集2015-08/2017-10在我院就诊的原发性闭角型青光眼患者82例82眼,随机分为单纯激光组(33例,采用Nd：YAG激光周边虹膜切除术)和联合激光组(49例,采用532半导体激光联合Nd：YAG激光周边虹膜切除术)。记录两组患者眼压、激光能量、虹膜出血情况。

结果：单纯激光组患者术后眼压升高较联合激光组明显,术后1h,1d,1wk两组患者眼压差异明显(均P<0.01); 术后1mo两组患者眼压基本恢复至术前水平。单纯激光组患者术中1次透切成功率明显低于联合激光组(73% vs 100%,P<0.05),且术中使用Nd：YAG激光总能量明显高于联合激光组(40.16±13.43mJ vs 23.23±6.70mJ,P<0.05)。两组患者术中虹膜出血率无明显差异(33% vs 26%, P>0.05)。

结论：532半导体激光联合Nd：YAG激光行周边虹膜切除术1次透切率高,尤其对于无虹膜隐窝的患者,可明显降低激光操作难度,减少激光能量,减轻前房炎症反应。     

The disease characteristics of patients both with IgA nephropathy and diabetes mellitus

Objective To sum up and analyze the clinical and pathological characteristics in patients with both IgA nephropathy (IgAN) and diabetes mellitus. Methods A total of 500 patients were recruited, including 25 patients with both IgAN and diabetes mellitus, and 475 patients with IgAN only, who were diagnosed by renal-biopsy during Jan 2015 to Jan 2017 at the First Affiliated Hospital of Zhengzhou University. The clinical and pathological data were collected and analyzed using SPSS 22.0. Propensity Score Matching was used to match and select the patients in the both groups, and thereafter the depth of the basement membrane from the matched patients were compared using electron microscopy. The data of the patients whose follow-up time was ≥3 months were retrospectively collected, and Kaplan-Meier analysis was used to compare the difference of the prognosis. Results Compared to the patients with IgAN only, patients with both IgAN and diabetes mellitus were older [(46.36±13.49) years vs (34.00±13.80) years, P＜0.001], had higher level of serum triglyceride [2.06(1.52, 3.11) mmol/L vs 1.51(1.01, 2.25) mmol/L, P=0.012] and thicker basement membrane [(384.33±61.20) nm vs (346.72±52.65) nm, P=0.044]. The patients with both IgAN and diabetes mellitus were more prone to reach the composite endpoint [4/7(57.14%) vs 25/265(9.33%), P＜0.001] and had worse prognosis (Log-Rank test, P=0.004). Conclusions IgAN patients with diabetes mellitus have different clinical, pathological characteristics and prognosis from patients with IgAN alone. These patients need to be closely monitored and actively treated.     

Multimodal investigation of dopamine D2/D3 receptors,default mode network suppression,and cognitive control in cocaine-use disorder

Stimulant-use disorders have been associated with lower availability of dopamine type-2 receptors (D2R) and greater availability of type-3 receptors (D3R). Links between D2R levels, cognitive performance, and suppression of the default mode network (DMN) during executive functioning have been observed in healthy and addicted populations; however, there is limited evidence regarding a potential role of elevated D3R in influencing cognitive control processes in groups with and without addictions. Sixteen individuals with cocaine-use disorder (CUD) and 16 healthy comparison (HC) participants completed [¹¹C]-(+)-PHNO PET imaging of D2R and D3R availability and fMRI during a Stroop task of cognitive control. Independent component analysis was performed on fMRI data to assess DMN suppression during Stroop performance. In HC individuals, lower D2R-related binding in the dorsal putamen was associated with improved task performance and greater DMN suppression. By comparison, in individuals with CUD, greater D3R-related binding in the substantia nigra was associated with improved performance and greater DMN suppression. Exploratory moderated-mediation analyses indicated that DMN suppression was associated with Stroop performance indirectly through D2R in HC and D3R in CUD participants, and these indirect effects were different between groups. To our knowledge, this is the first evidence of a dissociative and potentially beneficial role of elevated D3R availability in executive functioning in cocaine-use disorder.Subject terms: Addiction, Cognitive control     

A meta-analysis of the secondary fractures for osteoporotic vertebral compression fractures after percutaneous vertebroplasty

To identify the risk factors of the secondary fractures for osteoporotic vertebral compression fractures (OVCFs) after percutaneous vertebroplasty (PVP).We conducted a search of relevant articles using Cochrane Library, PubMed, Medline, Science Direct, Embase, the Web of Science and other databases. The time range we retrieved from establishment of the electronic database to November 2017. Gray studies were found in the references of included literature reports. STATA version 11.0 (Stata Corporation, College Station, Texas) was used to analyze the pooled data.Fourteen studies involving 1910 patients, 395 of whom had fracture secondary to the surgery were included in this meta-analysis. The result of meta-analyses showed the risk factors of the secondary fractures for OVCFs after PVP was related to bone mineral density (BMD) [95%CI (−0.650, −0.164), SMD=−0.407, P=.001], cement leakage ((RR=0.596, 95%CI (0.444,0.798), P = .001)), and kyphosis after primary operation ((SMD=0.741, 95%CI (0.449,1.032), P = .000)), but not to gender, age, body mass index, cement volume, thoracolumbar spine, and cement injection approaches.Bone mineral density, cement leakage, and kyphosis after primary operation are the risk factors closely correlative to the secondary fracture after PVP. There have not been enough evidences to support the association between the secondary fracture and gender, age, body mass index, cement volume, thoracolumbar spine, and cement injection approaches.     

医学院校中智库建设的因素分析

高校智库是我国当前智库构成中不可或缺的重要组成，医学院校的智库建设既有其必要性，同时也有自身的特点。结合医学院校自身特色，坚持问题导向原则，发挥研究基地优势，积极开展交叉学科研究，同时主动向媒体推介研究成果，通过建设医学院校的社科研究智库，大力推进社科研究成果的转化，真正增强医学院校智库的社会影响力和公信力。     

后腹腔镜肾上腺嗜铬细胞瘤切除术围手术期护理

目的探讨提高嗜铬细胞瘤患者围手术期治疗效果的护理配合。方法回顾性分析42例肾上腺嗜铬细胞瘤病例围手术期的护理配合方法与措施。结果经过正确的治疗和充分的围手术期护理,42例患者治疗过程顺利,均未发生并发症,治愈出院。结论充分做好手术前、手术中、手术后护理,是提高手术治疗成功率的关键。     

Enhanced immune response to foot-and-mouth disease vaccine by oral administration of ginseng stem-leaf saponins

Vaccination is an important approach to the control of foot-and-mouth disease (FMD). This study evaluated the effect of oral administration of ginseng stem–leaf saponins (GSLS) on the immune response to FMD vaccine and the gut mucosal immunity in mice. In experiment 1, mice were orally administered GSLS or not treated as a control. The animals were then immunized twice with FMD vaccine. Blood was sampled weekly within five weeks after the boost immunization for measurement of serum IgG and the isotypes. In experiment 2, mice were orally administrated GSLS or not treated as a control. After that, splenocytes were prepared from sacrificed mice for lymphocyte proliferation assay and intestinal tissues were sampled for immunohistochemistry and histological examination. The results showed that oral administration of GSLS significantly enhanced serum IgG and the isotype responses to FMD vaccine as well as the number of intestinal intraepithelial lymphocytes (IELs) and immunoglobulin A (IgA)+?cells. Therefore, GSLS may be a potent oral adjuvant and deserve further study to improve vaccination in susceptible animals.