采暖期与非采暖期大学生PM2.5中多环芳烃暴露及尿中羟基代谢物比较

比较采暖期和非采暖期环境颗粒物PM2.5中多环芳烃(PAHs)和人体尿中4种羟基多环芳烃代谢物(OH-PAHs)的水平差异,为进一步开展环境中PAHs低剂量长期暴露对健康影响的机制研究奠定基础.方法 于采暖期和非采暖期分别采集大气颗粒物样本并检测PM2.5中PAHs浓度,同时选取华北理工大学46名在校大学生进行尿样采集并检测尿中2-羟基芴、3-羟基菲、1-羟基菲和1-羟基芘的含量.结果 采暖期颗粒物PM2.5中总多环芳烃、芴、菲、芘的质量体积分数(中位数)分别为91.08,2.26,2.14,7.28 ng/m3,非采暖期分别为32.06,1.56,0.20,1.04 ng/m3,采暖期均高于非采暖期,差异有统计学意义(P值均<0.05).大学生尿液中4种OH-PAHs的含量(中位数)采暖期分别为0.63,0.73,0.40,0.42 μmol/mol Cr,非采暖期分别为0.25,0.04,0.03,0.08 μmol/mol Cr,采暖期含量高于非采暖期,差异均有统计学意义(P值均<0.05).1-羟基芘(1-OHPyr)与总多环芳烃相关性较弱,而3-羟基菲、1-羟基菲与总多环芳烃、菲的相关性均较强.结论 健康大学生体内OH-PAHs内暴露水平采暖期高于非采暖期.多种羟基代谢物联合评价可以更全面阐述多环芳烃对人类健康的影响.     

胆管癌的CT影像探讨

胆管癌是较常见的恶性肿瘤,可分为肝内胆管癌、肝门部胆管癌及胆总管癌。由于肿瘤特殊性及生长部位的不同,影像学表现及临床症状也有很大差异,常因误诊、漏诊给患者带来不应有的打击．本文统计了我院1993-01～2003-12 10年间证实了的78例胆管癌病例就其影像学特点、临床表现进行回顾性总结。     

尿微量白蛋白肌酐比值、血胱抑素C在2型糖尿病肾病中的临床应用

目的:探讨尿微量白蛋白肌酐比值与血胱抑素C在2型糖尿病肾病中的临床应用。方法:选取我院内分泌科2011年8月～2012年4月住院的2型糖尿病患者85例进行研究,根据尿微量白蛋白排泄率是否正常将其分组。检测尿微量白蛋白肌酐比值、血胱抑素C,观察指标间的相互关系。结果:尿微量白蛋白排泄率增高组与尿微量白蛋白排泄率正常组比较,尿微量白蛋白肌酐比值、血胱抑素C均有显著性差异(P<0.05)。尿微量白蛋白肌酐比值和尿微量白蛋白排泄率呈正相关(r=0.793,P<0.05)。胱抑素C和尿微量白蛋白排泄率呈正相关(r=0.529,P<0.05)。结论:尿微量白蛋白肌酐比值、胱抑素C在临床上可做为糖尿病肾病的监测指标。     

200例肝血管瘤的CT表现探究

肝血管瘤是最常见的肝内良性肿瘤,可单发、多发,影像表现不典型的病例,很难与肝原发性恶性肿瘤及转移瘤鉴别,常因错误诊断造成血管瘤患者进行不必要的手术治疗或恶性肝占位病灶误诊为血管瘤而耽误治疗时间,本文把我院1993～2003年10年间诊断为血管瘤而经手术、穿刺、随诊观察或经MIR、核素(99m)Tc红细胞扫描确诊的200例肝血管瘤病例的CT表现进行回顾性的对比分析,确定影像表现的病理基础,并制定出肝血管瘤的诊断标准,现报道如下.     

持续皮下胰岛素输注和胰岛素每日多点注射治疗2型糖尿病的成本效果分析

Objective To observe the cost-effectiveness of using continuous subcutaneous insulin infusion (CS Ⅱ) and multi-point daily insulin injections (MDI) in controlling blood sugar in the newly hospitalized type 2 diabetes patients. Methods Retrospective analysis on 86 cases taking CS Ⅱ and 103 cases using MDI on a 'blood sugar control program' among the newly hospitalized patients with type 2 diabetes. The period for observation was 2 weeks, using cost-effectiveness analysis methods to evaluate the two treatment programs. Results After two weeks of treatment, the effectiveness in the control of blood sugar in CS Ⅱ group was similar to the MDI group, with no significant difference(P<0.05) and the adverse reactions were similar. Costs in the CS Ⅱ program (Yuan/person) was less than in the MDI program (1478.34 vs. 1620.46), with significant differences (P< 0.05). The cost-effectiveness ratios (C/E) were 15.07 in the CS Ⅱ group, and 16.34 in the MDI group, with no significant difference (P>0.05). In order to further reduce the cost of CS Ⅱ group as a reference, the incremental cost-effectiveness ratio (△C/ △E)ofthe MDI group was 129.20. Conclusion Costs-effective of the CS Ⅱ program was better than the MDI one in treating the newly hospitalized patients with type 2 diabetes, suggesting that CS Ⅱ program might be a better choice for hospitals to carry on an intensive insulin therapy program.     

丙烯酰胺对大鼠血脑脊液屏障通透性损伤效应的研究

目的 探讨丙烯酰胺(ACR)对大鼠血脑脊液屏障通透性及脉络丛紧密连接蛋白ZO-1的影响,为阐明ACR神经损伤机制提供理论依据.方法 健康雄性SD大鼠32只随机分为对照组和ACR组,每组16只.ACR组按20 mg/kg体重腹腔注射丙烯酰胺溶液(1 ml/kg),每周5次,连续4周;对照组注射等量的生理盐水.每周进行神经(感觉和运动)功能测试.染毒结束后测定脑脊液中伊文氏蓝(EB)和荧光素钠(NaFI)含量,实时荧光定量PCR( real-time PCR)检测脉络丛上皮细胞紧密连接蛋白ZO-1的mRNA表达,激光共聚焦免疫荧光法观察脉络从紧密连接蛋白ZO-1的分布.结果 ACR组大鼠染毒第3周时,大鼠甩尾时间比对照组延长27.77％;染毒第4周时,甩尾时间延长53.71％;差异均有统计学意义(P＜0.05).ACR组大鼠染毒第3周时,大鼠后肢展开距离增加明显,是对照组的131.76％;染毒第4周后肢展开距离是对照组的153.77％;差异均有统计学意义(P＜0.05).ACR染毒组大鼠脑脊液中EB和NaFI含量均明显高于对照组,差异有统计学意义(P＜0.05).ACR染毒4周后,大鼠脉络丛中ZO-1 mRNA表达为0.21 ±0.07,与对照组[(0.31±0.11)]比较,下降32.26％,差异有统计学意义(P＜0.05).激光共聚焦免疫荧光检测结果显示ACR组染毒4周后大鼠脉络丛紧密连接蛋白ZO-1表达减少.结论 ACR可致染毒大鼠血脑脊液屏障通透性增高,脉络丛中紧密连接蛋白ZO-1表达下降,可能与ACR导致中枢神经损伤有关.     

持续皮下胰岛素输注和胰岛素每日多点注射治疗2型糖尿病的成本效果分析

Objective To observe the cost-effectiveness of using continuous subcutaneous insulin infusion (CS Ⅱ) and multi-point daily insulin injections (MDI) in controlling blood sugar in the newly hospitalized type 2 diabetes patients. Methods Retrospective analysis on 86 cases taking CS Ⅱ and 103 cases using MDI on a 'blood sugar control program' among the newly hospitalized patients with type 2 diabetes. The period for observation was 2 weeks, using cost-effectiveness analysis methods to evaluate the two treatment programs. Results After two weeks of treatment, the effectiveness in the control of blood sugar in CS Ⅱ group was similar to the MDI group, with no significant difference(P<0.05) and the adverse reactions were similar. Costs in the CS Ⅱ program (Yuan/person) was less than in the MDI program (1478.34 vs. 1620.46), with significant differences (P< 0.05). The cost-effectiveness ratios (C/E) were 15.07 in the CS Ⅱ group, and 16.34 in the MDI group, with no significant difference (P>0.05). In order to further reduce the cost of CS Ⅱ group as a reference, the incremental cost-effectiveness ratio (△C/ △E)ofthe MDI group was 129.20. Conclusion Costs-effective of the CS Ⅱ program was better than the MDI one in treating the newly hospitalized patients with type 2 diabetes, suggesting that CS Ⅱ program might be a better choice for hospitals to carry on an intensive insulin therapy program.     

水中苯并三唑类紫外吸收剂的分散固相萃取-高效液相色谱测定法

目的 建立水环境中4种苯并三唑类紫外吸收剂的高效液相色谱测定法.方法 取35 ml水样,调节水样pH值为6,采用40 mg Ce/MOF-801固相萃取柱富集5 min,1 ml乙腈洗脱待测物,经C18色谱柱(4.6 mm×250 mm,5 μm)分离,以乙腈∶水(体积比为52∶48)为流动相进行等度洗脱,柱温25 ℃.采用紫外检测器(200 nm)测定4种苯并三唑类紫外吸收剂,外标法定量.结果 在0.02～1.00 μg/ml的范围内,4种苯并三唑类紫外吸收剂所得回归方程的线性关系良好,r≥0.999 2.该方法的检出限为 0.057～0.117 μg/L,定量下限为 0.171～0.351 μg/L;平均回收率为 79.3％～107.2％,RSD 为 0.51％～4.47％.吸附剂可重复使用至少8次,富集因子可以达到56.6～73.9.结论 该方法具有灵敏、简便且快速等优点,适用于水环境中痕量4种紫外吸收剂的检测.     

基于数据挖掘技术探析针灸促醒的选穴规律

目的：采用数据挖掘技术分析针灸促醒的选穴规律。方法：检索中国知网(CNKI)、万方数据(WANFANG DATA)、维普中文科技期刊数据库(VIP)、PubMed收录的针灸促醒的临床研究文献,应用Excel 2019软件建立文献信息数据库,分析其选穴特点和规律,并应用SPSS 25.0软件进行聚类分析。结果：纳入文献136篇,获得针灸处方136首,涉及腧穴113个、头针刺激区7个。腧穴总使用频次为1197次,其中人中、内关、三阴交的使用频次最高;腧穴归经频次最高的为督脉、心包经;特定穴以交会穴和井穴为主;腧穴分布部位主要在下肢部、上肢部及头面部、颈项部;聚类分析得到印堂-四神聪-委中-太冲-合谷-足三里-涌泉-百会-三阴交-内关-人中、哑门-极泉-尺泽-神庭-风府-风池-劳宫-曲池、完骨-阳陵泉-隐白3类腧穴配伍。结论：醒脑开窍针刺法为现代针灸促醒的典型代表组穴,取穴以人中、内关、三阴交为主,强调醒脑开窍,同时兼顾养髓益神、滋补肝肾、调理气血、疏通经络;多选取督脉、手厥阴心包经腧穴,着重四肢部、头面及颈项部腧穴的应用,体现出局部取穴及辨证取穴相结合的特点及形神兼治的重要思想,注重特定穴...     

2型糖尿病患者加用Glargine/NPH治疗对血糖波动影响的对照研究

目的 比较单用口服药空腹血糖控制不佳的2型糖尿病患者加用甘精胰岛素(Glargine)或中性精蛋白锌胰岛素(NPH)后对血糖波动的影响.方法 72例经口服抗糖尿病药治疗的2型糖尿病患者(FBG＞7.0 mmol/L,GHbA1e＞7.5%),按1∶1随机分成两组,分别加用Glargine或NPH联合治疗.以空腹微量血糖(mFBG)＜6.0 mmol/L为目标,并监测早餐后2 h微量血糖(mP1BG)、午餐后2 h微量血糖(mP2BG)和晚餐后2 h微量血糖(mP3BG),计算一天4次微量血糖的样本标准差(SD),以及最高和最低血糖之差(△).结果 两组比较Glargine组SD和△均较小(P＜0.05),而低血糖发生率无显著差异(P＞0.05).结论 单用口服药物治疗但血糖控制不佳的2型糖尿病患者加用Glargine比加用NPH更有利于血糖的平稳,且不增加低血糖的发生率.