淋巴滤泡中补体成分沉积的意义

目的:观察补体成分在淋巴组织中的表达,探讨不同发育阶段淋巴滤泡中补体激活与免疫球蛋白沉积及滤泡树突状细胞之间的关系。方法:采用免疫组化方法对淋巴组织标本进行IgG、IgM、IgA、C3c、C4c、C1q和C4d标记,同时对其部分标本进行双标染色。结果:淋巴组织次级滤泡的Ⅰ~Ⅳ期的生发中心才出现不同程度的IgG、IgM、IgA、C3c、C4c、C1q、C4d阳性表达;免疫球蛋白与补体成分重叠沉积,并呈不规则网线状包绕在滤泡树突状细胞周围。其中以C4d的阳性表达最强。结论:淋巴滤泡生发中心有大量免疫球蛋白和补体成分围绕滤泡树突状细胞沉积,可能与中心淋巴细胞的发育和选择有关。     

新生儿败血症继发血小板减少症(附26例报道)

本文对26例败血症继发血小板减少症的观察、治疗结果表明,血小板减少症在新生儿败血症中的发生率高,是导致新生儿败血症死亡的重要因素之一.动态观察血小板计数,对败血症的诊断、治疗效果的判断以及预后估计均有帮助。根据临床表现,我们分别给予静脉滴注新鲜血、血浆、低分子右旋糖酐、激素等治疗,均获得较为满意效果。     

A risk prediction model for contrast-induced nephropathy associated with gadolinium-based contrast agents

ObjectiveThis is the first study to explore the risk factors for nephropathy caused by gadolinium-based contrast agents and establish a prediction model to identify high-risk patients.MethodsA total of 1404 patients who received gadolinium-based contrast agents in our hospital were included. The participants were randomly assigned in a 7:3 ratio to the modeling and validation groups. The modeling group was divided into a contrast-induced nephropathy group and a non-contrast-induced nephropathy group. The clinical characteristics before the use of contrast agents were compared between the two groups. The risk factors for contrast-induced nephropathy were analyzed by logistic regression. A nomogram that could predict the incidence of contrast-induced nephropathy was plotted. The validation group was used to verify the predictive model.ResultsThe incidence of contrast-induced nephropathy caused by gadolinium-based contrast agents was 3.92% (55/1404). The logistic stepwise regression analysis showed that sex, systolic pressure (SBP), absolute neutrophil count, albumin, fasting blood glucose level, and furosemide use were significant predictors of contrast-induced nephropathy caused by gadolinium-based contrast agents. The above predictors were then included in the nomogram construction. The area under the receiver operating characteristic (ROC) curve was 0.82 (p < 0.001). The specificity and sensitivity corresponding to the optimal cutoff point (0.039) based on the area under the ROC curve were 71.9% and 80.5%, respectively.ConclusionSex, SBP, absolute neutrophil count, albumin, fasting blood glucose levels, and furosemide use are significant predictors of contrast-induced nephropathy caused by gadolinium-based contrast agents. Therefore, the incidence of contrast-induced nephropathy may be estimated by the prediction model established in this study before the use of contrast agents.     

Subtoxic concentration of doxorubicin enhances TRAIL-induced apoptosis in human prostate cancer cell line LNCaP

Most tumor cells are sensitive to tumor necrosis factor-related apoptosis-inducing ligand (TRAIL)-induced apoptosis but sparing to normal cells, thus providing therapeutic potential for clinical use. Some tumor cells are resistant to TRAIL-induced cell death while the sensitivity could be recruited with the existence of some chemical agents. In this study, human prostatic cancer cell line LNCaP was found to be resistant to TRAIL-induced apoptosis while it could be restored to TRAIL sensitivity with combination treatment of low concentration of doxorubicin. TRAIL receptor-1 (DR4) and TRAIL receptor-2 (DR5) were upregulated under the treatment of doxorubicin and verified to be responsible for TRAIL-mediated signal transduction. Furthermore, caspase-8 and caspase-3 were activated and drove their autocleavage into programmed cell death. Interestingly, apoptosis-inhibitory protein c-FLIP, but not Bcl-2 and XIAP was downregulated after doxorubicin treatment. Taken together, these findings suggested that the pathway of cell apoptosis induced by TRAIL was intact but under negative control. Subtoxic concentration of doxorubicin effectively boosted TRAIL sensitivity via depletion of antiapoptotic protein. These findings support the new strategies for killing tumors with TRAIL and chemical agents.     

振动负荷前后家兔神经传导速度变化的实验研究

本文以５２只家兔为实验对象，按不同的接振剂量分为五个组（其中包括一对照组），采用后肢接振法来模拟人体局部振动作业状态，振动实验６０天，使用丹麦产Ｎｅｕｒｏｍａｔｉｃ２０００Ｃ型神经－肌动描记仪，在实验前、实验后１５天、３０天和６０天分别测定家兔在侧坐骨神经ＳＣＶ和ＭＣＶ。实验结果发现，接振组ＳＣＶ和ＭＣＶ均较对照组明显减慢，尤其是ＳＣＶ改变更为明显，与人体局部振动作业所致外周神经损伤检查结果有一致     

某三甲教学医院手术病人手术部位感染危险因素及人工网络模型探讨

目的 统计某医院外科病人手术部位感染发生率,找出导致术后感染的相关因素,对外科病人发生术后感染的机率进行科学预测。方法 研究对象选取2012—2015年某三甲教学医院术后病人,发生275例手术部位感染的病人为病例组,另按照1∶1比例选取术后无感染266例病人为对照组,进行病例回顾性调查研究,统计检出致病菌和手术感染部位情况,探讨手术部位感染综合因素,结合术后感染统计分析数据构建人工网络模型。结果 手术部位感染率0.35％。多因素分析结果表明,手术部位感染的独立危险因素分别是手术类型、是否有原发疾病、切口类别、ASA病情分级、病人年龄、手术时长、手术例次(OR=11.043,9.587,2.136,1.818,1.299, 1.293,1.041,P<0.05)。最终确定网络模型运行结果如下,平均误差为0.040%,网络错分率 0.038% ;通过曲线下面积(ROC)大于0.9。结论 部位感染危险因素前三位是手术类型、是否患有原发疾病、切口类别。人工网络模型针对手术部位感染危险度的预测结果较理想,建立与其相关预报信息平台系统,为临床院感管控决策提供指导依据。     

美国FDA医疗器械监管信息化情况及启示

信息技术与监管业务深度融合是美国食品药品管理局（FDA）医疗器械监管的重要特征。美国医疗器械监管信息化经过多年的发展,已形成相对复杂和较为完备的体系。本文从应用系统、数据库、数据标准等方面对美国FDA医疗器械监管信息化情况进行了梳理,分析其特点提出可借鉴启示。