2019年广东省部分地区感染性腹泻病原学及人轮状病毒分子流行病学特征

目的 对感染性腹泻样本进行检测鉴定,并对轮状病毒A组进行病毒分离,研究2019年广东省部分地区感染性腹泻病原学及轮状病毒分子流行病学特征。方法 2019年1月1日至2020年1月12日,采集广东省广州市、东莞市和江门市临床感染性腹泻患者粪便样本,进行多重RT-PCR扩增和微球杂交技术检测鉴定,并对轮状病毒A组阳性样本进行分离后,采用半巢式PCR试验对阳性细胞培养物进行G/P基因分型。结果 共纳入706例合格病例,病原体总检出率43.06%,病毒检出率18.13%高于细菌检出率8.36%高于寄生虫检出率1.27%。病毒病原谱以轮状病毒A组G9P[8]和诺如病毒GII型感染为主,细菌病原谱以沙门菌和艰难梭菌为主,寄生虫以蓝氏贾第鞭毛虫为首。不同季度、不同年龄组病原谱构成各不相同。轮状病毒A组主要受累群体为≤5岁儿童,主要时间分布于1—4月,基因型呈现多样性,包括G2P[4]、G3P[8]和G9P[8]。结论 2019年广东省部分地区感染性腹泻病毒类病原体高于细菌类高于寄生虫类,轮状病毒A组G9P[8]、诺如GII型、沙门菌和蓝氏贾第鞭毛虫是最主要的病原体,且G9P[8]型A组轮状病毒毒株在轮状病毒感染中占主导趋势。在防控病毒性和细菌性腹泻的同时,应警惕寄生虫所致腹泻并重视混合感染的病原学监测。     

脑卒中肺部感染危险因素及血清免疫炎性因子的预测价值

目的基于主成分分析(PCA)-决策树模型分析脑卒中肺部感染的危险因素及血清免疫炎性因子的预测价值。方法回顾性分析2014年12月-2019年12月江西省上饶市人民医院确诊的176例脑卒中患者,根据是否发生肺部感染,分为感染组40例和未感染组136例。记录患者临床特征,检测血白细胞(WBC)计数、血清C-反应蛋白(CRP)、降钙素原(PCT)和可溶性白细胞介素-2受体(SIL-2R)水平。采用Logistic回归和卡方自动交叉检验(CHAID)模型分析影响脑卒中后肺部感染的危险因素;受试者工作特征曲线(ROC)分析血WBC、CRP、PCT、SIL-2R预测肺部感染的价值。结果脑卒中肺部感染与患者年龄、卒中类型、是否合并糖尿病、吸烟史、吞咽困难、意识障碍、侵入性操作有关(P<0.05);感染组患者血WBC、CRP、PCT和SIL-2R水平高于未感染组(P<0.05);糖尿病、侵入性操作、CRP和PCT均为影响脑卒中患者肺部感染的独立危险因素(P<0.05);PCA-ROC分析显示,血WBC、CRP、PCT、SIL-2R和联合预测主成分1(PC1)的曲线下面积(AUC)分别为0.670、0.816、0.854、0.686、0.918;PCA-卡方自动交互检测(CHAID)模型分析显示,WBC、CRP、PCT、SIL-2R和PC1预测肺部感染的准确率为77.33%、84.72%、86.90%、79.02%和89.24%。结论血清PCT水平可用于预测脑卒中患者肺部感染的发生,临床可重点关注合并糖尿病、意识障碍和侵入性操作的患者。     

卵巢子宫内膜异位症和卵巢良性肿瘤患者血清CA125和唾液酸测定的临床意义

目的 探讨血清CA125和唾液酸（SA）对卵巢子宫内膜异位症及卵巢良性肿瘤的诊断价值。方法 对30例卵巢巧克力囊肿、30例卵巢良性肿瘤和15例正常妇女采用放免法测定血清CA125值,比色法测定血清SA值。结果 卵巢巧克力囊肿组血清CA125均值明显高于良性肿瘤组及正常对照组（P＜0．01）,而血清SA增值三组间无显著性差异（P＞0．05）。结论 血清CA125测定对巧克力囊肿有辅助诊断价值,且有助于与卵巢良性肿瘤的鉴别。     

The changing face of reoperative parathyroidectomy: a single-centre comparison of 147 parathyroid reoperations

IntroductionReoperative parathyroidectomy for persistent and recurrent primary hyperparathyroidism is dependent on radiology. This study aimed to compare outcomes in reoperative parathyroidectomy at a single centre using a combination of traditional and newer imaging studies.Materials and methodsRetrospective case note review of all reoperative parathyroidectomies for persistent and recurrent primary hyperparathyroidism over five years (June 2014 to June 2019; group A). Imaging modalities used and their positive predictive value, complications and cure rates were compared with a published dataset spanning the preceding nine years (group B).ResultsFrom over 2000 parathyroidectomies, 147 were reoperations (101 in group A and 46 in group B). Age and sex ratios were similar (56 vs 62 years; 77% vs 72% female). Ultrasound use remains high and shows better positive predictive value (76% vs 57 %). 99mTc-sestamibi use has declined (79% vs 91%) but the positive predictive value has improved (74% vs 53%). 4DCT use has almost doubled (61% vs 37%) with better positive predictive value (88% vs 75%). 18F-fluorocholine positron emission tomography-computed tomography and ultrasound-guided fine-needle aspiration for parathyroid hormone are novel modalities only available for group A. Both carried a positive predictive value of 100%. Venous sampling with or without angiography use has decreased (35% vs 39%) but maintains a high positive predictive value (86% vs 91%). Cure rates were similar (96% vs 100%). Group A had 5% permanent hypoparathyroidism, 1% permanent vocal cord palsy and 1% haematoma requiring reoperation. No complications for group B.ConclusionOptimal imaging is key to good cure rates in reoperative parathyroidectomy. High-quality, non-interventional imaging techniques have produced a shift in the preoperative algorithm without compromising outcomes.     

大黄-黄芪组分自微乳的制备及在体肠吸收特性研究

目的 研究大黄-黄芪多组分自微乳的处方与制备工艺,评价制剂质量,并考察其大鼠肠吸收特性。方法 通过溶解度实验、油相与乳化剂和助乳化剂配伍实验及伪三元相图的绘制,筛选出最优处方组成;并从自微乳的外观、形态、粒径、稳定性等方面对自微乳进行评价。通过大鼠在体单向肠灌流实验考察自微乳的肠吸收特性。结果 自微乳处方中油相为辛酸癸酸单双甘油酯、乳化剂为聚氧乙烯蓖麻油35、助乳化剂为乙二醇。在微乳形成区选择各辅料用量,采用适宜方法加入大黄总蒽醌及黄芪总皂苷制得的组分自微乳,外观均一透明,加水分散后形成黄色乳光的微乳液,透射电镜显微镜（transmission electron microscopy,TEM）下观察到微乳分散均匀,无黏连,呈大小均一圆球形乳滴;平均粒径为（33.01±0.12）nm、多分散指数（polydispersion index,PDI）为0.10±0.02、电位为（-10.10±1.00）m V;自微乳中大黄总蒽醌和黄芪总皂苷质量分数分别为6.29、8.80 mg/g。自微乳中大黄总蒽醌在十二指肠、空肠段的吸收速率常数（Ka）及表观吸收系数（Papp）较回肠段均有显著提高;黄芪...     

降糖方对糖耐量异常大鼠糖脂代谢及骨骼肌组织IκB-α和NF-κBp65的影响

目的:探讨降糖方对糖耐量异常大鼠糖脂代谢及骨骼肌组织κB抑制蛋白α(IκB-α)、核转录因子肽p65(NF-κBp65)的影响。方法:SD大鼠随机分为正常组、模型组、盐酸二甲双胍组、降糖方低、高剂量组,采用高脂饮食喂养4周,链脲佐菌素(STZ)腹膜内注射建立糖耐量异常大鼠模型,治疗8周后,观察骨骼肌组织病理变化,测定空腹血糖(FPG)、血清胰岛素(FINS)、胰岛素抵抗指数(HOMA-IR)、甘油三酯(TG)、总胆固醇(TC)、低密度脂蛋白(LDL-C)、骨骼肌组织IκB-α mRNA、NF-κBp65 mRNA水平、骨骼肌组织白细胞介素-4(IL-4)、白细胞介素-12(IL-12)、肿瘤坏死因子-α(TNF-α)蛋白水平。结果:正常组大鼠骨骼肌组织结构正常,模型组骨骼肌排列紊乱、肌纤维断裂、可见明显炎症细胞浸润;盐酸二甲双胍及降糖方干预后,骨骼肌炎症细胞浸润减少,肌纤维排列趋于整齐。模型组大鼠FPG、FINS、HOMA-IR水平、血清TG、TC、LDL-C水平、骨骼肌IκB-α mRNA、NF-κBp65 mRNA和蛋白水平、骨骼肌组织IL-4、IL-12、TNF-α蛋白水平高于对...     

乙酰基二肽-1鲸蜡酯的皮肤抗衰老作用及其机制

乙酰基二肽-1鲸蜡酯（acetyl dipeptide-1 cetyl ester,AD-1）是乙酸和十六烷基醇与精氨酸和酪氨酸组成的人工合成肽,具有一定的抗炎和提高皮肤屏障功能的作用,已被用于敏感肌化妆品中。该成分虽然也被用于抗衰老化妆品中,但缺乏公开的系统科学研究。本研究通过评价AD-1的体外抗氧化和抗糖基化作用、建立UVA反复照射真皮原代成纤维细胞的光老化模型,探讨其在光老化细胞中的抗衰老活性。采用MTT法测定AD-1对细胞活力的影响;RT-qPCR法检测AD-1和UVA对衰老相关p21、p53、MMPs、IL6、Col1、Col3以及自噬相关p62、ATG5、ATG7 mRNA表达的影响;Western blot法检测AD-1和UVA对衰老及自噬相关p16、p21、p53、Col1、LC3B、p62蛋白水平的影响;β-半乳糖苷酶染色和MDC染色评价细胞衰老损伤,并通过荧光探针DCFH-DA检测细胞内活性氧水平。实验结果显示,AD-1干预可以减少UVA诱导的细胞损伤和mRNA表达异常,改善p16、p21、p53、Col1、LC3B、p62蛋白水平异常。结果表明,AD-1具有一定的...     

Autologous peripheral blood stem cell transplantation in the patients with hematologic malignancies and solid tumors

Objective To evaluate the long-term therapeutic effects of autologous peripheral blood st em cell transplantation (auto-PBSCT) on the treatment of hematological and soli d tumors. Methods Fifty-one patients were recruited in this auto-PBSCT study, in which several p otentially important parameters were studied including the optimal time for stem cell co llection, the dose of stem cell reinfusion, the time of hematopoietic reconsti tution, the disease free survival (DFS) and overall survival (OS), complication s related to transplantation, and maintenance chemotherapy after auto-PBSCT. Results After APBSCT, 3-year and 5-year survival rates of NHL were 83.3%; those of AM L were 74.7%; those of MM were 37.9% and 19%; those of ALL were 40% and 0% res pectively. Hematopoietic reconstitution was greatly promoted by granulocyte col ony stimulating factor (G-CSF). The mean time for patients’ neutrophil to reco ver up to &gt;0.5×10(9) /L after APBSCT was 11.14 days in the group of the patien ts receiving G-CSF in contrast to 17.6 days in the group receiving no G-CSF. The most common complications of transplantation were fever, liver dysfunction and hypokalaemia, which were curable. No death was due to transplantation related complications.Conclusion Comparing with conventional chemotherapy, our study suggests that auto-PBSCT i s a very important therapeutic option that can significantly improve the prognos is in the patients with hematological and solid tumors, especially in the patien ts with AML and NHL.     

Effects of benactyzine on action potentials and contractile force of guinea pig papillary muscles

ＩＮＴＲＯＤＵＣＴＩＯＮＢｅｎａｃｔｙｚｉｎｅｉｓａｓｙｎｔｈｅｔｉｃｂｌｏｃｋｅｒｏｆＭ ｒｅｃｅｐｔｏｒｐｏｓ ｓｅｓｓｉｎｇｓｍｏｏｔｈｍｕｓｃｌｅｒｅｌａｘａｎｔｐｒｏｐｅｒｔｉｅｓａｎｄｑｕｉｎｉｄｉｎｅ ｌｉｋｅａｃｔｉｏｎｏｎｈｅａｒｔ[1] .Ｂｅｎａｃｔｙｚｉｎｅｉｓｅｆｆｅｃｔｉｖｅｉｎｒｅｓｔｏｒ ｉｎｇｃｉｒｃｕｌａｔｏｒｙｆｕｎｃｔｉｏｎｄｉｓｔｕｒｂｅｄｂｙｏｒｇａｎｏｐｈｏｓｐｈａｔｅｐｏｉ ｓｏｎｉｎｇ[2 ,3] .Ｐｒｅｖｉｏｕｓｓｔｕｄｉｅｓｓｕｇｇｅｓｔｅｄｔｈａｔｂｅｎａ…     

姜黄素与羟基脲对K562细胞的体外联合作用

目的 了解姜黄素与羟基脲合用对人白血病Ｋ５６２细胞的体外作用。方法 采用ＭＴＴ法测定药物的体外杀伤作用,应用ＡＯ／ＥＢ荧光染料染色观察药物诱导细胞凋亡,金氏公式进行联合用药分析。结果 姜黄素５,１０ｕｇ／ｍｌ,羟基脲２５,５０ｕｇ／ｍｌ同时给药,对Ｋ５６２细胞可产生单纯相加的协同杀伤效果。姜黄素与羟基脲同时给药诱导Ｋ５６２细胞凋亡率高于羟基脲单独用药,低于姜黄素单独用药。结论 姜黄素与羟基脲同时联