腹腔穿刺引流用于急性胰腺炎并液体积聚观察

评估早于经皮穿刺置管引流（PCD）进行腹腔穿刺引流（APD）的有效性,以代替单独经皮穿刺置管引流（PCD-alone）,作为升阶梯治疗的新的第2步治疗方法。 以2009年6月到2011年6月入院的102例急性胰腺炎患者为研究对象,根据是否行APD将患者分为APD+PCD组53例和单独PCD组49例。通过回顾性分析,比较其术后死亡率、反复发作急性胰腺炎和慢性胰腺炎的发生率、器官衰竭、远期干预等。APD+PCD组死亡率3.77%,单独PCD组死亡率8.16%,APD+PCD组显著低于单独PCD组（P＜0.05）。经2年随访,APD+PCD组反复发作急性胰腺炎及慢性胰腺炎发生率分别为7.84%、5.88%,单独PCD组反复发作急性胰腺炎及慢性胰腺炎发生率分别为14.29%、8.16%,APD+PCD组显著低于单独PCD组（P＜0.05）。APD+PCD组较单独PCD组器官衰竭数少,从发病到远期干预的时间明显延迟,住院费用较低。早于PCD进行APD有益于患者,且方法简单实用,值得临床推广。     

广西壮族自治区2005-2021年新报告男男性行为人群HIV感染者晚发现及影响因素分析

目的分析广西壮族自治区(广西)防治艾滋病攻坚工程开展前后MSM HIV感染者(MSM感染者)的晚发现变化趋势及其影响因素, 从中寻找现阶段需要优先干预的人群。方法从中国疾病预防控制信息系统艾滋病防治基本信息系统中选取2005-2021年广西新报告的MSM感染者作为研究对象。采用Joinpoint 4.9.1.0软件对晚发现病例和非晚发现病例进行时间趋势检验, 运用logistic回归分析各阶段晚发现的影响因素。结果 2005-2021年广西新报告MSM感染者共5 764例, 晚发现比例为28.45%(1 640例)。以2015年为界, 晚发现比例呈先急速下降后趋于稳定的趋势, 平均年度变化百分比=-6.90%(P<0.001), 2010年后常住人口、职业为农民工和样本来源于就诊医疗等因素在攻坚工程开展前后对晚发现的影响效应变化较大, 现阶段晚发现的影响因素有年龄、常住人口、职业为农民工和学生。结论攻坚工程前后广西新报告MSM感染者的晚发现比例下降趋势明显, 但晚发现仍不容忽视, 需针对常住人口、农民工和学生人群开展精准防控。     

介入治疗脑血管病相关对比剂脑病临床及影像学表现:7例报告

目的 观察介入治疗脑血管病相关对比剂脑病（CIE）的临床及影像学表现。方法 回顾性分析7例因脑血管病接受介入治疗后发生CIE患者,观察其临床及影像学表现。结果 7例介入治疗包括4例动脉瘤栓塞术、1例右侧大脑中动脉介入取栓术、1例左侧大脑中动脉取栓术联合球囊扩张成形术及1例颈内动脉狭窄球囊扩张成形术。术后12 h内6例新发偏瘫、1例偏瘫加重,出现癫痫及视力障碍（皮质盲）各4例,意识障碍3例,失语1例;影像学表现包括MRI显示术侧大脑皮层肿胀、脑组织呈弥散加权成像（DWI）高信号3例、两侧枕额叶DWI高信号1例,CT显示3例术侧脑沟高密度影。经降颅压等对症支持治疗2~5天后新发症状消失,2~14天后体征好转或消失;6例治疗后9~48 h、1例治疗后5天复查显示上述异常征象减弱或消失,脑血管MR造影（MRA）颅内动脉均未见狭窄及闭塞。结论 CIE临床及影像学表现均具有一定特异性,及时确诊并给予相应治疗预后较好。     

普通电切镜经尿道行前列腺剜除术治疗良性前列腺增生的疗效

目的 探讨以普通电切镜经尿道行前列腺剜除术(transurethral enucleative resection of prostate,TUERP)治疗良性前列腺增生(benign prostatic hyperplasia,BPH)的效果.方法 回顾性分析86例采用TUERP治疗BPH患者的临床资料,分别比较术前、术后国际前列腺症状评分(IPSS)、生活质量指数(QOL)、最大尿流率(Qmax)、残余尿量(PVR)情况.结果 手术均顺利完成,平均手术时间(62.7±19.3)min,切除腺体平均重量(37.2 ±8.5)g.术后IPSS由术前(23.9±5.2)分降至(5.4±3.7)分,QOL由术前(4.6±1.1)分降至(1.2±0.9)分,Qmax由术前(6.3±2.0)ml/s上升至(21.0±3.6) ml/s,PVR由术前(149.0±35.8)ml降至(21.2±9.9) ml.术后3例出现暂时性尿失禁,1例出现尿道外口狭窄,经治疗后痊愈.结论 TUERP术具有手术时间短、并发症少、术后恢复快、症状解除明显等优点,是治疗BPH的安全、有效的治疗方法.     

Hypoxia-Inducible Factor-2α Limits Natural Killer T Cell Cytotoxicity in Renal Ischemia/Reperfusion Injury

Natural killer T (NKT) cells are the major early-acting immune cell type and fundamental immune modulators in ischemia-reperfusion injury (IRI). Because lymphocytes are exposed to various oxygen tensions under pathophysiologic conditions, we hypothesize that hypoxia-inducible factors (HIFs) have roles in NKT cell activation, and thus determine the final outcome of renal IRI. In this study, we used Lck-Cre transgenic mice to specifically disrupt HIF-2α in T/NKT cells and found that HIF-2α knockout led to upregulated Fas ligand expression on peripheral NKT cells, but not on conventional T cells. HIF-2α knockout promoted infiltration of NKT cells into ischemic kidneys and exacerbated IRI, which could be mitigated by in vivo NK1.1⁺ cell depletion or Fas ligand blockade. Compared with wild-type NKT cells, HIF-2α^−/− NKT cells adoptively transferred to Rag1-knockout mice elicited more severe renal injury, and these mice were not protected by {"type":"entrez-protein","attrs":{"text":"CGS21680","term_id":"878113053","term_text":"CGS21680"}}CGS21680, an adenosine A2A receptor agonist. Mechanistically, hypoxia-induced expression of adenosine A2A receptor in NKT cells and {"type":"entrez-protein","attrs":{"text":"CGS21680","term_id":"878113053","term_text":"CGS21680"}}CGS21680-induced cAMP production in thymocytes were HIF-2α-dependent. Hydrogen peroxide-induced Fas ligand expression on thymic wild-type NKT cells was significantly attenuated by {"type":"entrez-protein","attrs":{"text":"CGS21680","term_id":"878113053","term_text":"CGS21680"}}CGS21680 treatment, but this effect was lost in HIF-2α^−/− NKT cells. Finally, {"type":"entrez-protein","attrs":{"text":"CGS21680","term_id":"878113053","term_text":"CGS21680"}}CGS21680 and LPS, an inducer of HIF-2α in endothelium, synergistically reduced renal IRI substantially, but this effect was absent in Mx1-Cre-induced global HIF-2α-knockout mice. Taken together, our results reveal a hypoxia/HIF-2α/adenosine A2A receptor axis that restricts NKT cell activation when confronted with oxidative stress and thus protects against renal IRI.     

关节镜下Intrafix联合Femoral-intrafix系统固定自体腘绳肌腱重建前交叉韧带的临床研究

目的探讨关节镜下应用Intrafix联合Femora-intrafix系统固定自体腘绳肌肌腱重建膝关节前交叉韧带(ACL)的临床效果。方法关节镜下应用Intrafix联合Femora-intrafix系统固定自体腘绳肌肌腱重建膝关节前交叉韧带33例,术后以膝关节的活动度、前抽屉试验、Lachman试验,参照Lysholm膝关节评分、国际膝关节文献委员会(IKDC)膝关节评分标准评价疗效。结果术前Lachman试验、前抽屉实验均为阳性。术后所有患者前抽屉实验为阴性。Lachman试验32例阴性,1例Ⅰ度阳性,术后与术前相比阳性率下降,差异有统计学意义(P<0.05)。术前Lysholm评分(36.76±3.69)分、膝关节IKDC评分(27.67±4.43)分,术后Lysholm评分(91.28±4.75)分、膝关节IKDC评分(82.16±3.13)分,术后评分与术前相比差异有统计学意义(P<0.05)。结论 Intrafix联合Femoral-intrafix系统固定自体腘绳肌腱重建前交叉韧带术中操作简易,创伤小,手术时间短,长期随访疗效满意。     

基于新型加工方法的九香虫药食两用价值研究

目的研究新型加工方法的九香虫药食两用价值。方法通过对九香虫进行新型加工处理,得到九香虫血淋巴蛋白,对提取血淋巴后的虫体进行营养成分测定和营养价值评价,采用倒置显微镜观察九香虫血淋巴蛋白对人胃癌BGC-823细胞形态变化,评价其抗癌活性。结果采用新型加工法处理的九香虫虫体蛋白质、氨基酸、粗脂肪及灰分含量分别为23.68%、29.99%、27.72%和2.83%;第一限制性氨基酸为色氨酸,不饱和脂肪酸占总脂肪酸的64.03%;矿物质和微量元素含量丰富,尤其是K和P的含量较高,分别达到了4.33 mg/g和3.62 mg/g。通过形态学观察发现,九香虫血淋巴对体外培养的人胃癌BGC-823细胞增殖具有较明显的抑制作用,且在浓度为20、30、40 mg/L时具有浓度依赖性。结论采用新型加工处理的九香虫虫体及提取物血淋巴具有较高的药食两用价值。     

Application of KDQOL-SFTM 1.3 version in evaluating quality of life of maintenance hemodialysis patients in multiple centers

Objective To understand the quality of life (QOL) and its influencing factors in maintenance hemodialysis patients (hemodialysis maintenance, MHD), and to provide theoretical basis for improving QOL of patients. Methods A cross-sectional study was conducted in the blood purification centre in 8 hospitals of Hefei, and patients clinical data were collected. KDQOL-SF self-administered questionnaire was applied to assess the health related quality of life (HRQL) of patients and to analyze the factors influencing the QOL. Results The QOL of MHD patients in Hefei City was better compared with previous similar research results. Generally speaking, gender (male), education degree and household income were positive correlated with QOL scores (P＜0.05), and the scores of primary disease of patients with diabetic nephropathy or drugs were lower (P＜0.05) in physiological component summary (PCS), mental component summary (MCS), SF-36 and KDTA. Charlson comorbidity index (CCI) was negatively correlated with the MCS scores, PCS scores and SF scores (P＜0.05), and patients' occupational and medical insurance had impacts on MCS and KDTA score (P＜0.05). Conclusions The QOL of MHD patients are affected by many factors, and the CCI and cultural level are possible independent influencing factors. In addition, gender, household income per capita, primary disease, occupation, medical insurance also have certain influence.     

Structural characterization of Campylobacter jejuni lipooligosaccharide outer cores associated with Guillain-Barre and Miller Fisher syndromes

Molecular mimicry between lipooligosaccharides (LOS) of Campylobacter jejuni and gangliosides in peripheral nerves plays a crucial role in the pathogenesis of C. jejuni-related Guillain-Barré syndrome (GBS). We have analyzed the LOS outer core structures of 26 C. jejuni strains associated with GBS and its variant, Miller Fisher syndrome (MFS), by capillary electrophoresis coupled with electrospray ionization mass spectrometry. Sixteen out of 22 (73%) GBS-associated and all 4 (100%) MFS-associated strains expressed LOS with ganglioside mimics. GM1a was the most prevalent ganglioside mimic in GBS-associated strains (10/22, 45%), and in eight of these strains, GM1a was found in combination with GD1a mimics. All seven strains isolated from patients with ophthalmoplegia (GBS or MFS) expressed disialylated (GD3 or GD1c) mimics. Three out of 22 GBS-associated strains (14%) did not express sialylated ganglioside mimics because their LOS locus lacked the genes necessary for sialylation. Three other strains (14%) did not express ganglioside mimics because of frameshift mutations in either the cstII sialyltransferase gene or the cgtB galactosyltransferase gene. It is not possible to determine if these mutations were already present during C. jejuni infection. This is the first report in which mass spectrometry combined with DNA sequence data were used to infer the LOS outer core structures of a large number of neuropathy-associated C. jejuni strains. We conclude that molecular mimicry between gangliosides and C. jejuni LOS is the presumable pathogenic mechanism in most cases of C. jejuni-related GBS. However, our findings suggest that in some cases, other mechanisms may play a role. Further examination of the disease etiology in these patients is mandatory.