中枢神经系统感染患儿血脑屏障与脑脊液白蛋白指数的变化

目的探讨中枢神经系统感染患儿血脑屏障（blood-brain barrier,BBB）与脑脊液（cerebrospinal-fluid,CSF）白蛋白指数的变化。方法采用溴甲酚绿法和免疫比浊法检测18例化脓性脑膜炎患儿急性期、恢复期及22例病毒性脑炎患儿急性期血清和CSF中白蛋白水平,并计算出CSF白蛋白指数。与正常对照组比较。结果化脓性脑膜炎、病毒性脑炎患儿急性期CSF白蛋白、CSF白蛋白指数显著高于正常对照组（P〈0.001）,且化脑组显著高于病脑组（P〈0.001）。化脑组恢复期患儿CSF白蛋白、CSF白蛋白指数与对照组无明显差异（P〉0.05）。结论监测CSF白蛋白和CSF白蛋白指数的水平可作为化脓性脑膜炎和病毒性脑炎早期诊断、鉴别诊断,以及判断BBB损伤程度的参考指标。     

Effects of interferons alpha and gamma on cytokine production and phenotypic pattern of human bronchial epithelial cells

Human bronchial epithelial cells are involved in airway immune mechanisms through secretion of cytokines and through cell-cell contacts with immunocompetent cells. The aim of our study was to assess the ability of interferon (IFN) alpha and gamma alone and in combination to modulate human bronchial epithelial cell (HBECs) release of the inflammatory cytokines IL-8 and IL-6 and fibronectin and to induce the surface expression of HLA-DR and ICAM-1 molecules involved in immune interactions with other cells. HBECs spontaneously secreted a limited amount of IL-8, which was significantly increased by IFN gamma. IFN alpha inhibited IFN gamma stimulated IL-8 secretion in a concentration-dependent manner. Further, IFN gamma induced IL-6 and fibronectin secretion, and this was also inhibited by IFN alpha. The expression of HLA-DR antigens was significantly increased by IFN gamma and partially inhibited by co-stimulation with IFN alpha. In contrast, IFN gamma also induced ICAM-1 expression by HBECs but co-stimulation with IFN alpha had no significant effect on the expression of this surface antigen. IFN alpha modulation of HBEC functions does not seem to be restricted to IFN gamma stimulation since either stimulatory or inhibitory effects of INF alpha on IL-8 production have been found in pilot experiments using IL-1 beta, TNF alpha, and TGF beta as stimuli. In summary, IFN-gamma induces a number of responses in HBECs including increased secretion of IL-6, IL-8 and fibronectin and increased expression of HLA-DR and ICAM-1. IFN alpha can inhibit all these except expression of ICAM-1 which is unaffected. IFN alpha can also interact with other inflammatory cytokines, but whether the effects are inhibitory or augmentive depends on the cytokines.     

Observations of development of resistance to detachment of cultured bovine bronchial epithelial cells in response to protease treatment.

Protease injury of the bronchial epithelium may play an important role in the pathogenesis of many airway diseases including asthma and chronic bronchitis. We hypothesized that neutrophil elastase can cause significant injury to the bronchial epithelium leading to detachment of bronchial epithelial cells. This detachment might be prevented if elastase is released into the airway lumen and the bronchial epithelium forms a barrier preventing access to the basal attachment sites. To assess this, the detachment of bronchial epithelial cells by elastase from extracellular matrix was measured. An increase in the resistance to detachment with time in culture was observed. The resistance to detachment was confirmed in bronchial epithelial cells, which were grown to electrically resistant monolayers on millipore filters and exposed to trypsin and elastase applied to both the apical and basal surfaces. Significantly greater detachment occurred when the proteases were applied at the basal surface versus the apical surface. Injury to the bronchial epithelium may enhance the proteolytic effect on the epithelium by disrupting epithelial barrier function. This was tested by exposing bronchial epithelial cell cultures to cigarette smoke extract before exposure to trypsin and elastase. The detachment of the bronchial epithelial cells exposed on the apical surface was increased greatly after smoke exposure. These data suggest that an intact bronchial epithelium can act as a barrier against proteolytic injury. Such a mechanism might protect the airway epithelium during intraluminal inflammation, and, if defective, might potentiate cigarette smoke-induced airway injury.     

品管圈对精神分裂症患者约束率及护理满意度的影响

目的总结和分析精神分裂症患者的护理中采用品管圈活动的临床效果。方法以本院于2017年8月—2019年6月收治的122例精神分裂症患者为研究对象,随机分为品管圈组和常规护理组,各61例。其中常规护理组患者选择传统的常规护理方法,而品管圈组患者则采取品管圈活动。比较两组患者的护理效果,对比指标主要有患者的约束率和护理满意度。结果品管圈组患者各项评价指标均优于常规护理组,差异具有统计学意义(P<0.05)。结论精神分裂症患者采用品管圈活动的总体临床效果较好,可提高患者的约束率,总体满意度高。     

2013年-2017年我国血站收入的结构变动情况分析△

目的：对我国不同类型血站的收入状况进行问卷调查和深度访谈,分析近年来我国血站收入结构变动情况及特征,找到影响血站收入结构变动的主要项目,合理优化血站收入结构。方法：2018 年8月采用普查的方法对全国353家（32 家血液中心、321 家中心血站）的收入状况进行问卷调查,同时选取山东省6地市中心血站的负责人进行深度访谈。对收集的血站收入数据,运用结构变动方法进行分析。 结果：2013年-2017年公益一类血站收入的结构变动度为24.22%,财政补助收入、事业收入是构成公益一类血站收入变动的主要来源,其中财政补助收入的贡献率53.20%;2013年-2017年我国公益二类血站收入的结构变动度为16.79%,财政补助收入、事业收入是构成公益二类血站收入变动的主要来源,其中贡献率最大的是事业收入49.99%。结论：财政补助收入、事业收入是影响血站收入结构变动的主要项目,两类血站的日常运营与建设对财政补助收入高度依赖,公益二类经营收入增幅不明显,发展不足。     

夜间最低血氧饱和度联合睡眠相关量表筛查儿童阻塞性睡眠呼吸暂停的应用

目的 评价夜间最低血氧饱和度(LSaO₂)联合OSA-18量表和针对儿童的改良版Epworth嗜睡量表(ESS-CHAD)初筛儿童阻塞性睡眠呼吸暂停(OSA)的准确性,以探讨更简便、快捷、可行的基层医院初筛疑似儿童OSA的方法。方法 纳入2020年8月13日—2021年2月8日就诊于本院耳鼻咽喉头颈外科睡眠监测中心完成整夜多导睡眠监测的儿童139例作回顾性分析研究,其家长在医生协助下完成OSA-18量表和ESS-CHAD。分析LSaO₂和两种量表及三者联合早期初筛疑似儿童OSA的诊断价值。结果 LSaO₂预测儿童是否患OSA的最佳界值为90.5%(P<0.00, AUC=0.82)。OSA-18和ESS-CHAD依据不同界值分别诊断儿童OSA的灵敏度最高,分别为74.8%、22.7%。LSaO₂/OSA-18,LSaO₂/ESS-CHAD、OSA-18/ESS-CHAD诊断儿童OSA的灵敏度最高,分别为88.2%、68.1%、77.3%。 结论 LSaO₂有诊断儿童OSA的临床价值,OSA-18量表较ESS-CHAD初筛疑似儿童OSA有更高的灵敏度,但特异度低,LSaO₂联合OSA-18量表诊断儿童OSA的灵敏度、特异度均较其他联合诊断方式高。在无法进行睡眠监测的基层医院可考虑应用LSaO₂ 与OSA-18量表结合的方式初步筛查儿童OSA。     

困难气管内插管的预测和处理

目的 探讨对困难气管内插管的预测及处理方法。方法 随机选取各类需行气管内插管麻醉下择期手术患者50例,术前测量IG、Slux,TM,HENE,HFNF、气道分类及声门分级等各项指标,并分析它们在气管插管难度之间的关系。结果 50例患者中,气道分类Ⅳ类者7例,声门分级Ⅲ级者17例,Ⅳ级者1例。17例声门Ⅲ级者以EtCO2引导下口腔盲插法插管成功,1例声门Ⅳ级者以气囊充气鼻腔盲控气管内插管法插管成功。结论 术前评价气管插管难易程度应综合考察各项测量指标,这些指标中又以声门分级最为可靠。     

基于特征的深度学习预测化合物-蛋白质相互作用的研究进展

药物研发过程中,化合物-蛋白质相互作用（compound-protein interaction,CPI）预测是发现苗头化合物、药物重定位等研究的关键技术手段。近年来,深度学习被广泛应用于CPI研究,加速了药物发现中CPI预测的发展。本文重点讨论基于特征的 CPI 预测模型,首先,介绍了CPI预测中常见的数据库、化合物和蛋白质的典型特征表示方法。根据建模中的关键问题,从多模态和注意力机制两个方面,对基于特征的CPI预测模型展开论述。在此基础上,选取其中12个模型,在3个经典数据集上评估了模型在分类任务和回归任务中的性能。本文总结当前该领域面临的挑战,对未来的发展方向进行展望,为CPI预测方法进一步研究提供思路。     

Expression of HLA-DR antigen in hepatocellular carcinoma and its up-regulation by interferon

Objective: To observe the expression of human leukocytic antigen DR (HLA-DR) in primary hepatocellular carcinoma (HCC) and its up-regulation by interferon (IFN). Methods: The expression of HLA-DR in 46 specimens of human HCC tissues, 4 human HCC cell lines (SMMC-7721, HCC-9204, BEL-7402 and HHCC) and a human hepatocyte cell line QZG was respectively detected by immunohistochemical ABC staining and flow cytometry. The expression of HLA-DR in the 5 cell lines was detected by ELISA before and after the cells were treated with IFN-γ or IFN-α. Results:Eighteen out of 46 HCC tissues (39.1%) expressed HLA-DR, whereas all the normal liver tissues immediately adjacent to HCC tissues were HLA-DR-negative. No obvious HLA-DR-positive staining was found in all the 5 cell lines. The expression of HLA-DR was up-regulated in all the 5 cell lines after IFN-γ or IFN-α treatment. The up-regulation of HI A-DR in QZG cells was less obvious than that in HCC cell lines. The effect of IFN-γ was more significant than that of IFN-α. Conclusion: HCC tissues can express HLA-DR to some extent, but HCC cell lines do not express detectable HLA-DR. IFN can up-regulate HLA-DR expression in HCC cells.