ELISA法检测乙肝5项指标室内质控初探

目前,市县级医院普遍采用固相酶联免疫法（ELISA）检测乙肝5项指标,该法操作方便、快捷,特别适合大批标本的筛查。但由于ELISA方法学特点,批内批间的CV值较大。因此,做好该项检测的质量控制是保证结果真实可靠的基础。现就本室开展此项室内质控若干措施和体会报告如下。     

白色萎缩7例报告与文献复习

目的：提高对白色萎缩的认识,探讨其诊断依据和有效的治疗方法。方法：对2002年以来我院住院的7例本病患者的临床资料进行回顾性分析。结果：本病发病年龄以中年以上女性居多,皮损表现为双小腿、踝部、足部散在淡红色和紫红色斑疹、斑片,逐渐破溃、渗液、溃疡、结痂、萎缩形成象牙白色瘢痕,夏重冬轻。实验室检查无特异性;组织病理改变为真皮浅层小血管数量增多,血管内皮细胞显著增生,管腔狭窄,少数血管壁有纤维蛋白样物质沉积及玻璃样变、透明血栓形成,血管周围有少量淋巴细胞和组织细胞浸润。结论：本病主要根据临床特点和组织病理诊断。目前,以大剂量双嘧达莫、小剂量阿司匹林联合治疗为首选;其他还可选用纤维蛋白溶解药、抑制血小板聚集药,以及中药生地、山药;重症患者采用血浆置换术可获得近期良好的疗效。     

皮质醇水平轨迹分析识别脓毒症新亚型

目的 采用纵向血浆皮质醇水平轨迹识别脓毒症患者的新亚型。方法 回顾性选择2019年3月至2021年8月于复旦大学附属中山医院重症医学科住院治疗的成人脓毒症患者96例,在入组后第1～3个晨8时和第1、2个下午4时采集患者血液,分析皮质醇浓度变化轨迹。根据轨迹潜在类别分析结果将患者分组,比较不同组基础情况、疾病严重程度、实验室检查及临床结局(如住院时间、死亡率)等。结果 96例脓毒症患者中位年龄68岁,以男性患者为主(68.8%)。诱发脓毒症的原发病以腹部感染为主(83.3%),而合并症以肿瘤居多(61.5%),特别是肠道肿瘤。根据皮质醇水平轨迹,将患者分为皮质醇水平由较高浓度逐渐回落组(回落组,n=33)和在正常范围且波动较为稳定组(稳定组,n=63)。回落组入组时病情更重,序贯器官衰竭评分（SOFA）分值[8(6, 11)分vs 6(4,8)分]及APACHEⅡ评分[20(15,23)分vs 15(11,18)分]高于稳定组（P<0.01）。回落组28 d死亡率(42.4%vs 17.4%)和90 d死亡率(45.5%vs 22.2%)明显高于稳定组（P<0.05）。结论 ...     

Development and Optimization of Broadband Acoustic Metamaterial Absorber Based on Parallel–Connection Square Helmholtz Resonators

An acoustic metamaterial absorber of parallel–connection square Helmholtz resonators is proposed in this study, and its sound absorption coefficients are optimized to reduce the noise for the given conditions in the factory. A two–dimensional equivalent simulation model is built to obtain the initial value of parameters and a three–dimensional finite element model is constructed to simulate the sound absorption performance of the metamaterial cell, which aims to improve the research efficiency. The optimal parameters of metamaterial cells are obtained through the particle swarm optimization algorithm, and its effectiveness and accuracy are validated through preparing the experimental sample using 3D printing and measuring the sound absorption coefficient by the standing wave tube detection. The consistency between the experimental data and simulation data verifies feasibility of the proposed optimization method and usefulness of the developed acoustic metamaterial absorber, and the desired sound absorption performances for given conditions are achieved. The experimental results prove that parallel–connection square Helmholtz resonators can achieve an adjustable frequency spectrum for the low frequency noise control by parameter optimization, which is propitious to promote its application in reducing the noise in the factory.     

Fraxinol attenuates LPS-induced acute lung injury by equilibrating ACE-Ang II-AT1R and ACE2-Ang (1-7)-Mas and inhibiting NLRP3

ContextAcute lung injury (ALI) is a serious heterogenous pulmonary disorder. Fraxinol was selected for this study since it is a simple coumarin compound, not previously investigated in ALI.ObjectivesThis study investigates the ALI therapeutic effect and mechanisms of fraxinol.Materials and methodsMale BALB/c mice were treated with fraxinol (20, 40, and 80 mg/kg) following intranasal injection of lipopolysaccharide (LPS; 10 μg in 50 μL). The mice in control group were intratracheally injected with 50 μL phosphate buffered saline (PBS). Raw264.7 cells were treated with fraxinol by 100 ng/mL LPS for 6 h, then treated by different concentrations of fraxinol (5, 10, and 25 μM) for 48 h. Cells in control group were treated with PBS.ResultsFraxinol with doses of 20, 40, and 80 mg/kg significantly attenuated LPS-induced lung injury in mice (lung injury score, 10.4, 31.2, 50.3%). Fraxinol attenuated the apoptosis and nucleotide-binding oligomerization domain-like receptor family pyrin domain-containing-3 (NLRP3) activation induced by LPS (apoptosis, 18.3, 30.2, 55.6%; NLRP3, 30.0, 47.7, 63.6%). The anti-apoptosis and anti-inflammation effects of fraxinol were also confirmed in Raw264.7 cells (apoptosis, 38.8, 55.3, 68.9%; NLRP3, 20.6, 55.7, 73.9%).Discussion and conclusionThe anti-ALI effects of fraxinol maybe by equilibrating ACE-Ang II-AT1R and ACE2-Ang (1-7)-Mas axis and inhibiting NLRP3 inflammasome. Our research provides a candidate drug in the treatment of ALI.     

人牙髓组织缺氧耐受机制的初步研究

目的：研究缺氧诱导因子-1α（Hypoxia inducible factor-1α,HIF-1α）和环氧化酶-2（Cyclooxygenase-2,COX-2）在人正常牙髓和炎症牙髓中的免疫定位,探讨缺氧耐受机制在牙髓炎病程中和牙髓自身修复过程中的作用和意义。方法：通过SP法对第1组10例健康牙髓、第2组10例深龋（有过敏症状但无牙髓炎症状）患牙牙髓、第3组15例急性牙髓炎牙髓和第4组15例慢性牙髓炎牙髓进行免疫组化染色,分别对HIF-1α和COX-2进行免疫定位和半定量分析。结果：①HlF-1α在第1组健康牙髓和第2组深龋牙髓标本中,只有个别标本呈弱阳性表达,二组问无显著性差异（P〉0．05）,但对比其它二组标本则有显著性差异（P〈0．001）：第3组急性牙髓炎牙髓呈强阳性表达,第四组慢性牙髓炎牙髓亦呈阳性染色与第3组比较总体偏弱,有显著性差异（P〈0．05）。②COX-2在第1组牙髓中个别标本呈弱阳性表达;第2组标本绝大多数染色呈弱阳性,与第1组比较有显著性差异（P〈0.05）;第3组标本染色均呈强阳性,与前两组比较有显著差异性伊值分别为P〈0.001,P〈0．05）;第4组标本亦呈阳性染色,总体上阳性程度明显高于第l组（P〈0．001）,高于第2组（P〈0．05）,弱于第3组（P〈0．05）。HIF-1α与COX-2的表达关系主要在第3组和第4组牙髓标本中体现明显,在第3组二者的变化大致呈平行关系;在第4组基本呈反向变化关系。结论：HIF-1α和COX-2在牙髓炎病程中可能发挥着重要的生理和病理作用,在牙髓炎进程中和牙髓自身修复过程中可能存在着缺氧环境和缺氧耐受机制。     

木耳菌丝体及其醇提物的药理作用

木耳菌丝体小鼠ip给药能明显提高外周血T淋巴细胞百分率,使环磷酰胺引起的半数溶血值HC₅₀减少恢复正常;其醇提物体内外均能明显抑制ADP诱导大鼠血小板聚集作用,缩短小鼠红细胞电泳时间。     

中医药防治多器官功能障碍综合征探讨

多器官功能障碍综合征(MODS)是创伤及感染后最严重的并发症。近年来,现代医学对MODS发生机制的认识已有长足进步,相对而言,临床疗效就不那么令人满意了。尽管全力采取积极复苏、器官支持、抗感染、介质拮抗等手段,其病死率仍居高不下。因此,越来越多的有识之士认为,运用中医药防治MODS是今后的一个重要发展方向。1　中医药防治MODS的简要回顾中医药治疗MODS是从治疗单一脏器衰竭起步的。王今达等于1972年用血府逐瘀汤治疗天津首例确诊DIC获成功。1976年根据ARDS多有苔黄燥、脉洪大、腹胀满、大便秘结之阳明腑实证,选凉膈散为主方…