成年功能性构音障碍患者辅音错误类型及方式分析

目的 探讨成年功能性构音障碍患者辅音发音错误的特点,为制定语音训练方案提供依据.方法以42例成年功能性构音障碍患者为研究对象,借助计算机语音工作站对患者进行语音评估,对其辅音的发音错误类型及方式进行分析.结果42例成年功能性构音障碍患者主要的辅音发音错误类型为置换、扭曲,其次为脱落.按发音部位,错误辅音依次为舌尖后音(39例,92.86%)、舌尖前音(31例,73.81%)、舌面音(22例,52.38%)、舌根音(19例,45.24%)、舌尖中音(18例,42.86%)、唇齿音(6例,14.29%)及双唇音(6例,14.29%);辅音错误频率由高至低依次为/sh/、/zh/、/ch/、/r/、/z/、/c/、/s/、/q/、/x/、/j/、/g/、/k/、/h/、/t/、/l/、/d/、/f/、/p/.辅音错误方式有:舌前音化(22例,52.38%)、非送气化(12例,28.57%)、侧化构音(12例,28.57%)、辅音脱落(9例21.42%)、舌后音化(8例,19.05%)、舌面音化(4例,9.52%)、双唇音化(4例,9.52%)、唇齿音化(3例,7.14%).结论成年功能性构音障碍患者的辅音发音错误类型主要是置换和扭曲;错误辅音主要为舌尖后音、舌尖前音、舌面音、舌根音、舌尖中音;辅音发音错误方式主要为舌前音化、非送气化、侧化构音、辅音脱落.     

中性粒细胞异常增殖相关的BCR/ABL-慢性白血病的临床特征

目的:探讨与中性粒细胞异常增殖相关的BCR/ABL-慢性白血病的临床特征.方法:报告3例不同类型与中性粒细胞异常增殖相关的BCR/ABL-慢性白血病并结合文献进行讨论.结果:3例均为老年男性,表现为以中性粒细胞为主的白细胞异常增多、BCR/ABL融合基因阴性.例1诊断为慢性中性粒细胞白血病(CNL),脾大,外周血以成熟中性粒细胞增高为特征,胞浆内中毒颗粒易见,无明显病态造血,中性粒细胞碱性磷酸酶(NAP)染色强阳性,骨髓粒系增生明显活跃.例2诊断为不典型慢性髓细胞白血病(aCML),血涂片示不成熟粒细胞比例增高伴粒系病态造血,尤其核染色质异常浓聚更为明显,骨髓象表现为髓系增生和病态造血,原始细胞轻度增多.例3诊断为慢性粒单核细胞白血病(CMML),外周血成熟单核细胞数量和比例异常偏高,粒系病态如核分叶过多、环状核和假性Pelger-Huet畸形等易见,骨髓髓系增生明显活跃伴病态造血,无原始细胞增多.结论:中性粒细胞异常增殖相关的BCR/ABL-慢性白血病较为少见,易于误诊,细胞形态学特征是诊断BCR/ABL-慢性白血病的基础.临床表现、多种实验室检查结果尤其是分子生物学等有助于正确诊断这类疾病.     

首发精神分裂症患者IL-1β的血清蛋白水平及PBMC mRNA表达

目的从基因转录和蛋白水平,观察精神分裂症中IL-1β的动态变化情况,了解其免疫状态,并探讨IL-1β与精神病理的关系。方法采用病例对照研究方法,精神分裂症组为根据DSM—Ⅳ诊断为精神分裂症的本地汉族患者83例,单一应用利培酮治疗,在治疗前后评定PANSS量表;对照组为健康志愿者65例。应用ELISA和RT—PCR方法,同时检测血清IL-1β蛋白水平和PBMC中IL-1β mRNA表达。结果（1）精神分裂症组治疗前、后与对照组血清IL--1β水平相比,均明显增高,差异有显著性（P〈0．05）。精神分裂症组治疗后血清IL—-1β水平与治疗前相比明显下降,差异有显著性（P〈0．05）。（2）IL-1β治疗前后的差值与PANSS量表降分率呈显著正相关（r=0．388,P〈0．05）。（3）精神分裂症组治疗前、后PBMC中IL-1β mRNA表达与对照组相比明显增高,差异有显著性（P〈0．05）。精神分裂症组治疗后PBMC中IL-1β mRNA表达与治疗前相比明显下降,差异有显著性（P〈0．05）。结论（1）精神分裂症患者存在免疫激活,IL-1β水平的变化可作为病情缓解的一个灵敏指标。（2）精神分裂症患者PBMC呈激活状态,是IL-1β的主要来源之一,探讨影响PBMC细胞因子mRNA表达的因素,有助于反映对机体的免疫状况的影响。     

APC介入治疗支气管结核的临床疗效探讨

目的探讨氩等离子体凝固(argon plasma coagulation,APC)介入治疗支气管结核的临床疗效。方法对40例确诊支气管结核的患者实施经可弯曲电子支气管镜氩气刀介入治疗,并观察其疗效。结果40例治疗1～4次,平均1.9次,经支气管镜复查,显效30例,占75%;有效10例,占25%;总有效率100%。不良反应:治疗中22例有轻微刺激性呛咳,4例感觉局部烧灼痛,未发生支气管壁坏死、穿孔、气胸、纵隔气肿等并发症。结论APC介入治疗支气管结核,在解除支气管阻塞、加速病灶的吸收及组织再生和修复方面疗效确切,痰菌阴转率及肺不张治愈率均较高,能缓解支气管狭窄后遗症,安全性高,不良反应小,有较好的临床应用价值。     

2006～2007年桐乡市不同人群HIV监测检测结果分析

目的:分析不同人群HIV监测结果及感染者特征,制定有效的防控措施。方法:采用EXECL数据库对2006~2007年桐乡市各艾滋病实验室检测数据和网络直报个案资料进行整理、分析。结果:2006年检测38674份血清,确认HIV抗体阳性为10例,占0.03%,2007年检测37287份,确认HIV抗体阳性为6例,占0.02%,HIV阳性者的家属的检测确认阳性率都最高,分别为14.29%和16.67%。感染者特征中21~25岁为感染主要年龄段,以无业为主,以性行为为HIV传播的高危行为,住在城镇较多。结论:桐乡市的艾滋病处于低流行水平,且以特定人群为主,有向一般人群扩散的趋势,故要继续加强监测并采取以开展健康教育为主的干预,特别是面向农村和农民,提高自我防范意识,以遏制艾滋病在我市的流行和蔓延。     

苏州地区城乡生活饮用水水质调查与分析

目的掌握苏州地区城镇与农村生活饮用水水质卫生状况及水质指标自然本底值,为建立健全城乡生活饮用水质监测网络提供依据。方法按现行《生活饮用水标准检验方法》（GB／T5750．2）中《水样的采集与保存》,于2010年丰水期在沿长江和环太湖等典型地区采集城镇和农村集中式供水单位的出厂水水样,按《生活饮用水标准检验方法》（GB／T5750—2006）进行水质全项目检测分析。结果2010年丰水期苏州地区城乡饮用水主要不合格指标为铝和三氯乙醛,主要理化常规指标铅、氟化物、硝酸盐、三氯甲烷、铝、氯化物、硫酸盐、溶解性总固体、总硬度、耗氧量等本底值,分别为0．0014、0．62、1．21、0．0046、0．17、48．6、70．0、288．3、118．1、1．44mg／L。结论苏州沿长江和环太湖等典型地区城乡饮用水水质指标基本符合《生活饮用水卫生标准》（GB5749—2006）水质要求,能够保障城乡居民饮水安全及社会发展需求。     

Th17 cell‐derived miR‐155‐5p modulates interleukin‐17 and suppressor of cytokines signaling 1 expression during the progression of systemic sclerosis

Background miR‐155‐5p is associated with autoimmune diseases. T helper 17 (Th17) cells, interleukin (IL)‐17, and suppressor of cytokines signaling 1 (SOCS1) have important roles in the pathogenesis of systemic sclerosis (SSc). The purpose of this study was to explore the role of miR‐155‐5p in the regulation of IL‐17 and SOCS1 expression in Th17 cells and the subsequent effect on SSc disease progression.MethodsTh17 cells were isolated from peripheral blood mononuclear cells of SSc patients and healthy controls (HCs). RT‐qPCR and western blotting were used to examine the expression patterns of miR‐155‐5p, IL‐17, and SOCS1. Luciferase reporter assays were performed to confirm SOCS1 as a target of miR‐155‐5p. RNA pull‐down assays were performed to detect the interaction of IL‐17 and SOCS1 with miR‐155‐5p. In situ hybridization was performed to analyze the co‐expression pattern of miR‐155‐5p and IL17A in Th17 cells.ResultsThe levels of Th17 cell‐derived miR‐155‐5p were significantly up‐regulated in SSc patients compared with HCs, and its levels were negatively correlated with SOCS1 levels. Meanwhile, miR‐155‐5p positively regulated IL‐17 expression levels in Th17 cells isolated from SSc patients as the disease progressed. Using pmirGLO vectors, SOCS1 was confirmed as a target of miR‐155‐5p. The binding status of IL‐17 and SOCS1 to miR‐155‐5p was related to SSc progression. An increase in the co‐localization of miR‐155‐5p and IL‐17 was associated with greater SSc progression.ConclusionsIL‐17 and SOCS1 expression modulated by Th17 cell‐derived miR‐155‐5p are critical for SSc progression, which may provide novel insights into the pathogenesis of SSc.     

170例肝移植病例医疗质量费用分析

目的:分析肝移植病例住院费用构成并评价其医疗质量.方法:收集手术操作代码为50.5001的病案170份,采用<病例分型质量费用管理系统>软件和SAS6.1 2,进行描述性统计分析.结果与讨论:肝移植治疗水平不断提高,但费用十分昂贵,必须采取各种有效措施,降低患者负担.     

Early postoperative pain after subxiphoid uniportal thoracoscopic major lung resection: a prospective,single- blinded,randomized controlled trial

Open in a separate window OBJECTIVESPreoperative selection bias led to the inability to generalize the proposed benefit of subxiphoid uniportal video-assisted thoracoscopic surgery (SVATS) as having less postoperative pain than uniportal intercostal VATS. So, we conducted this prospective, single-blinded, randomized controlled trial to investigate the hypothesis that SVATS may have less early postoperative pain than UVATS in patients who undergo major lung resection for early-stage lung cancer.METHODSA total of262 patients were randomly allocated between 2 groups (each with 131 patients), the first being the UVATS group and the second being the SVATS group. The values indicated on the numerical rating scale (NRS) of pain were collected at 24 h and 48 h during rest and during coughing. In addition, different perioperative variables were analysed and compared between the 2 groups.RESULTSMultiple linear regression analysis showed that the type of surgical approach was a significant predictor of the postoperative NRS values. The postoperative NRS pain values were significantly lower in the SVATS group after 24 h during rest and coughing and after 48 h during coughing. Postoperatively, patients in the SVATS group got out of bed significantly earlier [16.37 (2.54) vs 18.05 (3.29) h, p < 0.001]. The SVATS group showed a significantly higher rate of intraoperative arrhythmia [20 (15.3%) vs 3 (2.3%) patients, p = 0.03].CONCLUSIONSSVATS major pulmonary resection in early-stage lung cancer is associated with less early postoperative pain than the UVATS approach. Operating on patients with cardiac problems using the SVATS approach is still a limiting factor for randomization due to the potential compression on the heart with resulting arrhythmia.Clinical trial registrationThe trial was registered under clinical trials.gov Identifier: {"type":"clinical-trial","attrs":{"text":"NCT03331588","term_id":"NCT03331588"}}NCT03331588. https://clinicaltrials.gov/ct2/show/{"type":"clinical-trial","attrs":{"text":"NCT03331588","term_id":"NCT03331588"}}NCT03331588.