消岩汤姑息治疗中晚期非小细胞肺癌的回顾性临床研究

目的 观察消岩汤姑息治疗中晚期非小细胞肺癌(non-small cell lung cancer,NSCLC)的临床疗效。方法 采用回顾性临床研究方法,收集Ⅲ_b～Ⅳ期NSCLC患者127例,其中治疗组73例,采用了消岩汤加减联合姑息治疗;对照组54例,采用单纯姑息治疗。比较两组治疗后无进展生存期(progression free survival,PFS)和总生存期(overall survival,OS)及临床疗效,并对两组治疗前后卡氏评分(Karnofsky performance status,KPS)、免疫功能指标进行疗效评价和对比分析。结果 与对照组比较,治疗组显著延长了NSCLC患者的中位PFS(median PFS,m PFS)(3.6月vs 2.3月,P=0.017),但中位OS(median OS,m OS)未见显著获益(5.73月vs 5.33月,P=0.176)。治疗后,治疗组KPS评分较治疗前显著提高(P<0.05);治疗组较对照组KPS评分显著提高,差异具有统计学意义(P<0.05)。治疗组临床总有效率为75.34%,中医症状...     

Maternal Zinc,Copper, and Selenium Intakes during Pregnancy and Congenital Heart Defects

The effects of zinc, copper, and selenium on human congenital heart defects (CHDs) remain unclear. This study aimed to investigate the associations of the maternal total, dietary, and supplemental intakes of zinc, copper, and selenium during pregnancy with CHDs. A hospital-based case-control study was performed, including 474 cases and 948 controls in Northwest China. Eligible participants waiting for delivery were interviewed to report their diets and characteristics in pregnancy. Mixed logistic regression was adopted to examine associations and interactions between maternal intakes and CHDs. Higher total intakes of zinc, selenium, zinc to copper ratio, and selenium to copper ratio during pregnancy were associated with lower risks of total CHDs and the subtypes, and the tests for trend were significant (all p < 0.05). The significantly inverse associations with CHDs were also observed for dietary intakes of zinc, selenium, zinc to copper ratio, selenium to copper ratio, and zinc and selenium supplements use during pregnancy and in the first trimester. Moreover, high zinc and high selenium, even with low or high copper, showed a significantly reduced risk of total CHDs. Efforts to promote zinc and selenium intakes during pregnancy need to be strengthened to reduce the incidence of CHDs in the Chinese population.     

Abnormal interaction between cognitive control network and affective network in patients with end-stage renal disease

End-stage renal disease (ESRD) is a common complicated disorder that is generally associated with an altered central nervous system and cognitive impairment. Neuroimaging studies have recorded aberrant brain circuits in patients with ESRD that were closely associated with abnormal clinical manifestations. However, whether the altered interaction was within and/or between these circuits is largely unclear. We investigated brain topological organization and/or module interaction by employing resting-state functional magnetic resonance imaging (rs-fMRI) and modularity network analysis in 24 patients with ESRD and 20 age- and gender-matched healthy control (HC) subjects. Stroop task was used to evaluate the performance of cognitive control in all subjects. At the global level, ESRD patients exhibited significantly decreased global and local efficiency which were mainly related to abnormal functional connectivity of the amygdala and inferior frontal gyrus (IFG). Stepwise regression analysis was applied to estimate the relationships between network efficiency and blood biochemistry level (urea, creatine, phosphate, Ca²⁺, hematocrit, cystatin, hemoglobin levels, parathyroid hormone, K⁺ and Na⁺), and only the hematocrit level was significantly associated with global efficiency in patients with ESRD. At the modular level, we discovered an aberrant brain interaction between the amygdala- and IFG-related circuits in the ESRD group, and the regional efficiency of the amygdala was observably relative to the performance of cognitive control in patients with ESRD. Our results suggested that ESRD exhibited aberrant brain functional topological organization and module-level interaction between the affective and cognitive control circuits, providing crucial insights into the pathophysiological mechanism of ESRD patients.     

血清不对称二甲基精氨酸与服用质子泵抑制剂后初次发生急性冠状动脉综合征的相关性

目的本研究旨在探讨血清不对称二甲基精氨酸（ADMA）与服用质子泵抑制剂（PPI）后初次发生急性冠状动脉综合征（ACS）的关系。 方法研究纳入2017年1月至2018年10月因初次发生ACS入住徐州医科大学附属淮安医院的患者及体检中心同期健康体检者共210例,分为3组,PPI组（服用PPI＋初次发生ACS）患者70例,其中男性51例,女性19例,平均年龄为（62.80±11.87）岁;ACS组（未服用PPI＋初次发生ACS）患者70例,其中男性55例,女性15例,平均年龄为（62.66±12.13）岁;对照组为同期健康体检患者（未服用PPI＋未发生ACS）70人,其中男性54人,女性16人,平均年龄为（62.96±9.09）岁。采用酶联免疫吸附法检测血清ADMA浓度,同时测量总胆固醇、三酰甘油等指标。采用单因素方差分析、非参数检验和χ²检验比较3组研究对象一般人口学信息、各项生化指标及ADMA水平;组间两两比较采用Mann-Whitney U检验;采用Spearman相关分析分析血清ADMA水平与ACS传统危险因素的关系;采用多因素Logistic回归分析探讨ACS的独立危险因素。 结果PPI组和ACS组的血清ADMA水平均高于对照组,差异均有统计学意义（Z=-9.585、-4.793,P均<0.001）;PPI组的血清ADMA水平高于ACS组,差异具有统计学意义（Z=-8.750,P<0.001）;PPI组和ACS组（即ACS患者）的血清ADMA水平与年龄、性别、BMI、吸烟、糖尿病、高血压、总胆固醇、三酰甘油无相关性（P均>0.05）;Logistic回归分析显示血清ADMA水平是初发ACS患者的独立危险因素（β=0.017,OR=1.017,P<0.001）。 结论服用PPI后初次发生ACS患者的血清ADMA水平明显高于未服用PPI的初次发生ACS患者;初次发生ACS患者的血清ADMA水平明显高于健康对照者;血清ADMA升高是初次发生ACS的独立危险因素。     

CT诊断婴儿先天性膈膨升合并弯刀综合征1例

女性患儿,10月龄,出生后即发现右膈膨升,之后反复肺部感染,偶有气促;为进一步诊治入院.查体:右下肺呼吸音消失.超声心动图示房间隔缺损;上消化道造影示右侧膈膨升.胸部增强CT:右膈局部升高,部分肝脏突入胸腔(图1A);右肺静脉汇入右心房(图1B);右肺容积缩小,右中、下叶支气管未显示(图1C);右肺动脉纤细,未见右下肺...     

上肢康复操在维持性血液透析患者中的应用研究

目的 评价上肢康复操在维持性血液透析患者中的应用效果。 方法 选取2021年10月—12月于山东省某三级甲等医院血液净化中心行维持性血液透析治疗的患者77例,按随机数字表分为试验组38例和对照组39例,试验组在常规护理的基础上进行上肢康复操训练,对照组只接受常规护理。分别比较干预前和干预3个月后两组的双手握力、肩关节活动度、动静脉内瘘血流量及非内瘘侧头静脉直径。 结果 试验组36例、对照组38例完成研究。干预前两组双手握力、肩关节活动度、动静脉内瘘血流量及非内瘘侧头静脉直径比较,差异无统计学意义（P>0.05）;干预后试验组与对照组比较,内瘘侧握力（t=-2.350,P=0.022）、非内瘘侧握力（t=-3.693,P<0.001）,内瘘侧肩关节外展（t=-2.468,P=0.016）、外旋（t=-5.167,P<0.001）、内旋（t=-2.059,P=0.043）,动静脉内瘘血流量（t=-2.020,P=0.047）、非内瘘侧头静脉直径（t=-5.229,P<0.001）均增加,差异具有统计学意义。 结论 上肢康复操训练有助于改善维持性血液透析患者的上肢功能及维护动静脉内瘘。     

大学生自杀的原因和预防策略

目的 探讨大学生自杀的原因,并针对这些原因提出相应的预防措施.方法 采用综述的方法,分别从社会角度、学校角度、家庭角度和大学生自身等方面分析其自杀的原因.结果 从文献可以看出,自杀是导致大学生死亡的主要原因之一.研究发现近年来大学生自杀人数呈上升趋势,大学生自杀的问题应该引起社会的高度重视.结论 干预策略对于预防大学生自杀有一定的现实意义.     

影响射频消融灶尺寸的若干因素研究

探究三种独立因素(接触力、射频功率、作用时间)对于消融灶深度、直径的影响以及其数学模型.使用微孔(66孔)灌注导管,取新鲜猪心脏切片进行体外灌注消融,设定不同的接触力(10、15、20、25、30、35 g)、射频功率(15、20、25 w)及作用时间(30、45、60 s),实验测得消融灶的深度和直径,并在现有研究结果的基础上,通过统计学软件对数据进行分析和拟合.三种独立因素和消融灶的深度、直径之间分别存在不同程度的正相关性,经数据拟合可得到其数学模型,且准确率较高.射频消融灶深度和直径与接触力、功率、时间三个独立因素之间存在某种确定的函数关系,可用于指导一定条件下的体外消融实验.     

DRR1对小鼠神经干细胞分化以及神经元突起形成的影响

目的:本研究旨在阐明肾细胞癌下调蛋白1(DRR1)在小鼠大脑组织中的表达谱及相关生物学功能.方法:首先,通过real time RT-PCR的方法明确在不同发育阶段的小鼠大脑组织中DRR1的表达水平;利用免疫荧光染色法检测DRR1在原代培养的神经干细胞以及神经元中的表达情况.其次,采用real time RT-PCR的...