过敏性鼻炎患者血清食物特异性IgG检测结果分析

目的 探讨血清食物特异性IgG抗体检测在过敏性鼻炎中的临床意义.方法 采用酶联免疫吸附法检测1067例过敏性鼻炎患者血清14种食物特异性IgG抗体水平.结果 食物特异性IgG抗体阳性率为77.51％,其中单阳性的占32.53％,多重阳性的占67.47％;食物不耐受的程度,以轻度不耐受最为多见(61.62％),中度和重度不耐受分别占22.88％和15.51％,中、重度不耐受多见于鸡蛋、牛奶和小麦;检测阳性率从高到低依次为:鸡蛋(56.14％)、牛奶(28.40％)、小麦(20.43％)、西红柿(14.81％)、大米(13.12％)、大豆(11.90％)、鳕鱼(9.93％)、螃蟹(7.87％)、玉米(6.56％)、河虾(5.90％)、蘑菇(4.03％)、鸡肉(3.47％)、猪肉(2.44％)、牛肉(0.56％);阳性率较高的鸡蛋、牛奶、小麦、西红柿、大米在≤14岁患者组阳性率最高,随年龄增长而呈下降趋势.结论 过敏性鼻炎患者食物不耐受的发生率较高,血清食物特异性IgG检测可用于筛查不耐受食物.     

Impact of COVID-19 on Pregnancy

Coronavirus disease 2019 (COVID-19) is caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and is an emerging disease. There has been a rapid increase in cases and deaths since it was identified in Wuhan, China, in early December 2019, with over 4,000,000 cases of COVID-19 including at least 250,000 deaths worldwide as of May 2020. However, limited data about the clinical characteristics of pregnant women with COVID-19 have been reported. Given the maternal physiologic and immune function changes during pregnancy, pregnant women may be at a higher risk of being infected with SARS-CoV-2 and developing more complicated clinical events. Information on severe acute respiratory syndrome (SARS) and Middle East respiratory syndrome (MERS) may provide insights into the effects of COVID-19''s during pregnancy. Even though SARS and MERS have been associated with miscarriage, intrauterine death, fetal growth restriction and high case fatality rates, the clinical course of COVID-19 pneumonia in pregnant women has been reported to be similar to that in non-pregnant women. In addition, pregnant women do not appear to be at a higher risk of catching COVID-19 or suffering from more severe disease than other adults of similar age.Moreover, there is currently no evidence that the virus can be transmitted to the fetus during pregnancy or during childbirth. Babies and young children are also known to only experience mild forms of COVID-19. The aims of this systematic review were to summarize the possible symptoms, treatments, and pregnancy outcomes of women infected with COVID-19 during pregnancy.     

在校小学生意外伤害救护认知与教育需求调查

目的 了解小学生对意外伤害救护的认知水平、教育现状与需求,针对薄弱环节,探索适应小学生需求及学习特征的培训形式。 方法 通过学校微信平台,对武汉市江岸区某小学1 264名学生进行意外伤害救护认知与教育需求问卷调查,并进行统计学分析。 结果 小学生对心肺复苏有效时间、心肺复苏按压深度、按压部位、复苏抢救对象知晓率低,仅为12.82%、25.08%、50.55%、70.33%;溺水的急救知晓率仅30.46%;不同年级学生对学校易受伤地点、易受伤情境、易受伤原因、同学做危险活动时表现的认知及对心肺复苏知识的知晓和烫伤、眼部异物、气管异物的急救处理认知上存在统计学差异(P＜0.05);97.63%的小学生希望医院-学校建立联合培训模式;68.35%选择情景游戏方式进行培训。 结论 小学生对意外伤害救护认知存在局限,尤其心肺复苏知识与技能急待提升,学校及教育主管部门可探索医院-学校联合培训形式,建构科学规范的安全教育体系,提高小学生意外伤害救护能力。     

Time-average albumin predicts the long-term prognosis of IgA nephropathy patients achieved remission

Objective To clarify the long-term renal prognosis and related risk factors of progression for IgA nephropathy (IgAN) patients who achieved remission under current therapy. To identify the target value of the serum albumin level for Chinese patients with IgAN. Methods The patients with biopsy-proven primary IgAN in Nephrology Department of Renji Hospital in Shanghai were studied．The survival of renal and the relationships between clinical parameters and renal outcome were assessed. Results A total of 369 patients between Jan 2005 and Dec 2010 were included with a median follow-up time of 49.0 (38.0-65.8) months. All the subjects had achieved a complete remission (CR) or partial remission (PR) following six months’ therapy after diagnosis. Progressive renal disease had occurred in 61 cases at the end of follow-up. Three variables had a significant independent effect on renal outcome in patients achieving remission under current therapy regimen for IgAN, including time-average serum creatinine (TA-Scr) [HR(95%CI): 1.03(1.01-1.04)], time-average serum albumin (TA-Alb) [HR(95%CI): 0.83 (0.69-0.99)], and eGFR ratio within one year [HR(95%CI): 0.00(0.00-0.01)]. By multivariate Cox analyses, each 1 g/L drop of TA-Alb was related with 17.2% increase in the risk of renal progression. The ROC curve indicated that combination of serum albumin at baseline and during a long-term had a more significant value in prediction of renal outcome than independent predictor alone. By Kaplan-Meier analyses, patients with TA-Alb﹤38 g/L had a 10.4 fold sincreased risk of progressive disease compared with that of TA-Alb﹥38 g/L. Conclusions IgAN patients with lower eGFR ratio, higher TA-Scr and lower TA-Alb would progress to ESRD more quickly, and serum albumin during follow-up is important for predicting IgAN progression.     

母代大鼠高脂饮食对子代早期肝内脂肪酸代谢相关基因表达的影响

目的探索母代高脂饮食对子鼠早期肝脏病理改变的影响及其可能机制。方法 SD雌性大鼠随机分成高脂饮食组(HF组)和对照组,至交配怀孕产仔,哺乳期母鼠继续原饮食并喂养子鼠至其3周龄,取子鼠肝脏组织,观察肝脏病理变化,并检测肝脏内过氧化物酶体增殖物激活受体α(PPARα)、长链脂酰辅酶A合成酶3(ACSL3)、肉毒碱棕榈酰基转移酶1α(CPT-1α)及3-羟基酰基辅酶A脱氢酶(Ehhadh)的基因表达变化。结果 HF组母鼠所育的子鼠3周龄时肝细胞胞浆内可见弥漫性空泡变性,小叶内可见点灶状坏死;HF组子鼠肝脏组织PPARα和Ehhadh基因表达水平明显高于对照组,而ACSL3基因表达则显著低于对照组,差异均有统计学意义(P0.05);CPT-1α基因表达水平亦高于对照组子鼠,但两组间差异无统计学意义(P=0.19)。结论母鼠孕期持续至哺乳期的高脂饮食可引起子代早期肝内脂肪酸β氧化相关基因PPARα,CPT1α与Ehhadh表达代偿性增加,ACSL3表达降低,但尚不能逆转子代肝脏脂肪变性的发生。     

锁定加压钢板个体化治疗胫骨平台双柱或三柱骨折章建卫 陈榆 刘曦明 钟永翔 陈永志

【摘要】 目的 探讨锁定加压钢板（（locking compression plate, LCP)）治疗不同损伤程度的双柱或三柱胫骨平台骨折的疗效。 方法 依据骨折粉碎、分离移位的严重程度及软组织条件个体化选择适当的内固定进行治疗,其中30例患者应用单侧LCP固定;17例患者应用内、外双侧LCP固定;5例患者应用内、外、后侧三侧钢板支撑固定。术后定期复查X线片,依据骨折愈合的情况,指导患者行渐进性功能锻炼。膝关节功能评估按HSS）膝关节功能评价标准评定疗效。对术后X线片采用Rasmussen 放射学评分进行评估。 结果 所有患者术后获6～22个月（平均12个月）随访,随访无骨折再移位及螺钉松动、内固定失效等并发症发生。52例患者骨折获临床愈合,愈合时间为术后12～16周。4例患者术后3天出现切口渗液现象,细菌培养为阴性,考虑为脂肪液化所致,经换药治疗后渗液消失。1例发生慢性骨髓炎,后经换药、清创治愈。HSS膝关节功能评定疗效：优良率86.5%;术后Rasmussen 放射学评分为13-18分,平均16.3分。 结论 对于不同损伤程度的累及双柱或三柱的复杂胫骨平台骨折,术前应明确骨折的损伤情况,制定良好的手术方案,突出治疗的个体化,利用单侧LCP、双钢板或三钢板固定可获得满意疗效。     

超声测量颏舌骨肌长度对女性患者困难插管预测作用的初步研究

目的 研究超声测量颏舌骨肌长度对女性困难插管的预测作用.方法 选取择期手术需行气管插管的女性患者30例,手术麻醉前使用超声测量患者颏舌骨肌长度.所有患者采用相同麻醉诱导方案及相同的插管流程.气管插管后,记录气管插管困难评分(intubation difficult scale,IDS).结果 30例患者中有3例IDS评分＞5分,认为有插管困难.以颏舌骨肌长度为检验变量,绘制ROC曲线,曲线下面积为0.852,P=0.049.以约登指数最大值3.88 cm为临界值,评估困难气管插管,敏感度、特异度、阳性预测值、阴性预测值均大于Mallampati分级,但差异无统计学意义.结论 超声下测量颏舌骨肌长度对女性患者困难插管具有一定的预测作用.     

Targeting eradication of chronic myeloid leukemia using chimeric oncolytic adenovirus to drive IL-24 expression

Chronic myeloid leukemia (CML) is a clonal disorder in which cells of the myeloid lineage undergo massive clonal expansion as well as resistance to conventional chemotherapy. Gene therapy hold a great promise for treatment of malignancies based on the transfer of genetic material to the tissues. In this study, we explore whether chimeric oncolytic adenovirus-mediated transfer of human interleukin-24 (IL-24) gene induce the enhanced antitumor potency. Our results showed that chimeric oncolytic adenovirus carrying hIL-24 (AdCN205-11-IL-24) could produce high levels of hIL-24 in CML cancer cells, as compared with constructed double-regulated oncolytic adenovirus expressing hIL-24 (AdCN205-IL-24). AdCN205-11-IL-24 could specifically induce cytotoxocity to CML cancer cells, but little or no effect on normal cell lines. AdCN205-11-IL-24 exhibited remarkable anti-tumor activities and induce higher antitumor activity to CML cancer cells by inducing apoptosis in vitro. Our study may provides a potent and safe tool for CML gene therapy.