子宫弥散加权成像磁化率伪影与肠道准备之间的相关性研究

目的：探讨肠道准备对子宫扩散加权成像磁化率伪影的影响。方法：将60名健康女性受检者（23～45岁）随机分为2组（无肠道准备组和肠道准备组）,每组30名受检者,然后对每一位受检者进行T2轴位和失状位、DWI扫描,然后由2名医师分别对其图像进行双盲法评价。结果：2名医师评价无肠道准备组肠道以气体为主的出现率平均为65.00%,以液体为主的出现率平均为35.00%;肠道准备组肠道以气体为主的出现率平均为23.33%,肠道以液体为主的出现率平均为76.67%,2名医师评价的2组结果均具有统计学差异（P1=0.002,P2=0.004）。肠道以气体为主时子宫DWI磁化率伪影阳性率平均为82.91%,肠道以液体为主时子宫DWI磁化率伪影阳性率平均为13.46%,２名医师评价磁化率伪影结果均具有统计学差异（P1=0.000,P2=0.000）。结论：子宫DWI检查前进行肠道准备有助于减少子宫DWI磁化率伪影的产生,从而提高子宫DWI的图像质量,这更有利于进行子宫组织学的研究、子宫疾病的诊断、监测以及治疗后的疗效评价。     

两种不同晶体液预扩容对剖宫产术后炎性反应的影响

目的 研究分析剖宫产术实施两种不同晶体液预扩容对产妇术后炎性反应的影响,探讨最佳的术前扩容方案.方法 选取2014年10月至2015年12月收住本院的择期剖宫产产妇32例为试验组,麻醉前以15 ～ 20ml·kg-1·h-1输入复方醋酸钠预扩容,总量为10 ml/kg.另选取同期入院产妇30例为对照组,给予复方乳酸钠预扩容,用法用量同试验组.分别在术前、手术结束时以及术后24 h检测各组产妇静脉血IL-6、TNF-α和C反应蛋白(CRP)水平并进行分析比较.结果 试验组术后IL-6、TNF-α和CRP分别为(75.4±8.4)ng/L、(15.7±3.2)ng/L和(72.5±8.6)mg/L,而对照组则分别为(57.8±6.8)ng/L、(10.4±2.3) ng/L和(51.4±7.8) mg/L,试验组产妇IL-6、TNF-α和CRP水平显著高于对照组,差异有统计学意义(P＜0.05).但试验组与对照组产妇在术前及术后24 h IL-6、TNF-α和CRP水平比较差异无统计学意义(P＞0.05).结论 复方醋酸钠可促使产妇术后炎性因子释放.     

[In Press] Optical coherence tomography with or without enhanced depth imaging for peripapillary retinal nerve fiber layer and choroidal thickness

AIM: To assess peripapillary retinal nerve fiber layer (RNFL) and choroidal thickness obtained with enhanced depth imaging (EDI) mode compared with those obtained without EDI mode using Heidelberg Spectralis optical coherence tomography (OCT). METHODS: Fifty eyes of 25 normal healthy subjects and 32 eyes of 20 patients with different eye diseases were included in the study. All subjects underwent 3.4 mm diameter peripapillary circular OCT scan centered on the optic disc using both the conventional and the EDI OCT protocols. The visualization of RNFL and choroidoscleral junction was assessed using an ordinal scoring scale. The paired t-test, intraclass correlation coefficient (ICC), 95% limits of agreement (LoA), and Bland and Altman plots were used to test the agreement of measurements. RESULTS: The visibility score of RNFL obtained with and without EDI was of no significant difference(P=0.532), the visualization of choroidoscleral junction was better using EDI protocol than conventional protocol (P＜0.001). Peripapillary RNFL thickness obtained with EDI was slightly thicker than that obtained without EDI (103.25±9.42 μm vs 101.87±8.78 μm, P=0.010). The ICC of the two protocols was excellent with the value of 0.867 to 0.924, the 95% LoA of global RNFL thickness was between -10.0 to 7.4 μm. Peripapillary choroidal thickness obtained with EDI was slightly thinner than that obtained without EDI (147.23±51.04 μm vs 150.90±51.84 μm, P＜0.001). The ICC was also excellent with the value of 0.960 to 0.987, the 95% LoA of global choroidal thickness was between -12.5 to 19.8 μm. CONCLUSION: Peripapillary circular OCT scan with or without EDI mode shows comparable results in the measurement of peripapillary RNFL and choroidal thickness.     

Expert consensus on treating esophageal stenosis in children by magnetic recanalization

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IgG4 and IgE co-positive group found in idiopathic orbital inflammatory disease

AIM: To reveal the cytokines involved in idiopathic orbital inflammatory disease (IOID) and the relationship between Th17 cells, IgE and IOID pathogenesis. METHODS: Whole blood samples were processed immediately after collection and serological IgG4, IgG, and IgE antibodies were tested using ELISA. IOID and orbital cavernous hemangioma (CH) tissue samples underwent Bio-Plex multiplex cytokine detection. Hematoxylin-Eosin (HE) staining of all paraffin samples suggested the histological features of IOIDs, and expressions of IgG4 and IL-17A in affected tissues were detected by immunohistochemistry. RESULTS: Among 40 IOID plasma samples, 52.5% (21/40) were positive for IgG4 and 25% (10/40) were positive for IgE. Overlapped IgG4 or IgE positive samples accounted for 22.5% (9/40). Therefore, IOID samples were separated into three groups. The IgE+/IgG4+ group had a relevantly lower level of pro-inflammatory cytokine expression. IL-4 (Th2 cell related), IL-10 and TGF-β1 (Treg cell immunity related) were elevated in all three groups. Some of the Th17 cell related cytokines (i.e. IL-17A/F, IL-25, IL-23, and IL-33) displayed higher expression levels in the IgE-/IgG4- group compared to the other two groups. CONCLUSION: We discovered an IgG4-IgE co-positive group as well as Th17 cell immune involvement in IgG4-IgE co-negative subgtroup in IOID for the first time. The pathogenesis of IOID could differ from different subgroups according to the IgG4 and IgE detection. Therefore, we recommend that, Treatment stratagy should be made according to the clinical assessment of IgG4-IgE and Th17 profile detection.     

四川省西昌市吸毒人群首次吸毒情况的调查分析

目的:调查四川省西昌市吸毒人群首次吸毒的发生情况。方法:在四川省凉山彝族自治州西昌市戒毒所、拘留所和看守所调查吸毒人员的人口学特征,吸毒前吸烟和饮酒的情况,朋友、亲戚和家人吸毒的人数,首次吸毒的时间和使用毒品的方式和种类,吸毒前是否有被治安处理或违法行为。结果:共调查了619名吸毒人员,从出生到首次吸毒的发生率为4·08/100(95%可信区间为3·76-4·40)人年。在多因素Cox比例风险模型中,15a以前开始吸烟(危险率比值为1·58;95%可信区间为1·35-1·86),朋友中吸毒的人数(朋友中有1-4人吸毒危险率比值为1·25;95%可信区间为1·04-1·51,朋友中有5人及以上吸毒危险率比值为1·71;95%可信区间为1·39-2·09)和研究对象来源(拘留所和看守所危险率比值为1·52;95%可信区间为1·18-1·96)与首次吸毒的发生率有统计学意义。结论:需进一步了解首次吸毒发生的情况及其影响因素,为开展健康教育和行为干预来预防吸毒和有关疾病的传播提供科学依据。     

重症监护室日记对生存患者及家属心理状态和生活质量影响的meta分析

目的评价重症监护室(intensive care unit, ICU)日记对生存患者及家属心理状态和生活质量的影响。方法计算机检索PubMed、MEDLINE、EBSCO、OVID、The Cochrane Library、Proquest、中国知网、万方、维普等数据库ICU日记文献,检索时段为建库至2021年3月。由两名研究者进行文献筛选、资料提取和质量评价,应用RevMan 5.3统计软件进行meta分析。结果共纳入21篇文献,2 056例患者,797名家属。Meta分析结果显示,ICU日记能减少重症患者创伤后应激障碍(post traumatic stress disorder, PTSD)(OR=0.55,95%CI:0.41～0.74,P<0.01)和家属PTSD阳性症状(OR=0.34,95%CI:0.18～0.63,P<0.01),改善患者的抑郁程度(OR=0.58,95%CI:0.38～0.90,P=0.01),但对患者的生活质量和焦虑程度改善效果不明显(P>0.05)。ICU日记对减轻家属焦虑和抑郁状况的效果不明确(P>0.05)。结论 ICU...     

水甘油通道蛋白7与原发性肝细胞癌的相关性研究

目的：检测水甘油通道蛋白7（aquaglyceroporin,AQP7）是否在肝组织中有表达,并观察其在原发性肝细胞癌（human hepatocellular carcinoma,HCC）组织及其配对癌旁肝脏（non-tumourigenic liver,NTL）组织,以及正常肝脏（normal liver,NL）组织中的表达差异,并结合临床病理探讨AQP7与HCC发生发展的相关性。方法：收集34例HCC患者的HCC组织及其配对NTL组织和4例NL组织,分别应用real-time PCR法、蛋白免疫印迹（Western blot）法、免疫组织化学技术,在基因与蛋白、定性及定位层面检测HCC及NTL、NL组织中AQP7的表达情况。收集临床病理资料,分析AQP7的差异表达与患者临床病理参数的相关性。结果：（1）AQP7在所有HCC及NTL、NL组织中均有表达,免疫组化结果显示其主要表达于肝细胞胞膜及胞浆。（2）在HCC组织中AQP7的表达量无论在基因还是蛋白水平明显低于NTL与NL组织,NTL与NL组织中AQP7的表达量无明显差异：mRNA水平,NL组表达量与NTL组相比,无统计学差异（P=0.072）,HCC组表达量明显低于NTL组（t=3.841,P=0.000）及NL组（P=0.001）;蛋白水平,NL组与NTL组无明显统计学差异（t=0.264,P=0.798）,HCC组表达量明显低于NTL组（t=7.333,P=0.000）及NL组（t=5.648,P=0.011）。（3）应用多元线性回归分析法分析患者HCC组织中AQP7降低的差值与临床参数的相关性分析,发现有淋巴结转移的患者降低幅度更大（t=-2.837,P=0.008）。回归方程为：Y=1.612-0.472 X7（F=8.048,P=0.008）。结论：AQP7在人肝脏组织上有大量表达,主要表达于肝细胞胞膜及胞浆,且在ＨＣＣ组织上表达较其配对ＮＴＬ组织及ＮＬ组织表达明显降低,有淋巴结转移的患者降低幅度更大。