不典型再生障碍性贫血120例分析

分析120例不典型再生障碍性贫血临床特点及骨髓血液学特点。作者结合文献讨论了本病的发病特点和发展规律。     

2010-2012年柳州市结核病疫情分析

目的了解柳州市近年来结核病发病以及流行状况,分析存在的影响因素,预测流行趋势,探讨防治措施。方法对2010-2012年柳州市结核病网络直报资料和病人系统管理资料进行描述性流行病分析。结果柳州市结核病疫情总体呈下降趋势（χ2=10．42,P〈0．os）,发病率平稳。男性多于女性;25～74岁年龄组占79．03％,有逐步向高年龄组发展的趋势;以农民工为主（占54．83％）;3-9月份发病较多;柳州市市区以及所辖6县均有发病,其中融安县发病率最高。结论坚持实施现代结核病控制策略（Directly Observed Treatment Short-course,DOTS政策）和结核病“三位一体”综合防治模式,加强发现、规范化治疗和全程督导管理,以有效预防和控制结核病的发生和流行。     

1例重症Goodpasture病的诊治

作者报道了１例重症Ｇｏｏｄｐａｓｔｕｒｅ病患者。患者入院时血肌酐近１３００μｍｏｌ／Ｌ，肾活检发现新月体占肾小球总数的９１．７％。经过双重血浆滤过、甲基强的松龙和环磷酚胺冲击等强化、综合治疗，患者肺出血停止，血清抗肾小球基底膜抗体转阴，但肾功能及重复肾活检病理均无改善。     

Dioscin Ameliorates Hyperuricemia-Induced Atherosclerosis by Modulating of Cholesterol Metabolism through FXR-Signaling Pathway

Hyperuricemia is one of the independent risk factors for atherosclerotic cardiovascular disease. Herein, we investigate the association between uric acid and cholesterol metabolism and the effect of dioscin on the prevention of hyperuricemia-induced atherosclerosis. In the potassium oxonate-treated ApoE^{−/−−/−} mice, atherosclerosis was accelerated along with elevated serum cholesterol levels in the hyperuricemic state, which can be ameliorated by dioscin. Together with the in vitro assays, we found that the effect of dioscin was at least partially through the regulation of the farnesoid X receptor (FXR) -small heterodimer partner (SHP) -7α-hydroxylase (CYP7A1) signaling pathway in the liver. Tigogenin (a metabolite of dioscin) suppressed FXR activation and increased CYP7A1, resulting in an increased conversion rate of cholesterols into bile acids. Further clinical study revealed that treatment with a dioscin-enriched preparation decreased serum cholesterol levels in individuals with hyperuricemia. In summary, this study demonstrated a slowdown effect of dioscin on the progression of hyperuricemia-induced atherosclerosis.     

深低温保存兔角膜神经形态的观察

采用氯化金染色、乙醛酸诱发荧光（ＧＩＦ）和乙酰胆碱酯酶染色（ＡＣｈＥＳ）技术分别对兔深低温保存角膜中总体神经、肾上腺能和乙酰胆碱能神经形态进行系统观察。结果表明，深低温保存角膜的氯化金染色和ＡＣｈＥＳ神经形态与正常角膜神经相一致，但ＧＩＦ却为阴性。提示在光镜下，深低温保存角膜过程对角膜神经不造成形态损害。     

Pregnancy outcomes in women with type 1 diabetes in China during 2004 to 2014: A retrospective study (the CARNATION Study)

BackgroundWe aimed to report pregnancy outcomes of women with type 1 diabetes (T1D) in China, on which data were sparse.MethodsThis is a nationwide retrospective study conducted in 11 general medical centers in 8 cities across China. We investigated the clinical data of all women who attended these centers with a singleton pregnancy and whose pregnancy ended between 1 January 2004 and 31 December 2014. Pregnancies of women with pregestational T1D were ascertained and compared with those of women without T1D.ResultsFrom over 300 000 pregnancies over the 11‐year study period, we identified 265 singleton pregnancies of women with T1D. One maternal death was documented among 265 (0.37%) women with T1D and 83 among 318 486 (0.03%) women without T1D. Women with T1D suffered from higher rates of pregnancy loss (13.21% vs 2.92%, crude risk ratio [cRR] 5.08 [95% CI, 3.56‐7.26]) and preeclampsia (17.74% vs 4.20%, cRR 4.94 [95% CI, 3.60‐6.77]) compared with those without T1D. Infants of these women with T1D had elevated rates of neonatal death (5.65% vs 0.16%, cRR 37.36 [95% CI, 21.21‐65.82]) and congenital malformation(s) (8.26% vs 3.53%, cRR 2.46 [95% CI, 1.54‐3.93]) compared with those of women without T1D. No significant improvement in pregnancy outcomes in women with T1D was observed over the period 2004 to 2014.ConclusionsPregnancy outcomes were persistently poor in women with T1D during 2004 to 2014 in China. Pregnancy care needs to be improved to reduce adverse pregnancy outcomes among Chinese women with T1D.     

城市社区卫生服务工作动态评价及可持续发展建议

目的：调查试点城市社区卫生服务的发展状况、主要问题并对社区卫生服务的发展提出建议。方法：采用特而菲快速调查和分析法，进行动态比较研究。结果：当前社区卫生服务运作现状较好，国家在社区卫生服务方面的既定目标已经基本达到；各级政府重视社区卫生服务，组织网络比较健全，服务功能基本到们，人才培养已经开始。结论：应继续加强领导，改革体制，引入竞争，积极创新，完善和深化服务，保证质量，健康发展。     

The Presence of Giant Epsilon Waves in a Patient with Arrhythmogenic Right Ventricular Cardiomyopathy

Epsilon wave, which is a major diagnosis criterion for arrhythmogenic right ventricular cardiomyopathy/dysplasia (ARVD/C), is defined as small amplitude potentials. The present case is a 49‐year‐old man with a history of syncope and palpitations for 6 months. The ECG documented ventricular tachycardia (VT) when the patient has palpitations. However, there has been a giant epsilon wave in sinus rhythm. Electroanatomic mapping also has a prominent double potential identified on ABL catheter. The amplitude of epsilon wave reached 0.9 mV, which might be the maximum epsilon wave until now.     

陈旧性与新鲜性压缩骨折行椎体成形术的临床对比研究

【摘要】 目的 回顾性对比研究陈旧性与新鲜性椎体压缩性骨折行经经皮椎体成形术(percutaneouss vertebra plasty,PVP)后的临床效果。 方法 对24例老年骨质疏松性胸腰椎压缩性骨折患者行PVP治疗,将研究对象按陈旧性骨折和新鲜性骨折分为2组,分别拍摄2组术前、术后标准正侧位X线片,从而对骨折椎体高度的恢复、后凸畸形的矫正及疼痛视觉模拟量表（visual analogue scale, VAS）评分进行研究对比。 结果 所有患者术后平均随访6个月,无严重并发症发生。2组患者术后疼痛缓解且恢复良好,均恢复日常活动能力。但陈旧性压缩性骨折患者术后椎体高度恢复和后凸畸形的矫正程度均不如新鲜性骨折患者。 结论 PVP术操作简单、创伤小,对于骨质疏松性椎体压缩性骨折的治疗效果明显,尤其对新鲜骨折效果显著,且对于缓解陈旧性骨折疼痛症状也有良好效果。