Factors associated with mortality in human immunodeficiency virus type 1-infected adults initiating protease inhibitor-containing therapy: role of education level and of early transaminase level elevation (APROCO-ANRS EP11 study). The Antiprotéases Cohorte Agence Nationale de Recherches sur le SIDA EP 11 study

This study attempted to identify factors associated with mortality among human immunodeficiency virus (HIV)-infected adults starting a protease inhibitor (PI)-containing therapy. Among 1155 patients consecutively enrolled in the APROCO study between May 1997 and June 1998, clinical characteristics were as follows: median age, 36 years; median baseline CD4 cell count, 288 cells/mm(3); and median baseline plasma HIV RNA load, 4.4 log(10) copies/mL. After a median follow-up of 27 months, 48 deaths had occurred, of which 44% were related to acquired immune deficiency syndrome. The mortality rate was 2.9% at 12 months. When both data at baseline and data at 4 months after the start of PI therapy were considered, factors independently associated with mortality were (Cox model) low baseline plasma creatinine level, low school education level, low CD4 cell count at 4 months, low hemoglobin level, and elevated hepatic transaminase levels. Thus, social context plus clinical and biologic data, including the 4-month response to treatment, must be considered in treatment of HIV-infected patients.     

Coronary surgery in dialysis-dependent patients with end stage renal failure

The number of patients with dialysis-dependent end stage renal failure (ESRF) and coronary heart disease (CAD) has increased in recent years. Coronary artery bypass grafting (CABG) has become the standard treatment for CAD in this patient group, but is still considered as a risk procedure due to increased mortality and morbidity. In a retrospective study we analyzed our clinical results of isolated CABG in 40 dialysis-dependent patients with ESRF (5 female and 35 male, mean age 65+/-8.4 years) and the use of extracorporeal circulation. The perioperative control group comprised 51 patients (10 female and 41 male, mean age 67+/-7.3 years) with normal renal function and isolated CABG. Demographic and preoperative data were comparable in both groups. Hospital mortality was 2.5% in patients with ESRF and 0% in patients with normal renal function. Morbidity was comparable in both groups. The mean number of grafts was 3.1+/-0.9 in the dialysis group and 2.9+/-0.8 in the control group. In the follow-up of the dialysis group (34+/-23 months) 8 patients died. CABG in patients with dialysis-dependent ESRF can be performed with good clinical results and morbidity comparable to patients with normal renal function.     

甘肃省和政县野菜资源及其利用价值探讨

目的了解地产野菜品种及其营养价值、药用价值和食用现状,为甘肃省和政县野菜资源开发与药食两用提供依据。方法采用野外调查、资料查阅和民间访谈与市场调研方法。结果和政县共有野菜48科122属145种,多为药食两用植物,其中蕴藏量较大且食用较多的有98种,食用以凉拌、炒食或生食等传统方法为主。结论和政县野菜资源丰富,且具有较高的营养和药用价值;野菜食疗用于"治未病"切实可行、实用有效,值得推广。     

家兔对小鼠抗血吸虫靶抗原单克隆抗体的抗抗体应答

本文报告从分泌具血吸虫保护性IgG_(2a)表型1E2McAb的杂交瘤培养上清液中,应用蛋白A-葡聚糖柱层析法纯化的McAb免疫家兔,采用纯化McAb分别进行Dot-ELISA、免疫双扩散和免疫印迹试验、ELISA观察免疫血清中抗McAb和抗-抗McAb的产生及其动态变化规律。主要结果表明:(1)1E2McAb免疫后,20d开始出现抗McAb,若不加强免疫,抗McAb逐渐减弱:若加强免疫,则抗McAb水平较高,且持续30-50d。(2)免疫血清中的抗-抗McAb,能起抗-抗Id的作用,可识别不同的血吸虫抗原及血吸虫抗原中不同抗原决定簇(90,68和45kD_a),而且免疫后不同时期抗-抗McAb识别不同抗原的水平不同(滴度1:100-1:1600)。对抗血吸虫肥抗原McAb免疫后抗抗体应答的观察,可为研制不同抗独特型McAb创造条件。     

骨髓间充质干细胞在缺血性脑血管病治疗中的应用

缺血性脑血管病的病死率和致残率均很高，给社会和家庭带来了巨大负担。但目前在临床上无论是药物治疗还是外科手术治疗效果均不理想。最近的研究发现，骨髓间充质干细胞具有多向分化潜能，能跨胚层分化为神经细胞，其作为神经干细胞的来源，用于缺血性脑血管病的治疗具有广阔的前景。     

超声评价子痫前期患者胎儿主动脉峡部血流指数

目的 通过测量峡部血流指数（IFI）定量分析子痫前期（PE）患者胎儿主动脉峡部（AOI）血流变化特点与规律。方法 纳入38例PE患者（PE组）和孕周相匹配的38名正常单胎妊娠孕妇（对照组）。采集胎儿AOI、脐动脉（UA）、静脉导管（DV）的多普勒频谱,计算IFI,并分为Ⅰ~Ⅲ型,计算PE组胎儿AOI、UA舒张期血流及心房收缩波（DA-a）消失或反向率。结果 对照组胎儿IFI均为Ⅰ型,IFI值为1.40±0.09,AOI舒张期血流均为前向;PE组胎儿IFI Ⅰ型21胎,Ⅱ型10胎,Ⅲ型7胎,IFI值为0.81±0.80;2组IFI差异有统计学意义（t=4.439,P<0.001）。PE组胎儿AOI、UA舒张期血流和DV-a波消失或反向率分别为44.74%（17/38）、13.16%（5/38）和0,与对照组比较差异有统计学意义（χ²=25.796,P<0.001）。结论 PE患者胎儿IFI降低。检测胎儿AOI多普勒频谱可于胎儿循环缺氧早期检测其血流动力学变化。     

银翘散与盐酸左氧氟沙星联合治疗肺炎的临床效果评价

目的：主要对银翘散与盐酸左氧氟沙星联合治疗肺炎的临床效果进行评价。方法：221例肺炎患者分为治疗组（110例）和对照组（111例）2组,其中给予治疗组银翘散泡服,以及盐酸左氧氟沙星静脉滴注;给予对照组同样的盐酸左氧氟沙星静脉滴注。观察2组的治疗效果、细菌清除率、白细胞与中性粒细胞数目的变化以及不良反应。结果：治疗组细菌清除率明显优于对照组（P＜0.05）,但2组白细胞与中性粒细胞数无明显差异（P＞0.05）。结论：银翘散与盐酸左氧氟沙星联合治疗肺炎具有良好的临床效果。     

构建居家养老医疗信息平台的可行性研究

人口老龄化为当今中国医疗带来了巨大挑战,而国内与之对应的养老服务却相对滞后。随着大数据时代对健康和医疗领域带来深刻的变革,研究围绕智慧医疗服务计算模型以及体系结构展开,旨在利用新兴信息通信和医疗技术提供物超所值的医疗保健服务,分析"软硬云"结合的智能健康医疗平台介入居家养老模型的现实意义及支持因素,并探讨这一模型的可行性,以期推动居家养老的新模式,从而纵向整合医疗资源,实现从个人健康管理到公共健康管理的双赢。     

颅脑损伤合并高钠血症63例临床分析

目的：探讨颅脑损伤后合并高钠血症的临床治疗及高钠血症对预后的影响。方法回顾分析该院2007年1月-2014年12月间收治的重型颅脑损伤合并高钠血症63例患者临床资料,对比血钠高低对死亡率的影响,对比控制尿量组与非控制尿量组血钠恢复时间。结果轻度高钠组、中度高钠组、重度高钠组分别有17例、24例、22例,各组的死亡率分别为29.4%、45.8%、63.6%,轻度高钠组与重度高钠组间相比,差异有统计学意义(P<0.05)。控制尿量组28例,非控制尿量组18例,两组的血钠恢复正常所需的平均天数分别为(4.57±1.86)、(6.38±1.49),两组相比差异有统计学意义(P<0.05)。结论颅脑损伤合并高钠血症血钠值越高,死亡率越高,除常规治疗外,控制尿量可明显缩短血钠恢复的时间。     

阿曼托双黄酮对辐射损伤小鼠骨髓细胞的保护作用

目的 探讨阿曼托双黄酮(amentoflavone,AF)对辐射小鼠骨髓细胞的防护作用及可能机制。方法 培养C57BL/6小鼠骨髓原代细胞,分为正常对照组、照射对照组、AF 2.5和5μmol/L组,每组3复孔,给药12 h后换成普通培养基,给予12Gy60Coγ射线一次性照射,于照后6和12 h分别用Hoechst染色法检测细胞的凋亡,用PI染色和流式细胞仪检测细胞周期,用酶联免疫吸附法检测细胞培养基中TNF-α的浓度。结果 AF对辐射后小鼠骨髓细胞凋亡及细胞周期变化无明显影响,但能显著降低辐射后细胞上清中TNF-α的浓度,且对照后6 h细胞作用明显(2.5μmol/L组P<0.05,5μmol/L组P<0.01);照后12 h也具有同样趋势,与照射对照组相比,5μmol/L组细胞上清中TNF-α表达明显降低(P<0.05)。结论 AF对C57BL/6小鼠骨髓细胞具有一定的辐射防护作用,它可能是通过抑制辐射后骨髓细胞TNF-α的表达来发挥辐射防护作用。