细胞毒性T淋巴细胞增殖、分化能力对HIV/HCV重叠感染患者病情进展的影响

目的 探讨HIV/HCV重叠感染患者细胞毒性T淋巴细胞增殖能力和分化状态对病情进展的影响.方法 采用流式细胞仪检测CD57、CD27和CD28在CD8+T细胞上的表达,根据其表达差异,判断CD8+T细胞的增殖能力和不同的分化状态,比较HIV/HCV重叠感染者和单独HCV感染者增殖能力和分化状态的差异.探讨CTL功能与病情进展的关系.结果 HIV/HCV重叠感染者中CD57在CD8+T细胞上高表达28.84%±4.49%,而在HCV单独感染者中较低表达8.24%±5.05%,两组差异非常显著(P＜0.001).CD57+CD8+T细胞的百分数与HCV载量对数值间存在着正线性相关(P=0.023,R2=0.21).HIV/HCV重叠感染者的CTL细胞分化状态以晚期为主,而HCV单独感染者的CTL细胞分化状态以中期为主,两者比较差异非常显著(P＜0.001).结论 HIV/HCV重叠感染患者较HCV单独感染者CTL细胞增殖能力较低、呈终末期分化状态,进而影响CTL的免疫应答,可能是重叠感染者肝病进展的原因之一.     

透出液蛋白丢失与连续性非卧床腹膜透析患者营养不良-炎性反应-动脉硬化综合征的相关性

Objective To investigate the impact of peritoneal albumin leakage on malnutrition-inflammation-atherosclerosis (MIA) syndrome in continuous ambulatory peritoneal dialysis (CAPD) patients. Methods A cross-sectional study of a cohort of 130 CAPD patients without edema or active infection was performed. In order to identify peritoneal transport characteristics in CAPD patients, a standard peritoneal equilibration test (PET) was carried out. For malnutrition and inflammation, serum albumin and high-sensitivity C-reactive protein (hs-CRP) levels were measured. Mean-carotid artery intima media thickness (IMT) was used to determine atherosclerosis. Residual glomerular filtration rate (rGFR) was defined as the average of 24-hour urinary urea and creatinine clearances. Results Pearson and Spearman correlation analysis showed that peritoneal albumin leakage amount was positively correlated with age, body mass index, night dwell time, blood glucose, 4 h D/P creatinine levels and hs-CRP levels (r=0.204, P<0.05 ;r=0.314, P<0.01; r=0.265, P<0.01; r=0.212, P<0.05; r=0.401, P<0.01; r=0.216, P<0.05); whereas it was negatively correlated with diastolic perssure, serum albumin levels, glucose level of dialyzate and peritoneal Kt/V (r=-0.209, P<0.05; r=-0.123, P<0.05; r=-0.271, P<0.01; r=-0.212, P<0.01). Overall, there was no correlation between peritoneal albumin leakage and IMT. Patients was significantly greater (P<0.01), and there was a positive correlation between peritoneal albumin leakage amount and IMT (r=0.650, P<0.01). Conclusions Peritoneal albumin leakage is significantly associated with peritoneal transport characteristics, malnutrition and inflammatory state in CAPD patients. High peritoneal albumin leakage amount is a risk factor for atherosclerosis in patients with rGFR less than 1 ml·min-1(1.73 m2)-1.     

透出液蛋白丢失与连续性非卧床腹膜透析患者营养不良-炎性反应-动脉硬化综合征的相关性

Objective To investigate the impact of peritoneal albumin leakage on malnutrition-inflammation-atherosclerosis (MIA) syndrome in continuous ambulatory peritoneal dialysis (CAPD) patients. Methods A cross-sectional study of a cohort of 130 CAPD patients without edema or active infection was performed. In order to identify peritoneal transport characteristics in CAPD patients, a standard peritoneal equilibration test (PET) was carried out. For malnutrition and inflammation, serum albumin and high-sensitivity C-reactive protein (hs-CRP) levels were measured. Mean-carotid artery intima media thickness (IMT) was used to determine atherosclerosis. Residual glomerular filtration rate (rGFR) was defined as the average of 24-hour urinary urea and creatinine clearances. Results Pearson and Spearman correlation analysis showed that peritoneal albumin leakage amount was positively correlated with age, body mass index, night dwell time, blood glucose, 4 h D/P creatinine levels and hs-CRP levels (r=0.204, P<0.05 ;r=0.314, P<0.01; r=0.265, P<0.01; r=0.212, P<0.05; r=0.401, P<0.01; r=0.216, P<0.05); whereas it was negatively correlated with diastolic perssure, serum albumin levels, glucose level of dialyzate and peritoneal Kt/V (r=-0.209, P<0.05; r=-0.123, P<0.05; r=-0.271, P<0.01; r=-0.212, P<0.01). Overall, there was no correlation between peritoneal albumin leakage and IMT. Patients was significantly greater (P<0.01), and there was a positive correlation between peritoneal albumin leakage amount and IMT (r=0.650, P<0.01). Conclusions Peritoneal albumin leakage is significantly associated with peritoneal transport characteristics, malnutrition and inflammatory state in CAPD patients. High peritoneal albumin leakage amount is a risk factor for atherosclerosis in patients with rGFR less than 1 ml·min-1(1.73 m2)-1.     

脂联素在眼底新生血管性疾病中的作用

眼底新生血管性疾病是脉络膜和视网膜病理性血管生长引起的一系列临床病理改变, 是一类严重影响视力的眼底病变, 目前认为其主要发病原因是新生血管生成促进因子和抑制因子之间失衡。目前广泛使用的抗血管内皮生长因子的药物对许多眼底新生血管性疾病患者仍然无效。脂联素是由脂肪细胞分泌的一种内源性生物活性蛋白, 具有增加胰岛素敏感性、调节糖和脂质代谢、抗炎、抑制新生血管形成等作用。脂联素及其受体在眼底新生血管性疾病中扮演了重要角色。目前尚不清楚脂联素在眼内是血管生成分子还是抗血管生成分子。了解脂联素及其受体在眼底新生血管性疾病的相关研究, 有望为眼底新生血管性疾病的预防与治疗提供潜在治疗靶点和新的思路。本文对脂联素及其受体在眼底新生血管疾病的作用进行综述。     

透出液蛋白丢失与连续性非卧床腹膜透析患者营养不良-炎性反应-动脉硬化综合征的相关性

Objective To investigate the impact of peritoneal albumin leakage on malnutrition-inflammation-atherosclerosis (MIA) syndrome in continuous ambulatory peritoneal dialysis (CAPD) patients. Methods A cross-sectional study of a cohort of 130 CAPD patients without edema or active infection was performed. In order to identify peritoneal transport characteristics in CAPD patients, a standard peritoneal equilibration test (PET) was carried out. For malnutrition and inflammation, serum albumin and high-sensitivity C-reactive protein (hs-CRP) levels were measured. Mean-carotid artery intima media thickness (IMT) was used to determine atherosclerosis. Residual glomerular filtration rate (rGFR) was defined as the average of 24-hour urinary urea and creatinine clearances. Results Pearson and Spearman correlation analysis showed that peritoneal albumin leakage amount was positively correlated with age, body mass index, night dwell time, blood glucose, 4 h D/P creatinine levels and hs-CRP levels (r=0.204, P<0.05 ;r=0.314, P<0.01; r=0.265, P<0.01; r=0.212, P<0.05; r=0.401, P<0.01; r=0.216, P<0.05); whereas it was negatively correlated with diastolic perssure, serum albumin levels, glucose level of dialyzate and peritoneal Kt/V (r=-0.209, P<0.05; r=-0.123, P<0.05; r=-0.271, P<0.01; r=-0.212, P<0.01). Overall, there was no correlation between peritoneal albumin leakage and IMT. Patients was significantly greater (P<0.01), and there was a positive correlation between peritoneal albumin leakage amount and IMT (r=0.650, P<0.01). Conclusions Peritoneal albumin leakage is significantly associated with peritoneal transport characteristics, malnutrition and inflammatory state in CAPD patients. High peritoneal albumin leakage amount is a risk factor for atherosclerosis in patients with rGFR less than 1 ml·min-1(1.73 m2)-1.     

透出液蛋白丢失与连续性非卧床腹膜透析患者营养不良-炎性反应-动脉硬化综合征的相关性

Objective To investigate the impact of peritoneal albumin leakage on malnutrition-inflammation-atherosclerosis (MIA) syndrome in continuous ambulatory peritoneal dialysis (CAPD) patients. Methods A cross-sectional study of a cohort of 130 CAPD patients without edema or active infection was performed. In order to identify peritoneal transport characteristics in CAPD patients, a standard peritoneal equilibration test (PET) was carried out. For malnutrition and inflammation, serum albumin and high-sensitivity C-reactive protein (hs-CRP) levels were measured. Mean-carotid artery intima media thickness (IMT) was used to determine atherosclerosis. Residual glomerular filtration rate (rGFR) was defined as the average of 24-hour urinary urea and creatinine clearances. Results Pearson and Spearman correlation analysis showed that peritoneal albumin leakage amount was positively correlated with age, body mass index, night dwell time, blood glucose, 4 h D/P creatinine levels and hs-CRP levels (r=0.204, P<0.05 ;r=0.314, P<0.01; r=0.265, P<0.01; r=0.212, P<0.05; r=0.401, P<0.01; r=0.216, P<0.05); whereas it was negatively correlated with diastolic perssure, serum albumin levels, glucose level of dialyzate and peritoneal Kt/V (r=-0.209, P<0.05; r=-0.123, P<0.05; r=-0.271, P<0.01; r=-0.212, P<0.01). Overall, there was no correlation between peritoneal albumin leakage and IMT. Patients was significantly greater (P<0.01), and there was a positive correlation between peritoneal albumin leakage amount and IMT (r=0.650, P<0.01). Conclusions Peritoneal albumin leakage is significantly associated with peritoneal transport characteristics, malnutrition and inflammatory state in CAPD patients. High peritoneal albumin leakage amount is a risk factor for atherosclerosis in patients with rGFR less than 1 ml·min-1(1.73 m2)-1.     

腹膜透析卫星中心项目专科护士培训需求及其培训效果

目的探讨腹膜透析卫星中心项目专科护士培训需求及其培训效果。方法采用自行设计问卷调查腹膜透析卫星中心腹膜透析专科护士的培训需求。根据卫星中心腹膜透析专科护士的培训需求,对本省13家腹膜透析卫星中心34名腹膜透析专科护士进行培训。了解培训前后腹膜透析护士关于腹膜透析理论和实践知识的考核情况。结果34名腹膜透析专科护士理论知识方面培训需求排在前3位分别是：腹膜透析相关并发症处理（97．1％）、培训内容与技巧（94．1％）、腹膜透析基础理论知识（91．2％）;临床实践方面培训需求排在前3位分别是：腹膜透析患者自我管理能力的培训（91．2％）、独立处理并发症（88．2％）、建立随访及科研档案（85.3％）。培训前后护士关于腹膜透析理论和实践知识掌握情况明显优于培训前（均P〈0．001）。结论腹膜透析卫星中心项目专科护士培训可提高腹膜透析专科护士的专科知识和实践技能。     

子宫内膜癌中bcl-2、ki-67、p53、C-erbB-2、ER、PR的表达及意义

目的探讨bcl-2、ki-67、p53、C-erbB-2、ER、PR的表达在子宫内膜癌中的意义。方法应用免疫组化二步法检测6种基因蛋白在118例子宫内膜癌、20例增生期子宫内膜组织中的表达情况。结果在子宫内膜癌组织中bcl-2、ki-67、p53、C-erbB-2、ER、PR、阳性表达率分别为80.0%、67.7%、44.1%、42.4%、64.4%和61.9%。ER、PR的表达与临床分期、病理分级有关,即分期、分级越高,表达越弱,差异有统计学意义(P<0.05)。C-erbB-2、ki67的表达与病理分级有关,即高分化,低表达,差异有统计学意义(P<0.05)。p53的表达随临床分期增高,分级的降低而升高;bcl-2随分期的增高而降低,但与分级无关。结论ER、PR的表达对临床选择内分泌治疗具有指导意义;C-erbB-2、p53、Ki-67、bcl-2的检测对评价子宫内膜癌的生物学行为及预后有意义。     

消化内镜中心手术治疗车的研制

目的介绍一种消化内镜中心手术治疗车的设计与应用。方法对目前内镜中心简单的治疗车进行改进,新增抽屉、柜子、载物格、翻转盒及托盘等。结果方便了内镜护士拿取和摆放附件,增加了护士工作效率。结论消化内镜中心手术治疗车实用、储物空间大、美观易清洁,应用于消化内镜中心的日常或急诊治疗工作,使内镜中心护士在配合治疗时使用方便、操作规范,减少交叉感染概率,有效地提高工作效率,提高了医护人员的满意度,更好的满足了消化内镜下治疗的需求。     

超声在胃癌术前分期诊断的应用

目的探讨超声在胃癌术前分期诊断的应用价值。方法对50例胃癌患者进行术前超声分期诊断并与手术病理进行对比分析。结果 B超胃癌分期诊断与术后病理符合率为80％,其中T1 N0M0～T3-4N1M0各期判断符合率分别为50％,73％,83％,100％。早期癌与进展期癌的胃壁厚度差异均有极显著性(P<0.01),但T1N0M0与T2N0M0之间差异无显著性(P>0.05),T3N0M0与T3-4N1M0差异有显著性(P<0.05)。结论超声对胃癌浸润深度的判断为胃癌术前分期提供了重要依据,对临床选择治疗方案和手术切除范围具有一定的指导意义。