碘摄入量对大鼠钠/碘转运体分布及表达影响

目的 利用组织芯片分析钠/碘转运体(Na⁺/I-symporter,NIS)在不同碘摄入量下的大鼠组织器官的分布及表达.方法 Wistar大鼠随机分为3组,分别给予低碘(LI)、正常碘(NI)和高碘(HI)饮食,饲养3个月测定尿碘及制备不同碘摄入量大鼠组织器官的组织芯片,利用免疫组织化学的方法观察NIS的分布和表达.结果 LI组、HI组与NI组大鼠的尿碘含量中位数分别为1.7,305.8,28 056.5mg/L,LI组、HI组与NI组比较差异均有统计学意义(P<0.001);与NI组比较,LI组NIS在甲状腺滤泡上皮细胞基底膜上强表达,而HI组表达较弱;相反,NIS在组肾HI小管上皮细胞基底膜和胞头均有较强表达,而LI组相对较弱表达.结论 NIS不均一性分布于大鼠各组织器官,且碘摄入量可引起甲状腺和肾脏等组织NIS表达量的改变.     

血清高迁移率族蛋白1、可溶性CD163分子、粒细胞集落刺激因子对新生儿重症肺炎的预后评估价值

目的 观察新生儿重症肺炎患者血清高迁移率族蛋白1(high mobility group box-1 protein, HMGB1)、可溶性CD163分子(soluble CD163 molecule, sCD163)、粒细胞集落刺激因子(granulocyte colony-stimulating factor, G-CSF)水平,并分析其临床意义。 方法 选取2016年2月—2017年5月在周口市中心医院接受治疗的90例新生儿肺炎为研究对象,根据其病情程度分为重症肺炎组(35例)和轻症肺炎组(55例),并根据患儿的预后分为好转组(80例)和恶化组(10例),观察重症和轻症患儿、好转和恶化组患儿血清HMGB1、sCD163、G-CSF、炎症因子水平的差异,以及重症肺炎患儿HMGB1、sCD163、GC-SF与炎症因子水平的相关性。 结果 重症肺炎组患儿的HMGB1、sCD163、G-CSF、IL-6、IL-8、hs-CRP和TNF-α水平分别为(5.38±1.02)ng/ml、(95.67±6.43)U/ml、(15.24±2.43)μg/L、(48.37±4.35)mg/L、(755.28±15.85)pg/ml、(22.15±2.13)mg/L、(52.37±6.43)ng/L,均高于轻症肺炎组,差异均有统计学意义(P<0.05);好转组患儿血清HMGB1、sCD163、G-CSF、IL-6、IL-8、hs-CRP和TNF-α水平分别为(2.02±0.46)ng/ml、(28.65±3.12)U/ml、(7.44±1.56)μg/L、(22.35±3.02)、(108.97±12.15)、(11.33±2.01)mg/L、(20.14±2.76)ng/L,均低于恶化组患儿,差异均有统计学意义(P<0.05);重症肺炎组患者的HMGB1、sCD163、G-CSF水平与炎症因子水平正相关(均P<0.05)。 结论 新生儿重症肺炎患者的HMGB1、sCD163、G-CSF水平较高,与IL-6、IL-8、hs-CRP和TNF-α水平正相关,且与患者的预后密切相关,具有较好的临床应用价值。     

妊娠合并糖尿病内科治疗回顾分析

目的观察妊娠合并糖尿病的内科治疗效果。方法选取该院在2013年3~7月收治的妊娠合并糖尿病患者68例作为该次研究的实验组,并且选取同期接受治疗的正常产妇作为对照组,对实验组采用综合的内科治疗,比较两组产妇出现并发症的情况。结果两组产妇出现妊高症、低血糖、巨大儿、感染等并发症无显著差异。结论在妊娠合并糖尿病患者采用早期的内科治疗可以减少并发症出现的风险,对于产妇进行血糖控制和饮食的控制可以显著的治疗患者的病情,可以在临床治疗中推广和应用。     

流行性出血热并发严重心律失常致阿-斯综合征1例

患者，男，42岁。因发热、头痛、腰痛、尿少3d入院。体检：T37．4℃，P68次／min，BP80／50mm Hg（1mm Hg=0．133kPa）。神志清楚，精神萎靡不振，呈重症病容，两腋下、前胸、后背皮肤抓痕样、点状出血点，两眼睑及球结膜充血水肿，两肺下野呼吸音粗糙。心音低钝，心率68次／min，节律规整。双肾区叩击痛（＋）。血WBC11．0×10^9／L，N0．81，L0．13，[第一段]     

依诺沙星注射液治疗盆腔炎的临床观察

目的评价依诺沙星注射液治疗盆腔炎的疗效和安全性。方法用随机单盲对照试验设计,共治疗100例患者,随机分为试验组及对照组各50例,试验组静脉滴注依诺沙星400 mg(200 mL),每天1次共10 d,对照组静脉滴注左氧氟沙星注射液400 mg(200 mL),每天1次共10 d。结果试验组总有效率为84%,对照组为82%。试验组不良反应发生率为4%,对照组为4%。结论依诺沙星治疗盆腔炎的疗效较好,可推广使用。     

产科子宫切除术38例原因分析

目的探讨降低产科子宫切除术及并发症发生的可能性。方法对我院近14年所行的38例产科子宫切除术作回顾性分析。结果产科子宫切除术发生率0．13％，其中剖宫产子宫切除占71．1％，阴道分娩子宫切除占23．7％，引产子宫切除占5．2％。子宫切除术主要指征：胎盘因素、子宫收缩乏力、子宫破裂、羊水栓塞、妊娠急性脂肪肝。结论做好孕产妇保健和计划生育，提高产科工作质量，正确掌握剖宫产手术指征，可以有效地降低产科子宫切除率。     

新疆阿克苏地区重点人群碘营养和智力水平调查

Objective To investigate the iodine nutritional status of school children, lactating women and infants in iodine deficient areas of Baicheng and Wushi Counties in Xinjiang Autonomous Region. Methods According to the geographic location of east, south, west and north of county, 10 primary schools of 8 townships were selected. In each school, 10 children among each gender and age group from 8 to 10 years old were selected. A total of 300 school children were chosen. One hundred and four infants aged 0-2 years old and their mother were selected in 8 townships. Iodine content in edible salt at household level, the urinary iodine in school children and lactating women, total goiter rate(TGR) and the status of the intelligence quotient (1Q) of school children, the status of psychological development of infants were observed. Direct titration assay for testing the salt iodine, colorimetric ceric-arsenic assay and vitriolic ammonium assimilation were used for testing urinary iodine. The size of thyroid gland was measured by palpation. The Combined Raven Test for Chinese Rural was used to test the IQ. The psychological development of infants was tested by Danver Development Screening Test (DDST). Results The coverage rate of iodized salt at household level was 73.1% (123/182), however, the proportion of households using adequately iodized salt was 64.1% (118/182). The medium of urinary iodine in school children was 103.7 μ/L, with 47.8%(75/157) less than 100 μg/L and 28.0% (44/157) less than 50 μg/L; it was 123.0 μg/L in Baieheng County, with 44.4%(28/63) less than 100 μg/L and 33.3%(21/63) less than 50 μg/L; it was 100.3 μg/L in Wushi County, 50.0%(47/94) less than 100 μg/L and 24.5%(23/94) less than 50 μg/L. The medium of urinary iodine in locating women was 143.3 μg/L, it was 119.7 μg/L and 184.6 μg/L in Baicheng and Wushi Counties, respectively. The total rate of goiter in school children was 14.3%(43/300), it was 10.8%(13/120) and 16.6%(30/180) in Baicheng and Wushi Counties, respectively. The average IQ in school children was 80.6±11.6, it was 83.0±11.6 and 79.0±11.7 in Baicheng and Wushi Counties, respectively. The proportion of mental retardation in school children (IQ≤69) was 13.0% (39/300), it was 6.7% (8/120) and 17.2%(31/180) in Baicheng and Wushi Counties, respectively. In addition, the proportion of psychological development in infants being normal, suspicious and abnormal was 78.8%(82/104), 12.5% (13/104) and 8.7%(9/104), respectively. Conclusion This study confirms the fact that there is also existence of mental retardation in children and infants, caused by iodine deficiency.     

经胆道镜取石术与消炎利胆片治疗老年肝胆结石对患者血清 Ins、C-P、HA水平的影响

目的：探讨经胆道镜微创取石术与消炎利胆片治疗老年肝胆结石对患者血清Ins、C-P、HA水平的影响差异。方法将212例老年肝胆结石患者随机分为研究组与对照组各106例。对照组在常规药物治疗基础上口服消炎利胆片;研究组行经胆道镜微创取石术。比较2组患者治疗前、后第3、7、14天时胰岛素（ Ins）、C-肽（ C-P）、透明质酸（ HA）水平的变化。结果随着对患者治疗时间的延长,2组患者血清中Ins、C-P、HA三者水平均有所降低。治疗第3天时,研究组患者的血清Ins、C-P、HA水平均低于对照组,但差异无统计学意义（ P＞0．05）。2组治疗后第7、14天时,血清Ins、C-P、HA水平均显著性的低于治疗前,且研究组低于对照组,差异均有统计学意义（P＜0．05）。结论微创取石术治疗老年肝胆结石,可降低患者血清Ins、C-P、HA水平,疗效优于单纯微创取石术。     

高龄患者人工髋关节置换术围手术期的护理体会

目的总结高龄患者人工髋关节置换术围手术期的护理体会。方法选取2013年1月—2017年6月行人工髋关节置换术的患者25例,由护理组对患者提供全程个体化护理模式,术前给予心理护理、饮食护理、肺功能护理等,术后给予疼痛护理、专科护理、预防并发症、患肢功能锻炼和出院指导。结果 25例患者均痊愈出院,住院17~32 d,术后2例切口延迟愈合,经护理后切口疤痕愈合。结论人工髋关节置换术是治疗高龄患者髋关节疾病的安全有效的方法,通过围手术期精心护理,可促进患侧髋关节功能恢复,提高患者的生活质量。