Hp感染的功能性消化不良腹痛症状与P物质、降钙素基因相关肽的关系

目的 初步探讨幽门螺杆菌(Hp)感染的功能性消化不良(FD)患者腹痛的发病机制.方法 根据罗马Ⅲ诊断标准,选择以上腹痛为临床表现的FD患者36例.胃镜下Hp快速尿素酶及C13尿素呼气试验将36例患者分为Hp(+)组(n=20)和Hp(-)组(n=16),同时选择12例健康人设立对照组.免疫组织化学法检测P物质(SP)、降钙素基因相关肽(CGRP)在各组组织中的密度值及明确SP、CGRP在细胞中的定位.视觉模拟评分将Hp感染的FD患者腹痛程度分为轻度、中度、重度,比较SP、CGRP在不同腹痛程度患者中的平均光密度值.结果 Hp(+)组SP、CGRP的平均光密度值高于Hp(-)组(SP:0.056±0.016 vs.0.027±0.009;CGRP:0.073±0.018 vs.0.034±0.009,P＜0.05).SP、CGRP在重度腹痛患者中的平均光密度值明显高于中度腹痛者(SP:0.074士0.011 vs.0.055±0.012;CGRP:0.094±0.005 vs.0.075士0.009,P＜0.05);中度腹痛患者的平均光密度值明显高于轻度腹痛者(SP:0.055±0.012 vs.0.043±0.008;CGRP:0.075±0.009 vs.0.054±0.010,P＜0.05).显微镜下观察到CGRP位于胃窦腺上皮细胞胞质内,SP同样位于胃黏膜细胞胞质.结论 Hp感染的FD患者腹痛与SP、CGRP有关.     

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。     

模拟失重膳食Fe摄入及血清蛋白含量的变化

目的　探讨模拟失重膳食 Fe摄入量及蛋白质含量的变化 .方法　受试者 - 6°头低位卧床 2 1d,用称量法观察其营养素及 Fe摄入量的变化 ,并于卧床前 2 d,卧床 1,11和 2 1d测定血红蛋白 (Hb) ;用双缩脲法及溴甲酚绿法分别测定血清总蛋白及白蛋白含量 .结果　膳食 Fe摄入量 2 wk开始降低 16 % ,3wk后基本恢复 ,血清总蛋白也在 2 wk降低 5 % (P<0 .0 5 ) ,3wk回升 ,Hb不受影响 .结论　模拟失重对膳食Fe摄入量及总蛋白含量有短期影响 ,经过适应期后可恢复到正常范围     

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。     

压力接种训练对改善社区留守老年糖尿病患者低血糖恐惧的效果

目的 探讨压力接种训练在社区留守老年糖尿病患者低血糖恐惧中的应用效果。 方法 将长春市6个社区中存在低血糖恐惧的留守老年糖尿病患者126例随机分为对照组与观察组各63例,对照组给予常规心理干预,观察组在常规心理干预的基础上实施压力接种训练。比较两组干预前及干预8周后的低血糖恐惧评分及血糖水平。 结果 干预后观察组低血糖恐惧得分及空腹血糖、餐后2 h血糖、糖化血红蛋白显著低于对照组（均P＜0.01）。 结论 压力接种训练可降低社区留守老年糖尿病患者低血糖恐惧,改善患者血糖水平。