抗包虫药物的实验研究

用小白鼠腹腔包虫动物模型,以囊肿平均重量、囊肿抑制率和血清抗体滴度为指标,筛选了中(包括藏医药)、西药共51种。实验结果表明,甲苯咪唑、直茎紫堇对囊肿的抑制率分别达89—98％和67—85％,有较好的抗包虫作用,血清抗体滴度都显著低于对照组。贯众、赛北紫堇、青蒿素、蒿甲醚、吡喹酮、芦荟、Cetrimide、喜树碱、埃紫堇、绿绒蒿、补骨脂、复方3号、29味能消散等13种药物初步显示有抗包虫作用,但需进一步重复。其它的36种药物,未见到有抗包虫作用。     

Homoharringtonine mediates myeloid cell apoptosis via upregulation of pro-apoptotic bax and inducing caspase-3-mediated cleavage of poly(ADP-ribose) polymerase (PARP)

Homoharringtonine (HHT) is a plant alkaloid with antileukemia activity that is currently being used for treatment of acute, chronic leukemias and MDS. In this study, we show that HHT can induce apoptosis in a variety of human myeloid leukemia cell lines (U937, HL-60, HEL, THP, and K562). U937 and HL60 cells undergo rapid apoptosis on treatment with HHT, as indicated by increased annexin V binding capacity, caspase-3 activation, and cleavage of poly(ADP-ribose) polymerase (PARP). In addition, the expression of bax is upregulated during HHT-induced cell death, whereas the expression of bcl-2 is only slightly decreased. Importantly, treatment of primary leukemic cells, obtained from acute myeloid leukemia patients, resulted in rapid apoptosis. Thus, our data provide the mechanism of HHT and justify the use of HHT in the treatment of human myeloid leukemia.     

丙型肝炎抗病毒治疗药物研究进展

我国丙型肝炎病毒（HCV）感染发病率较高,一般人群抗HCV阳性率为3．2％,总数超过4000万,多数演变成慢性感染者,目前对HCV感染尚无有效疫苗预防。HCV属于黄病毒科,基因组为单股正链RNA,易变异,分为6个基因型及58个不同亚型,我国以1b型HCV感染最常见。HCV感染后,病毒血症持续6个月仍未清除者为慢性感染。丙型肝炎慢性化率为50％。85％。感染后20年,肝硬化发生率为10％-15％。一旦发展成为肝硬化,肝细胞癌（HCC）的年发生率为1％-7％。     

Risk factors for urinary infection after retrograde upper urinary lithotripsy: Implication for nursing

There are needs to evaluate the risk factors for urinary infection after retrograde upper urinary lithotripsy, to provide insights into the management and nursing care of patients with retrograde upper urinary lithotripsy.Patients who received retrograde upper urinary lithotripsy with a Foley 20 urinary tube insertion from June 1, 2019 to December 31, 2020 in our hospital were selected. Patients were grouped urinary infection and no infection group according to the culture results of urine, and the clinical data of the 2 groups of patients were collected and compared. Single factor and logistic regression analysis were used to analyze the risk factors of urinary tract infection after retrograde upper urinary lithotripsy.Four hundred ten patients with retrograde upper urinary lithotripsy were included, of whom 62 patients had the urinary tract infection, the incidence of urinary tract infection was 15.12%. There were significant differences in the gender, age, diabetes, stone diameter, duration of urinary tube insertion and duration of surgery between infection and no-infection group (all P < .05). The Escherichia coli (62.90%) was the most commonly seen bacterial in patients with urinary tract infection. Female (odds ratio [OR]: 1.602, 95% confidence interval 95% [CI]: 1.132∼2.472), age >50 years (OR: 2.247, 95% CI: 1.346∼3.244), diabetes (OR: 2.228, 95% CI: 1.033∼3.451), stone diameter ≥2 cm (OR: 2.152, 95% CI: 1.395∼3.099), duration of urinary tube insertion ≥3 days (OR: 1.942, 95% CI:1.158∼2.632), duration of surgery ≥90 minutes (OR: 2.128, 95% CI: 1.104∼3.846) were the independent risk factors for the postoperative urinary tract infection in patients with retrograde upper urinary lithotripsy (all P < .05).The incidence of urinary tract infection in patients undergoing retrograde upper urinary lithotripsy was high, counteractive measures targeted on those risk factors are needed to prevent and reduce the postoperative urinary infection in clinical settings.     

脑内移植时星状胶质细胞的变化

本文用胶质纤维酸性蛋白免疫组织化学方法研究了帕金森氏病模型鼠、老年性痴呆模型鼠及皮质损伤鼠等在脑移植２～３个月后移植区及其与宿主交界面的胶质细胞变化。结果发现不同动物模型的胚脑移植区及其与宿主交界面的胶质变化基本相同．Ｎｉｓｓｌ染色切片上可见移植区和宿主之间有直径小于８μｍ的小细胞集聚。胶质纤维酸性蛋白免疫组织化学法发现移植区和宿主脑交界面有深染的阳性纤维及细胞或交界面形成一包膜状结构；还有的在交界面无明显的胶质纤维酸性蛋白阳性纤维分隔，呈现两者相互融合的趋势．移植区内可见两种胶质细胞，一种与正常胶质细胞近似，另一种为胞体大、突起粗且深染的反应性胶质细胞；移植区内的血管周围也见有反应性胶质细胞包绕。本研究表明移植也可引起胶质反应，并且移植区内反应性胶质细胞可能对植入的神经元提供其生存所需要的营养物质。     

Symptomatic and asymptomatic infections of rotavirus, norovirus, and adenovirus among hospitalized children in Xi'an, China

Rotavirus (RV), norovirus (NoV), and adenovirus (AdV) have been reported as the common viral pathogens of acute gastroenteritis in children. To determine the prevalence of RV, NoV, and AdV infections among hospitalized children with and without symptoms of acute gastroenteritis, fecal specimens, and data on clinical symptoms were collected from 201 children with diarrhea and 53 children without diarrhea admitted to the Xi'an Children's Hospital in Xi'an, China between March 2009 and May 2010. RV, NoV, and AdV were identified in 68.7% (138/201), 20.4% (41/201), and 5.0% (10/201), respectively, of children with diarrhea. These three viruses were also detected in 13.2% (7/53), 35.9% (19/53), and 9.4% (6/53), respectively, of children without diarrhea. Diarrheal children infected with RV alone showed the average severity score of 6.5, statistically significant higher than the average score of 5.3 in children with unidentifiable viruses. GII.3 and GII.4 were the only two NoV genotypes identified, and the GII.4 sequences were genetically close to GII.4 2006b cluster. These findings highlight the importance of NoV as a causative agent of pediatric diarrhea after RV based on the clinical and epidemiological characteristics of NoV infection, and particularly convey information of asymptomatic infections of enteric viruses in young children.     

单倍体相合异基因造血干细胞移植治疗白血病

背景：对于无HLA全相合同胞供者的患者,采用单倍体相合造血干细胞移植面临移植物抗宿主病重、移植相关死亡率高的风险,但通过不同的移植模式,将有可能获取相近的疗效。 目的：观察亲缘HLA单倍体相合异基因造血干细胞移植治疗白血病的疗效,并与亲缘HLA全相合异基因造血干细胞移植相比较。 方法：45例白血病患者分为2组。单倍体组移植方式为外周血或联合骨髓干细胞移植,预处理方案为改良白消安与环磷酰胺或加抗胸腺细胞球蛋白,移植物抗宿主病的预防采用环孢素A+甲氨蝶呤+霉酚酸脂;全相合组移植方式为外周血干细胞移植,预处理方案为BuCY,移植物抗宿主病的预防采用环孢素A+甲氨蝶呤。 结果与结论：两组均获得造血重建时间差异无显著性意义。单倍体及全相合组急性移植物抗宿主病的累积发病率分别为73%对52%(P > 0.05);慢性移植物抗宿主病的累积发病率分别为56%对45%(P > 0.05);移植相关死亡率分别为36%对17%(P > 0.05);单倍体组无复发,全相合组复发2例;两组的预计3年累积无病生存率分别为61%对60%(P > 0.05)。结果提示,亲缘单倍体异基因造血干细胞移植的总体疗效与亲缘全相合异基因造血干细胞移植相似,但中重度急性移植物抗宿主病的发生率较后者为高。     

基于两水平Logistic回归模型的资中县农村中学生抑郁症状相关因素

目的了解四川资中县农村中学生抑郁症状现状,分析其主要影响因素。方法于2015年10月采用典型抽样和整群随机抽样相结合的方法,选取资中县农村的2所乡镇中学,对初一和高一年级2744名学生(其中男生1308名,女生1436名;初中生554名,高中生2190名)进行自填式问卷调查(一般人口学特征、抑郁量表、自尊量表和心理弹性量表),随后每学期开展一次追踪调查。根据使用的3次调查数据(基线数据、1年后的第3次追踪数据、2年后的第5次追踪数据)层次结构的特点,采用两水平Logistic回归模型分析中学生抑郁症状的影响因素。结果资中县农村中学生整体抑郁症状检出率为30.5%(基线调查为26.7%,第3次调查为35.7%,第5次调查为29.8%),女生抑郁症状检出率30.3%高于男生22.9%(χ²=19.72,P<0.05)。影响四川农村中学生抑郁症状的主要因素有性别(β=0.201,P=0.001)、自觉老师喜欢与否(β=0.228,P=0.005)、自觉同学喜欢与否(β=0.488,P<0.001)、自觉与父母关系(β=0.201,P=0.001)、心理弹性的...     

表象训练在虚拟现实内镜模拟器培训胃镜初学者中的应用

目的:探讨表象训练在胃镜技能获得中的作用.方法:分层抽样法抽取我校08级临床医学专业男学员30人,随机分为3组.A组(n=10)在常规模拟器练习过程中加入表象训练,B组(n=10)进行常规模拟器练习,C组(n=10)不做任何练习.完成培训结束时所有学员操作病例1,模拟器给出的评分,比较3组间的考核评分.所有学员接受培训前、后心理测评,评价心理状态是否稳定.结果:比较3组考核成绩显示,3组间总分差异有统计学意义,3组组间两两比较显示差异有统计学意义,其中A组优于B组,A组优于C组,B组优于C组.进一步分析差异原因,结果表明,安全性评分和准确性评分、残气量评分、患者痛苦指数评分、操作时间评分A、B、C3组间差异均有统计学意义;而A、B组两组之间比较,只有残气量评分、操作时间评分差异有统计学意义.结论:表象训练可提高使用虚拟现实内镜模拟器培训胃镜技能的效果,教学方法容易实施,学员容易掌握,是一种可行性较高的教学辅助方法.     

9例自发性血气胸的诊治

目的:探讨自发性血气胸的治疗方法.方法:采用经腋下纵形小切口手术治疗自发性血气胸9例.结果:9例患者经腋下小切口手术均获成功,无并发症,无死亡率.结论:自发性血气胸采取积极的手术治疗为最佳治疗方法,经腋下小切口手术适合在基层医院广泛开展.