食管癌防治的新策略

目的：寻找降低食管癌高发区食管癌发病率和死亡率的有效方法。方法：对重度不典型增生的人群根据病理学、细胞学和γ-GT反应的不同进行了三年的研究。结果：γ-GT阴性反应者和40岁以下伴γ-GT阳性的患者未发生癌变，γ-GT阳性伴重增I级患者的癌变率为5.7%，而γ-GT阳性伴重增Ⅱ级患者的癌变率为14.3%，结论：食管癌高发区的预防应以γ-GT转阴而定。在食管癌预防中应将重增患者依据γ-GT反应进行分类，仅对γ-GT阳性伴重增的患者进行干预，可明显提高食管癌防治中的效价比。此方法简单且符合中国国情。     

Survival rate,causes of death,and risk factors in systemic sclerosis: a large cohort study

To investigate the clinical pattern, survival rate, causes of death and risk factors in a large cohort of Chinese Han patients with systemic sclerosis (SSc). Inpatients treated from 2002 to 2014 were included in this study. Patients were classified into diffuse cutaneous SSc (dcSSc), limited cutaneous SSc (lcSSc), and SSc-overlap syndrome groups. Data were analyzed using Chi-squared tests, Kaplan–Meier curves, log-rank tests, and Cox proportional hazards modeling. Among a total of 201 patients, dcSSc (50.2%) was the major subtype, followed by lcSSc (30.3%) and SSc-overlap (19.4%). Interstitial lung disease (ILD, 148/201, 74%) was the most frequent organ involvement. The overall survival rates were 98% and 95% at 5 and 10 years, respectively. The overall standard mortality ratio (SMR) was 2.22. The most common cause of death was ILD combined with infection (8/16, 50%), followed by kidney failure (2/16, 12.5%). On crude analysis, pulmonary hypertension, ILD, cardiac involvements, renal involvements, and digital ischemia were associated with poor prognosis. On multivariate analysis, pericardial effusion (p?=?0.000) and digital ischemia (p?=?0.016) were independent prognostic factors of death. The mortality rate of patients with SSc is mildly increased in comparison with the general population. ILD is the most common systemic involvement and the principal cause of death in SSc. Pericardial effusion and digital ischemia are independent factors associated with death.     

山东省嘉祥县氟骨症X线检测及征象分析

目的探讨氟骨症前臂骨、小腿骨X线征象及其发展的规律。方法应用改装的F30型-30mAX线机在地方性氟中毒病区村进行流动检查，氟骨症诊断标准依照（WS192—1999）执行。结果嘉祥县4个监测点X线摄片94人，确诊氟骨症48例（51．06％），其中轻度27例，中度13例，重度8例。X线异常变化规律为前臂骨改变早于小腿骨，前臂桡骨改变早于尺骨，小腿胫骨改变早于腓骨；各骨（长骨）骨间膜骨化及骨小梁、骨密度改变发生早、且病变程度重。结论氟骨症X线诊断特别是早期诊断应侧重和把握前臂及其桡骨的特异征象。     

研究分析糖尿病足患者接受截肢手术后临床护理干预对于血糖调控的影响情况

目的研究分析糖尿病足患者接受截肢手术后临床护理干预对于血糖调控的影响情况。方法选取该院收治的122例接受截肢手术治疗的糖尿病足患者开展该次试验研究,纳入时间为2018年4月—2019年4月,所有患者通过数字表法进行平均分组,分别为参照组61例和研究组61例。其中参照组给予常规临床护理干预,研究组给予综合临床护理干预,比较两组患者的血糖控制情况及不良心理改善情况。结果护理前两组患者的空腹血糖指标和餐后2 h血糖指标基本一致(P>0.05),护理后研究组患者的空腹血糖指标和餐后2 h血糖指标均明显低于参照组(P<0.05);护理前两组患者的SAS评分与SDS评分基本一致(P>0.05),护理后研究组患者的SAS评分与SDS评分均明显低于参照组(P<0.05)。结论在接受截肢手术糖尿病足患者的护理工作中应用综合临床护理干预能够有效对患者血糖水平进行调控,能显著改善患者的不良情绪,有利于提升整体预后效果.     

Angiogenesis in chronic myeloproliferative diseases detected by CD34 expression

Increased bone marrow angiogenesis estimated as bone marrow microvessel density (MVD), or as serum angiogenic factor levels and/or immunohistochemical expression of these factors in bone marrow biopsy has been demonstrated in a variety of hematological disorders including chronic myeloproliferative diseases (MPDs). The aim of this study was to investigate the MVD in 25 cases of myelofibrosis with myeloid metaplasia (MMM). MVD was estimated by CD34 immunohistochemical expression in bone marrow biopsies. A control group of 27 patients without bone marrow disease, eight cases of polycythemia vera (PV), 41 cases of essential thrombocythemia (ET) and nine cases of chronic myeloid leukemia (CML) were also studied. Moreover, in cases with MMM, MVD was correlated with clinical, laboratory, histological parameters and the outcome of the patients. Our study confirmed a significantly higher degree of angiogenesis in MMM, PV, ET and CML compared with controls (P < 0.001, P = 0.0007, P < 0.001 and P = 0.0008, respectively). Angiogenesis was higher in MMM than PV, ET and CML cases (P < 0.001, P < 0.001 and P = 0.008). Increased angiogenesis was correlated with hypercatabolic symptoms in MMM patients (P = 0.009). No correlation with other clinicopathological parameters or clinical outcome was found. However, definitive conclusions regarding the prognostic value of increased angiogenesis may require additional follow-up and a larger group of patients.     

A seven-year study on an integrated hospital-community diabetes management program in Chinese patients with diabetes

Aims

To assess whether an integrated hospital-community diabetes management program could improve major cardiovascular risk factor control among patients with diabetes in real-world clinical settings.

Quantitation of CD 44 in tumor cells and peripheral blood of patients with gastric cancer

ＱｕａｎｔｉｔａｔｉｏｎｏｆＣＤ４４ｉｎｔｕｍｏｒｃｅｌｓａｎｄｐｅｒｉｐｈｅｒａｌｂｌｏｏｄｏｆｐａｔｉｅｎｔｓｗｉｔｈｇａｓｔｒｉｃｃａｎｃｅｒＺＨＡＯＪｕｎ，ＰＡＮＸｕｅａｎｄＹＩＮＧｅＰｉｎｇＳｕｂｊｅｃｔｈｅａｄｉｎｇｓｒｅｃｅｐｔｏｒ...     

弓形虫感染对雄性小鼠睾丸细胞周期影响的实验研究

目的　研究弓形虫感染对雄性小鼠睾丸组织细胞周期的影响。方法　应用流式细胞术检测弓形虫感染10 3/ ml、10 4 / ml、10 6 / ml3个剂量组小鼠睾丸组织细胞周期,并设立生理盐水和环磷酰胺对照组。结果　不同剂量的弓形虫感染均可使小鼠睾丸组织细胞各时相的细胞百分数发生变化,并随着剂量的增加,G0 / G1 、S时相的细胞百分数明显减少,与阴性对照组比较差异有显著性(P<0 .0 5 )。G2 / M时相的细胞百分数逐渐增多,各剂量组与阴性对照组比较差异有显著性(P<0 .0 5 )。结论　弓形虫感染可能抑制小鼠睾丸细胞的DNA合成,可引起G2 期细胞阻滞,从而使细胞的有丝分裂延伸。     

新基因TAHCCP1编码蛋白对NS3TP6基因启动子转录活性的调节

目的探讨丙型肝炎病毒（HCV）核心蛋白反式激活基因TAHCCP1编码蛋白对NS3TP6启动子转录活性的调节。方法以我室前期克隆的TAHCCP1基因表达谱芯片结果为基础,利用生物信息学方法确定NS3TP6基因的启动子区域（NS3TP6-p）,聚合酶链反应（PCR）扩增并克隆至真核报告载体pCAT3-basic中,构建重组报告质粒pCAT3-NS3TP6-p;以该质粒单独或与pcDNA3．1（-）-TAHCCP1共转染肝癌细胞系HepG2细胞,用酶联免疫吸附法（ELISA）检测氯霉素乙酰转移酶（CAT）的表达活性;观察细胞中表达的TAHCCP1蛋白对NS3TP6启动子转录活性的调节。结果构建的重组表达载体pCAT3-NS3TP6-P在HepG2细胞中能够启动报告基因CAT表达,表明克隆的NS3TP6启动子有指导下游基因转录表达的活性;共转染实验中pCAT3-NS3TP6-p与pcDNA3．1（-）-TAHCCP1组CAT的表达活性是对照组的3．1倍,说明TAHCCP1蛋白能够在转录水平反式激活NS3TP6基因启动子活性。结论本实验验证了基因芯片的实验结果准确性,进一步完善了新基因TAHCCP1的生物学功能,为深入理解HCV核心蛋白的反式激活调节机制提供了新的依据。     

分枝杆菌胞壁融合表达Ag85B-ESAT-6穿梭质粒的构建

目的　构建E coli BCG(BacilleCalmette Guerin)穿梭载体 ,在母牛分枝杆菌细胞壁融合表达结核分枝杆菌 (MTB)的分泌蛋白Ag85B ESAT 6。方法　用聚合酶链反应 (PCR)从MTB毒株H3 7Rv基因中扩增出结核分枝杆菌 190 0 0抗原 ( 19 ss)胞壁区及其上游调控元件基因 ,克隆入E coli BCG穿梭载体 pOLYG中 ,构建表达蛋白能嵌入细胞壁中的E coli BCG穿梭载体。用间接免疫荧光染色法观察该载体携带所构建的结核分枝杆菌分泌蛋白Ag85B和ESAT 6基因在母牛分枝杆菌宿主中的融合表达。结果　经测序证实所克隆的 19 ss基因序列正确 ,所构建的E coli BCG穿梭载体 (pCW )能完成在大肠杆菌和母牛分枝杆菌细胞之间的穿梭 ,经免疫荧光检查外源基因Ag85B ESAT 6可融合表达于分枝杆菌宿主表面。 结论　本方法可成功构建能够在分枝杆菌胞壁融合表达MTB分泌蛋白Ag85B ESAT 6的E coli BCG穿梭质粒