广州市黄埔区居民精神卫生知识知晓率现状调查

目的了解黄埔区居民精神卫生知识的知晓情况,为进一步有针对性地开展宣传教育、普及精神卫生知识提供依据。方法采用分层整群抽样方法,抽取1683名15岁以上常住居民为调查对象进行精神卫生问卷调查。结果该区居民精神卫生知识平均知晓率为57.8%,平均得分女性(11.71±2.70)高于男性(11.41±2.46),差异有统计学意义(P<0.05);不同年龄段、不同职位类别以及所属不同街道的群体平均得分差异有统计学意义(P<0.01)。结论有必要进一步加大精神卫生知识普及,并关注60岁以上、已退休、无业及其他行业人员等群体。     

麻黄附子细辛汤联合盐酸西替利嗪对变应性鼻炎的疗效以及对生活质量的影响

为了探讨麻黄附子细辛汤联合盐酸西替利嗪治疗变应性鼻炎的效果。现将96例变应性鼻炎患者分为观察组和对照组,每组48例。对照组患者给予盐酸西替利嗪治疗,研究组在对照组的基础上,采用麻黄附子细辛汤治疗。7天为一个疗程,两组患者均治疗4个疗程。研究组患者治疗后症候积分、生活质量各方面评分和血清炎性因子水平均优于对照组(P＜0.05),研究组治疗总有效率为91.67%显著高于对照组的77.08%(P＜0.05)。可见麻黄附子细辛汤联合盐酸西替利嗪可以有效改善变应性鼻炎患者的临床症状,降低血清IgE、IL-4和IL-17水平,提高治疗效果,改善患者生活质量。     

高分辨磁共振成像对直肠癌术前TN分期的应用价值

目的 评价高分辨磁共振成像(HR-MRI)对直肠癌术前TN分期的应用价值。方法 分析61例经手术病理证实的直肠癌患者的术前资料,由两名高年资影像医师协商阅片,并与最终手术病理结果对照。应用SPSS13.0软件对所得数据进行一致性检验。结果 HR-MRI用于直肠癌术前TN分期时,与病理T分期结果一致性好(Kappa=0.900,P<0.01)、与病理N分期结果的一致性较好(Kappa=0.716,P<0.01),HR-MRI对T分期的准确率为96.72%(59/61),N分期准确率为83.78%(51/61)。结论 HR-MRI可用于对直肠癌术前TN分期的评估。     

活血化滞消瘤汤联合西医疗法治疗子宫肌瘤临床观察

目的:观察活血化滞消瘤汤联合西医疗法治疗子宫肌瘤临床疗效。方法:126患者随机分为观察组和对照组,各63例。对照组给予米非司酮治疗;观察组在对照组基础上给予活血化滞消瘤汤治疗。观察2组临床疗效,比较治疗前后雌二醇和孕酮浓度、子宫肌瘤体积和子宫体积变化情况。结果:总有效率观察组93.65%,对照组77.78%,2组比较,差异有统计学意义(P<0.05)。2组治疗前后雌二醇和孕酮比较,差异均有统计学意义(P<0.05);治疗后雌二醇、孕酮观察组与对照组比较,差异均有统计学意义(P<0.05)。2组治疗前后子宫肌瘤体积和子宫体积比较,差异均有统计学意义(P<0.05);治疗后子宫肌瘤体积和子宫体积观察组与对照组比较,差异有统计学意义(P<0.05)。结论:活血化滞消瘤汤联合西医疗法治疗子宫肌瘤临床疗效明显,能够缩小肌瘤体积,促进病灶吸收,显著降低雌二醇和孕酮的浓度。     

EGFR、Her-2、HIF-1α、p53对进展期食管鳞癌新辅助化疗疗效的预测价值

目的:探讨食管鳞癌相关因子EGFR、Her-2、HIF-1α和p53对进展期食管鳞癌新辅助化疗疗效的预测价值.方法:回顾分析日照市人民医院2011年1月-2015年1月行紫杉醇联合顺铂方案新辅助化疗的进展期食管鳞癌(Ⅲ期)患者94例,采用免疫组化方法检测食管鳞癌组织中EGFR、Her-2、HIF-1α和p53的表达情况,应用RECIST1.1标准和病理组织学相结合方法行化疗疗效评估,Logistic多因素回归分析各标与化疗疗效关系.结果:本研究组患者新辅助化疗总有效率为56.38％ (53/94),全部为部分缓解.疾病稳定占41.49％ (39/94),疾病进展占2.13％ (2/94).新辅助化疗前后各因子表达差异无统计学意义(均P ＞0.05).Her-2表达阳、阴者化疗有效率分别为81.82％ (9/11)、53.01％(44/83),两者比较差异有统计学意义(P=0.01).p53表达阳、阴者化疗有效率分别为31.37％(16/51)、86.05％(37/43),两者差异有统计学意义(P＜0.01).Her-2阳表达同时p53阴表达者7例,其中化疗有效5例.EGFR和HIF-1α表达与化疗敏感无关(P＞0.05).多因素分析显,Her-2和p53是新辅助化疗的独立影响因素(均P＜0.05).结论:Her-2和p53作为新辅助化疗独立影响因子,可在化疗前对疗效进行预测,可能对患者新辅助化疗选择提供临床依据.     

影像组学对进展期远端胃癌下切缘预测的应用研究

目的:评估术前增强CT影像组学特征对进展期远端胃癌术中下切缘阳性的预测价值。方法:回顾性分析183例进展期远端胃癌患者术前增强CT图像,在CT图像上沿病变边缘手动绘制感兴趣区域（ROI）,并提取影像组学特征。利用Pearson相关性分析和序列前向浮动选择（SFFS）算法筛选特征,并构建影像组学模型、验证模型可靠性。此外,还开发了临床病理学模型,运用受试者工作特征曲线（ROC曲线）及曲线下面积（AUC值）对两个模型诊断性能进行比较。结果:筛选出5种最优影像组学特征,构建的影像组学模型表现出良好的诊断性能（AUC值=0.79）,且比临床病理学模型稍好（临床病理学模型AUC值=0.61）。结论:影像组学模型在术前无创预测术中切缘状态方面表现出良好的潜力。     

上海地区638例输血后丙型肝炎病毒感染者的临床分析

目的 分析输血后丙型肝炎病毒(HCV)感染者的临床特征.方法 采用PCR检测HCVRNA载量,ELISA检测抗-HCV,分析输血后HCV感染者的年龄、原发病因、暴露年份、输血成分与输血量、潜伏期、肝功能损害和腹部超声图像改变等.结果 578例感染者中有525例(90.8%)HCV RNA载量≥3.0 log10 copy/ml(M=6.10 log10 copy/ml),其中19.2%病例为3.0～4.0log10 copy/ml、66.1%为5.0～6.0 log10 copy/ml,仅14.7%病例≥7.0log10 copy/ml.HCV RNA定性阳性率为81.5%(44/54),HCV基因型主要为1型,抗-HCV阳性率达99.8%(636/637),其阳性敏感率高于HCV RNA定量和定性检测(均为P=0.000).输血后HCV感染以40～60岁年龄段多见,85.7%病例的暴露时间为1990-1994年,10%以上的感染者中基础疾病为妇产科、骨科疾病和胃肠道出血,79.9%的病例为输入全血者,输血至临床诊断时间平均(8.5±5.5)年;90.1%感染者有肝功能损害,多数病例血清丙氨酸氨基转移酶(ALT)升高水平≤5×ULN,而血清总胆红素升高、ALT和天冬氨酸氨基转氨酶≥5×ULN水平者临床表现较多(P值分别为0.000、0.001和0.009);8.9%感染者腹部超声显示有肝硬化改变,但多见于感染期＞5年者.结论 输血后HCV感染主要集中于1990-1994年,成年人患病率较高,常伴有肝功能损害,感染期＞5年者肝硬化发生率较高,HCV基因型主要为1型,血清HCV RNA载量多为中等水平.

Abstract：

Objective To investigate me clinical-epidemiologic characteristics of patients with hepatitis C virus(HCV)infection by post blood transfusion.Methods Polymerase chain reaction (PCR)and enzynle linked immunosorbent assay(ELISA)were used to detect HCV RNA and anti.HCV,respectively.Analysis was performed on patients'age distribution,cause of primary diseases,years ofexposure,ingredient and amount of transfusion,incubation period,disorder on liver function and changes on abdominal ultrasound image,etc.Results HCV RNA levels were higher than 3.0log10 copy/ml in 90.8%infected patients、with a median as 6.10 log10 copy/ml.19.2%of the patients showed viral load 3.0 to 4.0 iog10 copy/ml,and 66.1%of them showed 5.0 to 6.0 log10 copy/ml.Only 14.7%of the infected persons had HCV RNA levels higher than 7.0 log10 copy/ml.Eighty-one point five percent(44/54)of the infected persons were confirmed as HCV RNA positive by HCV RNA qualitative analysis with HCV genotype as primarily type 1.99.8%(636/637)of the pmients were detected as anti-HCV positive by serological test.The sensitivity of serological test was higher than both quantitative and qualitative HCV RNA assays(P=0.000,P=0.000,respectively).HCV infection post blood transfusion was more seen in common people at 40 to 60 years old Most cases(85.7%)had their first exposure during 1990 to 1994.More than 10% of the cases had primary diseases aS obstetrics,orthopedics or gastrointestinal tract hemorrhage.79.9%of the patients received whole blood product transfusion.The mean interval between transfusion and clinical diagnosis was 8.5±5.5 years.90.1%of the infected patients had liver function damage,while most of them showed elevated alanine aminotransferase(ALT)no more than 5 upper limits of normal(ULN).wheteas Serum total bilirubin(TBIL).ALT and aspartate aminotransferase(AST)≥5×ULN level were showing more clinicaI manifestations(P=0.000.P=0.001,P=0.009,respectively).Abdominal ultrasound among 8.9%of the infected persons showed changes in cirrhosis,and most of them werc older than 50years of age.Conclusion Most of the post transfusion HCV infected cases happened in adulthood,and were mainly exposed during 1990 to 1994.Infected pmients usually had their liver function damaged with elevated ALT no more than 5×ULN and with medium HCV RNA levels.HCV genotype was mainly for type 1.Patients who weTe ofolder age showed higher incidence ofcirrhosis.If a patients'infection period Was longer than 5 years,he/she would show higher incidence of cirrhosis.     

糖尿病合并肺结核患者外周血的免疫功能探讨

目的探讨糖尿病(diabetes mellitus,DM)合并肺结核(tuberculosis,TB)病人外周血是否存在免疫缺陷。方法分离肺结核病人、糖尿病合并肺结核病人和健康人外周血单个核细胞,用1640完全培养基培养,加结核杆菌滤液刺激,48h后收集上清液,ELISA检测上清液中IL-12、IFN-γ、TNF-α和IL-10水平。诱导培养巨噬细胞,用巨噬细胞吞噬结核杆菌悬液,24h后裂解巨噬细胞培养未被杀灭的结核杆菌,10d后计数菌落数。结果①第9天巨噬细胞具有典型的结构特征。②DM+TB组巨噬细胞分泌TNF-α水平(597.5±69.1)pg/mL显著低于另两组[TB组(688.2±64.8)pg/mL,健康组(839.3±74.5)pg/mL],差异有统计学意义(F=18.48,P<0.05);TB组低于健康组,差异有统计学意义(P<0.05)。③DM+TB组巨噬细胞分泌NO水平(57.3±14.6)μmol/L显著低于另两组[TB组(83.5±23.3)μmol/L,健康组(108.9±22.3)μmol/L],差异有统计学意义(F=9.522,P<0.05);TB组低于健康组,差异有统计学意义(P...     

肾综合征出血热合并恙虫病12例临床分析

肾综合征出血热（HFRS）是由汉坦病毒感染所致的急性自然疫源性传染病,而恙虫病则是由立克次体引起的急性自然疫源性传染病。浙江省龙泉地区为此两种疾病的疫源地,但HFRS合并恙虫病则较少见,现将笔者近年来收治的HFRS合并恙虫病患者的临床资料作一回顾性分析,报道如下。     

Fluoroquinolone resistance and mutation patterns in <Emphasis Type="Italic">gyrA</Emphasis> and <Emphasis Type="Italic">parC</Emphasis> genes in <Emphasis Type="Italic">Neisseria gonorrhoeae</Emphasis> isolates from Shanghai,China

In order to study the resistance of Neisseria （N.） gonorrhoeae to the fluoroquinolone and detect mutation patterns of quinolone resistance-determining regions （QRDRs） of clinical isolates in Shanghai, China, a total of 80 clinical isolates of N. gonorrhoeae were consecutively collected from Shanghai. The MIC of fluoroquinolone for the isolates was examined by using the agar dilution method and the mutation profiles of the QRDRs of gyrA and parC were analyzed by sequencing and restriction fragment length polymorphism （RFLP）. Chi-square test was used for comparison of the t：nutation patterns. The results showed that： （1） High percentages of the 8 isolates were resistant to ciprofloxacin （95.0%）, ofloxacin （95.0%） and lomefloxacin （97.5%）, only one strain was susceptible to the ciprofloxacin. （2） Sensitive strains had a substitute of Asp95→Ala in the gyrA, and all isolates that were resistant or intermediated to the ciprofloxacin, had a double mutation in the gyrA （Ser91, Ala 92 and Asp95）. Some strains also had a mutation in the parC. （3） The MICs of these isolates were significantly associated with the mutation patterns in the gyrA and parC. A double mutation of gyrA combined with parC87 mutation was a predominant pattern in Shanghai and could mediate high level resistance to ciprofloxacin. It suggests that mutations in the QRDRs of gyrA and parC may be responsible for the fluoroquinolone resistance. And fluoroquinolone could not be used as the first line antibiotics for gonorrhea treatment any more in Shanghai, China.