白细胞进入腹腔是引起蛋白质经腹腔丢失的关键

目的为了研究细菌性腹膜炎时经腹腔蛋白质丢失的机制,阐明白细胞移行与蛋白质丢失的关系。方法给兔腹腔内注射大肠杆菌(E.coil)4×106CFU+生理盐水(35ml/kg),做成急性腹膜炎动物模型。通过测定实验6或8h期间腹透液中白细胞总数(WBC)及中性粒细胞(PMNs)计数情况以及腹膜对蛋白质的通透性(蛋白质D/P比值)。设立了两个系列的实验系列一,应用氮介(mustine),1.2mg/kg,实验前3天静脉注射,以耗尽循环血中的白细胞;系列二,用单克隆抗体(mAb)60.32mg/kg,实验前5min静脉注射,以阻滞PMNs上的粘附分子CD18,从而抑制PMNs向腹腔移行。同时设立了阳性对照组(即腹膜炎组)及阴性对照组(无腹膜炎组)。结果系列一中mustine降低87%循环血中白细胞及93%循环血中PMNs,此时即使腹腔内注射细菌,白细胞向腹腔的移行及腹腔蛋白质的渗出均较未注射mustine的腹膜炎组明显降低,而与无腹膜炎的正常对照组结果相似。系列二,静脉注射mAb60.3同样也明显降低白细胞及PMNs向腹腔的移行及经腹腔蛋白质的丢失。结论急性细菌性腹膜炎时白细胞向腹腔移行导致了经腹腔蛋白质的丢失。     

中药治疗脂肪肝57例临床体会

1　临床资料1 .1　一般资料　共 57例 ,其中男 42例 ,女 1 5例 ,年龄最小 2 9岁 ,最大 69岁 ,病程 1个月～ 8年。脂肪肝诊断分轻、中、重三度 ,57例中重度脂肪肝 2 5例 ,中度脂肪肝 32例 ,未将轻度脂肪肝患者纳入观察病例中。伴有糖尿病者 8例 ,有肝炎病史 1 2例 ,胃炎病史 32例 ,血脂升高者 47例 ,43例患者有长期嗜酒的习惯。1 .2　病例纳入条件　共 57例患者均具备以下条件 :(一 )临床表现 :乏力 ,纳差 ,右上腹不适 ,胀闷或胀痛 ,可伴腹胀 ,肋下可及肝脏或未及。 (二 )均有肝功能异常。 (三 ) B超或 CT检查均呈典型的脂肪肝表现 ,且按 B…     

Left atrial appendage perforation with Watchman device implantation: Strategies for surgical repair

Percutaneous occlusion of the left atrial appendage is increasingly being used as an alternative for stroke prevention in patients with non‐valvular atrial fibrillation at high risk of complications from long term anticoagulation. We describe a case of left atrial appendage perforation during Watchman device implantation requiring emergency repair of the left atrium using sternotomy and cardiopulmonary bypass. Technical considerations for surgical decision making are discussed; in hemodynamically unstable patients as well as those at high risk for embolization.     

The impact of the COVID-19 pandemic on the mental health of young people: A comparison between China and the United Kingdom

Purpose: As COVID-19 spreads globally and affects people''s health, there are concerns that the pandemic and control policies may have psychological effects on young people (age from 17 to 35 years). This psychological impact might vary in different countries, and thus we compared the prevalence of selfreported psychological distress, loneliness and posttraumatic stress symptoms (PTSS) among young people in the United Kingdom (UK) and China at the beginning of the COVID-19 pandemic. Methods: Data of this study came from two sources. One source was the first wave of COVID-19 study in Understanding Society, a special wave of the UK household longitudinal study, which provided the highquality, national-wide representative panel data. The sample comprised 1054 young people. The other source was an online survey on the mental health of 1003 young people from Shanghai, a highly developed area in China. The questionnaire included questions on the prevalence of common mental disorders (cut-off score ≥ 4), loneliness and potential PTSS (cut-off ≥ 33). Univariable analyses were conducted to test the differences in the self-reported prevalence of psychological distress and loneliness between the two groups. Multivariable logistic regression analyses were run to explore the predictors of psychological distress and loneliness among all the young people from England and Shanghai. Results: Among the samples with self-reported psychological distress, the UK sample accounted for 34.4% (n = 1054) and the Chinese sample accounted for 14.1% (n = 1003). The difference between the two groups was statistically significant (p < 0.001). Additionally, 57.1% of people in the UK and 46.7% in China reported that they sometimes or often felt lonely, of which the difference is statistically significant (p < 0.001). Regression analysis of the entire samples showed that nationality, gender, psychotherapy and loneliness were significant predictors of 12-item General Health Questionnaire scores, while the variables of age and living alone were not. Significant predictors of self-reported loneliness were the nationality, gender, age, living alone and psychotherapy. In China, 123 (12.3%) young people, 49 men (11.3%) and 74 women (13.0%), met the criteria of PTSS symptoms (cut-off scores ≥ 33). These scores were only collected in China. Conclusion: This evidence suggests that mental health and loneliness reported by young people were lower in China than that in the UK during the studied period. More research is needed to understand these differences. If the differential negative psychological impacts are confirmed, country-specific measures of prevention and intervention should be adopted to improve the mental health of young people under the ongoing impact of the pandemic.     

益肾化湿颗粒联合达格列净治疗糖尿病肾病脾肾气虚证临床研究

目的：观察益肾化湿颗粒联合达格列净治疗糖尿病肾病（DN） 脾肾气虚证的临床疗效及对血小板 反应蛋白1（TSP-1）、可溶性Axl 受体酪氨酸激酶（sAxl） 水平的影响。方法：采用随机数字表法将88 例DN 脾肾气虚证患者分为对照组与观察组各44 例。对照组给予单纯达格列净治疗,观察组给予益肾化湿颗粒联合 达格列净治疗。比较2 组治疗前后中医证候积分、肾脏功能指标、血糖指标、TSP-1、sAxl 水平,评估2 组临 床疗效及不良反应发生情况。结果：治疗后,观察组总有效率93.18%,高于对照组77.27%（P＜0.05）。治疗 后,2 组中医证候积分、尿白蛋白/肌酐比值（UACR）、尿白蛋白排泄率（UAER）、空腹血糖（FBG）、餐后2 h 血糖（P2hBG）、糖化血红蛋白（HbA1c）、TSP-1、sAxl 水平均低于治疗前（P＜0.05）, 肾小球滤过 率（eGFR） 水平高于治疗前（P＜0.05）,且观察组治疗后UACR、UAER、TSP-1、sAxl 水平及血糖指标均低 于对照组（P＜0.05）,eGFR 水平高于对照组（P＜0.05）。2 组不良反应发生率比较,差异无统计学意义（P＞ 0.05）。结论：益肾化湿颗粒联合达格列净治疗DN 脾肾气虚证疗效显著,能有效改善患者肾脏功能,控制血 糖,降低TSP-1、sAxl 水平,安全性较高。     

直接法与统计法测试松质骨孔隙率的比较研究

目的 探讨松质骨孔隙率的测试方法。方法 对15根猪胫骨分别采用“直接法”与“统计法”测试松质骨孔隙率或其表观密度和材料密度。结果 （1）孔隙率与表观密度呈非常显著负相关,而与材料密度相关不显著;（2）孔隙率沿轴向靠近密质量骨逐渐减小,而沿横向基本不变;（3）统计法可测出松质骨各个层面的孔隙率大小。结论 直接法和统计法均能检测松质骨孔隙率,但统计法较直接法更能反映孔隙率的分布与变化规律。     

多普勒组织显像评价高血压病心房内传导间期变化与房性心律失常的关系

目的　应用多普勒组织显像评价高血压病心房内传导间期变化与房性心律失常的关系 ;方法　利用超声多普勒组织显像法测量了 2 0例高血压病心房内传导间期与正常人对比分析 ;结果　高血压病心房内传导间期存在异常 ,心房内传导间期与左房内径大小无相关 (r =0 1,P >0 2 5 ) ,与左室舒张功能指标E A比值中度相关 (r=0 5 7,0 0 1

0 2 5 ) ;结论　高血压病房性心律失常与心房内传导异常及左室舒张功能有关 ,多普勒组织显像法是一种较好的测量高血压病心房内传导间期的方法     

列车乘务员SCL—90评定结果分析

采用ＳＣＬ—９０症状自评量表对某铁路分局４６７名列车乘务员的心理卫生状况进行了分析。结果显示总均分、阳性症状均分、阳性项目数、九组症候群因子分、达到或超过中等严重程度的发生频数均显著高于对照组。经多元逐步回归分析,仅细菌总数和二氧化碳对列车乘务员心理卫生状况有一定影响,其原因多与工作环境的不良因素和工作性质有关。     

高压下滴流床反应器动持液量的测定

在常压－２．０ＭＰａ的系统压力下测定了滴流床中气－液两相并流下流动的动持液量,了气－液流率,液相粘度,填料大小,压力以及床层高度对动持液量的影响。实验结果表明增中液体流率动持流量增加,气体流率增加时,结果相反粘度的增加对动持液量的影响不大,动持液量随填料空隙率的增大而变小。     

鼻咽癌中与已知基因同源的差异表达cDNA序列

采用新近发展的ｃＤＮＡ代表性差异分析法筛选鼻咽癌中不表达的或表达降低的ｃＤＮＡ序列。结果显示：有９个与已知基因高度同源的ｃＤＮＡ序列。通过对这些已知基因的结构和功能分析,发现有与细胞骨架成分相关的基因：αａｃｔｉｎｉｎ,ｅｚｒｉｎ和细胞角蛋白１３;直接与瘤基因和抑瘤基因相互作用的基因：鲨烯合成酶和ＴＲＩＰ１基因;直接参与ＤＮＡ合成以及调控基因转录和翻译的基因：ＴＡＦⅡ６８和组蛋白Ｈ１０;另外还有人类补体因子Ｂ及类转运ＲＮＡ合成酶的基因。这些基因大多具有相当于抑瘤基因的功能。从而进一步说明鼻咽癌的发生是多基因相互作用的结果。