儿童先天性心脏病室间隔缺损致病因素分析

目的 :对儿童先天性室间隔缺损因素进行分析。方法 :报告 2 5 8例先天性室间隔缺损儿童 ,男性 14 4例 ,女性 114例 ,年龄 1～ 14岁。同时对 2 5 8例儿童的父母进行调查 ,调查对象为患先天性室间隔缺损儿童 ,儿童的父亲、母亲孕前和孕期多方面因素 ,将引起室间隔缺损的可能原因进行分析。结果 :发现家族中有遗传史 ,父母亲饮酒史 ,母孕期有感冒病史 ,母孕期服用抗病毒药物 ,父母孕期使用黄体酮及母孕期接触X射线 ,有较高先天性室间隔缺损的发病率。同时对患先天性室间隔缺损儿童血型分析 ,表明A型儿童和AB型儿童患先天性室间隔缺损频率较高 (分别为 4 2 2 5 %和 11 2 4 % )比值比(OR)分别为 1 6 3和 2 2 1。与对照组比较差异有显著性 (即A型 χ2 =7.0 2 ,P <0 0 0 1,AB型 χ2 =5 71,P <0 .0 5 )。A O ,AB O抗原患者组与对照组比较 ,OR分别为 1 72和 2 6 2 ,χ2 值分别为 6 72和 7 5 1均差异有显著性 (P <0 .0 0 1) ,而O型则相反患先天性室间隔缺损的机率相对减少。结论 :先天性室间隔缺损与家族遗传史、血型及父母孕期饮酒、服药等多方面因素有关。     

基于深度学习的像素闪烁算法对高体质量指数患者低剂量腹部CT平扫图像质量的影响

目的 探讨基于深度学习的像素闪烁（PS）算法对体质量指数（BMI）≥ 25 kg/m²患者低剂量腹部CT平扫图像质量的影响。方法 选取59例接受腹部CT检查、BMI ≥ 25 kg/m²的患者,根据管电压分为A组（100 kVp,n=30）和B组（120 kVp,n=29）。根据不同重建算法和处理方式,将A组分为A1亚组（FBP）、A2亚组（FBP+PS）、A3亚组（50% ASiR-V）和A4亚组（50% ASiR-V+PS）;将B组分为B1亚组（FBP）和B2亚组（50% ASiR-V）。测量2组肝右叶、右侧竖脊肌CT值及SD值,计算肝脏SNR、CNR及容积CT剂量指数（CTDI_vol）,评价2名观察者间所测数值的一致性。结果 2名观察者所测数据的一致性良好（ICC值均> 0.80）。A组各亚组间肝脏及竖脊肌CT值差异无统计学意义（P > 0.05）;肝脏及竖脊肌SD值、肝脏SNR值差异有统计学意义（P均< 0.001）;两两比较SD_A4 < SD_A2 < SD_A3 < SD_A1,SNR_A4 > SNR_A2 > SNR_A3 > SNR_A1;A1与A3亚组间CNR值差异无统计学意义（P=0.078）,其余亚组间两两比较CNR_A4 > CNR_A2 > CNR_A3或CNR_A1（P均< 0.001）。A2亚组肝脏SD值较B1亚组、A4亚组较B2亚组明显降低,SNR及CNR值明显增高（P均< 0.001）。A组CTDI_vol明显低于B组（P均< 0.001）。结论 采用基于深度学习的PS算法可改善高BMI患者低剂量腹部CT平扫图像质量。     

Effects of vitamin and omega-3 fatty acid co-supplementation on blood glucose in women with gestational diabetes mellitus: A protocol for systematic review and meta analysis

Background:There is limited study that has conducted a review investigating the clinical effects of vitamin and omega-3 fatty acid co-supplementation on blood glucose in women with gestational diabetes mellitus (GDM). Therefore, in order to provide new evidence-based medical evidence for clinical treatment, we undertook a systematic review and meta-analysis to assess the effectiveness and safety of vitamin and omega-3 fatty acid co-supplementation on blood glucose in women with GDM.Methods:This protocol was written following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Protocols (PRISMA-P) statement guidelines. We will conduct systematic reviews and meta-analyses to identify relevant randomized controlled trials (RCTs) involving vitamin and omega-3 fatty acid co-supplementation on GDM in electronic databases including PubMed, Web of Science, Embase, and the Cochrane Library up to June 2021. Exclusion criteria include observational studies, non-RCTs, review articles, studies with a sample size <50, and studies with insufficient outcome data. The primary outcomes include fasting glucose and insulin. Secondary outcomes are evaluated in a homeostasis model of insulin resistance, total antioxidant capacity, triglycerides, total cholesterol, low-density lipoprotein cholesterol, preterm birth and macrosomia over 4 kg.Results:The review will add to the existing literature by showing compelling evidence and improved guidance in clinic settings.Registration number:10.17605/OSF.IO/NSW54.     

The clinical pattern differentiates ANCA-positive infective endocarditis patients from ANCA-associated vasculitis patients: a 23 years’ retrospective cohort study in China and follow-ups

Clinical Rheumatology - Patients with infective endocarditis (IE) may present rheumatic manifestations concurrent with various autoantibodies and thus mimic antineutrophil cytoplasmic antibody...     

原发性子宫内膜弥漫大B细胞淋巴瘤一例

<正>一、病例摘要患者女,72岁。主因绝经20年后阴道不规则出血一月余入院。患者既往月经规律,月经初潮年龄15岁,5~6/30 d,绝经年龄52岁。患者糖尿病20余年,应用胰岛素,血糖控制理想;冠心病20余年,类风湿病史。孕4产4。无恶性肿瘤家族史。患者入院前1个月出现间断性阴道不规则出血,量少,色鲜红,无发热、腹痛等不适症状,     

针灸联合三阶药物疗法对原发性肝癌疼痛镇痛作用的疗效观察

目的观察针灸联合三阶药物疗法治疗肝癌疼痛的疼痛缓解情况及不良反应的发生率。方法 54例原发性肝癌疼痛患者随机分为3组,联合治疗组采用针灸与三阶梯药物止痛法联合治疗;针灸治疗组取双曲泉、双肝俞、双心俞、大椎7穴进行阻滞针法治疗;药物对照组采用三阶梯药物止痛法进行治疗。结果 3组的总有效率比较差异有统计学意义(P0.05);联合治疗组与针灸治疗组不良反应发生率较药物对照组低,差异有统计学意义(P0.05)。结论针灸联合三阶药物治疗肝癌疼痛疗效良好,明显优于单独使用三阶药物疗法治疗或针灸疗法治疗,且不良反应较单纯应用三阶药物疗法小。     

人PD-L1基因转染细胞株的构建及其对活化的Jurkat细胞增殖和凋亡的影响

目的:构建稳定表达人PD-L1分子的基因转染细胞株,观察其对活化的Jurkat细胞增殖和凋亡的影响。方法:将编码人PD-L1分子的全长c DNA重组入反转录病毒表达载体p EGZ-Term-R,将重组载体p EGZ-Term-R/PD-L1和辅助病毒载体用脂质体法共转染293T细胞,包装具有感染能力的完整病毒;收集含有完整重组反转录病毒的293T细胞培养上清,感染L929细胞,筛选并获得G418抗性的基因转染细胞。采用流式细胞术检测表达PDL1的基因转染细胞,命名为L929/PD-L1。采用PHA活化T细胞系来源的细胞株Jurkat,并将其与丝裂霉素预处理的L929/PD-L1细胞共培养,用细胞计数法观察L929/PD-L1细胞株对活化的Jurkat细胞增殖能力的影响,并检测其凋亡情况。结果:成功获得了稳定表达人PD-L1基因的转染细胞株L929/PD-L1。PHA可诱导Jurkat细胞活化并表达PD-1分子;L929/PD-L1与PHA刺激后的Jurkat细胞共培养,可抑制Jurkat细胞增殖,促进其凋亡。结论:成功构建了稳定表达人PD-L1的细胞株,PD-L1分子抑制活化的Jurkat细胞增殖,促进其凋亡。     

流感嗜血杆菌基因分型研究

目的应用生物学分型、血清学分型和脉冲场凝胶电泳(Pulsed-field gel electrophoresis,PFGE)分析从健康人群分离的流感嗜血杆菌(Haemophilus influenzae,Hi)的分子流行病学规律以及与Hi生物学分型、血清学分型、青酶素酶之间的关系。方法对深圳市1月龄以上380名健康人群采集咽拭子,共分离培养175株流感嗜血杆菌,参照Pitt-man方法对菌株进行血清学分型,应用PCR方法进行流感嗜血杆菌属及荚膜鉴定,参照Kilian方法对其中的141株菌株进行生物学分型,从不同年龄组选出共59株流感嗜血杆菌株,应用PFGE技术进行分子分型研究。结果 141株流感嗜血杆菌分为8个生物型,Ⅰ~Ⅷ型分别为8.51%、36.88%、34.04%、4.96%、7.80%、0.71%、6.38%、0.71%。分离的菌株以无荚膜的不可分型Hi为主(97.14%),5株为有荚膜型,其中2株为b型,3株为e型,Hi产青霉素酶的阳性率为14.18%,59株Hi菌株分为52个PFGE基因型。结论深圳市健康人群Hi携带菌株多为无荚膜的不可分型流感嗜血杆菌,生物学分型以Ⅱ、Ⅲ型为主。PGFE基因分型呈明显的多态性。     

民政精神病医院医务人员对医院感染认知的调查分析

目的:了解民政精神病医院医务人员对医院感染知识的认知水平,为加强对医院感染的管理奠定基础。方法:采用自行设计的《医院感染知识问卷》,对本院在临床一线工作的全体医务人员进行医院感染知识培训前后的调查。问卷采用百分制,50分以下为知晓差,51~80分为基本知晓,81分以上为熟知。医院感染知识培训内容包括基础知识培训、专业知识培训、开展手卫生宣传月系列活动、编制《医院感染知识手册》宣传手册等。结果:培训前医务人员对医院感染知识认知水平较低,知晓差的人数达71.89%,培训后医院感染认知程度明显提高,熟知程度从培训前的1.30%提高到培训后的37.09%,基本知晓从26.81%提高到56.29%,知晓差从71.89%降低到6.62%,培训前后差异显著,x2=148.97,P=0.000。其中医生对培训的医院感染知识掌握的最快,护士次之,护理员要相对慢些。结论:通过对医院感染知识培训后,全体医务人员的医院感染控制意识明显提高。     

Higher frequency of peripheral blood follicular regulatory T cells in patients with new onset ankylosing spondylitis

Follicular helper T (TFH) cells and B cells are linked to the pathogenesis of ankylosing spondylitis (AS). Follicular regulatory T (TFR) cells suppress TFH cell and germinal center B cell numbers in vivo. The role of TFR cells in AS is unknown. The frequency of peripheral blood inducible FOXP3+CXCR5+CD4+TFR cells and CXCR5+CD4+TFH cells were taken from 20 onset AS patients and 10 healthy controls, and were examined by flow cytometry, their disease activity were measured by the Bath Ankylosing Spondylitis Disease Activity Index. The concentrations of serum interleukin (IL)‐21, immunoglobulin G, immunoglobulin A, immunoglobulin M and C‐reactive protein were examined, and the values of erythrocyte sedimentation rate were measured. The frequency of peripheral blood FOXP3+CXCR5+CD4+TFR cells, CXCR5+CD4+TFH cells, the ratio of FOXP3+CXCR5+CD4+TFR/CXCR5+CD4+TFH cells and the concentration of serum IL‐21 in the AS patients were significantly higher than those in the healthy controls (P < 0.0001, P = 0.0027, P < 0.0001, P = 0.0039, respectively). The frequency of FOXP3+CXCR5+CD4+TFR cells and the ratio of FOXP3+CXCR5+CD4+TFR/CXCR5+CD4+TFH cells still significantly rose in those patients after standard treatment (P = 0.0006, P < 0.0001), the concentration of serum IL‐21 decreased after treatment (P = 0.0049), accompanied by significantly minimized disease activities. Furthermore, the TFR cells were negatively correlated with serum immunoglobulin A in those patients before treatment (r = ?0.582, P = 0.0071), and the frequency of TFR cells was negatively correlated with that of TFH cells and the concentration of serum IL‐21 after treatment (r = ?0.550, P = 0.046; r = ?0.581, P = 0.0371). TFR cells might participate in the pathogenesis of AS, and might be responsible for controlling the autoantibodies, the frequency and function of TFH cells to inhibit the development of AS.