脑外伤患者恢复期的注意障碍

目的探索脑外伤恢复期患者注意的改变及其特征.方法对42例大型医院神经外科住院治疗的脑外伤恢复期患者和42名正常人进行"2,7"划消测验和Strop测验.结果脑外伤患者在标准情况、不相关分心情况和相关分心情况下的划消速度明显低于正常对照组,而精确率无明显差异.进一步比较相关分心情况下划消速度的下降率显示脑外伤患者显著大于正常对照组.Stroop测验显示脑外伤患者读单色字时间、读色块时间和读彩色字颜色时间较正常对照组显著延长,但两组之间错误数无显著性差异.比较两组读彩色字颜色时间的延长率和读彩色字文字时间的延长率,脑外伤患者均显著大于对照组.结论脑外伤后患者的注意力下降.注意的分配受损,抗干扰能力下降,而选择注意相对完整.     

An ultrasensitive chemiluminescence immunoassay of chloramphenicol based on gold nanoparticles and magnetic beads

A competitive, direct, chemiluminescent immunoassay based on a magnetic beads (MBs) separation and gold nanoparticles (AuNPs) labelling technique to detect chloramphenicol (CAP) has been developed. Horseradish peroxidase (HRP)‐labelled anti‐CAP monoclonal antibody conjugated with AuNPs and antigen‐immobilized MBs were prepared. After optimization parameters of immunocomplex MBs, the IC₅₀ values of chemiluminescence magnetic nanoparticles immunoassay (CL‐MBs‐nano‐immunoassay) were 0.017 µg L^?1 for extract method I and 0.17 µg L^?1 for extract method II. The immunoassay with two extract methods was applied to detect CAP in milk. Comparison of these two extract methods showed that extract method I was advantageous in better sensitivity, in which the sensitivity was 10 times compared to that of extract method II, while extract method II was superior in simple operation, suitable for high throughout screen. The recoveries were 86.7–98.0% (extract method I) and 80.0–103.0% (extract method II), and the coefficients of variation (CVs) were all <15%. The satisfactory recovery with both extract methods and high correlation with traditional ELISA kit in milk system confirmed that the immunomagnetic assay based on AuNPs exhibited promising potential in rapid field screening for trace CAP analysis. Copyright © 2013 John Wiley & Sons, Ltd.     

小牛血清去蛋白注射液防治鼻咽癌放疗不良反应的疗效观察

目的:研究小牛血清去蛋白注射液(DCBSI)对鼻咽癌放疗不良反应的临床疗效.方法:选择诊断明确的鼻咽癌患者72例,随机分为两组:对照组36例,给予放疗及常规护理;小牛组36例,除接受与对照相同的治疗外,还给予静脉滴注DCBSI,比较两组放疗不良反应,免疫状态及生活质量(QOL).结果:小牛组患者的放射性皮肤损伤情况明显好于对照组,治疗后小牛组患者的免疫状态、疼痛评分及QOL均优于对照组(P＜0.05).结论:DCBSI能减轻皮肤放射性损伤,促进创面愈合,提高放疗患者的免疫状态和QOL.     

声门下冲洗引流在预防VAP中的作用

目的:观察可冲洗气管导管在预防呼吸机相关性肺炎中的作用,并探计相应的护理措施。方法:将收入ICU需行机械通气的病人随机分为二组,采用可冲洗气管导管接受声门下积液冲洗为引流组,采用普通气管导管为常规治疗组,定期从口咽部、声门下分泌物和下呼吸道获取细菌学样本,记录行机械通气的天数和发生VAP的病例数结果。常规治疗组VAP发病率为53.3％,平均发生时间8.4±3.0d积液引流组VAP发病率为25.7％,平均发生时间11.6±4.1d经统计学处理P<0.05,二组结果有显著性差异。结论:声门下积液的仔在是引起机体发生VAP的主要原因之一,应用可冲洗气管导管行声门下积液冲洗引流可以明显减少VAP的发生率,是一种简单而有效的方法。     

低负压电动吸痰采集小儿气管内痰液方法的研究

目的 为小儿下呼吸道疾病病因检查提供一种无损伤或损伤小的采集小儿气道内痰液的检查方法。方法 对108例肺炎患儿采用低负压电动吸痰法，采集气管内及咽部痰液各一份，作多酶体显微镜检查。结果 气管内痰液可查到纤毛柱状上皮细胞或圆柱形柱状细胞，但咽部痰液查不到上述细胞。结论 低负压电动吸痰采集小儿气管内痰液方法，可为下呼吸道感染性疾病提供可靠的病原学检查手段。     

抗β_2糖蛋白1抗体在狼疮性肾炎和类风湿性关节炎患者中的应用评价

目的探讨血清中抗β2糖蛋白1(抗β2GP1)抗体在狼疮性肾炎(LN)和类风湿性关节炎(RA)患者中的临床应用价值。方法用酶联免疫吸附试验(ELISA)定量检测45例LN患者和45例RA患者血清中抗β2GP1抗体及抗心磷脂(CL)抗体水平。结果抗β2GP1抗体在LN中的阳性率为42.2%,显著高于在RA中的阳性率(6.7%),但在LN和RA中抗β2GP1抗体和抗CL抗体的表达均没有相关性;抗β2GP1抗体与LN病情活动性无相关。结论血清抗β2GP1抗体在LN和RA患者中均有表达,但与LN的相关性更强,联合检测抗β2GP1抗体和抗CL抗体能显著提高抗磷脂抗体在LN和RA中的阳性率,并提高抗CL抗体检测的准确性。     

N-乙酰半胱氨酸对肺纤维化合并肺气肿综合征患者血清炎症细胞因子的影响

目的 探讨N-乙酰半胱氨酸(N-acetylcysteine,NAC)对肺纤维化合并肺气肿综合征(combined pulmonary fibrosis and emphysema syndrome,CPFE)患者血清炎症细胞因子的影响.方法 将2013年6月至2016年6月在重庆市人民医院呼吸内科门诊及住院的CPFE患者112例按照人组先后顺序排序,单号为治疗组,双号为对照组,每组各56例.两组都给予西医常规抗炎、支气管扩张剂及氧疗等基本治疗,治疗组除了给予基本治疗,还给予口服NAC治疗12个月.于治疗前,治疗3、6、9、12个月分别抽取受试者早晨空腹静脉血并处理,留取标本,运用酶联免疫法对各标本中的IL-8、TNF-α、TGF-β1、VEGF水平进行定量检测.结果 从NAC治疗6个月后,治疗组与对照组比较IL-8、TNF-α、TGF-β1水平明显下降(P＜0.001),VEGF水平明显升高(P ＜0.001).且随着治疗时间的推移,后一时间点细胞因子水平的改善比前一时间点更显著.结论 NAC治疗CPFE综合征时,随着时间的推移可以显著改善IL-8、TNF-α、TGF-β1、VEGF等细胞因子水平的表达.     

重庆市2011-2020年临床微生物室间质量评价运行总结分析

目的分析重庆市2011-2020年临床微生物项目室间质量评价运行情况,为提高该市临床微生物鉴定和药物灵敏度检测能力提供依据。方法收集2011-2020年参加该市临床检验中心临床微生物项目室间质量评价实验室结果,对结果进行统计分析。结果2011-2020年参加的实验室从93家发展至138家,合格率从61.3%到94.2%。10年共发放100株细菌,涉及35个菌属,55个菌种。细菌鉴定和药物灵敏度正确率逐年增高,少见菌鉴定和一些药物灵敏度检测仍存在一些问题。结论通过临床微生物室间质量评价,发现实验室检测的不足,持续改进,提高实验室的检测能力,为临床诊疗提供可靠的依据。     

Sirolimus-based regimen promotes inhibitory costimulatory signal of HVEM/BTLA/CD160/LIGHT pathway in allo-renal recipients

HVEM/BTLA/CD160/LIGHT pathway is a very special costimulatory molecule system which can regulate T-cell immune responses by activating both inflammatory and inhibitory signalings. The regulatory effect of Sirolimus on HVME costimulatory system in allo-renal recipients has not been reported. In this study, we analyzed the expression of HVEM, BTLA, CD160 and LIGHT on circulating T cell subgroups and the expression of HVEM on CD4 + Tregs by flow cytometry and also the pre-dose concentration of Sirolimus by automatic analyzer. Both the allo-renal recipients receiving Sirolimus immunosuppressive regimen and health volunteers were included. The expression of both BTLA and CD160 on T cells increased significantly while the expression of LIGHT on T cells decreased significantly in allo-renal recipients receiving Sirolimus regimen (p < 0.05). The expression of HVEM on T cells and CD4 + T-cell subgroup decreased (p < 0.05) while that on CD8 + T-cell subgroup remained roughly normal (p > 0.05).The expression of HVEM on CD4 + Tregs increased significantly (p < 0.05) in allo-renal recipients receiving Sirolimus regimen (p < 0.05). Though regulating the expression of HVEM/BTLA/CD160/LIGHT costimulatory system, Sirolimus-based regimen promotes inhibitory costimulatory signal in T cells and enhances the function of CD4 + Tregs in allo-renal recipients, which are in benefit of the control of transplant rejection as well as the induction and maintenance of transplant tolerance.