免疫疗法联合干扰素治疗慢性乙型肝炎的初步研究

探讨免疫疗法联合干扰素治疗不同免疫应答期慢性HBV感染患者的疗效.145例慢性乙型肝炎患者(免疫耐受期66例,免疫清除期64例,残余整合期15例)随机分为联合治疗组(乙肝疫苗 胸腺肽 绿脓杆菌菌毛 干扰素,其中免疫耐受期42例,免疫清除期46例.共88例)和对照组(单用干扰素治疗,其中免疫耐受期24例,免疫清除期18例.共42例),观察ALT及病毒标志物变化.治疗后,免疫清除期联合治疗组的ALT复常率、HBeAg、HBV DNA阴转率和HBeAg/抗-HBe血清转换率均显著高于对照组(P＜0.05).免疫耐受期,治疗组HBeAg、HBV DNA阴转率和HBeAg/抗-HBe转换率均明显高于对照组(P＜0.05).免疫疗法联合干扰素治疗慢性乙型肝炎,疗效明显优于单用干扰素治疗.     

精神分裂症并发糖尿病患者的护理干预

目的探讨精神分裂症合并糖尿病患者的护理干预措施对血糖的影响。方法选取我院2012年1月至2013年10月收治的78例精神分裂症合并糖尿病患者,随机分为实验组和对照组,两组患者给予相同治疗方案,对照组采取常规护理,实验组采取综合护理,比较两组患者护理干预前后空腹血糖、糖化血红蛋白水平及生命质量评分,开展用药、并对结果进行比较分析。结果经综合护理干预后,实验组患者空腹血糖、进餐后血糖、糖化血红蛋白均有显著改善,与干预前相比差异有统计学意义(P<0.05),与对照组相比有明显差异。结论在精神病分裂症合并糖尿病病人中开展综合护理干预,可提高治疗效果,减少并发症。     

注射用头孢哌酮钠/舒巴坦钠(3∶1)Ⅰ期临床试验耐受性研究

目的:观察健康受试者注射给予头孢哌酮钠/舒巴坦钠(3∶1)的安全性和耐受性。方法:选择28例受试者随机分配到1、2、4、6g单次给药组,每组人数分别为6、8、8、6例,男女各半,多次给药组纳入8例受试者,多次静滴药品,2g/次,bid,多次给药7d。观察受试者给药前后的临床症状和实验室检查指标。结果:所有受试者全部完成试验,单次和多次静脉给药对受试者的生命体征,血、尿、粪常规,凝血酶原时间,血液生化和心电图检查结果均无明显影响。多次给药组发生3例不良事件,其中1例为轻度头晕、口周部疱疹样水泡和腹胀,2例为丙氨酸氨基转移酶轻度增高,未采取干预措施或对症治疗后均恢复正常。结论:健康受试者单次及多次静滴头孢哌酮钠/舒巴坦钠(3∶1)耐受性和安全性良好。     

减毒猪霍乱沙门菌ΔcrpΔcyaΔasdC78-1(pYA3493)宿主-载体平衡致死系统的构建及其生物学特性研究

目的:开发应用于猪的稳定携带异源基因的口服活疫苗载体。方法:本研究在减毒猪霍乱沙门菌ΔcrpΔcya C78-1的基础上,运用自杀性质粒pREasd介导的细菌同源重组技术,构建缺失株ΔcrpΔcyaΔasd C78-1,再将携带asd基因的互补质粒p YA3493电转至上述菌株,构建ΔcrpΔcyaΔasd C78-1(p YA3493)宿主-载体平衡致死系统,并进一步研究其生物学特性。结果:PCR及测序结果共同表明ΔcrpΔcyaΔasd C78-1(p YA3493)构建成功。生物学特性检测结果表明ΔcrpΔcyaΔasd C78-1(p YA3493)的血清型与亲本株ΔcrpΔcya C78-1和疫苗株C500相同,并能够稳定遗传缺失型asd基因片段;其生长速度略慢于ΔcrpΔcya C78-1,且二者均明显慢于疫苗株C500;其生化特性结果也与ΔcrpΔcya C78-1基本相同。小鼠口服攻毒试验表明ΔcrpΔcyaΔasd C78-1(p YA3493)的毒力与ΔcrpΔcya C78-1基本相当,但其半数致死量约为疫苗株C500的412倍。结论:上述结果表明,减毒猪霍乱沙门菌ΔcrpΔcyaΔasd C78-1(p YA3493)有潜力作为高效表达外源基因的口服活疫苗载体。     

麻醉复苏室患者应用镇痛药物的观察及护理

目的：观察麻醉复苏室患者应用镇痛药物的影响,并分析相应的护理措施。方法回顾87例麻醉复苏室患者临床资料,对比观察患者镇痛药物使用前后的血压、心率、呼吸等指标情况,同时根据实际情况采取必要的护理措施。结果镇痛后15~30 min患者SBP、DBP、HR、RR与镇痛前对比差异显著(<0.05)。患者镇痛后疼痛程度明显减轻,镇痛后由无镇静程度转为浅镇静状态,与镇痛前对比(<0.05)。镇痛后4例患者呼吸抑制经面罩吸氧等处理措施维持气道通畅后恢复。结论麻醉复苏室患者使用镇痛药物,可明显减轻患者疼痛,但会出现呼吸抑制,为此需加强患者呼吸护理干预,确保使用镇痛药物患者呼吸通畅,用药安全。     

Laccase immobilization and surface modification of activated carbon fibers by bio-inspired poly-dopamine

In this study, we developed a new synthesis method for modifying activated carbon fibers (ACFs) by dopamine with oxidation-based self-polymerization (DA-ACFs). In addition, laccase was immobilized on the surface of unmodified ACFs (L-ACFs) and DA-ACFs (LDA-ACFs) via cross-linking after being incubated for 12 h at 5 °C. The surface composition and microstructure of the samples were characterized by scanning electron microscopy, X-ray photoelectron spectroscopy, attenuated total reflectance Fourier-transform infrared reflection and thermo-gravimetric analysis. The optimized laccase concentration for preparing the samples was 2.0 g L⁻¹. The results demonstrated that the successful poly-dopamine modification increased the catalytic abilities of the ACFs in terms of biocompatibility and hydrophilicity. Compared with free laccase, the immobilized laccase exhibited significantly higher relative activity over a pH range of 3.5–6.5 and a temperature range of 30–60 °C; the thermo-stability increased, and 50% relative activity of the LDA-ACFs remained after 5 h at 55 °C. After six cycles of reuse, the relative activity of LDA-ACFs remained ≥60%, compared to 40% activity remaining for L-ACFs, and long-term storage stability was demonstrated. Moreover, the kinetic parameters (K_m) of the two immobilized laccases were both higher than that of free laccase, whereas the maximum velocities (V_max) were lower. These results indicate that the DA-ACFs are economical, simple, and efficient carries for enzyme immobilization, and can be suitable for further biotechnology and environmental applications.

In this study, we developed a new synthesis method for modifying activated carbon fibers (ACFs) by dopamine with oxidation-based self-polymerization (DA-ACFs).     

定标活检术在肠道黏膜中临床应用价值的探讨及分析

目的 评价定标活检术在肠道黏膜中的应用价值.方法 选择行肠镜检查的患者89例,使用一次性定标活检钳在其肠道黏膜进行标记,通过定期复查肠镜,分析单次标记成功率、标记的存在情况、标记局部黏膜的组织反应及其并发症等情况.结果 89例患者中单次定标成功率84.27％,总有效率96.63％.随访超过6个月、12个月、1 8个月和24个月的患者中,定标总有效率分别为82.35％、78.56％、76.54％和67.89％.结论 定标活检术在肠道黏膜中具有标识清晰,留存时间较长,适合肠道疾病的纵向对比研究,临床推广意义较大.     

Association of IL33/ST2 Signal Pathway Gene Polymorphisms with Myocardial Infarction in a Chinese Han Population

This study investigated the relationship between IL-33/ST2 signal pathway gene polymorphisms and myocardial infarction(MI) in Han Chinese. A case-control association analysis was performed on a total of 490 MI patients(MI group) and 929 normal subjects(NC group). Sequenom Mass Array and Taqman genotyping technique were used to analyze the tag single nucleotide polymorphisms(SNPs) in the genes encoding IL-33, ST2, and IL-1Ra P(rs11792633, rs1041973 and rs4624606). The results showed that the frequencies of rs4624606 genotypes AA, TT, AT were 0.031, 0.647, 0.322 in MI group and 0.026, 0.712, 0.263 in NC group, and the allele frequencies of A and T were 0.192, 0.808 in MI group and 0.157, 0.843 in NC group. There were significant differences in rs4624606 genotypes and allele frequencies between MI group and NC group(P<0.05). For rs11792633, the allele frequencies of C and T were 0.45, 0.55 in MI group and 0.454, 0.546 in NC group with no significant differences found between the two groups. Compared with genotype CC+TC, rs11792633 genotype TT had an increased risk of hypertension(P<0.05). However, there were no significant differences in the frequencies of rs11792633 genotypes between the two groups. No significant differences were noted in the frequencies of rs1041973 genotype and allele between the two groups. Logistic regression analysis showed that rs4624606 genotypes AT and AA+AT were both significantly associated with MI(AT: OR=1.325, P=0.029, 95% CI=1.03–1.705; AA+AT: OR=1.316, P=0.028, 95% CI=1.03–1.681) after factors such as age, gender, smoking, drinking, body mass index(BMI), triglyceride(TG) and cholesterol were adjusted. Those carrying rs4624606 genotype AT or AA+AT had an increased risk of MI. No associations were found between the polymorphisms of the other two loci with MI. It was concluded that, in the IL33/ST2 signal pathway, the A allele of rs4624606 polymorphism of IL-1Ra P gene is a potential independent risk factor for MI, and the genotypes AA+AT and AT are associated with the incidence of MI.     

子宫内膜异位症致盆腔疼痛与病灶特点的相关性

目的 探讨子宫内膜异位症患者盆腔疼痛与病灶部位、粘连程度、浸润深度间的关系.方法 对湖州市菱湖人民医院2010年1月至2014年5月间妇科住院部确诊为子宫内膜异位症且经手术治疗的168例患者进行临床研究,观察痛经、排便痛、肛门坠痛、性交痛及慢性盆腔痛与病灶部位、粘连程度、浸润深度间的关系.结果 子宫内膜异位症发生部位在子宫骶韧带、子宫直肠凹部的肛门坠痛、排便痛、痛经、性交痛及慢性盆腔痛发生率均明显高于其它部位(子宫韧带:x2值分别为23.60、65.83、65.58、37.00、25.63,均P＜0.01;子宫直肠凹;x2值分别为17.98、56.41、54.49、27.93、40.90,均P＜0.01).术中见131例患者存在粘连,且多为复合粘连,卵巢粘连发生率明显高于其它部位(x2=115.43,P＜0.01),病灶浸润深度在≥5mm者,肛门坠痛、排便痛、痛经、性交痛及慢性盆腔疼痛患者发生率均明显高于＜5mm患者(x2值分别为6.62、11.83、10.62、10.66、7.29,均P＜0.05).结论 子宫内膜异位症患者盆腔疼痛与病灶部位、浸润深度及粘连程度为正相关性.