鉴别诊断临床急性肺炎病原体感染的血清标志物研究

目的 检测急性肺炎患者血清相关生物标志物含量,为建立一种快速鉴别诊断临床急性支原体肺炎、病毒性肺炎、细菌性肺炎的免疫胶体金检测法提供实验依据。方法 以临床病原学诊断明确的急性支原体肺炎,病毒性肺炎,细菌性肺炎患者和正常人血清为检测样品,采用血小板衍生生长因子（platelet-derived growth factor,PDGF）/杀菌渗透增强蛋白（bactericidal/permeability-increasing protein,BPI）酶联免疫法（enzyme-linked immunosorbent assay,ELISA）检测试剂盒检测上述血清中相关生物标志物含量。结果 （1）正常人群血清78份,急性支原体肺炎患者血清46份,病毒性肺炎和细菌性肺炎患者血清42份,其中病毒感者患者血清35份,细菌感染患者血清7份;（2）正常人群血清PDGF最大值<6 000 pg/mL;血清BPI最大值<80 ng/mL;（3）以血清PDGF值6 000 pg/mL作为鉴别诊断急性支原体感染的基线值,支原体感染患者阳性检出率为93.47%（43/46）;病毒和细菌感染患者出现支原体感染的假阳性率为7.14%（3/42）;（4）以血清BPI值80 ng/mL作为鉴别诊断急性细菌感染的基线值,细菌感染患者阳性检出率为85.71%（6/7）;病毒感染患者出现细菌感染的假阳性率为3.22%（1/31）。结论 以血清PDGF 6 000 pg/mL和BPI 80 ng/mL作为鉴别诊断不同病原体感染的基线值,对临床急性支原体肺炎、病毒性肺炎、细菌性肺炎鉴别诊断具有一定意义。     

体外循环和非体外循环下冠状动脉旁路移植术中 患者脑氧饱和度的变化趋势分析

目的 探讨体外循环和非体外循环下冠状动脉旁路移植术中患者脑氧饱和度（rScO2）的变化趋势。 方法 前瞻性选取2018 年2 月—2019 年6 月在上海市第一人民医院择期行冠状动脉旁路移植术的105 例患 者。其中,56 例接受非体外循环冠状动脉旁路移植术（OPCAB）,49 例患者接受体外循环冠状动脉旁路移植 术（CCABG）。术中分别选择T0 ～ T9 10 个时间点检测rScO2,另外记录术后7 d 内术后认知功能障碍（POCD） 发生率。结果 CCABG 组患者手术时间长于OPCAB 组（P <0.05）,术中最低鼻咽温和红细胞比容（HCT） 低于OPCAB 组（P <0.05）,术中最高血糖（Glu）和血乳酸（Lac）高于OPCAB 组（P <0.05）;但是两组术 中最低rScO2 比较,差异无统计学意义（P >0.05）。两组rScO2 在不同时间、组间、变化趋势上有差别（P <0.05）。 CCABG 组rScO2 与鼻咽温、Lac 呈正相关（r =0.229 和0.283,P =0.005 和0.002）,而OPCAB 组rScO2 只 与Lac 呈正相关（r =0.214,P =0.010）。OPCAB 组和CCABG 组POCD 发生率分别为39.29%（22/56）和 32.65%（16/49）,且CCABG 组POCD 患者最低rScO2 低于非POCD 患者（P <0.05）。结论 虽然OPCAB 与CCABG 术中患者rScO2 变化趋势有差异,但是rScO2 可能不是影响术后早期POCD 发生的主要原因。     

血清胱抑素C水平与急性缺血性脑卒中后抑郁共病状态的关系

目的 探讨血清胱抑素C水平与急性缺血性脑卒中后抑郁共病状态的关系。方法 采用前瞻性研究方法,选取2019年1月—2022年6月承德医学院附属医院100例急性缺血性脑卒中患者作为研究对象,根据发病2周时的汉密尔顿抑郁量表（HAMD-17）评分分为抑郁组与非抑郁组。对比两组临床资料及实验室指标,分析血清胱抑素C水平与急性缺血性脑卒中后抑郁共病状态的关系。结果 抑郁组大动脉粥样硬化型占比低于非抑郁组,影像学病变累及占比高于非抑郁组（P <0.05）。抑郁组与非抑郁组性别、年龄、梗死部位、吸烟史、入院时HAMD评分比较,差异无统计学意义（P>0.05）。抑郁组血清胱抑素C、同型半胱氨酸水平高于非抑郁组（P <0.05）。抑郁组与非抑郁组甘油三酯、总胆固醇、低密度脂蛋白胆固醇、高密度脂蛋白胆固醇比较,差异无统计学意义（P>0.05）。小动脉闭塞型组胱抑素C、同型半胱氨酸水平高于其他TOAST分型组（P <0.05）。累及组胱抑素C、同型半胱氨酸水平高于未累及组（P <0.05）。多因素一般Logistic回归分析结果显示：高胱抑素C[O^R=26.330(95...     

葡聚糖包裹的超顺磁性Fe3O4纳米颗粒用于MRI造影剂的研究

目的探讨葡聚糖包裹的超顺磁性Fe3O4纳米颗粒（dextran-coated superparamagnetic iron oxides nanoparticles,dextran／SPIONP）作为间质注射的MRI造影剂的可行性。方法应用界面共沉淀法,制备dex—tran／SPIONP,用透射电镜、能谱分析、X射线衍射、红外光谱测试、热重分析等方法对dextran／SPIONP的大小、磁性能等进行表征,并研究葡聚糖对SHONP的影响。然后,将dextran／SPIONP稀释成不同剂量,兔舌粘膜下间质注射后的不同时间段,切取前哨淋巴结,行核磁共振波谱分析,确定dextrart／SPIONP的最适剂量和最佳检测时间。结果dextran／SPIONP的平均直径为6～9nm,其表征与经典的共沉淀法制备的颗粒一致,具有超顺磁性,葡聚糖是影响SPIONP饱和磁化强度的主要因素。dextran／SPIONP用于间质注射的最适剂量为含铁量20μmol,最佳检测时间为注射后2Ah。结论用界面共沉淀法制备的dextran／SPIONP是一种适用于间质注射的MRI造影剂。     

Increasing sampling density improves reproducibility of optical coherence tomography measurements.

PURPOSE: Published series of peripapillary retinal nerve fiber layer (RNFL) measurements using optical coherence tomography (OCT) have sampled 100 evenly distributed points on a 360 degrees peripapillary circular scan. The goal of this study was to determine whether a four-fold increase in sampling density improves the reproducibility of OCT measurements. METHODS: Complete ophthalmic examinations, achromatic automated perimetry, and OCT imaging were performed in all patients. The OCT scanning consisted of three superior and inferior quadrantic scans (100 sampling points/quadrant) and three circular scans (25 points/quadrant). The RNFL thickness measurements and coefficient of variation (CV) were calculated for the superior and inferior quadrants for each sampling density technique. RESULTS: The study included 22 eyes of 22 patients (3 control subjects; 2 patients with ocular hypertension; and 17 patients with glaucoma). Quadrants with associated glaucomatous visual field loss on automated achromatic perimetry had thinner RNFLs than quadrants without functional defects for both the 25- and 100-points/quadrant scans. For quadrants associated with normal visual hemifields (n = 22), there was no difference between the 25- and 100-points/quadrant scans in mean RNFL thickness and CV. Among quadrants with visual field defects (n = 22), RNFL thickness measurements were thinner in the 25-points/quadrant scans than in the 100-points/quadrant scans. The CV for the 25-points/quadrant scans (25.9%) was significantly higher than that for the 100-points/quadrant scans (11.9%). CONCLUSION: Increasing the sampling density of OCT scans provides less variable representation of RNFL thickness. The optimal sampling density to achieve maximal reliability of OCT scans remains to be determined.     

上腔静脉塌陷指数预测机械通气患者容量反应的可行性

目的 探索上腔静脉塌陷指数(SVC?CI)对机械通气患者容量反应的预测效果.方法 选择择期气管插管全麻机械通气下行腹部手术患者36例,男20例,女16例,年龄18～64岁,ASAⅠ或Ⅱ级,NYHAⅠ或Ⅱ级.所有患者在全麻诱导后至手术开始前,快速输注复方乳酸钠10 ml/kg,输注时间10～15 min.记录补液前后MA...     

梯度洗脱HPLC测定辛伐他汀片的含量和有关物质

目的建立辛伐他汀片含量测定及有关物质的检查方法。方法采用反相高效液相色谱法,色谱柱:SUPELCO C18柱(4.6mm×33mm,3μm),以乙腈-0.1%磷酸(50:50)为流动相A,0.1%磷酸乙腈溶液为流动相B,线性梯度洗脱,流速:3.0mL.min-1,检测波长238nm。结果辛伐他汀与洛伐他汀及强制破坏产生的降解产物均分离良好,辛伐他汀浓度在21.88～196.9μg.mL-1内,与峰面积呈良好的线性关系,回归方程A=65929ρ+4676,r=0.9996(n=7);日内精密度为0.54%(n=5);日间精密度为0.85%(n=5);平均回收率为99.55%(RSD=0.67%,n=9);样品溶液至少在3h内稳定;最低检测限为25.14ng.mL-1。结论该法专属性强,准确、灵敏,可用于辛伐他汀片的含量测定和有关物质检查。     

Inhibition of indoleamine 2,3-dioxygenase (IDO) enhances elimination of virus-infected macrophages in an animal model of HIV-1 encephalitis

Indoleamine 2,3-dioxygenase (IDO) is the rate-limiting enzyme in the kynurenine pathway of tryptophan metabolism. IDO activity is linked with immunosuppression by its ability to inhibit lymphocyte proliferation, and with neurotoxicity through the generation of quinolinic acid and other toxins. IDO is induced in macrophages by HIV-1 infection, and it is up regulated in macrophages in human brain tissue with HIV-1 encephalitis (HIVE). Using a model of HIVE, we investigated whether IDO inhibitor 1-methyl-d-tryptophan (1-MT) could affect the generation of cytotoxic T lymphocytes (CTLs) and clearance of virus-infected macrophages from the brain. Severe combined immunodeficient mice were reconstituted with human peripheral blood lymphocytes, and encephalitis was induced by intracranial injection of autologous HIV-1-infected monocyte-derived macrophages (MDMs). Animals treated with 1-MT demonstrated increased numbers of human CD3+, CD8+, CD8+/interferon-gamma+ T cells, and HIV-1(gag/pol)-specific CTLs in peripheral blood compared with controls. At week 2 after MDM injection in the basal ganglia, mice treated with 1-MT showed a 2-fold increase in CD8+ T lymphocytes in the areas of the brain containing HIV-1-infected MDMs compared with untreated controls. By week 3, 1-MT-treated mice showed 89% reduction in HIV-infected MDMs in brain as compared with controls. Thus, manipulation of immunosuppressive IDO activity in HIVE may enhance the generation of HIV-1-specific CTLs, leading to elimination of HIV-1-infected macrophages in brain.     

The effect of metallic Fe(ii) and nonmetallic S codoping on the photocatalytic performance of graphitic carbon nitride

The metallic Fe(ii) ion and nonmetallic S codoped g-C₃N₄ photocatalyst was synthesized through the polymerization of melamine, ferrous chloride and trithiocyanuric acid (TCA) at elevated temperature. The performance of Fe(ii)–S codoped g-C₃N₄ compounds in RhB photocatalytic degradation was found to increase 5 times. This significant enhancement in catalytic activity is probably related to the enhanced visible light adsorption and the mobility of photoinduced electron/hole pairs, attributable to bandgap narrowing and also lowering in the surface electrostatic potential compared to that of the pure g-C₃N₄ nanosheets. XRD and XPS results indicate that the Fe species binds with N-atoms to form Fe–N bonds in the state of Fe(ii) ions. Fe(ii) doping increases the specific surface area, and enhances the photoinduced electron/hole pairs illustrated by PL, EIS spectra and transient photocurrent response measurements. The theoretical results show that divalent Fe(ii) ions coordinating in the pore centre among three triazine units form discrete dopant bands and S dopants substituting the N in triazine skeletons excite much stronger delocalized HOMO and LUMO states, facilitating the migration of photogenerated charge carriers, thus enhancing the visible-light driven photocatalytic performance.

The photoinduced electrons jump more easily to the conduction band of g-C₃N₄ for the Fe impurity band locates above the valence band acting a bridge for electron transfer.