脑卒中肺部感染危险因素及血清免疫炎性因子的预测价值

目的基于主成分分析(PCA)-决策树模型分析脑卒中肺部感染的危险因素及血清免疫炎性因子的预测价值。方法回顾性分析2014年12月-2019年12月江西省上饶市人民医院确诊的176例脑卒中患者,根据是否发生肺部感染,分为感染组40例和未感染组136例。记录患者临床特征,检测血白细胞(WBC)计数、血清C-反应蛋白(CRP)、降钙素原(PCT)和可溶性白细胞介素-2受体(SIL-2R)水平。采用Logistic回归和卡方自动交叉检验(CHAID)模型分析影响脑卒中后肺部感染的危险因素;受试者工作特征曲线(ROC)分析血WBC、CRP、PCT、SIL-2R预测肺部感染的价值。结果脑卒中肺部感染与患者年龄、卒中类型、是否合并糖尿病、吸烟史、吞咽困难、意识障碍、侵入性操作有关(P<0.05);感染组患者血WBC、CRP、PCT和SIL-2R水平高于未感染组(P<0.05);糖尿病、侵入性操作、CRP和PCT均为影响脑卒中患者肺部感染的独立危险因素(P<0.05);PCA-ROC分析显示,血WBC、CRP、PCT、SIL-2R和联合预测主成分1(PC1)的曲线下面积(AUC)分别为0.670、0.816、0.854、0.686、0.918;PCA-卡方自动交互检测(CHAID)模型分析显示,WBC、CRP、PCT、SIL-2R和PC1预测肺部感染的准确率为77.33%、84.72%、86.90%、79.02%和89.24%。结论血清PCT水平可用于预测脑卒中患者肺部感染的发生,临床可重点关注合并糖尿病、意识障碍和侵入性操作的患者。     

卵巢子宫内膜异位症和卵巢良性肿瘤患者血清CA125和唾液酸测定的临床意义

目的 探讨血清CA125和唾液酸（SA）对卵巢子宫内膜异位症及卵巢良性肿瘤的诊断价值。方法 对30例卵巢巧克力囊肿、30例卵巢良性肿瘤和15例正常妇女采用放免法测定血清CA125值,比色法测定血清SA值。结果 卵巢巧克力囊肿组血清CA125均值明显高于良性肿瘤组及正常对照组（P＜0．01）,而血清SA增值三组间无显著性差异（P＞0．05）。结论 血清CA125测定对巧克力囊肿有辅助诊断价值,且有助于与卵巢良性肿瘤的鉴别。     

The changing face of reoperative parathyroidectomy: a single-centre comparison of 147 parathyroid reoperations

IntroductionReoperative parathyroidectomy for persistent and recurrent primary hyperparathyroidism is dependent on radiology. This study aimed to compare outcomes in reoperative parathyroidectomy at a single centre using a combination of traditional and newer imaging studies.Materials and methodsRetrospective case note review of all reoperative parathyroidectomies for persistent and recurrent primary hyperparathyroidism over five years (June 2014 to June 2019; group A). Imaging modalities used and their positive predictive value, complications and cure rates were compared with a published dataset spanning the preceding nine years (group B).ResultsFrom over 2000 parathyroidectomies, 147 were reoperations (101 in group A and 46 in group B). Age and sex ratios were similar (56 vs 62 years; 77% vs 72% female). Ultrasound use remains high and shows better positive predictive value (76% vs 57 %). 99mTc-sestamibi use has declined (79% vs 91%) but the positive predictive value has improved (74% vs 53%). 4DCT use has almost doubled (61% vs 37%) with better positive predictive value (88% vs 75%). 18F-fluorocholine positron emission tomography-computed tomography and ultrasound-guided fine-needle aspiration for parathyroid hormone are novel modalities only available for group A. Both carried a positive predictive value of 100%. Venous sampling with or without angiography use has decreased (35% vs 39%) but maintains a high positive predictive value (86% vs 91%). Cure rates were similar (96% vs 100%). Group A had 5% permanent hypoparathyroidism, 1% permanent vocal cord palsy and 1% haematoma requiring reoperation. No complications for group B.ConclusionOptimal imaging is key to good cure rates in reoperative parathyroidectomy. High-quality, non-interventional imaging techniques have produced a shift in the preoperative algorithm without compromising outcomes.     

Autologous peripheral blood stem cell transplantation in the patients with hematologic malignancies and solid tumors

Objective To evaluate the long-term therapeutic effects of autologous peripheral blood st em cell transplantation (auto-PBSCT) on the treatment of hematological and soli d tumors. Methods Fifty-one patients were recruited in this auto-PBSCT study, in which several p otentially important parameters were studied including the optimal time for stem cell co llection, the dose of stem cell reinfusion, the time of hematopoietic reconsti tution, the disease free survival (DFS) and overall survival (OS), complication s related to transplantation, and maintenance chemotherapy after auto-PBSCT. Results After APBSCT, 3-year and 5-year survival rates of NHL were 83.3%; those of AM L were 74.7%; those of MM were 37.9% and 19%; those of ALL were 40% and 0% res pectively. Hematopoietic reconstitution was greatly promoted by granulocyte col ony stimulating factor (G-CSF). The mean time for patients’ neutrophil to reco ver up to &gt;0.5×10(9) /L after APBSCT was 11.14 days in the group of the patien ts receiving G-CSF in contrast to 17.6 days in the group receiving no G-CSF. The most common complications of transplantation were fever, liver dysfunction and hypokalaemia, which were curable. No death was due to transplantation related complications.Conclusion Comparing with conventional chemotherapy, our study suggests that auto-PBSCT i s a very important therapeutic option that can significantly improve the prognos is in the patients with hematological and solid tumors, especially in the patien ts with AML and NHL.     

Effects of benactyzine on action potentials and contractile force of guinea pig papillary muscles

ＩＮＴＲＯＤＵＣＴＩＯＮＢｅｎａｃｔｙｚｉｎｅｉｓａｓｙｎｔｈｅｔｉｃｂｌｏｃｋｅｒｏｆＭ ｒｅｃｅｐｔｏｒｐｏｓ ｓｅｓｓｉｎｇｓｍｏｏｔｈｍｕｓｃｌｅｒｅｌａｘａｎｔｐｒｏｐｅｒｔｉｅｓａｎｄｑｕｉｎｉｄｉｎｅ ｌｉｋｅａｃｔｉｏｎｏｎｈｅａｒｔ[1] .Ｂｅｎａｃｔｙｚｉｎｅｉｓｅｆｆｅｃｔｉｖｅｉｎｒｅｓｔｏｒ ｉｎｇｃｉｒｃｕｌａｔｏｒｙｆｕｎｃｔｉｏｎｄｉｓｔｕｒｂｅｄｂｙｏｒｇａｎｏｐｈｏｓｐｈａｔｅｐｏｉ ｓｏｎｉｎｇ[2 ,3] .Ｐｒｅｖｉｏｕｓｓｔｕｄｉｅｓｓｕｇｇｅｓｔｅｄｔｈａｔｂｅｎａ…     

国人无综合征性耳聋患者的线粒体基因组7445A→G突变263例调查

目的 :探讨国人无综合征性耳聋 ( NSD)患者的线粒体 DNA 744 5 A→ G( m t DNA744 5 A→ G)突变的发生情况。方法 :对 32个 NSD家系 12 8例和 135例散发的 NSD患者 ,10 0例正常人 ,以 PCR法检测 mt DNA 744 5 A→ G突变情况。结果 :全部受检者无 mt DNA744 5 A→ G突变发生。结论 :国人 NSD患者的 m t DNA744 5 A→ G突变的发生率较低 ,且明显低于 mt DNA15 5 5 A→ G的突变发生率     

舰艇环境对舰员心理功能和神经行为的影响

探讨封闭型舰艇环境对舰员心理功能和神经行为的影响。方法 采用微机化神经行为评价系统和症状自评量表对封闭型水面舰艇舰员进行了测试,并以开放型水面舰艇舰员为对照。结果 封闭型舰艇人员符号译码成绩明显低于开放型舰艇人员,并出现类似“空调病”的症状。结论封闭型舰艇环境能危害舰员的心理健康,负离子浓度低为重要的环境因素,应改进通风。     

人类白细胞抗原B27亚型基因与急性前葡萄膜炎的相关性研究

目的 探讨人类白细胞抗原B27亚型基因与急性前葡萄膜炎(acute anterior uveitis,AAU)易感性的关系。 方法 对49例临床确诊的AAU患者,通过聚合酶链反应(polymerase chain reaction, PCR)特异性扩增技术检测B27;以B27阳性者的DNA为模板对其人类白细胞抗原HLA-B的第二、三外显子片段扩增。采用DNA测序技术对扩增产物做基因序列分析,经计算机处理获得受检者HLA-B27亚型的信息。 结果 受检者中29例为B27阳性,占59.39%,其中仅发现B2704(13例,占44.00%)和B27052(16例,占56.00%)二种亚型基因携带者。二者间多数临床表现差异不大,但携带B27052基因的AAU患者伴发强直性脊柱炎(ankylosing spondylitis, AS)的人数(7人,占24.24%)显著高于B2704基因携带者(1人,占3.74%)。 结论 B2704和B27052单独的亚型特异性与AAU无易感性关联;但B27052基因可能与并发AS有关。 (中华眼底病杂志, 1999, 15:139-142)     

反相高效液相色谱法测定塞来昔布片含量

目的 :建立反相高效液相色谱法测定塞来昔布片的含量。方法 :采用ZorbaxSB -C18色谱柱 ,以 0 .0 2mol·L-1磷酸二氢钾缓冲液 (pH5 .8) 乙腈 (4 5 :5 5 )为流动相 ,流速为 1.0mL·min-1,以 5 甲基 2 硝基苯酚为内标物 ,检测波长为 2 5 2nm。结果 :塞来昔布在 10 .2～ 5 0 .1mg·L-1范围内呈良好线性 (r =0 .9998) ,平均回收率为 99.8% ,RSD为 0 .35 %。结论 :本法可用于该片的含量测定 ,操作简便 ,结果准确。