钙蛋白酶10基因多态性与多囊卵巢综合征患者糖耐量及脂代谢异常的相关性

目的 探讨钙蛋白酶10(CAPN-10)基因56位点单核苷酸多态性(SNP-56)与多囊卵巢综合征(PCOS)患者糖耐量及脂代谢异常的相关性.方法 选取山东地区PCOS患者334例(PCOS组),健康妇女304例(对照组),采用熔解温度不同的基因分型法检测CAPN-10基因SNP-56,并采用免疫化学发光法测定泌乳素、卵泡刺激素(FSH)、黄体生成素(LH)、雌二醇、睾酮水平.PCOS组同时测定血糖、血脂、血清胰岛素水平.结果 (1)基因型及等位基因频率分布两组比较,差异均无统计学意义(P＞0.05).(2)在PCOS组,口服葡萄糖耐量试验(OGTF)180 min血糖水平AA基因型者为(5.7±2.2)mmol/L,GA基因型者为(4.9±1.2)mmol/L,GG基因型者为(4.9±1.4)mmol/L,分别比较,差异均有统计学意义(P均＜0.01);总胆固醇(TC)水平AA基因型者为(4.9±1.0)mmol/L,GA基因型者为(4.5±0.9)mmol/L,两者比较,差异也有统计学意义(P＜0.05).(3)在PCOS组,有糖尿病家族史者共44例,AA基因型频率为22.7%(10/44),GA+GG基因型频率为77.3%(34/44),GG基因型频率为34.1%(15/44);无糖尿病家族史者共290例,AA基因型频率为11.0%(32/290),GA+GG基因型频率为89.0%(258/290),GG基因型频率为47.2%(137/290),有无糖尿病家族史者AA与GA+GG基因型频率比较及AA与GG基因型频率比较,差异均有统计学意义(x2=4.751,x2=5.697;P均＜0.05).在PCOS组,有肿瘤家族史者共21例,AA基因型频率为33.3%(7/21),GA+GG基因型频率为66.7%(14/21),GG基因型频率为19.0%(4/21);无肿瘤家族史者共313例,AA基因型频率为11.2%(35/313),GA+GG基因型频率为88.8%(278/313),GG基因型频率为47.3%(148/313).结论 (1)CAPN-10基因SNP-56与PCOS的遗传易感性无明显相关性,但与PCOS患者糖、脂代谢异常有明显相关性.(2)CAPN-10基因SNP-56与PCOS患者糖尿病家族史及肿瘤家族史相关,应重视对高危PCOS个体的随访.     

慢性乙肝患者HBV-DNA载量与超敏C反应蛋白及丙氨酸氨基转移酶水平的相关性分析

目的探讨慢性乙型肝炎（CHB）患者血清中HBV-DNA载量与超敏C反应蛋白（hs-CRP）及ALT水平的相关性。方法对141例慢性乙肝患者的血清采用荧光定量聚合酶链反应（FQ-PCR）检测HBV-DNA载量,免疫透射比浊法及酶速率法分别测定血清hs-CRP和ALT的水平。结果 CHB患者hs-CRP及ALT水平显著高于正常对照组（P均〈0.01）,且随肝损害程度的加重而升高（P〈0.01或P〈0.05）;不同HBV载量组间ALT及hs-CRP水平比较,差异均无统计学意义（P〉0.05）。hs-CRP及ALT水平变化与HBV-DNA载量均无相关性（r=0.137,r=0.211,P〉0.05）。结论多数CHB患者具有不同程度炎症反应,但其炎症程度与乙肝病毒复制程度无关。     

广州市外籍人员网络社交特征及临时性行为的相关因素分析

目的 分析广州市外籍人员的社会支持、网络社交、性行为特征及相关因素,为有效开展外籍人员干预活动提供参考依据。方法 采用横断面调查研究设计,在2019年11月至2020年1月,对符合标准的研究对象采用线下和线上相结合的方式开展调查,收集人口学特征、社会支持、网络社交行为、性行为等信息。采用统计学方法对可能影响临时性行为的因素进行分析。结果 纳入研究的434名外籍人员中,线下调查241人,线上调查193人。男性占68.4%（297/434）;年龄（31.0±8.8）岁;来源地为非洲地区的占79.0%（343/434）;经商占46.5%（202/434）,学生占48.2%（209/434）;在中国有生意伙伴、家人陪伴的比例分别为59.4%（258/434）和28.1%（122/434）;在中国有关系密切的朋友<10人的比例为57.1%（248/434）;每日使用社交软件时间为1~3 h的占43.3%（188/434）;最近3个月发生临时性行为占15.2%（55/363）。Logistic多元回归分析结果显示,与每日使用社交软件时间<1 h者相比,>6 h者更有可能最近3个月发生临时性行为（OR=3.63,95%CI：1.31~10.08）。结论 广州市外籍人员中每日使用社交软件时间较长者更有可能发生临时性行为。合理运用社交软件进行艾滋病宣传教育可促进外籍人员的健康意识。     

山羊颈椎次全切除减压非融合后生物力学特性

目的 探讨山羊颈椎次全切除减压非融合后生物力学特性.方法 选取成年雄性山羊6只造模(模型组),术前行颈椎X线检查,排除骨性结构异常,并测量节段性Cobb角(SCA)和颈椎Cobb角(CCA)于C4行颈椎次全切除术,并植入可动人工颈椎(ACV).术后行颈椎正侧位X线检查,再次测量SCA和CCA.术后6个月处死山羊,并以6...     

Endoscopic features of esophageal high-grade intraepithelial neoplasia dominated by cytological atypia

Little is known about esophageal high-grade intraepithelial neoplasia dominated by cytological atypia (HGINc). We aimed to elucidate the endoscopic features of HGINc compared with esophageal high-grade intraepithelial neoplasia dominated by architectural atypia (HGINa). All patients pathologically diagnosed as esophageal high-grade intraepithelial neoplasia after endoscopic submucosal dissection at our center between January 2018 and December 2019 were included in this study. According to the pathological diagnosis, the patients were divided into two groups: HGINa group and HGINc group. Basic characteristics and endoscopic information were collected in detail. Data were analyzed statistically. Binary logistic regression was performed and a predictive model for HGINc was established. Then we evaluated its predictive value and built a nomogram for clinical application. A total of 175 patients were included in this study (126 with HGINa and 49 with HGINc). Among 228 lesions found in all patients, there were 148 HGINa and 80 HGINc. The independent relevant factors for HGINc were tobacco and alcohol usage, color, and gross type. To predict risk of HGINc, a three-factor model (TFM) was established with a highest area under curve (AUC) as 0.869 (95% CI, 0.852, 0.939). When the cut-off value was set as 0.3569184, the diagnostic accuracy, sensitivity, specificity, positive predictive value, and negative predictive value for HGINc was 81.14%, 88.75%, 77.03%, 67.62%, and 92.68%, respectively. HGINc differs greatly in endoscopic features from HGINa in our study. It’s important to reduce misdiagnosis that our model was established with good predictive value for clinical application.     

高效液相色谱法同时测定大庆马齿苋中山奈酚和槲皮素的含量

目的建立采用高效液相色谱法同时测定大庆马齿苋中山奈酚和槲皮素含量的方法。方法采用Agilent1200 Series,Eclipse XDB-C18色谱柱(150 mm×4.6 mm,5μm),甲醇-0.2%磷酸(45∶55),流速1.0 mL/min,柱温25℃,检测波长360 nm。结果山奈酚进样量在0.448~2.240μg范围内线性关系良好(r=0.9997),平均回收率为96.90%,RSD=0.63%(n=6);槲皮素进样量在0.496~2.480μg范围内线性关系良好(r=0.9997),平均回收率为98.10%,RSD=0.45%(n=6)。结论此方法重复性好,精确可靠。     

姜黄素与顺铂联合对人肺腺癌A549细胞增殖和凋亡作用

目的:研究姜黄素、顺铂和两者联合应用对人肺癌A549细胞增殖、凋亡和细胞周期的影响。方法:采用MTT法观察姜黄素和顺铂对人肺癌A549细胞增殖的影响;采用流式细胞仪检测姜黄素、顺铂和两者联合应用对人肺癌A549凋亡和细胞周期的影响。结果:①姜黄素及顺铂能抑制人肺腺癌A549细胞的增殖,并呈浓度及时问依赖性;姜黄素10,15,20μmol/L分别与顺铂1,2 mg/L联合24,48,72 h的抑制率显著高于单用顺铂、姜黄素组(均为P<0.05),两者呈现出相加的抗瘤效果。②姜黄素和顺铂均可在一定程度上诱导细胞凋亡,并且凋亡率与浓度呈正相关。两种药物联用后,诱导细胞凋亡作用显著增强。③姜黄素将细胞周期阻滞在G2/M期(P<0.01),顺铂将细胞周期阻滞在S期(P<0.01)。结论:姜黄素、顺铂均可抑制人肺癌A549细胞的增殖、诱导细胞的凋亡,在一定浓度范围内,呈量-效关系,而且两者联合应用具有相加或协同作用。     

胃癌患者应用加速康复外科治疗的安全性及有效性研究

目的观察快速康复外科（FFS）治疗在胃癌手术患者中的安全性和有效性。方法80例胃癌患者行D2根治切除手术,分为两组,每组40例。传统对照组采用传统的围手术期处理方法;FTS组采用TIS程序治疗,主要措施包括缩短患者术前的禁食时间,术前口服含碳水化合物的液体,不放置鼻胃减压管,使用生物蛋白胶封闭手术创面,不放置腹腔引流管,术后早期口服饮食,加强术后止痛,尽早下床活动等。观察比较两组手术及术后住院时间、营养状态、肠道功能、并发症发生及费用等情况。结果FT组与传统对照组相比,术后住院时间缩短,治疗费用减少,术后肠排气时间提前,停止静脉输液时间提前,手术后体重下降减轻,以上指标两组差异均有统计学意义。FTS组术后并发症的发生率并未增加。结论胃癌患者按FTS治疗安全、有效,可以减少住院时间与治疗费用,加速患者的康复。     

Congenital biliary dilatation may consist of 2 disease entities

Background/Purpose

This study aims to establish the possible mechanisms of pathogenesis of congenital biliary dilatation and to classify the disease accordingly.

Methods

Radiologic features of congenital biliary dilatation and pancreaticobiliary malunion in 107 affected children were examined and correlated with laboratory results. Relative lengths/diameters were calculated to provide comparison between children of different ages. Intraluminal pressures of common bile duct (CBD) were measured intraoperatively.

Results

The minimal relative diameters of distal CBD negatively correlated with the maximal relative diameters/lengths of dilated CBD, the maximal relative diameters of common hepatic duct, and left/right hepatic ducts. The intraluminal pressure in patients with a stenotic distal CBD (stenotic group) was significantly higher than that in patients with a nonstenotic distal CBD (nonstenotic group). The narrower the distal CBD, the more deranged the liver function. Conversely, serum/bile amylase levels were more elevated in the nonstenotic group. Common channel protein plugs were only found in the nonstenotic group, whereas common hepatic duct strictures, intrahepatic duct dilatations, and calculi were detected more frequently in the stenotic group.

Conclusion

We propose to categorize congenital biliary dilatation into 2 subgroups: (1) cystic type with stenotic distal CBD associated with deranged liver function and common hepatic duct stricture and (2) fusiform type with nonstenotic distal CBD associated with pancreatitis and common channel protein plugs. Different underlying pathologies of each group require different operative strategies.     

冠心病合并糖尿病患者dTP分析及随访

目的 分析冠心病(CHD)合并糖尿病(DM)患者11脱氢血栓素B2/6-酮前列环素比值(11-dh-TXB2/6-k-PGF1a,dTP)及与主要不良心血管事件(MACE)和再住院之间的关系.方法 选择2013年7月至2014年6月270例CHD患者作为研究对象,其中136例非DM患者(非DM组),134例合并DM患者(DM组).记录患者临床情况,测量身高、体质量、血压、心率等指标,完善心电图、超声心动图、冠状动脉造影等检查.测定两组患者11-dh-TXB2和6-k-PGF1a水平,计算dTP值.随访1年,记录患者MACE事件及再次住院情况.Epdate软件建库,SPSS17.0软件进行统计分析.结果 非DM组与DM组dTP分别为1.8±0.6和2.0士0.7,差异有统计学意义(P＜0.05).对于非DM组,hs-CRP、收缩压、舒张压、冠状动脉病变数及严重病变数与dTP相关(P＜0.05).而对于DM组,hs-CRP、血糖、胆固醇水平、冠状动脉病变数及严重病变数与dTP相关(P＜0.05).随访1年,非DM组和DM组患者发生MACE事件分别为33例(24.3％)和44例(32.8％),两组比较差异无统计学意义(P＞0.05).非DM组和DM组再次住院患者分别为12例(8.8％)和24例(17.9％),两组比较差异有统计学意义(P＜0.05).发生MACE的患者与无MACE的患者住院时dTP分别为2.3±0.8和1.8±0.6,差异有统计学意义(P＜0.05).再住院患者与未再住院组患者住院时dTP分别为2.4±1.0和1.9±0.6,差异有统计学意义(P＜0.05).结论 CHD合并DM患者dTP明显增高,提示血小板明显活化,且较高的dTP增加了患者MACE事件及再次住院风险,应该强化抗血小板治疗.