流式细胞术分析六类肿瘤患者外周血淋巴细胞绝对数值的变化

目的了解六类肿瘤患者的免疫状态,探讨T细胞亚群、NK细胞、B细胞绝对数值与肿瘤的相关性.方法采用流式细胞术检测204例肿瘤患者外周血淋巴细胞(T、Th、Ts、NK、B细胞)绝对数值,其中肺癌71例,肝癌39例,鼻咽癌28例,结肠癌29例,乳癌22例,食道癌15例,并与38例正常对照比较.结果与正常对照组比较,肿瘤患者外周血T细胞、Th细胞、Ts细胞、NK细胞绝对数值均降低(P＜0.05),B细胞绝对数值无显著差异(P＞0.05);各数值在不同肿瘤之间无显著差异(P＞0.05).结论肿瘤患者细胞免疫功能普遍低下,T细胞亚群、NK细胞、B细胞绝对数值可作为肿瘤患者免疫功能的监测指标.     

电阻加温垫与充气加温毯预防胸腔镜手术患者低体温效果比较

目的探讨两种加温方式预防胸腔镜手术患者术中低体温的效果。方法将70例胸腔镜手术患者随机分为两组,电阻组(34例)术中采用电阻式碳纤维加温垫加温,充气组(36例)采用充气式加温毯覆盖加温。结果两组各测量时间点患者平均体温均36℃,在麻醉插管、手术开始时、手术开始30 min时电阻组患者体温高于充气组(均P0.01);手术开始1 h后至手术结束,两组体温差异无统计学意义(均P0.05)。结论两种加温方式均能有效预防胸腔镜手术患者术中低体温,其中电阻式碳纤维加温垫维持患者体温更平稳。     

不同剂量伊伐布雷定治疗病毒性心肌炎患儿的临床疗效及安全性

目的：探讨不同剂量伊伐布雷定治疗病毒性心肌炎（VMC）患儿的临床疗效及安全性。方法：选取2017年12月至2018年11月我院收治的病毒性心肌炎患儿84例，按就诊顺序单双号分为对照组和观察组各42例。对照组给予盐酸伊伐布雷定片2.5 mg，观察组给予盐酸伊伐布雷定片5 mg，2次/天，连续给药2周，比较两组临床疗效，观察治疗前后血清心肌肌钙蛋白I（cTnI）、心肌肌钙蛋白T（cTnT）、B型钠尿肽前体（NT-proBNP）水平及心率（HR），并记录不良反应发生情况。结果：观察组临床总有效率（90.48%）高于对照组（76.19%），差异有统计学意义P<0.05）。两组患儿治疗后cTnI、cTnT、NT-proBNP、HR水平均低于治疗前（P<0.05），且治疗后观察组cTnI、cTnT、NT-proBNP、HR水平均显著低于对照组（P<0.05）。两组不良反应均较轻微，无需停药处理，发生率比较差异无统计学意义（P>0.05）。结论：伊伐布雷定治疗VMC患儿的临床疗效显著，较大剂量的伊伐布雷定可获得更好的治疗效果，安全性可行，具有较高的临床应用价值     

中医周期疗法对多囊卵巢综合征患者卵泡发育及血流动力学的影响

目的:分析中医周期疗法对多囊卵巢综合征患者卵泡发育及血流动力学的影响。方法:将80例多囊卵巢综合征患者随机分为对照组与试验组,每组各40例,对照组采取常规西药治疗,试验组在对照组基础上行中医周期疗法治疗,比较两组患者临床疗效、卵泡发育及子宫、卵巢血流动力学情况。结果:试验组治疗有效率、排卵率、基础体温双相率分别为85.0%、65.0%、75.0%,较对照组的55.0%、40.0%、52.5%,差异有统计学意义(P0.05)。试验组平均窦卵泡数(6.01±0.42)个,成熟卵泡数(1.52±0.41)个,对照组平均窦卵泡数(8.79±0.65)个、成熟卵泡数(1.20±0.48)个,两组比较,差异有统计学意义(P0.05)。两组患者子宫、卵巢血流动力学参数比较,差异有统计学意义(P0.05)。结论:中医周期疗法能明显促进多囊卵巢综合征患者卵泡发育及排卵,显著改善子宫、卵巢血流动力学指标,疗效确切。     

我院3种非发酵革兰阴性杆菌耐药谱4年变迁

目的:分析我院4年来3种非发酵革兰阴性杆菌耐药谱的变化,为临床合理选用抗菌药物提供依据。方法:采用K-B纸片扩散法检测分析2001年7月~2005年6月我院临床标本中分离出的铜绿假单胞菌、鲍曼不动杆菌、嗜麦芽寡养单胞菌对常用抗生素的耐药性,数据结果输入WHONET5软件进行统计分析。结果:4年检出铜绿假单胞菌598株,鲍曼不动杆菌281株、嗜麦芽寡养单胞菌209株。对铜绿假单胞菌耐药率低于30%的有头孢他定、阿米卡星、头孢哌酮/舒巴坦、亚胺培南等抗生素;鲍曼不动杆菌对亚胺培南敏感率较高,对其它常用抗生素耐药率均超过50%;对嗜麦芽寡养单胞菌耐药率较低的有复方新诺明和氧氟沙星。结论:非发酵菌在我院耐药率高,常表现为多重耐药,监测非发酵菌的感染及其耐药性变化,对指导合理应用抗菌药物有重要意义。     

改良Morrow术治疗梗阻性肥厚型心肌病的治疗效果及围手术期护理要点

目的 探讨采用改良Morrow术治疗梗阻性肥厚型心肌病(HOCM)患者的治疗效果及围手术期护理要点.方法 选择首都医科大学附属北京安贞医院2016年1月至2017年1月收治的35例行改良Morrow术治疗HOCM患者.术前对患者进行心理护理,完善相关检查,指导患者进行呼吸锻炼,术中护士不应离开手术室,术后密切观察患者心...     

肥胖对男性生殖的影响研究进展

由于生活习惯和饮食结构改变,全球肥胖人口逐渐增多,发展中国家肥胖人群比率也大幅增加。肥胖者能量摄取和消耗失衡,脂肪积累过度,干扰人体正常代谢,引起心血管疾病和代谢综合征,还影响男性生殖内分泌调节,引起全身和局部的炎症反应以及过度的氧化应激和凋亡,损害精子生成及成熟的内环境,造成男性的性功能障碍,精子质量下降,生育能力降低。     

Evolutionary divergence of duplicated genomes in newly described allotetraploid cottons

Allotetraploid cotton (Gossypium) species represents a model system for the study of plant polyploidy, molecular evolution, and domestication. Here, chromosome-scale genome sequences were obtained and assembled for two recently described wild species of tetraploid cotton, Gossypium ekmanianum [(AD)₆, Ge] and Gossypium stephensii [(AD)₇, Gs], and one early form of domesticated Gossypium hirsutum, race punctatum [(AD)₁, Ghp]. Based on phylogenomic analysis, we provide a dated whole-genome level perspective for the evolution of the tetraploid Gossypium clade and resolved the evolutionary relationships of Gs, Ge, and domesticated G. hirsutum. We describe genomic structural variation that arose during Gossypium evolution and describe its correlates—including phenotypic differentiation, genetic isolation, and genetic convergence—that contributed to cotton biodiversity and cotton domestication. Presence/absence variation is prominent in causing cotton genomic structural variations. A presence/absence variation-derived gene encoding a phosphopeptide-binding protein is implicated in increasing fiber length during cotton domestication. The relatively unimproved Ghp offers the potential for gene discovery related to adaptation to environmental challenges. Expanded gene families enoyl-CoA δ isomerase 3 and RAP2-7 may have contributed to abiotic stress tolerance, possibly by targeting plant hormone-associated biochemical pathways. Our results generate a genomic context for a better understanding of cotton evolution and for agriculture.

Polyploidization is an important evolutionary process in many higher plants, contributing to speciation and adaptation (1–5). Allopolyploidy in particular has been considered a major evolutionary force due to the novel genomic possibilities resulting from hybridization and increased genetic variability. Approximately 1 to 2 million y ago (Mya), hybridization between geographically disjunct diploid A and D genome ancestors (2n = 26, AA and DD genome) and concomitant polyploidization generated allotetraploid cotton (2n = 52, AADD genome) (6, 7). This new allopolyploid clade subsequently diversified into the seven species recognized today [(AD)₁ to (AD)₇] (8, 9). Among them, Gossypium hirsutum [Gh, genome designation (AD)₁] and Gossypium barbadense [Gb, (AD)₂)], provide the majority of natural fiber for commercial production (10, 11). Five tetraploid cottons [(AD)₁ to (AD)₅], including the two domesticated species, have recently been sequenced using long-read technology, providing high-quality genome assemblies and genomic resources for uncovering the genetic basis of spinnable fiber (12–16). However, genome assemblies for the two most recently described wild tetraploid species, both of which are closely related to Gh, have not been reported. Genome sequences for these species may facilitate an improved understanding of evolution and fiber improvement in the dominant crop species, G. hirsutum. In fact, these species—that is, Gossypium ekmanianum [Ge, (AD)₆] from the Dominican Republic and Gossypium stephensii [Gs, (AD)₇] from the Wake Atoll near French Polynesia—are so similar to Gh that they have historically been confounded with wild accessions of Gh (8, 9). Additionally, there are no genome sequences for early domesticated or wild forms of either of the two domesticated species, precluding comparative genomic approaches to understanding cotton evolution and domestication. Among the great diversity of morphological forms spanning the wild-to-domesticated continuum in Gh, many of the least-improved forms occur in the Yucatan Peninsula of Mexico, including the truly wild race yucatanense, and the relatively unimproved race punctatum (Ghp) (17, 18). Assembling the genome of these tetraploid cottons will provide an important model system for understanding both the evolutionary consequences of polyploidy and of parallel domestication (19–21).Here, we report high-quality genome assemblies of the three tetraploid genomes, Ge, Gs, and Ghp. Using comparative genomics and phylogenomics, we reveal extensive genomic structural variations (SVs) in tetraploid cottons, and reevaluate phylogenetic relationships and divergence times within the polyploid clade. Extensive SVs are associated with phenotypic diversity, including the economically important trait, fiber length. We characterize wild gene resources that have the potential to facilitate adaptation to various abiotic and biotic stresses in domesticated cotton. These results deepen our understanding of genome evolution in polyploids and provide insight into the genetic and morphological diversity of tetraploid cottons.     

全科医生组织支持感与工作压力的关系：职业认同感的中介作用

目的　调查黑龙江省全科医生工作压力的现状,并探讨其与组织支持感以及职业认同感的关系。旨在为全科医生队伍建设、全科医学教育发展提供参考。方法　使用一般情况问卷、组织支持感量表、工作压力量表和职业认同感量表,通过网络调查及现场调查的方式收集数据,共回收问卷288份,有效问卷263份,有效率为91.3%。采用描述性统计分析、Pearson相关分析以及bootstrap中介效应检验方法对数据进行分析。结果　全科医生工作压力平均分为（115.95±22.40）,组织支持感与工作压力呈负相关（r＝-0.413,P＜0.01）,与职业认同感呈正相关（r＝0.587,P＜0.01）;职业认同感与工作压力呈负相关（r＝-0.442,P＜0.01）,中介检验的结果（LLCI=-0.2039,ULCI=-0.0760）,说明职业认同感在组织支持感与工作压力的关系中发挥部分中介作用。结论　全科医生的工作压力处于较高水平,可以通过提高全科医生职业认同感和组织支持感,降低全科医生的工作压力。