1,6-二磷酸果糖对体外循环患者血浆细胞因子的影响

目的　探讨 1,6-二磷酸果糖 (FDP)减轻体外循环 (CPB)术后全身炎症反应的临床效果。方法　将 3 8例心脏直视手术患者随机分为实验组 2 0例 ,对照组 18例。实验组在常规 CPB预充液中加入 FDP2 0 0 m g/kg,对照组不用 FDP。于手术开始前 (T0 )、 CPB结束后即刻 (T1)、CPB结束后 3小时 (T2 )、 6小时 (T3)及 2 4小时 (T4)分别抽取桡动脉血 ,采用 EL ISA法测定血浆肿瘤坏死因子 (TNF-α)、白介素 -6(IL-6)、白介素 -8(IL-8) ,用硫代巴比妥酸比色法测定血浆丙二醛 (MDA)。结果　两组术前血浆 TNF-α、IL-6、IL-8、MDA浓度无差异 ,CPB结束后均已明显升高 (P <0 .0 5) ,CPB后 3小时 TNF-α、 IL -6、 IL -8达高峰 ,6小时开始下降 ,MDA在 6小时达高峰 ,2 4小时 TNF-α、 MDA恢复到接近术前水平 (P >0 .0 5) ,IL -6、 IL -8仍高于术前 (P <0 .0 5)。实验组血浆 TNF-α、 IL -6、 IL -8浓度在 T1、 T2 、 T3均明显低于对照组 (P <0 .0 1) ,MDA浓度在 T1、 T2 (P <0 .0 5)和 T3 (P <0 .0 1)均明显低于对照组 ,血浆 IL -6、 IL -8在 T4也均低于对照组 (P <0 .0 1,P <0 .0 5)。结论　 CPB术后血浆 TNF-α、IL-6、IL-8、MDA浓度明显升高 ,在 CPB预充液中加入 FDP可明显降低 CPB术后TNF-α、 IL-6、 IL-8及 MDA的浓度 ,     

Diagnosis and surgical treatments of hepatocellular carcinoma with tumor thrombosis in bile duct： Experience of 34 patients

AIM: Hepatocellular carcinoma (HCC) with bile duct tumor thrombosis (BDT) is a rare event. The prognosis of this type of patients is very dismal. The aim of this study was to share the experience in the diagnosis and treatment of HCC with BDT, to further improve the prognosis of these patients.METHODS: Thirty-four patients of HCC with BDT received surgical treatment in authors‘ institute from July 1987 to January 2003 were reviewed retrospectively. The experience in the diagnosis and treatment, and the outcome of this type of HCC patients were summarized.RESULTS: Thirty of the 34 patients (88.2%) were positive for alpha-fetoprotein (AFP) (&gt;20 μg/L), and 12 patients (35.3%) were found having obstructive jaundice before operation, 18 cases were suspected of “obstruction of bile duct“ preoperatively. The primary tumors were frequently located at the left medial (13 cases) or right anterior lobe(14 cases). Thirty-one patients received liver resections and removal of BDT, while the other 3 patients received removal of BDT combined with hepatic artery ligation and cannulation(HAL+HAI), or only removal of BDT because their liver function reservation and general condition could not tolerate the primary tumor resection. The 1-year survival rate was 71.4%(20/28). The longest disease-free survival was over 15 years. The intrahepatic tumor recurrence within 1 year after operation was found in 14 patients (14/28, 50.0%).CONCLUSION: Surgical removal of primary tumors and BDT is safe and beneficial to the HCC patients with BDT. Early detection, diagnosis, and surgical treatment are the key points to prolong the survival time of patients.     

Medical humanities education in China: an exploratory cross-sectional study

Background

Governmental policies in China have strengthened education in the medical humanities. Previous publications have highlighted the inadequacy of medical humanities education in China and have promoted their advancement and evaluation. Medical disputes and mistrust between doctors and patients in China have been ascribed to a paucity of proper medical humanities education at the medical student level. However, no studies to date have specifically examined the frequency, structure, and characteristics of the medical humanities curricula at all Chinese medical schools, making it difficult to draw a comprehensive understanding of its current state. We therefore aim to provide such an understanding of the current role of the medical humanities at Chinese medical schools.

卡维地洛对老年高血压及伴有心力衰竭患者的疗效观察

目的 　探讨卡维地洛 (carvedilol)对 80岁以上老年高血压及伴有心力衰竭患者的疗效及安全性。　方法　观察了 5 1例老年高血压及 18例高血压伴有心力衰竭患者经卡维地洛治疗前后 6月的血压和心功能情况。　 结果　卡维地洛治疗后 8周的 2 4h白昼和夜间的平均收缩压 ,舒张压明显下降 ,有显著性差异 (P <0 .0 5～ 0 .0 1)。伴有心力衰竭患者 6月后左室射血分数 (EF)明显提高 ,由治疗前 0 .43± 0 .0 5上升为 0 .5 2± 0 .0 2 (P <0 .0 5 ) ,心功能改善 1级者 13例 ,改善 2级者 5例、左室壁厚度及左室质量指数 (LVMI)明显下降。　 结论　卡维地洛治疗高龄老年高血压及伴有心力衰竭患者是安全有效的 ,但要注意个体化用药。     

在娱乐场所服务小姐中开展艾滋病预防干预试点研究

目的 了解娱乐场所服务小姐中艾滋病的有关知识、态度和行为,探索在该人群中开展预防艾滋病宣传教育的措施和评价方法。方法 采用快速评估,现场访谈和咨询、免费发放艾滋病预防宣传折页、安全套和同伴教育等方法进行干预,运用问卷调查和定性访谈方法评价干预效果。结果 基线调查124名服务小姐,干预后调查135名,干预后性病和艾滋病预防知识知晓率等均有显著性提高,但态度及行为干预前后无显著性差异。85.0％的人愿意使用安全套,但实际只有42.1％的人每次都使用安全套。结论 干预活动中不仅要提供性病艾滋病的防治知识,还要提供改变高危行为的技能。定性访谈资料可信性较高,可做为定量资料的补充和评价,但如何把定量与定性资料有机的结合起来还有待进一步探讨。     

2006年湖北省血吸虫病疫情监测结果分析

目的分析湖北省2006年国家级血吸虫病疫情监测点监测结果,为制定血吸虫病防治对策提供科学依据。方法根据《全国血吸虫病监测方案》,在湖北16个国家级监测点开展监测工作,统计与分析各项指标。结果16个监测点居民感染率为1.91%,耕牛感染率为12.06%,活螺平均密度为0.67只/0.11m2,感染螺平均密度为0.0011只/0.11m2,钉螺感染率为0.17%。结论2006年监测点的人群感染率和螺情指标均比上年有所下降,但耕牛感染状况依然严重,是湖北省血防工作的重点和难点。     

Function of HAb18G/CD147 in invasion of host cells by severe acute respiratory syndrome coronavirus

To identify the function of HAb18G/CD147 in invasion of host cells by severe acute respiratory syndrome (SARS) coronavirus (CoV), we analyzed the protein-protein interaction among HAb18G/CD147, cyclophilin A (CyPA), and SARS-CoV structural proteins by coimmunoprecipitation and surface plasmon resonance analysis. Although none of the SARS-CoV proteins was found to be directly bound to HAb18G/CD147, the nucleocapsid (N) protein of SARS-CoV was bound to CyPA, which interacted with HAb18G/CD147. Further research showed that HAb18G/CD147, a transmembrane molecule, was highly expressed on 293 cells and that CyPA was integrated with SARS-CoV. HAb18G/CD147-antagonistic peptide (AP)-9, an AP of HAb18G/CD147, had a high rate of binding to 293 cells and an inhibitory effect on SARS-CoV. These results show that HAb18G/CD147, mediated by CyPA bound to SARS-CoV N protein, plays a functional role in facilitating invasion of host cells by SARS-CoV. Our findings provide some evidence for the cytologic mechanism of invasion by SARS-CoV and provide a molecular basis for screening anti-SARS drugs.     

养血清脑颗粒联合尼莫地平治疗颈性眩晕的临床研究

目的 研究养血清脑颗粒联合尼莫地平片治疗颈性眩晕的临床疗效。方法 选取2019年2月-2020年2月天津市第一中心医院收治的100例颈性眩晕患者,将所有患者随机分为对照组和治疗组,每组各50例。对照组患者口服尼莫地平片,1片/次,3次/d。治疗组在对照组基础上口服养血清脑颗粒,1袋/次,3次/d。两组患者持续治疗10 d。观察两组患者临床疗效,比较两组的临床症状缓解时间、椎动脉型颈椎病功能评定量表（FS-CSA）评分、椎动脉血流速度和血清内皮素（ET）、降钙素基因相关肽（CGRP）水平。结果 治疗后,对照组和治疗组的总有效率分别为78.00%、96.00%,两组比较差异有统计学意义（P<0.05）。治疗后,治疗组患者眩晕、前庭功能受损、耳蜗症状、自主神经症状消失时间显著短于对照组（P<0.05）。治疗后,两组FS-CSA评分显著降低,椎动脉血流速度显著升高（P<0.05）;并且治疗组FS-CSA评分和椎动脉血流速度改善较明显（P<0.05）。治疗后,两组血清ET水平显著降低,CGRP水平显著升高（P<0.05）;并且治疗组血清ET和CGRP水平改善较明显（P<0.05）。结论 养血清脑颗粒联合尼莫地平片用于治疗颈性眩晕能够缩短临床症状缓解时间,升高椎动脉血流速度,改善患者临床症状和血清ET、CGRP水平。     

舒芬太尼与瑞芬太尼分别复合丙泊酚对小儿麻醉诱导期血压和脑电双频指数的影响比较

目的:探讨舒芬太尼复合丙泊酚与瑞芬太尼复合丙泊酚两种麻醉方案的优劣。方法:以2016年3月至2017年3月在我院进行择期全麻手术的患儿150例作为研究对象,根据进行全麻手术的时间先后编号,采用随机数表法分为舒芬太尼组和瑞芬太尼组各75例。舒芬太尼组患儿采用舒芬太尼复合丙泊酚进行全麻,瑞芬太尼组患儿采用瑞芬太尼复合丙泊酚进行全麻。观察并比较两组患儿在麻醉诱导期[诱导前(T1)、静脉注射舒(瑞)芬太尼后(T2)、静脉注射丙泊酚后(T3)、插管即刻(T4)、插管后2 min(T5)、5 min(T6)]的收缩压(SAP)、舒张压(DBP)、平均动脉压(MAP)和脑电双频指数(BIS)。结果:舒芬太尼组患儿在T4时的DBP、MAP均优于瑞芬太尼组(P均<0.05);两组患儿在各时间点的BIS比较差异无统计学意义(P均>0.05)。舒芬太尼组患儿自主呼吸恢复、肢体动作恢复和拔管时间均短于瑞芬太尼组(P<0.05);呼吸抑制、苏醒期躁动、恶心呕吐和意识障碍发生情况均少于瑞芬太尼组(P<0.05)。结论:与瑞芬太尼复合丙泊酚相比,舒芬太尼复合丙泊酚能够显著改善患儿的术后疼痛,同时呼吸抑制等副作用较小,在需要进行全麻手术的患儿中应用具有明显优势。     

Comparison of seven different reagents of peroxidase method for small and dense low density lipoprotein cholesterol (sdLDL‐C) measurement

BackgroundWe validated the performance of seven different reagents of peroxidase method for sdLDL‐C in two automatic analyzers that are common in Chinese laboratories.MethodsSeven commercially available sdLDL‐C assays were analyzed with the Beckman AU5400 and Mindray BS2000 automatic analyzers. A total of 336 blood samples were collected and the reference interval was also validated in 298 apparently healthy individuals. Serum samples were used for method comparison of precision, recovery, lower limit of detection, comparison and concurrence analysis, as well as reference interval for the Mindray reagent.ResultsThe repeatability CV% of the seven sdLDL‐C assays were 0.81%~3.66% for Mindray BS2000 and 0.76%~3.91% for Beckman AU5400, while Total CVs for Mindray BS2000 sdLDL‐C assay were 1.34%~4.81%, and that of Beckman AU5400 were 2.25%~10.33%. The measured recovery rates of sdLDL‐C assays were within the allowable ±10% deviation range. There was no obvious difference between the reagents in the lower limit detection. There was a difference between the validation results of the reference range and the manufacturer''s.BSBE, Mindray, and Dongou had a high degree of association with DENKA SEIKEN on Mindray BS2000, while BSBE, Mindray, Dongou and Merit Choice had a high degree of association with DENKA SEIKEN on Beckman AU5400. Passing–Bablok regression showed excellent linear correlation between BSBE and Mindray and DENKA SEIKEN and on Beckman AU5400.ConclusionsOur results indicate that the basic performance can meet the testing requirements, but the comparability between them is still insufficient.