临床生化检验中血脂测量不确定度的评定

目的通过对血脂两项甘油三酯（TG）和胆固醇（CHOL）测量不确定度（measurement uncertainty,MU）的评定,熟悉临床检验项目测量不确定度的来源及评定过程。方法遵照《测量不确定度表达指南》（GUM）,根据血脂两项甘油三酯和胆固醇的检测原理,评估检测中测量不确定度的来源,确定各不确定度分量的大小,最终计算合成不确定度和扩展不确定度。结果甘油三酯和胆固醇的合成不确定度分别为6．00％、5．70％;取95％的置信区间K=2时,扩展不确定度对应为12．00％、11．40％。结论综观血脂评定的过程可以得出,测量不确定度能够更全面地反映检测的质量,测量不确定度有别于误差,其量值明显大于误差理论中的常规条件下的变异（RCV）和最适条件下的变异（OCV）值。熟悉检验项目测量的不确定度并积极开展其评定,最大限度地降低其量值的大小,有利于检验工作的持续改进。     

多层螺旋CT图像后处理在输尿管微小结石中的诊断

目的探讨多层螺旋CT（MSCT）图像后处理在输尿管微小结石诊断中的应用价值。方法对28例共29枚微小结石,应用多排螺旋CT扫描,图像拆薄后进行重建及图像后处理,在横断位、MPR、CPR、MIP、CTU、VR图像上对输尿管微小结石CT征象进行分析。结果对29枚微小结石在MSCT及图像后处理后全部明确诊断。输尿管上段10枚结石,中段8枚,下段11枚。检出率明显优于KUB及BUS。结论MSCT及图像后处理明显提高了输尿管微小结石的检出率,是诊断输尿管微小结石可靠的检查方法。     

心脏MR评价肥厚型心肌病左心房功能的应用研究

目的 探讨心脏MR在肥厚型心肌病的左心房功能评估中的价值,分析肥厚型心肌病的左心房功能的变化特点.方法 回顾性分析29例肥厚型心肌病患者的心脏MR资料,获取临床常规的二腔心、三腔心以及四腔心电影序列图像,使用心脏分析软件Report-Card 4.0测量左心房的内径、容积,评价左心房的收缩功能.收集30例正常志愿者作为对照,比较肥厚型心肌病组与正常组之间的左心房内径、容量以及功能的差异.结果 29例肥厚型心肌病左心房二腔心长径、四腔心长径、三腔心前后径较对照组增大[分别为（62.55±8.19）mm和（44.35±6.34）mm,t=9.565;（70.10±12.05）mm和（53.95±6.96）mm,t=6.332;（41.37±8.99）mm和（28.89±4.36）mm,t=6.819）],左心房二腔心面积、四腔心面积、三腔心面积较对照组增大[（分别为（2698.24±749.16）mm^2和（1634.41±294.67）mm^2,t=7.298;（3077.50±863.77）mm^2和（1909.23±323.86）mm^2,t=6.925;（2622.14±720.42）mm^2和（1633.63±281.41）mm^2,t=7.269）],左心房最大容积、最小容积、左房收缩前容积较对照组增大[（分别为（116.62±49.34）ml和（60.08±13.18）ml,t =6.058;（70.38±42.22）ml和（22.06±7.90）ml,t=6.161;（96.37±44.42）ml和（38.96±12.09）ml,t=6.825）],左心房射血分数、被动射血分数、主动射血分数较较正常组减小[（分别为（41.53±11.70）％和（63.61±9.56）％,t=-7.952;（17.55±9.48）％和（50.41±15.13）％,t=-9.958;（28.94±12.54）％和（43.20±12.78）％,t=-4.324）,两组之间的差异均有统计学意义（P值均小于0.05）.结论 利用心脏MR中临床常规的二、三、四腔心电影序列,对肥厚型心肌病患者的左心房功能进行定量评估发现,肥厚型心肌病患者不仅表现为心房增大,其心房的收缩功能也明显减退.     

斛皮素缓解阿霉素急性肝脏毒性的实验研究

[目的]研究斛皮素对阿霉素引起的小鼠急性肝脏毒性的作用。[方法]C57BL/6小鼠随机分成4组：对照组、斛皮素组、阿霉素组、联用组,观察体重、血清谷草转氨酶（AST）、谷丙转氨酶（ALT）变化,HE染色观察组织病理学改变,TUNEL染色观察细胞凋亡情况。[结果]阿霉素组小鼠死亡率为20%,其余组为0。斛皮素能明显缓解阿霉素引起的体重减轻及AST、ALT酶系失调,并明显缓解肝脏细胞的病变及细胞凋亡的发生。[结论]斛皮素对阿霉素引起的小鼠急性肝脏毒性具有保护作用。     

Association of Merkel cell polyomavirus infection with EGFR mutation status in Chinese non-small cell lung cancer patients

Objectives

Female lung cancer patients with no smoking habit and non-mucinous adenocarcinoma have a higher rate of epidermal growth factor receptor (EGFR) gene mutations, which is related to tyrosine kinase inhibitors (TKIs) sensitivity. Unfortunately the cause of EGFR gene mutations is still elusive. In this study, we search for the association between Merkel cell polyomavirus (MCPyV) infection and EGFR gene mutations.

Materials and methods

We studied 189 non-small cell lung cancer (NSCLC) samples for the presence of MCPyV large T (LT) DNA, LT antigen and EGFR hotspot mutations. Clinicopathological parameters of this cohort were also analyzed.

Results

Thirty out of 163 adenocarcinoma and 2 out of 18 squamous cell carcinoma were found to have MCPyV LT DNA by PCR. Immunostaining also showed LT protein expression in most of the DNA positive samples. EGFR mutations were more frequently detected in female (P = 0.009) and non-smoking patients (P = 0.0001). Furthermore, a significant association between MCPyV infection and EGFR mutations was found (P = 0.001).

Conclusion

Our study shows that MCPyV LT DNA is present in a subgroup of NSCLC, which is significantly correlated with EGFR mutations. To the best of our knowledge, this is the first study to find an association between MCPyV infection and EGFR hotspot mutations. These results support the possibility that MCPyV has a partial role in the carcinogenesis of NSCLC in a subgroup of patients.     

Bibliometric analysis of IgG4-related disease research from 2003 to 2022 based on Web of Science Core Collection Databases

Clinical Rheumatology - This study aimed to perform a bibliometric analysis of the IgG4-related disease (IgG4-RD) research field over the past 20 years to explore its research hotspots and trends....     

局部肌内注射致腰背部及臀部气性坏疽一例报告

报告1例因进行局部肌内注射导致腰背部及臀部气性坏疽的临床病例。男,43岁,因腰痛在当地私人诊所就诊,给予腰背部及臀部局部肌内注射封闭治疗,肌内注射5~6 h后腰痛加重,疼痛视觉模拟评分(visual analogue scale,VAS)为5分,伴发热;1天后,腰痛VAS评分8分,出现酱油色尿,伴发热。根据实验室检查以及临床表现出现多器官功能衰竭,影像学(CT)提示腰背部棘突旁及右侧臀部软组织出现大面积气体,伴椎旁及臀部肌肉坏死征象,初步诊断:腰背部及臀部感染,高度怀疑气性坏疽。根据病情进展,入院后急诊行腰背部及右臀部扩创术,术中细菌快速涂片报告革兰氏阳性粗大杆菌,厌氧菌培养提示产气荚膜梭菌,需氧菌培养结果未见任何细菌生长。根据病史、影像资料、术中判断、术后培养结果,临床诊断:气性坏疽。气性坏疽是临床特殊感染疾病,其发病率低,早期诊断困难,疾病进展快,死亡率高。肌内注射导致该疾病的发生,需要强调规范化无菌操作的重要性。