发热待查75例临床分析

目的探讨不明原因发热(FUO)的病因和临床特征。方法回顾性分析2005年1月～2012年1月在我科住院且符合FUO诊断标准的75例患者的临床资料,总结了病因、诊断方法和临床表现。结果 75例患者中,68例(90.7%)最终确诊,感染性疾病22例(32.4%),其中结核病9例(40.9%)、传染性单核细胞增多症5例(22.7%);结缔组织病29例(42.6%),其中成人Still病17例(58.6%)、系统性红斑狼疮6例(20.7%);恶性肿瘤10例(14.7%),其中淋巴瘤6例(60.0%);其他疾病7例(10.3%),其中组织细胞坏死性淋巴结炎4例(57.1%)。结论 FUO涉及的病因众多,发病机制复杂,感染性疾病、结缔组织病仍是发热待查的主要原因,肿瘤性疾病在发热待查中也占相当的比例,临床工作中要开阔思路,全面搜集资料,以利于明确诊断。     

住院患者入院时血糖水平与医疗费用、疾病预后的相关研究

目的探讨住院患者人院时不同血糖水平与住院时间、医疗费用及疾病预后的关系。方法选取2009年11月至2011年7月期间人院的4868例患者,按入院24h内测得的血糖水平分为非高血糖组3429例、高血糖组1439例,后者包括糖尿病和应激性高血糖患者;根据患者年龄分为非老年组（年龄〈60岁）2532例和老年组（年龄≥60岁）2336例;其中278例冠心病患者再分为高血糖组120例和非高血糖组158例。各组间进行有关数据比较。结果高血糖组患者的住院天数、医疗费用和总病死率均显著高于非高血糖组（中位数住院日：15vs10d,P〈0．01;中位数医疗费用：14064．7vs8980．9元,P〈0．01;死亡率：2．92％vs0．61％,P〈0．01）。按年龄分组后,无论是非老年组还是老年组中糖尿病和应激性高血糖患者的医疗费用均明显高于非高血糖患者,住院日明显延长;应激性高血糖患者的医疗费用明显高于糖尿病患者;非老年组中应激性高血糖患者的死亡率明显高于非高血糖患者,但与糖尿病患者相比无明显差异,老年组糖尿病和应激性高血糖患者的死亡率无明显差异,但均明显高于非高血糖患者。冠心病患者中糖尿病和应激性高血糖患者与非高血糖患者的年龄无明显差异,前两组的医疗费用明显高于非高血糖组,住院日更长（分别为14,15和12d）、死亡率更高（分别为6．41％,7．14％和0．63％）。结论入院时高血糖水平预示患者有更高的医疗花费、更长的住院时间和更高的死亡率。     

抗血小板疗法在老年急性冠脉综合征的临床应用

虽然大多数抗血小板疗法治疗急性冠脉综合征（ACS）的临床试验证实有显著临床效益,但老年患者,特别是≥75岁患者,仅少数有效,多数疗效欠佳,而出血风险增加。本文对因老龄化导致的止血血栓与出血的病理生物学,血管修复与整合作用变化,以及ACS抗血小板疗法在近年来临床试验中老年患者的效益与风险进行讨论。     

Colletotrichum species associated with cultivated citrus in China

There have been considerable advances in the understanding of species concepts in the genus Colletotrichum. This has lead to the need to carry out fresh surveys of Colletotrichum species associated with important hosts. Colletotrichum species are associated with Citrus plants as saprobes, important pre-harvest and post-harvest pathogens, as well as endophytes. In this study, a total of 312 Colletotrichum strains were isolated from leaves, shoots and fruits of cultivated Citrus and Fortunella species with or without disease symptoms across the main citrus production areas in China. The morphology of all strains were studied and multilocus (ACT, TUB2, CAL, GAPDH, GS, ITS) phylogeny established. Strains were from four important species complexes of Colletotrichum, namely C. gloeosporioides species complex, C. boninense species complex, C. acutatum species complex and a final group including C. truncatum, which was rare on Citrus species. The species belonging to the C. gloeosporioides species complex comprised C. gloeosporioides and C. fructicola, the C. boninense complex comprised C. karstii and a new species C. citricola and the C. acutatum complex included a new species, C. citri. The ability of strains to cause anthracnose on citrus fruits was tested by inoculation and strains of Colletotrichum gloeosporioides, C. fructicola and C. truncatum were pathogenic.     

Species of the Colletotrichum gloeosporioides complex associated with anthracnose diseases of Proteaceae

Anthracnose disease of Proteaceae has in the past chiefly been attributed to infections by C. acutatum, C. boninense and C. gloeosporioides. In the present study, a multi-locus phylogenetic analysis (ACT, CAL, CHS-1, GAPDH, GS, ITS, TUB2) revealed that strains of the C. gloeosporioides complex associated with Proteaceae belong to at least six species. These include C. alienum, C. aotearoa, C. kahawae (subsp. ciggaro), C. siamense, and two new taxa, C. proteae and C. grevilleae. The most economically important pathogen of Proteaceae seems to be C. alienum, and not C. gloeosporioides as previously reported. All taxa associated with Proteaceae are morphologically described on different media in culture, except strains of C. siamense, which proved to be sterile. Furthermore, C. populi is synonymised with C. aenigma.     

Secrets from friends and parents: Longitudinal links with depression and antisocial behavior

Keeping secrets from parents is associated with depression and antisocial behavior. The current study tested whether keeping secrets from best friends is similarly linked to maladjustment, and whether associations between secrecy and maladjustment are moderated by the quality of the friendship. Adolescents (N = 181; 51% female, 48% white, non-Hispanic, 45% African American) reported their secrecy from parents and best friends, the quality of their parent–adolescent relationships and best friendships, and their depression and antisocial behavior at ages 12 and 13. Keeping more secrets from best friends was associated with more depression, but not with more antisocial behavior, when controlling for earlier adjustment, secrecy from parents, and the quality of the friendship. For girls associations between maladjustment and secrecy were conditioned by the quality of the relationships and whether secrets were kept from parents and friends. Discussion argues for expanding the study of secrecy in adolescence beyond the parent–child dyad.     

改善愈合微环境是中西医创面治疗的共同思路

中医和西医创面治疗的根本是有效去除影响创面愈合的障碍性因素,改善创面愈合的微环境,提高组织的再生修复能力,进而加速创面愈合,提高创面愈合质量。两者都是通过补充和调控外源/内源性生长因子的合成和分泌,促进细胞分裂增殖,刺激创面新生血管形成,改善创面的血液循环,调控胶原的合成及代谢,调节创面修复基质形成,营养创面等方式发挥作用。在改善创面微环境的核心理念基础上,将两类方法有机地加以组合,可以加速创面修复。     

我国食品来源金黄色葡萄球菌种群结构分析

目的了解我国食源性金黄色葡萄球菌(金葡菌)的种群结构。方法通过全基因组测序方法对2006-2020年我国16个省份收集的763株食源性金葡菌进行多位点序列分型、葡萄球菌蛋白A编码基因(spa)和葡萄球菌染色体mec基因盒(SCCmec)分型, 使用BioNumerics 7.5软件创建基于ST类型的最小生成树。国外进口食品分离到的金葡菌31株被纳入基因组系统发育树的构建。结果 763株金葡菌共鉴定出90个ST型和160个spa型别, 其中20种为新ST型别。72个(72/90, 80.0%)ST型属于22个克隆群, 其中主要型别为CC7、CC1、CC5、CC398、CC188、CC59、CC6、CC88、CC15和CC25, 占82.44%(629/763)。其中优势克隆群中ST型和spa型别随着时间的变化呈多态性变化。耐甲氧西林金葡菌(MRSA)的阳性率为7.60%, 共鉴定出7种SCCmec型别, 以ST59-t437-Ⅳa(17.24%, 10/58)、ST239-t030-Ⅲ(12.07%, 7/58)、ST59-t437-Ⅴb(8.62%, 5/58)、ST338-t437-...     

人体系统变质量块体动力学研究

在人体系统变质量力学模型研究基础上,开展了人体系统变质量块体动力学研究.主要内容有人体系统变质量块体的概念、人体系统变质量块体坐标系与基本定义、人体系统变质量块体的质心运动定理、人体系统变质量体定点的运动定理,为人体系统变质量力学模型和人体系统在质量变化过程中的物质流、能量流、信息流的运动规律的数字化研究提供理论基础.