一体化链式急救措施结合Orem自理干预模式在糖尿病伴创伤性骨折患者中的应用价值

目的分析一体化链式急救措施结合Orem自理干预模式对糖尿病(DM)伴创伤性骨折患者救治情况及生活质量综合评定问卷(GQOLI-74)评分、心理健康自评量表(SAS/SDS)评分的影响。方法选取中国医科大学附属第一医院2017年1月-2019年4月收治的120例DM合并创伤性骨折患者,随机分为观察组与对照组,每组60例。对照组采用常规护理方案,观察组在对照组的基础上采用一体化链式急救措施结合Orem自理干预模式护理。记录两组患者的抢救成功率、急救时间,比较两组入组时、治疗2周及治疗1个月时的空腹血糖水平。治疗1个月后,对患者家属满意度及疾病相关知识知晓率进行调查,并记录患者的并发症发生情况。入组后及治疗3个月时采用GQOLI-74评分量表、SAS/SDS评分量表对患者生活质量及心理状态进行评估。结果观察组的抢救成功率为100.00%,明显高于对照组的95.00%,差异有统计学意义(P<0.05)。观察组的病情评估时间、生命体征判断时间及基本生命支持抢救时间均明显短于对照组,差异有统计学意义(P<0.05)。观察组治疗2周及治疗1个月时的血糖水平为(6.74±0.61)、(6.32±0.54)mmol/L,明显低于对照组的(7.58±0.55)、(7.11±0.38)mmol/L,差异有统计学意义(P<0.05)。观察组治疗后的满意率及疾病相关知识知晓率为93.33%、100.00%,明显高于对照组的80.00%、88.33%,差异有统计学意义(P<0.05)。观察组治疗3个月时GQOLI-74评分中的躯体功能、心理功能、社会功能及物质功能分别为(74.59±6.17)、(77.84±6.18)、(70.29±5.02)、(77.34±7.39)分,明显高于对照组的(67.85±5.75)、(69.43±6.05)、(66.12±4.95)、(70.93±6.55)分,差异有统计学意义(P<0.05)。观察组治疗3个月时的SAS评分及SDS评分为(34.28±5.03)、(35.58±5.73)分,明显低于对照组的(45.54±5.65)、(44.73±6.15)分,差异有统计学意义(P<0.05)。观察组治疗后的并发症发生率为5.00%,明显低于对照组的18.33%,差异有统计学意义(P相似文献   

Role of metalloproteinases in platelet function

Platelets contain and release matrix metalloproteinases (MMPs), their inhibitors (TIMPs) and disintegrin metalloproteinases (ADAMs) including MMP-1, MMP-2, MMP-3, MMP-9, MT1-MMP (MMP-14), ADAM-10, ADAM-17, ADAMTS-13, TIMP-1, TIMP-2 and TIMP-4. These proteins exert several effects regulating platelet functions such as agonist-stimulated platelet adhesion and aggregation, tumour cell-induced platelet aggregation and platelet-leukocyte aggregation. In this review, mechanisms of MMPs, TIMPs and ADAMs on platelets are discussed.     

七叶皂苷钠抑制人甲状腺未分化癌HTh74细胞株增殖作用的研究

目的 研究七叶皂苷钠对人甲状腺未分化癌HTh74细胞株增殖的潜在抑制作用及其分子机制.方法 以不同浓度的七叶皂苷钠(0,20,40,60,80 μmol/L)处理HTh74细胞48 h后,观察细胞形态变化;以不同浓度的七叶皂苷钠(0,20,40,60,80 μmol/L)处理HTh74细胞24h、48 h和72 h后,噻唑蓝比色(MTT)法检测七叶皂苷钠对HTh74细胞株增殖的抑制效应并计算细胞增殖率及半数抑制率(IC50);以不同浓度的七叶皂苷钠(0,5,10,15,20,25 μmol/L)处理HTh74细胞48 h后,Western印迹检测七叶皂苷钠引起的蛋白激酶B(Akt)、磷酸化Akt(p-Akt)以及细胞周期相关蛋白的表达.结果 七叶皂苷钠作用后,细胞发生明显皱缩,且作用浓度越高细胞皱缩越明显;MTT法结果显示,七叶皂苷钠对HTh74细胞有显著的生长抑制作用,呈现典型的时间与剂量依赖性,80 μmol/L七叶皂苷钠作用24 h,对细胞的生长抑制作用有统计学意义(F=111.4,P＜0.01),而40 μmol/L作用48 h及72 h时,细胞生长均受到抑制(F=543.6,722.1,P＜0.01),并且48 h的IC50为69.4μmol/L,72 h的IC50为32.5μmol/L;七叶皂苷钠作用48 h后Akt、p-Akt和细胞周期蛋白依赖性激酶(CDK)2的表达显著降低,并呈现剂量依赖效应.与未经处理的细胞相比,低浓度(5 μmol/L和10 μmol/L)七叶皂苷钠处理时Akt和p-Akt的表达水平已开始降低(F=613.9,P＜0.05),而从15 μmol/L开始,CDK2表达的降低有统计学意义(F=208.9,208.3,P＜0.05).CDK1、CDK6、细胞周期蛋白D以及细胞周期蛋白E的表达在各处理组间差异无统计学意义(P均＞0.05).结论 七叶皂苷钠可抑制人甲状腺未分化癌HTh74细胞的增殖,可能是通过调节Akt、p-Akt以及CDK2等蛋白的表达实现的.     

中国人群新等位基因HLA-B*40:74的序列分析及认定

目的 序列分析及认定1例中国人群HLA新等位基因.方法 应用聚合酶链反应-序列特异性寡核苷酸探针(polymerase chain reaction-sequence specific oligonucleotide probes,PCRSSOP)基因分型方法和基于测序的分型方法(sequencing-based typing,SBT),通过软件分析该基因序列及与最相近等位基因序列的差异.结果 PCR-SSOP结果显示,该样本HLA-B位点反应格局出现异常提示;测序结果最终表明其B位点第2外显子序列与所有已知HLA-B等位基因序列均不一致,与序列最相近的等位基因B* 40:01:01,在所检测的第2、3、4外显子中的差异只是在第2外显子发生了nt103G→T,nt106A→G两个核苷酸替代,并导致相应的第35位密码子由A(丙氨酸)→S(丝氨酸),第36位密码子由M(蛋氨酸)→V(缬氨酸).结论 该基因为HLA-B新等位基因,被世界卫生组织HLA因子专用术语命名委员会正式命名为HLA-B* 40:74( HWS10004518-EF458488).     

频率适应性起搏器对老年心动过缓患者生活质量的影响

目的:评估频率适应性起搏对老年心动过缓患者生活质量的影响。方法:选择来自本院安装人工心脏起搏器的96例老年心动过缓患者,并根据起搏器的类型分为频率适应性起搏器组(41例)和非频率适应性起搏器组(55例)。采用心脏超声、运动耐量测定及生活质量综合评定问卷调查,综合评估两组生活质量。结果:频率适应性起搏器组心脏超声及心功能指标不优于非频率适应性起搏器组,但前者的运动耐量及生活质量中的躯体功能、心理功能、社会功能多项指标明显提高。结论:频率适应性起搏器能明显提高老年心动过缓患者的运动耐量和生活质量。     

齐拉西酮对男性精神分裂症临床疗效及生活质量的影响

目的：探讨齐拉西酮对男性精神分裂症患者临床疗效及生活质量的影响。方法将66例男性精神分裂症患者随机分为两组,每组33例,研究组口服齐拉西酮治疗,对照组口服利培酮治疗,观察10周。于治疗前后采用简明精神病评定量表评定临床疗效,副反应量表评定不良反应,生活质量综合评定问卷评定生活质量。结果治疗后两组简明精神病评定量表评分均较治疗前显著下降（P＜0．01）,两组间评分比较差异均无显著性（P＞0．05）。两组不良反应较轻微,研究组总体不良反应发生率以及锥体外系反应、体质量增加发生率显著低于对照组（P＜0．05）。治疗10周末研究组生活质量综合评定问卷总分及身体健康、心理健康维度分显著高于对照组（ P＜0．05或0．01）。结论齐拉西酮治疗男性精神分裂症疗效显著且与利培酮相当,不良反应发生率低、治疗依从性好,有利于提高患者的生活质量。     

Prediction of the response to photodynamic therapy in patients with chronic central serous chorioretinopathy based on optical coherence tomography using deep learning

PurposeTo assess the prediction of the response to photodynamic therapy (PDT) in chronic central serous chorioretinopathy (CSCR) based on spectral-domain optical coherence tomography (SD-OCT) images using deep learning (DL).MethodsRetrospective study including 216 eyes of 175 patients with CSCR and persistent subretinal fluid (SRF) who underwent half-fluence PDT. SD-OCT macular examination was performed before (baseline) and 3 months after treatment. Patients were classified into groups by experts based on the response to PDT: Group 1, complete SRF resorption (n = 100); Group 2, partial SRF resorption (n = 66); and Group 3, absence of any SRF resorption (n = 50). This work proposes different computational approaches: 1st approach compares all groups; 2nd compares groups 1 vs. 2 and 3 together; 3rd compares groups 2 vs. 3.ResultsThe mean age was 55.6 ± 10.9 years and 70.3% were males. In the first approach, the algorithm showed a precision of up to 57% to detect the response to treatment in group 1 based on the initial scan, with a mean average accuracy of 0.529 ± 0.035. In the second model, the mean accuracy was higher (0.670 ± 0.046). In the third approach, the algorithm showed a precision of 0.74 ± 0.12 to detect the response to treatment in group 2 (partial SRF resolution) and 0.69 ± 0.15 in group 3 (absence of SRF resolution).ConclusionDespite the high clinical variability in the response of chronic CSCR to PDT, this DL algorithm offers an objective and promising tool to predict the response to PDT treatment in clinical practice.     

肺癌患者发病情况和经济负担的分析

背景与目的肺癌在我国具有较高的发病率和致死率，并造成了较大的经济负担，本研究旨在通过分析河北省肿瘤医院肺癌患者出院病历首页的相关信息，研究肺癌的发病情况和经济负担，为肺癌的防治研究提供科学依据。方法基于病案管理系统检索出2012年1月-2019年12月河北省肿瘤医院肺癌患者的出院人次、新发人数、手术人数、年龄、性别、住院天数和住院费用等信息，统计描述肺癌患者发病趋势、性别和年龄分布以及疾病的经济负担。结果肺癌新发人数逐年增加，2012年肺癌新发2, 235人，2019年为5, 012人。发病人数男性始终大于女性，但男女性别比逐年降低，由2012年的2.25降至2019年的1.56。肺癌新发人数中手术治疗的比例逐年增加，由2012年的28.14%增长到2019年的44.83%。除2012年外，2013年-2019年女性患者的手术比例均高于男性，并且逐年增加，2013年新发肺癌男女患者的手术比例分别为23.52%和28.07%，2019年分别为36.14%和58.37%。肺癌患者的中位发病年龄逐年增长，2012年新发肺癌患者的中位年龄为61岁，2019年为63岁。全部肺癌患者的中位发病年龄，男性均大于女性。肺癌新发患者和手术患者的人数都显示出随着年龄的增长而增加的趋势，且均在60岁-69岁的年龄组段达到最大值，随着年龄的增长，患者人数逐渐减少，所有年龄组段的发病人数也逐年增加。所有出院人次的肺癌患者和手术患者的中位住院天数逐年减少，分别由2012年的10 d和19 d降低至2019年的8 d和17 d，而中位住院费用逐年升高，分别由2012年的10, 611.46元和38, 750.13元增长到2019年的17, 187.15元和84, 030.16元。结论肺癌仍是危害我国居民健康的主要癌种之一，发病人数逐年增加，性别和年龄分布具有一定的特征，应制定有效的防控措施，加强医疗改革，减少发病人数和经济负担。     

Development and evaluation of an antigen-capture ELISA for detection of the UL24 antigen of the duck enteritis virus, based on a polyclonal antibody against the UL24 expression protein

An antigen-capture enzyme-linked immunosorbent assay (AC-ELISA) method was developed for the efficient detection of the UL24 antigen of the duck enteritis virus (DEV) using polyclonal antibodies. Ducks and rabbits were immunized, respectively, with expressed UL24 recombinant protein. The IgG antibodies against UL24 from ducks and rabbits were purified and used as the capture antibodies. The specificity of the optimized AC-ELISA was evaluated by use of DEV, duck hepatitis virus (DHV), duck hepatitis B virus (DHBV), gosling plague virus (GPV), Riemerella anatipestifer (R.A.), Escherichia coli (E. coli), Pasteurella multocida (P.M.) and Salmonella Enteritidis (S.E.). Only DEV specimens yielded a specific and strong signal. The limit of the sensitivity of this method for the detection of DEV was 46 ng/100 μl. Compared with PCR and virus isolation, the rate of agreement for the detection of experimentally infected sera was 100%. A comparative test used on clinical specimens between the neutralization test and the AC-ELISA showed that the proportions of true positives and true negatives by the AC-ELISA were 0.90 and 0.67 respectively. These results indicated that the AC-ELISA approach is rapid, sensitive, and reliable for specific detection of DEV antigen.     

Development of a novel,guinea pig-specific IFN-γ ELISPOT assay and characterization of guinea pig cytomegalovirus GP83-specific cellular immune responses following immunization with a modified vaccinia virus Ankara (MVA)-vectored GP83 vaccine

The guinea pig (Cavia porcellus) provides a useful animal model for studying the pathogenesis of many infectious diseases, and for preclinical evaluation of vaccines. However, guinea pig models are limited by the lack of immunological reagents required for characterization and quantification of antigen-specific T cell responses. To address this deficiency, an enzyme-linked immunospot (ELISPOT) assay for guinea pig interferon (IFN)-γ was developed to measure antigen/epitope-specific T cell responses to guinea pig cytomegalovirus (GPCMV) vaccines. Using splenocytes harvested from animals vaccinated with a modified vaccinia virus Ankara (MVA) vector encoding the GPCMV GP83 (homolog of human CMV pp65 [gpUL83]) protein, we were able to enumerate and map antigen-specific responses, both in vaccinated as well as GPCMV-infected animals, using a panel of GP83-specific peptides. Several potential immunodominant GP83-specific peptides were identified, including one epitope, LGIVHFFDN, that was noted in all guinea pigs that had a detectable CD8+ response to GP83. Development of a guinea pig IFN-γ ELISPOT should be useful in characterization of additional T cell-specific responses to GPCMV, as well as other pathogens. This information in turn can help focus future experimental evaluation of immunization strategies, both for GPCMV as well as for other vaccine-preventable illnesses studied in the guinea pig model.