血清sCD14、HMGB1联合检测在肺部感染疾病中的临床诊断价值

目的探讨肺部感染患者血清可溶性白细胞分化抗原14(sCD14)、高迁移率族蛋白B1(HMGB1)临床应用价值。方法选取2017年10月至2018年6月在新疆军区总医院就诊的74例肺部感染患者作为实验组,同期62例健康体检者为对照组。采集研究对象血清标本,采用酶联免疫吸附测定法检测血清中sCD14、HMGB1水平;采用全自动免疫化学发光分析仪检测血清降钙素原(PCT)及白细胞介素-6(IL-6)水平。结果实验组sCD14、HMGB1水平分别为4.06(2.98~5.31)ng/mL、469.50(251.35~746.33)pg/mL,显著高于对照组(P<0.05)。单独sCD14、HMGB1检测诊断肺部感染的灵敏度依次为82.40%、56.80%,特异度为90.30%、85.50%,二者联合检测可提升灵敏度至92.40%,与PCT、IL-6联合检测的诊断效能接近。结论血清中sCD14、HMGB1联合检测对于肺部感染的辅助诊断具有一定价值,操作简捷、便携、易行,可作为缺少大型检验仪器设备的小、散、远医疗卫生机构快速诊疗肺部疾病的感染性标志物。     

The protective effects of HMGA2 in the senescence process of bone marrow‐derived mesenchymal stromal cells

Bone marrow‐derived mesenchymal stromal cells (MSCs) have been wildly applied to cell‐based strategies for tissue engineering and regenerative medicine; however, they have to undergo the senescence process and thus appeared to be less therapeutic effective. HMGA2, a protein belonged to high mobility group A (HMGA) family, exhibits an inverse expression level related to embryonic development and acts as a developmental regulator in stem cell self‐renewal progression. Therefore, we performed senescence‐associated β‐galactosidase (SA‐β‐gal) staining, transwell assay, to examine the changes of MSCs in different stages and then over‐expressed HMGA2 in MSCs by lentivirus transfection. We found the percentage of SA‐β‐gal staining positive cells in MSCs from 24‐month‐old Sprague–Dawley (SD) rats (O‐MSCs) was significantly higher compared with MSCs from 2‐week‐old SD rats (Y‐MSCs), and the expression levels of P21 and P53, two senescence‐related molecules, were also significantly up‐regulated in O‐MSCs than in Y‐MSCs. In contrast, the HMGA2 expression level in O‐MSCs was dramatically down‐regulated in contrast to Y‐MSCs. In additional, the migration ability in O‐MSCs was significantly attenuated than in Y‐MSCs. After successfully over‐expressed HMGA2 in O‐MSCs, the percentage of SA‐β‐gal staining positive cells and the expression levels of P21 and P53 were reduced, and the migration ability was improved compared with O‐MSCs without treatment. Further, mRNA sequencing analysis revealed that overexpression of HMGA2 changed the expression of genes related to cell proliferation and senescence, such as Lyz2, Pf4, Rgs2, and Mstn. Knockdown of Rgs2 in HMGA2 overexpression O‐MSCs could antagonize the protective effect of HMGA2 in the senescence process of O‐MSCs.     

免气腹与CO 2气腹腹腔镜双侧精索静脉高位结扎术的临床疗效比较

目的探讨免气腹与CO₂气腹腹腔镜精索静脉高位结扎术的临床疗效。 方法回顾性分析2010年5月至2016年4月解放军71军医院68例双侧精索静脉曲张患者行腰硬联合麻醉或全麻下双侧精索静脉高位结扎术的临床资料,其中34例行腹壁悬吊式免气腹腹腔镜手术（免气腹组）,34例行经腹CO₂气腹腹腔镜手术（气腹组）。观察症状和体征改变及并发症情况,比较2组手术时间、术后住院时间、肠道功能恢复时间;分别比较气腹组、免气腹组术前和术后9个月的精子密度、精子活动度。 结果2组患者手术均顺利完成,症状、体征均改善,无严重手术并发症。2组手术时间、术后住院时间、肠道功能恢复时间比较,差异均无统计学意义（P均＞0.05）;2组患者术后9个月精子密度与术前比较,差异均无统计学意义（P均＞0.05）,术后9个月精子活动率均较术前增高［气腹组：（78.59±6.50）% vs（74.41±6.95）%,免气腹组：（75.88±7.47）% vs（68.71±7.43）%］,差异具有统计学意义（t=6.549,P=0.013;t=15.770,P＜0.001）。 结论2种微创术式均可准确结扎精索内静脉,疗效确切,切口美观,术后恢复较快。免气腹手术避免了CO₂气腹对呼吸、循环系统的影响,无气腹并发症,可采用椎管内麻醉,作为更经济的术式选择。     

High‐fat diet selectively decreases bone marrow lin−/CD117+ cell population in aging mice through increased ROS production

Bone marrow (BM) stem cells (BMSCs) are an important source for cell therapy. The outcome of cell therapy could be ultimately associated with the number and function of donor BMSCs. The present study was to evaluate the effect of long‐term high‐fat diet (HFD) on the population of BMSCs and the role of reactive oxygen species (ROS) in aging mice. Forty‐week‐old male C57BL/6 mice were fed with HFD for 3 months with regular diet as control. Experiments were repeated when ROS production was reduced in mice treated with N‐acetylcysteine (NAC) or using mice overexpressing antioxidant enzyme network (AON) of superoxide dismutase (SOD)1, SOD3, and glutathione peroxidase. BM and blood cells were analyzed with flowcytometry for lineage negative (lin^?) and Sca‐1⁺, or lin^?/CD117⁺, or lin^?/CD133⁺ cells. Lin^?/CD117⁺ cell population was significantly decreased with increased intracellular ROS and apoptosis and decreased proliferation in BM, not in blood, in HFD‐treated mice without change for Sca‐1⁺ or CD133⁺ cell populations in BM or blood. NAC treatment or AON overexpression effectively prevented HFD‐induced intracellular ROS production and reduction of BM lin^?/CD117⁺ population. These data suggested that long‐term HFD selectively decreased BM lin^?/CD117⁺ cell population in aging mice through increased ROS production.     

优质护理干预对高热惊厥患儿预后的影响

目的分析优质护理干预对高热惊厥患儿预后的影响。方法选取我院收治的84例高热惊厥患儿作为研究对象,采用随机数字表法将其分为对照组(42例,常规护理)与观察组(42例,优质护理)。比较两组的临床相关指标、并发症发生情况及护理满意度。结果观察组患儿护理30 min后的体温低于对照组,惊厥消失时间及住院时间均短于对照组(P<0.05)。观察组患儿的并发症总发生率低于对照组(P<0.05)。观察组患儿家属的护理满意度高于对照组(P<0.05)。结论优质护理干预用于高热惊厥患儿,护理可有效缩短其惊厥消失时间,降低并发症发生率,改善预后,提升护理满意度。     

Upper limb repetitive strain injuries in Manitoba

A review of workers' compensation board (WCB) claims in Manitoba, Canada identified an estimated 382 upper limb repetitive strain injury (RSI) claims or 9.3% of all upper limb WCB claims accepted in 1991. Tendonitis and carpal tunnel syndrome (CTS) were the most frequent diagnoses (27.5% and 19.3%, respectively). Rates of RSI were not significantly different by gender and age. RSI claimants had been experiencing symptoms for an average of 8 months prior to filing a compensation claim. While clerical occupations accounted for 13.6% of all upper limb RSI claims, the rates for RSIs in these occupations were low (0.67/1,000 workers), in contrast to occupations with the highest RSI rates: food, beverage, and related processing occupations (14.68/1,000 workers) and fabricating, assembling, and repairing of metal products (9.32/1,000). The highest risk industries were meat and poultry processing-related (23.48/1,000) and the manufacturing of airplanes (9.06/1,000). RSI claims were significantly more costly ($5,569 vs. $2,480, p <0.0001) and required more time loss (71.4 vs. 33.6 d. p <0.0001) than similar musculoskeletal non-RSI claims. Similarly, RSI claimants were less likely to return to the same job (67.3% vs. 81.0%, p <0.0001) than non-RSI claimants. It was concluded that the cost and severity of RSI claims militate for intensified preventive measures. © 1996 Wiley-Liss, Inc.     

Angiographic evidence of long-axis rotation in addition to short-axis aortopulmonary rotation: Its implication in transposition of the great arteries

To assess the pattern of aortic sinus in varied aortopulmonary rotations and its clinical implications, three aortic sinuses at the diastolic phase in true lateral view are identified in 53 angiograms of complete transposition of the great arteries recorded between 1988 and 1993. The patients with the high takeoff of the coronary arteries found at surgery and in the literature were selected for additional investigation. Six regions were defined on the horizontal plane. From left anterior 89° to 61°, the non-facing sinus moved toward the anterior aspect (one patient). From left anterior 60° to left anterior 1°, the left-hand sinus moved gradually from an anterior toward a posterior location (two patients). From directly anterior 0° to right anterior 59°, the right-hand sinus moved from posterior toward an anterior position (30 patients). From right anterior 60° to right posterior 105°, the non-facing sinus moved posteriorly (20 patients). On approaching directly anterior 0° and toward right anterior 60°, the left-hand sinus was the lowest in anterior transposition of the great arteries instead of the non-facing sinus, as in left anterior 90° and in posterior transposition of the great arteries. High takeoff occurred commonly above the lowest left-hand sinus in anterior transposition of the great arteries (2 cases here and 5 in the literature, 100%). In conclusion, aortopulmonary rotations about the short and long axes were both evident on identification of the aortic sinus in various rotations. The aortic sinus did not rotate along the long-axis in anterior transposition of the great arteries, thus making the left-hand sinus, the lowest of this group, vulnerable to the high takeoff of the coronary arteries in anterior transposition of the great arteries. © 1996 Wiley-Liss, Inc.     

渴络欣胶囊联合培哚普利治疗早期糖尿病肾病的临床研究

目的 探讨渴络欣胶囊联合培哚普利治疗早期糖尿病肾病的临床疗效。方法 选取2021年6月—2023年1月郑州大学第五附属医院收治的168例早期糖尿病肾病患者,按随机数字表法将患者分为对照组和治疗组,每组各84例。对照组晨服培哚普利叔丁胺片,4 mg/d,1次/d。治疗组在对照组基础上口服渴络欣胶囊,4粒/次,3次/d。两组疗程12周。比较两组临床疗效,治疗前后中医症状积分、肾功能指标[24 h尿蛋白定量（24 h UP）等]、相关量表[肾脏病生活质量量表1.3（KDQOL-SF 1.3）、简式抑郁-焦虑-压力量表（DASS-21）]评分及血清血管生成抑制蛋白1（VASH-1）、高迁移率族蛋白B1（HMGB1）、CXC趋化因子配体10（CXCL10）水平。结果 治疗后,治疗组总有效率是94.05%,显著高于对照组的84.52%（P＜0.05）。治疗后,两组气短乏力积分、咽干口渴积分、肢体麻木积分、肢体麻木积分、腰膝酸软积分、畏寒肢冷积分均较治疗前显著降低（P＜0.05）;治疗后,治疗组中医症状积分低于对照组（P＜0.05）。治疗后,两组血肌酐（Scr）、24 h UP、尿蛋白排泄率（UAER）低于同组治疗前（P＜0.05）;治疗后,治疗组肾功能指标改善优于对照组（P＜0.05）。治疗后,两组KDQOL-SF 1.3评分均显著增高,而DASS-21评分均显著降低（P＜0.05）;治疗后,治疗组KDQOL-SF 1.3评分和DASS-21评分改善优于对照组（P＜0.05）。治疗后,两组血清VASH-1、HMGB1、CXCL10水平均显著降低（P＜0.05）;治疗后,治疗组血清VASH-1、HMGB1、CXCL10水平低于对照组（P＜0.05）。结论 渴络欣胶囊联合培哚普利治疗早期糖尿病肾病具有良好的疗效,能有效缓解机体炎症反应、控制肾组织纤维化,在患者症状和负面情绪减轻、肾功能和生活质量改善方面获得更佳效果,值得临床推广应用。     

去甲肾上腺素在高原大鼠脑水肿形成中作用的实验研究

目的 探讨去甲肾上腺素（noradrenalin,NA）在高原脑水肿形成中的作用。方法 建立大鼠模拟高原7000m低氧低压模型。NA对照组大鼠分别给予NA 0mg／kg（生理盐水0．2m1）（正常对照）、1mg／kg（LNA）、2mg／kg（MNA）及5mg／kg（HNA）腹腔注射;NA高原组大鼠分别给予NA0mg／kg（生理盐水0．2m1）（高原对照）、1mg／kg（hLNA）、2mg／kg（hMNA）及5mg／kg（hHNA）腹腔注射后迅速置入低压舱内。应用脑干湿重比率法定量脑水肿情况,应用荧光素钠透过率测定BBB通透性。结果 正常对照、LNA、MNA及HNA组之间脑含水率差异无统计学意义（P〉0．05）。高原对照组脑含水率与正常对照组相比有明显增高,差异有统计学意义（P〈0．05）,hLNA、hMNA及hHNA组与相应LNA、MNA及HNA组相比脑含水率差异有统计学意义（分别为P〈0．01,P〈0．01,P〈0．05）。hLNA组脑含水率与高原对照组相比差异无统计学意义（P〉0．05）,hMNA及hHNA组脑含水率与高原对照组相比差异有统计学意义（P〈0．05）。正常对照、LNA及MNA之间NaF1差异无统计学意义（P〉0．05）,HNA NaF1与正常对照组相比差异有统计学意义（P〈0．05）。高原对照组NaF1与正常对照组相比差异有统计学意义（P〈0．01）,hLNA、hMNA及hHNA组与相应LNA、MNA及HNA组相比,NaF1均差异有统计学意义（分别为P〈0．01,P〈0．001,P〈0．001）。hLNA组NaF1与高原对照组相比差异无统计学意义（P〉0．05）,hMNA及hHNA组NaF1与高原对照组相比差异有统计学意义（分别为P〈0．05,P〈0．01）。结论 在高原状态下去甲肾上腺素可使血脑屏障通透性显著增高,诱发高原脑水肿加重。     

高原破片伤的创伤弹道特点

目的 了解高原球形和三角形破片分别击中猪后肢软组织的创伤弹道学特点。方法 在高原和平原,以53式滑膛枪分别发射1．03g钢球（射距20m）和0.37g三角形破片（射距10m）,射击猪（15-25kg）后肢肌肉丰满处,避免伤及股骨及大血管,测定投射物初速和终点速度。伤后6小时测量伤道出、入口面积以及琥珀酸脱氢酶、ATP酶活性测定、永久伤道容积;切取距伤道壁0．5cm、1．5cm处肌组织进行显微病理观察;按照“4C”法判定伤道失活组织后行手术清创,测定切除坏死组织量。按照前述生物实验的致伤方法,分别在高原和平原射击密度与猪肌肉组织相似的肥皂块,观察空腔大小。结果高原破片终点速度较平原快,高原组伤道的出入口面积、伤道容积、伤道长度比值、切除坏死组织以及破碎肌组织的比例均大于平原组,高原球形和三角形破片伤组伤道肌纤维断裂和变性的程度均较平原组重,肌组织琥珀酸脱氢酶和ATP酶的活性下降,分别为平原组的26．86％和55、77％。高原射击肥皂空腔容积大于平原。结论高原破片伤的损伤程度较平原重,这与高原空气密度低,破片飞行阻力小,破片飞行速度较平原快,击中组织的瞬时空腔大等有关。