Association between microalbuminuria and cardiovascular risk factors in general population

Objective To investigate the association between microalbuminuria and cardiovascular risk factors in a general Chinese population. Methods A multi-stage cluster randomized sampling method was used to select 2400 residents (18-69 years old) in four counties in Shandong and Jiangsu provinces in October 2013 to March 2014. 24-hour MAU were measured for each subject. The prevalence of MAU in different groups was analyzed. The relationship between the aggregation of risk factors and MAU was analyzed. Logistic regression analysis was used to evaluate the association between MAU and cardiovascular risk factors. Results A total of 2265 subjects were included in the analysis. The prevalence of MAU was 8.96%(203/2265, 95%CI: 7.82-10.21). The prevalence of MAU in obesity, hypertension, diabetes, hypertriglyceridemia, and low HDL-C group were 14.65%(63/430), 12.53%(104/830), 20.22%(36/178), 15.57%(64/411), 11.99%(53/442) respectively, which were significantly higher than the corresponding healthy population (all P＜0.01). Multivariate logistic regression analysis showed that obesity, hypertension, diabetes, and hypertriglyceridemia were risk factors for MAU. The OR(95%CI) values were 1.491(1.016-2.265), 1.660(1.190-2.314), 2.291(1.494-3.515) and 1.734(1.205-2.495) respectively. With the increase in the number of influencing factors, urinary albumin levels and the prevalence of MAU all showed an upward trend. Conclusion MAU was associated with cardiovascular risk factors such as obesity, hypertension, diabetes, and hypertriglyceridemia.     

Pan‐risk factor for a comprehensive cardiovascular health management

Cardiovascular diseases (CVDs) have become the leading cause of death in China. CVDs are mainly caused by multiple well‐known modifiable risk factors that are affected by socioeconomic and environmental determinants, lifestyle and behavioral choices, and familial and genetic predispositions. With more risk factors proved to be associated with CVD occurrence, the concept “pan‐risk factor” is proposed in this review to indicate all discovered and yet‐to‐be‐discovered CVD risk factors for comprehensive primary prevention of CVD. Recognizing more factors and their roles in CVD development and progression is the first step in reducing the ever‐increasing burden of CVD. This review is an overview of the pan‐risk factor whose associations with CVD outcomes have been established. Along with the accumulation of scientific evidence, an increasing number of risk factors will be discovered and included in the list of pan‐risk factors.     

加强烈性呼吸道传染病病房管理 确保医护人员零感染

我院分别于2003年和2009年成功收治了部队官兵SARS及甲型H1N1流感患者,通过采取阻断传播途径、加强医护人员岗前培训、提高自我防护意识和加强患者及陪护家属的管理等烈性呼吸道传染病病房管理措施,杜绝了疾病在部队内部传播,无一医护人员受到交叉感染,实现了医护人员零感染。     

血清生物标志物对纤维化性间质性肺疾病预后的预测价值

目的探讨与肺泡上皮细胞功能障碍相关的血清生物标志物对纤维化性间质性肺疾病(fibrosing interstitial lung diseases, FILD)预后的预测价值。方法前瞻性入组FILD患者,收集临床资料,检测生物标志物并随访1年进行病情评估。采用竞争风险模型的生存分析和Fine-Gray回归模型提取发展为进行性纤维化型和死亡风险的影响因素。结果共入组58例患者,35例诊断为特发性肺纤维化,14例诊断为结缔组织病相关间质性肺病,9例归为其他原因所致肺纤维化。12例(20.69%)患者发展为进行性纤维化型,8例(13.79%)死亡。单因素分析结果显示发展为进行性纤维化型的风险因素是糖蛋白抗原125(carbohydrate antigen-125,CA-125)基线增高,死亡的风险因素是糖蛋白抗原19-9(carbohydrate antigen 19-9,CA19-9)基线增高;多因素分析结果显示:CA19-9基线增高是死亡的风险因素(回归系数0.007,风险比1.007,95%CI:1.001～1.061,P=0.044)。结论 CA-125基线增高的患者发展为进行性纤维...     

血液系统疾病合并嗜水气单胞菌血流感染4例报告

本文报道了昆明医科大学第二附属医院4例血液系统疾病合并嗜水气单胞菌血流感染患者的诊疗及转归,进一步明确血培养重要性以及加深临床对此病的认识。 选择2017—2021年昆明医科大学第二附属医院收治的血液系统疾病合并嗜水气单胞菌血流感染的4例患者,对患者临床表现、血培养采集及嗜水气单胞菌检出时间、实验室检查、治疗及预后等临床资料进行回顾性分析。本研究中4例病例均为男性血液系统疾病患者,处于化疗后骨髓抑制期粒细胞缺乏,出现发热后采集血培养并检出嗜水气单胞菌,4例患者血培养报阳时间4~11 h。药敏检测结果显示对二代、三代、四代头孢类抗生素、喹诺酮类抗生素、碳青霉烯类抗生素敏感性较高。4例患者早期均使用亚胺培南-西司他丁钠进行经验性抗感染治疗,1例患者经积极抗感染及升白细胞等治疗后痊愈。1例患者未完成化疗,患者要求出院,后续不详。2例患者迅速发展为坏死性筋膜炎,后患者死亡。研究表明,血液系统疾病合并嗜水气单胞菌血流感染罕见但死亡率高,对于反复发热考虑感染致病的患者需尽早进行血培养确认病原体并进行药敏试验,临床治疗时应结合患者情况及时调整治疗,除抗感染治疗外同时要提升患者免疫力,警惕发展为坏死性筋膜炎。     

106例老年皮肤病变活检分析

本文报告106例老年皮肤病患者皮肤活检结果,发现皮肤肿瘤的患病率居首位,占41.56%,良、恶性肿瘤各占一半。结果提示:凡老年皮肤病患者均应警惕癌肿的发生。     

传染病学教学必须适应新形势的需要

在传染病学教学实践中进行以下改革：将教学内容扩展到经典传染病以外,按照感染病学研究范畴授课,学科新进展及时纳入授课内容;在教学方法上采用丰富多彩的形式,不拘泥于传统教学方法;在考试形式上突出实际能力的考察;在教学手段上以多媒体幻灯为主.以上教学改革措施取得良好的教学效果.     

常通口服液预防术后肠粘连的实验研究

目的 观察中药常通口服液用于术后腹腔肠粘连的效果。方法 选取54只SD雄性大鼠随机分为6组(n=9):正常对照组、模型对照组、四磨汤组、常通口服液低、中、高剂量组。除正常对照组外,其余大鼠均按Ellis法制备成肠粘连模型。正常及模型对照组予以蒸馏水灌胃(10ml/kg);四磨汤组以10ml/kg灌胃给药;常通口服液低、中、高剂量组分别按4.3、8.6、17.2g/kg灌胃给药。各组于术后第7天取血,测定白细胞(WBC)计数及纤维蛋白原(FIB)浓度;同时进行粘连程度肉眼分级。结果 常通口服液能明显减轻肠粘连程度,降低大鼠血浆中WBC计数及FIB浓度。结论 常通口服液能够预防腹腔术后肠粘连形成。     

151例系统性红斑狼疮血液学改变及误诊讨论

分析了 151例系统性红斑狼疮(SLE)的血象变化特点;贫血占75.5％,白细胞减少症23.2％,血小板减少症占30.6％。43例骨髓改变,其中增生活跃及明显活跃者占90.7％,故认为SLE的贫血主要为增生性贫血。本文对误诊为各种贫血、特发性血小板减少性紫癜、恶性组织细胞病等的SLE的误诊情况进行了分析。