电子支气管镜下冷冻结合抗结核药物治疗支气管结核的效果

目的探究电子支气管镜下冷冻结合抗结核药物治疗支气管结核的效果。方法选择96例支气管结核患者,按随机数字表法将其分为对照组与试验组,各48例。对照组患者给予常规抗结核药物治疗,试验组在对照组基础上给予电子支气管镜下冷冻治疗。比较两组患者的临床疗效。结果试验组患者的治疗总有效率显著高于对照组(P<0.05)。治疗后,两组患者的气促评分均降低,FEV1和气道内径均升高,且试验组均显著优于对照组(P<0.05)。结论电子支气管镜下冷冻结合抗结核药物治疗能够显著提高支气管结核治疗效果,同时能够改善患者临床症状,且治疗安全性较高,值得临床推广。     

门诊幽门螺杆菌感染者治疗分析

背景：在幽门螺杆菌（Hp）感染的根除治疗中,患者的执行是治疗链的最终端和关键环节,但在临床实践中常常被忽视。目的：从门诊患者角度了解Hp感染根除治疗中存在的问题,以促进治疗的进一步规范化。方法：对2012年12月1日～2013年4月1日在新疆医科大学第一附属医院消化科门诊就诊的Hp感染者进行调查,调查内容包括治疗原因、根除治疗药物、疗程、复查时间和复查结果。结果：共139例次门诊Hp感染者纳入研究,治疗原因主要是慢性胃炎,占61．9％。根除治疗方案主要采用第三次全国共识推荐的PPI＋两种抗菌药物三联疗法,以PPI＋阿莫西林＋克拉霉素标准三联疗法为主,占46．8％;采用第四次全国共识推荐的铋剂＋PPI＋两种抗菌药物四联疗法者仅占18．7％;采用不规范方案者占9．4％。43．2％的患者疗程为第四次全国共识规定的10～14d,69．1％的患者于停药≥4周后复查。结论：在执行Hp感染的根除治疗时,临床医师应及时进行知识更新,掌握最新共识推荐的根除治疗方案,并注意对患者进行治疗方案的解释和交待。     

1997～2001年乌鲁木齐市饮用水水质分析

为掌握乌鲁木齐市生活饮用水水质及变化趋势，于1997－2001年，每年对全市6个水厂的水源水、出厂水各监测2次，并在全市共布61个管网水及72个二次供水监测点，每季度监测1次，依据GB5749－85《生活饮用水卫生标准》进行水质评价。结果显示：1997－2001年，地面水源水检测项目的合格率明显下降（χ^=12.93,P＜0．01），出厂水中历年地面水水质的合格率与地下水比较差异均有显性，管网水细菌总数合格率也逐年降低（χ^2=15.37,P＜0．01），二次供水细菌学指标变化不明显，表明1997－2001年乌鲁木齐市地面水水质呈下降趋势，地面水水质优于地下水。     

体质量指数、三酰甘油与急性胰腺炎预后相关性分析

目的探讨体质量指数、血清三酰甘油水平与急性胰腺炎预后的相关性。方法 199例急性胰腺炎患者,其中重症急性胰腺炎19例(SAP组),轻症急性胰腺炎180例(MAP组),比较2组入院时体质量指数、三酰甘油、Ranson评分、Balthazar CT分级等指标,分析体质量指数、三酰甘油与急性胰腺炎病情严重程度及预后的关系。结果 SAP组入院时体质量指数、三酰甘油水平高于MAP组(P<0.05);Ranson评分≥3分、Balthazar CT分级为D或E级者体质量指数、三酰甘油水平分别高于Ranson评分<3分、Balthazar CT分级为A,B或C级者(P<0.05);体质量指数和血清三酰甘油水平与Ranson评分、Balthazar CT分级呈正相关(P<0.05)。结论体质量指数、三酰甘油水平可反映急性胰腺炎的病情严重程度,可用于评估急性胰腺炎病情严重程度及预后。     

不同人群的女性尿失禁调查分析

目的　调查分析不同人群女性尿失禁的发病情况。　方法　采用亚太地区尿控咨询委员会提供的成人尿失禁问卷表先后对北京社区、乌鲁木齐维族地区和北京大学第一医院职工 6 6 8位成人女性进行抽样调查。　结果　三类人群的尿失禁总发生率分别为北京社区 4 6 .5 % (94 / 2 0 2 )、维族地区 4 3.8% (134/ 30 6 )、医院职工 4 0 .6 % (5 8/ 14 3) ,P >0 .0 5。其中压力性尿失禁及混合性尿失禁在北京社区被调查者中占 93.6 % (88/ 94 ) ;维族被调查者 99.3% (133/ 134) ;医院被调查者 93.1%(5 4 / 5 8) ,P >0 .0 5。三组人群有就医意向者分别为 2 4 .5 % (2 3/ 94 )、2 9.1% (39/ 134)、13.8% (8/ 5 8) ,P <0 .0 5。　结论　不同职业及不同医疗环境的女性人群尿失禁的发病率相似 ,均以压力性尿失禁或混合性尿失禁为主。     

Up-regulation of lncRNA FALEC indicates prognosis and diagnosis values in cervical cancer

We examined the expression level of focally amplified lncRNA on chromosome 1 (FALEC) in cervical cancer patients and explore its clinical value in diagnosis and prognosis of cervical cancer. FALEC was significantly up-regulated in the blood plasma from cervical cancer patients and had significant correlation with tumor size, the FIGO stage, and lymph node metastasis. Furthermore, FALEC overexpression could stimulate proliferation and invasion of Hela cells. FALEC was a potential molecular marker used to diagnose cervical cancer and evaluate prognosis.     

2017年新疆喀什地区结核病流行病学特征分析

目的了解2017年新疆喀什地区结核病的流行现状和流行特征,为该地区结核病防控工作提供科学依据。方法通过全国结核病网络专报系统收集2017年1月1日至12月31日报告发病的喀什地区结核病患者相关数据资料,用描述性研究方法统计分析喀什地区结核病发病在时间、地点、人群的分布特征。结果 2017年喀什地区共报告发病结核病患者14 678例,以单纯肺结核为主(占99.95%)。其中,涂阳肺结核占13.44%。2017年喀什地区单纯肺结核、涂阳肺结核发病例数及发病率较前4年下降。结核病患者中,男性7 335例,女性7 343例,男、女性别比为1∶1.001。60~79岁年龄组结核病发病例数最多,占58.21%。农民占总发病例数的86.33%。发病例数居前3位的是莎车县(21.94%)、英吉沙县(13.88%)、喀什市(10.28%)。冬春季发病例数较高。结论 2017年喀什地区结核病疫情形势仍十分严峻,需加大力度实施该地区的各项结核病防控工作,加强健康宣教活动,提高人群疾病知晓率和治疗依从性,争取早发现、早治疗。     

Optochemical properties of gas-phase protonated tetraphenylporphyrin investigated using an optical waveguide NH3 sensor

5,10,15,20-Tetraphenylporphyrin (TPP) was synthesized, and a glass optical waveguide (OWG, which restricts and maintains the light energy in a specific, narrow space and propagates along the space axially) was coated with a gas-phase protonated TPP thin film to develop a sensor for NH₃ gas detection. The results show that the TPP thin film agglomerated into H-based J-type aggregates after H₂S gas exposure. The molecules in the protonated TPP film OWG sensor acted as NH₃ receptors because the gas-phase protonated TPP film morphologically changed from J-type aggregates into free-base monomers when it was deprotonated by NH₃ exposure. In this case, H₂S gas could be used to increase the relative amount of J-type aggregates in the TPP film and restore the sensor response. The reversible surface morphology of the TPP film was analyzed by ¹H NMR spectroscopy, atomic force microscopy, and UV-vis spectroscopy.

5,10,15,20-Tetraphenylporphyrin (TPP) was synthesized, and a glass optical waveguide (OWG) was coated with a gas-phase protonated TPP thin film to develop a sensor for NH₃ gas detection.     

Clinical Significance of Peripheral Blood Lymphocyte Sensitivity to Glucocorticoids for the Differentiation of High-risk Patients With Decreased Allograft Function After Glucocorticoid Withdrawal in Renal Transplantation

Purpose

A reliable biomarker to differentiate high-risk recipients who will experience a decrease in allograft function after glucocorticoid withdrawal has not been established in renal transplantation. We examined the clinical significance of peripheral blood lymphocyte sensitivity to glucocorticoids in vitro for the differentiation of the high-risk patients after glucocorticoid reduction/withdrawal in renal transplant recipients.

Methods

The study included 44 renal transplant recipients with stable allograft function. Peripheral lymphocyte responses to suppressive effects of cortisol, methylprednisolone, cyclosporine, and tacrolimus in mitogen assay procedures in vitro were examined. Clinical outcome after glucocorticoid reduction/withdrawal was retrospectively compared between recipients with lymphocytes normally sensitive to the drugs and those with hyposensitivity. The receiver-operating characteristic (ROC) curve analysis was undertaken for setting the cutoff IC₅₀ values of the drugs against the T cell mitogen–induced lymphocyte proliferation to differentiate the high-risk recipients with decreased allograft function after glucocorticoid withdrawal.

Findings

The median (range) IC₅₀ value for cortisol in the recipients who showed decreased renal function due to glucocorticoid withdrawal was 10,000 (570.9–72,279.3) ng/mL (n = 9), which was significantly higher than the value of 351.6 (2.0–10,000) ng/mL in the recipients who had not experienced glucocorticoid withdrawal symptoms (n = 35) (P < 0.001). Similarly, the median (range) IC₅₀ value for methylprednisolone in the recipients who showed decreased renal function after glucocorticoid withdrawal was 69.1 (21.5–1442.7) ng/mL (n = 9), which was significantly higher than the value of 13.8 (0.7–1000) ng/mL in the recipients who had not experienced glucocorticoid withdrawal symptoms (n = 30) (P < 0.003). In contrast, there was no significant difference in the median IC₅₀ values of cyclosporine and tacrolimus between the 2 recipient subgroups. The ROC curve analyses for the IC₅₀ values of the immunosuppressive drugs estimated the cutoff value of cortisol and methylprednisolone to be 3580.0 and 21.5 ng/mL, respectively. The ROC AUCs for cortisol and methylprednisolone were 0.83 and 0.84, respectively. According to the cutoff IC₅₀ value, the incidence of decreased allograft function in the low cortisol sensitivity (IC₅₀ >3580.0 ng/mL) subgroup was 7 of 13 patients, which was significantly higher than that of the higher sensitivity subgroup of 2 of 31 (P = 0.0012). A similar case was observed using the cutoff IC₅₀ value of methylprednisolone (P = 0.0012), whereas recipient grouping according to the cutoff IC₅₀ values of cyclosporine and tacrolimus failed to differentiate the high-risk recipients with decreased allograft function after glucocorticoid withdrawal.

Implications

Glucocorticoid pharmacodynamics in lymphocytes of individual patient origin is a reliable biomarker for differentiation of renal transplant recipients who will experience a safe reduction/withdrawal of glucocorticoid.     

血小板活化因子CD41、CD62P的表达在2型糖尿病患者中的临床意义

目的:探讨2型糖尿病患者血小板表面CD41,CD62p表达,内皮细胞损伤标志物变化及其临床价值。方法:用流式细胞术测定患者血小板表面CD41,CD62p;用放射免疫法检测血清ET-1;用ELISA方法检测血浆t-PA,PAI-1;统计学方法:所有实验数据采用SPSS13.0统计软件处理,用均数±标准差(x±s)表示;采用单因素方差分析,两组间比较采用t检验,P<0.05有统计学意义。结果:糖尿病组血小板表面CD62P的表达、血浆PAI-1水平均较正常组增高(P<0.05),而t-PA水平较正常组降低(P<0.05);糖尿病组血小板表面CD41的表达,血清ET-1水平与正常组比较无显著性差异(P>0.05);糖尿病伴血管病变组血小板表面CD62P的表达、血浆PAI-1水平均较不伴血管病变组增高(P<0.05);糖尿病伴血管病变组序小板表面CD41的表达、血浆t-PA水平、血清ET-1水平与不伴血管病变组指标比较没有显著性差异(P>0.05)。结论:探讨血栓前状态若干相关分子标志物即血浆内皮素-1(ET-1)、血小板α-颗粒膜蛋白(GMP-140)、组织纤溶酶原激活物(t-PA)及其抑制物(PAI-1)及变化,探讨血小板活化在糖尿病患者中的临床意义。