计量分析甘草甜素和绞股蓝总苷等对大鼠肝癌前病变的影响

采用被公认的以γ－谷氨酰转肽酶阳性灶（ＧＧＴ＋）为观察终点的二乙基亚硝胺（ＤＥＮ）致大鼠肝癌前病变的模型，对甘草甜素（ＧＬ）、纹股蓝总苷（绞股蓝总甙，ＧＰ）、茶多酚和柴胡水提取液等进行了筛选、并用体现学方法进行计量分析。结果显示，ＧＬ组的ＧＧＴ＋的面数由度（Ｎａ）为２４．１７±１．８３／ｃｍ２（ｘ±Ｓｘ，下同），体密度（Ｖｖ）为４．７４±０．５１％，数密度（Ｎｖ）为３９４．９±４５．２／ｃｍ３；ＧＰ组的Ｎａ为２５．３５±２．６４／ｃｍ２，Ｖｖ为５．９３±０．７５％，Ｎｖ为３７９．２±４８．４／ｃｍ２，这两组的３个估计值与对照组的３个估计值（Ｎａ为３７．２１±２．５６／ｃｍ２，Ｖｖ为８．１２±０．７０％。Ｎｖ为５７６．１±５８．０／ｃｍ３）分别比较时均有显著性差异，说明这两种药物对ＤＥＮ致肝癌发生有抑制作用，而茶多酚和柴胡水提取液则未显示抑制作用。     

糖骨康胶囊治疗糖尿病骨质疏松临床研究

目的:观察糖骨康胶囊对糖尿病骨质疏松的治疗作用。方法:将216例患者,遵照随机、盲法、对照原则分为治疗组144例、对照组72例,其中治疗组给予糖骨康胶囊,对照组给予甘露消渴丸,治疗8w后观察疗效。结果:治疗组显效率为40.0%;总有效率为88.6%。对照组显效率为28.9%,总有效率为82.6%。结论:糖骨康胶囊对2型糖尿病骨质疏松有显著的防治作用。     

小儿病毒性脑膜炎病原诊断与临床分析

应用酶联免疫吸附（ELISA）方法，对88例临床诊断病毒性脑膜炎患儿急性期及恢复期脑脊液进行了单纯疱疹病毒（HSV－I、HSV－Ⅱ）、柯萨奇B组病毒（CoxBV）、埃可病毒（ECHO）、EB病毒（EBV）、腺病毒（AdV)及流感病毒（IFV）特异性IgM抗体检测。结果表明：HSV、CoxBV、ECHO、EBV、AdV、IFV病毒感染率分别为9．09％、18．18％、22．72％、3．41％、4．54％、5．68％；HSV及EBV感染致残率及病死率分别为87．5％（7／8）和100％（3／3）。提示脑脊液中病毒特异性IgM抗体检测可作为早期病原诊断的指标之一；CoxBV及ECH病毒是本地区小儿中枢神经系统病毒感染的主要病毒；HSV及EBV感染致残率及病死率较其它病毒高，预后不良；早期阿昔洛韦治疗，可大大降低病死率。     

Hyperglycemia potentiates H(2)O(2) production in adipocytes and enhances insulin signal transduction: potential role for oxidative inhibition of thiol-sensitive protein-tyrosine phosphatases

Insulin signal transduction in adipocytes is accompanied by a burst of cellular hydrogen peroxide (H(2)O(2)) that facilitates insulin signaling by inhibiting thiol-dependent protein-tyrosine phosphatases (PTPs) that are negative regulators of insulin action. As hyperglycemia is associated with increased cellular reactive oxygen species, we postulated that high glucose conditions might potentiate the H(2)O(2) generated by insulin and modulate insulin-stimulated protein phosphorylation. Basal H(2)O(2) generation was increased threefold in differentiated 3T3-L1 adipocytes by growth in 25 mM glucose versus 5 mM glucose. High glucose increased the sensitivity of the insulin-stimulated H(2)O(2) signal to lower concentrations of insulin. Basal endogenous total PTP activity and the activity of PTP1B, a PTP implicated in the negative regulation of insulin signaling, were reduced in high glucose conditions, and their further reduction by insulin stimulation was more enhanced in high versus low glucose medium. Phosphorylation of the insulin receptor, IRS-1, and Akt in response to insulin was also significantly enhanced in high glucose conditions, especially at submaximal insulin concentrations. In primary rat adipocytes, high glucose increased insulin-stimulated H(2)O(2) production and potentiated the oxidative inhibition of total PTP and PTP1B activity; however, insulin signaling was not enhanced in the primary cells in high glucose apparently due to cross-regulation of insulin-stimulated protein phosphorylation by activation of protein kinase C (PKC). These studies indicate that high glucose can enhance insulin stimulated H(2)O(2) generation and augment oxidative PTP inhibition in cultured and primary adipocytes, but the overall balance of insulin signal transduction is determined by additional signal effects in high glucose, including the activation of PKC.     

An IFN-beta-albumin fusion protein that displays improved pharmacokinetic and pharmacodynamic properties in nonhuman primates.

The long half-life and stability of human serum albumin (HSA) make it an attractive candidate for fusion to short-lived therapeutic proteins. Albuferon (Human Genome Sciences [HGS], Inc., Rockville, MD) beta is a novel recombinant protein derived from a gene fusion of interferon-beta (IFN-beta ) and HSA. In vitro, Albuferon beta displays antiviral and antiproliferative activities and triggers the IFN-stimulated response element (ISRE) signal transduction pathway. Array analysis of 5694 independent genes in Daudi-treated cells revealed that Albuferon beta and IFN-beta induce the expression of an identical set of 30 genes, including 9 previously not identified. In rhesus monkeys administered a dose of 50 microg/kg intravenously (i.v.) or subcutaneously (s.c.) or 300 microg/kg s.c., Albuferon beta demonstrated favorable pharmacokinetic properties. Subcutaneous bioavailability was 87%, plasma clearance at 4.7-5.7 ml/h/kg was approximately 140-fold lower than that of IFN-beta, and the terminal half-life was 36-40 h compared with 8 h for IFN-beta. Importantly, Albuferon beta induced sustained increases in serum neopterin levels and 2',5' mRNA expression. At a molar dose equivalent to one-half the dose of IFN-beta, Albuferon beta elicited comparable neopterin responses and significantly higher 2',5'-OAS mRNA levels in rhesus monkeys. The enhanced in vivo pharmacologic properties of IFN-beta when fused to serum albumin suggest a clinical opportunity for improved IFN-beta therapy.     

甘肃省某三甲医院糖尿病足患者创面感染病原菌及相关因素分析

目的探讨甘肃省某三甲医院收治的糖尿病足患者创面感染病原菌情况,分析创面感染的相关因素,为后期临床救治提供理论依据。 方法选择2017年1月至2021年12月甘肃省人民医院收治的符合入选标准的糖尿病足患者,收集并分析患者的人口信息(年龄、性别)、糖尿病足创面特征(糖尿病病程、创面持续时间、创面部位)、抗生素应用数量、实验室检测指标(红细胞计数、白细胞计数、血红蛋白、白蛋白、肌酐、胆固醇、甘油三脂、高密度脂蛋白、低密度脂蛋白、空腹血糖、糖化血红蛋白、白细胞介素-6、降钙素原)、创面细菌培养结果及药物敏感试验结果。数据比较采用χ²检验、单因素分析、多因素Logistic回归分析。 结果(1)本研究共纳入糖尿病足患者173例,其中51~60岁人数最多,有53例,占比30.6%,其次为61~70岁、41~50岁、71~80岁,分别占24.3%、20.2%、16.8%;男性总体多于女性,男性138例,占比79.8%,女性35例,占比20.2%。(2)糖尿病足患者糖尿病病程10~14年人数最多,38例,占比为22.0%,创面持续时间中人数最多为15~30 d,53例,占比为30.1%。173例患者共185个创面,其中位于足趾部位最多,有68例,占比36.8%,其次为足底52例,占比28.1%。(3)患者的实验室检测指标结果显示,红细胞计数低于正常值范围的患者占比60.1%,白细胞计数高于正常值范围的患者占比34.7%,血红蛋白低于正常值范围的患者占比42.8%,白蛋白低于正常值范围的患者占比86.1%,肌酐高于正常值范围的患者占比20.8%,胆固醇高于正常值范围的患者占比11.6%,甘油三酯高于正常值范围的患者占比23.7%,高密度脂蛋白低于正常值范围的患者占比73.4%,低密度脂蛋白高于正常值范围的患者占比12.7%,空腹血糖高于正常值范围的患者占比82.1%,糖化血红蛋白高于正常值范围的患者占比77.5%,白细胞介素-6高于正常值范围的患者占比77.5%,降钙素原高于正常值范围的患者占比68.2%。(4)173例患者共送检标本257份,其中阳性210份,阴性47份,阳性率81.7%;其中革兰阳性菌共120株,占比57.1%,革兰阴性菌共89株,占比42.4%,真菌1株,占比0.5%;革兰阳性菌中金黄色葡萄球菌65株,占比最高,为31.0%,其次是粪肠球菌16株,占比7.6%;革兰阴性菌中阴沟肠杆菌24株,占比最高,为11.4%,其次是大肠埃希菌21株,占比10.0%;药物敏感试验结果显示,金黄色葡萄球菌对甲氧苄啶/磺胺甲恶唑、万古霉素、利奈唑胺等抗生素较为敏感,敏感率均为100.0%;其对青霉素耐药率高,耐药率为89.2%,其次为克林霉素和红霉素,耐药率分别为78.5%、76.9%;阴沟肠杆菌对美洛培南、厄他培南、头孢哌酮/舒巴坦、左旋氧氟沙星等较为敏感,敏感率均为100.0%,其次为阿米卡星、亚胺培南、头孢吡肟,敏感率均为95.8%;大肠埃希菌对美洛培南、厄他培南、亚胺培南、替加环素、头孢西丁、阿米卡星等较为敏感,敏感率均为100.0%。173例患者中,抗生素应用数量为0的有19例,占比11.0%;1种及2种的均有61例,占比均为35.3%;3种的有25例,占比14.4%;4种以上7例,占比4.0%。(5)对糖尿病足患者感染的17个相关因素进行单因素分析,结果显示,创面持续时间、抗生素应用数量、白细胞计数、血红蛋白、白蛋白、高密度脂蛋白、肌酐、糖化血红蛋白、白细胞介素-6、降钙素原等相关因素差异均有统计学意义(P<0.05);进一步行多因素Logistic回归分析结果显示,与创面感染相关的因素有创面持续时间、抗生素应用数量,高密度脂蛋白(OR＝1.530、1.923、2.587,P<0.05)。 结论糖尿病足患者创面病原菌培养中,革兰阳性菌中以金黄色葡萄球菌、粪肠球菌为主,而革兰阴性菌以阴沟肠杆菌、大肠埃希菌为主;糖尿病足患者感染的独立危险因素为创面形成时间长、抗生素滥用,高密度脂蛋白低。     

基层医院儿科应用抗菌素状况及葡萄球菌的耐药性调查

目的：观察儿科抗生素的应用状况以及葡萄糖球菌的耐药情况,并对儿科抗生素使用合理性进行评价。方法：选取我院儿科抗生素应用状况数据库资料作为研究对象,分析我院儿科抗生素应用状况、葡萄球菌对不同抗生素的耐药性情况。结果：儿科抗生素使用率较高,平均使用率达90．96％,而且某些单品种抗生素使用较多,微生物送检率达91．29％;葡萄球菌对常用抗生素青霉素、红霉素等的耐药性可达88．0％以上,对万古霉素尚未产生耐药性,辛内吉及呋喃坦啶耐药性较低,低于10％;抗生素二联用情况也比较常见,占35．83％,三联及以上联用情况尚未出现。结论：儿科抗生素使用率比较高,而且葡萄球菌的耐药性情况也较为普遍,临床医护人员需要对此引起重视,合理应用抗生素,保证疗效的同时,预防细菌耐药性的增强。     

4F2hc表达与人脑胶质瘤病理级别增殖和血管形成的关系

  目的  探讨细胞表面抗原4F2重链(4F2 heavy chain, 4F2hc)在人脑胶质瘤组织中的表达水平及其与胶质瘤病理学特征、细胞增殖以及血管形成的关系。  方法  采用免疫组化方法检测4F2hc、Ki-67和CD34在62例人脑胶质瘤组织中的表达, 计数Ki-67标记指数(Ki-67 LI)和微血管密度(MVD)。  结果  4F2hc在胶质瘤中高表达, 其免疫阳性染色既定位于瘤细胞也定位于血管内皮; 4F2hc表达随胶质瘤病理级别升高而明显增强(P=0.001), 在高度恶性胶质瘤中4F2hc表达明显强于低度恶性胶质瘤(P=0.002);4F2hc表达与胶质瘤Ki-67标记指数存在明显正相关(P=0.003), 但与微血管密度无明显相关性(P=0.214)。  结论  4F2hc与胶质瘤的发生和发展关系密切, 可能在胶质瘤的恶性增殖过程中具有重要作用。      

Status and influencing factors of patients with kinesiophobia after insertion of peripherally inserted central catheter: A cross-sectional study

This study aimed to investigate the current status and influencing factors of kinesiophobia in patients after insertion of peripherally inserted central catheter (PICC).A total of 240 patients with PICC were included. Their postinsertion status and influencing factors were investigated using the general information questionnaire, Tampa Scale of Kinesiophobia (TSK), Medical Coping Modes Questionnaire, Numerical Rating Scale, and Self-rating Anxiety Scale.The mean TSK score was 36.49 ± 4.19 points, and 89 patients (37.08%) had kinesiophobia. Multiple linear regression analysis showed that factors such as education level, age, monthly income level, catheterization history, face, pain level, anxiety, and number of needle insertions influenced postoperative kinesiophobia in patients with PICC (P < .05). The total variation in the TSK score was 71.8%.The incidence of kinesiophobia was relatively high after PICC insertion. The medical staff needs to undertake targeted intervention measures to help minimize kinesiophobia after PICC insertion, allowing patients to perform scientifically correct functional exercises and attain physical recovery.