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论著

131I治疗儿童及青年格雷夫斯病疗效及影响因素分析

Efficacy and affecting factors in 131I therapy for children and young people with Graves' disease

:991-996
 
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目的 探讨131I治疗儿童及青年格雷夫斯病(GD)的疗效及其影响因素。方法 回顾性分析2013年—2022年在简阳市人民医院核医学科院接受131I治疗且年龄≤22岁的儿童及青年GD患者的临床资料。采用个体计算剂量法,每克甲状腺组织的计划用量为80~140 μCi,依据甲状腺吸碘率及甲状腺质量,确定131I的用量。依据131I治疗后3~6个月的甲状腺功能指标,进行疗效评价,甲状腺功能恢复正常或发生甲减视为治愈。统计分析治愈组与非治愈组间的临床疾病特征参数,评估可能影响疗效的因素。结果 纳入患者71例:男23例、女48例,年龄11~22岁。患儿甲状腺质量4.8~60.0 g,均值22.1 g。131I的用量在6~24 mCi,均值11.3 mCi。49例(69%)患者获得治愈,22例(31%)未获治愈。单因素分析显示年龄、性别、促甲状腺激素受体抗体的滴度、甲状腺吸碘率、甲状腺质量及131I用量等,治愈组与非治愈组间比较差异均无统计学意义(均P>0.05)。结论 以每克甲状腺组织80~140 μCi的计划用量,确定131I用量治疗儿童青年GD的疗效可达69%。
Objective To investigate the effect of 131I on Graves' disease(GD)in children and young adults and its influencing factors.Methods The clinical data of GD patients aged ≤22 who received 131I treatment in Nuclear Medicine Department of Jianyang People's Hospital from 2013 to 2022 were retrospectively analyzed.The planned dosage of 131I was 80~140 μCi per gram of thyroid tissue,and the dosage of 131I was determined according to the iodine uptake rate and thyroid mass.According to the thyroid function indicators of 3 to 6 months after 131I treatment,the curative effect was evaluated,and the thyroid function returned to normal or hypothyroidism occurred were considered as cured.The clinical characteristic parameters of the cured group and the non-cured group were analyzed to evaluate the factors that might affect the curative effect.Results Seventy-one patients were included:23 males and 48 females,aged 11-22.The thyroid mass of the children ranged from 4.8 to 60.0 g,with an average of 22.1 g.The dosage of 131I ranges from 6 to 24 mCi,with an average of 11.3 mCi.Forty-nine patients(69%)were cured and 22(31%)were not cured.Univariate analysis showed that there were no significant differences in age,sex,titer of thyrotropin receptor antibody,thyroid iodine uptake rate,thyroid mass and 131I dosage between the cured group and the non-cured group(all P>0.05).Conclusions With the planned dosage of 80~140 μCi per gram of thyroid tissue,the efficacy of 131I in the treatment of GD in children and young adults can reach 69%.
论著

21例神经系统副肿瘤综合征临床分析

Clinical analysis of 21 cases of neurological paraneoplastic syndrome

:1198-1204
 
目的 分析神经系统副肿瘤综合征(PNS)的临床特点以提高对该病的早期诊断和治疗效果。方法 回顾性分析惠州市第一人民医院和惠州市中心人民医院神经内科2019年10月—2022年10月收治的21例PNS患者的临床表现、实验室检查结果和治疗效果,并作文献回顾。结果 21例患者中出现了10种副肿瘤综合征,其中经典综合征占比28.6%(6/21),最多见的是边缘叶脑炎;20例在血液或脑脊液中发现检测到抗神经元抗体,非特征性抗体阳性率最高(12/20),其中以半定量脑组织切片TBA检测阳性率最高(7/20);有特征性抗体的8例以抗Yo抗体阳性率最高(6/8)。21例患者均随访至2023年3月,8例发现原发肿瘤,其中4例在神经系统病变之后。69.25%(9/13)的患者使用糖皮质激素治疗和(或)丙种球蛋白治疗有效。结论 21例PNS患者中以非经典综合征占比较多,经典与非经典副肿瘤综合征均应进行肿瘤筛查,未发现肿瘤者应密切随访。非特征性抗体阳性率最高,提示PNS可能仍有许多相关抗体未明确,临床工作中也应对非特征性抗体阳性予以重视。
Objective To analyze the clinical features of paraneoplastic neurological syndrome(PNS)to improve the early diagnosis and treatment of this disease. Methods The clinical manifestations,laboratory results and treatment effects of 21 patients with PNS admitted to Huizhou First People's Hospital and Huizhou Central People's Hospital from October 2019 to October 2022 were retrospectively analyzed,and literature review was performed. Results There were 10 paraneoplastic syndromes in 21 patients,of which classical syndrome accounted for 28.6%(6/21),the most common was limbic lobe encephalitis.Anti-neuronal antibodies were detected in blood or cerebrospinal fluid in 20 cases,with the highest positive rate of non-characteristic antibodies(12/20),among which the positive rate of TBA detection by semi-quantitative brain tissue sections was the highest(7/20);Eight cases with characteristic antibodies had the highest positive rate of anti-Yo antibody(6/8).All 21 patients have been followed up so far,and 8 cases have found primary tumors,4 of which were after neurological lesions.There was 69.25%(9/13)of patients responded to hormone therapy or(and)gamma globulin therapy. Conclusions Non-classical syndrome accounts for more patients with PNS,and both classical and non-classical paraneoplastic syndromes should be screened for tumors,and those who have not found tumors should be closely followed.The positive rate of non-characteristic antibodies is the highest,indicating that there may still be many related antibodies in PNS that are not clear,and the positive of non-characteristic antibodies should also be paid attention to in clinical work.
论著

SP免疫组化染色检测IGF-1及组织P53蛋白的表达在结直肠腺癌中意义

The significance of SP immunohistochemical staining for detecting the expression of IGF-1 and tissue P53 in colorectal adenocarcinoma

:1269-1274
 
目的 探讨链霉菌抗生物素蛋白-过氧化物酶(SP)免疫组化染色检测胰岛素样生长因子-1(IGF-1)及组织P53蛋白的表达在结直肠腺癌中意义。方法 选取乌鲁木齐市中医医院2020年1月—2023年12月收治的169例结直肠腺癌患者为恶性组,另选取我院同期收治的169例良性结直肠肿瘤患者为良性组。取手术或活检病理组织应用SP免疫组化染色检测2组肿瘤组织IGF-1及P53蛋白表达水平,对比良性组与恶性组间差异,分析不同临床分期、淋巴结转移情况及组织分化程度患者的IGF-1水平、IGF-1mRNA及P53蛋白阳性率。结果 SP免疫组化染色检测IGF-1阳性率、P53蛋白阳性率,恶性组(72.78%、47.93%)均高于良性组(14.79%、6.51%),对比差异有统计学意义(χ2=115.440、χ2=73.180,P<0.05);Ⅳ期患者IGF-1阳性率(96.77%)及P53蛋白阳性率(77.42%)高于Ⅲ期(85.11%、63.83%)、Ⅱ期(62.69%、31.34%)及Ⅰ期患者(45.83%、25.00%),对比差异有统计学意义(χ2=24.860,χ2=28.000,P<0.05),各亚组两两比较差异无统计学意义(IGF-1阳性与阴性,Ⅰ期 vs Ⅲ期,χ2=12.110,P<0.001;Ⅰ期 vs Ⅳ期,χ2=16.060,P<0.001;Ⅱ期 vs Ⅲ期,χ2=6.880,P=0.009;P53蛋白阳性与阴性Ⅰ期 vs Ⅲ期,χ2=9.580,P<0.002;Ⅰ期 vs Ⅳ期,χ2=14.9990,P<0.001;Ⅱ期 vs Ⅲ期,χ2=11.790,P=0.001;);有淋巴结转移患者IGF-1阳性率(85.71%)及P53蛋白阳性率(71.43%)高于无淋巴结转移患者(14.79%、40.94%),对比差异有统计学意义(χ2=4.720、11.740,P<0.05);低分化患者IGF-1阳性率(93.48%)及P53蛋白阳性率(71.74%)高于中分化患者(81.18%、54.12%)、高分化患者(52.63%、31.58%),对比差异有统计学意义(χ2=21.250、13.510,P<0.05)。结论 SP免疫组化染色检测提示结直肠腺癌患者IGF-1、P53蛋白阳性率高于良性肿瘤患者,且临床分期高、淋巴结转移与肿瘤组织低分化者的IGF-1、P53蛋白阳性率高,因此IGF-1、P53有望成为结直肠腺癌诊治的重要检测指标。
Objective Exploring the significance of immunohistochemical staining with streptavidin-perosidase(SP)to detect the expression of insulin-like growth factor-1(IGF-1)and tissue P53 in colorectal adenocarcinoma.Methods A total of 169 patients with colorectal adenocarcinoma admitted to a hospital from January 2020 to December 2023 were selected and divided into the malignant group.Other 169 patients with benign colorectal tumors admitted to a hospital during the same period were selected and divided into the benign group.SP immunohistochemistry staining was used to detect and compare the expression levels of IGF-1 and P53 proteins in two groups of tumor tissues obtained in surgery or biopsy.And the IGF-1 levels,IGF-1 mRNA,and P53 positivity rates in patients with different clinical stages,lymph node metastasis,and tissue differentiation levels were compared.Results There was a significant difference in the positive rates of IGF-1mRNA and P53 detected by SP immunohistochemistry staining,and malignant group(72.78%,47.93%)were higher than the benign group(14.79%,6.51%),which were statistically significant(χ2=115.440,73.180,P<0.05).The positive rates of IGF-1 and P53 were 96.77% and 77.42% in stage IV,which were higher than those in Stage III(85.11%,63.83%),II(62.69%,31.34%)and I(45.83%,25.00%),the differences were statistically significant(χ2=24.860,28.000,P<0.05).The expression levels of IGF-1 and P53 in colorectal adenocarcinoma patients with different lymph node metastases showed significant differences,the positive rates of IGF-1(85.71%)and P53(71.43%)in patients with lymph node metastasis were higher than those without lymph node metastasis(14.79%,40.94%),and the differences were statistically significant(χ2=4.720,11.740,P<0.05).There were significant differences in the expression levels of IGF-1 and P53 among patients with colorectal adenocarcinoma of different degrees of differentiation,the positive rates of IGF-1(93.48%)and P53(71.74%)were significantly higher than those of moderately differentiated(81.18%,54.12%)and well differentiated(52.63%,31.58%),and the differences were statistically significant(χ2=21.250,13.510,P<0.05).Conclusion sThrough SP immunohistochemical staining,it was found that the positivity rates of IGF-1 and P53 in colorectal adenocarcinoma patients were higher than those in benign tumor patients,and those with high the clinical stage,lymph node metastasis,and low differentiation of tumor tissue,had higher the positivity rates of IGF-1 and P53.Therefore,IGF-1 and P53 are expected to become important monitoring indicators for the diagnosis and treatment of colorectal adenocarcinoma.
论著

联合PD-1/L1免疫检查点抑制剂方案用于EGFR-TKIs耐药后晚期非小细胞肺癌的疗效分析

Efficacy analysis of the combined PD-1/L1 immune checkpoint inhibitor regimen for advanced non-small cell lung cancer after EGFR TKIs resistance

:1437-1443
 
目的 探讨表皮生长因子受体酪氨酸酶抑制剂(EGFR-TKIs)一线治疗耐药后,二线化学治疗(化疗)联合程序性死亡蛋白1及其配体(PD-1/L1)免疫检查点抑制剂方案对晚期非小细胞肺癌(NSCLC)的疗效。方法 选取2018年 6月—2022年10月期间就诊于南通大学附属肿瘤医院院的80例有完整临床资料、应用EGFR-TKIs耐药后晚期NSCLC患者进行回顾性分析,依照不同治疗方式将患者分为观察组与对照组,均为40例。对照组一线EGFR-TKIs治疗耐药后进行二线化疗,观察组一线EGFR-TKIs治疗耐药后进行二线化疗联合PD-1/L1免疫检查点抑制剂治疗。对比两组临床疗效及无进展生存期(PFS),化疗前后血清中人细胞角蛋白21-1片段(Cyfra21-1)、糖类抗原125(CA125)、碱性成纤维细胞生长因子(bFGF)、血管内皮生长因子(VEGF)水平变化,不良反应发生率及生存质量。结果 观察组客观缓解率与疾病控制率高于对照组(P<0.05),对照组PFS为10(2.38,24.13)个月,观察组PFS为14(5.27~,5.27)个月,观察组高于对照组(χ2=4.536,P=0.041);化疗后两组bFGF、VEGF,CA125、Cyfra21-1肿瘤标志物水平均比化疗前降低,且观察组[(17.85±3.32)ng/L、(310.51±88.37)ng/L、(51.62±13.66)U/mL、(10.26±3.37)ng/mL]低于对照组[(19.62±3.24)ng/L、(366.26±49.42)ng/L、(59.26±9.35)U/mL、(12.62±2.73)ng/mL],对比差异有统计学意义(t1=2.413,P1=0.018;t2=3.482,P2<0.001;t3=2.919,P3=0.005;t4=3.442,P4<0.001);两组不良反应发生率对比差异无统计学意义(P>0.05);化疗后两组世界卫生组织生存质量量表简表评分均升高,观察组[(98.62±8.24)、(101.53±12.62)、(95.28±11.15)、(97.79±10.47)分]高于对照组[(84.25±7.32)、(93.58±15.75)、(82.24±9.34)、(83.47±8.38)]分,对比差异有统计学意义(t1=8.246,P1<0.001;t2=2.491,P2=0.015;t3=5.670,P3<0.001;t4=6.753,P4<0.001)。结论 对EGFR-TKIs耐药后晚期非小细胞肺癌患者采取二线化疗联合PD-1/L1免疫检查点抑制剂可提升其临床疗效及生存期,改善血清相关肿瘤标志物表达水平,提升患者生存质量。
Objective To explore the therapeutic effect of second-line chemotherapy combined with PD-1/L1 immune checkpoint inhibitor regimen on advanced non-small cell lung cancer(NSCLC) after epidermal growth factor receptor-tyrosine kinase inhibitors(EGFR-TKIs)resistance in first-line chemotherapy.Methods Retrospectively selected 80 patients with advanced NSCLC EGFR TKIs resistance,who were admitted to the Affiliated Cancer Hospital of Nantong University from June 2018 to October 2022.Patients were divided into an observation group and a control group according to different treatment methods,with 40 cases in each group.The control group received second-line chemotherapy after first-line EGFR-TKIs therapy resistance,while the observation group received second-line chemotherapy and PD-1/L1 inhibitor after first-line EGFR-TKIs therapy reactions and quality of live.Clinical efficacy and PFS,changes in serum levels of human Cyfra21-1,CA125,bFGF,VEGF,incidence of adverse chemotherapy of two groups were compared.Results The ORR and DCR of the observation group were significantly higher than those of the control group(P<0.05).The mean PFS of the control group was 10(2.38-24.13)months,while the mean PFS of the observation group was 14(5.27-35.27)months.The observation group was higher than the control group(χ2=4.536,P=0.041).After chemotherapy,levels of bFGF,VEGF,CA125 and Cyfra21-1 tumor markers decreased in both groups,and the observation group [(17.85±3.32)ng/L,(310.51±88.37)ng/L,(51.62±13.66)U/mL,(10.26±3.37)ng/mL] was lower than the control group [(19.62±3.24)ng/L,(366.26±49.42)ng/L,(59.26±9.35)U/mL,(12.62±2.73)ng/mL],which showed statistically significant difference in the comparison(t1=2.413,P1=0.018;t2=3.482,P2<0.001;t3=2.919,P3=0.005;t4=3.442,P4<0.001).There was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).After treatment,the WHO QOL-BREF scores increased in both patient groups and the observation group scores[(98.62±8.24),(101.53±12.62),(95.28±11.15),(97.79±10.47)] were higher than the control group scores[(84.25±7.32),(93.58±15.75),(82.24±9.34),(83.47±8.38)],which showed statistically significant difference.(t1=8.246,P1<0.001;t2=2.491,P2=0.015;t3=5.670,P3<0.001;t4=6.753,P4<0.001).Conclusions The combination of second-line chemotherapy with PD-1/L1 immune checkpoint inhibitors can improve the clinical efficacy and survival of advanced NSCLC patients who are resistant to EGFR-TKIs,improve the expression levels of serum related tumor markers,and enhance the quality of life of patients.
临床诊疗

2019—2021年广州地区无偿献血后回告及保密性弃血工作分析及思考

:95-98
 
目的 通过分析2019—2021年广州地区保密性弃血工作情况,完善献血者献血后回告受理和保密性弃血管理。方法 通过分析广州市血液中心2019年1月—2021年12月期间受理的无偿献血者献血后保密性弃血回告记录,统计分析无偿献血者要求保密性弃血的各种原因,以及保密性弃血施行程序中出现的新情况。结果 2019年、2020年、2021年保密性弃血人数分别占当年献血人数的0.156‰,0.090‰,0.091‰。2020年之后出现接触或疑似接触新型冠状病毒患者的回告案例;在这3年间,87.6%的保密性弃血在72小时内完成回告。结论 无偿献血者保密性弃血回告以及血液屏蔽是保障血液用血安全的重要举措之一,目前广州市回告率相对较低,提示要强化血液保密性弃血回告及方法途径指引宣传,注意对新回告原因的收集以有针对性开展献血前征询工作,从源头筛选出合格、低风险的无偿献血者,同时完善长时间(72小时以上)才回告的血液保密性弃血处理程序。
论著

MAML1与胃癌进展和预后相关性的生物信息学分析

Association between MAML1 and progression, prognosis in gastric cancer based on bioinformatics analysis

:56-63
 
目的 通过多种生物信息学方法分析MAML1在GC患者中的表达及与临床特征、预后和免疫治疗疗效的相关性。方法 利用TCGA数据库分析胃癌组织与正常胃黏膜组织中的MAML1表达水平;Kaplan-Meier在线工具对胃癌数据集GSE15459进行分析,阐明MAML1与患者临床特征及分期、治疗疗效的相关性;STRING软件预测与MAML1表达相关的基因,并用FUNRICH软件评估其富集的分子生物学功能和信号通路;TIMER和GEPIA数据库探索MAML1表达水平与肿瘤浸润免疫细胞及其相应基因标记集之间的关系。结果 MAML1在GC组织中的表达水平高于正常组织(P<0.001),且其表达水平与III期、有淋巴结转移、无远处转移的患者生存期相关(P<0.05),而与I、II和IV期、无淋巴结转移和有远处转移的患者生存期无相关性(P>0.05)。MAML1的相关作用基因主要分布在细胞核、参与转录调控,并且主要富集在雄激素受体、C-MYB转录因子和HIF-2α转录调控等相关的信号通路。MAML1表达水平与B细胞、CD4+ T细胞、巨噬细胞的表达水平存在正相关关系(P<0.05),但与肿瘤纯度、CD8+ T细胞、中性粒细胞、树突状细胞无相关性(P>0.05)。结论 MAML1有可能成为GC患者较差的临床预后标志物之一,其潜在分子机制可能与转录调控调节肿瘤微环境有关。
Objective To investigate the expression of MAML1 and its relationship with clinical characteristics, prognosis and the efficiency of immunotherapy in patients with GC. Methods MAML1 expression profile was observed by TCGA database. Kaplan-Meier survival analysis was applied to evaluate the correlation between the expression of MAML1 and clinical characteristics, prognosis and treatment efficiency of patients in GSE15459 dataset. MAML1-associated genes were predicted by STRING and were enriched in GO and KEGG by FUNRICH software. The relationship between MAML1 expression and markers of tumor infiltrated cells were explored by TIMER and GEPIA database. Results MAML1 was abnormally upregulated in GC tissues compared to normal gastric tissues (P<0.001). MAML1 expression was significantly associated with the overall survival of patients in stage III, with lymph node metastasis and without distant metastasis (P<0.001). There was no significant difference between MAML1 expression and the overall survival of patients in stage I, II, IV, without lymph node metastasis and with distant metastasis (P>0.05). MAML1-assoicated genes were mainly located at the nucleus, mediating transcriptional regulation and mainly enriching in androgen receptor, C-MYB transcription factor and HIF-2α transcription regulation and other related signaling pathways. MAML1 expression was positively related with the expression of B cell, CD4+ T cell and macrophages (P<0.05), but without significant difference with tumor purity, CD8+ T cell, neutrophils and dendritic cells (P>0.05). Conclusions MAML1 could be used as a marker of clinical prognosis of patients with GC. The potential molecular mechanism might be associated with its function in transcriptional regulation and changes in tumor microenvironment.
论著

SNHG12在乙肝病毒X蛋白诱导肝癌发生中的作用研究

Study on the role of SNHG12 in the occurrence of hepatocarcinoma induced by hepatitis B virus X protein

:16-24
 
目的 探究长链非编码RNA SNHG12在乙肝病毒X蛋白(HBx)诱导肝癌发生过程中的作用。方法 把课题组构建的肝前体细胞14-19、EGFP-14-19、HBx-EGFP-14-19通过小鼠肝门静脉注射到体内;采用 qRT-PCR、Western blot 方法检测30 d,90 d,180 d,360 d小鼠肝脏组织及细胞模型中HBx、SNHG12以及下游调节基因的mRNA和蛋白表达情况;使用si-SNHG12干扰其表达,并通过CCK-8、划痕实验、transwell实验、流式细胞术观察其对体外表型影响;检测SNHG12及下游的 mRNA 和蛋白表达;HE染色观察小鼠肝组织切片。结果 qRT-PCR结果表明SNHG12、Notch1、Hes1在HBx-EGFP-14-19细胞及各时间段的小鼠肝组织中均上调(F=48.808,P<0.000 1;F=13.322,P<0.000 1);Western blot结果显示在HBx过表达细胞及动物模型中,受HBx诱导SNHG12表达升高后Notch1信号通路被激活,促凋亡因子Bax下调,抗凋亡因子Bcl-2上调,细胞周期因子CDK2和Cyclin E上调;抑制SNHG12表达后,qRT-PCR、Western blot实验结果显示SNHG12(t=22.746,P<0.000 1)及其上述基因表达均扭转,CCK-8实验显示细胞增殖受到明显抑制,流式细胞术检测显示细胞凋亡增多,划痕及transwell实验表明细胞迁移及侵袭减弱。结论 HBx通过上调SNHG12诱导Notch1表达,导致细胞增殖、周期和凋亡异常,从而促进肝癌的发生。
Objective In order to explore the role of long non-coding RNA SNHG12 in hepatitis B virus X protein (HBx) induced hepatocarcinogenesis. Methods The liver precursor cells 14-19, EGFP-14-19 and HBx-EGFP-14-19 constructed by the research group was injected into the body through the hepatic portal vein of KM mice; qRT-PCR and Western blot were used to detect the mRNA and protein expression of HBx, SNHG12 and downstream regulatory genes in liver tissues of 30 d, 90 d, 180 d and 360 d mice and cell models. Si-SNHG12 was used to interfere with SNHG12 expression in vitro, the mRNA and protein expression of SNHG12 and downstream genes were detected, and its effect on phenotype in vitro was observed by CCK-8, flow cytometry, scratch test and transwell test. HE staining was used to observe the liver sections of mice. Results qRT-PCR showed that SNHG12, Notch1 and Hes1 were up-regulated in HBx overexpression cells and mouse liver tissue at each time point (F=48.808,P<0.000 1;F=13.322,P<0.000 1); the results of Western blot showed that in HBx over-expressing cells and animal models, the expression of SNHG12 was increased induced by HBx, resulting in the activation of Notch1 signal pathway, the down regulation of pro-apoptotic factor Bax, anti-apoptotic factor Bcl-2, and the up-regulation of cell cycle factors CDK2, cyclin E. After inhibiting the expression of SNHG12, the results of qRT-PCR and Western blot showed that SNHG12 (t=22.746,P<0.000 1) and the above genes were inhibited; CCK-8 experiment showed that cell proliferation was significantly inhibited, flow cytometry showed that cell apoptosis increased, scratch experiment and transwell experiment showed that cell migration and invasion decreased. Conclusions HBx induced Notch1 expression by up regulating SNHG12, resulting in abnormal cell proliferation, cycle and apoptosis, so as to promote the occurrence of liver cancer.
论著

2016—2021年茂名市临床供血数据统计与规律分析

Data statistics and periodic analysis of clinical blood supply in Maoming City from 2016 to 2021

:97-100
 
目的 统计分析茂名市2016—2021年各种成分血临床供血情况,分析不同成分ABO血型供血特点,总结供血趋势,为今后采供血工作提供参考。方法 通过血液信息管理系统和统计“血库库存监控”中血库预警情况,统计分析茂名市2016—2021年各类成分血临床供应情况。结果 2016—2021年茂名市中心血站临床供血总量1 635 494.5 U,年平均增长率10.74%;红细胞类、血浆类、冷沉淀和浓缩血小板临床供应量年平均增长速度分别为11.58%、8.68%、5.88%、19.41%,各血型占比均为O型>A型>B型>AB型;2018年后机采血小板临床供应量逐年增长;AB型浓缩血小板报废占比最大。结论 2016—2021年茂名市中心血站临床血液供应量逐年增长,O型用血在茂名地区所占比例最大,AB型所占比例最小。在未来采供血工作中,结合临床不同血型成分血使用特征,注意不同血型血液库存,优化血库库存警戒线,防止过多血液过期报废。
Objective To statistically analyze the clinical supply of various blood components in Maoming City from 2016—2021, analyze the characteristics of various ABO blood components supply, and summarize the trend of blood supply as a reference for future blood collection. Methods Using the blood information management system and the early warning situation of the blood bank in “blood bank inventory monitoring”, the clinical supply of various blood components from 2016 to 2021 was statistically analyzed. Results The total supply amount of clinical blood from Maoming Central Blood Bank in 2016-2021 was 1635 494.5 U, with an average annual growth of 10.74%; the percentage of each blood components (red cell, plasma, cryoprecipitate and pooled platelets) was O>A>B>AB, with an average annual growth rate of 11.58%, 8.68%, 5.88% and 19.41%.After 2018, the clinical supply of mechanically collected platelets increased year by year.Scrapped pooled platelets of AB type accounted for the largest proportion. Conclusions Clinical blood supply in Maoming central blood bank was increasing yearly from 2016 to 2021, with the largest proportion of blood type O in Maoming region and the smallest proportion of blood type AB.In the future blood collection and supply, we will pay attention to blood products for different blood types in stock by taking into account the different blood types usage,pay attention to the blood stocks of different blood types, optimize the alarm threshold of blood bank stocks, to prevent overmuch blood from expiring and being scrapped.
论著

S-ChE联合T细胞表面PD-1水平对脓毒症患者病情预后状况评估的价值

The effect of S-ChE combined with T cell surface PD-1 level on the evaluation of the prognosis of patients with sepsis

:83-87
 
目的 观察脓毒症患者血清胆碱酯酶(S-ChE)和T细胞程序性死亡分子-1(PD-1)以及炎症因子水平,并分析其与患者预后关系。方法 选取2018年8月—2021年5月在我院接受治疗的脓毒症患者为研究对象,同时选取同期在我院接受体检的健康人群为对照组。根据脓毒症患者的预后分为存活组和死亡组。比较脓毒症组和对照组、脓毒症存活组和死亡组患者S-ChE、PD-1水平和炎症因子水平的差异,并分析与患者预后的关系。结果 脓毒症患者的S-ChE水平低于对照组,PD-1水平高于对照组(P<0.05)。脓毒症患者的CRP、PCT水平高于对照组,CD3+T、CD3+CD4+T和CD4+CD8+T水平低于对照组(P<0.05)。死亡组患者的S-ChE水平低于存活组,PD-1水平高于存活组(P<0.05)。死亡组患者的CRP、PCT水平高于存活组,CD3+T、CD3+CD4+T和CD4+CD8+T水平低于存活组(P<0.05)。脓毒症患者S-ChE、PD-1水平呈负相关,(P<0.05)。脓毒症患者的S-ChE与 CRP、PCT水平负相关,与CD3+T、CD3+CD4+T、CD4+CD8+T水平正相关(P<0.05)。脓毒症患者的PD-1与 CRP、PCT水平正相关,与CD3+T、CD3+CD4+T、CD4+CD8+T水平负相关(P<0.05)。S-ChE、PD-1预测脓毒症患者预后的AUC值为0.725(95%CI:0.605~0.825)、0.706(95%CI:0.585~0.809),P<0.05。结论 脓毒症患者的S-ChE水平较低,PD-1水平较高,且与炎症因子水平和患者的预后相关。
Objective To analyze the levels of serum cholinesterase (S-ChE), programmed death 1 (PD-1) and inflammatory factors in patients with sepsis, and analyze the relationship between them and the prognosis of patients. Methods Patients with sepsis treated in our hospital from August 2018 to May 2021 were selected as the research subjects, and healthy people who received physical examinations in our hospital during the same period were selected as the control subjects.The differences in the levels of S-ChE, PD-1 and inflammatory factors between the sepsis group and the control group, the sepsis survival group and the death group were compared, and their relationship with the prognosis of the patients were analyzed. Results The level of S-ChE in patients with sepsis was lower than that of the control group, and the level of PD-1 was higher than that of the control group (P<0.05).The CRP and PCT levels of sepsis patients were higher than those of the control subjects, and the levels of CD3+T, CD3+CD4+T and CD4+CD8+T were lower (P<0.05).The S-ChE level of the death group was lower than that of the survival group, and the PD-1 level was higher than that of the survival group (P<0.05).The levels of CRP and PCT in the death group were higher than those in the survival group, and the levels of CD3+T, CD3+CD4+T and CD4+CD8+T were lower than those in the survival group (P<0.05).The levels of S-ChE and PD-1 in sepsis patients were negatively correlated (P< 0.05).S-ChE level in patients with sepsis was negatively correlated with CRP and PCT levels, and positively correlated with CD3+T, CD3+CD4+T, and CD4+CD8+T levels (P<0.05).PD-1 level in patients with sepsis was positively correlated with CRP and PCT levels, and negatively correlated with CD3+T, CD3+CD4+T, and CD4+CD8+T levels (P<0.05).The AUC values of S-ChE and PD-1 predicting the prognosis of patients with sepsis were 0.725 (95% CI: 0.605~0.825), 0.706 (95% CI: 0.585~0.809), P<0.05. Conclusions Patients with sepsis had lower level of S-ChE and higher level of PD-1, which were related to the levels of inflammatory factors and the prognosis of patients.
论著

120例动眼神经麻痹患者的病因及临床特点分析

Etiology and clinical characteristics of 120 patients with oculomotor nerve paralysis

:75-78
 
目的 分析120例动眼神经麻痹患者的病因及临床特点。方法 收集2019年5月—2021年7月我科收治的120例动眼神经麻痹患者临床资料进行分析,统计所有患者的病因、临床特点、治疗结果。结果 120例患者均急性起病,单眼发病105例(87.50%)、双眼发病15例(12.50%),所有患者均有不同程度的上睑下垂、眼球外下斜视、眼球转动受限、复视,入选患者中年龄构成占比最大的为41~60岁(49例,40.83%);在120例动眼神经麻痹患者中,明确诊断103例(85.83%)、病因诊断未明确17例(14.17%),完全性动眼神经麻痹23例(19.17%)、不完全性动眼神经麻痹97例(80.83%)。病因占比最多的分别是糖尿病18例(15.00%)、动脉瘤16例(13.33%)、脑梗死15例(12.50%);持续治疗3个月后,痊愈者88例(73.33%)、有效者21例(17.50%),无效者11例(9.17%)。结论 动眼神经麻痹的病因以糖尿病、动脉瘤、脑梗死最为常见,临床表现可有不同程度的上睑下垂、眼球外下斜视、眼球转动受限、复视,大多数患者经过积极治疗后可痊愈或好转,在临床中需结合多种诊断技术及原发性疾病进行诊断和治疗。
Objective To analyze the etiology and clinical characteristics of 120 patients with oculomotor nerve paralysis. Methods The clinical data of 120 patients with oculomotor paralysis treated in our department from May 2019 to July 2021 were collected and analyzed, and the etiology, clinical characteristics and treatment results of all patients were summarized. Results All 120 patients had acute onset, 105 cases (87.50%) had monocular onset and 15 cases (12.50%) had binocular onset.All patients had different degrees of ptosis, exophthalmos, hypotropia, limited eye rotation and diplopia.The largest age composition among the selected patients was 41 ~ 60 years old (49 cases, 40.83%).Among 120 patients with oculomotor nerve palsy, 103 cases (85.83%) were clearly diagnosed, 17 cases (14.17%) were not, 23 cases (19.17%) were complete oculomotor nerve palsy and 97 cases (80.83%) were incomplete oculomotor nerve palsy.The most common causes were diabetes mellitus (18 cases, 15%), aneurysms (16 cases, 13.33%), and cerebral infarction (15 cases, 12.50%).After 3 months of continuous treatment, 88 cases (73.33%) were cured, 21 cases (17.50%) were improved and 11 cases (9.17%) had few changes. Conclusions The main causes of oculomotor nerve palsy were diabetes mellitus, aneurysm and cerebral infarction.The clinical manifestations could be varying degrees of ptosis, exophthalmos and strabismus, limited rotation of eyeball and diplopia.Most patients could be cured or improved after treatment.In clinical practice, a variety of diagnostic techniques and primary diseases should be combined to diagnose and treat those patients.
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