目的 探讨SNCG蛋白在卵巢癌组织中的表达情况及临床意义,明确SNCG在人卵巢癌中的表达情况及其恶性程度的关系,为临床卵巢癌的诊断、治疗及预后提供理论依据。方法 收集2010年1月—2015年1月石河子大学医学院第一附属医院收治的具有完整临床病理资料和石蜡切片的119例卵巢癌以及50例正常卵巢患者,用免疫组化方法检测组织中SNCG的表达情况,并分析SNCG的表达与卵巢癌患者临床病理特征及预后的关系。结果 SNCG在卵巢癌组织中的表达高于正常卵巢组织(χ²=73.575,P＜0.001);SNCG的表达与卵巢癌患者的肿瘤分期、分化程度、淋巴结转移、达到满意减瘤术、CA125以及HE4水平相关,差异均有统计学意义(P＜0.05);与卵巢癌肿瘤的原发部位、腹水、复发及化疗耐药无关,差异无统计学意义(P＞0.05);SNCG的过表达与HGSOC患者的PFS、OS相关,差异有统计学意义(P＜0.05);多变量Cox比例风险模型分析显示SNCG是HGSOC患者的独立预后因素,与PFS(HR=2.107,95%CI:1.014～3.795,P=0.034)、OS(HR=1.238,95%CI:0.716～1.928,P=0.047)相关。结论 SNCG在卵巢癌中高表达,与患者肿瘤分期、分化程度、淋巴结转移、达到满意减瘤术、CA125以及HE4水平有关,与卵巢癌患者的复发与化疗耐药无关,SNCG蛋白的过表达可作为HGSOC患者的独立预后因素,指导临床诊治。

Objective To detect the expression of SNCG in ovarian cancer tissue and its clinical significance, to clarify the relationship between the expression of SNCG in human ovarian cancer and the degree of malignancy, so as to provide theoretical basis for the diagnosis, treatment and prognosis of clinical ovarian cancer. Methods From January 2010 to January 2015 in First Affiliated Hospital of Medical College of Shihezi University,119 patients with ovarian cancer and 50 patients with normal ovarian which had complete clinical data and paraffin section were selected. Immunohistochemical method was used to detect ovarian SNCG expression, and the expression of SNCG relationship with clinical pathological characteristics and prognosis of patients with ovarian cancer was analyzed. Results The expression of SNCG in ovarian cancer tissue was significantly higher than that in normal ovarian tissue (χ²=73.575,P＜0.001). SNCG expression was correlated with tumor stage, degree of differentiation, lymph node metastasis, satisfying tumor reduction, CA125 and HE4 levels in ovarian cancer patients, and the differences were statistically significant (P＜0.05). It was not correlated with the tumor primary site, ascites, recurrence of ovarian tumor and chemotherapy resistance, and the differences were not statistically significant (P＞0.05).The overexpression of SNCG was correlated with PFS and OS in HGSOC patients, and the differences were statistically significant (P＜0.05). Analysis of multivariate Cox proportional risk model showed that SNCG was an independent prognostic factor in patients with HGSOC, related to PFS (HR=2.107,95%CI: 1.014-3.795,P=0.034) and OS (HR=1.238,95%CI: 0.716-1.928,P=0.047). Conclusion The high expression of SNCG in ovarian cancer is related to tumor stage, degree of differentiation, lymph node metastasis, satisfying tumor reduction, CA125 and HE4 expressions, but it is not related to the recurrence of ovarian cancer or chemotherapy resistance. The overexpression of SNCG protein can be used as an independent prognostic factor in patients with HGSOC for clinical diagnosis and treatment guidance.

目的 研究碳氧血红蛋白在新生儿ABO溶血病中的诊断价值。方法 将患者分为三组,选取144例足月新生儿ABO溶血病患儿为溶血组(A组),选取同期160例不合并溶血的足月黄疸新生儿为非溶血性黄疸组(B组),同时与88例足月健康新生儿(C组)对比。分析三组间碳氧血红蛋白、总胆红素、红细胞计数等有无差异。结果 溶血组患儿的碳氧血红蛋白水平较健康新生儿高,两组间差异有统计学意义(P＜0.001)。同时,溶血组患儿的碳氧血红蛋白水平较非溶血性黄疸组患儿高,两组间差异有统计学意义(P＜0.001)。碳氧血红蛋白在非溶血性黄疸组和健康新生儿组无统计学差异。碳氧血红蛋白ROC曲线值为1.27%时诊断新生儿ABO溶血病的敏感度和特异度最高(分别为90%和70%,P＜0.001)。溶血组患儿总胆红素水平与碳氧血红蛋白呈正相关关系(r=0.83523,P＜0.001),非溶血性黄疸患儿总胆红素水平与碳氧血红蛋白无相关性(r=0.12571,P＞0.05),溶血组患儿组总胆红素水平低于非溶血性黄疸患儿,而碳氧血红蛋白水平高于非溶血性黄疸患儿(P＜0.001)。结论 碳氧血红蛋白对新生儿ABO溶血病的诊断有临床意义,同时碳氧血红蛋白检测可作为体内胆红素产生量的指标,其有助于黄疸病因的鉴别、诊断及治疗。

Objective To explore clinical significance of determination of carboxyhemoglobin in ABO hemolytic disease of the newborn. Methods A total of 392 cases were randomly selected in the study. The experiment consisted of three groups: a total of 144 newborns consecutively hospitalized with ABO hemolysis were treated as experimental group(Group A); 160 newborns with hyperbilirubinemia and without hemolysis were collected(Group B); and 88 healthy newborns at term were the control group(Group C). Carboxyhemoglobin, serum total bilirubin and hemoglobin was collected and were compared with in the three subgroups. Results Compared with group C, carboxyhemoglobin were higher in ABO hemolytic disease(P<0.001). Compared with group B, carboxyhemoglobin were higher in ABO hemolytic disease(P<0.001), while carboxyhemoglobin showed no significant difference between group B and C (P>0.05). A carboxyhemoglobin cut-off value of 1.27% had 90% sensitivity and 70% specificity for predicting prescription. There was a positive correlation between total bilirubin level and carboxyhemoglobin level in newborns with ABO hemolysis(r=0.83523,P＜0.001). Conclusion Carboxyhemoglobin indicates the procedure of ABO hemolytic disease of the newborn, which is helpful to diagnose the cause of hyperbilirubinemia and taken as a guide in therapy.

目的 探讨B超与MRI、宫腔镜联合诊断对宫腔占位性病变的临床意义。方法 选择2017年1月1日— 12月31日我院收治的108例疑似宫腔占位性病变患者为研究对象。所有患者均于宫腔操作前行阴道彩色多普勒超声(以下简称B超)检查、MRI检查及宫腔镜检查。与病理检查结果对比,分别分析其灵敏度、特异度。结果 108例患者中宫腔无病理变化者27例,子宫内膜息肉39例,子宫内膜增生27例,子宫黏膜下肌瘤10例,子宫内膜癌5例。B超、MRI、宫腔镜诊断灵敏度分别为72.84%、71.60%、75.31%,特异度分别为62.96%、85.19%、66.67%。B超+MRI诊断子宫黏膜下肌瘤和子宫内膜癌灵敏度100%,特异度分别为87.76%和99.03%。B超+MRI+宫腔镜诊断子宫内膜增生、子宫黏膜下肌瘤、子宫内膜癌灵敏度均为100%。结论 宫腔占位病变以良性病变居多,B超联合宫腔镜和MRI检查可提高诊断率。对子宫内膜癌高危人群应进行B超与MRI联合检查,宫腔镜定位活检仅在必要时实施。

Objective To explore the clinical significance of B-ultrasound, MRI and hysteroscopy in the diagnosis of uterine space occupying lesions. Methods 108 patients with suspected uterine space occupying lesions admitted to our hospital from January 1 to December 31 2017 were selected as the study objects. All patients were examined by vaginal color Doppler ultrasound, MRI and hysteroscopy before uterine operation. Compared with the results of pathological examination, the sensitivity and specificity were analyzed. Results Among the 108 patients, 27 had no pathological changes in uterine cavity, 39 had endometrial polyps, 27 had endometrial hyperplasia, 10 had submucous myoma, and 5 had endometrial cancer. The sensitivity of B-ultrasound, MRI and hysteroscopy were 72.84%, 71.60% and 75.31% respectively, and the specificity were 62.96%, 85.19% and 66.67% respectively. The sensitivity of B-ultrasound+MRI in the diagnosis of submucous myoma and endometrial carcinoma was 100% and the specificity was 87.76% and 99.03%, respectively. The sensitivity of B-ultrasound+MRI+hysteroscopy in the diagnosis of endometrial hyperplasia, submucous myoma and endometrial carcinoma was 100%. Conclusion Most of the uterine space occupying lesions are benign. B-ultrasound combined with hysteroscopy and MRI may improve the diagnosis rate. The high-risk group of endometrial cancer should be examined by B-ultrasound and MRI, and hysteroscopic biopsy would be performed only when necessary.

目的 分析应用蓝激光成像技术(BLI)联合内镜智能分光比色技术(FICE)诊断早期食管癌的临床意义。方法 收集本院及下级医院2016年1月—2018年6月在普通内镜下发现的108例食管可疑病变患者,分别给予白光、FICE和BLI不同模式进行观察诊断,再结合放大模式对病变部位的上皮乳头内毛细血管袢(IPCL)进行观察、分型、判断性质。最后取活检送病理学检查。内镜数据和病理数据采用Kappa一致性检验方法、Spearman相关性分析,统计每种内镜检查模式诊断的准确性,分析各方法下IPCL分型与病理诊断之间的相关性。结果 Kappa一致性检验显示,白光内镜、FICE、BLI以及FICE+BLI等模式诊断早期食管癌的准确度、敏感度、特异度、阳性预测、阴性预测及Kappa值呈逐步升高;Spearman相关性分析显示,FICE、BLI以及BLI与FICE联合诊断时,IPCL分型与早期食管癌的诊断均呈正相关,且BLI联合FICE的相关性强于BLI或FICE单独诊断。结论 BLI联合FICE可显著提高早期食管癌的诊断率,结合放大内镜下IPCL分型可判断早期食管癌病理分型。

Objective To analyze the clinical significance of blue laser imaging (BLI)technology combined with Fuji intelligent chromo endoscopy (FICE)in the diagnosis of early esophageal cancer. Methods 108 cases of patients with esophageal suspicious lesions admitted to our hospital from January 2016 to June 2018 were enrolled in the study. They were given different modes of white light, FICE and BLI for observation and diagnosis, and the magnifying endoscopy model was combined to observe the intraepithelial papillary capillary loop (IPCL)at lesions sites for IPCL typing. After complete endoscopic examinations, the lesions were taken for pathological examination. The accuracy, sensitivity, specificity, positive predictive value, negative predictive value and Kappa value of each method were tested by Kappa consistency test. Spearman correlation analysis was used to analyze the correlation between IPCL classification and pathological diagnosis under each method. Results Kappa consistency test showed that the accuracy, sensitivity, specificity, positive predictive value, negative predictive value and Kappa value of white light endoscopy, FICE, BLI and FICE+BLI were increased in the diagnosis of early esophageal cancer. IPCL classification under combined magnifying endoscopy showed that type IV was mainly early esophageal cancer, and types I-III were mainly precancerous lesions. Spearman correlation analysis showed that through FICE, BLI and BLI combined with FICE for diagnosis, IPCL classification was positively correlated with early esophageal cancer, and the correlation of BLI combined with FICE was stronger than that of BLI or FICE. Conclusions BLI combined with FICE can greatly improve the diagnosis rate of early esophageal cancer. Combined with magnifying endoscopy, IPCL classification can judge the pathological types of early esophageal cancer.

目的 分析小儿葫芦散应用于儿童喘息性支气管炎中的治疗效果。方法 在我院2015年8月—2018年12月诊治的喘息性支气管炎患儿中选取68例,并严格按照系统随机分配原则分为对照组和观察组,各34例。其中对照组采用常规治疗,观察组采用小儿葫芦散治疗,观察对比两组患儿治疗效果和临床症状消失时间。结果 对照组总有效率为76.47%,观察组总有效率为94.12%,对照组总有效率低于观察组,且对照组临床症状消失时间均长于观察组,差异有统计学意义(P<0.05)。结论 小儿葫芦散应用于喘息性支气管炎患儿中具有显著疗效,进一步改善肺功能情况,促进患儿康复,值得推广。

目的 探讨非霍奇金淋巴瘤(NHL)合并HBV感染患者化疗过程中肝功能监测的临床意义。方法 以2014年3月—2016年6月我院21例NHL合并HBV感染患者为研究对象,所有患者采用CHOP方案进行化疗,治疗2~6周期。 分别于化疗前后对患者肝功能进行检查,采用荧光定量PCR法进行乙肝病毒DNA复制情况检测;肝功能出现中重度异常患者进一步测定凝血酶原活动度(PTA)、活化部分凝血活酶时间(APTT)、纤维蛋白原(Fb)等,同时对NHL辅助性标志物进行监测,主要包括β₂微球蛋白(β₂-MG)及乳酸脱氢酶(LDH)。结果 随着化疗进行,患者ALT、GLB、胆红素水平逐渐增高(P<0.05),ALB、PA水平逐渐降低(P<0.05);相比于化疗进行2个周期,进行4～6周化疗者肝功能损害率和重症肝炎发生率均升高,差异有统计学意义(P<0.05)。结论 NHL合并HBV感染患者化疗过程中对肝功能监测,有助于防止重症肝炎发生,并降低病死率,具有重要临床意义。

目的 探究聚乙二醇筛查法在高泌乳血症诊断中的临床意义。方法 选取260例HP患者作为观察组以及80例健康体检者作为对照组。应用雅培I2000全自动化学发光检测仪对两组标本进行PRL浓度测定,并将标本进行PEG筛查法沉淀后再次进行PRL浓度测定,将所得数据进行对比。结果 观察组检出MP67例,检出率25.77%,对照组检出MP3例,检出率3.75%,二者差异有统计学意义(P＜0.05);HP组、MP组和对照组之间PEG沉淀前PRL浓度差异有统计学意义(P＜0.05),沉淀后HP组和MP组以及对照组差异有统计学意义(P＜0.05),MP组和对照组差异无统计学意义(P＞0.05);MP在HP引起的各种临床疾病中检出情况差异无统计学意义(P＞0.05)。结论 应用聚乙二醇筛查法对于排除MPRL对HP诊断的干扰具有可行性,对降低HP的误诊率有着重要的意义。

Objective To explore the clinical signification of polyethylene glycol screening method on the diagnosis of hyperprolactinemiat.Methods We selected 260 patients with hyperprolactinemia as observation group and 80 healthy individuals as control group. The two groups were measured with Abbott laboratories I2000 automatic chemiluminescence detector about the concentration of PRL. Then the groups were measured again after they were precipitated by the polyethylene glycol and the result data were analyzed.Results 78 cases of MP were checked out from the observation group and 3 cases were checked out from the control group. The proportion was 25.77% and 3.75% respectively, and the differences were statistically significant (P＜0.05). The difference of the concentration of PRL before precipitated by PEG among the HP group, the MP group and the control group were statistically significant (P＜0.05). After precipitating, the difference of the concentration of PRL between the HP group and the MP group were statistically significant (P＜0.05), as well as the HP group and the control group. However, there was no difference between the MP group and the control group (P＞0.05). The checking conditions of MP in some diseases caused by HP had no difference(P＞0.05).Conclusion The use of polyethylene glycol screening method is a practicable method to eliminate the interference of MPRL on the diagnosis in HP. It has significance reducing misdiagnosis rate of HP.

目的 探讨急性心衰(AHF)患者NTpro-BNP,cTnI,hs-CRP的变化及其临床意义。方法 分别选取342例AHF患者和30例同期健康查体者作为观察组和对照组。统计2组NTpro-BNP,cTnI,hs-CRP及LVEF水平及随访期间死亡率。分析患者NTpro-BNP,cTnI,hs-CRP与其LVEF的关系及其联合预测患者死亡率的价值。结果 观察组NTpro-BNP,cTnI,hs-CRP均较对照组升高,LVEF则较对照组降低;与T₀比较,患者T₂、T₃、T₄的NTpro-BNP,cTnI,hs-CRP均降低,LVEF则升高;心衰较严重患者其NTpro-BNP,cTnI,hs-CRP较高,LVEF则较低(P<0.05)。观察组存活患者NTpro-BNP,cTnI,hs-CRP较低,LVEF则较高(P<0.05)。AHF患者NTpro-BNP,cTnI,hs-CRP与其LVEF均呈负相关且预测预后的价值良好。结论 AHF患者NTpro-BNP,cTnI,hs-CRP与其心功能相关且其联合预测预后的价值较高,可能作为AHF患者心功能及患者预后评估的参考指标。

Objective To study the NTpro-BNP, cTnI and hs-CRP changes of patients with acute heart failure(AHF)and its clinical significance. Methods 342 patients with AHF and 30 healthy persons were selected as observation group and control group. NTpro-BNP, cTnI, hs-CRP and LVEF level of two groups and mortality during the follow-up period were analyzed. Relationship between NTpro-BNP, cTnI, hs-CRP and LVEF, and value of them unitedly predicting mortality of patients were analyzed. Results NTpro-BNP, cTnI, hs-CRP of observation group were higher than that of the control group while LVEF was lower than that of the control group; Compared with T₀, NTpro-BNP, cTnI, hs-CRP of observation group in T₂, T₃, T₄ were reduced while LVEF increased; Patients with more serious heart failure had higher NTpro-BNP, cTnI, hs-CRP and lower LVEF (P<0.05). NTpro-BNP, cTnI, hs- CRP of survived patients in observation group were lower while LVEF was higher(P<0.05). NTpro-BNP,cTnI and hs-CRP of AHF patients were negative correlated with LVEF and value of them predicting good prognosis. Conclusion NTpro-BNP, cTnI, hs-CRP of AHF patients are related to its heart function and the value of them unitedly predicting prognosis is good, thus they may used cardiac function and prognosis evaluation reference index of AHF patient.

目的 探讨系统性红斑狼疮(SLE)患者外周血中25-羟基维生素D(25-OH-D)和白介素-17(IL-17)水平的变化及其临床意义。方法 选取40例SLE患者作为研究对象, 20例健康体检人员为健康对照组。运用电化学发光法检测25-OH-D水平,酶联免疫吸附法检测IL-17水平。结果 SLE患者25-OH-D水平明显低于健康对照组(P<0.01),活动期SLE患者25-OH-D水平明显低于缓解期患者(P<0.01)。SLE患者IL-17水平明显升高(P<0.01)。低25-OH-D水平与肾损害(P<0.01)相关,与疾病活动度评分(SLEDAI评分)(r=-0.844,P<0.01)及IL-17水平(r=-0.596,P<0.01)负相关。结论 SLE患者25-OH-D水平降低,低25-OH-D水平与肾损害、病情活动及高IL-17水平相关,25-OH-D可能参与了SLE的炎症进程。

Objective To assess the 25-hydroxyvitamin D (25-OH-D) and interleukin-17(IL-17) status in patients with systemic lupus erythematosus(SLE) and its clinical significance. Methods 40 SLE patients along with 20 matched controls were collected. Chemilumineseent immunoassay (CLIA) was used to detect the levers of serum 25-OH-D. The levels of serum IL-17 were evaluated using enzyme-linked immunosorbent assay (ELISA). Results Serum 25-OH-D level in SLE patients was significantly lower than in healthy controls (P<0.01). Serum 25-OH-D level in active SLE patients was significantly lower than in inactive SLE patients (P<0.01). Lever of IL-17 was significantly higher in SLE patients than in healthy controls (P<0.01). Insufficiency of 25-OH-D was related to renal disorders. Serum 25-OH-D level was negatively correlated with systemic lupus erythematosus disease activity index (SLEDAI) scores(r=-0.844, P<0.01)and serum levels of IL-17(r=-0.596, P<0.01). Conclusion Insufficiency of 25-OH-D is prevalent in SLE patients. It is associated with nephritis, disease activity and high serum levels of IL-17, thus it may play an important part in the inflammatory process in SLE.

目的 探讨血清铁蛋白及超敏C反应蛋白联合检测对急性脑出血患者的临床意义。方法 2012年1月—2015年12月,自发性脑出血的患者77例,男42例,女35例;年龄45～82 a,平均年龄(67.19±10.17)a。根据Rankin 评分将患者分成两组,A组,MRS≤2分,预后良好; B组,MRS＞2分,预后差;另选取同期健康体检者35例作为健康对照组,即C组。分别于入院时、发病后第3天、7天、14天时,采静脉血化验血常规、Hs-CRP及SF;于入院时和发病后第3天时,进行头颅CT检查。采用美国国立卫生院神经功能缺损评分(National Institutes of Health Stroke Scale,NIHSS) 分别于入院及随访12个月时,对两组患者神经功能损伤及恢复情况进行评估。结果 77例脑出血患者在发病12个月随访时, 53例患者MRS≤2分,预后良好;24例患者MRS＞2分,预后较差。于入院时、发病后第3天、7天、14天,脑出血患者的Hs-CRP及SF水平均显著高于健康体检人员,差异具有统计学意义(P<0.05);在各时间点脑出血患者中的预后较差组Hs-CRP及SF水平均不同程度高于预后良好组;但在入院发病后第3天则显著高于预后良好组,差异具有统计学意义(P<0.05),同时,脑出血患者中的预后较差组脑水肿量及水肿系数均显著高于预后良好组,差异具有统计学意义(P<0.05)。影响脑出血预后的独立危险因素包括NIHSS评分(P=0.012),Hs-CRP(P=0.027)和SF水平(P=0.041)。结论 Hs-CRP及SF水平在一定程度上可作为脑出血预后的重要评估指标。

Objective To investigate the clinical significance of combined detection of serum ferritin and high sensitive C reactive protein in patients with acute cerebral hemorrhage. Methods From January 2012 to December 2013, 77 cases with cerebral hemorrhage male 42, female 35; aged 45 to 82 year old, average age (67.19±10.17)years old. According to MRS(Modified Rankin Scale) score criteria, patients were divided into good prognosis group(group A) with MRS ≤2, and poor prognosis group (group B)with MRS ＞2. Another 35 cases of healthy physical examination were selected as the healthy control group(group C). RT(Routine blood test), Serum Ferritin(SF)and Hs-CRP were tested at the time of admission, the third, the seventh and the fourteenth day from onset of the disease respectively. Head CT were done at the time of admission, the third day from onset of the disease respectively. Neurological assessment were scored according to the NIHSS criteria(National Institutes of Health Stroke Scale) for the patients in the two groups at the time of admission and 12 months of follow up. Results 77 cases of cerebral hemorrhage were followed up for 12 months, 53 cases with MRS ≤2, the prognosis was good; And 24 cases with MRS >2, the prognosis was poor. The levels of Hs-CRP and SF were all higher in patients with cerebral hemorrhage than that in healthy control group (P<0.05) at the time of admission, the third day,seventh and fourteen day from onset of the disease respectively. The levels of Hs-CRP and SF were higher in group B than that in control group at the time of admission, the third day, the seventh day and the fourteenth day from onset of the disease respectively, but only at the time of admission, three days from onset of the disease, the difference was statistically significant (P<0.05). At the same time, the brain edema and edema index in the group B were higher than those in group A. The independent risk factors influencing the prognosis of cerebral hemorrhage were NIHSS score (P=0.012), Hs-CRP(P=0.027) and SF(P=0.041). Conclusion Hs-CRP and SF may be important indicators of the prognosis for cerebral hemorrhage in a certain degree.