论著

老年脆性骨折患者术前衰弱前期、衰弱现状调查及影响因素分析

Status of preoperative weakness and influencing factors in elderly patients with osteoporotic fracture

:188-194
 
       目的 调查老年脆性骨折患者术前衰弱现况,并分析影响因素。方法 采用便利抽样法, 2024年11月—2025年3月, 选取于广州市某三甲医院骨科住院的207例老年脆性骨折患者, 使用一般资料调查表、简易衰弱评估量表、简版流调中心抑郁量表、广泛性焦虑量表和营养风险筛查量表2002开展问卷调查。采用有序分类Logistic回归, 分析老年脆性骨折患者术前衰弱的影响因素。结果 207例老年脆性骨折患者的术前衰弱前期占48.3%, 衰弱发生率为23.2%。有序分类Logistic 回归分析结果显示年龄(OR=1.131)、睡眠差(OR=2.557)、合并3种及以上慢性病(OR=3.990)、抑郁(OR=3.296)、营养不良风险(OR=4.005)为老年脆性骨折患者术前衰弱的危险因素,BMI正常(OR=0.206)是保护因素(均P<0.05)。结论 老年脆性骨折患者年龄, 睡眠情况, 多种共病,抑郁, 存在营养不良风险及BMI影响其术前衰弱水平, 重视衰弱的筛查及早期干预, 提升患者治疗效果和生活质量。
       Objective To explore the preoperative frailty status and influencing factors in elderly patients with osteoporotic fractures.Methods Using convenience sampling, 207 elderly patients with osteoporotic fractures admitted to the orthopedic department of a tertiary hospital in Guangzhou from November 2024 to March 2025 were selected.Data were collected using a general information questionnaire, the Frail Scale, the 10-item Center for Epidemiologic Studies Depression Scale(CES-D-10), the Generalized Anxiety Disorder Scale(GAD-7), and the Nutritional Risk Screening 2002(NRS-2002).Logistic regression was used to analyze factors influencing preoperative frailty.Results Among 207 elderly patients with osteoporotic fractures, the incidence of early stages of frailty was 48.3%, and the incidence of frailty was 23.2%.Logistic regression analysis revealed the following risk factors for preoperative frailty:age(OR=1.131), poor sleep quality(OR=2.557), multiple chronic comorbidities(OR=3.990), depression(OR=3.296), nutritional risk(OR=4.005).Normal body mass index(OR=0.206)was a protective factor.Conclusions Advanced age,poor sleep quality, multiple chronic comorbidities, depression, nutritional risk and body mass index are associated with frailty in elderly osteoporotic fracture patients.Health care providers should pay attention to frailty screening and early intervention, which can reverse or delay the progression of frailty and improve the treatment effect and quality of life of patients.
论著

延边州 70 例布鲁氏菌病临床特点分析

Clinical characteristics of 70 cases of brucellosis in Yanbian Prefecture

:100-104
 
      目的   分析布鲁氏菌病的临床表现以及实验室检查结果中的关键特征,系统总结布鲁氏菌病的诊断流程和治疗策略。方法   选择2013年11月—2023年11月在延边大学附属医院通过血清虎红平板凝集试验(RBT)及试管凝集试验(SAT)检测技术确诊的70名布鲁氏菌病住院病例,对患者的流行病学资料、临床表现特征以及常规实验室检查结果进行回顾性分析,进而总结临床特点。结果  70例布鲁氏菌病患者中,男性占84.29%,中位年龄45岁(IQR 35~58岁);91.43%具有牛/羊接触史。急性期占92.86%,主要症状为发热(100%)、多汗(88.57%)、关节痛(84.29%)及肝脾肿大(55.71%),90%为不规则热型。误诊率27.14%,多误诊为败血症或骨关节疾病。联合抗菌药物治疗(利福平+多西环素)有效。结论   延边州布鲁氏菌病非典型症状(如不规则热型)增加导致误诊率高。流行病学史(牛/羊接触史)是诊断关键。需强化对有牛羊接触史人群的防护意识及措施,提高临床对接触史线索和不规则热型等非典型表现的识别能力,规范治疗并控制传染源以遏制疫情。
   Objective  To analyze the clinical manifestations of  brucellosis and the  key characteristics in laboratory testing,and systematically summarize the diagnostic process and treatment strategies of brucellosis.Methods  The 70 patients with brucellosis diagnosed via rose bengal test(RBT)and standard agglutination test(SAT) were at Yanbian University Affiliated 
Hospital from November 2013 to November 2023.This study conducted a retrospective analysis of the epidemiological data,clinical manifestations and routine laboratory pathological examination data of these patients,and the characteristics of clinical changes were summarized.Results  Among the 70 patients with brucellosis,84.29% were male,with a median age of 45(IQR 35-58);91.43% patients had a history of cattle/sheep exposure.The acute phase accounted for 92.86%,and the main symptoms were fever(100%),sweating(88.57%),arthragia(84.29%),hepatosplenomegaly(55.71%),and 90% were irregular fever.The misdiagnosis rate was 27.14%,and most of them were misdiagnosed as sepsis or osteoarthritis.Combined treatment with antibiotics(rifampin + doxycycline)was effective.Conclusions  The increase in atypical symptoms(such as irregular heat type)leads to a high misdiagnosis rate.Epidemiological history(cattle/sheep contact)is the key to diagnosis.It is necessary to strengthen occupational protection and atypical case identification,standardize treatment and control the source of infection to curb the epidemic.
论著

LAMP3 基因表达与肾癌之间的因果关系:一项基于孟德尔随机化分析的研究

Causal relationship between LAMP3 gene expression and renal cancer:A Mendelian randomization analysis

:88-94
 
       目的   探讨溶酶体相关膜蛋白3(LAMP3)与肾癌发病风险之间的因果关系,为肾癌的分子致病机制提供新的理论依据。方法   基于全基因组关联研究(GWAS)数据,采用孟德尔随机化分析方法,评估LAMP3基因表达与肾癌的因果关系。并通过GEPIA2分析LAMP3表达对肾癌总体生存期(OS)及无病生存期(DFS)的关系。结果  LAMP3基因变异与肾癌风险呈正相关,提示LAMP3的表达可能增加肾癌的发病风险。此外,GEPIA2分析进一步显示,LAMP3的高表达与肾癌患者的低总体生存期(OS)及无病生存期(DFS)显著相关。结论   本研究通过孟德尔随机化分析探讨了LAMP3基因表达与肾癌的因果关系,结果表明LAMP3可能是肾癌的潜在致病因子,并与肾癌预后相关。这为肾癌的分子致病机制研究提供了重要的理论依据,并为未来的生物标志物和靶向治疗策略的开发提供了新的思路。
        Objective  To investigate the causal  relationship  between LAMP3 expression and  renal cancer  risk  using Mendelian randomization analysis,providing a theoretical basis for understanding the molecular mechanisms underlying renal cancer.Methods  This study utilized data from genome-wide association studies(GWAS)and employed Mendelian randomization analysis to assess the causal relationship between LAMP3 gene expression and renal cancer.Additionally,GEPIA2 was used to examine the association between LAMP3 expression and overall survival(OS)and disease-free survival(DFS)in renal cancer patients.Results  Variants in the LAMP3 gene were positively correlated with renal cancer risk,suggesting that LAMP3 expression may increase the likelihood of developing renal cancer.Furthermore,GEPIA2 analysis  revealed that high expression of LAMP3 was significantly associated with lower OS and DFS in renal cancer patients.Conclusions  This study explored the causal  relationship between LAMP3 gene expression and renal cancer through Mendelian randomization analysis.The results indicate that LAMP3 may be a potential pathogenic factor in renal cancer and is associated with poor prognosis.These findings provide important theoretical insights into the molecular mechanisms of  renal cancer and offer new perspectives for the development of biomarkers and targeted therapeutic strategies in the future.
论著

护士的护理伦理敏感性现状及影响因素 Meta 分析

Meta-analysis of the current status and influencing factors of nurses’ ethical sensitivity in nursing

:56-62
 
       目的   系统评价护士的护理伦理敏感性现状及影响因素,为针对性干预提供参考。方法   检索国内外相关数据库,检索时限为2024年7月护士的护理伦理敏感性现状及影响因素的相关文献。由两名分析人员独立筛选文献、提取资料、质量评价后采用Stata 15.0和RevMan 5.3软件进行meta分析。结果   纳入16篇文献,包括4 961例研究对象。Meta分析结果显示,护士的护理伦理敏感性处于中等偏高水平,总分为[OR=67.29,95%CI(53.24,81.34)]分。年龄OR=2.78,95%CI(1.45,5.33),P=0.002]、工作年限[OR=3.55,95%CI(1.35,9.33),P=0.001]、伦理知识教育[OR=14.60,95%CI(4.24,50.32),P<0.001]、共情能力[OR=1.35,95%CI(1.01,1.80),P<0.001]、工作场所氛围[OR=1.85,95%CI(0.42,4.51),P<0.001]、工作嵌入量[OR=3.60,95%CI(0.40,32.84),P=0.001]是护士护理伦理敏感性的主要影响因素。结论   当前证据表明,护士的护理伦理敏感性处于中等偏高水平,影响因素较多,管理者需结合人群特征实施干预,以提高护士护理伦理敏感性水平。
   Objective  To systematically evaluate the current status of nurses’  ethical  sensitivity in  nursing  and influencing factors that influence it,in order to inform targeted interventions.Methods  Domestic and international databases were searched to collect literature related to the current status of nurses’ ethical sensitivity in nursing and the factors influencing it from the year of construction to July 2024.Meta-analysis was performed by two analysts independently screening the literature,extracting information,and quality evaluation using Stata 15.0 and RevMan 5.3 software.Results  Sixteen papers including 4 961 study subjects were included.Meta-analysis results showed that nurses had moderately high level of ethical sensitivity in nursing with a total score of 67.29(95%CI[53.24,81.34]).Age(OR=2.78,95%CI[1.45,5.33],P=0.002),years of experienceOR=3.55,95%CI[1.35,9.33],P=0.001),education on ethical knowledge(OR=14.60,95%CI[4.24,50.32],P<0.001),and empathic ability(OR=1.35,95%CI[1.01,1.80],P<0.001),workplace atmosphere(OR=1.85,95%CI[0.42,4.51],P<0.001),and the amount of job embeddedness(OR=3.60,95%CI[0.40,32.84],P=0.001) were the main influences on nurses’ ethical sensitivity in nursing.Conclusions  The previous evidence suggests that nurses have moderately high levels of nursing ethical sensitivity,with a high number of influencing factors,and managers need to give interventions that incorporate the characteristics of the population in order to increase the level of nursing ethical sensitivity among nurses.
论著

炎症性肠病与 IgA 肾病共病特征基因及信号通路激活模式的整合分析

Integrated analysis of shared signature genes and signaling pathway activation patterns between inflammatory bowel disease and IgA nephropathy

:46-55
 
      目的   免疫球蛋白A肾病(IgAN)与炎症性肠病(IBD)的相互作用机制尚未阐明。本研究旨在解析IBD与IgAN共病的关键特征基因及核心信号通路,以揭示肠-肾轴的分子调控网络。方法   于GEO数据库获取IBD(GSE75214)和IgAN(GSE93798)基因表达谱,筛选差异表达基因(DEGs)。通过蛋白互作网络(PPI)和拓扑算法(MCC、MNC、Degree、EPC等)识别核心特征基因,并结合公共数据库(CTD、DISEASES和GeneCards)和单细胞转录组测序(GSE171314)进行验证。通过Nephroseq数据库验证基因表达与临床表型的相关性。结果   共筛选出17个IBD-IgAN共病DEGs,PPI网络分析等确定以FOS、EGR1、CXCL2JUNB为核心特征基因。功能富集分析显示白细胞介素-17(IL-17)信号通路显著激活。单细胞测序验证FOS、EGR1、CXCL2JUNB基因在IgAN特异性高表达,并通过Nephroseq数据库验证其与尿蛋白和估算的肾小球滤过率下降(eGFR)显著相关。结论  本研究揭示IBD与IgAN共享IL-17通路异常激活及FOS、EGR1、CXCL2JUNB的基因网络,为开发基于肠-肾轴调控的靶向治疗策略提供理论依据。
       Objective  The complex interplay between immunoglobulin A nephropathy(IgAN)and inflammatory bowel disease(IBD)remains poorly understood.This  study  aimed to identify  key  cross-talk  genes  and  pivotal  signaling pathways shared between IBD and IgAN,thereby elucidating the molecular regulatory network underlying the gut-kidney axis.Methods  Transcriptomic datasets for IBD(GSE75214)and IgAN(GSE93798)were retrieved from the GEO database.Differentially expressed genes(DEGs)were screened,and shared DEGs were intersected.Protein-protein interaction(PPI)networks were constructed using STRING and Cytoscape,with topological algorithms applied to identify hub genes.Gene expression profiles were validated through(CTD,DISEASES and GeneCards)and single-cell RNA sequencing(GSE171314)and the Nephroseq database,focusing on clinical correlations with proteinuria and estimated glomerular filtration rate(eGFR).Results  Seventeen shared DEGs were identified between IBD and IgAN.PPI network analysis revealed FOS,EGR1,CXCL2 and JUNB as core hub genes.Functional enrichment analysis demonstrated significant activation of the interleukin-17(IL-17)signaling pathway.Single-cell sequencing confirmed the specific upregulation of these genes in renal tubular epithelial cells of IgAN patients,which was further validated to correlate with proteinuria and eGFR decline.Conclusions  IBD and  IgAN share aberrant activation of the IL-17 pathway and a co-regulatory gene network involving FOS,EGR1,CXCL2 and JUNB,providing a theoretical foundation for developing therapeutic strategies centered on the gut-kidney axis.
论著

广州市某三甲医院老年住院患者服务需求现状及影响因素分析

Current status and influencing factors of elderly patients’ service needs in Guangzhou

:1736-1744
 
       目的   调查老年人照护服务需求现状并分析其影响因素,为构建基于需求为导向的老年照护服务体系提供参考依据。方法  采用便利抽样法,选取广州市某三甲医院212名老年人作为调查对象,采用日常生活能力量表、Fried衰弱评估量表及自行编制的老年人需求评估问卷进行调查。结果   老年人对运动与营养(1.96±0.90分)、心理慰藉(2.63±0.85分)、安宁服务(2.73±1.07分)的需求水平较高。多因素线性回归分析结果显示养老方式、日常生活活动能力、爱好数量、性别、衰弱等级、有无主要照顾者是照护服务需求的影响因素(P均<0.05),可解释61.5%的变异量。   老年人的照护服务需求受多种因素的影响。应根据老年人的不同特征,构建供需匹配的多元化,多层次照护体系。
       Objective  To investigate the status quo of care service needs of the elderly and analyze its influencing factors,so as to provide a reference for the construction of a needs-oriented care service system for the elderly.Methods  A total of 212 elderly people from a tertiary hospital in Guangzhou were selected by convenience sampling method and investigated with the Activity of Daily Living scale,Fried frailty scale and the self-designed elderly needs assessment questionnaire.Results  Elderly patients had higher demands for exercise,nutrition,psychological comfort and hospice services.The results of multivariate analysis showed that the influencing factors of care service demand included pension style,activities of daily living,number of hobbies,gender,frailty level,and having main caregivers(all P<0.05),which could explain 61.5% of the variation.Conclusions  The care needs of elderly patients are affected by many factors.A diversified and multi-level care system with matching supply and demand should be constructed according to the different characteristics of the elderly.
论著

经皮冠状动脉介入治疗后恐动症患者不良心理健康状态的影响因素分析

Analysis of the influencing factors of adverse psychological health status in patients with kinesiophobia after percutaneous coronary intervention

:1712-1723
 
       目的   识别经皮冠状动脉介入治疗(PCI)后恐动症患者抑郁、焦虑和压力的影响因素。方法   采用横断面研究,纳入780例行PCI术后恐动症患者。应用系列量表评估恐动症患者的不良心理健康状况、生活质量、自我感受负担、社会支持和运动自我效能,并通过问卷收集了患者的社会人口学数据。线性回归和Logistic回归用于识别抑郁、焦虑和压力等不良心理状态的影响因素,应用中介分析探索潜在的中介机制。结果  271例(34.7%)、304例(39.0%)和153例(19.6%)恐动症患者存在不同程度的抑郁、焦虑和压力。恐动症患者的抑郁、焦虑和压力水平呈正相关。线性回归和Logistic分析结果表明,较高的家庭月收入与较高的抑郁水平相关(线性回归:β为0.908和1.937;Logistic:OR2.05和5.47),社会支持程度与抑郁水平呈负相关(线性回归:β=-0.079;Logistic:OR=0.93)。单身/离异/寡居患者的焦虑水平显著高于已婚患者(线性回归:β=1.613;Logistic:OR=2.28)。与家庭月收入低于5 000元者相比,家庭月收入为5 000~10 000元之间的患者的压力水平较高(线性回归:β=1.065;Logistic:OR=3.14)。此外,自我感受负担较重的患者具有更高的压力水平(线性回归:β=0.077;Logistic:OR=1.05)。中介分析结果表明,焦虑和压力是社会支持/自我感受负担与抑郁之间关联的潜在中介因子。结论  PCI术后恐动症患者广泛存在心理健康问题,其家庭月收入、年龄、婚姻状况、生活方式和病史等因素对患者的不良心理健康状态具有显著影响。医务人员应关注这些患者的心理健康状况及影响因素,制定综合管理策略以改善其预后。
       Objective  To identify the risk factors associated with depression,anxiety  and  stress in  patients with kinesiophobia after percutaneous coronary intervention(PCI).Methods  In this cross-sectional study,780 patients who developed kinesiophobia after undergoing PCI were enrolled.A series of scales were used to assess the psychological health status,quality of life,self-perceived burden,social support,and exercise self-efficacy of patients with kinesiophobia,and socio-demographic data of the patients were collected through a questionnaire.Linear regression analyses and Logistic regression analyses were used to identify risk factors of adverse psychological outcomes,including depression,anxiety,and stress.Furthermore,mediation analysis was employed to explore the potential mediating mechanisms.Results  Among the 780 patients with kinesiophobia,271(34.7%),304(39.0%)and 153(19.6%)were found to have varying degrees of depression,anxiety,and stress,respectively.The levels of depression,anxiety and stress in patients with kinesiophobia were positively correlated with each other.The results of both linear regression and Logistic regression analyses indicated that higher levels of family monthly income were associated with higher levels of depression(linear:β=0.908 and 1.937;Logistic:OR=2.05 and 5.47),while the degree of social support was negatively correlated with depression levels(linear:β=-0.079;Logistic:OR=0.93).For patients who were single,divorced or widowed,their levels of anxiety were significantly higher than those of married patients(linear:β=1.613;Logistic:OR=2.28).Compared to patients with a monthly household income of less than 5 000 yuan,those with a monthly income between 5 000 and 10 000 yuan reported higher levels of stress(linear:β=1.065;Logistic:OR=3.14).Additionally,patients who perceived a higher personal burden also experienced greater stress(linear:β=0.077;Logistic:OR=1.05).Mediation analysis indicated that anxiety and stress were potential mediating factors in the relationship between social support/self-perceived burden and depression.Conclusions  This study  reported the widespread psychological health issues among patients with kinesiophobia after PCI and the interactions between these issues.Factors such as monthly household income,age,marital status,lifestyle and medical  history were found to  be significantly associated with these negative psychological outcomes.Clinicians and nurses should focus on the psychological health and influencing factors of these patients and develop comprehensive management strategies to improve their prognosis.
论著

急性 DVT 患者 CDT 治疗中血管导管相关感染危险因素及病原菌分析

Risk factors and pathogens analysis of vessel catheter associated infection in acute DVT patients undergoing CDT treatment

:1705-1711
 
       目的   通过对急性深静脉血栓形成(DVT)患者经导管接触性溶栓治疗(CDT)中,影响血管导管相关感染(VCAI)危险因素及病原菌分析,为VCAI的预防提供合理、有效的措施。方法   收集2019年1月—2022年12月徐州市肿瘤医院介入科行CDT治疗的急性DVT患者的临床资料,回顾性调查患者诊疗相关资料及血培养结果,并对发生VCAI和病原菌情况进行分析。结果   本研究共调查急性DVT行CDT治疗的患者437例,发生VCAI的患者共21例,千日感染率为0.543‰。多因素Logistic回归分析结果显示:溶栓频率>3次/天[OR=3.49(95%CI:1.86~6.45)]、导管留置时间>7 dOR=3.86(95%CI:1.26~10.18)]和有导管回送[OR=8.67(95%CI:4.83~12.65)]是患者发生VCAI的危险因素(P<0.05)。发生VCAI的21例患者,血培养共培养出24株病原菌,有3例患者出现复合病原菌感染情况。其中以革兰阳性球菌最为常见,共培养出13株,占比54.17%,革兰阴性菌9株,占比37.5 %。结论   导管留置时间>7 d、溶栓频率>3次/天和有导管回送是急性DVT患者CDT治疗中发生VCAI的危险因素。VCAI的病原菌以单一病原菌为主,可合并其他病原菌感染,其中以革兰阳性球菌为主。
        Objective  By analyzing the risk factors and pathogens of vessel catheter associated infection(VCAI)in patients with acute deep vein thrombosis(DVT)undergoing catheter directed thrombolysis(CDT),to provide  reasonable and effective measures for the prevention and treatment of VCAI .Methods  Clinical data of patients undergoing CDT treatment for acute DVT in the interventional department of the hospital from January 2019 to December 2022 was collected,patient diagnosis and treatment related data and blood culture results were retrospectively investigated and organized,and the occurrence of VCAI and pathogenic bacteria was statistically analyzed.Results  This study investigated 437 patients undergoing CDT treatment for acute DVT,and a total of 21 patients developed VCAI,with an infection rate of 0.543‰.The  results of multiple Logistic  regression analysis show that thrombolysis frequency>3 times/day(OR=3.49[95%CI:1.86-6.45]),catheter retention days>7 daysOR=3.86[95%CI:1.26-10.18]),and the presence of catheter return(OR=8.67[95%CI:4.83-12.65]) were risk factors for the occurrence of VCAI in patients.Among the 21 patients with VCAI,a total of 24 strains of pathogenic bacteria were discoveredin blood culture,and 3 patients developed composite pathogen infections.Among them,Gram  positive cocci were the most common,with a total of 13 strains cultured,accounting for 54.17%,9 strains of Gram negative bacteria,accounting for 37.5%.Conclusions  The duration of catheter retention>7 days,thrombolysis frequency>3 times/day,and the presence of catheter return are risk factors for VCAI in acute DVT patients undergoing CDT treatment.The pathogen of VCAI is mainly single pathogen,which can be combined with other pathogens,among which Gram positive cocci are the main pathogen.
论著

2014—2023 年广西某三级综合医院法定传染病疫情分析

Analysis of notifiable infectious diseases in a class Ⅲ general hospital in Guangxi from 2014 to 2023

:1693-1699
 
       目的   对2014—2023年广西梧州市某三级综合医院法定传染病疫情及流行病学特征进行分析,为地市级医院制定传染病防控策略提供科学依据。方法   采用描述性流行病学方法和Excel软件对该院法定传染病报告数据进行统计分析。结果  2014—2023年该院共报告法定传染病29 569例,其中,无甲类传染病报告,乙类传染病12 375例(41.85%),丙类传染病15 479例(52.35%),其他需监测报告的传染病1 715例(5.80%)。报告病例数排前4位的传染病依次为手足口病6 726例(22.75%)、感染性腹泻病6 451例(21.82%)、病毒性肝炎5 539例(18.73%)、肺结核3 552例(12.01%)。报告病例数在2014—2017年逐年增加,2017—2023年传染病报告病例降升交替,每年发病高峰期主要集中在5—10月;男性报告病例多于女性,男女之比为1.64∶1;0~10岁年龄段病例最多(46.89%),其次为40~60岁(26.91%);职业分布集中于散居儿童(33.90%)、农民和牧民(18.08%)、工人和民工(9.47%)及幼托儿童(8.48%);患者主要来自梧州市(79.17%)、广东省(17.34%)。传播途径构成比从高到低依次为肠道传染病(46.38%)、呼吸道传染病(26.03%)、血液及性传播传染病(24.92%)、其他传染病(2.66%)。结论  手足口病、感染性腹泻、病毒性肝炎、肺结核是该院传染病防治工作的重点,其中尤其要注重儿童手足口病和感染性腹泻病的预防,根据不同季节、疾病流行趋势,采取有针对性的传染病防控策略。
       Objective  To analyzed the epidemic and epidemiological characteristics of notifiable infectious diseases in a class Ⅲ general hospital in Guangxi Wuzhou from 2014 to 2023,to provide scientific basis for municipal hospitals to formulate infectious disease prevention and control strategies.Methods  Descriptive epidemiological method and Excel were used to sort out and analyze the data.Results  From 2014 to 2023,there were 29 569 cases of notifiable infectious diseases,with category B infectious diseases 12 375 cases(41.85%),category C infectious diseases 15 479 cases(52.35%),and others diseases 1 715 cases(5.80%).No category A infectious diseases were reported.The top 4 infectious diseases were 6 726 cases of hand-foot-and-mouth disease(HFMD)(22.75%),6 451 cases of infectious diarrhea(21.82%),5 539 cases of viral hepatitis(18.73%)and 3 552 cases of tuberculosis(12.01%).The number of reported cases increased year by year from 2014 to 2017,and the reported cases of infectious diseases decreased and increased alternately from 2017 to 2023,with the annual peak period mainly presented from May to October.Males reported cases were more than females,the ratio of males to females was 1.64∶1.The number of cases between 0 to 10 years old was the highest(46.89%),followed by 40-60 years old(26.91%).The occupational distribution was concentrated in scattered children(33.90%),farmers and herdsmen(18.08%),workers and migrant workers(9.47%)and children in childcare(8.48%).The patients were mainly from Wuzhou City(79.17%)and Guangdong Province(17.34%).The composition ratio of transmission route from high to low was as follows:intestinal infectious diseases accounted for 46.38%,respiratory tract infectious diseases accounted for 26.03%,blood-borne and  sexually transmitted infectious  diseases accounted for 24.92%,and other infectious diseases accounted for 2.66%.Conclusions  HFMD,infectious diarrhea,viral hepatitis and tuberculosis are the focus of the hospital’s infectious disease prevention and control work,especially the prevention of HFMD and infectious diarrhea in children,and the prevention and control strategies of infectious diseases are adopted according to different seasons and epidemic trends.
论著

非小细胞肺癌干细胞靶点筛选及 NDC80 临床意义分析

Screening of stem cell targets for non-small cell lung cancer and analysis of clinical significance of NDC80

:1638-1650
 
      目的   通过生物信息学手段筛选非小细胞肺癌(NSCLC)中的关键靶点基因,识别预后标志物NDC80,并探讨其在NSCLC中的表达意义,进而分析NDC80作为NSCLC基因治疗靶点的可行性。方法   采用癌症基因组图谱(TCGA)TCGA数据库检索NSCLC相关数据,进行加权基因共表达网络分析(WGCNA)以识别关键基因,并进行差异表达分析、相关性分析和蛋白互作网络构建。对筛选出的关键基因进行功能分析。利用免疫组化染色法检测癌组织及癌旁组织中NDC80蛋白的表达水平,并进一步探究其与临床病理特征的关系。采用Kaplan-Meier法分析NDC80表达与NSCLC患者无进展生存时间(PFS)的关系。结果   共筛选出20个与NSCLC高度关联的关键基因,包括CDC20、CDK1、MCM4、CDC6、MCM2、PLK1、NDC80、CCNB1、CDC45、AURKA、MCM8、BUB1、CDT1、ORC1、CCNA2、CASC5、MAD2L1、BUB1B、CENPA、AURKB。免疫组化验证显示,NDC80蛋白在NSCLC组织中高表达,其在NSCLC组(阳性表达率88.6%)显著高于癌旁组(50.0%)(P<0.05)。NDC80蛋白的阳性表达率在TNM分期(Ⅲ期+Ⅳ期)、低分化、淋巴结转移的NSCLC组高于TNM分期(Ⅰ期+Ⅱ期)、高分化及中分化以及未发生淋巴结转移的NSCLC组(P<0.05)。NDC80蛋白的阳性表达率在不同性别、年龄、病灶大小分类的NSCLC组织中无显著差异(P>0.05)。Kaplan-Meier分析显示,NDC80蛋白高表达组的PFS中位数为(9.00±0.27)个月,明显低于低表达组(11.00±0.79)个月(P<0.05)。结论   本研究发现的关键基因在NSCLC干细胞的维持中发挥重要作用。免疫组化结果显示,NDC80蛋白在NSCLC组织中高表达,且与肿瘤分化、TNM分期及淋巴结转移密切相关。NDC80蛋白高表达组的PFS明显低于低表达组,提示NDC80可能成为NSCLC筛查、治疗和预后评估的潜在生物标志物。
      Objective  To screen the key target genes in non-small cell lung cancer(NSCLC)by bioinformatics,identify the prognostic marker NDC80,and explore its expression significance in NSCLC,so as to analyze the feasibility of NDC80 as a gene therapy target for NSCLC.Methods  TCGA database was used to retrieve NSCLC-related data,and weighted gene co-expression network analysis(WGCNA)was used to identify key genes,and differential expression analysis,correlation analysis and protein-protein interaction network construction were carried out.The function of the selected key genes was analyzed.Immunohistochemical staining was used to detect the expression level of NDC80 protein in cancer tissues and adjacent tissues,and to further explore its relationship with clinicopathological features.Kaplan-Meier method was used to analyze the relationship between NDC80 expression and progression-free survival (PFS)of NSCLC patients.Results  A total of 20 key genes highly associated with NSCLC were screened out,which were CDC20,CDK1,MCM4,CDC6,MCM2,PLK1,NDC80,CCNB1,CDC45,AURKA,MCM8,BUB1,CDT1,ORC1,CCNA2,CASC5,MAD2L1,BUB1B and CENPA.Immunohistochemical  verification  showed that NDC80 protein was highly expressed in NSCLC tissue,and its positive expression rate in NSCLC group(88.6%)was significantly higher than that in adjacent cancer group(50.0%,P<0.05).The positive expression rate of NDC80 protein in NSCLC with TNM staging(Ⅲ+Ⅳ),low differentiation and lymph node metastasis was higher than that in NSCLC with TNM staging(Ⅰ+Ⅱ),high differentiation and moderate differentiation and no lymph node metastasis(P<0.05).There was no significant difference in the positive expression rate of NDC80 protein among NSCLC tissues with different gender,age and lesion size(P>0.05).Kaplan-Meier analysis showed that the median PFS of high expression group of NDC80 protein was(9.00±0.27)months,which was significantly lower than that of low expression group(11.00±0.79)months(P<0.05).Conclusions  The key genes found in this study play an important role in the maintenance of NSCLC stem cells.Immunohistochemical results showed that NDC80 protein was highly expressed in NSCLC,and it was closely related to tumor differentiation,TNM staging and lymph node metastasis.The PFS of high expression group of NDC80 protein was significantly lower than that of low expression group,suggesting that NDC80 may become a potential biomarker for screening,treatment and prognosis evaluation of NSCLC.
出版者信息








《广州医药》公众号