目的 探讨莫西沙星结合抗结核药物治疗糖尿病合并肺结核患者的临床疗效分析。方法 将本组126例糖尿病合并肺结核患者分为对照组(n=63)和观察组(n=63);对照组给予降血糖治疗及抗结核药物降糖治疗,观察组在对照组治疗基础上服用莫西沙星;两组治疗均以3个月为一个疗程,2个疗程后统计疗效。结果 观察组总有效率(93.65%)高于对照组(76.19%),差异有统计学意义(P<0.05);观察组痰菌检测转阴率(94.59%)高于对照组(79.49%),差异有统计学意义(P<0.05);治疗过程中观察组与对照组出现不良反应情况相比较差异无统计学意义(P＞0.05)。结论 莫西沙星结合抗结核药物治疗糖尿病合并肺结核疗效显著,具有较强的杀菌作用。

Objective To investigate the clinical efficacy of moxifloxacin combining with antituberculosis drug in the treatment of diabetic patients with pulmonary tuberculosis. Methods A group of 126 patients of diabetes complicated with pulmonary tuberculosis were divided into control group (n=63) and observation group (n=63); the control group was given by hypoglycemic therapy and therapy of antituberculosis drug only, and the observation group was also given by moxifloxacin; two groups were treated for 3 months as a course.The clinical efficacy was evaluated after 2 courses. Results The total effective rate of observation group (93.65%) was significantly higher than that of the control group (80.95%), and the difference was statistically significant (P<0.05); the negative sputum rate of observation group (94.59%) was higher than that of the control group (79.49%), and the difference was statistically significant (P<0.05); there was no statistically significant difference between the observation group and the control group in adverse effects. Conclusion The curative effect of moxifloxacin combining with antituberculosis drug in the treatment of diabetes mellitus complicated with pulmonary tuberculosis was good, with strong bactericidal effect.

目的 探讨老年人血尿酸(serum uric acid,SUA)水平与阿尔茨海默病(Alzheimer's disease,AD)的相关性。方法 选择227例我院老年病科住院患者为研究对象,其中阿尔茨海默病67例,其余160例为非AD组。收集病史、吸烟史、服药史,并检测血尿酸、总胆固醇(TC)、甘油三酯(TG)、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)、空腹血糖(FBS)、血肌酐(Cr)水平。比较各SUA四分位数水平AD的发生率,并进行相关性分析。结果 AD组血尿酸水平低于非AD组,差异有统计学意义(P＜0.01);多因素分析筛选出年龄、性别、缺血性脑卒中是危险因素(P＜0.05),而服用他汀、SUA、HDL-C是保护因素(P＜0.05)。对AD和SUA的四个分组做Spearman等级相关分析(rs=-0.285,P<0.001),结果呈等级负相关。结论 血尿酸水平与老年人AD相关,血尿酸可能是AD发病的保护性因素。

Objective To explore the correlation between serum uric acid(SUA) level and Alzheimer's disease(AD) in elderly patients. Methods 67 cases of the elders with Alzheimer's disease and 160 elders matching with age and gender were enrolled from Jan 2013 to Dec 2014 in the study,the blood levels of biochemical factors such as SUA,total cholesterol(TC),triglycerides(TG),low-density lipoprotein cholesterol(LDL-C),high-density lipoprotein cholesterol(HDL-C),fasting blood sugar(FBS) and creatinine(Cr) were measured by automatic biochemistry analyzer in the two groups. The related factors such as history of disease,smoking and medication history were collected. The correlation between the level of SUA and AD was analyzed. Results The serum uric acid levels in AD group were significantly lower than those in control group(P＜0.01). Multivariate logistic regression analysis showed that age, gender, ischemic stroke were risk factors, and taking statin, SUA, and HDL-C were protective factors(P＜0.05). Spearman correlation tests indicated that there was an inverse correlation between SUA levels and AD(rs=-0.285,P<0.001). Conclusion Serum uric acid level is significantly related to AD in the elderly.SUA may be a protective factor of the occurrence of AD.

目的 了解青海省北京/W系结核分枝杆菌分布特征。方法 收集青海地区结核分支杆菌临床分离株,采用RD105缺失基因检测鉴定北京/W系结核分枝杆菌。结果 共收集237株结核分枝杆菌临床分离株,采用RD105缺失基因检测鉴定北京/W系结核分枝杆菌220株,占92.8%,非北京/W结核分枝杆菌,共17株,占7.2%。北京/W系结核分枝杆菌在青海地区性别与民族分布差异没有统计学意义(P＞0.05)。结论 北京/W结核分枝杆菌为青海地区流行菌株,在人群易于发生感染和传播。

Objective To ascertain the epidemiological characteristics of Beijing/W lineage Mycobacterium tuberculosis in Qinghai Province. Methods M. tuberculosis clinical isolates were collected and identified with an RD105 deletion test.Statistical analysis was performed by using the test. Results Totally, 237 clinical isolates of M. tuberculosis were collected in which 220 strains (92.8%) belonged to the Beijing/W lineage of M. tuberculosis while 17strains (7.2%) belonged to the non-Beijing/W lineage of M. tuberculosis according to the RD105 deletion test. There were no significant differences in the distribution of Beijing/W lineage of M. tuberculosis in the gender and nationality (P＞0.05). Conclusion Beijing/W lineage of M. tuberculosis were prevalent in Qinghai province and prone to having infection and transmission in the crowd.

目的 分析总结12例原发性肺淋巴上皮瘤样癌(LELC)的临床病理特点。方法 回顾性分析12例肺LELC患者的临床病理资料。结果 12例肺LELC患者的组织学标本中,肿瘤细胞均明显表达HCK,原位杂交EBER阳性率为91.7%。全组中位生存期61.3个月,2年和5年生存率分别为84.6%和57.7%。结论 原发性肺LELC临床罕见,发病可能与EB病毒感染有关,经及时治疗有较好的预后。

Objective To investigate the pathological and clinical significance of 12 cases with primary Lymphoepithelioma-like carcinoma of the lung (LELC). Methods Retrospectively detectded and analyzed the clincalpathological feature of 12 cases of LELC of the lung. Results Histological study showed that tumor cells were significantly expressed HCK by immunohistochemistry staining and showed out 91.7% positive rate of EBER by situ hybridization. In this series, the median survival time was 61.3 months. The overall 2 and 5 year survival rates of the 12 cases were 84.6% and 57.7%. Conclusion Pulmonary LELC is very rare. It may be associated with Epstein-Barr virus infection, and has a batter prognosis after therapy.

目的 探讨磷酸二酯酶4抑制剂对人肺泡巨噬细胞(AM)吞噬非生物性颗粒及革兰阳性菌、阴性菌能力的影响。方法 使用Ficolll-Hypaque密度梯度法将外周血单核细胞分离的静脉血,在含有2 ng/m GM-CSF的培养液中经12天诱导培养成AM替代细胞模型—单核细胞源性巨噬细胞(MDM)。用酶标仪检测MDM经磷酸二酯酶4抑制剂Rolipram预处理过夜(16~18 h)后吞噬荧光标记的非生物颗粒Beads和热灭活的流感嗜血杆菌(H.influenzae)、金黄色葡萄球菌(S.aureus)量的改变,另使用MTT法检测细胞活性。结果 成功建立的MDM细胞模型对Beads和细菌的吞噬呈时效关。Rolipram在实验浓度(10^~8~10^-5 M)下对MDM吞噬Beads、H.influenzae和S.aureus能力无明显促进或抑制作用,也不影响MDM的活性。结论 磷酸二酯酶4抑制剂不会因升高巨噬细胞内cAMP水平而影响其吞噬非生物颗粒和细菌的能力。

Objective To investigate the influence of phosphodiesterases 4 inhibitor on the phagocytosis of non-biological particles and gram-positive bacteria, gram-negative bacteria by human alveolar macrophages. Methods Peripheral blood mononuclear cells (PBMCs) were isolated from venous blood from 12 healthy volunteers using Ficoll-Hypaque density gradients. Monocytes were incubated with media containing 2 ng/ml GM-CSF for 12d to allow full differentiation into macrophage (MDM), a functionally equivalent model of human AM. MDM were pretreated with Rolipram overnight (16-18h),phagocytosis of fluorescent labeled beads and H.influenzae,S.aureus by MDM was measured using a fluostar optima fluorimeter. Cell viability was assay with MTT. Results MDM phagocytosis of beads and bacteria was a time-dependant process. Rolipram in the concentration of 10^-8-10^-5M didn't inhibit or promote phagocytosis of beads and bacteria by MDM, and didn't affect the cell viability. Conclusion Phosphodiesterases 4 inhibitor would not affect the human macrophage phagocytic capacity of non-biological particles and bacteria associated with enhanced intracellular cAMP level.

目的 观察对应手术时点小剂量丙泊酚抑制无痛人工流产手术孕者应激反应的有效性。方法 选择门诊自愿在全麻下行无痛人工流产手术的早孕妇女80例,ASAⅠ或Ⅱ级,随机分为前臂头静脉组(A组)、下肢踝前大隐静脉组(B组)。两组早孕者分别在抬臀铺入无菌臀巾时(T₁)、置入窥器即刻(T₂)、钳夹宫颈即刻(T₃)时点,推注不同剂量丙泊酚,观察记录麻醉效果相关指标。结果 A组追加丙泊酚次数与B组相比少(P<0.01),A组丙泊酚用量与B组相比减少(P<0.01),A组术毕到唤醒睁眼的时间与B组相比缩短,差异有统计学意义(P<0.01)。结论 对应手术操作时点经上肢头静脉小剂量推注丙泊酚能较好的抑制无痛人工流产手术孕者应激反应,且苏醒快,并发症少。

目的 了解河源市无偿献血者的人群结构特征及其与血液检测结果的关系,为完善该地区安全血源招募和献血者筛查策略提供依据。方法 收集2014年1月1日—2014年12月31日该市15184例首次无偿献血者登记表及检测结果,统计分析无偿献血者的年龄、性别、职业、文化程度等分布情况及其血液检测结果不合格率。结果 该地区无偿献血者以男性(78.91%)、年龄以35岁以下(63.44%)、在职职员(34.08%)、大学专科以上文化程度(39.59%)为主体;献血模式以个人自愿(53.58%)和团体自愿(38.41%)为主。该市无偿献血者血液检测结果总体不合格率为4.29%,其中不同性别、年龄、职业、文化程度、献血模式的无偿献血者组间不合格率差异有统计学意义(χ²值分别为 19.079、38.103、61.042、41.191、44.079,P值均<0.05);多因素Logistic 回归分析显示性别、年龄、职业、文化程度和献血模式为血液检测结果不合格率的主要影响因素。结论 应根据无偿献血者人群结构特点有效开展献血知识宣传教育,认真做好献血前筛查。

目的 目前对于生物反馈发挥治疗作用的机理还未完全研究清楚,该实验借助近似熵(ApEn)这一新型的非线性研究方法,研究在生物反馈过程中心电的变化,从而希望发现生物反馈对心脏功能的潜在影响。方法 总数30人的健康正常受试者纳入研究,其中20人为生物反馈实验组,10人为正常对照组。该实验采用肌电生物反馈作为反馈方法,同时记录心电的变化。实验所得数据采用非线性动力学参数—近似熵(ApEn)进行研究。结果 实验组的平均心率在最后两个生物反馈阶段高于对照组。随着实验进展,实验组的心率标准差逐渐缩小,而心率和心电ApEn明显增高。结论 该实验发现生物反馈能够影响心电生理系统,使得心脏系统变得更加健康,展现出更强的抗应激能力,从而揭示了生物反馈潜在的治疗机理。

Objective The mechanism about biofeedback is not complete clear. Our aim was to study changes of cardiac function (electrophysiology) during biofeedback with the help of approximate entropy (ApEn), and a potential new mechanism about neurofeedback may be detected. Methods A total of 30 healthy volunteers participated in this study which consisted of the neurofeedback group(n=20) and the control group (n=10). We applied electromyogram neurofeedback as the feedback method, and simultaneously recorded electroencephalogram(EEG) and electrocardiogram(ECG). We applied the nonlinear analysis ApEn assess obtained data. Results In the biofeedback group the average of heart rate was higher than that of control group in the last two sessions. As the biofeedback experiment sessions were progressed, the standard deviation of heart rate gradually reduced and the ApEn of ECG increased with statistic significance in the biofeedback group. Conclusion We found that biofeedback can influence cardiac electrophysiological system and make cardiac systems progress healthily and achieve greater ability of anti-stress.

目的 观察Bax抑制因子(Bax-inhibiting peptides,BIP)对肠上皮细胞的保护作用,并探讨其作用机制。方法 建立1日龄新生大鼠的坏死性小肠结肠炎模型。BIP于建模前腹腔内注射,建模后分别检测各组肠组织病理,并分别用流式细胞仪检测各组肠细胞凋亡率,western blot法检测bax下游凋亡蛋白细胞色素C、caspase 9和caspase 3含量。结果 与NEC组及Bax10 μg组比较,bax50 μg和100 μg可减轻肠上皮损伤,减少肠细胞凋亡率,降低bax下游凋亡蛋白细胞色素C、caspase9和caspase3含量。结论 一定剂量的Bax抑制肽可通过降低活性Caspase-3及CytC蛋白释放,保护线粒体膜,抑制肠上皮细胞调亡,发挥对肠上皮细胞的保护作用。

Objective To investigate the protective effects of Bax-inhibiting peptides(BIP) on intestinal epithelial cells and to explore its mechanism. Methods The model of neonatal necrotizing enterocolitis in 1 day neonatal rats were established. Before establishing the model, BIP was intraperitoneal injected to the rats. The pathological of intestinal tissue were detected respectively, the intestinal cell apoptosis rate were detected by flow cytometry, the levels of downstream apoptosis proteins of Bax were detected by Western blotting respectively. Results Compared to NEC and Bax10μg group, bax50μg and 100 μg can significantly reduce the intestinal epithelial damage and intestinal cell apoptosis rate and can decrease the levels of cytochrome C, caspase-9 and caspase-3, downstream apoptosis proteins of Bax,significantly. Conclusion A certain dose of Bax-inhibiting peptides can protect the mitochondrial membrane, inhibit the apoptosis of intestinal epithelial cells by reducing the level of Caspase-3 and CytC and play a protective effect on intestinal epithelial cells.

目的 探讨子宫内膜微腺体癌的临床病理特征、诊断及鉴别诊断。方法 对1例首诊误诊为子宫颈微腺体增生的子宫内膜微腺体癌病例进行临床、病理组织学及免疫组织化学特征的观察及总结,同时进行相关文献复习。结果 本例患者年龄61岁,因绝经后阴道不规则流血1年就诊,B超提示子宫内膜不规则增厚,并行分段诊刮术,先后两次诊刮标本光镜下均见黏液性柱状上皮呈乳头状及网格状结构,细胞轻度异型,核分裂罕见,间质内大量中性粒细胞浸润伴腺上皮内“微脓肿”形成;免疫组化示:上皮成分P16弥漫强(+),CEA小灶(+),Vimentin弥漫(+),ER约90%(+,中-强),PR约90%(+,弱),Ki-67约3%(+),间质细胞CD10(+)、CD34(-)。结论 子宫内膜微腺体癌是一种极为罕见的子宫内膜黏液腺癌,其组织学形态与子宫颈良性病变微腺体增生十分相似,易于混淆,但通过免疫组化检查及详细地临床病史资料收集、分析,可以与其鉴别,从而做出正确地诊断。

Objective To investigate clinical and histopathological features, dignosis and differential diagnosis of the endometrial microglandular adenocarinoma (MGA). Methods The clinical and pathological features of microglandular adenocarinoma in a patient were observed. Immunohistochemical staining and literature review were also used. Results In the case, the age of patient was 61 years. Clinical manifestation was vaginal irregular bleeding for 1 year. Type-B ultrasound suggested endometrium was irregular thickening. Histologically, it was mainly composed of irregular shape, closely spaced small glands, and glandular cells was mild atypical. Mitosis was rarely observed. The endometrial stromata between gland were rare, but neutrophil were much observed with the formation of neutrophil microabscess in the glandular epithelium. Immunohistochemical study showed neoplastic cells were diffuse and strongly positivity for P16, diffuse positivity for vimentin, focally positive for CEA. ER and PR expression was found in approximately 90% tumor cells. The index of Ki-67 was about 3%. Interstitial cells were positivity for CD10, negativity for CD34. Conclusion The microglandular adenocarcinoma is a rare endometrial adenocarcinoma. It can be differentiated from cervical microglandular hyperplasia(MGH) and cervical mucinous adenocarcinoma by immunohistochemistry and morphological characteristics.