目的 本研究旨在探讨2型糖尿病不同程度肾病与chemerin、SOD及MDA的相关性。方法 选取2016年1月—2017年12月期间于广州市第一人民医院内分泌科门诊和住院的患者100例,根据尿白蛋白/肌酐比(ACR)分为正常尿蛋白组(NA组,n=33),微量白蛋白尿组(MA组,n=34)及大量蛋白尿组(CA组,n=33),另选取32例我院体检中心体检结果正常的正常健康人作为对照组(NC组,n=32),测定血糖、糖化血红蛋白、血肌酐、ACR、24小时尿蛋白定量、胆固醇、甘油三酯、SOD、MDA、chemerin等水平。结果 SOD的水平:NC组> NA组> MA组>CA组(P<0.05);MDA的水平:CA组>MA组>NA组>NC组(P<0.05);Chemerin水平:CA组>MA组>NA组>NC组(P<0.05)。相关性分析提示ACR与血清SOD呈负相关,与MDA、chemerin呈正相关。多元回归分析显示,病程、胆固醇、糖化血红蛋白、chemerin是影响ACR的主要因素。结论 Chemerin、MDA、SOD可能参与糖尿病肾病的发生发展,检测其水平可以在一定程度上反映2型糖尿病肾病患者的病情严重程度。

Objective To explore the relationship between different type of Type 2 diabetes nephropathy and chemerin,SOD,MDA. Methods A total of 100 inpatients and outpatients were enrolled in this study between January 2016 and December 2017 in Guangzhou First People's Hospital. They were divided into normal urinary protein group (NA group, n=33), microalbuminuria group (MA group, n=34) and massive proteinuria group (CA group, n=33) based on ACR. Another 32 healthy people were collected as a control group in medical examination center (NC group, n=32). The levels of blood sugar, glycated hemoglobin, serum creatinine, ACR, 24-hour urinary protein, cholesterol, triglyceride, SOD, MDA and chemerin were measured. Results The level of SOD: NC group > NA group > MA group > CA group (P< 0.05). The level of MDA: CA group > MA group > NA group > NC group (P< 0.05). The level of chemerin: CA group > MA group > NA group > NC group (P< 0.05). Correlation analysis showed that ACR was negatively correlated with serum SOD and positively correlated with MDA and chemerin. Multivariate logistic regression demonstrated that course of disease, CHOL, HbA1c and chemerin were the main factors affecting ACR. Conclusion Chemerin, MDA and SOD may be involved in the occurrence and development of diabetic nephropathy. Chemerin, MDA and SOD may reflect the severity of type 2 diabetic nephropathy

目的 分析抽检血液成分关键指标结果并采用趋势分析方法进行评估。方法 收集整理2015—2017年每月1次的8种血液成分质量控制的检测数据,选择关键指标并制作折线图,联合行动限和警戒限进行趋势分析。结果 未能100%达到GB 18469—2012《全血及成分血质量要求》的项目包括悬浮红细胞容量及Hct、单采血小板及浓缩血小板血小板含量、新鲜冰冻血浆及冷沉淀VIII因子含量。新鲜冰冻血浆及冷沉淀的VIII因子含量项目分别出现10次和5次偏离数据;单采血小板及浓缩血小板的血小板含量项目分别出现3次和4次偏离数据。结论 根据血液成分的关键指标结果进行趋势分析发现问题,主动寻找原因并及时采取相应措施,是确保血液质量的一种有效手段。

Objective To analyze and evaluate the results of key indexes of the blood component by trend analysis. Methods Collected and arranged the data of eight kinds of blood component quality control,which was did once month in 2015-2017.Selected the key indexes and made the line charts.Allied with the action limits and warning limits for trend analysis. Results The key indexes could not 100% meet the “Quality requirements for whole blood and component blood”,including capacity and Hct of suspended red blood cell,platelet content of apheresis platelets and platelets concentrate,factor VIII content of fresh frozen plasma and cryoprecipitate.The factor VIII of fresh frozen plasma and cryoprecipitate showed ten and five deviation data, respectively, the platelet content of apheresis platelet and platelets concentrate showed three and four deviations, respectively. Conclusion It's an effective way to ensure blood quality by trend analysis based on the results of key indexes of blood components, and actively find the cause and take corresponding measures in time.

目的 分析2016—2018年度广州市单采血小板报废的主要原因,并探讨如何降低单采血小板报废率。方法 统计2016—2018年度广州市单采血小板的采集量、报废数量和报废率等相关数据,分析报废原因,提出相应改进措施。结果 2016—2018年广州血液中心单采血小板总报废率为1.13%,三年的报废率逐年下降。报废的最主要原因为血液感染因子筛查不合格或ALT异常,占总报废率64.44%;其次分别为血量不足(占比14.4%)、采血耗材/血袋/热合口漏(占比11.01%)等。结论 我中心单采血小板报废率虽逐年下降,但仍需加强献血前宣传,动员更多的健康适龄公民参加无偿献血,同时重视采前血液感染因子的筛查工作、采血前及采血过程的护理干预、设备维护保养和产品处理能力的培训,进一步有效降低血液报废率。

Objective To analyze the main causes of apheresis platelets discarding in Guangzhou from 2016 to 2018, and discuss how to reduce the discarding rate. Methods Collected the data of apheresis platelets collection, the discarding number and the discarding rate in Guangzhou from 2016 to 2018,to analysis the reasons of apheresis platelets discarding and introducing improvement measures. Results From 2016 to 2018, the total discarding rate of apheresis platelets collected from Guangzhou Blood Center was 1.13%. In the three years,the discarding rate declined year by year.The main reasons for apheresis platelets discarding were the result of blood infection factor test or ALT was not qualified, accounting for 64.44% of the total scrapping rate. Then followed by insufficient blood volume (14.4%) and Blood consumables/blood bags/heat closure leakage (11.01%). Conclusion Although the rate of apheresis platelet discarding in Guangzhou Blood Center is decreasing year by year, we still need to enhance blood donation propaganda, mobilize more healthy citizens to participate in blood donation, and pay attention to the screening of blood infection factors before blood collection, nursing blood donor before and during blood collection, and training of ability in equipment maintenance and product handling, so as to further effectively reduce the rate of blood discarding.

目的 了解长沙市雨花区环卫工人的健康状况,为有针对性地制定健康教育措施提供依据。方法 为环卫工人进行体格检查,对其体检资料进行统计分析。结果 1 672名受检环卫工人中仅有57人所检项目完全正常,异常检出率达96.60%,其中男性职工的总体检出率要高于女性职工(P<0.05);男性职工慢性咽炎、高血压、血脂异常、高尿酸血症、肾囊肿的检出率较女性职工高(P<0.05);而女性职工肾结石、甲状腺结节、痔疮的检出率要高于男性职工(P<0.05)。体检结果尚具有一定的年龄段分布规律,膝关节退变、超重和肥胖、慢性咽炎、脂肪肝、高尿酸血症、甲状腺结节等检出率差异有统计学意义(P<0.05);其中膝关节退变、高血压、前列腺增生等检出率随着年龄的增长而增加。结论 环卫工人的卫生保健意识薄弱,进一步促进改善他们的工作条件,并对其进行健康教育非常必要。

Objective To understand the health status of sanitation workers in Yuhua District of Changsha city, and to provide evidence for the establishment of health education measures. Methods The sanitation workers were examined by medical examination and their physical examination data were statistically analyzed. Results In the 1 672 subjects of sanitation workers there were only 57 people seized items completely nor -mal. Abnormal rate was 96.60%. The total examination rate of male workers was higher than that of female workers (P<0.05); morbidity of male workers in chronic pharyngitis, hypertension, dyslipidemia, hyperuricemia and renal cysts were higher than female workers (P<0.05); morbidity of the female workers in kidney stones, thyroid nodules, hemorrhoids, was higher than that of the male workers (P<0.05). The examination results had age distribution. There was statistically significant in knee joint degeneration, overweight and obesity, chronic pharyngitis, hyperuricemia, fatty liver, thyroid nodule (P<0.05); the knee joint degeneration, hyperten -sion, prostatic hyperplasia detection rate increased with age. Conclusion The sanitation workers' awareness of health care is weak. It is necessary to further improve their working conditions and to carry out health education for them.

目的 探讨肝硬化失代偿期患者前列素E2(PGE2)水平对患者感染发生预测价值。方法 选取2016年3月—2017年6月我院收治肝硬化失代偿期患者64例为研究对象,根据患者是否合并有感染分为A组(合并感染,23例)和B组(未合并感染,41例),采用酶联免疫吸附(ELISA)法检测患者PGE2水平,比较两组患者血清PGE2水平,并用ROC曲线预测PGE2在肝硬化失代偿期合并感染价值。结果 A、B两组患者在性别、年龄、白蛋白水平、WBC计数、Child分级、肝硬化病因方面比较均无统计学意义(P＞0.05)。A组患者PGE2水平高于B组[(3 894.6±368.4)pg/mL vs(2 541.8±318.6)pg/mL,P＜0.05]。ROC曲线在肝硬化失代偿期患者合并感染风险曲线下面积为0.86(95%CI为0.75～0.91),有统计学意义(P=0.000 0),当肝硬化失代偿期患者血清PGE2浓度为2 845 pg/mL时,预测肝硬化失代偿期患者合并感染灵敏度和特异度最高,分别为0.831和0.794。结论 肝硬化失代偿期患者PGE2水平显著升高,检测PGE2水平对肝硬化失代偿期患者发生感染有一定预测价值。

目的 了解我院肺炎链球菌的临床分布及耐药情况,为临床合理应用抗菌药物提供依据。方法 采用WHONET 5.6软件对我院2012年—2016年培养、分离和鉴定出的肺炎链球菌的临床分布及药敏试验结果进行分析。结果 2012年—2016年共检出肺炎链球菌519株(不含重复菌株),每年秋冬和初春季节检出率最高。五年检出的肺炎链球菌对各类抗生素的耐药率变化不大。从8个科室和病区分离出此菌,以呼吸科为主,分离出313株,占60.3%。痰液中共分离出488株,占94.03%,其次从血液中分离出32株,占4.24%。对抗生素耐药率大于60%的有:复方新诺明、四环素、克林霉素和红霉素;未出现耐药的抗生素有厄他培南、莫西沙星、利奈唑胺和万古霉素;其余抗生素的耐药率均小于30%,其中肺炎链球菌对青霉素的耐药率为2%、中介率为20%。结论 青霉素仍可以作为治疗肺炎链球菌感染的首先药物;三代头孢菌素可用于青霉素非敏感的肺炎链球菌(PNSSP)治疗;未发现万古霉素非敏感菌株;红霉素、克林霉素的耐药率极高,不适合肺炎链球菌的治疗。临床应当根据培养药敏结果合理使用抗菌药物,减少细菌耐药率的发生。

目的 探讨分析莫西沙星对2型糖尿病合并肺部感染患者内皮素及降钙素基因相关肽的影响。方法 回顾性分析2015年1月—2016年1月来我院就诊并确诊为2型糖尿病合并肺部感染的84例患者的临床资料,根据治疗方案将其分为对照组和观察组,每组各42例。对照组患者给予常规治疗,观察组患者在对照组的治疗基础上予以莫西沙星治疗。观察两组患者治疗后内皮素以及降钙素基因相关肽的变化。结果 ①观察组总有效率(92.86%)优于对照组(78.57%),两组患者间总有效率的比较有统计学意义(P<0.05);②两组患者治疗前ET、CGRP水平无差异(P>0.05)。治疗后,观察组ET水平低于对照组,CGRP水平高于对照组(P<0.05)。结论 临床应用莫西沙星治疗2型糖尿病合并肺部感染具有明显的临床疗效,值得临床推广应用。

目的 评估AMA-M2、SP100和GP210三种自身抗体在诊断原发性胆汁性肝硬化(primary biliary cirrhosis,PBC)中的应用价值。方法 收集我院近3年就诊患者的AMA-M2、SP100、GP210、ALP和GGT检测数据,其中PBC患者50例,非PBC肝胆疾病或自身免疫病患者226例,正常对照290例。分析这些检测指标对PBC诊断的敏感度和特异度。结果 AMA-M2、SP100和GP210诊断原发性胆汁性肝硬化的敏感度分别为96.00%、36.00%、8.00%,特异度分别为98.26%、97.87%、99.03%。PBC组病人的ALP和GGT检测结果高于非PBC病人组。结论 AMA-M2、SP100和GP210对PBC的临床诊断特异度较高;AMA-M2的敏感度高,但SP100和GP210敏感度低。

Objective To evaluate the diagnostic accuracy of AMA-M2, SP100 and GP210 for the primary biliary cirrhosis (PBC).Methods A total of 50 patients with PBC and 226 patients with other liver diseases or autoimmune diseases were enrolled in this study and 290 healthy individuals were included as normal controls. The data of AMA-M2, SP100, GP210, ALP and GGT were collected and analyzed for sensitivity and specificity in the diagnosis of PBC.Results The sensitivity and specificity of AMA-M2, SP100 and GP210 in the diagnosis of PBC were 96.00%, 36.00%, 8.00% and 98.26%, 97.87%, 99.03%, respectively. Compared to PBC group, the concentrations of ALP and GGT in non-PBC patients and controls were low.Conclusion AMA-M2 is quite accurate with high specificity and sensitivity in the diagnosis of PBC. However, SP100 and GP210 have high sensitivity but low sensitivity.

目的 探讨广东汉族儿童ACE2基因A9570G多态性与儿童激素敏感型肾病综合征(SSNS)复发的关系。方法 选取广东汉族SSNS患儿92例,按发病后1年复发情况分为频复发组31例、非频复发组61例,健康体检者60例为对照组,采用聚合酶链反应-DNA直接测序技术观察患儿与对照组ACE2基因A9570G基因型分布和等位基因频率。结果 在女性,SSNS组G等位基因频率及GG基因型分布均低于对照组(39％ vs 65％,P<0.05;27％ vs 50％,P<0.05);在男性,SSNS组G等位基因/GG基因型分布亦低于对照组(35％ vs 60％,P<0.05 )。亚组分析发现,在女性,频复发组G 等位基因频率及GG 基因型分布均高于非频复发组(58％ vs 29％,P<0.05;42％ vs 19％,P<0.05);在男性,频复发G基因型/G等位基因频率高于非频复发(58％ vs 24％,P<0.05)。结论 ACE2基因A9570G多态性与儿童SSNS复发相关,携带G等位基因的患儿容易表现为频复发。

Objective To investigate the association between the A9570G polymorphism of ACE2 gene and the relapse of steroid-sensitive nephrotic syndrome (SSNS) in Han childhood of Guangdong.Methods Ninety-two children with SSNS were selected from Guangdong Han nationality. According to the relapse frequency during the first year of the disease, 31 cases with more than 3 relapses were as frequency relapse group, 61 cases with less than 3 relapses were as non-frequent relapse group, and 60 healthy children were as control group. The gene distribution and allele frequency of ACE2 gene A9570G were observed by polymerase chain reaction-DNA direct sequencing technology.Results In female,the distribution of G allele frequency and GG genotype in SSNS group were significantly lower than that in the control group(39％ vs 65％, P<0.05; 27％ vs 50％, P<0.05). In male, the distribution of G allele/GG genotype in SSNS group was also significantly lower than that in the control group(35% vs 60%, P<0.05). Subgroup analysis found that the distribution of G allele frequency and GG genotype in female of the frequency relapse group were significantly higher than that of the non-frequency relapse group(58% vs 29%, P<0.05; 42% vs 19%, P<0.05), and the distribution of G allele/GG genotype in male of the frequency relapse group was significantly higher than that of the non-frequency relapse group (58% vs 24%, P<0.05).Conclusion The A9570G polymorphism of ACE2 gene was associated with the recurrence of children's SSNS, and the children with G allele were susceptible to recurrence.

目的 探讨HHIP基因单核苷酸多态性与新疆蒙古族慢性阻塞性肺疾病易感性之间的关系。方法 以259例蒙古族吸烟慢性阻塞性肺疾病患者为病例组,245例蒙古族吸烟健康体检者为对照组,提取外周血标本 DNA,运用Taqman分型技术检测HHIP基因rs13118928、rs13141461位点多态性。结果 HHIP基因rs13118928、rs13141461位点基因型与等位基因在病例组和对照组之间的频率分布,结果显示差异有统计学意义(P<0.05)。rs13118928位点基因型AG、GG,等位基因G在病例组与对照组分布差异有统计学意义(P<0.001),且OR<1,可能降低发生COPD的风险。rs13141461位点基因型TC在病例组与对照组分布差异无统计学意义(P>0.05),rs13141461位点基因型CC, 等位基因C在病例组与对照组分布差异有统计学意义(P<0.05),且OR>1,可能增加发生慢阻肺的风险。rs13118928、rs13141461位点基因型与肺功能 FEV1%预计值比较差异有统计学意义(P<0.05)。结论 HHIP基rs13118928、rs13141461位点多态性可能与新疆蒙古族人群慢阻肺的发生有关。

Objective To explore the relationship between HHIP gene single nucleotide polymorphism and the susceptibility of Mongolian chronic obstructive pulmonary disease.Methods DNAs were extracted from the peripheral blood of 259 patients with COPD (case group) and 245 healthy controls (control group) from Xinjiang Mongolian population. Polymorphisms of HHIP rs13118928 and rs13141461 were determined by the Taqman PCR method.Results The frequency of HHIP rs13118928 and rs13141461 genotypes and alleles in the case group and the control group showed significant difference (P<0.05). HHIP rs13118928 genotype, AG, GG and allele G were significantly different between case group and control group (P<0.001), and OR<1. It could reduce the risk of COPD. There was no significant difference in HHIP rs13141461 genotype TC between the case group and the control group (P>0.05). HHIP rs13141461 genotype CC and allele C were significantly different between the case group and the control group (P<0.05), and OR>1. It may increase the risk of COPD. The difference of HHIP rs13118928, rs13141461 and FEV1% predicted value was statistically significant(P<0.05).Conclusion The polymorphism of HHIP rs13118928 and rs13141461 may be related to the occurrence of COPD in Xinjiang Mongolian population.