目的 在原来研究的基础上进一步研究Wnt-1信号通路蛋白-3（WISP-3）在高氧诱导肺上皮细胞凋亡中的作用。方法 通过Western blot检测和免疫组化检测不同肺上皮细胞中WISP-3的蛋白表达量。利用质粒转染和siRNA的方法在Beas-2B细胞中高表达和基因沉默WISP-3,通过细胞活性检测和流式细胞学技术检测高氧刺激后细胞的凋亡情况。结果 与空气对照相比,高氧刺激使肺上皮细胞的WISP-3蛋白表达量下降;WISP-3基因沉默或高表达使高氧诱导的肺上皮细胞凋亡增加或减少。结论 高氧刺激下,肺上皮细胞中WISP-3表达下降,WISP-3对高氧诱导的肺上皮细胞凋亡具有保护作用。

Objective To explore how Wnt-1 inducible signaling pathway protein-3 （WISP-3） participate in and play a regulatory role in the process of hyperoxia induced apoptosis in lung epithelial cells. Methods The expression of WISP-3 was detected via Western blot and immunohistochemistry. High expression and low expression of WISP-3 were performed by plasmid transfection and siRNA. Cell viability and flow cytometry were executed to detect the hyperoxia-induced apoptosis in Beas-2B. Results Compared to the group of air control,the expression of WISP-3 protein in lung epithelial cells decreased obviously after hyperoxia. Cell survival decrease and apoptosis increased after hyperoxia in Beas-2B cells with low expression of WISP-3. Vice versa. Conclusion The expression of WISP-3 decreased after hyperoxia in lung epithelial cells. The role of WISP-3 in this process may be protective.

目的 探究彩色多普勒超声在乳腺良恶性肿瘤鉴别诊断中的应用价值。方法 抽取2012年2月—2016年6月我院门诊、社区普查中的病例中选取符合研究标准的298例乳腺肿瘤疾病患者,所有患者均行彩色多普勒超声检查。通过SPSS 19.0软件对数据进行分析,以病理检查结果作金标准,分析彩色多普勒超声诊断结果,对比良性肿瘤与恶性肿瘤血流分级情况及良性肿瘤与恶性肿瘤收缩期流速峰值(PSV)及(阻力指数)RI水平。结果 经病理检查证实,298例患者中恶性肿瘤32例,良性肿瘤266例;超声诊断恶性肿瘤42例,良性肿瘤256例;超声诊断灵敏度为93.75%(30/32)、特异度为95.49%(254/266)、准确度为95.30%(284/298)。良性肿瘤血流信号检出率为55.26%(147/266),恶性肿瘤血流信号检出率为96.87%(31/32),其中良性肿瘤以0～I级血流为主,为83.83%(223/266),恶性肿瘤以I～III级血流为主,为96.87%(31/32),各分级情况对比,差异有统计学意义(P＜0.05)。恶性肿瘤PSV(20.11±6.76)cm/s、RI(0.65±0.07)均明显高于良性肿瘤[(15.30±9.21)cm/s、(0.56±0.09)],差异有统计学意义(P＜0.05)。结论 彩色多普勒超声在乳腺良恶性肿瘤临床鉴别诊断中具有较高准确度、特异度及灵敏度,可结合血流分级和RI水平提高乳腺良恶性肿瘤鉴别准确度。

目的 探讨含双歧杆菌乳杆菌三联活菌新四联疗法对消化性溃疡患者幽门螺杆菌(Helicobacter pylori, Hp)根除治疗中的疗效。方法 将342例Hp阳性的消化性溃疡患者随机分为三个治疗组:A组(三联疗法)、B组(含铋剂四联疗法)及C组(含益生菌四联疗法),疗程均2周。疗程结束4周后复查¹³C-尿素呼气试验评估根除疗效。治疗期间记录患者不良反应发生情况。结果 300例(87.72%)患者按方案完成治疗,A、B及C组治疗完成率分别为85.71%(96/112)、82.50%(99/120)和95.45%(105/110),C组显著高于A及B组(P＜0.05)。在胃溃疡Hp根除率比较中,按意愿(方案)分析,A、B及C组疗法的Hp根除率分别为64.71%(75.86%)、71.43%(85.71%)及84.38%(87.10%),各组间差异无统计学意义(P均>0.05)。在十二指肠球部溃疡Hp根除率比较中,按意愿(ITT)分析,C组(85.90%)明显高于A组(62.82%)及B组(71.79%),差异有统计学意义(χ²=10.893,P=0.001;χ²=4.650,P=0.031);按方案(PP)分析,B组(87.50%)与C组(90.54%)明显高于A组(73.13%),差异有统计学意义(χ²=4.246,P=0.039;χ²=7.304,P=0.007),但B组与C组之间差异无统计学意义(P<0.05)。胃肠道不良反应中,便秘、味觉异常及腹胀的发生率,含益生菌疗法组明显少于另两组,差异有统计学意义(P均<0.05)。结论 含双歧杆菌乳杆菌三联活菌新四联疗法能够显著降低传统三联及四联根除疗法的胃肠道不良反应,提高患者依从性,从而提高消化性溃疡患者Hp的根除率。

Objective To investigate the efficacy of quadruple therapy containing bifidobacterium and lactobacillus triple live bacteria on eradication of Helicobater pylori (Hp) among the patients with peptic ulcer. Methods 342 Hp-infected peptic ulcer patients were randomly divided into three groups:A, B and C. The patients in group A were treated with standard triple therapy. The patients in group B and group C were treated with Colloidal Bismuth Subcitrate and Bifidobacterium and Lactobacillus combined with standard triple therapy, respectively. All patients in three groups were treated for 14 days. In the 4th week after end of treatment, Hp eradication was assessed by ¹³C-urea breath test. Adverse effects during the course of treatment were recorded. Results A total of 300(87.72%) patients completed the treatment. The completion rates in group A, B and C were 85.71%(96/112), 82.50%(99/120) and 95.45%(105/110) respectively, and the completion rate in group C were significantly higher than that in group A and group B(P<0.05). With intention to treat and per-protocol analysis in gastric ulcer, the eradication rates of group A, B and C were 64.71%(75.86%), 71.43%(85.71%)and 84.38%(87.10%) respectively, but there were not significant difference in the three groups(P>0.05). With intention to treat analysis in duodenal ulcer, the Hp eradication rate in group C was 85.90%, which was significantly higher than that in group A (62.82%;χ²=10.893,P=0.001) and in group B (71.79%;χ²=4.650,P=0.031). With per-protocol analysis in duodenal ulcer, the Hp eradication rate was 90.54% in group C and 87.50% in group B. No Obviously difference was found between group B and group C (P<0.05), but both were higher than that in group A(73.13%) (χ²=4.246,P=0.039;χ²=7.304,P=0.007). The incidence of adverse reactions including constipation, taste distortion and bloating in group C were significantly lower than those in the other two groups (P<0.05). Conclusion The quadruple therapy containing bifidobacterium and lactobacillus triple live bacteria can obviously enhance the patient's compliance and decrease the adverse reactions, thereby may increase the Hp eradication rate among the patients with peptic ulcer.

目的 探索蟾毒灵对舌鳞状细胞癌Tca8113细胞增殖、凋亡的影响及可能作用机制。方法 以人舌鳞癌Tca8113细胞为研究对象,MTT法检测10、20、40、80、160 nmol/L浓度蟾毒灵体外抑制Tca8113细胞增殖的活性;检测蟾毒灵干预下肿瘤细胞Na⁺-K⁺-ATP酶活性的变化;Western blot发检测Bcl-2、Bax、caspase-3蛋白表达。结果 蟾毒灵有抑制Tca8113细胞的活性,且呈剂量-时间依赖性;在蟾毒灵干预下Tca8113细胞Na⁺-K⁺-ATP酶收到抑制;Western blot结果显示凋亡相关Bax、caspase-3蛋白表达上调,Bcl-2蛋白表达下调。结论 蟾毒灵通过抑制细胞膜Na⁺-K⁺-ATP酶活性,通过调节Bcl-2凋亡通路的相关蛋白,最终激活caspase-3,诱导人舌鳞癌Tca8113细胞凋亡。

Objective To explore the effects of bufalin on proliferation and apoptosis of tongue squamous cell carcinoma Tca8113 cells and its possible mechanism. Methods Tca8113 cells were treated with 10, 20, 40, 80 and 160 nmol/L Tca8113 cells in vitro. MTT assay was used to detect the inhibitory effect of bufalin on the proliferation of Tca8113 cells; And the activity of Na⁺-K⁺-ATPase in tumor cells was detected by the interference of bufalin; The expression of Bcl-2, Bax and caspase-3 protein was detected by Western blot. Results Bufalin inhibited the activity of Tca8113 cells in a dose-and time-dependent manner; Na⁺-K⁺-ATPase in Tca8113 cells was inhibited by bufalin; The results of Western blot showed that the expression of Bax and caspase-3 protein was up-regulated and the expression of Bcl-2 protein was down-regulated. Conclusion Bufalin induced the apoptosis of human tongue squamous cell carcinoma Tca8113 cells by inhibiting the activity of Na⁺-K⁺-ATPase and regulating the related proteins of Bcl-2 apoptosis pathway, finally activating caspase-3.

目的 探讨个体化健康管理对超高龄结直肠癌患者希望水平的影响效果。方法 对66例超高龄结直肠癌患者实施个体化健康管理,3个月后对患者进行希望水平、肛门括约肌功能、生活质量的测评。结果 3个月后患者排便功能恢复良好的达90.91%,与出院前比较差异有统计学意义(P＜0.01);3个月后患者HHI各维度和SF-36各维度的得分明显提高,与干预前比较差异均有统计学意义(P＜0.01)。结论 对超高龄结直肠癌患者实施个体化健康管理,可提高其生存希望水平,改善生活质量。

Objective To explore the effect of individualized health management on the hope level of patients with advanced colorectal cancer. Methods Using individualized health management for 66 elderly patients with colorectal cancer for 3 months, the level of hope, anal sphincter function and quality of life were evaluated. Results After 3 months, the defecation function of the patients recovered well to reach 90.91%, and the difference was statistically significant (P<0.01); After 3 months, the scores of each dimension of Herth Hope Index (HHI) and SF-36 were significantly improved, and the difference was statistically significant (P<0.01). Conclusion The implementation of individualized health management for the elderly patients with colorectal cancer may improve the survival level and improve the quality of life.

目的 探讨ERCC1、RRM1、TS蛋白表达对晚期非小细胞肺癌(NSCLC)个体化治疗的指导意义。方法 收集经病理确诊的晚期NSCLC患者87例,其中67例愿意接受药敏免疫组化检测的患者作为研究组,采用SP法检测肿瘤组织ERCC1、RRM1、TS蛋白表达,并根据蛋白表达情况选择化疗方案;另外20例患者不进行药敏免疫组化检测,以常规吉西他滨联合顺铂方案化疗,以此作为对照组。比较两组患者化疗的有效率,疾病控制率(DCR),并以无进展生存期(PFS)为指标比较患者预后。结果 研究组67例患者中,PR 33例(49.25%),SD 13例(19.4%),PD 21例(31.35%);对照组20例患者中,PR 4例(20%),SD 4例(20%),PD 12例(60%),两组疗效之间有差异( χ²=6.437,P=0.04),研究组DCR为68.6%,高于对照组DCR 40%,差异有统计学意义(χ²=5.372,P=0.034)。研究组患者的中位PFS高于对照组,研究组的PFS为5月,对照组为3月,差异有统计学意义(P＜0.05)。结论 对晚期NSCLC患者进行ERCC1、RRM1、TS药敏蛋白免疫组化检测,指导个体化治疗方案,能提高患者化疗的疾病控制率及延长患者的疾病进展时间。

目的 探讨手动杠杆式胸外按压心肺复苏(CPR)装置对院内心肺复苏按压质量和复苏疲劳的影响。方法 将12名医学生志愿者分为手动杠杆式胸外按压CPR装置组(LDCPR)(n=6)和徒手标准CPR组(STCPR)(n=6)模拟院内心肺复苏场景进行CPR试验。LDCPR组采用手动杠杆式胸外按压CPR装置对模拟人进行连续6min连续胸外按压,STCPR组徒手对模拟人进行6min连续胸外按压。监测复苏期间按压的深度、频率以及按压者的心率和疲劳程度等变化。结果 随着连续胸外按压的进行,按压者的心率和疲劳程度都在不断增加,有效按压深度超过5 cm次数逐渐减少,但是在连续胸外按压的第4～6min,LDCPR组按压者的心率较STCPR组慢(P<0.05),疲劳程度较轻(P<0.05),有效按压的比例更高(P<0.05)。按压频率两组比较无明显差异。结论 在本模拟人试验中,手动杠杆式胸外按压CPR装置可减轻按压者疲劳,有助于提高院内CPR时长时间胸外按压的质量。

Objective We aimed to investigate simulated in-hospital cardiopulmonary resuscitation (CPR) quality and rescuer fatigue of external chest compression-only CPR by a manual leverage device(LDCPR). Methods All 12 volunteers (medical staffs: male 6 and female 6) were randomized to standard CPR by hand(STCPR)group (n=6)or LDCPR group(n=6). At STCPR group, continuous external chest compression-only was performed for 6 minutes to simulate in hospital cardiopulmonary resuscitation on a manikin; at LDCPR group, compression-only was performed for 6 minutes by a leverage device on a manikin. We measured blood pressure of the volunteers before and after performing each CPR technique, volunteers self-report fatigue scale and continuously monitored heart rate (HR) of the volunteers during each CPR technique by smart ring. CPR quality measures included chest compression rate and depth. Results During continuous external chest compression-only CPR, compressor's heart rate and fatigue scale were rising continuously, and percent of compress depth >5 cm were declining, too.Compressor's heart rate and fatigue scale were higher in the STCPR group than in the LDCPR group (P<0.05) during the fourth to sixth minutes CPR (P<0.05). Percent of compress depth > 5 cm was higher in the LDCPR group than in the STCPR group (P<0.05) during the fourth to sixth minutes of CPR (P<0.05).Compress rate had not differed between the 2 groups during CPR. Conclusion In the manikin study, manual leverage external chest compress device may reduce fatigue scale and improve long term compression quality during in-hospital cardiopulmonary resuscitation.

目的 探讨优质护理模式干预对凶险性前置胎盘患者胎盘恢复及胎儿的影响。方法 选取2015年3月—2017年6月我院妇产科收治的凶险性前置胎盘患者80例,随机分为对照组和观察组,各40例,分别实施常规护理及优质护理模式干预,对比分析两组患者护理干预效果。结果 观察组患者术后大出血及感染总并发症发生率低于对照组(P<0.05)。观察组患者产前、产后总出血量低于对照组,同时新生儿Apgar评分高于对照组,其差异比较均有统计学意义(P<0.01)。结论 在凶险性前置胎盘患者中实施优质护理模式干预对胎盘恢复效果更显著于常规护理,同时改善新生儿健康情况。

目的 探究儿童抗NMDA受体脑炎临床特点、诊治及预后。方法 回顾性分析16例儿童抗NMDA受体脑炎的临床表现、辅助检查、治疗与预后。结果 16例患儿中,意识障碍16例, 语言障碍15例,运动障碍13例,11例惊厥发作。9例脑脊液NMDA受体抗体阳性,14例血清NMDA受体抗体阳性。16例患儿脑电图均出现背景中高波幅慢活动,头颅磁共振检查未见异常。所有患儿均接受丙种球蛋白联合激素冲击治疗,14例症状缓解,2例需加用利妥昔单抗治疗,症状缓解。结论 识别儿童抗NMDA受体脑炎多样临床表现,筛查NMDA受体抗体有助于早期诊断及治疗儿童抗NMDA受体脑炎。

Objective To investigate clinical features, diagnosis, treatment and prognosis of the patient with anti-NMDA receptor encephalitis in children. Methods The data of clinical feature,auxiliary examination of 16 cases with anti-NMDA receptor encephalitis in children were reviewed and analyzed. Results Of all 16 cases, there were 16 cases with decreased consciousness, 15 cases developed speech alteration, 13 cases developed movements disorder and 11 cases with seizure. Cerebrospinal fluid NMDA antibody were positive in 9 cases and serum NMDA antibody were positive in 14 cases. The EEG of 16 patients showed high-amplitude slow activity in the background. There were no significant abnormalities in head magnetic resonance imaging (MRI) of all children. After all children received gamma globulin combined hormone therapy, 14 cases had boen improved and another 2 cases need to be further treated combined with Rituximab. Conclusion Pediatric patients had diverse clinical manifestations. Screening of NMDA receptor antibody may help early diagnosis of anti-NMDA receptor encephalitis. And timely treatment may yield a favorable prognosis.

目的 调查新疆疏附县基层医务人员对男童外生殖器畸形的认知及筛查能力,为制定新疆少数民族地区医务人员培训计划提供数据支持。方法 采用自行设计的问卷调查表,对新疆疏附县人民医院、乡卫生院及村医进行问卷调查,确定其对男童外生殖器畸形的认知程度。采用SPSS 13.0进行数据分析,比较维、汉两族医务人员的认知差异。结果 发放调查问卷400份,收回有效问卷365份,占91.25%。调查发现,新疆疏附县基层医务人员对外生殖器畸形相关知识认知正确率超50%的占参与问卷调查的54.79%。其中男性21.92%,女性32.87%。汉族医务人员对外生殖器畸形相关知识认知正确率超50%的占参与问卷调查的汉族医务人员50%,维族约57.40%,统计分析显示差异无统计学意义(P＜0.05);有关外生殖器畸形相关知识获取途径中,未参加相关知识培训占61.64%,参加过培训者38.36%;在临床实践中主动筛查新生儿外生殖器畸形者86.30%,发现外生殖器畸形病例者27.39%。结论 新疆疏附县基层医务人员普遍缺乏男童外生殖器畸形相关诊疗知识,在实际工作中发现并恰当处置此类疾病的能力亦相对欠缺。因此提高新疆少数民族地区基层医务人员对男童外生殖器畸形的诊断和治疗能力非常必要。

Objective To survey on the recognition and diagnosis capability of frontline healthcare workers in boy's genital malformation in Shufu, Xinjiang. Thereby to provide data support for the healthcare workers training there. Methods We designed a questionnaire and carried out a survey in Shufu people's hospital, township clinics and village doctors. Based on SPSS 13.0 data analysis, we made comparison on recognition difference between the Han and Uygur healthcare workers. Results 400 questionnaires were handed out, among them 365 were valid which accounted for 91.25%. The survey showed that there were 54.79% survey participators whose recognition correct rate was over 50% in Shufu, Xinjiang (21.92% for man, 32.87% for woman), 50% Han healthcare workers whose recognition correct rate was over 50% and that of 57.4% in Uygur peers.There was no significant difference in statistics(P<0.05). It accounted for 38.36% that participating in training as the access to relevant knowledge of genital malformation,but 61.64% was not. In clinical practice, 86.3% of survey participators screen the possibility of newborn genital malformation. And 27.39% of screened newborn have genital malformation. Conclusion The frontline healthcare workers in Shufu, Xinjiang at large are short of diagnosis knowledge on boy's genital malformation, as a result that they are difficult to recognize and give proper treatment on such cases in practice. The status thereby shows that it is critical to improve the diagnosis and treatment capability of frontline healthcare workers in boy's genital malformation in Xinjiang ethnic group area.