简介：【摘要】目的：探究血清白细胞介素-28A、-28B、-29水平表达同强直性脊柱炎患者疾病严重程度的相关性。方法：将我院2020.1~2021.1月收治的53例该疾病患者、同期健康体检者53例作为此次研究对象，该疾病患者为试验组，健康体检者为对照组。检测两组血清白细胞介素-28A、-28B、-29水平，并收集患者治疗前后Bath强直性脊柱炎疾病活动性指数（BASDAI）、C反应蛋白（CRP）、红细胞沉降率（ESR），对比两组检测结果。结果：试验组IL-28A、IL-29水平高于对照组，IL-28B水平低于对照组（P＜0.05）；治疗后患者BASDAI、CRP、ESR、IL-28A、IL-29水平低于治疗前，IL-28B水平高于治疗前（P＜0.05），结果存在差异。结论：血清白细胞介素-28A、-28B、-29水平可反应强直性脊柱炎患者疾病严重程度。

简介：摘要机体特异性免疫应答是一个需要一系列免疫细胞和免疫分子共同参与的异常复杂的过程，这些免疫细胞及分子之间相互调节又相互制约。目前大多数肾脏疾病发病机制尚不明确。B7(CD80)位于调节CD4+和CD8+T细胞的抗原提呈细胞上，通过与细胞上的糖蛋白CD28结合发挥信号传递作用、增强或放大免疫反应的功能，或者与细胞毒性T细胞蛋白-4(cytotoxic T lymphocyte-associated antigen4 CTLA-4)结合后抑制免疫应答。通常肾组织不表达或低表达B7，然而某些肾小球疾病的发生与B7的增加有关，其降低了足细胞附着肾小球基底膜的能力，增加炎症反应及肾脏纤维化。当B7与CTLA-4相结合时，免疫反应就会被减弱。因此通过阻断CD28或增强CTLA-4信号可能阻止疾病的发生。该文就共刺激分子B7/CD28在足细胞损伤、原发性肾小球肾炎、紫癜性肾炎、狼疮性肾炎等肾脏疾病的发病机制中的作用，以及B7阻滞剂在部分肾脏疾病靶向治疗的研究进展进行综述。

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简介：【摘要】目的 了解IL-28B基因多态性在不同丙肝病毒基因型的慢性患者中的分布情况。方法 收集到60例慢性丙肝（chronic hepatitis C, CHC）患者的抗凝全血，采用多重高温连接酶检测反应检测IL-28B 单核甘酸多态性（single nucleotide polymorphisms, SNPS）位点rs8099917, rs12980275, rs12979860。结果 ①60例CHC患者中非1b型占71.7%（43/60）, 1b型占28.3%（17/60）, IL-28BSNPS位点rs8099917TT,rs12980275AA,rs12979860CC基因型占80%（48/60），在HCV基因1b型组中rs8099917GT,rs12980275GA, rs12979860CT基因型占58.8%（10/17）。IL-28BSNPS在1b型与非1b型分布存在差异，差异有统计学意义。（P=0.00

简介：【摘要】目的：探讨治疗儿童支气管哮喘时应用孟鲁司特钠后患儿肺部功能及炎症因子间的关系与治疗效果。方法：选取2020年6月至2021年6月间，我院收治的92例病患展开研究。将92例病患儿童依照计算机表法均分为研究组46例对照组46例，对照组应用常规药物治疗，研究组使用孟鲁司特钠治疗，对比两组病患临床治疗效果及患儿治疗后肺部功能与细胞因子改善效果。结果：研究组临床治疗有效为（97.83%），明显高于对照组患儿（84.78%），且研究组患儿经临床治疗后细胞因子及肺部功能改善效果显著优于对照组病患儿童，两组对比存在统计学意义，（P

简介：摘要回顾性分析2012年3月至2019年6月期间28例行胰腺节段性切除术患者的临床资料。全组患者中24例行开腹手术，4例行腔镜手术；26例行胰肠Roux-en-Y吻合，2例行胰胃吻合。术后生化漏9例，B级胰瘘4例，无C级胰瘘；无活动性出血病例，1例出现慢性渗血，经保守治疗后好转；术后新发糖尿病1例。围手术期均无二次手术、无死亡病例。笔者认为胰腺节段性切除术对患者的内、外分泌功能影响小，但胰瘘发生率较其他胰腺手术高。

简介：摘要：重组人白介素-11（rhIL-11）是临床常用的治疗化疗后血小板减少的药物，其参与血小板生成的全过程。临床常见不良反应为心律失常、水肿等，极少伴发意识障碍。本次报道临床所见1例使用rhIL-11后反复发作心律失常伴发意识障碍的病例，以为广大一线临床医生提供经验。

简介：摘要目的探讨高迁移率族蛋白B1(HMGB1)、肿瘤坏死因子-α(TNF-α)和白介素-6(IL-6)在老年人病毒性肺炎中的表达和临床意义。方法选择安徽医科大学附属六安医院收治的160例老年病毒性肺炎患者为研究对象，另选取健康体检的40例老年人作为对照组。将全部病毒性肺炎患者根据英国胸科协会改良肺炎(CURB-65)评分和肺炎严重指数(PSI)评分进行分组，分为低危组、中危组和高危组，比较不同组别患者的HMGB1、TNF-α和IL-6水平，分析CURB-65评分、PSI评分与HMGB1，TNF-α和IL-6水平的相关性，采用多因素Logistic回归分析老年人病毒性肺炎严重程度的影响因素。结果低危组、中危组和高危组患者的HMGB1、TNF-α和IL-6水平显著高于对照组，且随着疾病严重程度的升高，HMGB1、TNF-α和IL-6水平显著升高(均P<0.05)；重症病毒性肺炎组患者的HMGB1、TNF-α和IL-6水平显著高于非重症病毒性肺炎组患者(均P<0.05)。病毒性肺炎患者HMGB1、TNF-α和IL-6水平与CURB-65评分和PSI评分均呈正相关性(CURB-65评分：r＝0.463、0.392、0.497，P＝0.015、0.003、0.025；PSI评分：r＝0.596、0.515、0.381，P＝0.007、0.011、0.009)。HMGB1、TNF-α和IL-6是影响老年人病毒性肺炎严重程度的影响因素(OR＝1.344、1.422、1.351，P＝0.006、0.015、0.009)。结论HMGB1、TNF-α和IL-6水平与病毒性肺炎患者的严重程度密切相关，有助于早期评估病毒性肺炎的病情。

简介：摘要目的研究脊髓白介素33(IL-33)在非压迫性腰椎间盘突出症神经根性疼痛大鼠模型中的作用。方法选取成年雄性SD大鼠80只，随机分为假手术组、模型组、空载慢病毒组、IL-33重组慢病毒低剂量组、IL-33重组慢病毒高剂量组，每组16只。模型组、空载慢病毒组、IL-33重组慢病毒低剂量组与高剂量组建立非压迫性腰椎间盘突出症模型，假手术组仅暴露手术部位。建模后第3天，模型组、空载慢病毒组、IL-33重组慢病毒低剂量组与高剂量组四组分别鞘内注射感染增强液10 μl、空载慢病毒10 μl、IL-33重组慢病毒混合液5 μl＋感染增强液5 μl、IL-33重组慢病毒混合液10 μl，于建模前1天和建模后第1、3、5、7、9、11、13、15、17、19、21天检测各组大鼠术侧50%缩足阈值(50% PWT)，并在建模后第12天检测脊髓IL-33蛋白和mRNA的表达情况。结果建模后，模型组和空载慢病毒组大鼠脊髓IL-33蛋白和mRNA的表达量均明显增高(P<0.01)，而IL-33重组慢病毒低剂量组和高剂量组大鼠脊髓IL-33蛋白和mRNA的表达量较空载慢病毒组显著下降(P<0.01)。建模后，模型组、空载慢病毒组、IL-33重组慢病毒低剂量组和高剂量组大鼠术侧50% PWT较建模前1天均明显下降(P<0.01)。建模后第9～21天，IL-33重组慢病毒低剂量组和高剂量组术侧50% PWT较模型组和空载慢病毒组显著升高(P<0.01)。大鼠脊髓腰段免疫荧光结果显示，相比假手术组，模型组脊髓背角中的IL-33蛋白表达明显增加，而鞘内给予IL-33重组慢病毒5 μl或10 μl均可显著下调脊髓背角中IL-33蛋白的表达。结论腰椎间盘突出髓核可致大鼠脊髓的IL-33表达上调，参与椎间盘源性神经根性疼痛的发生和发展。

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简介：AbstractObjective:To evaluate the ability of cervical length (CL) at 28-32 weeks of gestation to predict spontaneous preterm delivery and preterm premature rupture of membranes (PPROM).Methods:It was a retrospective cohort study that vaginal ultrasonography at approximately 28-32 weeks of gestation was performed in 14,953 women between 17-49 years old with singleton pregnancies who delivered after 28 weeks of gestation at the Peking University First Hospital from June 2008 to December 2012. The pregnancy outcomes were followed and the relationship between the CL and preterm delivery or PPROM was assessed. The relative risk was calculated to assess group differences in the likelihood of an event occurring.Results:The overall prevalence of preterm delivery was 5.7% (858/14,953); the incidence for therapeutic preterm delivery was 2.1% (318/14,953), for spontaneous preterm delivery was 0.9% (133/14,953), and for PPROM was 2.7% (407/14,953). Excluding the 318 women who had therapeutic preterm delivery, the relative risk of preterm delivery for women with a CL between 25 mm and <30 mm, between 15 mm and <25 mm, and <15 mm was 3.7, 9.3, and 30.2, respectively. The sensitivity, specificity, and positive and negative predictive values of CL ≤25 mm at 28-32 weeks of gestation as the cut-off value for predicting preterm delivery were 19.8%, 97.5%, 23.4%, and 96.9%, respectively. For preterm delivery before 35 weeks of gestation, the sensitivity, specificity, and positive and negative predictive values of a CL ≤ 25 mm at 28-32 weeks of gestation as the cut-off value were 30.0%, 97.2%, 11.8%, and 99.1%, respectively. In addition, women with PPROM (n = 407) had significantly shorter CL (31.9 ± 7.4) mm at 28-32 weeks of gestation compared that of women without PPROM (34.0 ± 8.3) mm. The incidence of PPROM in women with a CL ≤25 mm at 28-32 weeks of gestation (19.4%, 79/407) was significantly lower than that for women with a CL >25 mm (80.6%, 328/407, P < 0.05).Conclusion:CL at 28-32 weeks of gestation can predict spontaneous preterm delivery, and is valuable for predicting PPROM.

简介：AbstractBackground:To explore central nervous system (CNS) involvement in this disease, from the perspectives of diagnosis, treatment, and misdiagnosisMethods:Twenty-eight patients with CNS echinococcosis were included in this retrospective study, including 18 males (64.3%) and 10 (35.7%) females. The average age of all the patients were 23.5 years (ranged 4-60 years). Twenty-three (23) patients (82.1%) received the first surgical resection in our hospital. Five (5) patients (17.9%) gave up surgical treatment for multiple-organ hydatidosis and previous surgery history at other hospitals, and albendazole was applied for a long-term (3-6 months) adjunct therapy for the 5 patients. The average follow-up time was 8 years.Results:For the 28 patients, 23 cases received surgical treatments, and the diagnosis was confirmed by pathological examinations. The diagnosis of 4 cases of brain echinococcosis and 2 cases of spinal cord echinococcosis could not be confirmed, resulting in a misdiagnosis rate of 21.4% (6/28). For the pathological examination, a total of 17 cases were infected with Echinococcus granulosus (including 2 cases of spinal cord echinococcosis), and 6 cases were infected with Echinococcus alveolaris.Conclusion:The diagnosis should be specifically considered in endemic regions. The clinical features of CNS hydatidosis were intracranial space-occupying lesions. For the treatment, the surgical removal of cysts should be necessary. In addition, the adjuvant therapy with drug and intraoperative prophylaxis is also suggested. The misdiagnosis may have resulted from atypical clinical features and radiographic manifestations, as well as the accuracy of hydatid immunologic test.

简介：【摘要】目的：对异位妊娠患者应用阴道B超与腹部B超诊断的效果进行对比。方法：样本选取在我科住院治疗的，符合纳入和排除标准的异位妊娠患者132例，并分为参照组（采纳腹部B超检查）和观察组（采纳阴道B超检查）各66例，对比两组的效果。结果：就胚芽、附件包块、心血管搏动、宫内假孕囊等相关指标检出率而言，观察组分别为30.30%、93.94%、33.33%以及18.18%，均明显高于参照组的6.06%、63.64%、6.06%、3.03%，有统计学意义（χ2=13.338

简介：摘要：目的：探讨阴道B超与腹部B超诊断异位妊娠的价值。方法：收集

简介：【摘要】目的：观察对妇产科急腹症患者实施腹部B超与阴道B超联用的诊断价值。方法：从2019年10月至2021年6月择取50例妇产科急腹症患者，所选患者均实施腹部B超检查、阴道B超检查、腹部B超与阴道B超联合检查，对照病理检查结果，分析三种检查方式的诊断结果。结果：经过病理检查，50例患者均确诊，其中30例异位妊娠、12例卵巢囊肿蒂扭转、6例黄体囊肿破裂、2例急性盆腔炎；在腹部B超检查中，38例患者确诊，其中23例异位妊娠、10例卵巢囊肿蒂扭转、4例黄体囊肿破裂、1例急性盆腔炎；在阴道B超检查中，42例患者确诊，其中26例异位妊娠、12例卵巢囊肿蒂扭转、2例黄体囊肿破裂、2例急性盆腔炎；在腹部B超与阴道B超联合检查中，49例患者确诊，其中30例异位妊娠、12例卵巢囊肿蒂扭转、5例黄体囊肿破裂、2例急性盆腔炎；腹部B超与阴道B超联合检查的诊断符合率高于单独腹部B超检查、阴道B超检查，误诊及漏诊率低于单独腹部B超检查、阴道B超检查，P

简介：【摘要】 目的 探讨血清铁调素(Hepcidin)联合骨髓铁染色及炎性介质白介素-6（IL-6)等在慢性病贫血诊断中的价值及相关性评价。方法 选取我院2018年1月至2020年12月以符合“慢性病贫血专家共识”的慢性病贫血（ACD）患者以及同期因单纯血小板减少做骨髓检查的患者作为研究对象，且所选患者骨髓铁染色外铁均为阳性(+～++++），按铁粒幼细胞的比例将ACD患者分为ACD1组（铁粒幼细胞≤15%）和ACD2组（铁粒幼细胞＞15%），把单纯血小板减少做骨髓检查的非贫血患者作为对照组，采集三组患者的血样检测血清铁调素（Hepcidin）、白介素-6（IL-6）、C反应蛋白(CRP)、血清铁（SI）、铁蛋白（Fer)、转铁蛋白受体（sTfR），记录所有检测数据，并将观察指标在三组间进行比较。结果 血清铁（SI）水平在ACD1组明显低于ACD2组和对照组，差异具有统计学意义（P＜0.001），ACD2组与对照组差异不明显（P＞0.05）；sTfR水平在ACD1组明显高于ACD2组和对照组，差异具有统计学意义（P＜0.001），ACD2组与对照组差异不明显（P＞0.05）；Fer、Hepc、IL-6、CRP水平在ACD1组明显高于ACD2组和对照组，差异具在统计学意义（P＜0.001），ACD2组明显高于对照组，差异有统计学意义（P＜0.05）； 相关性比较：血清铁调素水平与IL-6、CRP、Fer、sTfR水平呈正相关（P＜0.05），与SI呈负相关。结论 血清铁调素与患者体内铁的分布有密切的关系，是ACD患者的主要致病因素，联合其他铁代谢指标和炎性介质对ACD诊断及鉴别诊断具有重要的临床价值。

简介：AbstractBackground:Hepatitis B core-related antigen (HBcrAg) is a promising disease-monitoring marker for chronic hepatitis B (CHB). We investigated correlations between HBcrAg with antiviral efficacy and virological and histological variables.Methods:One hundred and forty-five CHB patients from the mainland of China between August 2013 and September 2016 who underwent liver biopsy received entecavir therapy and had paired liver biopsy at 78 weeks. We analyzed correlations between HBcrAg and virological and histological variables in hepatitis B e antigen (HBeAg)-positive and HBeAg-negative patients. We also explored the predictors of HBeAg loss after 78 weeks of antiviral therapy. Pearson correlation analysis and logistic forward stepwise regression were the main statistic methods.Results:HBeAg-positive patients (n = 93) had higher baseline HBcrAg (median 7.4 vs. 5.3 log10 U/mL P < 0.001) and greater HBcrAg declines (median 1.6 vs. 0.9 log10 U/mL P= 0.007) than HBeAg-negative patients after 78 weeks of therapy. At baseline, HBcrAg correlated with hepatitis B virus (HBV) DNA in both HBeAg-positive (r = 0.641, P < 0.001) and -negative patients (r = 0.616, P < 0.001), with hepatitis B surface antigen (HBsAg) in HBeAg-positive patients (r = 0.495, P < 0.001), but not with anti-hepatitis B virus core antibody (anti-HBc). Weak correlations existed between HBcrAg, histology activity index (HAI; r = 0.232, P= 0.025), and Ishak fibrosis score (r= -0.292, P= 0.005) in HBeAg-positive patients. At 78 weeks, significant correlations existed only between HBcrAg and anti-HBc in HBeAg-positive (r = -0.263, P = 0.014) and HBeAg-negative patients (r= -0.291, P= 0.045). Decreased HBcrAg significantly correlated with reduced HBV DNA (r= 0.366, P= 0.001; r= 0.626, P < 0.001) and HBsAg (r = 0.526, P = 0.001; r = 0.289, P = 0.044) in HBeAg-positive and -negative patients, respectively, and with reduced HAI in HBeAg-positive patients (r = 0.329, P = 0.001). Patients with HBeAg loss (n = 29) showed a larger reduction in HBcrAg than those without (median 2.3 vs. 1.3 log10 U/mL, P = 0.001). In multivariate analysis, decreased HBcrAg was an independent predictor of HBeAg loss (P = 0.005).Conclusions:HBcrAg reflects viral replication and protein production. Decreased HBcrAg could predict HBeAg loss after antiviral therapy.Trial registration:Clinical Trials.gov: NCT01962155; https://www.clinicaltrials.gov/ct2/show/NCT01962155?term=NCT01962155&draw=2&rank=1

简介：摘要：超声检查具有诸多优点,如没有副作用、操作方便、不会对身体带来创伤及可重复性好等,从其在临床中应用以来,在各科室疾病检查诊断中,尤其是妇产科,发挥着举足轻重的作用,并且已经成为首选检查方法。现阶段在对异位妊娠的诊断上首选超声检查方式，应用这一检查方式不但可以直观地显示胎儿宫内生长情况，而且可以从多角度展现胎儿形态，实现立体化的观察，且图像清晰度高可放大，如此便于早期发现胎儿畸形情况。

简介：摘要：目的：探讨28例消化道出血患者的临床效果以及护理要点。方法：随机分组，对照组患者采取的是常规护理措施，观察组患者采取的是综合护理措施，对比两组患者临床护理效果。结果：观察组患者实施综合护理干预后，总有效率为92.86%，观察组患者出血止血时间为（1.62±0.24）d。对照组患者实施综合护理干预后，总有效率为64.28%，对照组患者出血止血时间为（3.11±1.56）d，两组患者数据对比，差异显著（P＜0.05）。结论：对28例消化道出血患者实施综合护理干预，提高了患者临床护理效果，改善了患者临床症状，止血效果显著，提升了患者护理满意度。

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