简介:目的探讨甲型H1N1流感患者心脏损害的特点。方法回顾性研究分析2009年7月至2010年1月期间确诊为甲型H1N1流感患者172例的临床资料,所有患者根据病情分为轻症组,重症组,危重症组,并收集非甲型H1N1流感患者21例作为对照。大部分患者接受分子生物学检测磷酸肌酸激酶,磷酸肌酸激酶同工酶,高敏C反应蛋白,并接受胸部X线摄片检查,计算心胸比。结果甲型H1N1流感多发生于青壮年患者,轻症患者较重症患者更年轻(P<0.05)。在危重症患者中,磷酸肌酸激酶,磷酸肌酸激酶同工酶,高敏C反应蛋白和心胸比均较其他组高(P<0.05或P<0.01)。1例死于心肌损害。结论与既往研究相符,2009甲型H1N1流感可以导致心肌损害,特别是在危重症患者中心肌损害较显著,从而将导致心脏扩大等损害,导致死亡率升高。
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简介:【摘要】目的:探讨接种甲型 H1NI流感疫苗的应用效果和价值。方法:选取 120例 2015年 8月— 2016年 8月间在我院接种甲型 H1NI疫苗人员为接种组,按照年龄、性别、疾病匹配选取未接种甲型 H1NI流感疫苗者 120例为对照组。调查接种组在接种疫苗后 90d内的甲型 H1NI流感及其他流感样疾病发生的情况,在疫苗接种后 48h内的不良反应发生情况。结果:接种组 90d内甲型 H1N1流感发病率为 0%,未有就诊记录。对照组甲型 H1N1流感发病率及就诊率为 7.3%,两组差异有统计学意义( P< 0.05);接种组在疫苗接种后 90d内的流感保护率为 100%,就诊率减少 100%。接种组的其他流感疾病发生率为 15%,就诊率为 8.3%,对照组为 22.7%和 16.3%,差异有统计学意义( P< 0.05);接种组在 90d内其他流感疾病保护率为 33.9%,减少就诊 49.4%,共出现 8例不良反应,占比 6.7%,症状较轻。结论:接种甲型 H1N1疫苗可见明显的流感预防效果,具备安全性。
简介:AIMToinvestigatetherolesandinteractionsofmutThomolog(MTH)-1andhypoxia-induciblefactor(HIF)-1αinhumancolorectalcancer(CRC).METHODS:TheexpressionanddistributionofHIF-1αandMTH-1proteinsweredetectedinhumanCRCtissuesbyimmunohistochemistryandquantitativerealtimepolymerasechainreaction(qRT-PCR).SW480andHT-29cellswereexposedtonormoxiaorhypoxia.ProteinandmRNAlevelsofHIF-1αandMTH-1wereanalyzedbywesternblottingandqRT-PCR,respectively.InordertodeterminetheeffectofHIF-1αontheexpressionofMTH-1andtheamountof8-oxodeoxyguanosinetriphosphate(dGTP)inSW480andHT-29cells,HIF-1αwassilencedwithsmallinterferingRNA(siRNA).GrowthstudieswereconductedoncellswithHIF-1αinhibitionusingaxenografttumormodel.Finally,MTH-1proteinwasdetectedbywesternblottinginvivo.RESULTS:HighMTH-1mRNAexpressionwasdetectedin64.2%ofcases(54/84),andthiswassignificantlycorrelatedwithtumorstage(P=0.023)andsize(P=0.043).HIF-1αproteinexpressionwascorrelatedsignificantlywithMTH-1expression(R=0.640;P〈0.01)inhumanCRCtissues.HypoxicstressinducedmRNAandproteinexpressionofMTH-1inSW480andHT-29cells.InhibitionofHIF-1αbysiRNAdecreasedtheexpressionofMTH-1andledtotheaccumulationof8-oxo-dGTPinSW480andHT-29cells.Intheinvivoxenografttumormodel,expressionofMTH-1wasdecreasedintheHIF-1αsiRNAgroup,andthetumorvolumewasmuchsmallerthanthatinthemocksiRNAgroup.CONCLUSION:MTH-1expressioninCRCcellswasupregulatedviaHIF-1αinresponsetohypoxicstress,emphasizingthecrucialroleofHIF-1α-inducedMTH-1intumorgrowth.
简介:摘要目的研究分析奥司他韦(达菲)联合扎那米韦治疗新型甲型H1N1流感的方法及临床效果。方法此次研究的对象是选取2017年4月-11月,我院收治的新型甲型H1N1流感患者22例,临床采用抗病毒药物治疗,总结临床资料。结果对比分析患者用药治疗前后咽痛、呼吸急促症状的评估,评估分低于25分表示患者各项指标恢复正常,患者经治疗前咽痛症状的评估分为38.85-4.75,经治疗后咽痛症状的评估分为22.55-3.35,治疗后的评估分明显低于治疗前,p<0.05,治疗前患者呼吸急促症状评估的评估分为39.65-3.85,治疗后患者呼吸急促症状评估的评估分为23.35-2.25,治疗后的评估分明显低于治疗前,p<0.05,通过两项指标的对比评估,说明治疗效果显著。结论临床通过奥司他韦(达菲)联合扎那米韦药物的治疗有效的改善了患者的临床症状,降低了患者因发热引起的头痛,提高了患者的生活质量。
简介:通过对危重症甲型H1N1流感患儿的救治,笔者体会到随着突发性公共卫生事件的不断发生,新的传染病不断出现,作为一所综合医院,必须培养出一支经过严格培训,具有较强的应急能力、指挥协调能力、危重患儿抢救能力的护理队伍,并制定对突发公共事件应急预案,各方面资源合理配置、保障体系完善、信息资源充分利用都是处理和应对突发性公共卫生事件的重要因素。
简介:AbstractBackground:Macrophages play an important role in renal ischemia reperfusion injury, but the functional changes of macrophages under hypoxia/reoxygenation and the related mechanism are unclear and need to be further clarified.Methods:The effects of hypoxia/reoxygenation on functional characteristics of RAW264.7 macrophages were analyzed through the protein expression detection of pro-inflammatory factors TNF-α and CD80, anti-inflammatory factors ARG-1 and CD206. The functional implications of C-X3-C motif chemokine receptor 1(CX3CR1) down-regulation in hypoxic macrophages were explored using small interfering RNA technology. Significance was assessed by the parametric t-test or nonparametric Mann-Whitney test for two group comparisons, and a one-way ANOVA or the Kruskal-Wallis test for multiple group comparisons.Results:Hypoxia/reoxygenation significantly increased the protein expression of M1-related pro-inflammatory factors TNF-α, CD80 and chemokine C-X3-C motif chemokine ligand 1 (CX3CL1)/CX3CR1 and inhibited the protein expression of M2-related anti-inflammatory factors ARG-1 and CD206 in a time-dependent manner in RAW264.7 cells. However, the silencing of CX3CR1 in RAW264.7 cells using specific CX3CR1-siRNA, significantly attenuated the increase in protein expression of TNF-α (P < 0.05) and CD80 (P < 0.01) and the inhibition of ARG-1 (P < 0.01) and CD206 (P < 0.01) induced by hypoxia/reoxygenation. In addition, we also found that hypoxia/reoxygenation could significantly enhance the migration (2.2-fold, P < 0.01) and adhesion capacity (1.5-fold, P < 0.01) of RAW264.7 macrophages compared with the control group, and CX3CR1-siRNA had an inhibitory role (40% and 20% reduction, respectively). For elucidating the mechanism, we showed that the phosphorylation levels of ERK (P < 0.01) and the p65 subunit of NF-κB (P < 0.01) of the RAW264.7 cells in the hypoxic/reoxygenation group were significantly increased, which could be attenuated by down-regulation of CX3CR1 expression (P < 0.01, both). ERK inhibitors also significantly blocked the effects of hypoxic/reoxygenation on the protein expression of M1-related pro-inflammatory factors TNF-α, CD80 and M2-related anti-inflammatory factors ARG-1 and CD206. Moreover, we found that conditioned medium from polarized M1 macrophages induced by hypoxia/reoxygenation, notably increased the degree of apoptosis of hypoxia/reoxygenation-induced TCMK-1 cells, and promoted the protein expression of pro-apoptotic proteins bax (P < 0.01) and cleaved-caspase 3 (P < 0.01) and inhibited the expression of anti-apoptotic protein bcl-2 (P < 0.01), but silencing CX3CR1 in macrophages had a protective role. Finally, we also found that the secretion of soluble CX3CL1 in RAW264.7 macrophages under hypoxia/reoxygenation was significantly increased.Conclusions:The findings suggest that hypoxia/reoxygenation could promote M1 polarization, cell migration, and adhesion of macrophages, and that polarized macrophages induce further apoptosis of hypoxic renal tubular epithelial cells by regulating of CX3CL1/CX3CR1 signaling pathway.
简介:摘要目的探讨细胞质动力蛋白1重链1(DYNC1H1)基因相关下肢明显型脊髓性肌萎缩症(SMALED)1型患儿的临床特征及基因变异特点。方法收集2018年12月至2021年5月北京大学第一医院收治的经基因检测发现DYNC1H1基因致病性变异的4例SMALED1型患儿病例资料,均除外已知与运动发育落后相关的其他基因变异,回顾性分析临床表现和基因型特点。结果4例患儿中男3例、女1例,起病年龄分别为1岁、1日龄、1日龄和4月龄,确诊年龄分别为4岁10月龄、9月龄、5岁9月龄和3岁1月龄。临床表现均存在下肢为主的肌无力、肌萎缩,2例合并足畸形,1例合并早期非进展性关节挛缩,1例合并髋关节脱位,1例合并智力障碍。4例患儿均发现DYNC1H1基因新生杂合错义变异,根据美国医学遗传学与基因组学学会评级为可能致病和致病性变异,其中p.R598C、p.P776L、p.Y1109D变异已报道,p.I1086R变异尚未见文献报道。结论对于婴儿期出现不明原因下肢肌无力、肌萎缩、关节挛缩及足畸形、上肢运动能力保留、伴或不伴智力障碍,运动能力缓慢进展者,需考虑SMALED1型可能,必要时完善DYNC1H1基因检测。
简介:目的研究探讨S100A1、人源葡萄糖转运蛋白(GLUT-1)及微囊蛋白1(Caveolin-1)在嗜酸细胞性肾癌中的表达意义。方法选取2014年2月至2016年2月该院诊治的嗜酸细胞性肾癌患者86例,其中肾嗜酸细胞瘤(RO)组25例、嗜酸型透明细胞性细胞瘤(CCRCC)21例、嗜酸型嫌色细胞癌(ChRCC)15例、嗜酸型乳头状肾癌(PRCC)13例、上皮样血管平滑肌脂肪瘤(EAML)12例。应用组织芯片技术联合免疫组织化学法对S100A1、GLUT-1及Caveolin-1在各组患者体内的表达情况进行检测。结果S100A1在ChRCC组中的阳性表达率显著低于其余各组,差异有统计学意义(P〈0.05);GLUT-1在CCRCC组中的阳性表达率显著高于其余各组,差异有统计学意义(P〈0.05);Caveolin-1在EAML组中阳性表达率显著高于RO组及ChRCC组,差异有统计学意义(P〈0.05)。S100A1诊断RO、EAML的敏感性较高,GLUT-1诊断CCRCC的敏感性较高,Caveolin-1诊断EAML的敏感性及特异性均较高。结论S100A1可用于临床上对RO的鉴别诊断,GLUT-1可用于CCRCC的鉴别诊断,而Caveolin-1可用于鉴别诊断EAML。
简介:目的报告GFM1突变所致疾病的临床特征及验证基因型和临床表型关系。方法回顾性分析1例门诊就诊的GFM1基因突变儿童的临床及基因突变资料,结合文献归纳GFM1基因突变的临床特点,构建编码线粒体翻译因子G1(mtEFG1)空间结构图,检验GFM1基因错义突变位置与临床表型关系的假说。结果患儿,女,6个月28d。生长发育迟缓,急性肝衰竭。体格检查:反应差,嗜睡,全身皮肤黏膜黄染,腹平软,肝脾肿大。辅助检查:总胆红素、直接胆红素、转氨酶、碱性磷酸酶、血清γ-谷氨酰转肽酶和血氨升高,白蛋白下降,凝血酶原时间延长,血糖下降,酸中毒,血乳酸升高,血浆氨基酸及酰基肉碱谱示血中多种氨基酸升高,尿有机酸检查提示酮尿,头颅MRI示双侧丘脑、大脑脚、基底节区、枕叶前内侧异常信号。GFM1基因的复合杂合突变,第5外显子c.688G〉A点突变致蛋白质改变为p.Gly230Ser;第14外显子c.1686delG的移码突变致蛋白质改变为p.Asp563Thrfs*24。mtEFG1空间结构图显示,p.Gly230Ser处于蛋白周边位置,预测表现应该为脑型。结论1例携带GFM1基因复合杂合突变(c.688G〉A和c.1686delG)的中国儿童,其临床表现为急性肝衰竭,不支持以往GFM1基因错义突变导致蛋白周边位置的氨基酸改变时临床表现为脑型的假设。