简介:【摘要】 20 世纪 90 年代后期,深静脉置管技术在我国逐渐开始应用,主要适用于危重病人抢救、血液透析、血浆置换术、药物治疗(化疗、高渗、刺激性)、胃肠外营养、中心静脉压监测等方面。由于保留时间长、输液种类广、导管弹性好而广泛应用于临床。随着小儿外科的飞速发展,深静脉置管在儿科领域被逐渐应用,由于普外科患儿胃肠道术后长期禁食,需长期输注静脉高营养液维持,本身患儿外周表浅静脉较细小、在术后、禁食、脱水等危重状态下极易发生周围循环衰蝎而导致外周静脉瘪陷 , 进而增加了静脉穿刺的难度 , 尤其是婴幼儿通过外周小静脉建立通道非常困难,长期输注静脉高营养液容易发生输液渗漏及肿胀,导致延误治疗,应用深静脉置管术建立静脉通道 , 在小儿普外科取得了较为满意的疗效。由于颈外静脉置管属于有创性操作,所以疗效背后出现的并发症也是不可避免的,本院出现 2 例颈外静脉置管穿刺成功后因导管移位至导致胸腔积液的发生。现报告如下。
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简介:摘要目的分析2~7岁儿童功能性便秘的影响因素。方法采用病例对照研究方法,选取2019年5月20日至2019年9月20日在北京大学第三医院儿科就诊的2~7岁功能性便秘儿童及同期同年龄健康对照儿童为研究对象。通过问卷研究对象收集一般情况、排便情况及可能影响便秘产生的因素,包括0.5岁内抗生素使用、乳儿期喂养情况、饮食偏好、运动、过敏相关病史、父母病史、家庭收入、主要看护人等信息,采用二元Logistic回归模型分析功能性便秘的影响因素。结果共纳入研究对象203例,其中便秘组儿童81例,健康对照组122例。粪便粗大、粪便干结、排便疼痛和排便次数减少是功能性便秘最常见的症状。添加辅食及上幼儿园是该年龄段儿童出现功能性便秘最常见的诱因。单因素分析发现,6月龄内应用抗生素史、挑食偏食习惯、运动量及变应性疾病、便秘相关家族史及父亲变应性疾病背景、主要看护人是否为父母差异均有统计学意义(均P<0.05)。二元Logistic回归分析显示,父亲有变应性疾病病史(OR=2.302,95%CI:1.109~4.780)、0.5岁内应用抗生素(OR=2.300,95%CI:1.053~5.022)、父母有便秘病史(OR=2.151,95%CI:1.106~4.128)及偏好主食的饮食习惯(OR=3.526,95%CI:1.402~8.867)是2~7岁儿童发生功能性便秘的影响因素。结论父母有便秘病史、父亲有变应性疾病病史及偏好主食的饮食习惯可能是功能性便秘发生的影响因素。
简介:摘要目的分析肺部磨玻璃结节随访中的变化和干预情况,探讨肺部磨玻璃结节的生长规律。方法纳入2017年10月至2019年6月复旦大学附属中山医院门诊随访的肺部磨玻璃结节2 247例,其中男633例,女1 614例,平均年龄49.9岁。分析其随访过程中接受治疗的情况和结节变化情况。结果266例选择手术治疗,1 981例继续随访中。继续随访的患者随访(35.5±21.1)个月,中位随访29(12~165)个月;手术患者随访(19.5±18.5)个月,中位随访13(3~97)个月。手术的266例患者中,19例磨玻璃结节进展,166例磨玻璃结节未进展,81例未知是否进展,在外院手术。结节进展和未进展的患者术后病理和手术方式无显著差异,进展组纯磨玻璃结节的基线最大径明显大于未进展组[(1.3±0.5)cm对(0.9±0.4)cm,P=0.038]。结论磨玻璃结节进展缓慢,进展后再进行手术并不影响手术的方式和效果。
简介:AbstractBackground:Immune- and inflammation-related genes (IIRGs) play an important role in the pathogenesis of tuberculosis (TB). However, the relationship between IIRG polymorphisms and TB risk remains unknown. In this study, the gene polymorphisms and their association with tuberculosis were determined in a Chinese population.Methods:We performed a case-control study involving 1016 patients with TB and 507 healthy controls of Han Chinese origin. Sixty-four single-nucleotide polymorphisms (SNPs) belonging to 18 IIRGs were genotyped by the PCR-MassArray assay, and the obtained data was analyzed with χ2-test, Bonferroni correction, and unconditional logistic regression analysis.Results:We observed significant differences in the allele frequency of LTA rs2229094*C (P = 0.015), MBL2 rs2099902*C (P = 0.001), MBL2 rs930507*G (P = 0.004), MBL2 rs10824793*G (P = 0.004), and IL12RB1 rs2305740*G (P = 0.040) between the TB and healthy groups. Increased TB risk was identified in the rs930507 G/G genotype (Padjusted = 0.027) under a codominant genetic model as well as in the rs2099902 (C/T + C/C) vs T/T genotype (Padjusted = 0.020), rs930507 (C/G + G/G) vs C/C genotype (Padjusted = 0.027), and rs10824793 (G/A + G/G) vs A/A genotype (Padjusted = 0.017) under a dominant genetic model after Bonferroni correction in the analysis of the overall TB group rather than the TB subgroups. Furthermore, the rs10824793_rs7916582*GT and rs10824793_rs7916582*GC haplotypes were significantly associated with increased TB risk (P = 0.001, odds ratio [OR] = 1.421, 95% confidence interval [CI]: 1.152-1.753; and P = 0.018, OR = 1.364, 95% CI: 1.055-1.765, respectively). Moreover, the rs10824793_rs7916582*AT/AT or rs10824793_rs7916582*GT/GT diplotype showed a protective (P = 0.003, OR = 0.530, 95% CI: 0.349-0.805) or harmful (P = 0.009, OR = 1.396, 95% CI: 1.087-1.793) effect against the development of TB.Conclusions:This study indicated that MBL2 polymorphisms, haplotypes, and diplotypes were associated with TB susceptibility in the Han Chinese population. Additionally, larger sample size studies are needed to further confirm these findings in the future.
简介:摘要:目的 对脑梗死合并 2型糖尿病的临床诊治情况进行分析。方法 选取我院 2019年 1月至 2020年 2月间收治的脑梗死合并 2型糖尿病患者共 50例,将其设定为观察组,同期选取 50例脑梗死患者,将其设定为对照组,对比两组医学影像检查结果、血浆相关指标结果及治疗效果。结果 经头颅 CT和 MRI检查发现,观察组中单发性脑梗死 10例,腔隙性脑梗死 29例,多发性脑梗死 11例,对照组分别占 32例、 8例、 10例 ,两组数据差异较大,( P< 0.05)。观察组和对照组的总胆固醇、甘油三酯、高密度脂蛋白、全血低且还原黏度相比,数据差异较大,( P< 0.05)。观察组和对照组的治疗总有效率分别为 XX,数据差异大,( P< 0.05)。结论 临床采用头颅 CT和 MRI联合诊断脑梗死合并 2型糖尿病,利于疾病的治疗,此外,只有严格控制患者血糖水平、血脂黏度,才能提升疾病治疗效果。
简介:摘要目的探讨中心体相关蛋白激酶2(NEK2)和环氧合酶2(COX2)在前列腺癌组织的表达及两者与前列腺癌临床病理参数的关系。方法选取广东医科大学附属医院2013年2月至2019年9月收治的77例前列腺癌组织标本和27例前列腺增生组织标本作为研究对象,应用免疫组织化学法检测两者组织中NEK2和COX2的表达水平,结合临床资料进行相关统计学分析。各组间比较采用t检验。结果前列腺癌组织中的NEK2表达率明显高于前列腺增生组织NEK2表达率(61.43%比20.00%,t= 10.702,P<0.01),NEK2表达水平与前列腺癌组织学分级、临床分期明显相关(t=8.901、9.848,P<0.05);前列腺癌组织中的COX2表达率明显高于前列腺增生组织COX2表达率(64.29%比15.00%,t= 15.182,P<0.01),COX2表达水平与前列腺癌组织学分级、精囊腺侵犯、临床分期明显相关(分别为t=9.043、4.400、10.536,P<0.05)。结论NEK2和COX2在前列腺癌组织中高表达,检测NEK2和COX2有助于判断前列腺癌患者恶性程度。
简介:【摘要】目的:观察分析在小儿流行性腮腺炎合并脑膜脑炎治疗中应用干扰素 α-2b联合更昔洛韦治疗的临床效果。方法:选取 2018年 3月至 2019年 5月我院收治的流行性腮腺炎合并脑膜脑炎患儿 80例随机分为对照组和观察组,各 40例。对照组单独行 干扰素α-2b治疗,观察组行干扰素 α-2b、更昔洛韦联合治疗,比较两组治疗效果和不良反应发生情况。结果:观察组治疗总有效率为 100.00%,对照组治疗总有效率为 80.00%,差异显著( P< 0.05);对照组中皮疹与白细胞减少等不良反应发生率显著低于观察组,差异显著( P< 0.05)。结论:流行性腮腺炎合并脑膜脑炎患儿经干扰素 α-2b联合更昔洛韦治疗的临床效果突出,且安全性高。
简介:摘要:自发布“中国学生发展核心素养总体框架”,中国学生的教育就由“三维目标”向“全面发展”的目标迈进。培养学生的核心素养就明确了促进学生的全面发展,即除了发展学生的语言能力外,还要注重学生的学习能力、思维品质和文化意识的培养,从而帮助他们更好地去适应将来的社会和生活。自此,课程改革的目标就由“能力”向“素养”的转变。在高中英语教学中,阅读是最重要的一个环节,能够促进学生的核心素养的养成,促进他们的全面发展。但是,面对英语学科核心素养,一线教师在进行阅读教学时,所展现的教师教学素养对学生“核心素养”的养成形成了直接的影响。对此,笔者进行了一些思考。
简介:AbstractObjective:In order to study the important role and molecular mechanism of Brevinin-2 family antimicrobial peptide Brevinin-2ISb in methicillin-resistant Staphylococcus aureus (MRSA) infection of Caenorhabditis (C.) elegans, and to find the optimal therapeutic concentration of Brevinin-2ISb.Methods:By using a C. elegans model and MRSA infection modelto study the therapeutic effect of different concentrations of Brevinin-2ISb on C. elegans. Real-time PCR was used for investigating the effect of Brevinin-2ISb on the downstream gene expression of DAF-2/DAF-16 innate immune pathway and the major virulence factor gene expression of MRSA. With protein activity tests to study the inhibitory effect of Brevinin-2ISb on MRSA virulence factor protein activity. Finally, laser confocal imaging was carried out to observe real-time expression and distribution of downstream antimicrobial proteins to further prove the effect of Brevinin-2ISb on the activation of DAF-2/DAF-16 pathway by in vivo imaging. All animal study procedures were approved by the Academic Committee at Xidian University and Xi’an Jiaotong University Animal Care and Use Committee, China (approval No. JGC201207) on July 15, 2017.Results:Host immunity was largely enhanced by Brevinin-2ISb, and the expression of staphylococcal enterotoxin genes, as well as virulence factors, was suppressed by Brevinin-2ISb. Indeed, the expression of many C. elegans innate immune genes, including lys-7, spp-1, K05D8.5 and C29F3.7, was induced by Brevinin-2ISb. In particular, robust, sustained expression of the antibacterial gene lys-7 was observed after Brevinin-2ISb treatment, resulting in increased protein levels. These effects correlated with a reduction in the MRSA-mediated death of the C. elegans host. Low concentrations of Brevinin-2ISb exhibited very low hemolytic activity, and may play a positive role in host innate immunity. Specifically, activation of the DAF-2/DAF-16 pathway appears to be essential for immune activation in C. elegans treated with Brevinin-2ISb. Based on the evolutionary conservation of innate immune pathways, our results suggest that Brevinin-2ISb not only has strong antibacterial activity, but may also enhance the innate immune response in humans. This study demonstrates that Brevinin-2ISb-related peptides are potential candidates for the development of novel anti-inflammatory or anti-microbial drugs.Conclusion:Antimicrobial peptide Brevinin-2ISb effectively inhibits MRSA at low concentration. This antimicrobial peptide can prolong the life of MRSA-infected C. elegans, has very low hemolytic activity and inhibits the activity and expression of various MRSA virulence factors. More importantly, Brevinin-2ISb activated the expression of antimicrobial genes downstream of DAF-2/DAF-16, which enhanced the MRSA resistance of C. elegans. This peptide could be used as the basis for developing new drugs to replace antibiotics.