目的 探讨外周血嗜酸性粒细胞(EOS)计数在术后静脉血栓中的应用价值及与凝血功能和血小板(PLT)的关系.方法 选取2018年1月至2019年6月于本院收治的360例术后静脉血栓患者(VTE组)和360例健康体检者(对照组)临床资料进行回顾性分析.其中EOS计数和PLT计数用SysmexXN-2000全自动血细胞分析仪检测;凝血功能指标包括血浆凝血酶原时间(PT)、活化部分凝血活酶时间(APTT)、凝血酶时间(TT)、纤维蛋白原(FIB)和D-二聚体(D-D),用STAGO-COM-PACT全自动血凝仪检测.结果 对照组和VTE组术前EOS计数绝对值比较差异无统计学意义(P＞0.05);与术前比较,术后VTE组EOS计数绝对值明显升高,差异有统计学意义(P＜0.05).ROC曲线分析发现,术后EOS计数绝对值诊断VTE的敏感度和特异度分别为74.6％和70.5％;EOS计数绝对值可预测DVT并发PTE,其敏感度和特异度分别为78.4％和74.6％.术后EOS计数、PLT计数和凝血功能指标在DVT不同分期上比较,差异有统计学意义(P＜0.05).经Spearman相关分析,EOS计数绝对值与PLT计数、APTT和TT呈正相关(P＜0.05),与PT、INR、FIB和D-D呈负相关(P＜0.05).结论 外周血EOS计数在术后静脉血栓中异常表达,与DVT类型和分期密切相关,有望成为诊断术后静脉血栓和预测DVT并发VTE的有效指标,具有一定临床参考价值.

Regenerating islet-derived protein 1-alpha (REG1A) was abnormally upregulated in a series of gastrointestinal inflammatory disorders. However, the potential biological function and underlying regulatory mechanisms of the increased REG1A in inflammatory bowel disease (IBD) pathogenesis remain to be fully elucidated. In this study, we uncovered that REG1A was substantially increased in the inflamed colorectal tissues of IBD patients. And the aberrantly expressed REG1A in intestinal epithelial cells (IEC) prominently inhibited inflammatory responses, promoted cell proliferation and suppressed epithelial apoptosis. Mechanically, IL-6 and IL-22 markedly activated REG1A transcription through triggering JAK/STAT3 signaling pathway. In addition, overexpression of REG1A in mice by systematic delivery of REG1A lentivirus remarkably alleviated DSS-induced inflammatory injury and maintained the integrity of intestinal mucosal barrier. Taken together, our data demonstrated that the novel proliferative factor REG1A controlled by IL-6/IL-22-JAK-STAT3 signaling may provide a promising therapeutic target for patients with IBD.

目的 探讨实时荧光定量聚合酶链反应法(FQ-PCR)联合咽拭子快速培养法在疑似肺炎支原体(MP)感染患儿诊断中的应用价值.方法 选取2018年4月至2020年3月就诊于驻马店市第一人民医院的100例疑似MP感染患儿,以间接荧光免疫法测定MP-IgM表达,同时取咽拭子样本行FQ-PCR法、快速培养法检测.以血清学检测为"金标准",记录检测结果并分析不同检测方法准确度、特异度、灵敏度、阳性预测值、阴性预测值,同时比较MP-IgM阳性、阴性患儿MP-DNA拷贝数.结果 联合检测特异度、阳性预测值(85.37％、90.48％)与单一FQ-PCR法检测(90.24％、91.67％)及快速培养法检测(85.37％、88.24％)对比,差异无统计学意义(P>0.05).联合检测灵敏度、准确度、阴性预测值(96.61％、92.00％、94.59％)较单一FQ-PCR法检测(74.58％、81.00％、71.15％)、快速培养法检测(76.27％、80.00％、71.43％)高(P<0.05).MP-IgM阳性患儿MP-DNA拷贝数较阴性患儿高(P<0.05).结论 咽拭子快速培养法联合FQ-PCR法在疑似MP感染患儿诊断中具有较高的灵敏度、准确度、阴性预测值,且荧光拷贝数越高对诊断MP感染越有利,可为临床明确MP感染和早期治疗提供依据.

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Objective To determine the levels of serum IL-6,IL-17,IL-18 and MCP-1 and the diagnostic value of the combination detection of IL-6,IL-17,IL-18 and MCP-1 on CoxB-VMC. Methods The 158 patients with VMC were selected as the experiment group and 94 healthy persons were selected as the control group. The serum CK-MB and cTnT were tested by electrochemolumines-cence assay,while the levels of IL-6,IL-17,IL-1,MCP-1 and CoxB IgM antibody were detected by ELISA assay. Results The serum levels of CK-MB,cTnT,IL-6,IL-17,IL-18 and MCP-1 in patients with VMC were(27. 90 ±4. 72),(0. 37 ± 0. 02),(361. 60 ± 45. 39),(445. 70 ± 67. 97),(168. 60 ± 35. 87)and(376. 20 ± 49. 50)ng / L respectively,which were significantly higher than those of healthy persons(P < 0. 01). The CoxB virus infection in VMC patients was positively correlated with the heart function classification,IL-17,IL-18,IL-6 and MCP-1 levels(P < 0. 05). The combined detection of IL-6,IL-17, IL-18 and MCP-1 can significantly improve the sensitivity ( 97. 30% ), specificity (94. 60% )and accuracy(96. 70% )of CoxB-VMC detection. Conclusions The serum levels of IL-6, IL-17,IL-18 and MCP-1 in acute phase can reflect the cardiac function of patients with CoxB-VMC in certain extent,and the combined detection of these four indicators can effectively enhance the clinical di-agnosis and assessment of CoxB-VMC.

Transmembrane tumor necrosis factor-α (tmTNF-α) is known to induce the activation of NF-κB to protect tumor cells. Upregulation of tmTNF-α leads to resistance to apoptosis and induces drug resistance in breast cancer. However, the expression of tmTNF-α in colorectal cancer (CRC) and its association with clinical outcome in CRC have remained unclear. In this study, we examined the tmTNF-α expression in CRC by immunohistochemistry and western blotting, assessed the prognostic value of tmTNF-α related to the recurrence/metastasis and survival of stage II/III CRC by the Kaplan-Meier survival curve and Cox regression model, and also explored the role of tmTNF-α expression on the chemotherapeutic efficacy of 5-Fluorouracil by flow cytometry assay and cell counting kit-8 (CCK-8) in vitro. Overall, we found that 77 (78.6%) out of 98 patients exhibited higher tmTNF-α expression in the CRC tissues comparing with the adjacent tissues. The tmTNF-α expression was correlated with Differentiation (P = 0.019), TNM stage (P = 0.039), Lymph nodes metastasis (P = 0.024) and Lymphovascular invasion (P = 0.027) but not related with Age (P = 0.617), Gender (P = 0.625), Tumor location (P = 0.138), Perforation/Obstruction (P = 1.000), Depth of invasion (P = 0.327), and microsatellite instability status (P = 0.150). The prognostic analyses showed that high tmTNF-α expression patients was significantly associated with decreased Disease-Free Survival (P = 0.0209) and Overall Survival (P = 0.0163). CCK-8 results suggested that the tmTNF-α influenced the chemotherapeutic effect of 5-Fluorouracil on colon cancer cells. Altogether, these data indicated the stageII/III CRC patients with high tmTNF-α expression were more likely to have a worse prognosis than patients with low tmTNF-α expression and tmTNF-α may influence the chemotherapeutic effect of 5-Fluorouracil. The mechanism for these observations warrants further study.

The aim of the present study was to evaluate the effects of thymidylate synthase (TYMS) and excision repair cross-complementing 1 (ERCC1) polymorphisms on chemotherapeutic efficacy in patients with gastrointestinal tumors using peripheral venous blood. Preoperative peripheral venous blood and tumor tissue samples of 43 patients with gastric cancer and the peripheral venous blood samples of 76 patients with cancer who underwent chemotherapy were studied. The 3R/3R and 2R/2R or 2R/3R genotypes of TYMS were identified in 72.09 and 27.91%, respectively (P<0.01), of untreated patients, and the C/C and T/T or C/T genotypes of ERCC1 were present in 81.39 and 18.61%, respectively (P<0.01), of patients. The 3R/3R and 2R/2R or 2R/3R genotypes of TYMS were identified in 65.79 and 34.21%, respectively, of chemotherapy-treated patients. The overall response rates (ORRs) for the two aforementioned genotypes were 18.00 and 57.69%, respectively (P<0.01), and those for the C/C and T/T or C/T genotypes of ERCC1 were 63.16 and 36.84%, respectively. The ORRs were 47.91 and 3.57%, respectively (P<0.01). In conclusion, peripheral blood samples may be used to replace tumor tissue for detecting TYMS and ERCC1 polymorphisms, and may be used to evaluate the efficacy of 5‐fluorouracil and platinum drugs.

The aim of the present study was to evaluate the effects of thymidylate synthase (TYMS) and excision repair cross-complementing 1 (ERCC1) polymorphisms on chemotherapeutic efficacy in patients with gastrointestinal tumors using peripheral venous blood. Preoperative peripheral venous blood and tumor tissue samples of 43 patients with gastric cancer and the peripheral venous blood samples of 76 patients with cancer who underwent chemotherapy were studied. The 3R/3R and 2R/2R or 2R/3R genotypes of TYMS were identified in 72.09 and 27.91%, respectively (P<0.01), of untreated patients, and the C/C and T/T or C/T genotypes of ERCC1 were present in 81.39 and 18.61%, respectively (P<0.01), of patients. The 3R/3R and 2R/2R or 2R/3R genotypes of TYMS were identified in 65.79 and 34.21%, respectively, of chemotherapy-treated patients. The overall response rates (ORRs) for the two aforementioned genotypes were 18.00 and 57.69%, respectively (P<0.01), and those for the C/C and T/T or C/T genotypes of ERCC1 were 63.16 and 36.84%, respectively. The ORRs were 47.91 and 3.57%, respectively (P<0.01). In conclusion, peripheral blood samples may be used to replace tumor tissue for detecting TYMS and ERCC1 polymorphisms, and may be used to evaluate the efficacy of 5-fluorouracil and platinum drugs.

Objective To investigate the application and clinical value of lipoprotein ( a) , homocysteine ( HCY) and hypersensitive c-reactive protein ( hsCRP ) in coronary heart disease ( CHD ) . Methods According to the different clinical types, two hundrad and eighty-four patients with coronary heart disease ( CHD) were divided into three groups ( stable angina pectoris group, unstable angina pectoris group and myocardial infarction group) , and 209 cases of healthy people as the control group. The serum concentration levels of lipoprotein ( a) , HCY and hsCRP in each group were detec-ted through immunoturbidimetric assay. Results The concentration levels of lipoprotein (a), HCY and hsCRP in each CHD group were significantly higher than those in control group (P<0. 05). Meanwhile, the three factors combined detec-tion in coronary heart disease CHD group were significantly higher than that of single factor (P<0. 05). Conclusions Se-rum LP ( a) , HCY, HsCRP is closely correlated with the occurrence and development of coronary heart disease ( CHD) , and combined detection is helpful for the early detection, diagnosis and intervention of CHD. The three factors have impor-tant clinical value in prevention, risk assessment, and auxiliary diagnosis, and prognosis of CHD.

Objective To investigate the levels and clinical significance of matrix metalloproteinase-9(MMP-9), cellular fibronectin(c-Fn), matrix metalloproteinase inhibitors-1(TIMP-1), interleukin-6 and Fibrinogen(Fbg) in plas-ma of patients with early hematoma enlargement of cerebral hemorrhage , to provide the basis for screening the predic-tive indexes of early hematoma enlargement.Methods Eighty-six patients with cerebral hemorrhage from February 2010 to November 2012 in the first affiliated hospital of Zhengzhou university were randomly selected as subjects .The enzyme-linked immunosorbent assay ( ELISA) was used to determine the expression of MMP-9, c-Fn and TIMP-1, the electrochemi-cal luminescence was performed to identify IL-6 level, and the solidification(turbidity) method was applied to detect Fbg content in patient plasma .Results Brain CT testing for 78 individuals at the onset of the disease within 24 hours in 86 pa-tients were shown that 19 cases with hematoma enlargement , the incidence was 24.36%, and the incidence of irregular he-matoma in intracerebral hematoma enlargement group ( 47.3%) was obviously higher than that of no-enlarged group (8.5%), the difference was significant(P<0.05).The Fbg level in hematoma enlargement group and no-enlarged group was(2.8 ±0.7)g/L and(2.3 ±0.6)g/L, respectively(P <0.05), and the IL-6 level was(21.6 ±8.1)pg/ml and (14.7 ±5.6)pg/ml(P<0.05).There was no significant difference in MMP-9, c-Fn TIMP-1 between the enlargement group and no-enlarged group(P>0.05).Conclusions Levels of Fbg, IL-6 and MMP-9 have strong correlation with in-tracerebral hematoma enlargement , but the relativity between c-Fn, TIMP-1 and hematoma enlargement is comparatively no obvious.The data provid us the theoretical basis of exploring the early hematoma enlargement in intracerebral hemorrhage .

Objective To investigate the distribution and antibiotic resistance of pathogens among patients with lower respiratory tract infection in intensive care unit (ICU). Methods The bacterial spectrum and drug resistance of 239 patients with lower respiratory tract infection in ICU from January to May 2012 were analyzed, retrospectively. Results Total of 177 pathogens were identified from the sputum in 160 patients, including the gram-negative bacteria (76.8%, 136/177), the gram-positive bacteria (15.3%, 27/177) and the fungus (7.9%, 14/177). The most common pathogens in low respiratory tract were Acinetobacter baumannii (32.5%, 53/163), Pseudomonas aeruginosa (23.3%, 38/163), Staphylococcus aureus (16.6%, 27/163) and Klebsiella pneumoniae (9.2%, 15/163). Sixteen patients were multiple infection (11.0%, 16/146) and most of them (56.2%, 9/16) were Staphylococcus aureus and the gram-negative bacteria co-infection. Among the 17 kinds of antibiotics applied, the resistance rates of Acinetobacter baumannii to16 kinds of antibiotics and Pseudomonas aeruginosa to 14 kinds of antibiotics were higher than 68%and 55%, respectively. Among the 16 kinds of antibiotics applied, Klebsiella pneumoniae and Escherichia coli had higher than 60%resistance rates to 14 and 13 kinds of antibiotics, respectively. Among the 12 kinds of antibiotics used, Staphylococcus aureus had higher than 74%resistance rate. Conclusions The gram-negative bacteria were the major pathogens and Acinetobacter baumannii ranked the ifrst. Gram-negative bacilli and gram-positive cocci showed wide resistance to drugs, the Acinetobacter baumannii were only sensitive to minocycline, the pseudomonas aeruginosa and enterobacteriaceae were only sensitive to imipenem, and Staphylococcus aureus were only sensitive to vancomycin. The monitoring of drug-resistance of pathogenic bacteria should be strengthened in ICU, which could provide proof to antibiotics application for clinical rational.

目的:探讨胃癌患者手术前后血清标志物的变化及其临床意义。方法:用电化学发光法检测了胃癌患者手术前后、胃良性疾病患者和对照组血清CA72-4、CA19-9、CA125、CA50水平。结果:胃癌患者血清中四种肿瘤标志物阳性检出率均高于胃良性疾病组(P<0.05)和正常对照组(P<0.01)。胃癌患者TNM分期越高,其血清四种肿瘤标志物的水平也越高。结论:血清CA72-4、CA19-9、CA125和CA50是用于胃癌血清学诊断较好的肿瘤标志物,其水平与肿瘤的浸润及转移密切相关,动态观察其含量的变化对胃癌患者病情判断及预后具有一定的临床价值。

丙型肝炎与乙型肝炎存在着共同的传播途径,由于临床上存在着消毒不严,相关性防治措施不利等原因,使丙型肝炎与乙型肝炎重叠感染逐渐增多,造成临床治疗困难,已愈来愈引起临床高度重视.我们对400例丙型肝炎病毒(HCV)感染者和470例正常体检者的血清分别做了乙型肝炎病毒(HBV)5种标记物的检查,并对其相关性加以分析探讨,报告如下.

前列腺特异性(Prostate Specific antigen,PSA)作为前列腺癌最有价值的肿瘤标志物,在临床上研究较多.但它在精浆中的含量与精液液化的关系研究的并不多.我们选择门诊迟缓液化组不孕症患者20例,正常液化对照组20例,对其精浆中前列腺特异性抗原的含量进行了测定,分析了PSA对精液液化的关系如下.