The study analyzed the effect of leukocyte elastase (LE) in 460 semen on sperm quality, and explore the reference interval of normal level of LE in semen. The differences of LE levels between normal semen and few, weak and abnormal semen were analyzed. Referring to domestic standards, the samples were divided into normal group (LE ≤ 250 ng/mL), occult infection (250 < LE ≤ 1000 ng/mL), and infection group (LE > 1000 ng/mL), and the differences in semen quality among the groups were compared. According to European standards, the samples were divided into normal group (≤600 ng/mL) and abnormal group (>600 ng/mL), and the differences in semen quality between the 2 groups were compared. The correlation between LE levels in semen and semen quality were analyzed. The positive rates of LE in the normal semen group and abnormal semen groups were 30.7% versus 34.7%, and there was no significant difference between the two groups (P> .05). When the semen divided into 3 groups, there was no significant difference between the physicochemical parameters, kinetic parameters, movement trajectory parameters, morphological parameters, and sperm DNA fragmentation index (DFI) (P> .05). There were significant differences in sperm morphology and sperm DFI between the two groups at 600 ng/mL (P< .05). Spearman correlation analysis showed that there was no significant difference between the level of LE in semen and physicochemical parameters, sperm kinetic parameters, sperm movement trajectory parameters, sperm morphological parameters, and sperm DFI (P> .05). It is appropriate to use 600 ng/mL as the threshold for the concentration of LE in semen; the correlation between the level of LE and sperm quality is not significant.

目的 探讨血清同型半胱氨酸(Hcy)与白细胞介素-6(IL-6)在不同分期胃癌患者中的表达及临床意义.方法 选取2019—2021年福建省肿瘤医院收治的80例胃癌患者为研究对象,根据胃癌TNM分期标准将患者分为Ⅰ期组(31例)、Ⅱ期组(20例)、Ⅲ期组(19例)及Ⅳ期组(10例).对4组患者均进行血清Hcy、IL-6检测,比较4组患者血清中Hcy、IL-6表达情况,分析血清Hcy、IL-6表达与胃癌TNM分期的相关性.结果 Ⅰ期组血清Hcy、IL-6水平低于Ⅱ期组、Ⅲ期组及Ⅳ期组,Ⅱ期组血清Hcy、IL-6水平低于Ⅲ期组、Ⅳ期组,Ⅲ期组血清Hcy、IL-6水平均低于Ⅳ期组,差异有统计学意义(P<0.05);经Kendall's tau-b相关系数检验,血清Hcy、IL-6水平与胃癌临床分期成正相关(r>0,P<0.05).结论 不同临床分期胃癌患者血清Hcy、IL-6表达存在显著差异;血清Hcy、IL-6水平与胃癌临床分期具有明显的相关性,临床可将其作为诊断胃癌临床分期的参考指标.

目的 探讨血清降钙素原(PCT)联合C反应蛋白(CRP)检测在婴幼儿社区获得性肺炎(CAP)诊断中的应用价值.方法 选取2018年1月至2021年1月福建省第二人民医院收治的100例CAP婴幼儿作为试验组,选取同期医院50名健康体检婴幼儿作为对照组;测定所有研究对象的血清PCT、CRP水平,并分析血清PCT、CRP单独与联合检测诊断婴幼儿CAP的价值.结果 试验组血清PCT、CRP水平均高于对照组,差异有统计学意义(P<0.05);绘制ROC曲线,结果显示,血清PCT、CRP单独与联合检测诊断婴幼儿CAP的曲线下面积(AUC)分别为0.685、0.776、0.863,联合检测的诊断价值更高.结论 血清PCT联合CRP检测在婴幼儿CAP诊断中的应用价值较高,可为临床诊治提供参考依据.

目的 探讨唾液胃蛋白酶检测在咽喉反流(LPR)诊断及疗效评估中的应用价值.方法 选取2020年6月至2021年6月就诊于福建中医院大学附属第二人民医院耳鼻喉科门诊的116例咽喉不适患者为研究对象.所有患者均接受8周的质子泵抑制剂(PPI)诊断性治疗,治疗前后均接受症状体征评估[采用反流症状指数量表(RS I)与反流体征量表(RFS)评估]与唾液胃蛋白酶检测,最终有67例患者完成治疗.根据RSI与RFS评分进行疗效评估,治疗有效的46例患者纳入LPR组,治疗无效的21例患者纳入慢性咽喉炎组,比较唾液胃蛋白酶阳性率,唾液胃蛋白酶检测LPR的效能及与PPI诊断性治疗结果的一致性,以及两组治疗前后的RSI评分、RFS评分、唾液胃蛋白酶水平.结果 LPR组的唾液胃蛋白酶阳性率高于慢性咽喉炎组,差异有统计学意义(P<0.05);唾液胃蛋白酶检测诊断LPR的灵敏度为93.5％,特异度为71.4％,阳性预测值为87.8％,阴性预测值为83.3％;唾液胃蛋白酶检测结果与PPI诊断性治疗结果的一致性好(Kappa=0.675).治疗前,LPR组RSI评分、RFS评分、唾液胃蛋白酶水平均高于慢性咽炎组,差异均有统计学意义(P<0.05);治疗后,LPR组RSI评分、RFS评分、唾液胃蛋白酶水平均低于治疗前,差异均有统计学意义(P<0.05);但治疗后LPR组RFS评分和唾液胃蛋白酶水平仍高于慢性咽喉炎组,差异有统计学意义(P<0.05).结论 唾液胃蛋白酶检测对LPR具有较高的诊断价值,对疗效评估具有一定的意义,可为该病的诊断及疗效评估提供指导.

目的:研究同型半胱氨酸(Hcy)、D-二聚体(D-D)及糖基化血红蛋白(HbA1C)对糖尿病肾病的临床诊断价值.方法:回顾性收集2020年8月至2022年1月就诊或体检的80例糖尿病患者(观察组)和20例体检者(对照组)的资料.根据尿微量白蛋白和尿肌酐比值(ACR)进一步将观察组分为单纯糖尿病组(21例)、微量蛋白尿组(32例)和大量蛋白尿组(27例).观察Hcy、D-D、HbA1c水平在受试者中的不同,并分析各指标水平与尿蛋白水平的相关性,根据受试者工作特征曲线(ROC)评价Hcy、D-D、HbA1c在糖尿病肾病诊断中的临床价值.结果:单纯糖尿病组Hcy水平与对照组比较,差异无统计学意义(P>0.05);单纯糖尿病组D-D、HbA1c水平均高于对照组,差异有统计学意义(P<0.05);微量蛋白尿组、大量蛋白尿组Hcy、D-D、HbA1c水平均高于对照组,差异有统计学意义(P<0.05);单纯糖尿病组、微量蛋白尿组和大量蛋白尿组Hcy、D-D水平依次递增,差异有统计学意义(P<0.05);单纯糖尿病组和微量蛋白尿组HbA1c水平比较,差异无统计学意义(P>0.05),但两组HbA1c水平均低于大量蛋白尿组(P<0.05);进行Spearman相关分析,Hcy、D-D、HbA1c水平均与ACR呈正相关;ROC曲线分析显示以上三个指标联合检测的诊断性能良好.结论:Hcy、D-D、HbA1c参与糖尿病肾病的发生发展,对糖尿病肾病的早期诊断可推荐以上三个指标联合检测.

目的:探讨系统性红斑狼疮肾损害的危险因素及几种实验室指标诊断早期肾损害的价值.方法:回顾性收集2021年3～11月于福建中医药大学附属第二人民医院就诊或体检的280例患者或体检者的资料,其中220例系统性红斑狼疮(观察组)患者分为肾功能正常组(180例)和肾功能损害组(40例),60例体检者作为对照组.探讨各指标在受试者中的变化情况.采用Logistic回归分析影响系统性红斑狼疮患者发生肾损害的相关因素.采用受试者工作特征(ROC)曲线评价红细胞体积分布宽度(RDW)、抗ds-DNA抗体、抗C1q抗体对系统性红斑狼疮肾损害的诊断价值.结果:肾功能损害组RDW、抗C1q抗体、抗ds-DNA抗体水平均显著升高(P<0.05).Logistic回归分析结果显示RDW、抗C1q抗体、抗ds-DNA抗体水平升高是系统性红斑狼疮患者肾损害的独立危险因素.ROC曲线分析显示,三项指标联合检测的诊断性能最好.结论:RDW、抗C1q抗体、抗ds-DNA抗体水平升高是系统性红斑狼疮患者肾损害的独立危险因素,三项指标联合检测对系统性红斑狼疮早期肾损害诊断价值较大.

Abstract Objective: To analyze the correlation between vitamin A, D, E levels and tumor necrosis factor (TNF-a), interleukin-1 (IL-1), interleukin-10 (IL-10), neutrophil, C-reactive protein (CRP) levels in pediatric community-acquired pneumonia (CAP). Methods: 110 children with CAP and 100 normal children were collected.The concentrations of fat-soluble vitamin A, D, E, the proportion of leukocytes and subtypes, the concentration of CRP, and the concentration of cytokines TNF-a, IL-1, and IL-10 were tested. Differences between vitamin levels and inflammatory factor levels were compared between the two groups.The correlation between vitamin levels and inflammatory factor levels was analyzed in children with CAP. Results: The hemoglobin, leukocyte concentration, neutrophils, monocytes and CRP concentration in the CAP group showed significant differences (P <0.05).The levels of vitamin A, D and E in the CAP group were lower than those in the control group, and the levels of TNF-a and IL-1 were higher than those in the control group, and the difference was statistically significant (P<0.05). IL-10 levels have no significant between 2 groups (P>0.05).The Pearson analysis showed that the vitamin A, D, and E levels were all correlated with the TNF-a, IL-10, and CRP levels (P <0.05). Conclusion: The vitamin A, D, E levels of CAP children were lower than normal children. The content of fat-soluble vitamins are somewhat correlated with the secretion of TNF-a and IL-10 .

目的 探讨罹患2型糖尿病的老年患者血清同型半胱氨酸(Hcy)指标水平与尿酸(UA)指标水平之间的相关性.方法 选取该院收治2019年10月—2020年11月罹患2型糖尿病的患者110例为研究对象,设为观察组,其中肾功能异常者51例,肾功能正常者59例.收集同期到院进行健康体检者100名,设为对照组,分别对各组血清Hcy指标、UA指标测定,同时掌握其他生化指标状况,并分析血清Hcy指标、UA指标测同肾功能指标之间的相关性.结果 相较肾功能正常者,肾功能异常者血清Hcy指标、UA指标、ACR指标、FPG指标、Scr指标均居更高水平,差异有统计学意义(P<0.05).肾功能正常组与对照组除Hcy、ACR、FPG外,其他指标差异无统计学意义(P>0.05).Hcy指标、UA指标均与ACR、Scr指标水平呈正相关性(P<0.05).结论 针对临床收治的罹患2型糖尿病的患者血清Hcy指标、UA指标进行检测,均表现为异常表达的情况,且与早期肾功能损害存在一定关联,加强对两项指标的检测工作,有利于对2型糖尿病患者机体肾功能状况进行监测.

目的 探讨艾拉莫德对类风湿关节炎患者17型辅助性T细胞(Th17)与调节性T细胞(Treg)失衡的调节作用.方法 选取2016年6月至2017年1月住院的活动期类风湿关节炎患者74例,随机分为A组44例和B组30例.B组给予安慰剂口服,A组给予艾拉莫德口服,两组均坚持服药24周.采用流式细胞术检测外周血Th17和Treg细胞比例;采用酶联免疫吸附技术检测血浆Th17和Treg细胞分泌的相关细胞因子;治疗前后对患者进行DSA28,ACR20,ACR50和ACR70等综合疾病临床评分.结果 A组治疗24周后DSA28评分较治疗前有明显改善,差异有统计学意义(P<0.05);治疗24周后A组DSA28评分及ACR20,ACR50,ACR70改善情况均优于B组,差异有统计学意义(P<0.05).治疗24周后,A组外周血中Th17细胞(CD4+IL-17+)比例相较于治疗前降低,但差异无统计学意义(P>0.05),而Treg细胞(CD4+CD25+)比例相较于治疗前显著升高,差异有统计学意义(P<0.05);治疗24周后,B组外周血中Th17细胞比例无明显改变,Treg细胞比例略有升高,但与治疗前比较,差异无统计学意义(P>0.05).治疗24周后,A组促炎细胞因子IFN-γ、TNF-α、IL-17A水平较治疗前显著降低,差异有统计学意义(P<0.05);治疗24周后,B组促炎细胞因子IFN-γ、TNF-α、IL-17A水平较治疗前升高,差异有统计学意义(P<0.05).结论 艾拉莫德可通过下调Th17细胞,上调Treg细胞来恢复类风湿关节炎患者内环境细胞稳态,从而缓解疾病进展.

顺式AB（ cisAB）血型是ABO亚型中特殊的，而且相对常见的一种表现型，是ABO血型表观遗传学不符合孟德尔规律的AB亚型，可表现为O型父亲（母亲）和AB型的子女［1］。定型上可表现为ABO血型正反定型不符，从而导致ABO血型鉴定和配血困难，以及父权纠纷等问题。在胎母免疫方面也曾有cisAB血型引起ABO新生儿溶血病的报道［2］。对cisAB血型分子机制的研究有利于正确认识cisAB血型及其检测方法的改进，在安全输血、器官移植、产前胎儿ABO-HDN预测以及亲子鉴定等方面具有十分重要的作用。cisAB血型在NCBI中血型抗原基因突变数据库（ BGMUT ）中注册的等位基因有9种［3］，其分子机制尚未完全阐明。

Objective To evaluate the effect of hedyotis diffusa willd on phosphoinositide 3 kinase(PI3K),pro-tein kinase B(Akt)protein and phosphorylated Akt(p-Akt)protein expressions in nude mice with hepatic carci-noma transplanted subcutaneously. Methods Nude mice xenografts were established. The mice were randomly divid-ed into 2 groups:the hedyotis diffusa willd group and the vehicle group,which received hedyotis diffusa willd(6 g·kg -1 ·d -1 ,intragastric administration)and normal saline( intragastric administration),respectively. After 4 weeks of treatment,the tumors were harvested and weighed. The levels of PI3K,Akt and p-Akt proteins were ob-served with immunohistochemical staining. Results The tumor weight of the hedyotis diffusa willd group were high-er than that of the vehicle group(t = 4. 270,P = 0. 006). The gray levels of PI3K,Akt and p-Akt in the hedyotis dif-fusa willd group(118. 67 ± 8. 44,105. 19 ± 4. 718,96. 34 ± 5. 72)were also higher than those in the vehicle group (82. 00 ± 2. 72,72. 37 ± 2. 89,87. 99 ± 4. 16)(t = 0. 209,P = 0. 049;t = 2. 050,P < 0. 001;t = 4. 123,P =0. 002). The expressions of PI3K,Akt and p-Akt proteins were suppressed significantly by hedyotis diffusa willd. Conclusion Hedyotis diffusa willd could inhibit angiogenesis in hepatocellular carcinoma via regulating the PI3K/ Akt pathway.

目的：分析小儿过敏性咳嗽患者高气道反应性的特点及诊断。方法：选取我院2014年1－11月就诊的50例小儿过敏性咳嗽患者作为研究组，并选取同期进行健康体检的50例健康小儿作为对照组，比较两组小儿的白细胞总数（WBC）、C-反应蛋白（CRP）、嗜酸性粒细胞（EOS）及免疫球蛋白E（IgE）。结果：小儿过敏性咳嗽患者高气道反应性特点包括：昼夜均有咳嗽、咽部重度充血、胸闷、咽痒等，分别占40．0％、60．0％、52．0％、46．0％；比较两组小儿的WBC、CRP等指标，差异无统计学意义（P＞0．05）；研究组患者的EOS、IgE等指标均显著高于对照组，差异有统计学意义（P＜0．05）。结论：临床医生应准确掌握小儿过敏性咳嗽患者高气道反应性的特点，密切观察患者生命体征及临床特征，有利于及早准确诊断，为临床制定有效治疗方案奠定基础。

目的 探讨芪灵扶正清解颗粒含药血清对人HepG2肝癌细胞增殖及对ras基因和蛋白表达的影响.方法 制备含药血清和空白血清,体外干预HepG2细胞24 h.流式细胞术检测细胞周期,荧光定量PCR检测h-ras、n-ras和k-ras基因表达量,免疫细胞化学染色检测P21 ras蛋白表达情况. 结果 芪灵扶正清解颗粒含药血清干预人HepG2细胞后,G0/G1期细胞的百分含量明显升高,S期细胞的百分含量和增殖指数明显降低.中剂量组k-ras、h-ras和n-ras mRNA的基因表达量和蛋白表达均明显低于空白血清组. 结论 芪灵扶正清解颗粒抑制HepG2细胞ras基因和蛋白的表达,影响G1/S转换的进程,进而抑制HepG2的增殖.

Objective To study the relationship between plasma P-selectin,h-CRP and diabetic nephropathy(DN).Methods 93 cases with diabetes mellitus(DM) were classified into two groups:diabetic nephropathy(DN) groups and diabetes mellitus groups.And 30 healthy individuals were as normal control.Plasma FPG,h-CRP,P-selectin were measured.Results The plasma levels of FPG,h-CRP,P-selectin in the DN group were higher than those of normal control,and plasma levels of h-CRP,P-selectin in the DN group were higher than those of DM group,with significant difference(P 0.01).Conclusion The results show that the relationship between plasma h-CRP,P-selectin and DM is intensive,which is of great clinical importance to the diagnosis,treatment and prognosis of DM.