目的:探讨2型糖尿病(T2DM)患者血清羧化不全骨钙素(ucOC)水平与糖、脂代谢的相关性.方法:选取81例T2DM患者设为病例组,检测血清ucOC水平,根据中位ucOC水平分为两个亚组,≥中位ucOC水平的41例T2DM患者设为高ucOC组,

目的:对血清羧化不全骨钙素(undercarboxylated osteocalcin,ucOC)水平与2型糖尿病(type 2 diabetic mellitus,T2DM)患者心血管疾病危险因素的关系进行分析,为T2DM患者心血管疾病的预防提供依据.方法:选择2020年6月至2022年5月在承德医学院附属医院门诊就诊的T2DM患者95例作为研究对象,检测血清ucOC水平,根据中位ucOC水平分为2组,ucOC水平≥0.59 μg/L的48例患者设为高ucOC组,ucOC水平＜0.59 μg/L的47例患者设为低ucOC组;测量身高、体重、腰围、臀围、血压、血脂指标,计算体脂率、体重指数(body mass index,BMI),记录每周运动次数和运动平均时间.采用Pearson分析血清ucOC水平与心血管危险因素的相关性.结果:高ucOC组平均病程短于低ucOC组,舒张压(diastolic blood pressure,DBP)、三酰甘油(triglyceride,TG)水平低于低ucOC组,差异均有统计学意义(均P＜0.05).高ucOC组与低ucOC组平均年龄、收缩压(systolic blood pressure,SBP)、总胆固醇(total cholesterol,TC)、高密度脂蛋白胆固醇(high-density lipoprotein-cholesterol,HDL-C)、低密度脂蛋白胆固醇(low-density lipoprotein-cholesterol,LDL-C)及性别构成差异均无统计学意义(均P＞0.05).高ucOC组体脂率、BMI均低于低ucOC组,运动次数多于低ucOC组,ucOC水平高于低ucOC组,差异均有统计学意义(均P＜0.05).2组运动平均时间差异无统计学意义(P＞0.05).血清ucOC水平与运动次数呈正相关(r=0.421,P＜0.001).与体脂率、BMI、DBP、TG水平均呈负相关(分别r=-0.478、-0.637、-0.680、-0726,均P＜0.001).结论:T2DM患者心血管危险因素中体脂率、DBP、TG水平升高,BMI增加,运动时间少与血清ucOC水平低有关,提示高ucOC对心血管疾病可能具有保护作用.

目的 探讨磁共振成像(MRI)弥散张量成像(DTI)参数联合血清抗心磷脂抗体(ACA)、抗β2糖蛋白1抗体(aβ2-GP1)在脑梗死诊断中的应用价值.方法 回顾性选取2015年6月至2017年1月在承德医学院附属医院接受治疗的脑梗死患者131例作为观察组,同时选取同期在神经内科接受治疗的非脑梗死患者50例作为对照组.观察组根据病灶大小分为小面积梗死组58例,中面积梗死组41例,大面积梗死组32例;根据严重程度分为轻度组67例,中重度组64例;根据预后效果分为预后良好组90例,预后不良组41例.比较两组血清ACA、aβ2-GP1差异,同时比较不同梗死面积、严重程度及预后患者血清ACA、aβ2-GP1以及各向异性分数(FA)值、表观扩散系数(ADC)值差异.结果 观察组血清ACA、ab2-GP1分别为(8.95±1.87)、(14.87±3.35)RU/mL,明显高于对照组,差异均有统计学意义(P<0.05).随着梗死面积增加,患者病灶FA值和ADC值降低,而血清ACA、aβ2-GP1升高,差异均有统计学意义(P<0.05).观察组中重度患者FA值和ADC值分别为0.38±0.10和(2.88±0.91)×10-3mm2/s,均明显低于轻度患者,而ACA和aβ2-GP1分别为(9.82±1.32)、(16.46±3.08)RU/mL,均明显高于轻度患者,差异均有统计学意义(P<0.05).观察组预后不良患者FA值和ADC值分别为0.36±0.12和(2.62±0.94)×10-3 mm2/s,均明显低于预后良好患者,而ACA和aβ2-GP1分别为(10.55±1.15)、(17.26±3.12)RU/mL,明显高于预后良好患者,差异均有统计学意义(P<0.05).FA值、ADC值联合血清ACA、aβ2-GP1预测患者预后不良的ROC曲线面积为0.911,明显高于各参数单独预测的0.715、0.768、0.793和0.820,P<0.05.结论 MRI DTI参数FA值、ADC值以及血清ACA、aβ2-GP1与脑梗死梗死面积、严重程度及预后有关,且在联合预测患者预后方面有一定应用价值.

目的 研究多发性骨髓瘤(MM)患者长链非编码RNA(LncRNA)肺腺癌转移相关转录本1(MALAT1)在血清中的表达水平与MM类型的关系,探讨其在MM中的诊断价值.方法 收集我院2018年1月至2020年10月MM患者60例(MM组),健康体检者60例(对照组),检测两组患者血清中LncRNA MALAT1的表达水平,分析其与MM疾病分型和分期的关系.同时研究MM患者血清LncRNA MALAT1表达水平与患者血红蛋白和生化指标的关系.结果 MM组与对照组血清LncRNA MALAT1表达水平显著不同,差异有统计学意义(t=21.157,P<0.05).MM组患者血清LncRNA MALAT1表达水平与患者的年龄、性别无关(t=1.512,t=1.396,P>0.05).不同DS分期和ISS分期LncRNA MALAT1表达水平不同,Ⅲ期高于Ⅱ期和Ⅰ期,差异有统计学意义(P<0.05);MM组患者血清LncRNA MALAT1表达与血钙、β2微球蛋白、血轻链、乳酸脱氢酶呈正相关(r=0.619、0.871、0.809、0.746,P<0.05),而与血红蛋白水平呈负相关(r=-0.756,P=0.000).MM患者血清LncRNA MALAT1表达轻链型高于其他类型(P<0.05),而IgG型和IgA型差异无统计学意义(q=1.512,P>0.05).血清LncRNA MALAT1在MM诊断中的AUC为0.977,敏感度88.3％,特异度85％.MM患者治疗有效,治疗前后MM患者血清LncRNA MALAT1表达水平比较,差异有统计学意义(t=4.386,P=0.000).未缓解患者治疗前后比较,差异无统计学意义(t=0.538,P=0.6).结论 MM患者血清MALAT1可以作为诊断和判断预后的指标.

目的 研究多发性骨髓瘤(MM)患者血清瘦素水平,探讨其与MM的关系.方法 收集我院2018年1月至2020年10月初诊的MM患者60例,同时选取60例健康人做对照,分别检测血清瘦素表达水平,并检测MM患者血钙、β2微球蛋白、血轻链、乳酸脱氢酶和C反应蛋白水平.结果 MM患者与健康对照组血清瘦素比较,两组差异有统计学意义(t=3.174,P<0.05);BMI对MM患者和健康对照组血清瘦素水平没有影响,差异无统计学意义(P>0.05).轻链型瘦素水平高于IgG型(q=3.845,P=0.04),IgG型高于IgA型(q=4.35,P=0.02),IgA高于不分泌型(q=4.838,P=0.000).MM患者瘦素水平DSⅢ期高于DSⅡ期,DSⅡ期高于DSⅠ期(q=3.987、q=4.587,P<0.05);MM患者CRP水平DSⅢ期高于DSⅠ、Ⅱ期(q=5.157、q=4.367,P<0.05).MM患者血清瘦素水平与血钙、β2微球蛋白、血轻链、乳酸脱氢酶、CRP呈正相关(r=0.419、0.692、0.623、0.405、0.677).绘制ROC曲线发现,血清瘦素ROC曲线面积为0.764,敏感度70.5％,特异度74.6％.MM患者治疗前后缓解患者血清瘦素水平比较,差异有统计学意义(t=3.361,P=0.001);未缓解患者治疗前后比较,差异无统计学意义(t=1.012,P=0.3).结论 血清瘦素可以作为临床诊断和监测MM临床治疗效果的可靠指标.

目的:了解鲍曼不动杆菌感染的临床分布特点及耐药情况.方法:收集住院患者细菌学送检标本371株,剔除重复菌株.应用全自动微生物分析仪(VITEK 2 Compact型)及其相配套的药敏卡、鉴定卡开展试验.所得到的数据使用WHONET5.6软件进行统计分析.结果:临床患者感染的371例ABA中主要分布科室是ICU(44.47％)和呼吸内科(14.82％);临床各种标本类型中,痰液分离率最高,327例,占88.14％,还有尿液、血液和其他标本;鲍曼不动杆菌对替加环素、阿米卡星及多黏菌素B显示较低的耐药率,分别是14.1％、7.3％、0.5％,对碳青霉烯类抗生物耐药率大约70％.结论:鲍曼不动杆菌的分离率和耐药率已成为本地区医院内感染的重要病原菌,临床抗感染治疗应根据本地区分离菌株的体外抗菌药物敏感性实验结果为依据,选择敏感抗菌药物对其感染进行治疗.

目的:探讨不同血糖控制水平的老年2型糖尿病(T2 DM)伴慢性牙周炎(CP)患者的牙周炎症状况,血清、全唾液中白细胞介素(IL)-6水平及临床意义.方法:纳入T2 DM伴CP患者48例,单纯CP患者20例,收集受检者非刺激全唾液及血清,采用酶联免疫吸附试验(ELISA)检测全唾液及血清中IL-6含量;并观察牙周状况进行统计分析.结果:T2 DM伴CP组全唾液及血清中IL-6含量均高于单纯CP组(P<0.05);且T2 DM伴CP组中HbA1c≥8％者全唾液及血清中IL-6含量高于HbA1c<8％者全唾液及血清中IL-6含量(P<0.05).T2 DM伴CP组中HbA1c≥8％的患者BI、PD、CAL均高于HbA1c<8％患者(P<0.05).HbA1c≥8％患者中重度牙周炎患病率高于HbA1c<8％者.T2 DM伴CP组的HbA1c与血清、唾液中IL-6水平、CAL呈正相关.结论:血清、全唾液中IL-6与老年T2 DM伴CP患者牙周炎发生发展密切相关.血糖控制不佳的老年T2 DM伴CP患者牙周炎症损害程度较高.HbA1c≥8％的老年T2 DM伴CP患者中重度牙周炎所占比例高于HbA1c<8％者.

目的 探讨戴用可摘局部义齿对老年中重度牙周炙伴2型糖尿病患者牙周状况及全唾液中基质金属蛋白酶(MMP)-8水平的影响.方法 选取2015年7-12月在承德医学院附属医院口腔科行远中游离端铸造支架式可摘局部义齿修复的老年中重度牙周炎伴2型糖尿病患者16例(试验组)和单纯老年中重度牙周炎患者14例(对照组),分别于可摘局部义齿修复前及戴用义齿1、3个月后检测两组患者基牙临床牙周指标和全唾液中MMP-8含量.结果 两组患者戴用义齿1、3个月后的各项牙周指标值及全唾液中MMP-8水平均明显高于义齿修复前(P＜0.05);与戴用义齿1个月后相比较,戴用义齿3个月后牙龈指数(GI)及全唾液中MMP-8水平显著降低(P＜0.05);戴用义齿1、3个月两次复查时,两组患者颊舌侧的菌斑指数(PLl)存在显著性差异(P＜0.05),舌侧PLI明显高于颊侧.两组间比较,患者在修复前、戴用义齿1个月后的各牙周指标值相似,差异无统计学意义(P＞0.05);戴用义齿3个月后,两组患者的基牙PLI值差异不明显,而基牙GI及全唾液中MMP-8水平的差异有统计学意义(P＜0.05),试验组明显高于对照组.结论 老年中重度牙周炎伴2型糖尿病患者戴用可摘局部义齿后牙龈炎症较重;戴用可摘局部义齿可引起老年中重度牙周炎伴2型糖尿病患者全唾液中MMP-8表达水平升高.

Objective To investigate the levels of lipoprotein associated phospholipase A2(Lp-PLA2),D-dimer(D-D),antithrombin Ⅲ (AT Ⅲ) in acute cerebral infarction (ACI)patients,and to analyzed their correlation with ACI.Methods Sixty-nine patients with ACI(ACI group) and 40 individuals undergoing healthy physical examination(control group) were selected in this study.The levels of Lp-PLA2,D-D and ATⅢ were compared between the two groups and their positive rates were statistically analyzed.Then the correlation between Lp-PLA2,D-D and ATⅢ with ACI was analyzed.Results The levels of Lp-PLA2 and D-D in the ACI group were higher than those in the control group,while the ATⅢ level was lower than that in the control group(P<0.05).Their positive rates in the ACI group were higher than those in the control group (P<0.05).Lp-PLA2,D-D and ATⅢ were correlated with ACI occurrence and had mutual correlation (all P<0.05).Conclusion Lp-PLA2,D-D and AT Ⅲ participate in the occurrence process of ACI,and their detection can be applied to screen out ACI high-risk groups,and may guide early prevention and early diagnosis of ACI.

目的 探讨血清肿瘤标志物CEA、NSE和ProGRP与病理指标Syn、CD56、CgA在小细胞肺癌诊断中的关系.方法 应用电化学发光技术和化学发光技术检测48例小细胞肺癌患者血清标志物CEA、NSE和ProGRP的浓度;采用MaxVision免疫组化技术检测Syn、CD56、CgA;用x2检验、两独立样本非参数检验分析结果.结果 小细胞肺癌免疫组化Syn、CD56、CgA表达阳性率高于血清CEA,差异有统计学意义(P＜0.01).免疫组化Syn、CD56、CgA表达阳性率与血清NSE、ProGRP比较,差异无统计学意义(P＞0.05).局限期与广泛期免疫组化指标阳性率差异无统计学意义;广泛期血清肿瘤标志物CEA、NSE、ProGRP浓度均高于局限期,差异有统计学意义(Z值分别为-5.760、-10.833、-12.076;P＜0.01).结论 NSE和ProGRP在诊断SCLC时优于CEA.而免疫组化Syn、CD56、CgA表达阳性率与血清NSE、ProGRP阳性率比较却没有明显优势.SCLC广泛期血清肿瘤标志物CEA、NSE、ProGRP浓度均高于局限期.

Objective To study the effects of midkine(MK) by RNAi on gene expression and apoptosis in A549 cell .Methods Construct MK siRNA expression vector ,and then was transfected that into A549 cells(positive group ,negative group ,blank cell group) .Expression of MK was determined by RT‐PCR and Western blot in each group ;apoptosis was evaluated by flow cytometry . Results The expression of MK protein declined 89 .3% and expression of mRNA declinded 83 .3% in positive group (positive group) .Spontaneous apoptosis was deteted in positive group ,early apoptosis increased by 15 .5 times and 9 .34 times than the nega‐tive control group and blank group .Activities of caspase‐3 was higher than other two groups(P<0 .05) .Conclusion RNAi can in‐hibit expression of MK and induce apoptosis of A549 cells .

Objective:To analyze the correlation between serum midkine (MK) and plasma D-dimer level in patients with non-small cell lung cancer. Methods:The serum midkine level and plasma D-dimer level of 52 non-small cell lung cancer patients and 52 healthy controls were respectively detected and analyzed their correlation. Results:The serum midkine level and plasma D-dimer level of non-small cell lung cancer patients were obviously higher than that of healthy controls (P<0.05). The midkine and D-dimer level were related to TNM stage (P<0.05), but unrelated to pathological type (P>0.05). For non-small cell lung cancer patients, the midkine level was positively correlated to D-dimer level (r=0.683, P<0.05). Conclusions:Midkine and D-dimer may have synergistic effects in development of non-small cell lung cancer.

Objective To detect the levels of midkine (MK) in the serum of patients with non-small cell lung cancer (NSCLC), and to explore the relationship between MK levels and NSCLC. Methods Enzyme-linked immuno-sorbent assay (ELISA) was used to detect the levels of serum MK in 52 patients with NSCLC, 52 patients with pneu-monia and 52 healthy people. The relationships between MK levels and clinical pathological characteristics, treatment effect in non-small cell lung cancer were analyzed. Results MK levels were significantly higher in NSCLC patients than patients with pneumonia and healthy people (P<0.05), in smoking patients than non-smoking patients (P<0.05), and in NSCLC patients of stageⅢ~Ⅳthan NSCLC patients of stageⅠ~Ⅱ(P<0.05). There was no significant differ-ence in MK levels between adenocarcinoma and squamous carcinoma (P>0.05). MK levels of patients who have lymph node metastasis were higher than patients with no lymph node metastasis (P<0.05). In the 48 NSCLC patients, Mk levels were significantly decreased after treatment, showing statistically significant difference with those before treatment (P<0.05). Conclusion The midkine level of patients with NSCLC has close relationships with pathologi-cal type, clinical stage and smoking, which is a reliable indicator for clinical therapeutic effect.

目的：探讨多发性骨髓瘤（ MM ）患者血浆C反应蛋白（ CRP ）水平与血浆白蛋白和凝血酶原时间（ PT）的相关性。方法检测30例MM患者血浆CRP水平，并分析CRP与DS分期、血浆白蛋白水平和PT的关系。结果30例MM患者中有18例CRP升高，这些患者的血浆白蛋白水平明显低于CRP水平正常的患者，差异有统计学意义（P＜0.05）；而CRP正常的MM患者PT长于CRP升高的MM患者（P＜0.05），血浆CRP与白蛋白、PT呈负相关（r＝－0.847，r＝－0.755）。结论 MM患者CRP升高多见于DS分期的Ⅲ期患者，其水平与血浆白蛋白和PT有相关性，是临床判断患者病情的重要参考指标。

目的：探讨血清中期因子（MK）和癌胚抗原（CEA）联合检测在非小细胞肺癌诊断中的价值。方法采用 ELISA 和电化学发光的方法分别测定非小细胞肺癌患者、肺炎患者和健康对照者血清中 MK 和 CEA 的含量。其中非小细胞肺癌患者又分为腺癌患者和鳞癌患者。结果腺癌患者 MK 和 CEA 水平均高于肺炎患者和健康对照者（P ＜0.05）；鳞癌患者 MK 水平高于肺炎患者和健康对照者（P ＜0.05），而 CEA 水平与肺炎患者和健康对照者相比差异无统计学意义（P ＞0.05）；鳞癌患者血清 MK 水平与腺癌患者相比差异无统计学意义（P ＞0.05），而血清 CEA 水平鳞癌患者与腺癌患者差异有统计学意义（P ＜0.05）；肺炎患者与健康对照者比较 MK 和 CEA 差异无统计学意义（P ＞0.05）。 MK、CEA 联合（并联）检测诊断非小细胞肝癌的灵敏度和准确度均高于 MK、CEA 单独检测，而联合检测的特异度低于 MK、CEA 单独检测（P ＜0.05）。结论CEA 联合 MK 检测在非小细胞肺癌的诊断中具有显著的应用价值。

目的 了解承德市及周边地区不同年龄段儿童全血6种元素(铜、锌、铁、钙、镁、铅)水平,分析各元素缺乏或中毒的相关因素.方法 采用博晖BH5100五通道原子吸收光谱仪和BH2100原子吸收光谱仪对2 222名儿童静脉全血中的铜、锌、钙、镁、铁、铅6种元素进行检测.对受检儿童按性别或年龄进行分组,并对检测结果进行统计分析.结果 不同性别儿童全血6种元素水平比较差异无统计学意义(P＞0.05).不同年龄组之间比较,镁元素水平差异无统计学意义(P＞0.05),其余5种元素差异均有统计学意义(P＜0.05).铜、钙随年龄增长呈下降趋势,锌、铁、铅随着年龄增长呈上升趋势,镁元素水平则较为稳定.该地区儿童以锌缺乏最为严重,0～1岁组中锌缺乏率为45.5％、铁缺乏率为33.8％、钙缺乏率为6.9％.铜、镁的缺乏率极低,铅中毒率较低.结论 调查发现该地区儿童普遍存在锌、铁、钙缺乏,需给予更多关注.因此合理调节膳食结构,克服挑食的习惯,定期监测6种元素水平,是确保儿童健康成长的重要措施.

目的 探讨同型半胱氨酸(HCY)、癌胚抗原(CEA)和C-反应蛋白(CRP)联合检测在浆膜腔积液鉴别诊断中的价值.方法 分别检测50例恶性浆膜腔积液(恶性组)、40例结核性浆膜腔积液(结核组)和40例感染性浆膜腔积液(炎症组)患者积液中HCY、CEA和CRP含量,并进行比较分析.结果 恶性组积液HCY、CEA含量明显高于结核组和炎症组(P<0.05),CRP水平明显低于结核组和炎症组(P<0.05).结论 浆膜腔积液中HCY、CEA和CRP水平联合检测在浆膜腔积液鉴别诊断中具有重要临床价值.

Objective To explore the value of combined detection of homocysteine(HCY),carcinoembryonic antigen(CEA),C-reactive protein(CRP),β2-microglobulin(β2-MG) and adenosine deaminase(ADA) for differential diagnosis of splanchnocoele effusion.Methods Contents of HCY,CEA,CRP,β2-MG and ADA were determined and compared in 50 patients with malignant splanchnocoele effusion(malignant group),40 patients with tuberculous splanchnocoele effusion(tuberculosis group) and 40 patients with inflammatory splanchnocoele effusion(inflammatory group).Results The contents of HYC and CEA in malignant group were significantly higher than in tuberculosis and inflammatory group(P<0.05),but that of CRP was obviously lower(P<0.05),while those of β2-MG and ADA were obviously lower than in tuberculosis group(P<0.05).Conclusion Combined determination of HCY,CEA,CRP,β2-MG and ADA might be with significant clinical significance for the differential diagnosis of splanchnocoele effusion.

OBJECTIVE To understand the clinical distribution and drug resistance of Enterococcus causing infections in elderly patients.METHODS By the means VITEK-32 type automatic microbial analyzer of French company BioMerieux and supporting GPI identification card,the identification of the strains was performed,and the antibiotic susceptibility testing was carried out using K-B method;the data processing was performed with WHONET5.4 software.RESULTS Of 136 strains of Enterococcus causing infections in elerly patients,there were 67(49.3%)strains of Enterococcus faecalis and 52(38.2%) strains of Enterococcus feces,those isolates mainly distributed in department of geriatrics,ICU,department of nephrology,and department of respiratory medicine;of the various specimen sources,66(44.1%) strains were isolated from urine,47(34.5%) strains were isolated from the sputum;the drug resistance of E.faecalis was lower than that of E.feces,but the resistance of E.faecalis to tetracycline was higher than that of E.feces,no strains of vancomycin or teicoplanin-resistant Enterococci were found.CONCLUSION Enterococci vary in drug resistance,it is necessary to choose the susceptible antibiotics for the clinical anti-infection treatment on the basis of the in vitro antibiotics susceptibility testing for the isolated strains from the local region.

目的探讨同型半胱氨酸(HCY)、癌胚抗原(CEA)和腺苷脱氨酶(ADA)联合检测在胸腔积液鉴别诊断中的价值。方法检测50例恶性胸腔积液(恶性组)、40例结核性胸腔积液(结核组)和40例感染性胸腔积液(炎症组)HCY、CEA和ADA水平,并进行比较分析。结果恶性组HCY、CEA水平高于结核组和炎症组(P<0.05),ADA水平低于结核组(P<0.05)。结论 HCY、CEA和ADA水平联合检测在良恶性胸腔积液鉴别诊断中具有重要临床价值。