目的:分析25例达出院标准的新型冠状病毒肺炎(COVID-19)复检新型冠状病毒(SARS-CoV-2)核酸阳性(简称复阳)患者的临床表现、实验室指标.方法:回顾性分析2020年1-4月在湖北医药学院附属东风医院收治的25例复阳患者不同时间点临床资料.结果:淋巴细胞(LYM)在各时期均有明显差异(均P＜0.05);与确诊时比,复阳和出院时超敏C反应蛋白(hs-CRP)明显降低(均P＜0.05),复阳时Ct值、白细胞(WBC)明显升高(均为P＜0.05),中性粒细胞比值、淋巴细胞比值、降钙素原在各时间点均无统计学差异(均P＞0.05);影像学显示复阳时患者肺部病灶较出院时进一步吸收或无明显差异.结论:复阳患者以LMY和WBC进行性升高,hs-CRP进行性下降为特点.各指标均较前趋好,推测复阳可能对患者无致病作用,但其传染性还待深究,管理部门需加强对COVID-19出院患者的随访和管理.

目的 建立新冠病毒IgG抗体的快速检测方法.方法 制备并纯化重组新冠病毒N蛋白,将获得的重组N蛋白免疫家兔,获得多克隆抗体.将鼠抗人IgG单克隆抗体和兔抗新冠病毒N蛋白多克隆抗体分别喷于硝酸纤维素膜的检测线和控制线,用重组N蛋白标记荧光纳米颗粒作为标记抗原,建立荧光免疫层析方法.结果 重组新冠病毒N蛋白经表达纯化后,纯度达到90％以上.用新冠病毒IgG抗体标准品测得建立的荧光层析方法灵敏度为1:5 000;与甲型流感病毒(H1N1、H3N2、H5N1、H7N9)、乙型流感病毒、呼吸道合胞病毒和腺病毒IgG抗体无交叉反应;批内、批间变异系数均低于10％.结论 建立的新冠病毒IgG抗体检测方法具有较好的灵敏性和特异性,可用于新冠病毒抗体的快速筛查.

Objective To investigate the changes of Troponin Ⅰ(cTnⅠ),high sensitivity C reactive protein(hs-CRP) and N-terminal pro brain natriuretic peptide type B(NT-ProBNP) in elderly patients with chronic heart failure and its prognostic value.Methods 76 elderly patients with chronic heart failure in our hospital from January 2015 to February 2016 were selected as the observation group,and according to the heart function classification program recommended by New York Heart Association (NY-HA),they were divided into 10 cases of grade Ⅰ,25 cases of grade Ⅱ,26 cases of grade Ⅱ,15 cases of grade Ⅳ.50 healthy elderly patients in our hospital were selected as the control group.The levels of cTnI,hs-CRP and NT-ProBNP were detected and compared between the two groups.The patients in the observation group were followed-up for 1 year after discharge,and the incidence of cardiovascular events were observed.Results The levels of cTnI,hs-CRP and NT-ProBNP in the observation group were higher than those in the control group;the levels of cTnI,hs-CRP and NT-ProBNP in patients in grade Ⅰ,grade Ⅱ,grade Ⅲ and grade Ⅳ gradually increased;19 patients had cardiovascular events,55 patients had no cardiovascular events,and another 2 cases were lost.The levels of cTnI,hs-CRP and NT-ProBNP in the cardiovascular event group were higher than that in the non cardiovascular event group,and the differences above were statistically significant (P ＜ 0.05).Conclusion CT-hI,hs-CRP and NT-ProBNP can better reflect the cardiac function in elderly patients with chronic heart failure,and have important reference value for the evaluation of the disease and prognosis.

目的 探讨血清神经元特异性烯醇化酶(NSE)水平对非痴呆性血管性认知障碍(VCIND)患者进展至血管性痴呆(VaD)的预测价值.方法 前瞻性、连续性队列研究,纳入湖北医药学院附属东风医院于2014年6月14日～2015年10月1日期间初次收治、尚处于VCIND阶段的患者为观察队列,对其进行为期一年的随访以确认预后转归,确诊VaD后,采用修订版简易精神状态检查量表(MMSE-R)评定痴呆程度.分析进展至VaD与未进展至的VaD患者各项临床资料差异性;按基线NSE水平对其进行四分位数分组,使用Logistic回归分析不同NSE水平对于进展至VaD的预测价值;以随访时MMSE-R量表为因变量,以NSE等其他临床指标为自变量,基于多元线性回归分析基线NSE水平对进展至VaD的影响.结果 (1)观察队列中所有患者均至少进行为期一年的随访,最终纳入66患者的临床资料,16例患者于随访期内进展至VaD(实验组)、50例患者于随访期未见病情进展(对照组).实验组患者的年龄、BMI、吸烟史所占比、TC、NSE均显著高于对照组,其差异均有统计学意义(P＜ 0.05);C-Peptide显著低于对照组,差异具有统计学意义(P＜0.05).(2)依照基线NSE水平行四分位分组,单因素Logistic 回归分析显示,最高四分位分组进展至VaD的风险是最低四分位分组的1.43倍;通过多因素Logistic回归分析校正其他危险因素后,最高四分位分组进展至VCIND的风险依然为最低四分位分组的1.21倍.(3)多元线性回归显示,基线NSE水平与随访时MMSE-R评分存在显著相关性,依据多元线性回归方程,以一年为随访周期,NSE含量每升高1ng/mL,VaD患者的MMSE-R评分降低0.368分.结论 VCIND患者的NSE水平增加是其进展至VaD的独立危险因素,其水平与病情程度存在显著相关性.

Objective To investigate the clinical value of procalcitionin (PCT),high sensitive C reactive protein (hs-CRP),white blood cell count (WBC) and neutrophil (NEUT) in the diagnosis of pulmonary infection.Methods Selection of 167 patients with pulmonary infection in our hospital during the period of August,2016 in March 2015,and 156 patients with healthy physical examination during the same period were observed.The patients were grouped according to the degree of infection and the type of pathogenic bacteria infection.The levels of serum PCT,hs-CRP,WBC and NEUT were detected in the two groups respectively.Results Pulmonary infection in patients with PCT,hs-CRP,white blood cell and neutrophil percentage were significantly higher than the control group (P＜0.05),and increased with the aggravation of the disease (P＜0.05),the difference was statistically significant;the area under the PCT curve of maximum ROC curve analysis results (0.839),the diagnosis had the best effect.Followed by hs-CRP (0.746),WBC (0.700) and NEUT (0.635);PCT and hs-CRP in patients with different etiology of pulmonary infection,fine (true) bacteria infection group serum PCT and hs-CRP levels were significantly higher than those in the control group,viral infection group and atypical pathogen infection group (P＜0.05),statistically significant differences;atypical pathogens in patients with PCT compared with the healthy group,P＞0.05,the difference was not statistically significant.Hs-CRP＞0.05,P＞,the difference was not statistically significant in the patients with viral infection group compared with the healthy group.Conclusion PCT,hsCRP,WBC and NEUT four indicators of inflammation are able to respond to a certain extent in patients with pulmonary infection.The diagnosis of PCT is the best,in the judgment of severity of pulmonary infection and has important clinical value of bacterial infection,so the detection of serum PCT can be used as a pulmonary infection disease diagnosis and monitoring in a simple and reliable method.

目的：明确血浆脂蛋白相关磷脂酶A2含量（ LP－PLA2）与慢性心力衰竭（ CHF）患者预后的关联性。方法测定126例CHF患者入院时的血浆LP－PLA2水平，出院后常规随访12个月，依据随访期内出现心血管事件（ CE）与否，将CHF患者分为CE组与非CE组，分析2组临床资料及血清LP－PLA2对于CHF的检测价值。结果包括LP－PLA2在内，CE组与非CE组之间有9项组间资料差异有统计学意义。多因素Logistic回归分析显示LP－PLA2水平升高、NT－proBNP水平升高、LVEF降低、LVDD增加、BMI升高是CHF患者12个月内发生CE的独立危险因素。使用ROC曲线判定LP－PLA2预测CHF患者12个月内发生CE的概率，LP－PLA2水平5．12 ng／mL时预测价值最高，灵敏度为76．07％、特异性为67．89％。 Kaplan－Meier生存曲线提示LP－PLA2水平≥5．12 ng／mL时，CHF患者CE发生率增高。结论血浆LP－PLA2水平升高是CHF患者12个月内CE发生的独立危险因素，LP－PLA2水平可对CHF患者的预后转归进行有效预测。

Objective To investigate the clinical significance of N-terminal pro-B-type natriuretic peptide(NT-proBNP) detection in evaluation of acute type A aortic dissection (AAAD) prognosis .Methods Medical records of patients with confirmed diagnosis of AAAD were retrospectively analyzed .64 patients were enrolled in accordance with the inclusion and exclusion criteria ,and were di-vided into survival group(n=56) and death group(n=8) according to prognosis .Multivariate Logistic regression analysis was em-ployed to screen the independent risk factors which would affected the prognosis .Receiver operator characteristic ,ROC) curve was used to evaluate the predictive value of NT-proBNP for AAAD prognosis .Results Differences of history of smoking ,incidence sea-son ,disturbance of consciousness ,misdiagnosis ,low density lipid-cholesterol(LDL-C) ,fasting C-peptide(FCP) ,hypersensitive C-re-active protein(hs-CRP) ,cardiac troponin I(cTnI) ,NT-proBNP ,mean arterial pressure(MAP) and prothrombin time(PT) of pa-tients between the survival group and the death group showed statistical significance (P<0 .05) .Multivariate Logistic regression a-nalysis demonstrated that smoking history ,disturbance of consciousness ,high LDL-C ,high cTnI ,high NT-proBNP and low MAP were independent risk factors for patients with poor prognosis .ROC area under the curve(AUC) of NT-proBNP prediction for peri-operative mortality risk of patients with AAAD was 0 .697(P< 0 .05 ,95% CI:0 .643~0 .733) ,and its specificity and sensitivity were 75 .85% and 70 .07% ,respectively .When NT-proBNP was 909 .69 pg/mL ,its predictive value for AAAD was the best .Set the critical value as the threshold ,the patients above were divided into the threshold above group and the threshold below group . The survival rate of patients in the threshold below group [98 .18% (54/55)] was significantly higher than that in the threshold a-bove group[22 .22% (2/9)](χ2 = 7 .211 ,P< 0 .05) .Conclusion NT-proBNP level is closely related to the prognosis of patients with AAAD and NT-proBNP detection may be conducive to predicting high risk of AAAD .

Objective To investigate the effects of different glucose concentration on EGR2 protein expression in Schwann cells . Methods Schwann cells were cultured in different glucose concentrations ,and they were divided into two groups ,normal glucose concentration (5 .5 mmol/L ,N group) and high glucose concentration(25 mmol/L ,H group) .Immunocytochemistry and Western blot were used to study EGR2 expression .Results The expression of EGR2 protein was higher in H group than that in N group the difference was statistically significont (P<0 .05) .Conclusion High glucose can lead to EGR2 protein upregulate in Schwann cells ,and EGR2 maybe one of the reasons of diabetic neuropathy .

Objective To study the effect of netrin-1 expression in cerebral ischemia compensatory area with the application of Schwann cell transplant and hyperbaric oxygen therapy.Methods Establish middle cerebral artery occlusion model,rat were divided into twice,the first group was the transplantation of schwann cell,the second group is cell transplant and hyperbaric oxygen.Netrin-1mRNA is detected with the application of reverse transcription PCR(RT-PCR).Results Netrin-1mRNA decreased a quarter between the combination therapy group and only cell transplant group.Conclusion Netrin-1 is decreased by hyperbaric oxygen,possibly because hyperbaric oxygen increase free radicals,but free radicals decrease netrin-1mRNA.

选择本院2011年4月至8月门诊就诊1871例患者的hsCRP和血液分析WBC联合检测的EDTA-2K抗凝血标本的检测结果,进行统计分析,结合患者病史及其他实验数据和最后的临床诊断,表明凭单一的白细胞对细菌感染炎症性病患或相关急诊患者的筛查远不能满足临床诊疗的需要,二者联合检测更有利于对炎症疾病的鉴别和诊断,可提供临床医生对各种患者的病情做到早期、快速而又准确的诊断信息.作者认为超敏CRP有待普及并广泛应用于门诊、急诊等各种病患初筛检测中,与WBC联合检测应全面普及和推广.现报道如下.

Objective Influence on immune function of patient with breast cancer by herceptin unite with chemotherapy.Methods 87 patients with breast cancer were divided into two groups,one is chemotherapy group,another is herceptin unite with chemotherapy group.The expression of the lymphocyte sub group of these groups and 30 healthy physical examination people were detected by flow cytometry.Results The values of the CD3,CD4 and the ratio of CD4 and CD8 of chemotherapy group and herceptin unite with chemotherapy group were lower than control group during preoperative period,but the values of the CD19 of these two groups were higher than control group,yet when the values of CD8 and NK cell of these two group were compared with control group,the distinction was not significant.34 patients of breast cancer by herceptin unite with chemotherapy were relieved,8 patient's developed.23 patient's condition of breast cancer by herceptin unite with chemotherapy wre relieved,22 patient's developed.Conclusion The herceptin unite with chemotherapy could notable increase curative effect of anti-breast cancer,but it also result in lower cell immune function of patient.