Objective:To investigate the relationship between plasma carbon monoxide levels and hypothyroidism and the therapeutic effects of hyperbaric oxygen combined with Roy’s adaptation model nursing.Methods:A total of 100 outpatients with hypothyroidism treated in the Department of Outpatient of the First Affiliated Hospital of Air Force Medical University between January 2022 to January 2023 were assigned to the observation group，and another 20 healthy persons undergoing physical examinations were assigned to the control group. The plasma carbon monoxide levels and serum thyroid function indicators，including thyroid-stimulating hormone（TSH）and free thyroxine（FT4）levels，of the two groups were recorded；and the relationship between carbon monoxide levels and hypothyroidism was analyzed. Then，the patients in the observation group were randomly divided into a conventional treatment and nursing（CO）subgroup and a hyperbaric oxygen combined with Roy's adaptation model nursing（HR）subgroup，with 50 cases in each subgroup. The therapeutic effects of the two subgroups were observed.Results:Compared with the control group，the serum TSH and plasma carbon monoxide contents in the observation group were significantly increased（ P<0.001），and the serum FT4 content was significantly decreased（ P<0.001）. In comparison，the plasma carbon monoxide content in the patients with severe hypothyroidism was significantly higher than those with mild hypothyroidism（ P<0.001）. Carbon monoxide level was positively correlated with TSH（ r=0.863， P<0.01），and negatively correlated with FT4（ r=-0.835， P<0.01）. Compared with the CO subgroup，the serum TSH and plasma carbon monoxide contents in the HR subgroup were significantly decreased（ P<0.001），and the serum FT4 content was significantly increased（ P<0.001）. The total effective rate in the HR subgroup（92.00%）was significantly higher than that in the CO subgroup（72.00%），and the difference between the groups was statistically significant（ P<0.05）. Conclusion:There is a certain correlation between plasma carbon monoxide levels and hypothyroidism. Hyperbaric oxygen combined with Roy's adaptation model nursing can significantly reduce plasma carbon monoxide levels，hence significantly improve therapeutic effects.

目的 探讨硝苯地平联合依诺肝素钠对重度子痫前期剖宫产术后凝血功能、血清因子及妊娠结局的影响.方法 将110例重度子痫前期剖宫产术患者根据随机数字表法分为2组,对照组55例患者接受硝苯地平治疗,研究组55例患者在对照组治疗的基础上联合依诺肝素钠治疗,比较2组不同孕周及不同血压水平患者的治疗总有效率、治疗前后各凝血指标、血清因子与24 h尿蛋白水平变化以及不良妊娠结局发生率.结果 研究组在不同孕周及不同血压水平患者中的治疗总有效率均显著高于对照组(P＜0.05);治疗前2组患者血管性血友病因子(vWF)、妊娠相关血浆蛋白(PAPP-A)和24 h尿蛋白水平比较差异无统计学意义,治疗后研究组患者vWF、PAPP-A和24 h尿蛋白水平均显著低于对照组(P＜0.05);治疗前2组患者各凝血指标水平比较差异无统计学意义,治疗后研究组患者溶酶原激活物特异性抑制物(PAI-I)、血小板计数(PLT)、D-二聚体(D-D)、血红蛋白(HB)及纤维蛋白原(FIB)水平均显著低于治疗前及对照组,凝血酶原时间(PT)、活化部分凝血活酶时间(APTT)和组织型纤溶酶原激活物(t-PA)水平均显著高于治疗前及对照组(P＜0.05);研究组产妇及胎儿不良妊娠发生率均显著低于对照组(P＜0.05).结论 硝苯地平联合依诺肝素钠可有效改善患者的凝血功能,降低血清因子及24 h尿蛋白水平,改善妊娠结局,在重度子痫前期剖宫产术患者治疗中具有较高的应用价值.

多学科联合会诊具有明诊断、定方向、细方案的重要作用.但在实际工作中,也存在管理制度难统一、会诊病种及形式较单一、信息化平台未建立等问题.为提高多学科联合会诊质量,某院组建了管理小组,明确了推进科室,完善了运行机制,搭建了信息化平台,探索建立了更高效的多学科联合会诊模式,为患者提供了更加精准的诊疗方案,提高了诊疗质量.未来将从机制、团队、平台建设等方面进行优化,以使多学科联合会诊模式更加完善.

目的 探讨大动脉粥样硬化性(LAA)脑梗死发病特点与病情恶化的相关影响因素及相关实验室指标的预测价值.方法 选取2017年2月至2019年1月收治空军军医大学第一附属医院的359例LAA脑梗死患者,统计患者临床特征、病灶分布、入院时神经缺损情况、预后情况,根据欧洲进展性卒中标准分为进展组102例和非进展组257例,比较两组性别、年龄、既往史、吸烟史、饮酒史、入院时收缩压(SBP)、舒张压(DBP)、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)、总胆固醇(TC)、空腹血糖(FPG)、糖化血红蛋白(HbA1c)、高敏C反应蛋白(hs-CRP)、纤维蛋白原(FIB)、D-二聚体(D-D)、脑利钠肽(BNP)、淀粉样蛋白A(SAA)、梗死灶的最大直径,采用Logistic回归方程分析进展性LAA脑梗死发生的相关影响因素,采用Pearson线性相关性分析FIB、D-D、SAA与美国国立卫生研究院卒中量表(NIHSS)、Rankin修订量表(mRS)评分关联性,采用受试者工作特征曲线(ROC)及ROC下面积(AUC)分析FIB、D-D、SAA预测LAA进展性脑梗死的效能.结果 359例LAA脑梗死患者,102例(28.41％)为进展性LAA脑梗死,257例(71.59％)为非进展性LAA脑梗死,临床特征以单侧肢体无力、单侧肢体麻木最为常见,病灶主要分布于皮质、基底核区,入院时神经缺损以中度为主,大多患者预后优良.Logistic回归方程分析,将梗死面积、位置控制后,糖尿病、入院时SBP、FIB、D-D、SAA、梗死灶的最大直径仍与进展性LAA脑梗死相关(P＜0.05).Pearson线性相关性分析,FIB、D-D、SAA均与进展性LAA脑梗死患者NIHSS评分、mRS评分呈正相关(P＜0.05).FIB、D-D、SAA联合预测进展性脑梗死的AUC最大,为0.880,敏感度、特异度分别为74.51％、90.60％.结论 LAA脑梗死进展性发生率略偏低,糖尿病、入院时SBP、FIB、D-D、SAA、梗死灶的最大直径是进展性LAA脑梗死发生的重要因素,早期联合检测上述实验室指标水平,有助于指导临床预测进展性LAA脑梗死发生,实施对症处理.

目的:探讨近红外七甲川菁染料IR-783作为检测宫颈癌的显像剂的价值以及IR-783介导成像的潜在机制.方法:以宫颈癌细胞为研究对象,观察IR-783染料的摄取、积累和亚细胞定位.对患有宫颈癌异种移植瘤的小鼠和新采集的临床宫颈癌标本进行全身显像,评估特定染料的摄取和保留.冷冻组织切片证实染料在组织和细胞水平上的积累.检测外周血中加入宫颈癌细胞的循环肿瘤细胞.结果:培养的宫颈癌细胞、人宫颈癌细胞加标全血、人宫颈癌异种移植物和新鲜人宫颈癌组织均能特异性摄取IR-783染料,而正常细胞组织则不能.结论:IR-783在临床标本和循环血中检测宫颈癌细胞的潜力,其可进一步作为宫颈癌深部组织成像的模式剂应用于临床.

Objective:To explore the expression of inward rectifier potassium channel Kir4.1 in malignant gliomas and its correlation and correlation mechanism with epilepsy, edema and other symptoms of gliomas through database and document analysis.Methods:Oncomine database was used to analyze the expression of glioblastoma compared with normal brain tissue in TCGA data set. Specimens and pathological information of patients with different clinical grades of glioma were collected to analyze the expression of Kir4.1 in different grades of glioma. Kir4.1 mutations in gliomas were analyzed by cbioportal database.Results:The results of oncomine database showed great differences due to the differences of sample size. RT-PCR and immunohistochemistry showed that the expression of Kir4.1 in high-grade glioma was less than in low-grade glioma, but the expression of Kir4.1 in low-grade glioma was higher than in normal brain tissues, and the difference was statistically significant (P<0.05). The cbioportal database showed that the mutation probability of Kir4.1 was extremely low in glioblastoma, and the difference between partial genome alteration and the number of mutations was statistically significant (P<0.05). MSH2, ERRFI1, CTNNB1, SEPRINE1, FOXM1, RAD50 and other genes were highly expressed in the altered group, while INPP4B, XBP1, AXL and other genes were highly expressed in the non-altered group.Conclusion:The expression of Kir4.1 is different in different grades of glioma. High grade glioma has lower expression of Kir4.1, and the expression of Kir4.1 may be related to epilepsy, edema and other clinical symptoms in patients with high grade glioma, which provides a new idea for exploring the potential mechanism of Kir4.1 in glioblastoma in the future.

目的 探讨阿托西班联合盐酸利托君对先兆早产患者的临床疗效、血清学指标及母婴结局的影响.方法 收集2018年6月至2020年6月空军军医大学第一附属医院妇产科138例先兆早产患者,根据随机数字表法分为两组,对照组69例患者予以盐酸利托君治疗,研究组69患者在对照组的基础上联合阿托西班治疗,比较两组患者的临床疗效、各血清学指标水平变化、母婴结局及用药安全性.结果 研究组治疗总有效65例(占94.20％),对照组治疗总有效56例(占81.16％),两组比较存在统计学差异(P<0.05);研究组患者药物起效时间显著短于对照组,妊娠延长时间显著长于对照组,两组比较存在统计学差异(P<0.05);治疗前两组患者基质金属蛋白酶抑制剂-1(TIMP-1)、白细胞介素-8(IL-8)、白细胞介素-6(IL-6)、一氧化氮(NO)及前列腺素E2(PGE2)水平比较无统计学差异(P>0.05),治疗后研究组患者TIMP-1、IL-8、IL-6、NO及PGE2水平均显著低于对照组(P<0.05);研究组保胎成功率、分娩孕周、新生儿体质量及Apgar评分均显著高于对照组,早产率显著低于对照组,两组比较存在统计学差异(P<0.05);研究组患者药物所致不良反应发生率(5.80％)显著低于对照组(26.09％),两组比较存在统计学差异(P<0.05).结论 阿托西班联合盐酸利托君可有效延长妊娠时间,降低各血清学指标水平,改善母婴结局,且起效快、疗效安全显著,值得在先兆早产患者治疗中应用推广.

目的 探讨地诺孕素联合散结镇痛胶囊对子宫内膜异位症的临床疗效及各血清学指标的影响.方法 选取2017年10月至2019年10月空军军医大学第一附属医院妇产科收治的94例子宫内膜异位症患者为研究对象,将受试者根据随机数字表法分为两组,对照组和研究组每组各47例,对照组患者口服散结镇痛胶囊治疗,研究组患者在对照组的基础上加用地诺孕素治疗,比较两组的治疗总有效率、治疗前后各性激素指标与血清因子水平变化及用药安全性.结果 研究组患者治疗总有效45例(占95.74％),对照组治疗总有效37例(占78.72％),两组比较差异有统计学意义(χ2=6.144,P<0.05).治疗前后两组患者黄体生成素(LH)、卵泡刺激素(FSH)水平比较差异均无统计学意义(P>0.05),治疗后两组患者雌二醇(E2)、孕酮(P)水平较治疗前均明显降低(研究组:t值分别为32.475、25.386,P<0.05;对照组:t值分别为20.473、15.483,P<0.05),且研究组E2、P水平显著低于对照组(t值分别为13.273、9.658,P<0.05).治疗前两组患者血清CA125、基质金属蛋白酶(MMP)-2、MMP-9、血管内皮生长因子(VEGF)、半乳糖凝集素-3(Gal-3)水平差异均无统计学意义(P>0.05);治疗后两组患者血清CA125、MMP-2、MMP-9、Gal-3及VEGF水平均显著低于治疗前(t=13.267～52.493,P<0.05),且研究组患者血清CA125、MMP-2、MMP-9、Gal-3及VEGF水平均显著低于对照组(t值分别为12.473、14.358、21.356、9.332、20.342,P<0.05).两组患者药物引起的不良反应发生率比较差异无统计学意义(P>0.05).结论 地诺孕素联合散结镇痛胶囊可有效降低各性激素与血清因子水平,疗效安全显著,对促进子宫内膜异位症患者病情康复具有积极意义.

目的:探究高迁移率族蛋白1(HMGB1)拮抗剂BoxA尾静脉注射对细菌性脑膜炎(BM)大鼠模型的临床体征改善和炎症抑制作用.方法:除外正常对照的雄性Sprague-Dawley(SD)大鼠设为对照组(n=20),另取60只大鼠行脑室立体定向注射20 μL大肠杆菌Escherichia coli (DH5α 1×107 CFU/mL)建立BM模型,之后随机分为两组(各组n=30),一组尾静脉注射HMGB1拮抗剂BoxA,即BoxA组;一组麻醉后进行尾静脉注射无菌磷酸盐(PBS),即Vehicle组.造模3d后,对各组大鼠的临床指标以及病理生理参数(颅内压和脑脊液白细胞(WBC)计数)进行评估,使用酶联免疫吸附实验(ELISA)法检测血清中HMGB1的相对含量,使用伊文思蓝染色观察血脑屏障(BBB)通透性,使用免疫荧光染色检测大脑皮层炎症因子(IL-1β和TNF-α)的表达水平.结果:相比Contro1组,Vehicle组临床指标,颅内压,WBC计数以及血清HMGB1含量明显提升(P＜0.05);而BoxA组相比Vehicle组,以上改变有部分减少(P＜0.05).另外,Vehicle组较Control组EB渗漏增加且炎症因子(IL-1β和TNF-α)表达水平增高(P＜0.05).与Vehicle组相比,BoxA组的这些变化亦被部分调节(P＜0.05).结论:HMGB1抑制剂BoxA尾静脉注射能够下调HMGB1表达水平并同时缓解细菌性脑膜炎大鼠的临床症状和炎症反应.