目的 分析消化系统恶性肿瘤患者的贫血情况,为临床诊断及合理治疗提供指导.方法 对浙江省肿瘤医院2016年1月-2018年12月18 152例消化系统恶性肿瘤患者资料进行回顾性分析.结果 本组患者发病年龄大多分布在50岁～70岁,贫血的总体发生率为33.8％,小肠癌、胃癌、贲门癌、结肠癌贫血发生率高,依次为52.0％、46.8％、45.4％、37.9％.1级～2级贫血(轻中度)占比88.9％,3级～4级(重度)贫血占比11.1％.小肠癌、结肠癌、胃癌和贲门癌3级～4级贫血发生率高,依次为22.7％、15.8％、15.4％和12.8％.贫血组年龄高于未贫血组(P＜0.05);女性贫血发生率高于男性(P＜0.05).结论 消化系统恶性肿瘤患者贫血发生率较高,贫血与肿瘤类型、年龄和性别有相关关系.对中老年人不明原因的贫血,应该考虑消化道恶性肿瘤的可能.对伴发贫血的患者应开展规范合理的治疗,提高患者的生存质量.

目的 探讨脑膜败血伊丽莎白菌(Elizabethkingia meningoseptica,EM)医院感染的临床特征及耐药性,为指导临床合理使用抗菌药物提供依据.方法 回顾性分析2013年9月-2018年9月浙江省中医院下沙院区临床分离的36株EM,进行菌种鉴定及药敏试验,并统计分析该菌感染的特点及耐药性.结果 36株EM主要来源于重症医学科(72.22％),其次是血液科(8.33％)和神经内科(5.56％);主要分离自呼吸道标本(痰液占83.33％),其他为血液、导管及腹水等.EM感染患者平均年龄为60岁,并伴有呼吸系统疾病、脑部疾病或肿瘤等.药敏结果显示,EM对呋喃妥因的耐药率达100％;对亚胺培南、头孢曲松等β-内酰胺类及丁胺卡那、妥布霉素等氨基糖苷类的耐药率均＞97％;对左氧氟沙星、环丙沙星和哌拉西林/他唑巴坦敏感率＞83％.结论 EM感染患者主要为老年人,并伴有一定基础疾病,EM菌株对临床常用的β-内酰胺类和氨基糖苷类抗菌药物耐药率较高,临床治疗可考虑选择喹诺酮类和β-内酰胺酶抑制剂类抗菌药物.

目的 通过观察冬凌草甲素对胃癌Sgc-7901细胞体外培养的增殖、凋亡的影响及作用前后细胞炎性因子的变化程度,探讨其抗肿瘤的分子机制.方法 将胃癌Sgc-7901细胞系进行无菌培养,通过CCK-8法筛选冬凌草甲素作用24h后抑制Sgc-7901细胞增殖的最佳浓度;RT-PCR法检测冬凌草甲素对Sgc-7901细胞表达MMP-2和MMP-9水平的影响;Western Blot法检测冬凌草甲素作用对Sgc-7901细胞表达IL-1β和IL-33水平的情况;通过免疫细胞荧光法检测冬凌草甲素作用后Sgc-7901细胞因子IL-33表达的情况.结果 CCK-8法检测结果显示:冬凌草甲素能抑制Sgc-7901细胞增殖,并且这种影响呈剂量-效应关系,其24h半数生长抑制剂量(IC50)为66.88μm;RT-PCR实验结果显示,冬凌草甲素能下调Sgc-7901细胞MMP-2和MMP-9的表达;Western Blot和免疫细胞荧光法检测结果显示,冬凌草甲素能下调Sgc-7901细胞中IL-1β和IL-33的表达.结论 冬凌草甲素通过体外诱导细胞凋亡来抑制胃癌Sgc-7901细胞的增殖;同时,也可通过下调细胞中IL-1β、IL-33等炎性因子的分泌,从而达到抗肿瘤的作用,为临床治疗胃癌提供新的理论依据.

目的 探讨脐血红细胞流变学相关指标改变与新生儿高胆红素血症的相关性.方法 选择2016年9月至2017年9月出生的新生儿100例,采集脐动脉血进行红细胞流变学指标及血气指标测定,同时经皮监测新生儿的胆红素(TcB)值及静脉总胆红素(TB)值,按72h内是否出现高胆红素血症分为高胆红素血症组(46例)和对照组(54例),比较两组脐血红细胞流变学指标的差异,分析高胆红素血症出现的时间及TB峰值高低两者与红细胞流变学变化间的相互关系.结果 高胆红素血症组脐血的全血5mPa/s切变率粘度、全血200mPa/s切变率粘度、全血还原低切粘度、全血还原高切粘度、红细胞聚集指数、红细胞刚性指数、红细胞变形指数TK值等红细胞流变学指标均高于对照组(P<0.01).比较0~24h、24~48h、48~72h三个出现高胆红素血症时间段的脐血红细胞流变指标,新生儿高胆红素血症出现的时间越早,脐血红细胞流变相关指标升高越明显,差异有统计学意义(P<0.01或<0.05).46例高胆红素血症组按TB峰值从低至高分成171~230μmol/L, 231~290μmol/L,291~342μmol/L,>342μmol/L四个TB峰值组,比较各组间脐血红细胞流变学变化,脐血红细胞流变学检测结果与新生儿TB峰值呈正相关,TB峰值越高,脐血红细胞流变学指标升高越明显(P<0.01).结论 新生儿红细胞破坏和被清除与胎儿时红细胞的聚集性和变形性改变有关,脐血反映红细胞聚集性和变形性的流变学指标对新生儿高胆红素血症有早期预测价值.

目的 研究硫代乙酰胺(TAA)对大鼠骨髓间充质干细胞(BMSCs)的毒性作用.方法 体外分离大鼠骨髓间充质干细胞并培养;光学显微镜下观察原代细胞生长的过程;CCK-8检测TAA对BMSCs细胞的生长抑制作用;流工式细胞术法检测细胞凋亡率;免疫印迹法(Western blot)检测凋亡蛋白Bax,Bcl-2,Caspase-3的表达情况.结果 分离培养的BMSCs阳性表达CD90,CD29,阴性表达CD45,CD11 b/c;与对照组比较,TAA能显著的抑制BMSCs细胞增值,具有明显的时间和剂量依赖性;流式细胞术结果显示TAA能够诱导细胞凋亡;Western blot结果显示TAA能够上调Bax,Caspase-3的表达,Bcl-2的表达下降.结论 TAA对BMSCs具有促进其凋亡的作用.

目的 探究硫代乙酰胺不同注入途径、不同剂量引起新西兰大白兔肝纤维化及肾毒性的作用机制.方法 15只新西兰大白兔随机分成空白对照组,腹腔注射高和低剂量组,耳缘静脉注射高和低剂量组.硫代乙酰胺干预20周处死试验阶段动物,制备肝、肾病理组织切片,苏木素-伊红(HE)染色观察肝肾组织结构病理改变;Western blot检测肝肾组织细胞凋亡相关蛋白Casepase3、Bax、Bcl-2表达水平的变化;免疫组化检测NF-κB表达水平的变化.结果 病理组织切片结果显示,2种注入途径均可导致新西兰大白兔肝细胞肿胀、纤维化形成,且都引起肾上皮细胞肿胀、出血等病理损伤,但无明显纤维化病变;Western blot结果显示2种注入途径均可使肝肾组织细胞凋亡相关蛋白Casepase3和Bax表达上调,Bcl-2表达下降,且呈现剂量依赖性;免疫组化结果表明两种注入途径NF-κB在肝肾组织的表达均随剂量增加表达上调.结论 硫代乙酰胺可引起兔肝纤维化合并肾损伤毒性,可能与其诱导细胞凋亡有关.

Objective To explore the value of umbilical cord related projects for early detection of neonatal jaundice through the analysis of total bilirubin in serum of umbilical cord blood(TBIL),direct bilirubin(DBIL),indirect bilirubin(IBIL),total protein(TP),albumin(ALB) and blood red blood cells(RBC),hemoglobin(Hb),hematocrit(Hct),mean corpuscular volume(MCV),hemoglobin concentration (MCH),mean hemoglobin concentration(MCHC)and correlation index for clinical diagnosis of neonatal hyperbilirubinemia.Methods 361 cases of newborn umbilical vein blood collection of 3ml in our hospital,which took 1ml umbilical cord blood routine test,2ml cord blood separated the serum liver function were measured. Retrospectively collected clinical data of neonates and their mothers,according to neonatal jaundice within 24 hours and whether with the diagnosis of hyperbilirubinemia,unqualified data was eliminated,200 cases of random sampling was divided into two groups. The pathological jaundice group 100 cases and temporary jaundice group 100 cases,comparison between the two groups of umbilical cord blood of above index Results ,Analysis of umbilical cord blood between these indicators,and the concentration of early neonatal jaundice.Results TP and ALB reduced significantly. Hb,MCV,MCH,TBIL and IBIL increased significantly in Cord blood.Conclusions Combined analysis of TBIL, IBIL,TP,ALB,Hb,MCV and MCH levels in umbilical cord blood can be used to predict pathologic jaundice in early neonates.

Objective To evaluate the clinical significance of autoimmune antibodies in the diagnosis and therapy of hematologic malignancies. Methods During the period of 2011 to 2016,453 patients with hematologic malignancies in Zhejiang provincial TCM hospital were enrolled in this retrospective analysis. The antibodies profiles were tested for each patients by using immunoblotting and indirect immunofluorescence. Results The positive rates of MDS and CLL were higher than those of other malignant hematologic diseases,accounting for 29.7%(27/91)and 27.5%(19/69) respectively. Among the detected autoimmune antibodies,ANA positive rate was the highest,accounting for 11.7%(53/453),while positive rate of Anti-PR3 was lowest,accounting for 2.6%(12/453). RBC and PLT counts in CLL patients with positive antibodies were lower than in those with negative ones,and WBC count in MDS patients with positive antibodies was lower than in those with negative ones. Conclusions Autoimmunity is more frequently observed in CLL and MDS than other malignant hematologic diseases,associated with hemocytopenia. It's helpful for clinical doctors to deepen the understanding of the pathogenesis of MDS and CLL,and to help clinical treatment according to different patients' immune status to detect the autoimmune antibodies.

Objective To understand the expression of miR-19a in peripheral blood in patients with lung cancer and the correlation with poor prognosis,and to investigate the effect of miR-19a on invasion and metastasis of lung cancer cells.Methods miR-19a and miR-19a inhibitor slow virus particles were used to build the stable expressions of non-small cell lung cancer cell line(H1299 and H460) in MiR-19 a and miR-19a inhibitor,and cell proliferation assay,invasion test,cell cycle detection,fluorescence quantitative PCR,Western Blot,cell DNA content and light scattering were adopted for the analysis of miR-19a expression levels in lung cancer cells,and compared with BEAS-2B in normal lung mucosa epithelial cell line.Results miR-19a expression was significantly higher than BEAS-2B in the lung cancer cell line,with the difference statistically significant;miR-19a can promote the proliferation,invasion and metastasis of lung cancer cells,accelerate the cell cycle and inhibit the expression of MXD1 gene.Conclusion Target genes of miR-19a MXD1 participated in the miR-19a promote lung cancer cell proliferation and metastasis process,miR-19a can regulate lung cancer cell proliferation and metastasis ability through MXD1,and affect the prognosis of patients.

Objective To cultivate Bcap-37 cells of breast cancer through aseptic manipulation in vitro,observe the influence of oridonin on the activity and apoptosis of Bcap-37 cells,and explore anti tumor mechanism of oridonin. Methods Axenic cultivation of Bcap-37 cells,set the concentrations of oridonin by 0,1,2,4,8,16,32,64ug/ml respectively,after 12,24,36,48 hours,detect the inhibition of oridonin to Bcap-37 cells activity by MMT method;set the concentrations of oridonin by 8 ug/ml,32ug/ml,24 hours later,use flow cytometry to detect the effect of apoptosis on Bcap-37 Cells by oridonin. Results Oridonin has the effect on inhibiting the proliferation and inducing apoptosis of Bcap-37 cells. Conclusion Oridonin can inhibit the proliferation of Bcap-37 cells and induce the apoptosis of Bcap-37 cells,thus providing a new reference for the clinical treatment of breast cancer.

Objective:To investigate the effects of oridonin on proliferation and expression of interleukin 1 family cytokines in human pancreatic cancer cells.,to provide theoretical basis for oridonin in clinical treatment of pancreatic cancer. Methods:Analyzed proliferation activity of human pancreatic cancer cells BxPC-3 and PANC-1 using Cell Counting Kit-8 (CCK-8). Detected secretion of IL-18 in BxPC-3 and PANC-1 cells treated with different concentrations of oridonin by Enzyme Iinked Immunosorbent Assay (ELISA). Observed effects of oridonin on IL-1βin BxPC-3 and PANC-1 cells by Immunofluorescence. Analyzed expression of IL-1β and IL-33 in BxPC-3 and PANC-1 cells by western blot. Results:The proliferation of human pancreatic cancer cells BxPC-3 and PANC-1 was significantly inhibited by oridonin with a dose-dependent manner. Secretion of IL-18 was inhibited by oridonin with a dose-dependent manner. Expression of IL-1βwas inhibited by oridonin. Expression of IL-1βand IL-33 was inhibited by oridonin with a dose-dependent manner. Conclusion: Oridonin inhibited proliferation and expression of interleukin 1 family cytokines in pancreatic cancer BxPC-3 and PANC-1 cells in vitro. Oridonin maybe a novel chemotherapy for pancreatic cancer.

产单核细胞李斯特菌广泛存在于环境中,主要通过污染的食物感染人,可以是散发或爆发,多见于夏末秋初.围产期母婴感染后起病急,进展快,新生儿尤其是早产儿死亡率较高.本文就1例围产期母婴感染产单核细胞李斯特菌的临床诊治过程进行总结报道,为临床的诊断和治疗提供经验.

黄连素(俗称小柴碱)是从毛莨科植物(如黄连)的根茎中提取的一种季胺类异喹啉生物碱,作为抗菌药在临床上已应用多年,是一种广谱抗菌药物.笔者分析黄连素感触前后多重耐药鲍曼不动杆菌培养液中酶活性的变化,了解黄连素对细胞膜通透性的改变,现报道如下.

Objective To observe the effect of the expression of inflammatory cytokines in Sgc-7901 after adding the oridonin and to evaluate oridonin on the changes of inflammatory cytokines in Sgc-7901 and the effects of oridonin on anti-tumor mechanism through SGC-7901 cells cultured in vitro by sterile,then provide a new theoretical basis for the clinical treatment of gastric cancer. Methods Sgc-7901 cells fostered in sterile culture, through CCK-8 experiment,the optimal concentration to inhibit the proliferation of Sgc-7901 cells were screened to oridonin after 24h. Liquid chip analysis system for determination of oridonin on the effect of IL-2,IL-4,IL-6,IL-10 and TNF-α in Sgc-7901 cells. Results CCK-8 experiment results showed that oridonin could inhibit the proliferation of Sgc-7901 cells in a dose-dependent manner,and the IC50 was 66.88μm. The results of Liquid chip analysis system that to test the differential expression of IL-2,IL-4,IL-6,IL-10 and TNF-α after oridonin treated Sgc-7901 cells before and after showed that partial inflammatory factors expression down regulated,the oridonin group with the blank control group were compared. Conclusion Oridonin can inhibit the proliferation of Sgc-7901 cells,and reduce the secretion of IL-6 and other inflammatory factors in Sgc-7901 cells,so as to achieve anti-tumor effect.

OBJECTIVE To understand the effect of berberine on the multidrug resistance of Acinetobacter bauman-nii and efflux pump mechanism ,so as to provide references for clinical treatment .METHODS A total of 32 strains of multidrug-resistant A .baumannii were collected from Jan .to Jun .2016 from inpatients .The changes of MIC values of four commonly used antimicrobial agents before and after the treatment of berberine and the detection rate of mdfA proton pump were compared .RESULTS The MIC values of A .baumannii to ceftazidime ,imipenem , aztreonam and ciprofloxacin were lower than those before berberine treatment .While the 5 strains of experimental bacteria in addition to one was not detected outside ,except one strain was not detected the mdfA proton pump , the other four strains had not detected the mdfA proton pump after the treatment of low concentration of berber-ine .CONCLUSION Berberine can not only reverse the multidrug resistance of A .baumannii to antimicrobial a-gents ,but also eliminate the A .baumannii mdfA proton pump to reverse its multidrug resistance of commonly used antimicrobial agents .

Objective To investigate the expression of HepG2 low-density lipoprotein(LDL) receptor affected by hawthorn flavones. Methods MTT method was used to screen appropriate hawthorn flavone concentrations for cul-ture of the HePG2 line.The numbers and activity of LDL receptorwere measured by cell immunity technology and flow cytometer technology. Results With the increase in concentration of hawthorn flavones, the expression and activity of HepG2LDL receptorincreased. With 5-25 μmol/L amount of hawthorn flavone,the geometric mean of flu-orescene value of LDL receptors on 10000 HepG2cells was11.21, 14.39, 19.67 and the activity value was 6.34,10.11,16.77, respectively. Conclusion Hawthorn flavones can up-regulate the expression of LDL receptorson HepG2.

Objective To analyze the current epidemiology of enteroaggregative Escherichia coli (EAEC) in healthy elderly people, in order to help formulate prevention strategies. Methods Stool specimens from 175 healthy elderly people were cultured on blood plates, SS plates, and MAC plates. Bacterial strains were identified by the VITEK-2 compact automated identification system and mass spectrometry. The phenotype of extended-spectrum beta-lactamases (ESBL) was determined by the double-disk synergy method. The resistance genes and EAEC virulence genes astA and aggR were amplified by polymerase chain reaction (PCR), which was also used to detected EAEC strains with positive ESBL phenotypes. Results Among the 175 samples, 160 strains were E. coli, with an ESBL-positive rate of 36.3% (58/160); 16 stains (10.0%, 16/160) were EAEC, of which, 14 strains (8.75%) were astA-positive and 2 strains (1.3%) were aggR-positive, and the ESBL-positive rate of the EAEC strains was 56.25% (9/16). All of the EAEC strains with positive ESBLs carried CTX-M types, and CTX-M-14 was the most dominant genotype, accounting for 66.7% (6/9). Conclusions EAEC is a common bacterial pathogen of diarrhea and has a high carrier rate and drug resistance rate in healthy elderly people. Therefore, heightened prevention measures should be considered. Key words: Escherichia; Escherichia coli infection

目的 分析健康老年人肠道中肠集聚性大肠埃希菌(EAEC)的检出率,并探讨其毒力基因及超广谱β内酰胺酶(ESBL)的携带情况.方法 取健康老年人的粪便标本分别接种于血平板、SS平板、麦康凯平板进行细菌培养,用全自动微生物鉴定仪和质谱仪鉴定细菌到种;对分离的大肠埃希菌采用双纸片协同法检测其ESBL的表型,用PCR法扩增其EAEC毒力基因astA和aggR;ESBL表型阳性的EAEC菌株用PCR法检测其ESBL基因型.结果 在1 75例研究对象中,共检出160株大肠埃希菌,ESBL携带率为36.30％ (58/160);EAEC检出16株(10.o0％),其中astA阳性14株(8.75％),aggR阳性2株(1.25％);EAEC菌株的ESBL携带率为56.25％ (9/16),其基因型均为CTX-M型,其中以CTX M 14最多,占66.70％ (6/9).结论 本研究获得了健康老年人肠道中EAEC的检出率及其毒力基因和ESBL的携带情况,提示我们EAEC不仅是腹泻患者的病原菌,还可以在健康老年人群中携带,且具有较高的携带率和耐药性,提醒我们加强防范.

目的 分析健康老年人肠道中肠集聚性大肠埃希菌(EAEC)的检出率,并探讨其毒力基因及超广谱β内酰胺酶(ESBL)的携带情况.方法 取健康老年人的粪便标本分别接种于血平板、SS平板、麦康凯平板进行细菌培养,用全自动微生物鉴定仪和质谱仪鉴定细菌到种;对分离的大肠埃希菌采用双纸片协同法检测其ESBL的表型,用PCR法扩增其EAEC毒力基因astA和aggR;ESBL表型阳性的EAEC菌株用PCR法检测其ESBL基因型.结果 175例健康体检者,共检出160株大肠埃希菌,ESBL携带率为36.25％ (58/160);EAEC检出16株(10.00％),其中astA阳性14株(8.75％),aggR阳性2株(1.25％);EAEC菌株的ESBL携带率为56.25％(9/16),其基因型均为CTX-M型,其中以CTX-M-14最多,占66.67％ (6/9).结论 本研究获得了健康老年人肠道中EAEC的检出率及其毒力基因和ESBL的携带情况,提示EAEC不仅是腹泻患者的病原菌,健康老年人也可以携带,且具有较高的携带率和耐药性,提醒应加强防范.

Objective To study the levels of bone alkaline phosphate (BALP) in healthy children in the specific hospital.Methods Totally 990 healthy children from 0-16 years old were selected,all of whom received physical examination in the Xiasha branch of Zhejiang Provincial Hospital of TCM during August 2013 to April 2014.Serum was collected and tested for BALP levels with a Beckman Coulter Immunoassay System UniCel DxI 800.Z-test was used to verify age and gender grouping,after which the 2.5th and 97.5th percentile values of serum BALP levels were calculated.Results The levels of serum BALP(bilateral 95％ range) in healthy children were as follows:trottie stage (0-1 years old):37-300μg/L;infancy to school stage (＞ 1-9 years old):40-196 μg/L;puberty stage (＞9-16 year-old):25-284 μg/L (male),30-199 μg/L (female).The serum BALP levels of male children showed a weak correlation with height,while the correlation for female children was not significant.Conclusions The levels of BALP in healthy children of the specific hospital and area were established.Serum BALP levels in children varied with age and sex.