Objective To evaluate the relationship between the expression of alpha fetoprotein(AFP)and chemoresistance in hepatocellular carcinoma.Methods Hepatocellular carcinoma was screened from liver tumor tissue samples,which was obtained by puncture before transcatheter arterial chemoembolization(TACE).Immuno-histochemical staining was used to detect the expression of AFP in HCC tissues and the effect of AFP expression in HCC on the effect of chemotherapy was analyzed.Results A total of 62 patients met the inclusion criteria,of which 36 were in the chemotherapy resistant group and 26 in the chemotherapy sensitive group.There were 42 patients with positive expression of AFP in tumor tissues(including 29 patients with chemoresistance)and 20 patients with negative expression of AFP in tumor tissues(including 7 patients with chemoresistance).There were no significant difference between the two groups in sex,age,tumor differentiation,Child-Pugh classification of liver function,tumor size,tumor site and hepatitis(P＞0.05).In elevated serum AFP level,tumor single,and with portal vein tumor thrombus(PVTT),the proportion of patients in the chemosensitivity group were significantly lower than that in the chemosensitivity group (P＜0.05).The results of logistic multivariate regression analysis showed that positive expression of AFP [OR=0.280,95%CI (0.092,0.950),P=0.045] and PVTT [OR=0.026,95%CI(0.004,0.322),P=0.005] were independent risk factors for chemotherapeutic resistance in hepatocellular carcinoma.Conclusion AFP positive expression in liver tumor tissues and PVTT are useful indicators of resistance to chemotherapy.

目的 探讨PD-L1和CD68分子的表达与卵巢浆液性腺癌患者发病风险及临床预后的关系.方法 收集泰州市人民医院2010年1月—2017年6月49例确诊为卵巢浆液性腺癌患者的临床资料并进行回顾性分析,并选取8例卵巢良性疾病患者的临床资料作为正常组.比较两组PD-L1和CD68分子的表达水平及观察组中PD-L1分子的表达与临床预后关系.两组间平均年龄等一般资料差异无统计学意义(P>0.05).结果 ①卵巢浆液性腺癌患者PD-L1和CD68分子的表达较正常组显著表达;②PD-L1分子的表达与患者生存年数呈负相关(P<0.05).结论 该结果提示我们PD-L1分子的表达可以作为判断卵巢浆液性腺癌患者发病风险及临床预后的重要指标.

Objective:To discuss the mind map in tumor patients with PICC catheter complications nursing care in the application. Methods:80cases of cath-eter were divided into observation group and control group. The control group received routine nursing care,observation group were based on the application of mind map. Results:The catheter complications of observation was lower than the control group. Conclusion:According to the PICC analysis of causes of common complications and treatment measures of tube design their own mind map,improve the observation and nursing ability of nurses,and reduce the com-plications,improve patient satisfaction.

目的:研究α-干扰素治疗慢性乙型肝炎效果与患者HBV基因B、C型关系。方法:采用基因芯片法对69例慢性乙型肝炎患者HBV基因分型,观察慢性乙型肝炎B、C基因型患者α-干扰素治疗前、后谷胺酰氨基转移酶、HBV DNA水平。结果:69例慢性乙型肝炎患者中B、C基因型分别为36和33例。α-干扰素治疗1年时,慢性乙型肝炎B基因型患者完全应答率(53.35%)高于C基因型患者(32.56%),差异有统计学意义(P<0.05)。结论:α-干扰素治疗慢性乙型肝炎B基因型患者效果优于C基因型患者。HBV基因型的检测对干扰素抗病毒治疗有一定的临床指导意义。

目的分析HBV感染者外周血CD4+CD25+调节性T细胞(Tregs)水平,并探讨其在HBV感染发病机制中的作用。方法采用流式细胞术检测不同类型HBV感染者及健康对照组外周血Tregs水平,并应用荧光定量PCR技术测定其血清中HBV DNA载量。结果慢性乙型肝炎组(CHB)Tregs表达率明显高于急性乙型肝炎组(AHB)(P<0.01),与无症状携带组及健康对照组比较差异有统计学意义(P均<0.01);AHB组Tregs表达率较健康对照组稍低,但差异无统计学意义(P>0.05);无症状携带组与健康对照组相比差异无统计学意义(P>0.05)。CHB组外周血HBV DNA载量较其他三组明显偏低(P<0.01);AHB组与无症状携带组、健康对照组相比,差异无统计学意义(P>0.05)。不同类型HBV感染患者外周血Tregs表达率与HBV DNA载量呈正相关。结论外周血Tregs表达水平与HBV感染患者病情轻重有一定关系,并在乙型肝炎持续感染中可能发挥重要作用。不同类型HBV感染患者外周血Tregs表达率与HBV DNA载量呈正相关。

目的探讨影响聚乙二醇干扰素α-2a治疗慢性乙型肝炎的相关因素及护理.方法本文对150例采用聚乙二醇干扰素α-2a治疗的慢性乙肝患者进行定向性观察,分析其影响的相关因素.结果针对影响因素,采取相应的护理措施,减轻了患者的不良反应.结论通过有效地护理,提高了患者的耐受性,确保治疗顺利进行.

目的探讨粒细胞肉瘤(granulocytic sarcoma,GS)的临床病理学特征、诊断与鉴别诊断、治疗及预后。方法对5例GS的临床病理分析及免疫组化进行研究,并复习相关文献。结果 5例患者平均年龄23岁,多数以淋巴结肿大或其他局部孤立性肿物为首发症状,3例为非白血病性GS,2例为白血病性GS,分别发生于乳腺、膀胱、胸椎管、腰椎及淋巴结。1例形态学误诊为低分化肉瘤样癌,1例误诊为非霍奇金淋巴瘤,1例误诊为神经内分泌癌。免疫组化染色5例瘤细胞均表达髓过氧化物酶(MPO)、CD45和CD43,2例表达溶菌酶、CD34,CD99、CD68散在表达各1例。2例有急性髓性白血病(AML)-M2病史,复发后接受造血干细胞移植(HSCT)的中位生存期30个月(24～36个月),明显优于常规治疗的2例患者的12个月(6～18个月)。结论 GS在临床特征、病理形态学上容易误诊,免疫组化检测是诊断该肿瘤的重要手段。GS预后差,复发率高,高强度的化疗及HSCT治疗有望延缓复发,提高生存率。

目的:分析乙型肝炎患者外周血Tregs水平并探讨其在HBV感染者中发病机制的作用。方法:采用流式细胞术检测不同类型乙型肝炎患者及健康对照组外周血Tregs的水平及应用荧光定量PCR技术测定其血清中HBVDNA载量。结果:①慢性乙型肝炎组(CHB)Tregs表达率较急性乙型肝炎组(AHB)有明显差异(P<0.05),与无症状携带者组及健康对照组则有显著差异(P均<0.01);②AHB组较健康对照组的稍低,但无统计学意义(P>0.05),且明显低于CHB组(P<0.01);③无症状携带者组与健康对照组相比无显著差异(P>0.05)。④CHB组外周血HBVDNA载量较其他三组明显偏低(P<0.01);AHB组与无症状携带者组、健康对照组相比,差异无统计学意义(P>0.05)。⑤不同类型HBV感染患者外周血Tregs表达率与HBVDNA载量呈正相关。结论:①外周血Tregs表达的水平与乙肝患者病情轻重有一定关系,它在乙型肝炎持续感染中可能发挥了重要作用。②不同类型HBV感染患者外周血Tregs表达率与HBVDNA载量呈正相关。

目的调查某院医务人员手卫生的依从性现状。方法采用隐蔽式现场观察的方法,根据《医务人员手卫生规范》,对128名医务人员接触患者前后手卫生的依从性进行调查。结果 128名医务人员中,接触患者前后执行手卫生者40人,手卫生依从率31.25%。手卫生依从率最高的科室为重症监护室（53.85%）,其次为妇产科（36.36%）、内科（34.62%）、急诊科（25.00%）和外科（20.00%）;不同岗位间,手卫生依从率最高的是护士（48.57%）,其次为医生（38.71%）、实习护士（20.83%）、实习医生（16.67%）、护工和保洁员（15.38%）。结论该院医务人员手卫生依从性不高,应加强宣教、监督和管理。

From 19 cases of psychological crisis case populat-ion statistics,the author analyzes the psychological crisis case discovery and the intervention process,discusses the crisis stressor and case,main types of psychological crisis in practice on the basis of summing up university psychological crisis management experience and practice,reflects current average college psychological crisis work existed problems and difficulties,and put forward the college psychological crisis intervention suggestions.

<正>大学生心理委员是随着我国大学生心理健康教育工作进一步发展而产生的高校学生组织。2000年至今,北京、上海、广东等地区的高校纷纷建立起心理委员制度并积极进行探索。其中,中国农业大学、中国科技大学、温州医学院以及北京印刷学院等院校率先建立了心理委员制度。我们在收到一定的效果的同时,也发现心理委员制度存在的一些问题。

Objective To observe the clinical effect of puerarin in treatment of early patients with anterior ischemic optic neuropathy(AION).Methods 44 patients(44 eyes) were randomly divided into two groups(n=22).Patients in treatment group were intravenously performed with 200 mg puerarin plus 250 mL normal sodium once a day for 14 days,500 mL low molecule dextran were intravenously performed once a day for 14 days in control group.The sight and visual field were detected pre-and post-treatment in two groups.Results The effective rate in treatment group(95.45%) was obviously higher than this in control group(59.09%,P<0.05).There were no significant difference in sight,average visual impairment and,sensitiveness before treatment between(P>0.05).There were no significant difference in these indexes pre-and post-treatment in control group(P>0.05),but there was significant difference in treatment group(P<0.01),and there was significant difference of these indexes between two groups post-treatment(P<0.05).Conclusion Puerarin can improve visual function in patients with early AION.