披针叶野决明(Thermopsis lanceolata)具有饲用、有机肥料和药用等多重功效.采用Illumina高通量测序技术,借助K-mer分析工具,揭示了披针叶野决明基因组的多个分子遗传学特征,包括基因组大小、杂合度和GC含量等,此外,采用MISA工具进行SSR(Simple Sequence Repeats)特征分析,通过NT数据库(Nucleotide Database)进行BLAST比对,以探讨其物种多样性.研究结果显示,披针叶野决明的基因组大小为786.16 Mbp,测序深度为61.09×,重复序列比例为59.99%,杂合率为0.60%,GC含量为36.4%.通过对基因组序列进行SSR特征分析,共鉴定了72 357个SSR,其中单、二、三、四、五和六核苷酸重复模体分别占总重复模体数的49.34%,22.17%,18.08%,2.02%,0.70%和0.54%;从测序得到的350 bp文库中,提取前50 000条reads与NT数据库进行BLAST比对,发现披针叶野决明的近缘物种新疆野决明(Thermopsis turkestanica)和狭叶羽扇豆(Lupinus angustifolius)上的reads匹配率较高,分别占21.90%和15.46%.综合基因组调研和SSR特征分析显示,披针叶野决明为高杂合、高重复的复杂基因组,这为其资源保护和遗传多样性研究等工作提供遗传信息支撑.

目的 了解西藏自治区拉萨市≥ 40岁社区居民慢性阻塞性肺疾病(简称慢阻肺或COPD)的患病率及知晓率情况.方法 此次研究通过参考WHO慢性阻塞性肺疾病负担研究项目,并结合西藏本地域特点而制定的调查表,采用整群随机抽样方法,抽取西藏自治区拉萨市≥40岁常住社区居民.调查通过入户及集中采集的形式,经由统一培训合格的相关医护人员采取面对面的方式帮助调查对象进行问卷调查,并进行体检及肺功能检查.结果 纳入资料完整、有肺功能检查结果且质量控制合格的713例,其中男性223人、女性490人,平均年龄(55.94±9.238)岁.慢阻肺患病率为6.45％,其中男患病率9.87％,女患病率4.90％;生物燃料接触史患病率5.76％,非生物燃料接触史患病率11.36％,吸烟者患病率6.88％,非吸烟者患病率6.18％.调查人群对慢阻肺疾病名称知晓率为0.84％(6/713),慢阻肺患者疾病名称知晓率为6.52％(3/46).肺功能检查率为3.65％(26/713),慢阻肺患者肺功能检查率为2.17％(1/46).结论 2021年拉萨市40岁及以上社区居民慢阻肺患病率较高,但对其知晓率及肺功能检查率低.应加大对人群慢性阻塞性肺疾病防治知识的宣传、教育力度,提高慢阻肺高危人群肺功能的检查率,加强早期预防控制,提高诊断率、降低漏诊率.

Background:COPD patients living in Tibet are exposed to specific environments and different risk factors and probably have different characteristics of COPD from those living in flatlands. We aimed to describe the distinction between stable COPD patients permanently residing at the Tibet plateau and those in flatlands.Methods:We conducted an observational cross-sectional study that enrolled stable COPD patients from Tibet Autonomous Region People's Hospital (Plateau Group) and Peking University Third Hospital (Flatland Group), respectively. Their demographic information, clinical features, spirometry test, blood routine and high-resolution chest CT were collected and evaluated.Results:A total of 182 stable COPD patients (82 from plateau and 100 from flatland) were consecutively enrolled. Compared to those in flatlands, patients in plateau had a higher proportion of females, more biomass fuel use and less tobacco exposure. CAT score and frequency of exacerbation in the past year were higher in plateau patients. The blood eosinophil count was lower in plateau patients, with fewer patients having an eosinophil count ≥300/μL. On CT examination, the proportions of previous pulmonary tuberculosis and bronchiectasis were higher in plateau patients, but emphysema was less common and milder. The ratio of diameters of pulmonary artery to aorta ≥1 was more often in plateau patients.Conclusion:Patients with COPD living at Tibet Plateau had a heavier respiratory burden, lower blood eosinophil count, less emphysema but more bronchiectasis and pulmonary hypertension. Biomass exposure and previous tuberculosis were more common in these patients.

目的 分析对慢阻肺并2型呼吸衰竭患者采用无创呼吸机治疗对改善其血气分析和炎症因子水平的实际价值.方法 抽取2021年1月至2022年1月西藏自治区人民医院74例慢阻肺并2型呼吸衰竭患者,随机数字表法分组,即对照组、观察组,各组均为37例患者,对照组为常规治疗,观察组加用无创呼吸机治疗,就2组患者的治疗总有效率、血气分析指标、血清炎症因子指标、生命体征指标、肺功能指标、康复进程指标和不良反应率等进行对比.结果 治疗前2组PaO2、PaCO2、SaO2对比P>0.05,治疗后PaO2、SaO2观察组高于对照组,PaCO2观察组低于对照组P<0.05;治疗前2组CR P、PCT水平对比P>0.05,治疗后CR P、PCT水平观察组低于对照组P<0.05;治疗总有效率观察组为97.30％,对照组为86.49％,P<0.05;治疗前2组H R、RR、PA SP对比P>0.05,治疗后H R、RR、PA SP观察组均低于对照组P<0.05;呼吸衰竭纠正时间、IC U重症监护时间以及总住院时间观察组短于对照组P<0.05,气管插管率观察组低于对照组P<0.05;治疗前2组FEV 1、FV C、FEV 1/FV C对比P>0.05,治疗后FEV 1、FV C、FEV 1/FV C观察组高于对照组P<0.05;不良反应率观察组为5.41％,对照组为2.70％,P>0.05.结论 对于慢阻肺并2型呼吸衰竭患者给予无创呼吸机治疗可获得确切疗效,并可有效改善其血气分析及降低血清炎症因子水平.

Background COPD at high altitude may have different risk factors and unique clinical and radiological phenotypes. We aimed to investigate the demographic data, clinical and radiological features of COPD patients permanently residing at the Tibet Plateau (≥3000 meters above sea level). Methods We conducted an observational cross-sectional study which consecutively enrolled COPD patients visiting the outpatient of Respiratory Medicine at Tibet Autonomous Region People’s Hospital from January 2018 to March 2021. All patients were Tibetan permanent residents aging ≥40 years and met the diagnosis of COPD according to Global Initiative for Chronic Obstructive Lung Disease (GOLD) guidelines. Data including demographic characteristics, altitude of residence, risk factors, respiratory symptoms, comorbidities and medications, as well as computed tomography (CT) measurements were collected. Results Eighty-four patients with definite COPD were enrolled for analysis. Their mean age was 64.7 (±9.1) years. All patients lived at ≥3000 m above sea level and 34.5% of them lived at ≥4000 m. About 8.3% of the patients were current smokers and 44.0% were ex-smokers. Up to 88.1% of the patients reported long-term exposure to indoor biomass fuels. Most of the patients were classified as having mild-to-moderate (GOLD I: 27.4%; GOLD II: 51.2%) COPD, while 89.3% had a CAT score ≥10. Only 36.9% of the patients received regular long-term medications for COPD in the past year, in whom ICS/LABA and oral theophylline were the most common used pharmacological therapy. On CT scanning, the majority of our patients (70.7%) showed no or minimal emphysema, while signs of previous tuberculosis were found in 45.1% of the patients. Conclusion COPD patients living at the Tibet Plateau had a heavy respiratory symptom burden, but most of them did not receive adequate pharmacological treatment. Indoor biomass fuel exposure and previous tuberculosis were prevalent, while the emphysema phenotype was less common in this population.