急性胰腺炎患者的CT、MRI影像学表现及其诊断价值对比研究

摘要 目的：比较急性胰腺炎患者的电子计算机断层扫描（CT）、磁共振成像（MRI）影像学表现及其诊断价值。方法：选择2018年1月-2019年12月我院收治并初步诊断为急性胰腺炎的患者124例，所有患者均同时行CT和MRI检查，并比较两种检查方式诊断急性胰腺炎的影像学表现，以临床最终诊断结果作为参考，比较两种检查方式诊断急性胰腺炎的价值。结果：124例患者，经临床最终诊断为急性胰腺炎96例，28例为非急性胰腺炎，以临床最终诊断结果为"金标准"，CT诊断急性胰腺炎的灵敏度、特异度、阳性预测值、阴性预测值和准确度分别为84.38%、75.00%、92.05%、58.33%、82.26%，MRI诊断急性胰腺炎的灵敏度、特异度、阳性预测值、阴性预测值和准确度分别为95.83%、78.57%、93.88%、84.62%、91.94%，MRI诊断急性胰腺炎的灵敏度、阴性预测值和准确度显著高于CT（P<0.05），两种检查方式诊断急性胰腺炎的特异度、阳性预测值比较无统计学差异（P>0.05）。结论：CT和MRI影像学表现有利于急性胰腺炎的诊断，两者对急性胰腺炎诊断均具有较高的灵敏度、特异度和准确度， 但MRI诊断急性胰腺炎的灵敏度、准确度优于CT。     

系统和四维超声对胎儿器质性异常筛检价值分析

摘要 目的：探究系统及四维超声在胎儿器质性异常筛选中的应用价值。方法：回顾性分析2018年3月至2019年3月于我院接受检查的887例中晚期产妇超声检测资料,所有产妇均行系统及四维超声检测,对比系统超声、四维超声和联合检测在胎儿器质性异常筛查中的特异性、敏感性和准确性,分析上述检查方式对不同胎儿器质性异常筛查的价值。结果：（1）887例产妇共娩出899例胎儿,其中87例存在器质性异常,异常率9.68 %（87/899）,联合检测对器质性异常检出率为94.25 %（82/87）,系统超声检出率为68.97 %（60/87）,四维超声检出率为79.31 %（69/87）,联合检测明显优于单独检测（P<0.05）;（2）系统超声检测一致性为96.05 %,灵敏度为70.59 %,特异度为98.54 %,四维超声一致性为96.47 %,灵敏度为75.40 %,特异度为98.54 %,联合检测一致性为99.57%,灵敏度为96.26 %,特异度为99.90 %,对比发现联合检测一致性、灵敏度均优于单独检测。结论：系统及四维超声对胎儿器质性异常具有较好的筛查效果,联合检测筛查效果优于单独检测。     

产前经腹灰阶联合彩色血流超声多参数对胎盘植入性疾病的诊断效能研究

摘要 目的：探究产前经腹灰阶联合彩色血流超声多参数对胎盘植入性疾病的诊断效能。方法：2019年11月-2021年12月于我院收治的产前超声诊断为前置胎盘的孕妇共计62例,其中44例超声诊断合并了胎盘植入的孕妇。所有孕妇产前均进行经腹灰阶检查、经腹彩色超声检查和二者联合检查胎盘植入性疾病,通过分析胎盘植入性疾病筛查结果,评价产前超声经腹灰阶联合彩色血流超声多参数对胎盘植入性疾病的筛查效能。结果：（1）通过灰阶超声诊断检出胎盘植入的灵敏度为73.42 %,特异度为86.54 %;（2）通过彩色超声诊断检出胎盘植入的灵敏度为76.89%,特异度为89.07 %;（3）经腹灰阶联合彩色血流超声多参数诊断检出胎盘植入的灵敏度为87.79 %,特异度为90.36 %;（4）经腹灰阶检查、经腹彩色超声检查和二者联合检查对胎盘植入性疾病筛查阳性率分别为56.45 %、62.90 %和67.74 %,二者联合检查对产前胎盘植入性疾病筛查阳性率显著高于经腹灰阶检查和经腹彩色超声检查（P<0.05）。（5）二者联合检查的敏感度为72.26 %,特异度为90.54 %,阳性比为95.55 %,诊断比值比为78.89 %。结论：产前经腹灰阶联合彩色血流超声多参数对胎盘植入性疾病的诊断有较高的灵敏度和特异度,值得临床推广应用。     

血浆内皮素配合描记动态脑电图在儿童晕厥诊断中应用的临床意义

摘要 目的：探究血浆内皮素配合描记动态脑电图在儿童晕厥诊断中的应用意义。方法：选择2017年1月至2020年1月于我院接受治疗的83例存在晕厥风险儿童,采集其静脉血样进行血浆内皮素水平测定,并实施动态脑电图检测,而后以倾斜试验结果为金标准,分别分析单纯血浆内皮素、单纯动态脑电图以及血浆内皮素+动态脑电图对晕厥的诊断应用意义。结果：（1）83例入组儿童中阳性为68例,阴性为15例,血浆内皮素检测阳性51例,阴性32例,一致性为77.11 %,灵敏度为73.53 %,特异度为93.33 %,阳性预测值为98.04 %, 阴性预测值为43.75 %;（2）动态脑电图诊断一致性为78.31 %,灵敏度为80.88 %,特异度为66.67 %,阳性预测值为91.67 %,阴性预测值为43.48 %;（3）联合检测诊断一致性为93.98 %,灵敏度为94.12 %,特异度为93.33 %,阳性预测值为98.46 %,阴性预测值为77.78 %;（4）检测方式差异性比较发现,联合检测在一致性、灵敏度、阴性预测值方面明显优于血浆内皮素和动态脑电图检测,在特异度方面优于动态脑电图检测（P<0.05）。结论：血浆内皮素联合描记动态脑电图对儿童晕厥具有较好的诊断辅助价值,能够显著提高诊断的一致性、灵敏度和特异度。     

三种宫颈癌筛查方法的临床效果比较及筛查阳性者认知状况调查

摘要 目的：研究三种宫颈癌筛查方法的临床效果比较及筛查阳性者认知状况。方法：选取2018年3月～2019年12月有阴道镜检查指征并完成阴道镜检查和宫颈活检的287例患者作为研究对象。对所有研究对象在阴道镜检查前均开展宫颈液基细胞学（TCT）检查、人乳头瘤病毒-脱氧核糖核酸（HPV-DNA）检查以及细胞DNA定量检查。以活检后病理检查结果为金标准,分析上述三种宫颈癌筛查方式的灵敏度、特异度以及准确度。此外,采用自拟的调查问卷的方式明确宫颈癌筛查阳性患者的认知状况。结果：以病理学结果为金标准,宫颈上皮内瘤变2（CIN2）及以上为阳性,TCT检查宫颈癌前病变的灵敏度、特异度以及准确度分别为68.63%（35/51）、78.81%（186/236）、77.00%（221/287）。HPV-DNA检查宫颈癌前病变的灵敏度、特异度以及准确度分别为94.12%（48/51）、59.32%（140/236）、65.51%（188/287）。细胞DNA定量检查宫颈癌前病变的灵敏度、特异度以及准确度分别为72.55（37/51）、86.86%（205/236）、84.32%（242/287）。 HPV-DNA检查的灵敏度高于TCT检查和细胞DNA定量检查（P＜0.05）,细胞DNA定量检查的特异度及准确度均较TCT检查和HPV-DNA检查更高（P＜0.05）。了解宫颈癌筛查的人数占比为92.16%,了解定期筛查宫颈癌的重要性人数占比17.65%,了解宫颈癌筛查方式人数占比为9.80%,了解HPV相关知识人数占比0.00%,了解宫颈癌筛查可早期检出病变人数占比为15.69%。结论：HPV-DNA检查应用于宫颈癌筛查中具有较高的灵敏度,而细胞DNA定量检查具有较高的特异度以及准确度,筛查阳性者的认知状况有待提高。     

皮胆红素百分位曲线图结合相关风险因素预测新生儿高胆红素血症的临床价值

摘要 目的：评价新生儿出生后72 h经皮胆红素（TcB）百分位曲线图结合临床相关风险因素，预测新生儿高胆红素血症的发生情况。方法：选择2018年1月-2019年12月在安徽理工大学第一附属医院出生的晚期早产儿和足月儿，使用经皮黄疸仪监测其黄疸值，绘制TcB百分位列线图，以新生儿出生后72 h内末次TcB值对应的风险区结合致病风险因素预测新生儿高胆红素血症发生的价值。结果：3818例新生儿出生后72 h后高危区人数为278例（7.28%）。TcB数值在4 h到48 h内上升最快，峰值出现在出生后84 h-120 h，P40、P75及P95峰值分别为193.75 μmol/L，224.75 μmol/L和282.25 μmol/L，其中P95峰值出现最晚。新生儿出生后0-48 h内共计有244例TcB值处于高危险区，其中92例在72 h后仍处高危区，预测灵敏度为29.97%，特异度为95.67%；49-72 h内共计有269例新生儿TcB值处于高危区，其中116例新生儿在72 h后TcB值仍处高危区，灵敏度为36.48%，特异度为95.62%。多因素Logistic回归分析显示，相关致病危险因素有：胎龄、住院时间、分娩方式、胎膜早破及喂养方式（P<0.05）。72 h内TcB危险区的受试者工作特征（ROC）曲线下面积为0.75（95%CI:0.56-0.93），结合相关风险因素的ROC曲线下面积为0.93（95%CI:0.81-1.00），预测价值明显提高。结论：TcB百分位曲线图结合"高危因素"预测新生儿高胆红素血症准确性较高，操作简便，具有较好的临床价值。     

孕中期超声联合无创产前基因筛查在检出染色体异常胎儿中的应用价值

摘要 目的：孕中期超声联合无创产前基因筛查（NIPT）在染色体异常胎儿检出中的应用价值。方法：选取2019年8月～2021年12月在石家庄市妇幼保健院产前检查的2000例孕中期孕妇,均接受超声检查和NIPT筛查。以羊水穿刺或引产后高通量测序结果为金标准,四格表法分析孕中期超声联合NIPT在染色体异常胎儿检出中的应用价值。结果：2000例孕中期孕妇中,超声检查共检出软指标异常37例,结构指标异常30例。NIPT筛查检出高风险孕妇17例,其中21-三体综合征11例、18-三体综合征6例。超声软指标和结构指标联合NIPT诊断胎儿染色体异常的灵敏度、特异度、阳性预测值、阴性预测值、漏诊率、误诊率、准确率分别为95.00%、99.95%、95.00%、99.95%、5.00%、0.05%、99.90%。结论：联合孕中期超声和NIPT可提高检出高风险染色体异常胎儿的灵敏度,降低漏诊率,对于早发现染色体异常胎儿具有重要价值,进而提高生育质量。     

高频超声联合低频超声检查诊断新生儿颅脑病变的临床价值研究

摘要 目的：探讨高频联合低频超声对新生儿颅脑病变的诊断价值,为新生儿颅脑病变的诊断提供依据。方法：选择2019年1月-2021年4月安徽省儿童医院接诊并疑似出现颅脑病变的新生儿62例作为研究对象,所有研究对象均应用高频超声联合低频超声探头对颅脑进行检查,并住院治疗。比较高频超声、低频超声、高频联合低频超声对新生儿颅脑病变的检出率;根据出院诊断结果比较高频超声、低频超声及联合检查与临床诊断符合情况及对颅脑病变的诊断价值。结果：高频超声检出颅脑病变35例（56.45%）,低频超声检出颅脑病变27例（43.55%）,高频超声联合低频超声检出颅脑病变53例（85.48%）,高频超声联合低频超声对新生儿颅脑病变的检出率显著高于高频超声、低频超声（P<0.05）;高频超声对新生儿颅脑病变的检出率显著高于低频超声（P<0.05）。高频联合低频超声对新生儿颅脑疾病诊断与临床诊断总体符合率高于高频超声、低频超声,高频超声对新生儿颅脑疾病诊断与临床诊断总体符合率高于低频超声（P<0.05）。高频联合低频超声对新生儿不同颅脑疾病诊断灵敏度、准确度显著高于高频超声、低频超声（P<0.05）,高频超声对新生儿不同颅脑疾病诊断灵敏度、准确度显著高于低频超声（P<0.05）,三种检查方法对新生儿不同颅脑疾病诊断特异度比较无统计学意义（P>0.05）。结论：高频联合低频超声检查诊断新生儿不同颅脑病变的灵敏度、准确度均较高,具有一定的临床应用价值。     

Ki67与MRI在宫颈癌根治性手术后宫颈癌淋巴结转移中评价对比

摘要 目的：探究Ki67与MR在宫颈癌根治术后宫颈癌淋巴结转移中评估价值的对比。方法：选择2016年1月至2018年1月于我院接受宫颈癌根治术的151例宫颈癌患者,分别对其实施Ki67检测及MRI检测,以病理学检测结果为金标准,计算两种检测方式对宫颈癌淋巴结转移评估的准确度、敏感度、特异度、阳性预测值及阴性预测值,并进行对比分析。结果：检测评估发现,MRI对宫颈癌淋巴结转移评估准确度为31.79 %,灵敏度为46.75 %,特异度为16.22 %,阳性预测值为36.73 %,阴性预测值为22.64 %。Ki67检测对宫颈癌淋巴结转移评估准确度为42.38 %,灵敏度为52.56 %,特异度为31.51 %,阳性预测值为45.05 %,阴性预测值为38.33 %。两种检测方式对比显示Ki67对宫颈癌淋巴结转移具有更高的诊断准确度。结论：3 相比于MRI检测,Ki67对宫颈癌淋巴结转移具有更高的诊断准确度、特异度和阴性预测值,分析其原因与MRI检测受个体因素影响更大有关。     

QRS、QT、QTc及LVEF预测心源性猝死的价值分析

摘要 目的：探讨QRS时限值（QRS）、QT间期延长（QT）、QTc间期（QTc）及左室射血分数（LVEF）预测心源性猝死的价值分析。方法：选择2018年1月至2019年12月川北医学院附属医院心血管内科治疗的356例心源性猝死患者进行研究,设为病例组,并选择同期体检的健康人200例作为对照组,分析QRS、QT、QTc及LVEF水平变化情况及其预测价值。结果：病例组QRS、QTc水平显著高于对照组,QT、LVEF水平显著低于对照组,差异显著（P＜0.05）;轻度QRS、QTc显著低于中度、重度患者,QT、LVEF水平显著高于中度、重度患者;中度患者QRS、QTc显著低于重度患者,QT、LVEF水平显著高于重度患者,差异显著（P＜0.05）;ROC结果显示,QRS预测心源性猝死的AUC为0.989,灵敏度△为84.59%,特异度为87.68%,截断值为115.59ms;QT预测心源性猝死的AUC为0.944,灵敏度85.12%,特异度为88.45%,截断值为21.69ms;QTc预测心源性猝死的AUC为0.984,灵敏度为86.05%,特异度为88.61%,截断值为416.39ms,LVEF预测心源性猝死的AUC为0.997,灵敏度87.15%,特异度为89.05%,截断值为45.63%,（P＜0.05）。结论：QRS、QT、QTc及LVEF在心源性猝死患者中检查,可显著提高心源性猝死临床诊断效能。     

六种藓类植物茎的比较解剖学研究

通过对6种藓类植物,即褶叶青藓(Brachythecium salebrosum(Web.et Mohr.)B.S.G.)、湿地匐灯藓(Plagiomnium acutum(Lindb.)Kop.)、侧枝匐灯藓(Plagiomnium maximoviczii(Lindb.)Kop.)、大凤尾藓(Fissidensnobilis Griff.)、大羽藓(Thuidium cymbifolium(Doz.et Molk.)B.S.G.)和大灰藓(Hypnum plumaeforme Wils.)嫩茎和老茎的石蜡切片和显微观察发现,同一藓类植株的嫩茎和老茎,茎结构稳定,不同种藓类植物茎横切面具有不同特征.植物体茎横切面形状、表层细胞的层数、细胞大小和细胞壁厚薄、皮层细胞大小和形状、中轴的有无以及比例等特征可以作为藓类植物的分科分类依据之一.     

Photoregulation of seed germination of wild-type and of an aurea-mutant of tomato

Seed germination of an aurea mutant of tomato ( Lycopersicon esculentum Mill.) is promoted by continuous irradiation with red, far-red or long-wavelength far-red (758 nm) light as well as by cyclic irradiations (5 min red or 5 min far-red/25 min darkness). Far-red light applied immediately after each red does not change the germination behaviour. Seed germination of the isogenic wild-type, cv. UC-105, is promoted by continuous and cyclic red light while it is inhibited by continuous and cyclic far-red light and by continious 758 nm irradiation. Far-red irradiation reverses almost completely the promoting effect of red light. The promoting effect (in the aurea mutant) and the inhibitory effect (in the wild-type) of continuous far-red light do not show photon fluence rate dependency above 20 nmol m⁻² s⁻¹. It is concluded that phytochrome controls tomato seed germination throgh low energy responses in both the wild type and the au mutant. The promoting effect of continuous and cyclic far-red light in the au mutant can be attributed to a greater sensitivity to P_fr.     

Cause of Senescence of Nine Sorts of Flowers

The levels of endogenous phytohormones and respiratory rate in nine sorts of flowers such as Cymbidium faberi Rolfe, Nopalxochia ackermannii Kunth and others were investigated both at full bloom and senescence and meanwhile the effect of exogenous phytohormones on prolonging the blossoms and promoting ethylene production were tested. There is a high content of endogenous ethylene in all the long-lived flowere, about 3–16 folds higer than the short-lived ones. There is a high level of ABA at full blooming flowers of short-lived flowers, in which there is no or only some cytokinins in it, but the ratio of CTK (6BA+zeatin)/ABA is smaller(l.7). The endogenous ABA reached a much higher level at senescence in all nine sorts of flowers, so it is reasonable to consider that it is ABA which plays an important role of regulation in controlling flower's senescence. There is a much higher level of GA3 and zeatin in the long-lived flowers which is not demonstrated in the shortlived ones. The respiratory rate is one of the factors controtling the longevity of flowers, but it does not play a decided role. Application of 6BA and zeatin prolongs distinctly orchid’s longevity, however exogenous IAA through the promotive action on ethylene production, evidently extends the longevity of the flowers of the Nopalxochia ackermannii Kunth.     

龙胆科药用植物化学成分的研究现状

龙胆科植物在我国的分布范围很广,且多数为药用植物,其多数种属的药用植物,至今其化学成分尚未被系统研究。综述了目前龙胆科药用植物的化学成分的研究现状及一般提取方法,对近年来发现的环烯醚萜及裂环烯醚萜类化合物进行了总结,为本科药用植物的更深入研究提供了参考。     

Interconnection of parameters of regulation system of lipid peroxidation and of morphophysiological parameters of mouse liver

A complex analysis of seasonal fluctuations of the mean group parameters of the system of regulation of lipid peroxidation has been performed in liver of Balb/c mice. Association of lipid characteristics and morphophysiological parameters is studied in the Balb/c mouse liver. An inter-connection is revealed between the liver index and the amount of lysoforms of phospholipids, the scale and character of the interconnection differing essentially depending on proportion of phos-phatidylcholine in mouse liver phospholipids.     

真菌类遗传学分析的知识结构教学

本文以认知结构理论为指导,讨论了真菌类遗传分析与高等动植物遗传分析的内在联系,认为利用这种内在联系进行教学可收到好的效果并说明了作者的具体教学过程。 Abstract:In the paper, the relationship between genetic analysis of Fungi and genetic analysis of high animal and plant was discussed.A good results were obtained when we adopted this method in the teaching.     

Physiological characteristics of various species of strains of carboxydobacteria

Seven strains of aerobic carbon monoxide-oxidizing bacteria (carboxydebacteria) when growing on CO as sole source of carbon and energy had doubling times which ranged from 12–42 h. The activity profiles obtained after discontinuous sucrose density gradient centrifugation indicated that the CO-oxidizing enzymes are soluble and the hydrogenases are membrane-bound in all strains examined. The CO-oxidizing enzymes of Pseudomonas carboxydohydrogena, Pseudomonas carboxydoflava, Comamonas compransoris, and the so far unidentified strains OM2, OM3, and OM4 had a molecular weight of 230,000; that of Achromobacter carboxydus amounted to 170,000. The molecular weights of the CO-oxidizing and H₂-oxidizing enzymes turned out to be identical. The cell sonicates were shown to catalyze the oxidation of both CO and H₂ with methylene blue, thionine, phenazine methosulfate, toluylene blue, dichlorophenolindophenol, cytochrome c or ferricyanide as electron acceptors. Methyl viologen, benzyl viologen, FAD⁺, FMN⁺, and NAD(P)⁺ were not reduced. The spectrum of electron acceptors was identical for all strains tested. Neither free formate, hydrogen nor oxygen gas were involved in the CO-oxidation reaction. Methylene blue was reduced by CO at a 1:1 molar ratio. The results indicate that CO-oxidation by carboxydobacteria is catalyzed by identical or similar enzymes and that the reaction obeys the equation CO+H₂OCO₂+2H⁺+2e^- as previously shown for Pseudomonas carboxydovorans.Dedicated to Otto Kandler remembering almost three decades of enjoyable cooperation     

Modulation of allostery of pyruvate kinase by shifting of an ensemble of microstates

Since the introduction of the concepts of allostery about four decades ago, much advancement has been made in elucidating the structure-function correlation in allostery. However, there are still a number of issues that remain unresolved. In this review we used mammalian pyruvate kinase (PK) as a model system to understand the role of protein dynamics in modulating cooperativity. PK has a triosephosphate isomerase (TIM)(α/β)₈ barrel structural motif. PK is an ideal system to address basic questions regarding regulatory mechanisms about this common (α/β)₈ structural motif. The simplest model accounting for all of the solution thermodynamic and kinetic data on ligand-enzyme interactions involves two conformational states, inactive E^T and active E^R. These conformational states are represented by domain movements. Further studies provide the first evidence for a differential effect of ligand binding on the dynamics of the structural elements, not major secondary structural changes. These data are consistent with our model that allosteric regulation of PK is the consequence of perturbation of the distribution of an ensemble of states in which the inactive E^T and active E^R represent the two extreme end states. Sequence differences and ligands can modulate the distribution of states leading to alterations of functions. The future work includes: defining the network of functionally connected residues; elucidating the chemical principles governing the sequence differences which affect functions; and probing the nature of mutations on the stability of the secondary structural elements, which in turn modulate allostery.