河南省76698例体检人群心肺功能检查结果与分析

目的:肺功能和心电图检查是心肺运动试验(CPET)人体心肺代谢整体功能评估不可或缺的组成部分,本研究对肺通气功能、换气功能和小气道功能异常及其临床相关特征进行分析。方法:采用横断面研究方法对2016年1月至2019年l2月在河南省人民医院就诊76 698例体检人员行常规心电图、肺通气和换气功能检查,比较不同性别、年龄组心肺功能异常检出率,进一步分析心肺功能异常严重程度的特点。结果:(1)在76 698例常规心电图异常检出率为71.04%。(2)肺通气功能异常检出率36.86%,其中男性44.78%(17 570/39 237),女性28.57%(10 703/37 461),男性显著高于女性(P0.01),且各年龄段男性检出率均高于女性(P均0.01)。(3)小气道功能异常检出率为56.26%,男性57.73%(22 661/39 237),女性54.72%(20 499/37 461),不同性别比较,差异有统计学意义(P0.01),其中30～39岁组,40-49岁组女性检出率高于男性(P均0.05),20～29岁组,50～59岁组,60～69岁组,≥70岁组均男性高于女性(P0.05)。(4)换气功能异常检出率为28.54%,其中男性30.55%(7 433/24 327),女性26.50%(5 507/20 780),二者差异有统计学意义(P0.05);30～39岁组(P0.05)、20～29岁组和40～49岁组(P均0.05),检出率女性高于男性,50～59岁组,60～69岁组,≥70岁组,男性检出率均高于女性(P均0.05)。结论:河南体检人群心功能、肺通气功能、换气功能及小气道功能异常的检出率较高,男性明显大于女性,年龄≥70岁者高于其他年龄段。     

预防经皮球囊二尖瓣成形术后二尖瓣反流的进一步研究

目的:对342例经皮球囊二尖辫成形术(Percutaneous Balloon Mitral Valvuloplasty,PBMV)资料进行回顾性分析,进一步探讨PBMV的适应证及总结二尖瓣反流并发症的预防.方法:我院2000年1月至2009年12月行PBMV的二尖瓣狭窄患者342例中,男性69例(20.18%),女性273例(79.82%).年龄18-63岁,平均(35.20±11.47岁).收集术前、术后超声心动图和临床评估资料进行回顾性分析.结果:wilkins评分为9-11分与评分≤8分的相比、常规扩张法与逐渐扩张法组相比、完美组与可接受组相比发生二尖辩关闭不全比率均明显增加,均有统计学意义.结论:二尖瓣反流是PBMV中主要的并发症,严格掌握适应证和仔细的术中操作,可以减少并发症的发生率.     

肥厚梗阻性心肌病的外科治疗

目的：总结肥厚室间隔切除术治疗肥厚梗阻性心肌病的手术效果,探讨外科治疗策略。方法：2002年3月至2010年10月,外科手术治疗33例肥厚梗阻性心肌病病人。其中男16例,女17例;年龄13～59岁,平均（42.7±13.6）岁;左室流出道压差（LVOTGP）70～120 mmHg（1 mmHg=0.133Kpa）,平均（95.0±22.6）mmHg。其中合并二尖瓣关闭不全24例,主动脉瓣关闭不全7例,升主动脉增宽3例,冠心病2例。手术在全麻低温体外循环下完成,按常规经主动脉切口行室间隔心肌切除术,同期完成二尖瓣置换术（MVR）7例,二尖瓣成形术（MVP）7例,二尖瓣、主动脉瓣成形术（MVP＋AVP）5例,二尖瓣、升主动脉成形术3例,二尖瓣、主动脉瓣成形、冠状动脉旁路移植术（MVP＋AVP＋CABG）2例。分析比较病人术前超声心动图（UCG）,术中经食管心脏超声（TEE）,以及术后1周、3月、6月、1年超声心动图结果。结果：手术死亡1例（3.0%,1/33例）,主要死因为严重低心排综合症以及多脏器功能衰竭。二次开胸止血1例（3.0%,1/33例）。术中经食管心脏超声示所有病人二尖瓣前叶收缩期前向运动现象（SAM征）消失。存活病人手术效果良好,解剖狭窄解除,峰值压差降低,SAM现象基本消失。远期随访生存病人症状消失,生活质量明显改善,心功能I～II级,无远期死亡、并发症或再次手术。结论：外科治疗肥厚梗阻型心肌病具有良好的手术效果。了解病生理过程、术中仔细探察、手术切除彻底是手术成功的关键。     

肥厚梗阻性心肌病的外科治疗

目的:总结肥厚室间隔切除术治疗肥厚梗阻性心肌病的手术效果,探讨外科治疗策略。方法:2002年3月至2010年10月,外科手术治疗33例肥厚梗阻性心肌病病人。其中男16例,女17例;年龄13～59岁,平均(42.7±13.6)岁;左室流出道压差(LVOTGP)70～120 mmHg(1 mmHg=0.133Kpa),平均(95.0±22.6)mmHg。其中合并二尖瓣关闭不全24例,主动脉瓣关闭不全7例,升主动脉增宽3例,冠心病2例。手术在全麻低温体外循环下完成,按常规经主动脉切口行室间隔心肌切除术,同期完成二尖瓣置换术(MVR)7例,二尖瓣成形术(MVP)7例,二尖瓣、主动脉瓣成形术(MVP+AVP)5例,二尖瓣、升主动脉成形术3例,二尖瓣、主动脉瓣成形、冠状动脉旁路移植术(MVP+AVP+CABG)2例。分析比较病人术前超声心动图(UCG),术中经食管心脏超声(TEE),以及术后1周、3月、6月、1年超声心动图结果。结果:手术死亡1例(3.0%,1/33例),主要死因为严重低心排综合症以及多脏器功能衰竭。二次开胸止血1例(3.0%,1/33例)。术中经食管心脏超声示所有病人二尖瓣前叶收缩期前向运动现象(SAM征)消失。存活病人手术效果良好,解剖狭窄解除,峰值压差降低,SAM现象基本消失。远期随访生存病人症状消失,生活质量明显改善,心功能I～II级,无远期死亡、并发症或再次手术。结论:外科治疗肥厚梗阻型心肌病具有良好的手术效果。了解病生理过程、术中仔细探察、手术切除彻底是手术成功的关键。     

四川地区2013—2014年供血浆人群HBsAg、抗-HCV和抗-HIV检测结果分析

目的分析四川地区2013—2014年供血浆人群的血液检测HBs Ag、抗-HCV、抗-HIV阳性率与年龄和性别的相关性,为制定从低危供血浆人群中招募策略及安全供血提供依据。方法收集2013年1月至2014年12月四川地区10家单采血浆公司采集的111 816名供血浆者年龄、性别资料及血浆样品HBs Ag、抗-HCV、抗-HIV确证检测结果,比较分析不同年龄、性别的供浆人群的病毒指标阳性率差异。结果 2013年和2014年总体阳性率分别为0.58%和0.52%,抗-HIV阳性率由2013年的0.02%下降到2014年的0.01%;2013年和2014年总体阳性率随年龄增加呈递减的趋势;HBs Ag不合格率随年龄增加而降低,抗-HCV不合格率在41~55岁年龄段高于18~40岁年龄段,抗-HIV不合格率在18~40岁年龄段高于41~55岁年龄段;女性供血浆者总体阳性率为0.43%,男性为0.77%,女性低于男性;女性HBs Ag、抗-HIV阳性率分别为0.35%和0.01%,低于男性的0.67%和0.03%。结论女性、较年长的供血浆者为供浆低危人群,应该作为重点招募稳定供献血浆的对象,同时应进一步提高献浆前问询技巧,增强对高危人群的评估辨别能力,从而更有效的减少不必要的血浆报废,保证血浆采集安全性,促进采浆事业科学可持续发展。     

健康体检人员脂肪肝超声诊断结果及其危险因素分析

目的:了解健康体检人员脂肪肝超声诊断结果,分析患病危险因素。方法:选择2018年2月至2018年8月我院体检科接受体检的人员1078例,应用超声对脂肪肝进行筛查,统计受检者脂肪肝超声诊断结果,分析脂肪肝发病的性别、年龄分布情况,应用单因素和多因素Logistic回归分析脂肪肝发病的临床相关因素。结果:1078例受检者中发现脂肪肝158例,占14.66%,其中女性43例,检出率为9.31%,男性115例,检出率为18.67%,男性脂肪肝检出率显著高于女性(P0.05)。男性受检者和女性受检者46～55岁年龄段检出率最高,不同年龄段男性、女性受检者脂肪肝检出率均有统计学差异(P0.05)。多因素Logistic回归分析显示:饮酒、体质指数(BMI)≥28 kg/m2、糖尿病、胆石症、总胆固醇(TC)升高、总甘油三酯(TG)升高、低密度脂蛋白胆固醇(LDL-C)升高、谷草转氨酶(ALT)和(或)谷丙转氨酶(AST)升高均为脂肪肝发病的独立危险因素(P0.05)。结论:我院健康体检人员脂肪肝检出率为14.66%,男性脂肪肝检出率显著高于女性,且46～55岁年龄段检出率最高。饮酒、BMI≥28 kg/m2、糖尿病、胆石症、TC升高、TG升高、LDL-C升高、ALT和(或)AST升高均为脂肪肝发病的独立危险因素,值得临床重点关注。     

不同年龄大肠息肉患者的临床病理特征分析

目的:探讨不同年龄段大肠息肉的临床及病理特点。方法:选取经电子结肠镜检查确诊大肠息肉并行内镜下息肉切除的患者182例,根据年龄分组,老年组(年龄≥60岁)98例,检出息肉121枚,中青年组(年龄60岁)84例,检出息肉97枚。将老年组和中青年组的性别构成、息肉数量、部位、形态、病理类型及CEA值进行回顾性分析。结果:中青年组男性大肠息肉发生率高于老年组,差异具有统计学意义(P0.01);老年组远端结肠息肉发生率高于中青年组,差异显著(P0.05);中青年组直径在0.5-1.0 cm的息肉枚数明显高于老年组,而老年组山田I型息肉枚数明显高于中青年组,具有统计学意义(P0.05);两组患者腺瘤性息肉的发生率明显高于其他类型息肉,尤其以管状腺瘤为高发;两组间CEA值均部分升高,但无统计学差异(P0.05)。结论:应根据不同年龄组大肠息肉的临床和病理特点,采取相应诊疗方案。     

河南省76 698例体检人群心肺功能检查结果与分析*

目的: 肺功能和心电图检查是心肺运动试验（CPET）人体心肺代谢整体功能评估不可或缺的组成部分,本研究对肺通气功能、换气功能和小气道功能异常及其临床相关特征进行分析。方法: 采用横断面研究方法对2016年1月至2019年l2月在河南省人民医院就诊76 698例体检人员行常规心电图、肺通气和换气功能检查,比较不同性别、年龄组心肺功能异常检出率,进一步分析心肺功能异常严重程度的特点。结果: ①在76 698例常规心电图异常检出率为71.04%。②肺通气功能异常检出率36.86％,其中男性44.78％（17 570/39 237）,女性28.57％（10 703/ 37 461）,男性显著高于女性（P<0.01）,且各年龄段男性检出率均高于女性（P均<0.01）。③小气道功能异常检出率为56.26％,男性57.73%（22 661/39 237）,女性54.72％（20 499/37 461）,不同性别比较,差异有统计学意义（P<0.01）,其中30~39岁组,40-49岁组女性检出率高于男性（P均<0.05）,20~29岁组,50~59岁组,60~69岁组,≥70岁组均男性高于女性（P<0.05）。④换气功能异常检出率为28.54％,其中男性30.55％（7 433/24 327）,女性26.50％（5 507/20 780）,二者差异有统计学意义（P<0.05）;30~39岁组（P<0.05）、20~29岁组和40~49岁组（P均>0.05）,检出率女性高于男性,50~59岁组,60~69岁组,≥70岁组,男性检出率均高于女性（P均<0.05）。结论: 河南体检人群心功能、肺通气功能、换气功能及小气道功能异常的检出率较高,男性明显大于女性,年龄≥70岁者高于其他年龄段。     

心外膜脂肪厚度与冠脉病变严重程度的相关性研究

目的:探讨心外膜脂肪组织(Epicardial adipose tissue,EAT)厚度与冠状动脉病变严重程度的相关性。方法:收集167名符合纳入标准的患者,根据冠状动脉造影(coronary arteriography,CAG)结果分2组:正常冠脉组(65例)及冠心病冠脉病变组(≥1支冠状动脉病变狭窄程度≥50%)(102例)。同期经胸超声心动图测量EAT厚度,并依据CAG图像计算Gensini评分、Syntax评分。结果:冠脉正常组和冠心病病变组EAT厚度分别为(3.89±0.2 mm)、(6.19±1.19 mm),冠心病病变组显著高于冠脉正常组(P0.001)。进一步分析EAT的厚度分别为5 mm、5-7 mm和7 mm时,Gensini评分分别为:7.21±7.73,37.80±29.55和62.77±27.26;Syntax评分分别为:7.13±7.70,19.71±7.27和24.95±4.31。EAT的厚度与Gensini评分(r=0.621;P0.001)、Syntax评分(r=0.689;P0.001)呈正相关。结论:心外膜脂肪组织厚度与冠状动脉狭窄的复杂程度评分Gensini评分、Syntax评分呈正相关。     

对SK、AK、cSCC临床及病理特征的差异性分析

摘要 目的：探讨SK、AK、cSCC临床及病理特征的差异。方法：收集2010年1月-2020年12月期间经皮肤科病理确诊为SK（484例）、AK（68例）和cSCC（152例）患者的临床及病理资料,分析患者发病性别、年龄、皮损部位、病理分型及误诊疾病的构成等特点。结果：1. SK好发于46-60岁和61-75岁,在31-45岁年龄段好发于非暴露部位;AK好发于61-75岁和≥76岁年龄段,无论在哪个年龄段均好发于暴露部位,且随年龄增长患病率增高;cSCC好发于61-75岁和≥76岁年龄段,在46-60岁年龄段,好发于非暴露部位,在≥76岁年龄段,cSCC好发于暴露部位。2. SK及cSCC可发生于任何部位;AK可发生于除外阴以外的其他部位,好发于头面颈部。3. SK发病男女无差异,AK发病女多于男,cSCC发病男多于女。4. SK以棘层肥厚型（52.9%）和角化过度型（38.2%）多见,AK以萎缩型（47.0%）和角化过度型（26.5%）多见。6.SK误诊率为29%,AK误诊率为63%。结论：SK、AK及cSCC发病性别、年龄、皮损部位等各有异同,临床表现多样,易误诊,临床需提高警惕。     

A Unique Protease Cleavage Site Predicted in the Spike Protein of the Novel Pneumonia Coronavirus (2019-nCoV) Potentially Related to Viral Transmissibility

正Dear Editor,In December 2019, a novel human coronavirus caused an epidemic of severe pneumonia(Coronavirus Disease 2019,COVID-19) in Wuhan, Hubei, China(Wu et al. 2020; Zhu et al. 2020). So far, this virus has spread to all areas of China and even to other countries. The epidemic has caused 67,102 confirmed infections with 1526 fatal cases     

Curcuminoids as inhibitors of thioredoxin reductase: A receptor based pharmacophore study with distance mapping of the active site

Curcumin is the yellow pigment of turmeric that interacts irreversibly forming an adduct with thioredoxin reductase (TrxR), an enzyme responsible for redox control of cell and defence against oxidative stress. Docking at both the active sites of TrxR was performed to compare the potency of three naturally occurring curcuminoids, namely curcumin, demethoxy curcumin and bis-demethoxy curcumin. Results show that active sites of TrxR occur at the junction of E and F chains. Volume and area of both cavities is predicted. It has been concluded by distance mapping of the most active conformations that Se atom of catalytic residue SeCYS498, is at a distance of 3.56 from C13 of demethoxy curcumin at the E chain active site, whereas C13 carbon atom forms adduct with Se atom of SeCys 498. We report that at least one methoxy group in curcuminoids is necessary for interation with catalytic residues of thioredoxin. Pharmacophore of both active sites of the TrxR receptor for curcumin and demethoxy curcumin molecules has been drawn and proposed for design and synthesis of most probable potent antiproliferative synthetic drugs.     

Comparative morphology of the carpel in the Liliaceae: Hewardieae, Petrosavieae, and Tricyrteae

The young pistils in the melanthioid tribes, Hewardieae, Petrosavieae and Tricyrteae, are uniformly tricarpellate and syncarpous. They lack raphide idioblasts. All are multiovulate, with bitegmic ovules. The Petrosavieae are marked by the presence of septal glands and incomplete syncarpy. Tepals and stamens adhere to the ovary in the Hewardieae and the Petrosavieae but not in the Tricyrteae. Two vascular bundles occur in the stamens of the Hewartlieae and Tricyrtis latifolia. Ventral bundles in the upper part of the ovary of the Hewardieae are continuous with compound septal bundles and placental bundles in the lower part. Putative ventral bundles occur in the alternate position in the Tricyrteae and putative placental bundles in the opposite. position in the Petrosavieae. The dichtomously branched stigma in each carpel of the Tricyrteae is supplied by a bifurcated dorsal bundle.     

Enterovirus 71 3C proteolytically processes the histone H3 N-terminal tail during infection

Highlights
1. The N-terminal tail of histone H3 is specifically cleaved during EV71 infection.
2. Viral protease 3C is identified as a protease responsible for proteolytically processing the N-terminal H3 tail.
3. Our finding reveals a new epigenetic regulatory mechanism for Enterovirus 71 in virus-host interactions.     

Detection of EBV and HHV6 in the Brain Tissue of Patients with Rasmussen’s Encephalitis

Rasmussen’s encephalitis (RE) is a rare pediatric neurological disorder, and the exact etiology is not clear. Viral infection may be involved in the pathogenesis of RE, but conflicting results have reported. In this study, we evaluated the expression of both Epstein-Barr virus (EBV) and human herpes virus (HHV) 6 antigens in brain sections from 30 patients with RE and 16 control individuals by immunohistochemistry. In the RE group, EBV and HHV6 antigens were detected in 56.7% (17/30) and 50% (15/30) of individuals, respectively. In contrast, no detectable EBV and HHV6 antigen expression was found in brain tissues of the control group. The co-expression of EBV and HHV6 was detected in 20.0% (6/30) of individuals. In particular, a 4-year-old boy had a typical clinical course, including a medical history of viral encephalitis, intractable epilepsy, and hemispheric atrophy. The co-expression of EBV and HHV6 was detected in neurons and astrocytes in the brain tissue, accompanied by a high frequency of CD8⁺ T cells. Our results suggest that EBV and HHV6 infection and the activation of CD8⁺ T cells are involved in the pathogenesis of RE.     

Perinatal Vertical Transmission of Chikungunya Virus in Ruili,a Town on the Border between China and Myanmar

正Dear Editor,Chikungunya virus (CHIKV), an arbovirus in the family of Togaviridae, genus Alphavirus, is transmitted by the A.aegyptii or A. albopictus mosquito, and causes disease in humans characterized by fever, rash, and arthralgia (Silva and Dermody 2017; Suhrbier 2019). It was first reported in 1953 in Tanzania, and caused only a few outbreaks and sporadic cases in Africa and Asia in last century. However, in the epidemic in 2004, CHIKV acquired mutations that conferred enhanced transmission by the A. albopictus mosquito(Schuffenecker et al. 2006). Since then, it has successively caused outbreaks in Africa, the Indian Ocean, South East Asia, the South America, and Europe (Zeller et al. 2016).     

Development of a Novel Reverse Transcription Loop-Mediated Isothermal Amplification Method for Rapid Detection of SARS-CoV-2

In conclusion, the novel visual RT-LAMP assay is a simple, rapid, and sensitive approach for detection of SARS-CoV-2, and it is ready for application in primary care and community hospitals or health care centers, and even patients' own houses in response to the current SARS-CoV-2 epidemic because the assay does not require sophisticated equipment and skilled personnel. Furthermore, it is also ready to be used in fields for screening samples from wild animals and environments to facilitate the identification of potential intermediate hosts that mediate the cross-species transmission of SARS-CoV-2 from bats to humans.