脓毒症患者发生凝血功能紊乱的临床特征及预后影响因素分析

摘要 目的：探究脓毒症患者发生凝血功能紊乱的临床特征及预后影响因素。方法：选择2019年9月~2023年1月本院收治的80例脓毒症患者为本次研究对象,对所有患者开展凝血功能检验,并依据检验结果,将患者分为凝血功能异常组（n=60）及正常组（n=20）,分析凝血功能障碍异常及正常患者临床特征、凝血功能障碍异常及正常患者病情严重程度,并依据脓毒症患者预后,将其分为存活组（n=64）及死亡组（n=16）脓毒症患者预后的单因素与多因素Logistic回归分析。结果：凝血功能正常组及异常组平均动脉压、体温、白细胞计数（WBC）、纤维蛋白原（FIB）、凝血酶时间（TT）指标水平无较大差异（P＞0.05）,与凝血功能正常组比较,凝血功能异常组患者呼吸、脉率、降钙素原（PCT）、C反应蛋白（CRP）指标水平相对较高,部分凝血活酶时间（APTT）、凝血酶原时间（PT）指标水平相对较长,PLT指标水平相对较高（P＜0.05）;与凝血功能正常的脓毒症患者相比较,凝血功能异常患者急性肾损伤（AKI）及急性呼吸窘迫综合征（ARDS）发生率、急性生理与慢性健康评分（APACHE Ⅱ）及急性生理功能评分（SOFA）评分更高,住ICU时间均相对较长（P＜0.05）,机械通气及住院时间比较（P＞0.05）;脓毒症患者预后影响因素分析中,结果显示,年龄、体质量指数（BMI）、性别、糖尿病史、高血压病史均未对脓毒症患者预后产生较大影响（P＞0.05）,PT、PCT、APTT、CRP、SOFA评分及APACHE Ⅱ评分对脓毒症预后产生严重影响,死亡组患者各指标水平均高于存活组（P＜0.05）;将影响脓毒症患者预后的单因素予以赋值,纳入Logistic回归分析,以PCT、PT、APTT、CRP、SOFA、APACHE Ⅱ 评分为自变量,结果显示,PCT、PT、CRP、SOFA、APACHE Ⅱ 评分是影响脓毒症患者预后的独立危险因素（P＜0.05）。结论：脓毒症患者发生凝血功能紊乱会对临床相关指标产生影响,从而增加疾病严重程度,依据脓毒症患者预后,研究结果显示,PT、PCT、CRP、SOFA及APACHE Ⅱ评分均会对脓毒症患者预后产生不良影响,检验上述指标水平,可为临床评估脓毒症预后提供一定参考价值。     

孕期规律运动与妊娠期糖代谢异常关系的研究

目的探讨不同方式干预孕期运动与妊娠期糖代谢异常的关系及对妊娠结局的影响。方法将300例孕14周单胎孕妇按阶段分为两组各150例,干预组对孕妇进行评估,建立孕妇档案,孕期通过个体化运动干预,给予孕妇个体化、具体的适度运动处方及给予督导规律运动;对照组采用传统的产前检查及常规护理。观察比较两组孕妇血糖变化、体重增长及妊娠结局。结果干预组空腹,餐后2h血糖值,妊娠末期体重,发生糖代谢异常,早产儿、新生儿窒息、巨大儿以及剖宫产率均低于对照组,差异有统计学意义(P0.05)。结论通过个体化护理对孕期运动进行干预,有效控制血糖值,降低母婴并发症的发生。     

A cytogenetic study of couples with recurrent spontaneous abortions and infertile patients with recurrent IVF/ICSI failure

PURPOSE:

This study was conducted to determine the frequency and contribution of chromosomal abnormalities in miscarriages and in couples with recurrent in vitro fertilization/intra cytoplasmic sperm injection (IVF/ICSI) failure.

MATERIALS and METHODS:

A total of 221 individuals; 79 with three or more recurrent spontaneous abortions and 142 with at least three IVF/ICSI failures. Chromosomal analysis from peripheral blood lymphocytes was performed according to standard cytogenetic methods using G-banding technique.

RESULTS:

Abnormal karyotype was found in 21 (9.50%) individuals. Of these 21 subjects, 4 (19.04%) exhibited sex chromosomal abnormalities and 17 (80.96%) had autosomal abnormalities. Male partners had significantly higher chromosomal abnormalities (5.88%) than of females (3.61%). These abnormalities were also higher in patients with recurrent spontaneous abortions than with IVF/ICSI failure (P < 0.05).

CONCLUSIONS:

These data may be indicative that chromosomal abnormalities are involved more in spontaneous abortions than in recurrent IVF/ICSI failure. Cytogenetic analysis could be valuable for these couples when clinical data fail to clarify the cause.     

High frequency plant regeneration following abnormal shoot organogenesis in the medicinal tree Hovenia dulcis

An efficient plant regeneration protocol for shoot organogenesis from Hovenia dulcis callus cultures was established. Induction of organogenic callus was achieved on Murashige and Skoog (MS) medium supplemented with 4.65 μM kinetin and 4.5 μM 2,4-dichlorophenoxyacetic acid (2,4-D). Further differentiation of organogenic callus into primordia, shoot-like structures, and plantlets was achieved on MS medium supplemented with 0.23 μM gibberellic acid (GA₃) and 0.46 μM kinetin. Numerous abnormal shoots developed upon transfer of callus to MS medium containing cytokinins, and these failed to grow further into whole plantlets. However, transfer of ‘abnormal’ shoots to a fresh MS medium lacking cytokinins resulted in growth of normal shoots. Elongated shoots subsequently were rooted in basal MS medium, and whole plantlets were established in a soil mix. Analysis of regenerated plants using random amplified polymorphic DNA (RAPD) confirmed the genetic stability of these regenerant plantlets.     

Somatic Embryogenesis and in vitro Flowering in <Emphasis Type="Italic">Saposhnikovia divaricata</Emphasis>

Efficient somatic embryogenesis (SE) and in vitro flowering and fruiting were achieved in Saposhnikovia divaricata (Turcz.) Schischk. Friable embryogenic callus developed from the root, internode, and leaf explants on Murashige and Skoog medium (MS) with 2.26 μM 2,4-dichlorophenoxyacetic acid (2,4-D), and subsequently developed into somatic embryos on MS medium containing 4–5% sucrose, 1.74 μM naphthaleneacetic acid (NAA), 4.44 μM 6-benzylaminopurine (BA), and 1.90 μM abscisic acid (ABA). Then the mature embryos were separated and transferred onto MS with 3% sucrose and 0.6% agar for further development and conversion to plantlets. In vitro flowering and fruiting were obtained when the subcultures were carried out for over 15 months. Paclobutrazol (PP333) or ethephon (ETH) at low levels promoted flowering significantly. Also, abnormal rootless somatic embryos of S. divaricata could form flowers and fruits in vitro.     

中国林蛙变态蝌蚪对pH、盐度和碱度的适应性

在水温16～18℃的野外条件下,采用单因子急性毒性实验法,研究了水环境中pH、盐度和碱度对中国林蛙(Rana chensinensis)变态蝌蚪的毒性效应．结果表明,中国林蛙变态蝌蚪对pH的适应范围为4．3～9．7,最低耐受限3．6,最高耐受限10．7;对盐度的最高耐受限为9．98g·L^-1,适应盐度上限7．14g·L^-1,安全盐度上限1．70g·L^-1;对碱度的最高耐受限为19．96mmol·L^-1,适应碱度上限8．76mmol·L^-1。安全碱度上限2．41mmol·L^-1．野外变态蝌蚪饲养池水体pH应控制在6．5～8．5,盐度控制在2．0g·L^-1以下,碱度不超过4．0mmol·L^-1．中国林蛙变态蝌蚪是一种狭酸碱、低耐盐、低耐碱生物。     

异常黑胆质肝癌移植模型大鼠Rho/Rock信号通路相关分子表达研究

目的:探讨异常黑胆质证肝癌移植模型大鼠Rho/Rock信号通路相关分子的蛋白表达,诠释异常黑胆质肿瘤高发的分子生物学基础。方法:采用足底电击、干寒饲料、铁管制动等多种因素刺激21 d建立异常黑胆质证大鼠模型,在此基础上通过肝内注射walker-256瘤细胞建立异常黑胆质大鼠肝癌移植模型,观察其肝脏组织形态结构变化,并采用Western Blot法检测大鼠肝脏相关蛋白的表达变化。结果:异黑肿瘤组肝脏组织形成明显癌巢,与对照组相比癌旁组织肝索结构紊乱,癌细胞向肝小叶深部迁移;异常黑胆质成熟剂给药组癌细胞崩解、凋亡,胶原纤维增生,癌旁肝索重构。与对照组相比,肿瘤组Cdc42和Rock2蛋白表达均明显增加(P0.05),异黑肿瘤组Cdc42、Rac1、Rock1、Rock2和Myl1蛋白表达明显增加(P0.05);与异黑肿瘤组相比,异常黑胆质成熟剂(ASM)给药组Cdc42、Rac1、Rock1、Rock2和Myl1蛋白表达呈剂量依赖性降低(P0.05),且与对照组无显著差异。结论:异常黑胆质证肝癌移植模型可能与Rho/Rock信号通路分子通过调控肌动蛋白收缩引起的肿瘤细胞侵袭、转移生物学行为等作用有关,异常黑胆质成熟剂可能通过下调Rho/Rock信号通路分子使损伤的组织形态逆转。     

60Co─r射线辐射番茄种子对其生理生化影响的研究

用６０Ｃｏｒ射线辐射番茄种子,观察辐射种子发芽率、根尖细胞有丝分裂、减数分裂及过氧化物酶同工酶的影响。实验结果表明：辐射剂量１０～２０ｋｒａｄ范围内,种子发芽率最高,有丝分裂畸变率最高,畸变类型最丰富,对减数分裂的抑制小,过氧化物酶同工酶活性最高。     

High-frequency conversion of abnormal peanut somatic embryos

Peanuts (Arachis hypogaea L.) are widely cultivated as a rich source of protein and oil. Although protocols for the regeneration of peanut via somatic embryogenesis and organogenesis have been developed, most of them have resulted in low frequencies of plant recovery. In this report, we describe a protocol for plantlet formation at high frequency from somatic embryos. Morphologically abnormal somatic embryos germinated and produced roots only in medium devoid of growth regulators. Shoots emerged from the undeveloped plumule of these rooted embryos in medium containing both 6-benzyladenine (BA) and kinetin (KN), or in medium with thidiazuron (TDZ) alone. In Murashige and Skoog basal medium supplemented with 8.9 μm BA and 14 μm KN, 86% of the embryos developed shoots. Substitution of BA and KN with 22.7 μm TDZ increased plant recovery from 86% to 92%. Plants grown on TDZ had multiple shoots. Eighty-four percent of these plants survived in sandy soil and were grown to maturity. Received: 12 February 1996 / Revision received: 11 July 1996 / Accepted 30 April 1997     

山明桐小孢子败育及与小孢子囊壁发育异常的关系

作者研究了山明桐(Paulownia sp.)小孢子败育及小孢子囊壁异常发育的过程,并探讨了两者之间的关系。结果表明:小孢子败育发生在减数分裂至单核小孢子期间。在小孢子有丝分裂前小孢子已全部敗育拚辈惴⒂斐V饕硐衷诒3只疚唇到饣虬虢到庾刺敝脸墒旎ㄒ┦逼凇R┦夷诒谙赴┓只鎏踝丛龊裣赴凇P℃咦幽冶诜⒂械恼庑┮斐O窒蟮氖抵适瞧湔7⒂瘫恢型就V?而以幼态保持至花药最后干缩。观察表明小孢子囊壁发育异常不是小孢子败育的原因,而可能是其结果。