Biological characteristics of peptidoglycans of group A streptococcus and some other bacterial species. I. Tolerance and effect of antibody in fever response, and heart damaging effect in rabbits.

Induced tolerance to the pyrogenic action of group A streptococcus peptidoglycan decreased after one week and was no longer detectable after the second week. However, one or two further doses of peptidoglycan rapidly restored the tolerance. The passive transfer of plasma from rabbits tolerant to streptococcus peptidoglycan to nontolerant animals failed to transfer tolerance. Antiserum to streptococcus peptidoglycan neutralized the pyrogenic effect of not only streptococcus but also staphylococcus and pneumococcus peptidoglycan; it did not influence the febrile response to endotoxin. Histopathologic changes in the rabbit heart produced by the intravenous injection of staphylococcus or pneumococcus peptidoglycans were similar and were characterized by various stages of degeneration and necrosis. The changes were less pronounced than after streptococcus peptidoglycan. Antiserum to streptococcus peptidoglycan had modest or no counteracting effect on the development of heart alterations after staphylococcus or pneumococcus peptidoglycan.     

海金沙提取物体外抑菌性能研究

用M／C和纸片法考查了海金沙提取物对藤黄球菌、枯草芽孢杆菌、金黄色葡萄球菌和乙型溶血性链球菌的抑菌性能。结果表明：海金沙对4种受试菌株都有抑菌活性;37℃时,醇提物对乙型溶血性链球菌的抑菌效果最好,最大抑菌圈为8．5mm;42℃时,对藤黄球菌、金黄色葡萄球菌和枯草杆菌的抑菌效果最好,最大抑菌圈分别为21、13．2和6．5mm。pH值为7．6时,海金沙醇提物在对藤黄球菌、金黄色葡萄球菌、枯草杆菌和乙型溶血性链球菌的最大抑菌圈分别为9．1、8．2、9mm和11．3mm。海金沙水提物和醇提物对藤黄球菌、乙型溶血性链球菌、枯草芽孢杆菌、金黄色葡萄球菌的最低抑菌质量分数分别为25％、12．5％、12．5％、25％和3．12％、1．56％、6．25％、3．12％．     

An epizootic of necrotic dermatitis in laboratory mice caused by Lancefield group G streptococci.

During a 7-mo period, mice from a group of 383 being used in a toxicology experiment developed severe progressive necrotic dermatitis, and some animals developed paralysis. The overall mortality rate for the group was 134/383 (35%). Seventeen mice were necropsied for bacteriologic and histopathologic examination. A streptococcus identified as Lancefield group G was isolated from the skin lesions of 15 of the mice, from 8 of 9 throats cultured, from 4 of 8 spleens, and occasionally from other sites. It was thought that the infections were initiated and perpetuated by bites from mice carrying the streptococcus in their mouth and throats. Microscopic examination of affected skin revealed necrotic dermatitis characterized by epithelial ulceration with suppuration. The skin lesions were reproduced in 6 of 15 mice inoculated with the isolated streptococcus.     

超声引导下18针与20针穿刺活检对甲状腺结节的诊断效果比较

摘要 目的：比较超声引导下18针与20针穿刺活检对甲状腺结节的诊断效果。方法：选取我院超声科2018.8.6-2020.9.30共收治的167例甲状腺结节患者作为研究对象,将患者分为18针穿刺组（n=86）和20针穿刺组（n=81）,分别对两组患者应用超声引导下18针和20针穿刺活检,比较不确定结果的发生率,包括非诊断性或异型性/滤泡性病变的未确定显著性,恶性肿瘤的诊断性能在最终诊断的结节中进行评估。比较两组并发症发生率及超声引导下的核心针穿刺活检标本产率。结果：对比20针穿刺组和18针穿刺组患者的临床特征发现,两组患者性别、年龄、结节大小、结节形状、方位、回声强度、表现和钙化情况对比无明显差异（P＜0.05）;在20针穿刺组中43个结节和18针穿刺组中46个结节最终确诊。恶性结节的比例在两组之间没有显著差异。在最终诊断分析中,20针穿刺组有38个结节,18针穿刺组中有40个结节。在20针穿刺组,38个结节包括6个非诊断结果、18个不典型/滤泡性病变（未确定显著性）和14个滤泡性肿瘤。在18针穿刺组中,40个结节包括1个非诊断结果,22个不典型/滤泡性病变未确定的显著性,17个滤泡性肿瘤;18针穿刺组的未确诊率（包括非诊断结果和未发现显著性的异型性/滤泡性病变）较低（29.1 % vs 37.0 %）,尽管这一差异在统计学上没有显著性（P＞0.05）。然而,18针穿刺组的非诊断性结果发生率（1.2 % vs 8.6 %;P＜0.05）显著低于20针穿刺组。两组的不典型/滤泡性病变的发生率（27.8 % vs 28.4 %）相似。20针穿刺组的CNB显示出更高的敏感性（75.0 % vs 66.7 %）,更高的阴性预测值（NPV;83.9 % vs 75.9 %）和更高的准确率（78.3 % vs 74.4 %）,虽然结果没有达到统计显著性。两组的特异性（81.8 % vs 80.8 %）和阳性预测值（PPV;两者均为100 %）相似;18针穿刺组和20针穿刺组患者的并发症发生率对比无明显差异（P＞0.05）。结论：18针芯针活检对甲状腺结节的诊断较20针更有效,且不增加并发症情况,安全性好,值得临床应用推广。     

Effects of combined therapy with thalidomide and glucantime on leishmaniasis induced by Leishmania major in BALB/c mice

For treating Leishmania major infection in BALB/c mice, we used thalidomide in conjunction with glucantime. Groups of mice were challenged with 510(3) metacyclic promastigotes of L. major subcutaneously. A week after the challenge, drug treatment was started and continued for 12 days. Thalidomide was orally administrated 30 mg/kg/day and glucantime was administrated intraperitoneally (200 mg/kg/day). It was shown that the combined therapy is more effective than single therapies with each one of the drugs since the foot pad swelling in the group of mice received thalidomide and glucantime was significantly decreased (0.9 +/- 0.2 mm) compared to mice treated with either glucantime, thalidomide, or carrier alone (1.2 +/- 0.25, 1.4 +/- 0.3, and 1.7 +/- 0.27 mm, respectively). Cytokine study showed that the effect of thalidomide was not dependent on IL-12; however, it up-regulated IFN-gamma and down-regulated IL-10 production. Conclusively, thalidomide seems promising as a conjunctive therapy with antimony in murine model of visceral leishmaniasis.     

Impetigo—Bacteriologic Features and Renal Involvement

One hundred children with impetigo were studied with particular emphasis upon the organism causing the infection and associated renal complications. In 50 per cent of cases, Group A beta-hemolytic streptococcus grew on cultures of material from the lesions, and evidence of recent infection with this organism as shown by an elevation of antistreptolysin O titer was present in an additional 17 per cent of cases.Acute glomerulonephritis developed in three of the 66 children with bacteriologic or serologic evidence of streptococcal infection. Four other children in this group and nine children with staphylococcal impetigo had unexplained microscopic hematuria.All children with nephritis already had evidence of the disease when first seen. In most of those with unexplained hematuria, this condition was detected at the first visit. Hematuria developed in others while they were receiving systemic antibiotics. The significance of isolated microscopic hematuria is uncertain, but is seen often in association with cutaneous infection with both staphylococcus and streptococcus. Microscopic hematuria as defined is apparently not prevented by antibiotic therapy.If acute glomerulonephritis that follows streptococcal cutaneous infection is to be prevented, streptococcal impetigo will have to be treated promptly after onset.     

Analysis of renal lesions in Chinese tuberous sclerosis complex patients with different types of TSC gene mutations

We sought to explore the relationship between renal lesion features and genetic mutations in tuberous sclerosis complex (TSC) patients. TSC patients with renal lesions were subjected to TSC1/2 gene next-generation sequencing (NGS). TSC1/2 mutation types and imaging examinations were screened for combined analysis of genetic and clinical features. Seventy-three probands among TSC patients with renal lesions were included. Twenty affected relatives were also included. In total, 93 patients were included. Eighty patients (86.0%) had bilateral renal angiomyolipomas (AMLs), and one had epithelioid AML. Two patients had polycystic kidney disease, one had renal cell carcinoma, and one had Wilms tumor. Among the 73 probands, four had TSC1 mutations, 53 had TSC2 mutations, and 16 had no mutations identified (NMI). There was no statistically significant difference between TSC1 mutation, TSC2 mutation and NMI group (P= 0.309), or between familial and sporadic groups (P= 0.775) when considering AML size. There was no statistically significant difference between pathogenic/likely pathogenic and benign/likely benign/NMI groups (P= 0.363) or among patients with different mutation types of TSC2 (P= 0.906). The relationship between the conditions of TSC gene mutations and the severity of renal lesions still needs more analysis. Patients with NMI, particularly those with familial disease, need more attention because the pathogenesis remains unknown.     

Detection of a factor suppressing leukocyte migration in the sera of allergy patients following antigen administration]

The effect on donor leukocyte migration of serum obtained from the patients with tuberculosis of the lungs, chronic pneumonia and healthy persons was studied after subcutaneous or intradermal injection of the microbial antigen (PPD, streptococcus and staphylococcus antigen). A factor inhibiting donor leukocyte migration appeared in the blood serum of sensitized individuals after the antigen injection. This factor proved to be localized in the serum fraction III obtained after the gel-filtration of sephadex G-200, and is sorbed by leukocytes.     

同期与分期鼻内镜手术治疗慢性泪囊炎合并慢性鼻-鼻窦炎的疗效对比研究

摘要 目的：探讨同期与分期鼻内镜手术治疗慢性泪囊炎合并慢性鼻-鼻窦炎的临床疗效。方法：回顾性分析本院2017年1月至2019年10月期间收治的76例慢性泪囊炎合并慢性鼻-鼻窦炎患者的临床资料,根据手术方式分为A组和B组,各38例。A组行分期手术（鼻腔鼻窦病变处理控制鼻腔鼻窦炎症后再行鼻内镜下泪囊鼻腔造孔术）。B组行同期手术（处理鼻腔鼻窦病变后立即行鼻内镜下泪囊鼻腔造孔术）,比较两组围术期指标、临床疗效、术后并发症发生情况,采用慢性泪囊炎生活质量量表（DQOLS）评价患者术前和术后6个月时的生活质量。结果：B组总有效率为94.74 %（36/38）,A组总有效率为92.11 %（35/38）,两组总有效率比较无明显差异（P>0.05）;B组术后并发症总发生率为13.16 %（5/38）,与A组的10.53 %（4/38）比较无明显差异（P>0.05）。两组患者术后6个月时的DQOLS各维度评分和总分均较术前升高（P<0.05）,但组间比较差异均无统计学意义（P>0.05）。B组患者住院总费用少于A组,住院时间、手术时间均短于A组（P<0.05）,两组术中出血量比较无明显差异（P>0.05）。结论：同期手术与分期手术治疗慢性泪囊炎合并慢性鼻-鼻窦炎患者具有相当的临床疗效和安全性,且对患者生活质量的改善程度亦无明显差异,但前者能够缩短手术时间、住院时间及减少住院费用。     

Effects of the glucantime on the kinetic of biodistribution of radiopharmaceuticals in Wistar rats.

There are evidences that some drugs used for the human diseases can modify the biodistribution of radiopharmaceuticals. The N-methyl meglumine antimoniate, commercially known as glucantime (Rhodia, Brazil), is the elected drug for the treatment of all the clinical forms of leishmaniasis. As therapeutic drugs can present important toxic effects, we studied the effects of the glucantime on the kinetic of biodistribution of radiopharmaceuticals. To study the glucantime effect on the biodistribution of technetium-99m-methylenediphosphonic acid (99mTc-MDP), glucantime IM (80 mg/kg/day) was administered into male Wistar rats (3 months old age) in single dose during 7 days. 99mTc-MDP was injected 1 hr after the last dose. The animals (n = 24) were divided into two groups: treated (n = 12) and control (n = 12) and they were rapidly sacrificed, respectively, in 3 periods (5, 30 and 120 min) after administration of the 99mTc-MDP. The organs were isolated (brain, heart, thyroid, lungs, kidneys, testis, stomach, intestines, pancreas, spleen, liver, muscle, bone and bladder) and the percentages of radioactivity (%ATI) in each organ were calculated. The results were analyzed by the Wilcoxon test (p < 0.05). The analysis of the results has shown a significant increase of the %ATI after 5 min administration of the 99mTc-MDP in spleen, kidneys, testis, heart, liver and a reduction of %ATI in bladder. Thirty minutes after administration of the 99mTc-MDP, the analysis ofthe results reveals a significant reduction of the %ATI in femur, kidneys, thin bowel, lungs, heart, liver and an increase in abdominal muscle and stout bowel. One hundred-twenty min after administration of the 99mTc-MDP, the analysis of the results shows a significant reduction of the %ATI in spleen, thyroid, blood, femur, kidneys, liver and an increase in bladder, pancreas and lungs. Biochemical dosages were also performed before (control group, n = 12) and after (treated group, n = 12) treatment with glucantime. There was a significant (p < 0.05) decrease to the biochemical levels after the treatment with glucantime in following dosages: blood urea nitrogen, creatinine, alkaline phosphatase, lactic dehydrogenase, aspartate amino transferase, total creatine kinase, total protein, globulin and albumin. These results were compared with the control group, without glucantime, and statistical analyses were performed (t-student test, p < 0.05). These results could be associated with the biological effects and/or metabolization of the studied drug.     

双氯芬酸钠栓和索利那新片治疗TURP术后OAB的临床疗效观察

目的:探讨双氯芬酸钠栓和索利那新治疗TURP术后OAB的临床疗效及预防性用药的必要性。方法:采取随机区组单盲的临床试验设计,将入选患者随机分为预防用药组和观察用药组。预防性用药组分别别使用双氯芬酸钠栓、索利那新片单药处理及两种药物联合处理,观察用药组在出现症状后按照预防性用药组的相同方法给药。结果:观察用药组中,双氯芬酸钠栓治疗的完全缓解率为50%,索利那新为81.8%,联合用药为90.5%,显著高于双氯芬酸钠栓(P0.05),各组不良反应的发生情况比较无显著性差异(P0.05)。预防用药组中,索利那新、双氯芬酸钠栓及联合用药分别可使TURP术后OAB的发生率降低45.0%、50.9%、53.8%.,三组之间比较无统计学差异(P0.05),且三组不良反应的发生情况比较无显著性差异(P0.05)。结论:双氯芬酸钠栓和索利那新治疗TURP术后OAB均安全有效,联合用药效果更佳,且预防性用药可以显著降低TURP术后OAB症状的发生率。     

阴道微生态异常与高危型人乳头瘤病毒感染及宫颈病变的关系

目的 探讨阴道微生态异常与高危型人乳头瘤病毒（HR-HPV）感染及宫颈病变的相关性。方法 选取2015年1月至2017年6月在十堰市妇幼保健院妇科门诊接受宫颈病变筛查的562例患者为研究对象,分别进行阴道微生态、HR-HPV检测、宫颈脱落细胞检查和组织病理学活检,对检查结果进行分析。结果 562例患者中,宫颈病变发生率为16.01%,液基薄层细胞检测（TCT）阳性率为19.93%,HR-HPV感染率为28.47%,阴道微生态失调发生率为30.78%,其中细菌性阴道病（BV）、滴虫性阴道炎（TV）、外阴阴道假丝酵母菌病（VVC）、需氧菌性阴道炎（AV）和乳杆菌减少检出率分别为24.02%、3.20%、12.28%、8.54%和28.47%。宫颈病变患者微生态失调率为67.78%,明显高于正常组的23.73%（P<0.05）。宫颈病变患者其BV、VVC、AV和乳杆菌减少检出率分别为66.67%、30.0%、22.22%和75.56%,均明显高于正常者的15.89%、8.90%、5.93%和19.49%（P<0.05）;宫颈病变患者HR-HPV阳性率为75.56%,明显高于正常者的19.49%（P<0.05）。HR-HPV阳性患者BV、VVC、AV和乳杆菌减少的检出率分别为51.88%、24.38%、16.88%和62.5%,明显高于HR-HPV阴性患者的12.94%、7.46%、5.22%和14.93%（P<0.05）。结论 阴道微生态环境的改变与高危型HPV感染及宫颈病变的发生具有一定关系。     

Determination of antibodies to Streptococcus group A polysaccharide by an immunodiffusion method in human sera in various pathological processes of streptococcal etiology

A method for the assay of antibodies to the specific antigenic determinant of group A streptococcal polysaccharide (A-polysaccharide) in human sera was developed. The sera were tested in the precipitation test in agar gel with different doses of A-polysaccharide. The presence of a high level of the above-mentioned antibodies is indicative of infection caused by group A streptococcus, but not streptococci of other groups or by the L-forms of streptococci. In 87.5% of patients with primary rheumatism a high level of antibodies to the specific antigenic determinant of A-polysaccharide was detected during the first day of the disease, which confirms most convincingly the etiological role of group A streptococcus in rheumatism. Considerable differences in the level of antibodies to A-polysaccharide in the active and non-active phases of rheumatism have been established, which makes it possible to use the presence of a high level of these antibodies as an indicator of the rheumatic process activity. A considerable percentage of sera with a high level of antibodies to A-polysaccharide was also detected in erysipelas and acute glomerulonephritis patients.     

Association between HLA class II antigens and hepatitis C virus infection

The aim was to confirm the influence of HLA Class II antigens on the progression of HCV infection and to assess the relationship between these antigens and histological damage, HCV viral load and HCV genotype. 143 patients were enrolled and divided into three groups. Group A included 34 anti-HCV positive, HCV-RNA negative patients with ALT persistently normal; group B included 39 patients with HCV-RNA positive and abnormal ALT level; group C included 70 normal subjects. Serological HCL typing was performed with lymphocytotoxicity test by Terasaky and McClelland, using lymphobeads HLC class II. The frequency of HLA DR11 (5) was significantly higher in the control group (52.9%) and in group A (64.7%), than in group B (28.2%). Allele HLA DR6 was demonstrated in a similar proportion (26%) among control group and group B, while HLA DR14 (6) was less frequent among controls (18% vs 1.4%). In group A the frequency of HLA DR14 (6) was 3% compared to group B, HLA DR17 (3) was prevalent (15.4%) in group B. Liver damage was associated with the detection of HLA DR14 (6) and HLD DR17 (3) antigens. Significantly lower levels of HCV-RNA were measured in subjects with HLA DR11 (5) than in these with either DR6 or DR17 (3). HLA class II antigens appear crucial for resolution or progression of HCV hepatitis. The punctual identification of these genetic factors may, therefore, prove to be useful in predicting disease evolution, in guiding the appropriate therapy for patients with poor prognosis, and in encouraging the development of now therapeutic strategies.     

显微外科与腹腔镜手术治疗精索静脉曲张疗效比较的回顾性研究

摘要 目的：对比显微外科与腹腔镜手术治疗索静脉曲张（VC）的临床效果。方法：回顾性分析2018年8月~2020年8月期间在我院接受精索静脉结扎术治疗的75例VC患者,其中接受腹腔镜手术的34例纳为A组,接受显微外科手术的41例纳为B组。观察两组手术及住院指标情况,对比两组手术前后精液质量变化,观察两组术后并发症发生率和复发率。结果：两组住院天数、住院费用组间对比差异无统计学意义（P>0.05）。B组手术时间长于A组,排气时间短于A组,组间对比差异有统计学意义（P<0.05）。手术后6个月,两组患者的精液量均增加,精子密度均增大,精子活率、活动精子总数均升高,精液液化时间均下降,且B组的变化程度大于A组（P<0.05）。B组的并发症发生率小于A组（P<0.05）。A组有2例患者随访期间复发,B组未见有患者复发,两组复发率组间对比差异无统计学意义（P>0.05）。结论：与腹腔镜手术治疗VC相比,显微外科手术能更有效地改善精液质量、缩短排气时间、降低并发症发生率,虽然手术时间稍长,仍属于较为可靠的术式。     

90株链球菌血清学及生化特征分群鉴定的研究

本文报告90株链球菌血清学和生化特征分群鉴定结果。研究结果表明,90株链球菌用血清学分群,属A群的63株,B群3株,C群12株,D群10株,G群2株。采用生化鉴定,对链球菌属的确认有参考价值。对分群鉴定无鉴别意义。我国过去沿用的非血清学推测性分群法,只适用于B、D群和绝大部分A群菌的鉴定,对C群和G群菌无鉴别意义。因此,在链球菌分群鉴定时,要采用血清学方法,对非血清学推测性分群需进一步完善,以提高其鉴定的准确性。     

The Role of Patients’ Age on Their Preferences for Choosing Additional Blood Pressure-Lowering Drugs: A Discrete Choice Experiment in Patients with Diabetes

ObjectivesTo assess whether patients’ willingness to add a blood pressure-lowering drug and the importance they attach to specific treatment characteristics differ among age groups in patients with type 2 diabetes.ResultsOf the 161 patients who completed the questionnaire, 151 (72%) could be included in the analyses (mean age 68 years; 42% female). Aged patients were less willing to add a drug than non-aged patients (67% versus 84% respectively; P = 0.017). In both age groups, the effect on blood pressure was most important for choosing a drug, followed by the risk of adverse drug events and the risk of death. The effect on limitations due to stroke was only significant in the non-aged group. The effect on blood pressure was slightly more important in the non-aged than the aged group (P = 0.043).ConclusionsAged patients appear less willing to add a preventive drug than non-aged patients. The importance attached to various treatment characteristics does not seem to differ much among age groups.     

A method for early diagnosis of reduced mobility of hand joints in diabetes mellitus type I

The study aimed at elaborating the technique of an early diagnosis of cheiroarthropathy. The study involved 170 patients with diabetes mellitus type I aged between 16 and 45 years and disease duration ranging from 1 year to 33 years. Advanced cheiroarthropathy with shining waxy skin was diagnosed in 41 patients (group I). No lesions characteristic for cheiroarthropathy was diagnosed in 122 patients (group II) while in 7 patients (group III) only skin lesions without contractures were noted. Proliferative retinopathy was significantly more frequent (p less than 0.001) in the group with cheiroarthropathy--39% to 8%. Mean age of patients of group I is 31.5 +/- 5.9 years, in group II--31.0 +/- 6.6 years. Duration of diabetes mellitus is 17.8 +/- 6.2 and 9.6 +/- 7.2 years respectively (p less than 0.05). An angle of metacarpophalangeal joint of the V finger extension was measured in all patients with goniometer. A significant difference was noted in both groups: 34.4 +/- 8.08 degrees and 56.5 +/- 7.1 degrees, respectively (p less than 0.01). Mathematic models were designed basing on the value of measured angle and duration of the disease. These models facilitate possible risk of cheiroarthropathy. Systematic measurements of metacarpophalangeal joint extension seems valuable means of early diagnosis of diabetic cheiroarthropathy and follow-up of such patients.     

载脂蛋白E基因多态性检测对ACS患者降脂疗效的影响

目的:探究载脂蛋白E(ApoE)基因多态性检测在急性冠脉综合征(ACS)患者降脂治疗的中应用价值。方法:选取2019年2月~2020年6月180例ACS患者,采用随机数字表法分为A、B、C共3组各60例,各组患者均接受ApoE基因多态性检测,并根据Sanger法测序判断ApoE基因表型(E2、E3、E4表型),A组予以瑞舒伐他汀口服(10 mg/d),B组予以瑞舒伐他汀强化治疗(20 mg/d),C组予以瑞舒伐他汀(10 mg/d)+依折麦布(10 mg/d)口服,连续治疗1个月,评价3组各基因表型血脂[总胆固醇(TC)、三酰甘油(TG)、低密度脂蛋白(LDL-C)]改善情况、LDL-C达标率,记录药物副反应,所有患者随访1个月,统计心血管不良事件(MACE)发生情况。结果:3组ApoE基因E2、E3、E4表型构成比无显著差异(P>0.05)。治疗后,各组不同ApoE基因表型TC、TG、LDL-C水平均较治疗前下降,且变化率比较差异有统计学意义(P<0.05),表现为E2型>E3型>E4型;其中,3组E2表型TC、TG、LDL-C水平变化率无显著差异(P>0.05);B组、C组E3表型TC、TG、LDL-C水平变化率均显著高于A组(P<0.05),但B组、C组各指标变化率比较差异无统计学意义(P>0.05);3组E4表型TC、TG、LDL-C水平变化率比较差异有统计学意义(P<0.05),且表现为C组>B组>A组。治疗后,A组LDL-C达标率为61.67%,显著低于B组的85.00%、C组的90.00%(P<0.05);其中,3组E2表型LDL-C达标率比较无显著差异(P>0.05),A组E3表型LDL-C达标率显著低于B组、C组(P<0.05),A组、B组E4表型LDL-C达标率低于C组(P<0.05)。治疗期间,仅B组出现1例ALT超出正常上限3倍,停药后可恢复正常。3组MACE发生率比较差异有统计学意义(P<0.05),表现为A组发生率18.33%明显高于B组5.00%、C组3.33%(P<0.05),但3组E2、E4型MACE发生率均无明显差异(P>0.05),而A组E3型MACE发生率高于B组、C组(P<0.05)。结论:ACS患者降脂疗效与ApoE基因表型有关,对E2表型单用瑞舒伐他汀即可取得良好降脂效果,对E3表型强化瑞舒伐他汀或联合依折麦布治疗较单用瑞舒伐他汀均能提高降脂效果,而对E4表型联合依折麦布降脂效果优于单用瑞舒伐他汀或强化治疗。     

肺癌患者肺动脉和支气管动脉CTA的临床研究

目的:对比分析肺癌患者和肺部非癌性病变肺动脉和主支气管动脉CTA特点。方法:回顾性统计分析82例行高度怀疑肺癌患者的肺部CTA,经病理证实肺癌54例,肺结核球28例,同时选择对照组22例。对比分析肺动脉(Pulmonary artery,PA)内径、主支气管动脉(Bronchial artery,BA)显影率和及其各级分支显影率。结果:肺癌组、肺结核球组和对照组左主支气管动脉显影率分别为83.3%、77.7%和72.7%。右主支气管动脉显影率87.0%、83.3%和68.1%。肺癌组左右主支气管动脉清晰显影率高于肺结核球组和对照组,差异有统计学意义(P0.05)。左右两侧肺癌组PA内径明显大于结核球和对照组,差异有统计学意义(P0.05)。左右侧肺癌组PA显影分级明显高于结核球和对照组,差异有统计学意义(P0.05)。左右双侧PA主干内径差异无统计学意义(P0.05)。结论:肺部癌性病灶动脉供血增加,肺动脉和支气管动脉CTA能够显示肺癌病灶供血情况,可用于临床辅助鉴别诊断影像学不能确诊的肺部病变。