加味八珍汤联合PFNA术治疗老年股骨转子间骨折患者的临床效果及对血液流变学指标的影响

目的:研究加味八珍汤联合股骨近端防旋髓内钉(Proximal Femoral Nail Antirotation,PFNA)对老年股骨转子间骨折患者的临床效果及对术后隐性失血和血液流变学的影响。方法:选择2014年3月至2017年3月我院收治的68例接受PFNA治疗的转子间骨折者,将其随机平均分为观察组(34例,术后口服加味八珍汤颗粒7天)、对照组(34例)。对比两组总失血量、隐性失血量、隐性失血比例、血液流变学指标(血浆粘度及全血黏度低、中、高切)、不良反应等。结果:⑴两组各剔除2例,94.12%(64/68)的受试者完成研究。⑵两组总失血量相当,差异无统计学意义(P0.05);与对照组相比,观察组隐性失血量及隐性失血发生率均显著降低(P0.05)。⑶治疗前,两组血浆粘度及低、中、高切全血黏度比较差异无统计学意义(P0.05);治疗后,两组血浆粘度及低、中、高切全血黏度均显著低于本组治疗前(P0.05),且观察组以上指标均明显低于对照组(P0.05)。⑷观察组发生肌间静脉血栓1例,无药物过敏及毒副反应;对照组发生1例深静脉血栓、4例肌间静脉血栓。观察组不良反应率为3.125%,显著低于对照组(15.625%,P0.05)。结论:加味八珍汤既可显著减少老年股骨转子间骨折患者PFNA术后隐性失血,又能改善血流动力学、减少并发症。     

社区2型糖尿病患者血糖自我管理水平调查及并发糖尿病周围神经病变的影响因素分析

摘要 目的：调查社区2型糖尿病（T2DM）患者血糖自我管理水平及分析T2DM并发糖尿病周围神经病变（DPN）的影响因素。方法：于2016年6月~2017年6月期间采用整群随机抽样法随机抽取苏州市6个社区符合纳排标准的539例T2DM患者进行问卷调查,了解社区T2DM患者血糖自我管理水平情况,对患者进行体格检查并检测血生化指标,统计社区T2DM患者的DPN发生情况,采用多因素logistic回归分析T2DM患者并发DPN的影响因素。结果：本次研究共发放调查问卷539份,实际回收531份,其中T2DM并发DPN者86例,根据是否并发DPN将所有入选患者分为DPN组（n=86）和无DPN组（n=445）。社区T2DM患者的糖尿病自我管理行为量表（SDSCA）平均得分率为（49.38±5.23）%,DPN组和无DPN组在病程、体质量指数（BMI）、腰围、糖化血红蛋白（HbAlc）、空腹胰岛素（FINS）、低 密 度 脂 蛋 白（LDL-C）、血 尿 素 氮（BUN）、血肌酐（Cr）、合并外周动脉疾病（PAD）、合并糖尿病视网膜病变（DR）中比较差异有统计学意义（P<0.05）。多因素logistic回归分析结果显示：病程≥7年、HbAlc≥8 mmol/L、合并PAD、合并DR、BMI≥25 kg/m²是社区 T2DM患者并发DPN的危险因素（P<0.05）。结论：苏州市6个社区的T2DM患者血糖自我管理水平较低,且T2DM并发DPN的概率较高,病程≥7年、HbAlc≥8 mmol/L、合并PAD、合并DR、BMI≥25 kg/m²均是社区 T2DM患者并发DPN的危险因素,临床可对上述危险因素采取积极有效的措施,以有效降低T2DM并发DPN的发生率。     

冠心病患者血浆CD69、DKK-1与血脂、炎性因子的关系及其诊断价值分析

摘要 目的：分析冠心病（CHD）患者血浆CD69、Wnt拮抗剂蛋白-1（DKK-1）与血脂、炎性因子的关系,并分析CD69和DKK1对于CHD患者的诊断价值。方法：选取2016年6月~2018年12月在我院诊治的CHD患者136例,根据Gensini评分分为轻度亚组、中度亚组、重度亚组,同时纳入与之年龄、性别匹配的冠状动脉造影正常者136例作为对照组。检测受试者血清炎性因子、血脂、及血浆CD69、DKK-1水平,分析CHD患者CD69、DKK-1水平与血脂、炎性因子、Gensini评分的相关性,采用受试者工作特征（ROC）曲线分析CD69和DKK1对于CHD患者的诊断价值。结果：CHD患者CD69、DKK-1、白细胞介素-10（IL-10)、白细胞介素-6（IL-6）、三酰甘油（TG）、总胆固醇（TC）、低密度脂蛋白（LDL）水平高于对照组,高密度脂蛋白（HDL）水平低于对照组（P<0.05）;随着冠脉狭窄病变程度的加重,CD69、DKK-1、IL-10、IL-6、TC、TG、LDL水平呈升高趋势,HDL水平呈降低趋势（P<0.05）。CHD患者CD69、DKK-1水平与IL-10、IL-6、TC、TG、LDL、Gensini评分均呈正相关,与HDL呈负相关（P<0.05）。ROC曲线分析结果显示,CD69、DKK-1联合检测诊断CHD的灵敏度、特异度分别为0.816、0.846。结论：CHD患者血浆DKK-1、CD69水平升高,与血脂、炎性因子和Gensini评分密切相关,两者联合检测可提高CHD诊断效能。     

肺炎支原体感染对儿童血常规参数及C反应蛋白水平的影响

摘要 目的：探讨肺炎支原体（Mycoplasma pneumoniae, MP）感染对儿童血常规数及C反应蛋白（C reactive protein, CRP）水平的影响。方法：以60例肺炎支原体抗体（MP-IgM）阳性患儿作为观察组,选取同期60名MP-IgM阴性儿童作为对照组,对两组患儿血常规参数和CRP水平进行回顾性分析。结果：与对照组比较,观察组红细胞压积、血红蛋白、单核细胞比例、单核细胞计数、中性粒细胞比例、中性粒细胞计数、红细胞计数均数或中位数升高,嗜碱性粒细胞比例、嗜碱性粒细胞计数、嗜酸性粒细胞比例、嗜酸性粒细胞计数、淋巴细胞比例（LY）、淋巴细胞比计数（LY#）、平均红细胞血红蛋白量、红细胞平均体积、平均血小板体积、血小板压积、血小板分布宽度、血小板计数、红细胞分布宽度均数或中位数降低;观察组患儿的CRP水平中位数显著高于对照组,以上差异有统计学意义（P<0.05）;Logistic多元回归分析结果显示,MP感染与淋巴细胞比例、淋巴细胞比计数降低具有正相关性（P<0.05）。结论：MP感染患儿的血常规参数和CRP水平均发生变化,临床医生应对这些参数给予关注和连续监测,从而提高诊疗效果。     

Performance,rumen fermentation,blood minerals,leukocyte and antioxidant capacity of young Holstein calves receiving high-surface ZnO instead of common ZnO

ABSTRACT

This study was conducted to assess the effect of feeding high-surface ZnO instead of common ZnO on the performance, rumen fermentation, blood minerals, leukocytes and antioxidant capacity of pre- and post-weaning calves. Thirty male suckling Holstein calves were allotted to one of three experimental groups (10 replicates) in a completely randomised design. Calves received: (1) a low Zn diet without Zn supplementation (control diet), (2) a high Zn diet containing 50 mg supplementary Zn/kg dry matter (DM) as common ZnO or (3) a high Zn diet containing 50 mg supplementary Zn/kg DM as high-surface ZnO (nano-ZnO). The control diet contained a native Zn content of 35.5, 34.7 or 33.7 mg/kg DM for the age periods of 7 to 30, 31 to 70 and 71 to 100 d, respectively. Supplementation of the diet with Zn did not change the dry matter intake (DMI) of calves during d 7 to 30 but increased the ADG in this period (p < 0.05). During age periods of 31 to 70 and 71 to 100 d, DMI and ADG of the Zn supplemented calves were higher (p < 0.05) than the control animals. The nutrient digestibility and the concentration of rumen volatile fatty acids were positively affected (p < 0.05) and the rumen ammonia-N concentration decreased (p < 0.05) by dietary Zn supplementation. Furthermore, the incidence of diarrhoea and pneumonia was lower in calves receiving the Zn supplemented diets. Irrespective of ZnO source, the blood total antioxidant capacity, leukocyte and haematocrit levels significantly increased (p < 0.05) with the ZnO supplemented diets. The post-weaning DMI, nutrient digestibility and blood haematocrit levels were higher in calves receiving high-surface ZnO, compared to those supplemented with common ZnO. With inclusion of the Zn sources in pre- and post-weaning diets, the blood Zn concentration increased (p < 0.05), but the blood Cu, Fe, Ca, P and Mg levels remained unchanged. Regardless of source, dietary supplementation of young calves with ZnO improved the performance and decreased rumen ammonia-N and the incidence of diseases. Moreover, high-surface ZnO had advantages over common ZnO in increasing the post-weaning feed intake, digestibility and blood Zn concentration.     

Effects of manganese-supplemented diets on growth performance,blood biochemistry,nitrogen metabolism and skeletal development of rex rabbits

(Background) Manganese (Mn) is an essential mineral, although its effects on rabbits is not clear. (Research Purpose) This study was conducted to investigate the effects of the level of supplementation of dietary manganese on growth performance, blood biochemistry, nitrogen metabolism and skeletal development of growing Rex rabbits. (Methods) Two hundred 3-month-old healthy Rex rabbits with similar body weights were randomly divided into 5 groups (A, B, C, D, E), with 40 replicates in each group. The rabbits in the 5 groups were fed a basal diet containing 0, 5, 10, 20 and 40 mg/kg manganese (in the form of manganese sulfate), respectively. The trial included 7 days for adaptation and 29 days of testing. Seven days before the end of feeding, eight rabbits from each group were transferred into a metabolic cage for metabolic testing. (Results) The results showed that supplemental dietary manganese levels did not significantly influence final body weight (FBW) or average daily feed intake (ADFI) (P＞0.05). Average daily gains (ADG) were significantly higher in the 20 mg/kg manganese group than in the other groups, and the ratio of feed to body weight gain (F/G) was significantly affected by manganese level (P < 0.05). No significant differences were found in the digestion coefficients among the groups (P > 0.05). Regarding carcass traits, the thymus index and total fat were significantly different (P < 0.05) among the groups, but there were no other significant differences (P > 0.05). The addition of manganese had no significant effect on the intake of nitrogen (IN), fecal nitrogen (FN), digestible nitrogen (DN) or the apparent digestibility of nitrogen (NAD). Compared to the other groups, urinary nitrogen (UN) was lower in the 20 mg/kg group, although nitrogen deposition (RN), nitrogen utilization (NUR) and the biological potency of nitrogen (NBV) were higher in this group (P < 0.05). As the amount of manganese added to the diet increased, serum triglycerides decreased (P < 0.05). Serum Mn-SOD was significantly lower in the 5 mg/kg manganese group than in the other groups (P < 0.05). The results of this study demonstrate that a diet with supplemented manganese can improve Rex rabbit growth performance and increase RN, NUR and NBV. There were no significant effects of different dietary levels of Mn on the ratio of bone to meat (P > 0.05) or bone strength (P < 0.05). (Conclusion) In conclusion, we determined that the optimal level of manganese supplementation in the diet of growing Rex rabbits was 20 mg/kg, which was also found to reduce nitrogen emissions into the environment.     

圈养黑猩猩血液生理生化指标测定

正动物园作为综合保护、科普宣传与公众教育的重要场所,在濒危物种的迁地保护工作中发挥着十分重要的作用(Kleiman et al.,2010)。然而,不同的濒危物种在生理学及生活史方面存在很大差异;加之部分物种的生物学信息匮乏,使得动物园的饲养繁育和疾病防控工作面临重大挑战。在常规体检及疾病诊断时,血液参数值有助于对动物机体的临床检查与诊断,解读动物的生理、营养和病理状态(胡翊群,2004;Etim et al.,2014),是及时发现动物     

乳果糖联合双歧杆菌三联活菌胶囊在轻微性肝性脑病患者中的应用效果

目的探讨乳果糖联合双歧杆菌三联活菌胶囊在轻微性肝性脑病(MHE)患者中的应用效果。方法选择2015年1月至2019年4月在我院消化科住院就诊的94例MHE患者为研究对象,随机分为观察组和对照组各47例。两组患者均予基础治疗。观察组患者在基础治疗上加用双歧杆菌三联活菌胶囊(630 mg/次,2次/d,温开水送服)联合乳果糖口服液(20 mL/次,3次/d,口服)治疗,连用8周。对照组患者单用乳果糖口服液治疗,剂量、用法及疗程同观察组。观察两组患者治疗前后血氨、血清内毒素(ET)、数字连接试验(NCT)时间和数字符号实验(DST)评分及肠道菌群数量的变化,并比较肝性脑病(HE)的转变率。结果治疗8周后,两组患者血氨、ET和NCT时间均较治疗前明显下降,DST评分较治疗前明显上升,且观察组变化幅度大于对照组(均P0.05)。治疗8周后,两组患者肠道双歧杆菌和乳杆菌数量较治疗前显著增加,大肠埃希菌数量较治疗前显著减少,且观察组变化幅度大于对照组(均P0.05)。治疗后观察组患者HE的转变率为8.51%(4/47),明显低于对照组的23.40%(11/47),差异有统计学意义(χ~2=3.89,P=0.049)。结论乳果糖联合双歧杆菌三联活菌胶囊能显著改善MHE患者智力测验结果,降低HE转化率,其作用机制可能与其能纠正患者肠道菌群紊乱,降低血氨水平,控制内毒素血症相关。     

老年冠心病患者血尿酸水平与肠道菌群的关系

目的探讨老年冠心病患者血尿酸(SUA)水平与肠道菌群的关系,为该类患者的治疗提供参考。方法选择2018年5月至2019年5月我院收治的83例冠心病患者为研究组,选择同期我院83例健康体检者的作为对照组。比较两组对象SUA水平及粪便标本中肠道菌群分布情况(乳杆菌、双歧杆菌、幽门螺杆菌、大肠埃希菌、链球菌);比较不同菌群紊乱程度冠心病患者SUA水平;比较不同SUA水平冠心病患者肠道菌群分布情况。采用Pearson相关分析冠心病患者SUA水平与肠道菌群相关性。结果研究组患者肠道乳杆菌、双歧杆菌数量明显低于对照组(均P<0.05),而肠道幽门螺杆菌、大肠埃希菌、链球菌数量明显高于对照组(均P<0.05)。研究组患者SUA水平明显高于对照组(P<0.05),不同菌群紊乱程度冠心病患者SUA水平有差异有统计学意义(均P<0.05)。不同SUA水平冠心病患者肠道乳杆菌、双歧杆菌、幽门螺杆菌、大肠埃希菌、链球菌数量差异有统计学意义(均P<0.05)。冠心病患者SUA水平与肠道乳杆菌、双歧杆菌数量呈负相关(r=-0.872、-0.912,均P<0.001),与肠道幽门螺杆菌、大肠埃希菌、链球菌数量呈正相关(r=0.915、0.896、0.889,均P<0.001)。结论冠心病患者存在肠道细菌紊乱及高尿酸现象。冠心病患者SUA水平与肠道菌群显著相关,检测冠心病患者SUA水平对监测肠道菌群状态及治疗方案制定具有重要意义。     

贝那普利和氨氯地平对自发性高血压大鼠血压和肠道微生物的影响

目的观察贝那普利和氨氯地平对自发性高血压大鼠(SHR)血压及肠道微生物的影响。方法 18只14周龄雄性SHR随机分为模型组(Mod组,n=6)、贝那普利组[Bph组,盐酸贝那普利灌服0.90 mg/(kg·d),n=6]、氨氯地平组[Aml组,苯磺酸氨氯地平灌服0.45 mg/(kg·d),n=6],另以Wistar-Kyoto(WKY)大鼠作为正常对照组(NC组,n=6), NC组和Mod组每日给予蒸馏水灌胃,干预8周后测定各组大鼠血压,观察结束处死大鼠取空肠粪便,进行16S rDNA V4区扩增子信息采集与分析。结果贝那普利和氨氯地平对SHR具有明显的降压作用,用药后对SHR肠道微生物的门属组成、α多样性、β多样性有一定影响;根据关系热图分析菌群和环境因子血压的关系,拟杆菌属(Bacteroidetes)、厚壁菌属(Firmicutes)和粪球菌属(Coprococcus)与收缩压(SBP)相关,拟杆菌属与平均动脉压(MBP)相关。结论贝那普利和氨氯地平具有明确的降压作用,并对SHR肠道微生物有一定的影响。