基于动物学、临床医学跨界研究快速准确诊断1例不明蛇类咬伤的分析

目的 探讨动物学、临床医学跨界研究成果联合运用于快速准确诊断不明蛇类咬伤中的作用及效果.方法 通过回顾性分析1例不明蛇类咬伤患者的临床资料,从病史、动物学生活习性、咬痕鉴别、流行病学、临床表现、蛇类动物学分布6个方面进行剖析不明蛇类咬伤的诊断思路与方法.结果 该例蛇伤患者的病史特征以及诊断与鉴别诊断:(1)病史特征符合...     

基于分级诊疗的医疗机构分工协作机制探究

通过探讨医疗机构分工协作机制的内容和形式,并与医联体、医疗服务整合以及对口支援等模式进行辨析和比较。认为分工协作机制的实质是在初级卫生保健和专科医疗服务之间进行分工,在相关领域开展协作。分工协作机制的建立最主要的是来自政府的作用,其次是发挥医疗保险政策的杠杆作用。     

Molecular diagnosis and frequencies of primary hypolactasia in populations of Russia and neighboring countries

Normally, the ability to digest milk sugar (lactose) is present in every child, but not in every adult. The decrease in lactase synthesis (hypolactasia) results in the inability to digest whole milk. Recent studies of the Finnish population have associated lactase persistence in adults with allele T of the C/T_?13910 polymorphism located upstream of the lactase gene; a 100% correlation of primary hypolactasia with genotype C/C has been proved. In this study, the allele and genotype frequencies of C/T_?13910 were determined in populations of Russia. The frequencies of genotype C/C, varying from 36.6% in Russians to 88.2% in Chukchi, were close to the published medical and epidemiological data on the hypolactasia frequencies in these populations. Genotyping was carried out by three different methods to determine the optimal one. Genotype C/C proved to be the key determinant of primary hypolactasia. It was assumed that DNA diagnosis of genotype C/C provides a predictive test to detect primary hypolactasia long before its clinical manifestation.     

特发性腹膜后纤维化一例并文献复习

目的:分析腹膜后纤维化(RPF)的诊断以及治疗情况,以提高对RPF的认识。方法:回顾性分析我科18F-FDGPET/CT诊断的1例RPF患者的临床资料,并对相关文献进行复习。结果:本例患者以腹胀及右下腹部隐痛不适就诊,腹部CT表现为腹主动脉周围肿块,18F-FDGPET/CT显示腹膜后间隙中线大血管周围糖代谢增高肿块,经CT引导下穿刺及手术病理确诊为特发性腹膜后纤维化。结论:腹膜后纤维化属罕见病,CT、MRI在诊断中有较重要作用,PET/CT在IRPF的诊断及治疗随访中有比较重要的价值,在治疗方面,糖皮质激素治疗效果较好,晚期常需要手术治疗。     

DNA technological progress toward advanced diagnostic tools to support human hookworm control

Blood-feeding hookworms are parasitic nematodes of major human health importance. Currently, it is estimated that 740 million people are infected worldwide, and more than 80 million of them are severely affected clinically by hookworm disease. In spite of the health problems caused and the advances toward the development of vaccines against some hookworms, limited attention has been paid to the need for improved, practical methods of diagnosis. Accurate diagnosis and genetic characterization of hookworms is central to their effective control. While traditional diagnostic methods have considerable limitations, there has been some progress toward the development of molecular-diagnostic tools. The present article provides a brief background on hookworm disease of humans, reviews the main methods that have been used for diagnosis and describes progress in establishing polymerase chain reaction (PCR)-based methods for the specific diagnosis of hookworm infection and the genetic characterisation of the causative agents. This progress provides a foundation for the rapid development of practical, highly sensitive and specific diagnostic and analytical tools to be used in improved hookworm prevention and control programmes.     

联合检测EB-IgG、IgM，EB-DNA在鼻咽癌中的诊断价值分析

摘要 目的：分析联合检测EB-IgG、IgM,EB-DNA在鼻咽癌中的诊断价值。方法：选择我院自2019年1月至2022年1月接诊的100例鼻咽癌患者作为观察组,另选同期的100例健康体检者作为对照组。使用化学发光免疫夹心法检测血清EB-IgG、IgM,实时荧光定量聚合酶链反应检测血浆EB-DNA表达水平;比较两组EB-IgG、IgM和EB-DNA的阳性率,分析不同临床分期的鼻咽癌患者EB-IgG、IgM和EB-DNA的阳性率及EB-DNA表达水平,使用AUC评价EB-IgG、IgM联合EB-DNA对鼻咽癌的诊断效能,计算单独和联合应用上述指标诊断鼻咽癌的敏感度和特异度。结果：观察组EB-IgG、IgM和EB-DNA的阳性率均明显高于对照组,差异均有统计学意义（P＜0.05）;EB-IgG、IgM和EB-DNA的阳性率及EB-DNA表达水平在不同临床分期的鼻咽癌患者中差异均有统计学意义（P＜0.05）,均随着临床分期升高而升高;经ROC曲线分析,EB-IgG、IgM联合EB-DNA诊断鼻咽癌的AUC为0.930,大于单一指标EB-IgG的0.755、IgM的0.740和EB-DNA的0.750,差异均有统计学意义（P＜0.05）;EB-IgG、IgM联合EB-DNA诊断鼻咽癌的敏感度为97.00 %,特异度为96.00 %,准确度为96.50 %。结论：EB-IgG、IgM和EB-DNA均对鼻咽癌具有一定的临床诊断价值,联合检测有助于提高鼻咽癌的诊断效能,值得予以重视应用。     

一种基于流式细胞术的牛多细胞因子检测方法

本研究旨在建立一种基于流式细胞术的牛多细胞因子检测方法。对前期制备并筛选出的针对牛细胞因子IFN-γ、IL-2、TNF-α、IP-10和MCP-1的单克隆抗体进行荧光标记,与细胞表面分子抗体组合搭配,进行牛多细胞因子流式检测方法的建立和优化。随后利用建立的方法进行BCG体外感染牛外周血单个核细胞的细胞因子表达规律测定,并结合CFP10-ESAT6蛋白刺激剂评价上述细胞因子作为牛结核诊断标识的潜力。建立的牛多细胞因子流式检测方法可以有效测定BCG感染牛外周血T淋巴细胞的细胞因子表达,其中IFN-γ、IL-2、TNF-α在感染40h后持续上升,而IP-10和MCP-1表达水平呈现下降趋势;对于牛外周血CD4⁺T淋巴细胞IFN-γ、IL-2、TNF-α的联合检测能有效区分牛结核阳性和阴性样品。这一方法为牛病原菌感染、疫苗注射后细胞免疫应答水平评价以及疫病诊断提供了重要技术手段。     

Senescence evasion in melanoma progression: uncoupling of DNA‐damage signaling from p53 activation and p21 expression

The best‐established function of the melanoma‐suppressor p16 is mediation of cell senescence, a permanent arrest following cell proliferation or certain stresses. The importance of p16 in melanoma suggests indolence of the other major senescence pathway through p53. Little or no p53 is expressed in senescent normal human melanocytes, but p16‐deficient melanocytes can undergo p53‐mediated senescence. As p16 expression occurs in nevi but falls with progression toward melanoma, we here investigated whether p53‐dependent senescence occurs at some stage and, if not, what defects were detectable in this pathway, using immunohistochemistry. Phosphorylated checkpoint kinase 2 (CHEK2) can mediate DNA‐damage signaling, and under some conditions senescence, by phosphorylating and activating p53. Remarkably, we detected no prevalent p53‐mediated senescence in any of six classes of lesions. Two separate defects in p53 signaling appeared common: in nevi, lack of p53 phosphorylation by activated CHEK2, and in melanomas, defective p21 upregulation by p53 even when phosphorylated.