失眠患者神经损伤标志物水平变化研究

目的:检测失眠患者神经损伤标志物水平变化,为失眠发病机制的探索提供新的思路。方法:104例失眠患者,按照其治疗情况分为初诊组(n=66)、复诊组(n=38),并选取同期30名健康体检者纳入对照组。检测三组受试者血清神经丝重链(NfH)、神经元特异性烯醇化酶(NSE)、S100钙结合蛋白B(S100B)水平,并分析上述神经损伤标志物与受试者多导睡眠图(PSG)参数的相关性。结果:初诊组NfH高于复诊组,NSE高于复诊组合对照组,初诊组、复诊组血清NfH、S100B均高于对照组,差异有统计学意义(P<0.05),复诊组与对照组血清NSE水平比较,差异无统计学意义(P>0.05)。初诊组睡眠潜伏期高于复诊组,其睡眠效率低于复诊组、对照组,初诊组、复诊组睡眠潜伏期高于对照组,差异有统计学意义(P<0.05),三组受试者总睡眠时间、REM期睡眠时间、REM%、N3期睡眠时间、N3%比较,差异无统计学意义(P>0.05)。相关性分析显示NfH与睡眠潜伏期呈正相关,NSE与睡眠效率呈负正相关(P<0.05)。结论:失眠患者血清NfH、NSE、S100B均显著升高,经治疗后,患者血清NfH、NSE明显降低且PSG参数有所改善,神经损伤标志物与患者病情变化具有密切关联。     

脑出血患者血清铁蛋白水平与预后相关性

目的 :研究脑出血(ICH)患者血清铁蛋白(SF)水平及其与临床预后相关性。方法 :选取2014年1月至2016年1月期间,住院治疗的ICH患者38例(ICH组),分别于入院时、第3d、7d、14d、21d,测定ICH患者的血清SF水平、脑血肿量、脑水肿量、相对脑水肿系数及神经功能缺损(NIHSS)评分。以同期健康体检者38例为对照组检测SF,ICH组在发病90d时根据改良Rankin量表(MRS)评分分为预后良好组(MRS≤2分)和预后不良组(MRS>2分),比较各组血清SF水平、脑血肿量、脑水肿量、相对脑水肿系数及神经功能缺损(NIHSS)评分,并评价SF与各指标间的相关性。结果 :ICH患者的SF水平在第3d时开始显著升高,在发病第7d时达到峰值水平。预后良好组患者的SF水平在发病7d左右达到峰值后表现出逐渐降低趋势,而预后不良组始终处于较高水平。ICH组从入院第3d之后时点SF水平显著高于对照组,且ICH预后不良组显著高于预后良好组(P<0.05);ICH预后不良组的脑血肿量、脑水肿量及NIHSS评分均显著高于预后良好组(P<0.05),相对水肿系数显著低于预后良好组(P<0.05);SF与脑血肿量、水肿量、NIHSS评分呈正相关,而与相对脑水肿系数呈显著负相关。结论 :ICH患者SF水平明显增高,SF能够敏感地反映ICH后铁超载及其神经毒性,SF水平与ICH临床预后密切相关,高SF多提示预后不良。     

短期内大量输血患者血清电解质变化分析

目的 :探讨产后大出血短期内大量输血中、后患者血清电解质浓度变化,以提高输血疗效。方法 :对32例产后大出血24h内输注红细胞悬液在10U或以上的大量输血产妇输血前、中、后血清电解质浓度进行检测分析。结果 :输血中血清钾平均值低于输血前,差异有统计学意义。32例患者输血中22例(68.75%)血清钾浓度较输血前低,P<0.05,其中9例低于正常参考值(3.5 mmol/L-5.5mmol/L);18例(56.25%)输注中、输注后均较输血前降低,P<0.05,其中6例低于正常参考值;11例(34.38%)输血后血清钾浓度较输血前高,P﹥0.05,1例血清钾浓度高于正常参考值。输血中、输血后低血钙病例增多;镁、钠、氯离子浓度无明显变化。结论 :产妇大出血后大量输血应注意监测血清钾、钙离子浓度的变化,及时调整治疗措施,以提高输血效果。     

抽动症患儿血清NSE水平变化与发病机制探讨

目的 :观察抽动症患儿血清神经元特异性烯醇化酶(NSE)水平变化,探讨抽动症的发病机制。方法:2014年7月至2016年7月134例抽动症患儿以同期100名健康体检儿童为对照组,检测两组受试儿童血清NSE水平,并比较3~6岁、7~10岁、11~14岁亚组儿童血清NSE水平差别。抽动症组患儿接受为期12周的阿立哌唑治疗,判断其治疗效果,并于治疗后再次检测其血清NSE,探讨血清NSE变化的临床意义。结果 :抽动症组各年龄段亚组血清NSE浓度均高于对照组,差异有统计学意义(P<0.05),11~14岁亚组血清NSE浓度均低于3~6岁、7~10岁亚组,差异有统计学意义(P<0.05),3~6岁、7~10岁亚组血清NSE浓度比较,差异无统计学意义(P>0.05)。抽动症组134例患儿总有效率为80.60%,不良反应发生率为8.96%(12/134)。患儿治疗12周后血清NSE浓度及YGTSS评分均较治疗前下降,差异有统计学意义(P<0.05)。血清NSE浓度与YGTSS评分呈显著正相关(r=0.727,P<0.05)。结论 :抽动症患儿血清NSE浓度高于正常儿童、与病情变化具有密切关联且随年龄增长有下降趋势,NSE升高反映的神经元受损可能是抽动症发生的重要机制。     

血清胆碱酯酶水平变化与多器官功能障碍综合征患者病情严重程度及预后的关系

目的 :分析血清胆碱酯酶(CHE)水平变化与多器官功能障碍综合征(MODS)患者病情严重程度及预后的关系,为MODS患者病情严重度及预后的评估提供参考指标。方法 :2013年10月至2016年10月我科129例MODS患者及同期未发生MODS者100例进行对照,比较两组患者入组时、入组后24 h血清CHE水平。此外,比较入组28 d后存活、死亡患者入组时、入组后24 h血清CHE水平,计算血清CHE与患者急性生理与慢性健康评分(APACHEⅡ)的相关性,并运用受试者工作特征曲线(ROC)分析血清CHE评估MODS患者预后的效能。结果 :MODS组患者平均APACHEⅡ评分为(22.98±7.25)分,高于对照组的(9.11±1.37)分,差异有统计学意义(P<0.05)。MODS组入组时、入组后24 h血清CHE水平均低于对照组,差异有统计学意义(P<0.05),MODS组入组后24 h血清CHE水平较入组时下降(P<0.05),对照组入组时、入组后24 h血清CHE水平未见明显变化,差异无统计学意义(P>0.05)。MODS组存活、病死患者入组后24 h血清CHE水平均较入组时下降,病死患者入组时、入组后24 h血清CHE水平均低于存活组,差异有统计学意义(P<0.05)。Pearson相关性分析示,血清CHE水平与患者APACHEⅡ评分呈负相关(r=-0.429,P<0.05);ROC曲线示,入组时、入组后24 h血清CHE水平判断MODS患者病死风险的曲线下面积分别为0.652、0.771(P<0.05)。结论 :血清CHE变化与MODS患者病情严重度及预后具有密切关联,患者入院后24 h血清CHE水平在判断其病死风险方面参考价值更高。     

多发性硬化患者血清与脑脊液中IL-23、IL-17、TNF-α水平变化

目的:分析多发性硬化(MS)患者血清与脑脊液中白细胞介素-23(IL-23)、白细胞介素-17(IL-17)、肿瘤坏死因子-α(TNF-α)水平变化,了解MS发病机制。方法:2014年7月至2017年2月37例MS患者按照症状分期分为急性发作组(n=22)及缓解期组(n=13);并选取同期31名健康体检者,作为对照组。使用酶联免疫吸附法(ELISA法)检测各组受试者入组次日及急性发作组患者治疗前后血清与脑脊液中IL-23、IL-17、TNF-α水平变化,分析上述细胞因子在MS发生发展中发挥的作用。结果:MS组血清与脑脊液中IL-23、IL-17、TNF-α均高于对照组,差异有统计学意义(P<0.05);急性发作组血清与脑脊液中IL-23、IL-17、TNF-α均高于缓解期组,差异有统计学意义(P<0.05)。急性发作组治疗后血清与脑脊液中IL-23、IL-17、TNF-α均逐渐降低,差异有统计学意义(P<0.05)。结论:MS患者血清与脑脊液中IL-23、IL-17、TNF-α水平均有所升高,上述细胞因子可能参与了MS急性发作的发病过程,有望为MS病情评估及治疗药物研发提供新的思路。     

牙龈炎和牙周炎患者龈沟液内一氧化氮水平变化

目的:观察牙龈炎和牙周炎患者龈沟液内一氧化氮(NO)水平变化。方法:随机抽取牙龈炎组、牙周炎组及正常组。使用硝酸还原酶法测定3组受试者龈沟液内NO水平,并检测牙龈炎组、牙周炎组患者治疗前后牙周临床指标、龈沟液内NO水平变化。结果:正常组龈沟液NO水平低于牙龈炎组,牙龈炎组龈沟液NO水平低于牙周炎组,差异有统计学意义(P<0.05)。两组患者治疗后龈沟液内NO水平有所下降仍高于正常组,差异有统计学意义(P<0.05)。牙龈炎组、牙周炎组患者牙周临床指标均较治疗前降低,牙龈炎组治疗后牙周探诊深度、附着丧失低于牙周炎组,差异有统计学意义(P<0.05)。结论:健康人群龈沟液内亦可检出NO,但水平较低,NO水平的上升伴随着牙周疾病的发生、发展,且与牙周疾病炎症程度具有一定关联。     

类风湿关节炎患者血清IL-34水平与骨质疏松的相关性

目的 :分析类风湿关节炎(RA)患者血清白细胞介素-34(IL-34)水平与骨质疏松的相关性,探讨IL-34与RA骨质疏松的关系。方法 :选取我院2015年1月至2017年4月就诊的152例RA患者及同期90名健康体检者,分别纳入患者组、对照组,检测其腰椎、股骨近端骨密度,按照患者组骨密度检测结果将其分为骨量正常组、骨量减少组、骨质疏松组,比较各组受试者血清IL-34水平,计算IL-34与受试者骨密度以及患者组RA活动度积分的相关性。结果 :患者组骨密度低于对照组,其骨质疏松发生率及血清IL-34水平高于后者,差异有统计学意义(P<0.05)。随着RA患者骨密度的下降,其血清IL-34水平、RA活动度积分逐渐上升,差异有统计学意义(P<0.05)。Pearson相关性分析示,IL-34与RA患者骨密度呈负相关,与RA活动度积分呈正相关。结论 :RA患者血清IL-34水平的上升伴随着骨密度的下降与RA活动度积分的上升,IL-34可能在RA患者骨质疏松的发生发展中扮演了重要角色。     

尘肺患者停止接尘后胸片动态观察

本文对３７例铸工尘肺、５例焊工尘肺患者停止接尘后进行定期胸片追踪观察，其中５年内评定内等级Ⅰ期对Ⅰ＾＋者８例，升为Ⅱ期者５例；６－１０年内评定升级３例。作者认为５年内为观察尘肺进展的最佳时期。尘肺阴影以不规则影宽径，密集度变化为主体，其次并发症Ｘ线表现较为突出，与临床症状密切相关，并提出并发症常致尘肺阴影隐匿，复查时结合老片、临床情况可减少诊断的贻主及尘肺等级的评定。同时严格选择摄片条件可获优良胸     

肥胖不育患者精浆中ROS、GSTs水平变化分析

目的 :探讨肥胖不育患者精浆中ROS、GSTs水平变化及其与精液相关指标、血脂相关性。方法 :选取2013年10月-2015年6月来我院就诊105例男性不育患者(分为肥胖不育组合体重正常不育组)和60例正常已育者(NC组)为研究对象,分析各组精液质量和精浆中ROS、GSTs水平变化。结果 :正常体重不育组与肥胖不育组精子前向运动率、活动率、GSTs水平均明显低于NC组,畸形率、ROS水平高于NC组,差异有统计学意义(P<0.05);肥胖不育组精子前向运动率、活动率、GSTs水平低于正常体重不育组,畸形率、ROS水平高于正常体重不育组,差异有统计学意义(P<0.05);BMI及精浆ROS与精子前向运动率、精子活动率、精浆GSTs呈负相关,BMI与精子畸形率、精浆ROS呈正相关;TC、TG、LDL-C与精子前向运动率、精子活动率呈负相关,HDL-C与精子前向运动率、精子活动率呈正相关;精浆GSTs与精子前向运动率、精子活动率呈正相关,与畸形率呈负相关。结论 :肥胖不育患者精浆中ROS水平明显升高、GSTs降低,BMI及精浆ROS、GSTs与精子活动能力、精子畸形率存在相关关系。     

替米沙坦联合瑞舒伐他汀对早期2型糖尿病肾病患者血清内脂素和颈动脉内膜中层厚度的影响

目的:观察替米沙坦联合瑞舒伐他汀对早期糖尿病肾病患者血清内脂素和颈动脉内膜中层厚度(IMT)的影响。方法:将96例血压正常的早期糖尿病肾病患者随机分为替米沙坦联合瑞舒伐他汀组(治疗组)和瑞舒伐他汀组(对照组),每组各48例;2组患者均行常规降糖治疗,治疗组联合应用替米沙坦40mg/qd和瑞舒伐他汀10mg/qd,对照组仅给予瑞舒伐他汀10mg/qd,疗程均为16周。比较2组治疗前后尿白蛋白排泄率(UAER)、血清内脂素及颈动脉IMT等指标的变化。结果:2组患者的基线特征无明显差异。治疗组较对照组能更好降低血清内脂素、UAER及颈动脉IMT水平[(46.9±9.8对67.2±11.5)ng/mL,(59±29对88±36)μg/mL,(0.89±0.26对0.96±0.30)mm],差异有统计学意义。结论:与瑞舒伐他汀单药治疗相比,替米沙坦联合瑞舒伐他汀能降低血清内脂素水平,减少UAER,具有更好的肾脏保护作用,延缓动脉粥样硬化进展。     

HBeAg阴性慢性乙型肝炎患者血清HBV-DNA病毒载量与ALT水平相关性探讨

目的探讨HBeAg阴性慢性乙型肝炎患者血清HBV-DNA病毒载量和ALT水平之间的相关性。方法以HBeAg阳性慢性乙型肝炎病例为对照,回顾分析同期收治的HBeAg阴性慢性乙型肝炎患者血清HBV-DNA病毒载量和ALT水平之间的关系。结果 HBeAg阴性慢性乙型肝炎患者的HBV DNA病毒载量及ALT水平明显低于HBeAg阳性慢性乙型肝炎患者(P<0.05);HBeAg阴性慢性乙型肝炎患者血清中HBV-DNA病毒载量与ALT水平之间呈正相关(rs=0.811,P=0.000);而HBeAg阳性慢性乙型肝炎患者血清中HBV-DNA病毒载量与ALT水平之间无相关性(rs=0.097,P=0.281)。结论 HBeAg阴性慢性乙型肝炎患者血清HBV-DNA病毒载量低,HBV-DNA病毒载量与ALT水平呈正相关。     

Modelling of aircraft manufacturing cost at the concept stage

The work presented is concerned with the estimation of manufacturing cost at the concept design stage, when little technical information is readily available. The work focuses on the nose cowl sections of a wide range of engine nacelles built at Bombardier Aerospace Shorts of Belfast. A core methodology is presented that: defines manufacturing cost elements that are prominent; utilises technical parameters that are highly influential in generating those costs; establishes the linkage between these two; and builds the associated cost estimating relations into models. The methodology is readily adapted to deal with both the early and more mature conceptual design phases, which thereby highlights the generic, flexible and fundamental nature of the method. The early concept cost model simplifies cost as a cumulative element that can be estimated using higher level complexity ratings, while the mature concept cost model breaks manufacturing cost down into a number of constituents that are each driven by their own specific drivers. Both methodologies have an average error of less that ten percent when correlated with actual findings, thus achieving an acceptable level of accuracy. By way of validity and application, the research is firmly based on industrial case studies and practice and addresses the integration of design and manufacture through cost. The main contribution of the paper is the cost modelling methodology. The elemental modelling of the cost breakdown structure through materials, part fabrication, assembly and their associated drivers is relevant to the analytical design procedure, as it utilises design definition and complexity that is understood by engineers.     

经阴道彩色多普勒超声在宫外孕早期诊断中价值及临床意义

目的:探讨经阴道彩色多普勒超声对早期宫外孕的诊断价值及临床意义。方法:选取56例早期宫外孕患者,分别运用经腹部超声和经阴道彩色多普勒超声检查,与手术结果进行对照,对比两种方法的疾病诊断准确率和对附件区包块的检出率。结果:与手术结果对照,腹部超声检查诊断率符合率为73.21%(41/56);而经阴道彩色多普勒超声为94.64%(53/56),两者差异具有统计学意义(P<0.05)。经阴道超声检查出附件区包块的检出率为96.43%(54/56),而经腹部超声检出率为78.57%(44/56),差异显著,有统计学意义(P<0.05)结论:经阴道彩色多普勒超声对诊断早期宫外孕诊断准确率高。     

Design optimization of mixed-flow pump impellers with various shaft diameters at the same specific speed

In this study, the hydraulic performance of a mixed-flow pump depending on the impeller hub ratio was analyzed using Computational- fluid-dynamics (CFD). The impeller inlet shape varies according to the hub ratio even at the same specific speed. It is important to ensure an optimum impeller design according to the hub ratio in order for the impeller shape to provide the desired performance at constant specific speed. The design variables of inlet part for meridional plane and vane plane development were defined for optimum impeller design. The objective functions were defined as the total head and total efficiency of the mixed-flow pump impellers. The optimum impeller design was carried out by controlling the design variables of impeller inlet parts by using the Response-surface-method (RSM). The tendency of impeller design variables depending on the hub ratio was identified by analyzing the optimum impeller design. Further, the impeller shape was designed on the basis of the tendency of the design variables depending on the hub ratio. Finally, the performance of an impeller with the designed shape was verified by numerical analysis.     

Analysis of specific lipid metabolites in cord blood of patients with gestational diabetes mellitus

This work aimed to clarify the interaction between the fetus and pregnant patients with gestational diabetes mellitus (GDM), the lipid metabolomics analysis of the fetal umbilical cord blood of GDM patients and normal pregnant women were performed to screen out the specific lipid metabolites for pathogenesis of GDM. From 2019–2020, 21 patients with GDM and 22 normal pregnant women were enrolled in Hexian Memorial Hospital, Panyu District, Guangzhou. The general information such as weight, height, age, body mass index (BMI) before pregnancy were analyzed. Non-targeted metabonomic detection and analysis were performed in umbilical cord plasma using LC-MS method. The age, BMI, delivery methods, and infant weight were different between GDM and control. There were 167 lipid metabolites in umbilical cord blood associated with GDM. Among them, 158 upregulated and 9 downregulated in GDM. There were 13 dysregulated metabolites with C < 30, including Lyso-phosphatidyl-colines LPC 16:0, 18:2, 18:1, 18:0, 20:4 and 22:6, glycerophosphocholines PC O-16:1, oleoylcarnitine CAR 18:2 and 18:1, dihexosylceramides Hex2Cer 13:0;2O, phosphatidylethanolamine PE O-22:6_2:0 and PE O-22:6_3:0 and sphingomyelin SM 8:0; 2O/11:0. Those metabolites were associated with glycerophospholipid metabolism and sphingolipid metabolism. Therefore, Lyso-phosphatidyl-colines, glycerophosphocholines, oleoylcarnitine, dihexosylceramides, phosphatidylethanolamine, and sphingomyelin were main lipid metabolites of GDM, which might be used for diagnosis and treatment of GDM.     

血脂水平对糖尿病前期人群转归的影响

目的 :分析血脂水平对糖尿病前期人群转归的影响,为糖尿病前期人群的转归预测提供参考。方法 :调查1800例糖尿病前期患者基线资料、检测其入组后血脂水平,并对患者实施3年随访,于末次随访时记录患者血糖转归情况,比较不同血糖转归患者基线资料与血脂水平,运用非条件Logistic回归分析,探讨血脂水平对糖尿病前期人群转归的影响。结果 :1800例糖尿病前期患者中,共有1603例获得有效随访,IFG、IGT患者糖尿病转变率分别为12.93%、15.09%,均低于IFT+IGT患者的31.74%,差异有统计学意义(P<0.05)。非条件Logistic回归分析显示TG是糖尿病前期人群转归的危险因素;在排除其他因素影响下,与基线TG水平0.35~0.98 mmol/L(TG1)相比,TG水平1.41~2.07 mmol/L(TG4)者糖尿病转变风险上升1.283倍(P<0.05)。结论 :TG水平升高可造成糖尿病前期人群糖尿病转变风险上升,根据基线TG所处范围评估患者糖尿病转变风险,对于指导临床血脂调节、糖尿病的预防具有积极作用。     

胚胎停育患者血清及组织中IL-6表达

目的 :检测胚胎停育患者血清及组织中白细胞介素-6(IL-6)表达水平,探讨IL-6对胚胎停育的影响。方法 :将我院2014年5月~2016年5月收治的74例胚胎停育患者纳入胚胎停育组,并选取同期50名正常早孕女性、50名健康未孕女性,分别纳入早孕组、健康组,检测各组受试者血清IL-6水平及绒毛、蜕膜组织IL-6表达水平。结果 :胚胎停育组与早孕组年龄、停经时间、孕次、孕囊直径比较,差异无统计学意义(P>0.05)。胚胎停育组血清IL-6水平低于早孕组、健康组,早孕组血清IL-6水平高于健康组,差异有统计学意义(P<0.05);胚胎停育组绒毛组织、蜕膜组织IL-6表达水平均低于早孕组,差异有统计学意义(P<0.05)。结论:胚胎停育患者血清及组织中IL-6表达水平显著下降,这可能是造成其早期胚胎停止发育原因之一。     

Working with the confocal scanning UV-laser microscope: specific DNA localization at high sensitivity and multiple-parameter fluorescence

The use of fast-staining DNA-specific dyes such as DAPI or Hoechst 33342/33258 has been a major problem for confocal scanning laser microscopy (CSLM) studies of intranuclear chromatin organization. Moreover, the availability of a confocal ultraviolet scanning laser microscope configuration, which allows an excitation at wavelengths of 364 nm as well as 488, 514 and 543 nm, is a prerequisite for single as well as multiple fluorescence parameter studies, especially if these studies are concerned with the precise localization of intranuclear signals. Here we report the characteristics and application of a CSLM, which was adapted for UV-excitation and therefore enables comparison of the spatial distribution of several types of signals within one preparation. In addition to multiple-parameter studies, we have also investigated the sensitivity of the system with regard to the identification of the double-stranded DNA of lampbrush chromosome loops in germinal vesicles of amphibian oocytes.