血清脑钠肽、心肌肌钙蛋白T及休克指数与急性心肌梗死患者经皮冠脉介入术后主要不良心血管事件的相关性分析

目的 探讨血清脑钠肽(BNP)、心肌肌钙蛋白T(c Tn T)及休克指数(SI)与急性心肌梗死(AMI)患者经皮冠脉介入术(PCI)后主要不良心血管事件(MACE)的相关性。方法 回顾性分析2017年11月至2022年11月于徐州医科大学附属医院、江苏省滨海县人民医院进行PCI治疗的200例AMI患者的临床资料,将其分为MACE组(60例)与无MACE组(140例)。比较两组基线资料、血管狭窄程度(Gensini)评分、总胆固醇(TC)、甘油三酯(TG)、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)及术前白蛋白、BNP、c Tn T、SI。采用logistic逐步回归分析MACE的危险因素,通过受试者工作特征(ROC)曲线分析各指标预测MACE的价值。结果 MACE组糖尿病患者占比及年龄、BNP、c Tn T、SI水平高于无MACE组(P<0.05)。logistic逐步回归分析结果显示,年龄(OR=2.145,95%CI=1.056~4.357)、BNP (OR=1.985,95%CI=1.156~3.408)、c Tn T (OR=1.997,95%CI=1.145~3.483)、SI(OR=1.897,95%CI=1.260~3.196)是AMI患者PCI治疗后MACE发生的危险因素(P<0.05)。ROC曲线分析结果显示,年龄、BNP、c Tn T、SI均可用于预测AMI患者PCI治疗后MACE的发生(P<0.05)。结论 年龄、BNP、c Tn T、SI可影响AMI患者PCI治疗后MACE的发生,可用于预测MACE的发生。

外周T细胞淋巴瘤的治疗和生存预后分析

目的分析外周T细胞淋巴瘤(PTCL)的临床特征、生存和预后影响因素。方法回顾性分析253例PTCL患者的临床特征、生存和预后影响因素等资料。采用Kaplan-Meier法进行生存分析,log-rank检验进行组间比较,Cox比例风险回归模型进行单因素及多因素分析。结果253例患者中位年龄为60岁,3、5、10 a的疾病无进展生存(PFS)率分别为43.70%、36.60%和20.60%,3、5和、10 a的总生存(OS)率分别为56.60%、49.20%和30.00%。多因素Cox分析结果回示,Ann Arbor分期(HR=3.600,95%CI=1.277~10.145,P=0.015)是PFS独立的不良预后因素,Ann Arbor分期(HR=4.812,95%CI=1.389~16.679,P=0.013)和国际预后指数评分(HR=0.308,95%CI=0.109~0.870,P=0.026)是OS独立的不良预后因素。GDPT方案组患者的总反应率、PFS率和OS率明显高于CHOP方案组(P=0.033、0.011、0.042)。结论Ann Arbor分期和IPI评分是影响PFS和OS的预后因素,GDPT是一种具有前景的新方案,有望成为PTCL的一线疗法。

Geomorphological responses of rivers to active tectonics along the Karahay?t Fault, Western Türkiye

Understanding the topography in active tectonic areas and assessing the rates and models of active deformation in the upper crust are primary objectives in tectonic geomorphology studies. The drainage pattern of river systems is highly sensitive to tectonically induced changes, and it often preserves the records of the formation and progression of most tectono-geomorphic processes within its boundaries. Therefore, the evolution of landforms is a consequence of the evolution of individual drainage basins in which they are formed. Assessing the rates of tectonic deformation using geomorphic data is a traditionally adopted method to characterize the nature of active faults. Globally, the Digital Elevation Model(DEM) is widely used as a crucial tool to analyze the morphotectonic features of drainage basins. In this study, some geomorphic indices were applied to investigate the impact of tectonism on landscape along the Karahay?t Fault and its associated drainage areas. These geomorphic indices are mountain front sinuosity(Smf values between 1.17-1.52), valley floor width-to-height ratio(Vf values between 0.25-1.46), basin asymmetry factor(AF values between 15-72), drainage basin shape(Bs values between 3.18-6.01), hypsometric integral and curve(HI values between 0.32-047), channel sinuosity(S values between 1-1.6), normalized steepness index(Ksn values between 1-390) and Chi integral(χ values between 200-4400). The development of drainage areas on the hanging wall and footwall block of the Karahayit Fault differs depending on the uplift. The drainage areas developed on the hanging wall present different patterns depending on the regional uplift caused by the fault. This reveals that the fault contributed significantly to the development of drainage areas and regional uplift in the region. In addition, the maximum earthquake magnitude that may occur in the future on the Karahayit Fault, whose activity is supported by geomorphic indices, is calculated as 6.23. Since an earthquake of this magnitude may cause loss of life and property in the region, precautions should be taken.

系统性红斑狼疮患者外周血T淋巴细胞Mg^(2+)转运蛋白1水平表达及临床价值研究

目的探讨Mg^(2+)转运蛋白1(magnesium transporter protein 1,MagT1)在系统性红斑狼疮(systemic lupuserythematosus,SLE)患者外周血T淋巴细胞中的表达情况,并阐述其临床意义。方法选取西双版纳傣族自治州人民医院2019年1月~2021年6月收治的79例SLE患者作为研究对象,依据SLE疾病活动指数(SLE disease activityindex,SLEDAI)评分将SLE患者分为中重度组(SLEDAI≥10,n=32)和轻度组(SLEDAI<10,n=47),另选取同期体检健康者40例作为对照组。记录患者临床生化和血清免疫相关指标水平;采用实时定量PCR(quantitative realtimePCR,qRT-PCR)法和Western Blot法检测患者外周血T淋巴细胞中MagT1 mRNA和蛋白表达情况;Pearson相关性分析外周血T淋巴细胞MagT1蛋白与生化免疫相关指标表达的关系;绘制受试者工作特征(receiver operatingcharacteristic,ROC)曲线分析外周血T淋巴细胞MagT1蛋白表达对SLE及其严重程度的诊断价值。结果与对照组比较,轻度组和中重度组患者外周血T淋巴细胞中MagT1 mRNA[0.65(0.36,0.99),0.23(0.07,0.36)vs 1.20(0.83,1.37)]和MagT1蛋白[0.35(0.22,0.42),0.22(0.15,0.27)vs 0.53(0.40,0.63)]表达水平明显降低,差异具有统计学意义(Z=5.247,7.078;5.128,7.257,均P<0.05);与轻度组比较,中重度组患者外周血T淋巴细胞中MagT1 mRNA和蛋白表达水平明显降低,差异具有统计学意义(Z=5.169,3.599,均P<0.05)。Pearson相关性结果显示,外周血T淋巴细胞MagT1蛋白表达水平与血清血红蛋白(hemoglobin,HGB)及补体3(complement 3,C3)和补体4(complement 4,C4)水平呈正相关(r=0.496,0.637,0.588,均P<0.05);与红细胞沉降速率(erythrocyte sedimentation rate,ESR)、超敏C反应蛋白(hypersensitive-C reactive protein,hs-CRP)、免疫球蛋白(immunoglobulin G,IgG)水平和SLEDAI呈负相关(r=-0.598,-0.476,-0.646,-0.514,均P<0.05)。ROC曲线结果显示,外周血T淋巴细胞MagT1蛋白表达水平诊断SLE曲线下面积为0.893(95%CI:0.838~0.948),敏感度和特异度分别为90.0%,67.1%,诊断SLE严重程度曲线下面积为0.739(95%CI:0.631~0.848),敏感度和特异度分别为57.4%,84.4%。结论外周血T淋巴细胞MagT1在SLE患者中表达下调,且与SLE严重程度呈负相关,对SLE诊断和病情严重程度具有一定的诊断价值。

预后营养指数联合T淋巴细胞亚群对AECOPD继发性肺部真菌感染的预测价值分析

目的探究预后营养指数(PNI)联合T淋巴细胞亚群对慢性阻塞性肺疾病急性加重期(AECOPD)继发性肺部真菌感染(PFI)的预测价值。方法选取2015年1月至2022年12月我院收治的47例AECOPD继发PFI患者,纳入PFI组;另选取同期我院收治的94例未发生PFI的AECOPD患者,纳入AECOPD组。比较两组患者PNI、T淋巴细胞亚群水平(CD4^(+)、CD8^(+)及CD4^(+)/CD8^(+))。收集所有患者的临床资料,采用多因素Logistic回归方程明确AECOPD继发PFI的影响因素。受试者工作特征(ROC)曲线分析PNI及T淋巴细胞亚群水平对AECOPD继发PFI的预测价值。结果PFI组PNI值、CD4^(+)占比、CD4^(+)/CD8^(+)均低于AECOPD组,CD8^(+)占比高于AECOPD组(P<0.05);PFI组有糖尿病史、抗菌药使用时间≥7 d、抗菌药物使用种类≥2种、入侵性操作种类≥2种占比及机械通气占比均高于AECOPD组(P<0.05);多因素Logistic回归分析结果显示,有糖尿病史、抗菌药物使用种类≥2种、PNI低水平、CD8^(+)高水平及CD4^(+)/CD8^(+)低水平是AECOPD继发PFI的危险因素(P<0.05);ROC分析结果显示,PNI、CD8^(+)及CD4^(+)/CD8^(+)单独及联合预测AECOPD继发PFI的AUC(95%CI)分别为0.670(0.586~0.747)、0.694(0.611~0.769)、0.653(0.569~0.732)、0.863(0.795~0.915),其中三者联合预测AECOPD继发PFI的效能高于单独检测(Z=3.095、2.839、3.429,均P<0.05)。结论PNI低水平、CD8^(+)高水平及CD4^(+)/CD8^(+)低水平是AECOPD继发PFI患者的独立危险因素,三者联合对AECOPD继发PFI具有较高的预测价值。

内皮激活和应激指数(EASIX)对外周T细胞淋巴瘤患者预后的影响

目的:探讨内皮激活和应激指数(EASIX)对血管免疫母细胞性T细胞淋巴瘤(AITL)和外周T细胞淋巴瘤非特指型(PTCL-NOS)患者预后的影响,并比较低EASIX组和高EASIX组患者的临床特征。方法:回顾性分析2010年1月至2021年9月由徐州医科大学附属医院收治的59例初诊AITL和PTCL-NOS患者的临床资料通过受试者工作特征(ROC)曲线确定EASIX的最佳截断值,卡方检验分析EASIX与AITL和PTCL-NOS患者临床特征的相关性,Kaplan-Meier生存曲线分析患者的总生存期(OS)和无进展生存期(PFS),Cox比例风险模型进行单因素与多因素分析。结果:EASIX的最佳截断值为0.95以此为界将患者分为低EASIX(<0.95)组和高EASIX(≥0.95)组。与低EASIX组患者相比,高EASIX组PTCL患者具有Ann Arbor分期晚、IPI评分高中危以上、LDH升高、易发生低白蛋白血症与贫血、易合并B症状、结外累及和骨髓累及等临床特点。生存分析结果显示,59例PTCL患者中,高EASIX组患者的OS和PFS较低EASIX组患者均明显缩短(P<0.001)。多因素分析结果显示,EASIX是影响患者OS[HR=7.217(95%CI:1.959-26.587),(P=0.003)]和PFS[HR=2.718(95%CI:1.032-7.161),P=0.043]的独立危险因素。结论:初诊AITL和PTCL-NOS患者高EASIX提示患者预后不良,高EASIX是影响患者预后的危险因素。

新预后积分系统对血管免疫母细胞性T细胞淋巴瘤的预后评估意义

目的探讨血管免疫母细胞性T细胞淋巴瘤(AITL)的临床特征和预后影响因素,比较几种预后分层模型对其预后的评估价值。方法回顾性分析79例AITL患者的临床资料,采用国际预后指数(IPI)、外周T细胞淋巴瘤预后指数(PIT)、AITL预后指数(PIAI)评分及新建立的预后积分系统对患者进行危险分层。采用Kaplan-Meier法及Cox回归模型进行生存及预后分析,受试者工作特征(ROC)曲线比较不同预后积分系统的预测价值。结果AITL患者的中位发病年龄为66(29~83)岁。可评估疗效的73例患者中,获得完全缓解27例(37.0%),部分缓解20例(27.4%),总体缓解率为64.4%。中位总生存期(OS)为17(1.0~107.0)个月,3年和5年生存率分别39.76%和26.51%,3年和5年无进展生存率分别为23.58%和17.33%。基于多因素分析不良预后因素为年龄>65岁、ECOG评分>1分、C-反应蛋白(CRP)>20 mg/L和预后营养指数(PNI)<44.35,建立一种新的预后积分系统,其在甄别低危及中低危、中高危及高危患者方面优于IPI、PIT、PIAI评分。在预测AITL患者OS和无进展生存期(PFS)的ROC曲线中,新预后积分系统的AUC分别为0.8259(95%CI 0.7157~0.9361)和0.8592(95%CI 0.7513~0.9670)。结论AITL好发于高龄老年人,初诊时多为Ⅲ-Ⅳ期,疾病进展快,疗效及预后较差。与IPI、PIT及PIAI评分相比,基于年龄>65岁、ECOG评分>1分、CRP>20 mg/L和PNI<44.35所建立的新预后积分系统预后评估价值更高,更有助于识别高危患者。

36 t压路机填石路基施工工艺与压实质量控制研究

对36 t压路机下填石路基进行数值模拟分析,并进行填石路基现场试验,选取4组工况、2种松铺厚度和5种检测指标进行填石路基超厚层快速施工工艺与检测方法研究。结果表明,36 t压路机振动荷载在填石路基路表0.9 m深度范围内产生的应力较大;采用36 t压路机静压1遍、强振碾压2遍、弱振碾压2遍、静压1遍收尾压实效果最好;85 cm的松铺厚度为匹配施工工艺的最优松铺厚度;动态变形模量检测效率高,与孔隙率有较好的相关性,建议采用动态变形模量作为填石路基的检测指标,软质岩石填石路基下路堤动态变形模量指标建议控制在69 MPa以上。

内置T形钢骨-T形钢管混凝土短柱轴压性能试验研究

为研究钢骨-异形钢管混凝土短柱轴压性能,对9个内置T形钢骨的T形钢管混凝土短柱和3个未配置钢骨的T形钢管混凝土短柱进行了轴压试验研究,考察了试件破坏模式,分析了荷载-钢管应变、荷载-钢骨应变、荷载-平均纵向应变等相关曲线的变化过程,探讨了含钢率、套箍指数和配骨率等参数对试件承载力的影响。结果表明:所有试件在轴心受压下的破坏模式均为局部屈曲破坏;在保持其他因素不变的情况下,随着配骨率由0增加到39.1%、58.6%和69.9%,试件极限承载力分别提高了42.9%、56.5%和67.2%;随着套箍指数的增长率由24.5%增加到62.8%,试件极限承载能力分别提高了5.4%和11.1%,但随着钢骨和钢管厚度的增加,其对试件极限承载能力的增强效果逐渐减弱。基于试验研究和参数分析,提出了内置T形钢骨-T形钢管混凝土短柱极限承载力计算公式,计算结果与试验结果吻合良好。

Assessment of structural brain changes in patients with type 2 diabetes mellitus using the MRI-based brain atrophy and lesion index

Patients with type 2 diabetes mellitus(T2 DM) often have cognitive impairment and structural brain abnormalities.The magnetic resonance imaging(MRI)-based brain atrophy and lesion index can be used to evaluate common brain changes and their correlation with cognitive function,and can therefore also be used to reflect whole-brain structural changes related to T2 DM.A total of 136 participants(64 men and 72 women,aged 55–86 years) were recruited for our study between January 2014 and December 2016.All participants underwent MRI and Mini-Mental State Examination assessment(including 42 healthy control,38 T2 DM without cognitive impairment,26 with cognitive impairment but without T2 DM,and 30 T2 DM with cognitive impairment participants).The total and sub-category brain atrophy and lesion index scores in patients with T2 DM with cognitive impairment were higher than those in healthy controls.Differences in the brain atrophy and lesion index of gray matter lesions and subcortical dilated perivascular spaces were found between non-T2 DM patients with cognitive impairment and patients with T2 DM and cognitive impairment.After adjusting for age,the brain atrophy and lesion index retained its capacity to identify patients with T2 DM with cognitive impairment.These findings suggest that the brain atrophy and lesion index,based on T1-weighted and T2-weighted imaging,is of clinical value for identifying patients with T2 DM and cognitive impairment.Gray matter lesions and subcortical dilated perivascular spaces may be potential diagnostic markers of T2 DM that is complicated by cognitive impairment.This study was approved by the Medical Ethics Committee of University of South China(approval No.USC20131109003) on November 9,2013,and was retrospectively registered with the Chinese Clinical Trial Registry(registration No.Chi CTR1900024150) on June 27,2019.

Cache-Conscious Index Mechanism for Main-Memory Databases

Recent studies have addressed that the cache be havior is important in the design of main memory index structures. Cache-conscious indices such as the CSB^＋-tree are shown to outperform conventional main memory indices such as the AVL-tree and the T-tree. This paper proposes a cacheconscious version of the T-tree, CST-tree, defined according to the cache-conscious definition. To separate the keys within a node into two parts, the CST-tree can gain higher cache hit ratio.

Residual urinary output in high body mass index individuals on chronic hemodialysis:A disregarded life vest?

AIM： To assess residual diuresis and diverse variables according to body mass index （BMI）.METHODS： Cross-sectional study （n = 57）, with 3 groups. Group A： BMI 〈 25, n = 22; Group B： BMI 25-30, n = 15; Group C： BMI 〉 30, n = 20. Diuresis, hematocrit, albumin, C-reactive protein, Malnutrition infammatory score, Pro-BNP, Troponin T, leptin and in-sulin levels are expressed as median and ranges （r）. RESULTS： Albumin （g/dL）： GA vs GC, 3.70 （r2.20-4.90） vs 3.85 （r3.40-4.90）, P = 0.02. Diuresis （mL/d）： GA 690 （r0-1780）; GB 660 （r60-1800）; GC 840 （r40-2840）. Diuresis GA vs GC, P = 0.01. Leptin （ng/mL）： GA vs GC, 3.81 （r0.78-69.60） vs GC, 32.80 （r0.78-124.50）, P 〈 0.001. Insulin （μU/mL）： GA vs GB, 7 （r2-44） vs 11.50 （r4-38）, P = 0.02; GA vs GC, 7 （r2-44） vs 19.5 （r5-155）, P = 0.0001. Troponin T and Pro-BNP levels were not different. Significant correlations： GC, Insulin-UF： ρ= 0.53; P = 0.03; TroponinT-diuresis： ρ = -0.48, P 〈 0.05; Pro-BNP-diuresis： ρ = -0.39, P 〈 0.01; Troponin T-ProBNP： ρ = 0.77, P 〈 0.0001; albumin-Troponin T： ρ = -0.66, P 〈 0.0001; albumin-ProBNP： ρ = -0.44, P 〈 0.05.CONCLUSION： High BMI associated positively with higher diuresis and albuminemia, and negatively with TropT and Pro-BNP. High BMI-associated better survival may be explained by better urinary output, lowering cardiovascular stress.

CD64指数PCT和CD4^(+)T淋巴细胞亚群联合预测模型对高甘油三酯血症性急性胰腺炎早期感染的预测价值

目的 探讨多指标联合预测模型对高甘油三酯血症性急性胰腺炎(HTG-AP)患者早期继发感染的临床应用价值。方法 收集2021年1月至2023年5月在安徽医科大学第一附属医院、合肥市第二人民医院就诊的248例HTG-AP患者的临床资料,并根据早期是否继发感染分为感染组和非感染组。分析并比较两组的一般资料、感染指标等。应用单因素分析及二分类Logistic回归分析筛选HTG-AP患者早期继发感染的独立影响因素,建立多指标联合预测模型。通过受试者工作特征(ROC)曲线、Hosmer-Lemeshow拟合优度和决策曲线分析(DCA)评估模型的区分度、准确性和临床实用性。结果 248例HTG-AP患者分为感染组70例,非感染组178例。两组患者空腹血糖、感染相关指标包括中性粒细胞百分比、CRP、CD4^(+)T淋巴细胞亚群、PCT、CD64指数比较差异有统计学意义(P<0.05);CD64指数、PCT、CD4^(+)T淋巴细胞亚群为HTG-AP早期继发感染的独立预测因子。三者联合预测模型(AUC为0.865)对HTG-AP早期继发感染的诊断价值优于单个指标,敏感度(78.5%)和特异度(87.7%)均较高,阳性预测值71.83%,阴性预测值91.08%。校准后联合预测模型的预测结果与临床实际观察结果一致性较高;通过Bootstrap内部验证,联合预测模型校准后的AUC值为0.865,其预测效能曲线与临床实际发生的曲线具有良好的一致性;DCA分析显示阈概率为12%~88%时,可预测HTG-AP早期继发感染。结论 基于CD64指数、PCT、CD4^(+)T淋巴细胞亚群建立的多指标联合预测模型可早期诊断HTG-AP继发感染。

体质量指数和血脂相关指标与肾癌病理T分期的关系——一项基于山东肾癌协作网的回顾性研究

目的探讨肥胖和血脂相关指标在肾癌患者不同病理T分期中的差异分布。方法回顾性分析在山东肾癌协作网中2019年12月至2022年8月行手术治疗的肾癌患者。收集了所有患者在初始诊断时的临床和实验室特征。分析不同体质量指数(body mass index,BMI)分组与患者手术切除范围和病理T分期之间的相关性。同时,分析在不同病理T分期中,血脂相关指标和其他血清指标的差异分布。结果本研究纳入肾癌患者共1671例,其中含有BMI资料的肾癌患者共961例,体重不足者10例、正常体重者200例、超重者217例、肥胖者534例。与超重、正常体重和体重不足的肾癌患者相比,在肥胖的肾癌患者中行肾部分切除术的患者占比明显升高,达到58.43%。进一步分析发现在不同BMI分类中,T1期的肾癌占比最大;随着BMI的升高,T1期肾癌所占的比例逐步升高,由体重不足组的50.00%逐步升到肥胖组的85.39%。亚组分析显示,在不同BMI分类中,T1a期的肾癌占比最大;随着BMI的升高,T1a期肾癌所占的比例逐步升高。同时发现,随着病理T分期的增加,总胆固醇、高密度脂蛋白、低密度脂蛋白、载脂蛋白A、载脂蛋白B、淋巴细胞、血红蛋白、白蛋白、总胆红素和谷丙转氨酶的水平逐步降低。随着病理T分期的增加,脂蛋白a、同型半胱氨酸、白细胞、中性粒细胞、血小板、乳酸脱氢酶和碱性磷酸酶的水平升高。结论在肾癌患者中,BMI分级与患者的手术切除范围、病理T分期有关;部分血脂相关指标和其他血清相关指标在肾癌患者的不同病理T分期中分布有差异,具有进一步深入研究的临床价值。

子痫前期孕妇外周血T淋巴细胞亚群和线粒体损伤指数变化及其临床意义

目的 探讨子痫前期孕妇外周血T淋巴细胞亚群和线粒体损伤指数变化及其临床意义。方法 选取2021年2月至2023年2月绍兴市柯桥区妇幼保健院收治的58例行孕期管理并分娩的子痫前期孕妇作为研究对象,设为观察组。根据病情程度将其分为非重度子痫前期组(n=40)和重度子痫前期组(n=18)。另选取同期58例健康孕妇作为对照组。于孕中期(24~28周)分别检测各组外周血T淋巴细胞亚群(CD3^(+)、CD4^(+)、CD8^(+))和辅助性T细胞(Th)、抑制性T细胞(Ts)线粒体损伤指数,比较各组间指标差异,并关注妊娠结局,分析指标与妊娠结局的关系。结果 观察组CD3^(+)、CD4^(+)、CD8^(+)水平及Th、Ts线粒体损伤指数阳性率均高于对照组(P<0.05);非重度子痫前期组CD3^(+)、CD4^(+)、CD8^(+)水平及Th、Ts线粒体损伤指数阳性率均低于重度子痫前期组(P<0.05)。观察组总不良妊娠结局发生率为51.72%,其中妊娠结局良好者CD3^(+)、CD4^(+)、CD8^(+)水平及Th、Ts线粒体损伤指数阳性率均低于妊娠结局不良者(P<0.05)。受试者工作特征(ROC)曲线分析显示,CD3^(+)、CD4^(+)、CD8^(+)水平及Th、Ts线粒体损伤指数均具有预测新生儿不良妊娠结局的价值(P<0.05)。结论 子痫前期孕妇存在免疫功能紊乱和异常氧化应激,T淋巴细胞亚群和线粒体损伤指数的检测可作为病情评估和不良妊娠结局预测的指标。

Torsadogenic Index: Its Chinese Medical Origin

The foundational chronology of Torsadogenic Index is introduced to explain the relationship between impending death situations and drug prescription, combination, self-indication, or abuse of torsadogenic pharmacological products. The pathophysiological basis of Torsade de Pointes is presented with the most frequent causes of Long QT syndrome. Traditional Chinese Medical principles are exposed in order to help people to understand its para-logical sequence, providing another view of medical explanations upon scientific evidence. Development of Torsadogenic Risk Management Project and Torsadogenic Traceability concepts derived from these Chinese Medical perpetual axioms are presented in this paper.

乙型肝炎患者体内滤泡辅助性T细胞的功能特点及临床意义研究

目的 通过分析HBV感染者体内滤泡辅助性T细胞(follicular helper T cell,Tfh)的频率和功能,探讨其在HBV感染中的临床意义。方法 本研究入组HBV感染者36例,包括6例急性恢复期(acute recovery,AR)患者和30例慢性HBV感染者,其中慢性HBV感染者又包括免疫耐受期(immune tolerance,IT)患者10例、免疫活化期(immune activation,IA)患者20例。另外纳入8例健康对照(health control,HC)。通过流式细胞术和多色免疫组化技术比较HC组和HBV感染者外周血和肝内Tfh的表达差异,以及通过单细胞分泌蛋白组芯片检测Tfh的功能特点,并对HBV感染者Tfh的频率与HBV相关临床指标(HBV表面抗原、HBV载量、ALT、AST)的相关性进行分析。结果 IA组外周血中Tfh频率显著高于HC组(1.487%vs.0.876%,t=2.126,P=0.043)和IT组(1.487%vs.0.737%,t=3.144,P=0.004);与外周血一致,肝内Tfh也在IA组患者中富集。外周血中Tfh的频率与肝脏炎症指标ALT、AST水平呈正相关(ALT:r=0.488,P=0.000;AST:r=0.498,P=0.000)。单细胞分泌蛋白组芯片检测Tfh的多功能强度指数(polyfunctional strength index,PSI)在AR组患者中最高(AR组>IA组>IT组>HC组),其中AR组患者分泌TNF-、IL-2和IFN-能力较高、IA组分泌IL-10和IL-17A能力较高、IT期分泌粒细胞-巨噬细胞集落刺激因子和IFN-较高,HC组分泌IL-4较高。结论 肝内与外周血结果一致,Tfh在IA组CHB患者中增多,这可能提示Tfh与肝脏炎症的免疫状态密切相关。进一步功能分析表明Tfh在HBV感染不同阶段分泌的细胞因子不同,其可能倾向于不同的分化表型,其中IA期Tfh倾向于cTfh17类表型,而IT期和AR期Tfh倾向于cTfh1类表型,表明Tfh在HBV感染不同阶段表现出不同的CD4^(+)T细胞极化特征。

Research Progress of Related Laboratory Testing Indexes before and after Mother-Infant Blocking in HIV/AIDS Pregnant Women

More than 90% of HIV-positive children come from mother-to-child transmission, so mother-to-child interdiction is the main measure to prevent AIDS in children. Relevant data show that the incidence of mother-to-child transmission of HIV usually fluctuates between 15% and 50% without intervention. Standardized and effective comprehensive intervention can reduce the transmission rate of mother to child to less than 1%. At present, it is believed that mother-to-child transmission of AIDS can be blocked by comprehensive intervention, and its mechanism has been clearly studied. Combined with highly effective antiviral treatment, safe labor and artificial feeding, the mother to child transmission rate can be reduced to less than 1%. However, due to the effect of drugs on mother-to-child transmission of AIDS may lead to some changes in the main biochemical indicators of mother-to-child, there is no systematic analysis of the viral load, T lymphocyte subsets and major biochemical indicators of HIV/AIDS pregnant women before and after maternal-to-child transmission. In this study, the viral load, T lymphocyte subsets and major biochemical indicators of HIV/AIDS pregnant women before and after maternal-infant blockade were dynamically analyzed. It is hoped that this study will help to observe the basic physical fitness and disease development of pregnant women with HIV/AIDS during pregnancy, to provide a strong basis for the treatment and evaluation of maternal-infant blockade of HIV/AIDS pregnant women, and to establish a complete set of laboratory indicators to understand the body status of pregnant women at all stages to minimize the probability of fetal transmission, which will make good economic and social benefits.

Changes of T lymphocyte subpopulation and its relationship with Modified Bobath score in index stroke

Objective To analyze the correlation of changes of T lymphocyte subpopulation and Modified Bobath index in acute stroke.Method Peripheral blood CD3+,CD4+,CD8+,CD16+56+ and ratio of CD4+/CD8+ were measured using bicolor fluorescent monclonal antibody and flow cytometry and compared with those of 23 healthy controls. Simultaneously,relationship between modified Bobath index and changes of T lymphocytes subpopulation was analyzed.Result Compared with healthy controls, peripheral blood percent of CD3+,CD4+ of subjects with acute stroke was marked lower,which was positively correlated with modified Bobath index.Conclusion Immune response is involved in development of acute cerebrovascular diseases.Improving immune function is important for prevention and treatment of cerebrovascular diseases.

北京产业创新政策的方向选择--基于TÖrnqvist 指数法的实证研究

本文基于TÖrnqvist指数法测算北京各门类行业多要素生产率指数,基于链式结构汇总得到三次产业和宏观经济总量多要素生产率指数,并测算各门类行业对宏观经济总量多要素生产率指数的贡献率,建立起北京各行业与宏观经济总量多要素生产率指数之间的联系,基于此提出相应对策建议,为进一步推进北京经济提质增效、实现高质量发展提供参考借鉴。结果显示,北京重点发展行业对宏观经济总量多要素生产率贡献率在提升,产业朝预期方向发展良好,但重点发展行业本身的多要素生产率有所下降,带动宏观经济总量生产率下降,据此建议北京在产业发展上进行“双向调控”,并针对不同产业发展特征及生产率影响因素施行“一行一策”,实现精准引导支持。