Relevance of early intervention in Fahr's disease: understanding through a case study

SUMMARY Intracranial calcification may result from disturbances in calcium metabolism. It often remains asymptomatic, but may present with symptoms like seizure and neurological deficits. Correction of the underlying metabolic disturbance before damage of neuronal tissues due to intracranial calcification may be useful in preventing irreversible neurological deficits. This window period may be the crucial period that needs a thorough clinical evaluation and urgent intervention. We highlight the case of an adult woman with Fahr's disease presented with generalised tonic-clonic seizure. The management priorities were also discussed along with review of literature.

Damage Symptoms and Damage Degree of Main Diseases and Pests in Foxtail Millet in Chengde Area

The species of main diseases and pests in foxtail millet and their damage status were investigated in 15 survey points in Longhua, Weichang, Chengde, Fengning and Luanping counties, Chengde City from 2015 to 2017. It was preliminarily cleared that there were 11 species of main diseases and 8 species of pests in continuous cropping millet field. The diseases damaged severely were millet downy mildew and kernel smut, and pests were yellow-legged lema, millet shoot fly and soil insects. The results provided a scientific basis for green control of millet pests and diseases and safe production in Chengde area.

Blunt dopamine transmission due to decreased GDNF in the PFC evokes cognitive impairment in Parkinson’s disease

Studies have found that the absence of glial cell line-derived neurotrophic factor may be the primary risk factor for Parkinson’s disease. However, there have not been any studies conducted on the potential relationship between glial cell line-derived neurotrophic factor and cognitive performance in Parkinson’s disease. We first performed a retrospective case-control study at the Affiliated Hospital of Xuzhou Medical University between September 2018 and January 2020 and found that a decreased serum level of glial cell line-derived neurotrophic factor was a risk factor for cognitive disorders in patients with Parkinson’s disease. We then established a mouse model of Parkinson’s disease induced by 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine and analyzed the potential relationships among glial cell line-derived neurotrophic factor in the prefrontal cortex, dopamine transmission, and cognitive function. Our results showed that decreased glial cell line-derived neurotrophic factor in the prefrontal cortex weakened dopamine release and transmission by upregulating the presynaptic membrane expression of the dopamine transporter, which led to the loss and primitivization of dendritic spines of pyramidal neurons and cognitive impairment. In addition, magnetic resonance imaging data showed that the long-term lack of glial cell line-derived neurotrophic factor reduced the connectivity between the prefrontal cortex and other brain regions, and exogenous glial cell line-derived neurotrophic factor significantly improved this connectivity. These findings suggested that decreased glial cell line-derived neurotrophic factor in the prefrontal cortex leads to neuroplastic degeneration at the level of synaptic connections and circuits, which results in cognitive impairment in patients with Parkinson’s disease.

Significance of changes of serum ICAM-1 and LDH activity in different severity of vascular lesions of coronary heart disease

Objective:To analyze the relationship between serum ICAM-1,lactate dehydrogenase(LDH)and coronary heart disease(CHD)by clinical detection of serum ICAM-1 and LDH Objective to investigate the relationship between the severity of different types of coronary artery stenosis(CHD)and its role in the progression of CHD.Methods:180 patients with chest pain and coronary angiography were selected,including 145 patients with CHD diagnosed by coronary angiography and 35 patients without abnormal coronary angiography(control group).The 145 patients with CHD were further divided into mild partial stenosis group(a-chd,stenosis development≤49%),moderate partial stenosis group(b-chd,stenosis development 50%~74%)and severe partial stenosis group(c-chd,stenosis development≥75%).The levels of ICAM-1 and LDH in serum of patients were detected by ELISA,and the differences of ICAM-1 and LDH activities in different degrees of coronary artery disease and control group were statistically analyzed.Results:in the control group,HDL was higher than that in the c-chd group(P<0.05),neutrophils in the control group was lower than that in the c-chd group(P<0.05);ICAM-1,LDH and Gensini scores in the a-chd group,b-chd group and c-chd group were higher than those in the control group(P<0.05-P<0.01),and gradually increased with the aggravation of different coronary artery stenosis processes(P<0.05-P<0.01).The levels of serum ICAM-1 and LDH increased significantly with the increase of the number of CHD lesions(P<0.01).The levels of ICAM-1 and LDH were positively correlated with Gensini score(LDH r=0.409,P<0.01 and ICAM-1 r=0.463,P<0.01).The levels of ICAM-1 and neutrophils were positively correlated(r=0.208,P<0.01).The levels of LDH and ICAM-1 were negatively correlated with HDL(LDH r=-0.184,P<0.05 and ICAM-1)There was a negative correlation between LDH and total protein(r=-0.218,P<0.01),and a positive correlation between ICAM-1 and LDH(r=0.441,P<0.01).Conclusion:the levels of serum ICAM-1 and LDH gradually increase with the aggravation of different coronary artery stenosis,and there is a certain linear relationship between them.

Bioecology of Fungi-Pathogens of Flower Crops and the System to Combat Them

For the first time, degree of damage of the disease Botrytis cinerea Pers. is founded in decorative colors in the Tashkent region. Chemical preparations are the most effective methods of struggle in the fight against diseases of ornamental crops.

Application of Optical Methods in Blood Studies upon Evaluation of Severity Rate of Diffuse Liver Pathology

Possible early diagnostic application of optical methods (dielectrophoresis, spectral and imaging ellipsometry, Fourier-transform infrared spectroscopy, Raman spectroscopy) in studies of red blood cells and serum of patients with diffuse liver disease with varying degrees of fibrosis has been evaluated. Application of combined optical methods was confirmed to significantly improve the performance of sensitivity, specificity, and accuracy index as well as to achieve the reliable results in diagnosis of both severe fibrosis and slight ulterior liver fibrosis. Identified diagnostic potential of optical methods can be effectively utilized in noninvasive screening evaluation of stages of diffuse liver disease of various geneses.

Combination patterns of precipitation and its concentration degree determining the risk of dengue outbreaks in China

The amount and distribution of precipitation can determine dengue risk by affecting mosquito breeding;however,previous studies failed to incorporate this bivariate characteristic to examine dengue fever transmission.In the present research,nationwide data on daily dengue cases in China between January 2005 and December 2020 were obtained,and the top 12 cities accounting for 78%of total cases were selected for analysis.Precipitation patterns were quantified by weekly precipitation and precipitation concentration degree(PCD).On the basis of the combinations of both parameters,the exposure-response relationships of precipitation with dengue risk were established using generalised additive models,and the high-dengue-risk thresholds of precipitation patterns were further identified.Dengue burden was assessed by calculating attributable dengue cases.For the same amount of precipitation,the dispersed precipitation in the pre-summer rainy season leads to a higher dengue risk in autumn.The weekly precipitation of 100-150 mm and PCD of 0.2-0.4 constitute the highest risk scenario,and the average frequency of precipitation associated with dengue risk in 2013-2020 is 1.6 times higher than that in 2005-2012.A total of 3093 attributable dengue cases are identified.From 2005 to 2020,the amount of dispersed precipitation increased in southern and southwestern China and posed high dengue risks in central China.This study has improved the understanding of the health impacts of irregular rainfall under climate change.Our approach to identifying thresholds provides information for early warning systems and helps reduce the risk of dengue transmission in the long run.

Correlation between Nrf2‑GPX4 signaling pathway and patients with coronary heart disease

Objective:To analyze the correlation between serum Nrf2 and GPX4 activity levels with coronary heart disease(CHD)and the severity of coronary artery disease,and to explore the role of ferroptosis mediated by its signaling pathway in the progression of CHD.Methods:A total of 540 patients suspected of CHD were selected for coronary angiography,of which 360 patients were diagnosed with CHD.The activity levels of Nrf2 and GPX4 in the serum of CHD patients were detected by ELISA,and the differences in the activities of Nrf2 and GPX4 in the presence or absence of CHD were statistically analyzed.Western blot detection of Nrf2 protein expression of peripheral blood mononuclear cells(PBMCS)in the control(CON)and CHD groups(90 cases each).The expression and significance of its signaling pathway in CHD patients were analyzed.Results:The activity levels of Nrf2 and GPX4 in the CHD group were lower than those in the CON group(P<0.05),and the expression levels of Nrf2 in PBMCs of the two groups were detected by Western blot.The protein expression level of Nrf2 in the CHD group(0.25±0.05)was down‑regulated compared with CON group(0.87±0.16)(P<0.05),indicating that Nrf2 protein expression level was low in CHD patients.Pearson correlation analysis showed that serum Nrf2 and GPX4 levels were negatively correlated with Gensini score(Nrf2:r=‑0.347,P<0.001;GPX4:r=-0.423,P=0.001).Nrf2 and GPX4 were negatively correlated with TG(Nrf2:r=-0.284,P<0.001;GPX4:r=-0.275,P=0.001),Nrf2 and GPX4 levels were negatively correlated with LDL(Nrf2:r=-0.418,P<0.001)0.05;(GPX4:r=-0.426,P<0.05),Nrf2 and GPX4 levels were positively correlated with HDL(Nrf2:r=0.318,P<0.05;GPX4:r=0.428,P<0.05),and Nrf2 was positively correlated with GPX4(r=0.456,P<0.01).Conclusion:The ferroptosis pathway mediated by the Nrf2‑GPX4 signaling pathway is closely related to the degree of coronary artery disease and the pathogenesis of CHD,and its mechanism may be related to the down‑regulation of the Nrf2‑GPX4 signaling pathway.

基于MRI评估股骨头灌注指数、突出指数、受累程度与Perthes病分期的关系

目的 探讨基于磁共振成像(MRI)评估股骨头灌注指数、突出指数、受累程度与Perthes病分期的关系。方法 选取我院116例Perthes病患儿,初次就诊时均行MRI检查,评估股骨头灌注指数、突出指数、受累程度,分析其临床价值。结果 良好组改良Waldenstrom分期及突出指数、受累程度低于不良组,股骨头灌注指数高于不良组(P<0.05);Perthes病患儿改良Waldenstrom分期与股骨头灌注指数呈负相关,与突出指数、受累程度呈正相关(P<0.05);股骨头灌注指数、突出指数、受累程度预测Perthes病患儿预后不良的曲线下面积(AUC)分别为0.855、0.748、0.802,各指标联合预测的AUC最大,为0.963。结论 MRI检测股骨头灌注指数、突出指数、受累程度与Perthes病分期密切相关,且在预测患儿疾病转归方面具有较高应用价值。

Outcomes in patients with COVID-19 and new onset heart blocks: Insight from the National Inpatient Sample database

BACKGROUND Coronavirus disease 2019(COVID-19)caused by the severe acute respiratory syndrome coronavirus 2(SARS-CoV-2)has resulted in a worldwide health crisis since it first appeared.Numerous studies demonstrated the virus’s predilection to cardiomyocytes;however,the effects that COVID-19 has on the cardiac conduc-tion system still need to be fully understood.AIM To analyze the impact that COVID-19 has on the odds of major cardiovascular complications in patients with new onset heart blocks or bundle branch blocks(BBB).METHODS The 2020 National Inpatient Sample(NIS)database was used to identify patients admitted for COVID-19 pneumonia with and without high-degree atrioven-tricular blocks(HDAVB)and right or left BBB utilizing ICD-10 codes.The patients with pre-existing pacemakers,suggestive of a prior diagnosis of HDAVB or BBB,were excluded from the study.The primary outcome was inpatient mortality.Secondary outcomes included total hospital charges(THC),the length of hospital stay(LOS),and other major cardiac outcomes detailed in the Results section.Univariate and multivariate regression analyses were used to adjust for confounders with Stata version 17.RESULTS A total of 1058815 COVID-19 hospitalizations were identified within the 2020 NIS database,of which 3210(0.4%)and 17365(1.6%)patients were newly diagnosed with HDAVB and BBB,respectively.We observed a significantly higher odds of in-hospital mortality,cardiac arrest,cardiogenic shock,sepsis,arrythmias,and acute kidney injury in the COVID-19 and HDAVB group.There was no statistically significant difference in the odds of cerebral infarction or pulmonary embolism.Encounters with COVID-19 pneumonia and newly diagnosed BBB had a higher odds of arrythmias,acute kidney injury,sepsis,need for mechanical ventilation,and cardiogenic shock than those without BBB.However,unlike HDAVB,COVID-19 pneumonia and BBB had no significant impact on mortality compared to patients without BBB.CONCLUSION In conclusion,there is a significantly higher odds of inpatient mortality,cardiac arrest,cardiogenic shock,sepsis,acute kidney injury,supraventricular tachycardia,ventricular tachycardia,THC,and LOS in patients with COVID-19 pneumonia and HDAVB as compared to patients without HDAVB.Likewise,patients with COVID-19 pneumonia in the BBB group similarly have a higher odds of supraventricular tachycardia,atrial fibrillation,atrial flutter,ventricular tachycardia,acute kidney injury,sepsis,need for mechanical ventilation,and cardiogenic shock as compared to those without BBB.Therefore,it is essential for healthcare providers to be aware of the possible worse predicted outcomes that patients with new-onset HDAVB or BBB may experience following SARS-CoV-2 infection.

12个燕麦品种在黄土高原沟壑区生产性能及适应性

为筛选适宜黄土高原沟壑区种植的高产、抗倒伏、抗病性强的燕麦(Avena sativa)品种,以国内外引进的12个燕麦品种为试验材料,分析其产量相关性状、倒伏率和病害发生率,并利用灰色关联度分析和聚类分析法进行综合评价。结果表明:12个燕麦品种干草产量为10800.00~15233.33 kg·hm^(−2),平均干草产量13298.61 kg·hm^(−2);种子产量为3095.24~7857.14 kg·hm^(−2),平均值5407.14 kg·hm^(−2);其中,‘坝燕6号’的倒伏率较低,红叶病和锈病发病率最低,为抗倒伏兼抗病品种。灰色关联度分析结果表明:株高、干草产量、叶茎比在灰色关联评价系统中所占权重最高,是品种选择时的重要指标。采用聚类分析方法将12个燕麦品种划分为3个类群,第Ⅰ类群可作为饲草品种,第Ⅱ类群可作为籽粒型品种,第Ⅲ类群倒伏率及病情指数低,抗逆性好。综合灰色关联度和聚类分析方法,筛选出适宜黄土高原沟壑区种植的产量高、适应性好的饲草型燕麦品种‘加燕2号’,籽粒型燕麦品种‘坝燕6号’和‘美达’。

CT血管造影联合血清尿素、胱抑素C、甘油三酯葡萄糖乘积指数对冠心病患者冠脉狭窄程度的诊断价值和斑块性质的关系

目的探讨CT血管造影(CTA)联合血清尿酸(UA)、胱抑素C(Cys C)、甘油三酯葡萄糖乘积(TyG)指数对冠心病(CHD)患者冠状动脉(以下简称冠脉)狭窄程度诊断价值和斑块性质的关系。方法选择2021年2月至2023年2月我院收治的129例CHD患者,所有患者均接受CTA检查获得血管体积、斑块体积、重建指数(RI)、斑块负荷等参数资料,检测血清UA、Cys C、甘油三酯及空腹血糖水平,并计算TyG指数。根据冠脉狭窄程度和斑块性质将CHD患者分为中度狭窄组和重度狭窄组,钙化斑块组和非钙化斑块组。比较不同冠脉狭窄程度和斑块性质CHD患者CTA参数和血清UA、Cys C、TyG指数的差异。受试者工作特征(ROC)曲线分析CTA参数联合血清UA、Cys C、TyG指数对冠脉狭窄程度诊断价值。结果CHD组血管体积小于对照组(P<0.05),斑块负荷、血管狭窄程度、RI、CTA参数模型CTA'和血清UA、Cys C、TyG指数高于对照组(P<0.05)。重度狭窄组斑块负荷、血管狭窄程度、RI、CTA参数模型CTA'和血清UA、Cys C、TyG指数高于中度狭窄组(P<0.05),非钙化斑块组斑块负荷、RI和血清UA、Cys C、TyG指数高于钙化斑块组(P<0.05)。CTA参数(CTA')、血清UA、Cys C、TyG指数等4指标单独及联合应用时:ROC-AUC(0.95CI)分别为0.767(0.568~0.954)、0.703(0.432~0.963)、0.732(0.524~0.918)、0.741(0.560~0.914)、0.891(0.773~0.983)。联合应用诊断效能更高。结论CHD患者的血管体积减小,斑块负荷、血管狭窄程度、RI增加,血清UA、Cys-C、TyG指数均升高,与钙化斑块形成有关。CTA与血清UA、Cys C、TyG指数均可诊断冠脉狭窄程度,且联合诊断效能更高。

高表达抗β2糖蛋白I(β2GPI)自身抗体可加重结缔组织病炎症程度及免疫功能紊乱

目的 观察抗β2糖蛋白I(β2GPI)自身抗体在结缔组织病表达及其与炎症及免疫功能的关系。方法 观察对象为广义结缔组织病患者,包括结缔组织病(CTD)、类风湿性关节炎(RA)、干燥综合征(SS)和系统性红斑狼疮(SLE)。采用化学发光法进行定量检测抗β2GPI。采用魏氏法检测血沉(ESR),采用全自动生化分析仪检测C反应蛋白(CRP)、类风湿因子(RF)和抗环瓜氨酸多肽(CCP)抗体。结果 RA患者抗β2GPI抗体及其亚型较CTD、 SS、 SLE患者均明显升高。结缔组织病患者中CRP与抗β2GPI抗体、抗β2GPI抗体IgM呈正比。ESR与抗β2GPI抗体呈正比。与CRP正常组比较,CRP异常组抗β2GPI抗体、抗β2GPI抗体IgM升高。与ESR正常组比较,ESR异常组抗β2GPI抗体、抗β2GPI抗体IgG升高。RA患者中抗β2GPI抗体与ESR、抗CCP抗体呈正相关。抗β2GPI抗体IgG与RF呈正相关。结论 抗β2GPI抗体水平可作为结缔组织病炎症程度和评估免疫紊乱的一个预测因子。

鼻病研究细胞培养实验室“1+2”教学培训模式的效果分析

目的探讨鼻病研究细胞培养实验室“1+2”教学培训模式在实践应用上的效果分析。方法选取2020~2023年4年间进入鼻病细胞培养实验室的研究生为研究对象,将2020~2021年进入鼻病细胞培养实验室的研究生33人纳入对照组,2022~2023年进入鼻病细胞培养实验室的研究生33人纳入实验组。对照组研究生采用常规实验室老师培训模式;实验组研究生采用“1+2”教学培训模式,即在线上培训交流基础上,结合实践培训模式(导师制模式+实验室制模式)。比较两组研究生理论知识考核、实验常规操作行为评估、实践操作考核及培训效果调查的差异。结果实验组研究生的理论知识考核成绩、实践操作考核成绩明显高于对照组(P均<0.001),且实验组研究生的细胞复苏、细胞传代、细胞冻存、仪器设备正确使用、实验室使用流程、实验器材的消毒灭菌、实验过程中的无菌操作得分均高于对照组(P均<0.05)。实验组研究生8项实验常规操作错误行为较对照组均明显减少(P均<0.05)。实验组研究生在实验室安全培训效果、实验室考核制度效果、培训后解决实践问题的能力、培训对提升综合能力的作用、整体满意度方面评分均高于对照组(P均<0.05)。结论“1+2”教学培训模式,可提升鼻病研究细胞培养实验室研究生的理论知识、细胞培养技术熟练度和整体实践能力,可促进鼻科学研究中细胞培养实验室的教学质量提升。

下腰椎椎体在不同负荷下屈伸运动特点的分析

目的探索不同负重状态下直立位腰椎L_(3)、L_(4)椎体屈伸运动过程中体运动轨迹,分析负重状态下腰椎在体运动的规律和特点。方法招募2018年8月至2020年8月10名无症状的青年志愿者,使用双荧光透视系统DFIS与CT相匹配技术,经平扫CT获取L_(3)~S_(1)的图像进行三维重建。于放射线透视不同负重下0、5、10 kg完成下腰椎的前屈到直立到后伸动作获得X线影像,通过轮廓重叠实现二维到三维图像的匹配,还原下腰椎椎体的三维运动轨迹。结果下腰椎在前屈到站立位时:不同负重下腰椎椎体0、5、10 kg的X轴的运动位移分别为-1.05(-2.42,1.72)、0.63(0.15,4.26)、-0.39(-0.75,3.12)mm。X轴运动位移比较5 kg>10 kg>0 kg,差异有统计学意义(P<0.05)。γ角度分别为-0.26(-1.30,5.43)、0.93(0.24,5.42)、-0.95(-2.12,4.32)°。γ角度比较5 kg>0 kg>10 kg,差异有统计学意义(P<0.05)。下腰椎在站立到后伸位时:不同负重下腰椎椎体0、5、10 kg X轴的运动位移分别为0.90(-0.82,3.74)、-0.91(-1.55,4.26)、0.07(-0.92,3.25)mm。Z轴的运动位移分别为-0.25(-0.54,1.78)、0.40(-0.68,2.37)、-0.19(-0.92,1.03)mm。X轴运动位移比较0 kg>10 kg>5 kg,Z轴运动位移比较5 kg>10 kg>0 kg,差异有统计学意义(P<0.05)。α角度分别为0.91(-0.82,2.85)、-0.61(-0.14,3.79)、0.54(-0.82,3.87)°。γ角度分别为1.15(0.24,5.32)、0.92(-0.67,5.45)、0.65(-1.24,5.32)°。α角度比较0 kg>10 kg>5 kg,γ角度比较0 kg>5 kg>10 kg,差异有统计学意义(P<0.05)。结论负重5 kg下腰椎椎体在体运动的位移和旋转角度和0 kg相比差异有统计学意义,可能与腰椎退行性疾病有一定关联。下腰椎退行性疾病可能与X轴位移的关系更为密切。

急性心肌梗死患者血清ANGPTL8、KLF2表达与冠脉病变程度及主要心脏不良事件发生的关系

目的探讨急性心肌梗死(AMI)患者血清血管生成素样蛋白8(ANGPTL8)、Kruppel样因子2(KLF2)表达与冠脉病变程度及主要心脏不良事件(MACE)发生的关系。方法选取106例AMI患者为研究对象,根据冠脉病变程度将患者分为轻度组(52例)和重度组(54例),根据MACE发生情况将患者分为MACE组(18例)和非MACE组(88例)。收集患者一般资料,酶联免疫吸附试验(ELISA)法检测血清ANGPTL8、KLF2水平,Spearman相关分析AMI患者血清ANGPTL8、KLF2水平与Gensini评分的相关性,多因素Logistic回归分析AMI患者冠脉病变程度的影响因素;绘制受试者工作特征(ROC)曲线分析血清ANGPTL8、KLF2水平预测AMI患者发生MACE的价值。结果重度组AMI患者高血压史、高血脂史患者比例,收缩压、舒张压、三酰甘油(TG)、N-末端B型利钠肽原(NT-proBNP)、心肌肌钙蛋白I(cTnI)水平,Gensini评分以及血清ANGPTL8水平高于轻度组(P<0.05),高密度脂蛋白胆固醇(HDL-C)水平以及血清KLF2水平低于轻度组(P<0.05);且轻度组和重度组AMI患者病变支数比较,差异有统计学意义(P<0.05)。AMI患者血清ANGPTL8水平与Gensini评分呈正相关(r=0.638,P<0.05),血清KLF2水平与Gensini评分呈负相关(r=-0.612,P<0.05)。高血压史、高血脂史、cTnI、ANGPTL8是AMI患者冠脉病变进展为重度的危险因素(P<0.05),而HDL-C、KLF2是保护因素(P<0.05)。MACE组血清ANGPTL8水平高于非MACE组(P<0.05),而血清KLF2水平低于非MACE组(P<0.05)。血清ANGPTL8、KLF2水平及二者联合预测AMI患者发生MACE的曲线下面积分别为0.740(95%CI:0.646~0.820)、0.799(95%CI:0.710~0.870)、0.806(95%CI:0.717~0.876)。结论血清ANGPTL8、KLF2表达均与AMI患者冠脉病变程度密切相关,且对MACE发生具有一定预测价值。

健康焦虑元认知和家庭关怀度对中青年宫颈癌患者恐惧疾病进展的影响

目的:研究中青年宫颈癌患者健康焦虑元认知程度、家庭关怀度和恐惧疾病进展的现状,为改善患者治疗依从性和生活质量提供理论依据。方法:以2022年12月至2023年11月在某市医院确诊为宫颈癌的60例中青年患者为主要研究对象,选择健康焦虑元认知量表、家庭关怀度量表、癌症患者恐惧疾病进展简化量表进行研究。结果:中青年宫颈癌患者健康焦虑元认知与恐惧疾病进展呈正向相关,家庭关怀度与恐惧疾病进展呈现负相关性(P<0.01)。结论:患者健康焦虑元认知水平能够正向预测恐惧疾病进展水平,医护人员对健康焦虑元认知水平较高,家庭关怀度中、低水平的患者进行早期干预,可降低其恐惧疾病进展水平,提高家庭关怀度。

红细胞分布宽度、糖化血红蛋白水平与不稳定型心绞痛患者冠状动脉病变程度及狭窄程度的相关性分析

目的分析红细胞分布宽度、糖化血红蛋白水平与不稳定型心绞痛患者冠状动脉病变程度及狭窄程度的相关性。方法120例不稳定型心绞痛患者,根据冠状动脉病变支数的不同分为单支病变组(60例)、双支病变组(40例)、多支病变组(20例),根据冠状动脉狭窄程度的不同分为轻度狭窄组(50例)、中度狭窄组(40例)、重度狭窄组(20例)、完全闭塞组(10例)。对比不同冠状动脉病变支数组和狭窄程度组的红细胞分布宽度、糖化血红蛋白水平;使用Pearson法分析红细胞分布宽度、糖化血红蛋白水平与不稳定型心绞痛患者冠状动脉病变支数、冠状动脉狭窄程度的相关性。结果单支病变组、双支病变组、多支病变组的红细胞分布宽度分别为(9.27±0.71)%、(12.59±1.36)%、(17.87±2.68)%,糖化血红蛋白分别为(6.57±1.12)%、(8.89±2.06)%、(12.65±3.18)%。单支病变组、双支病变组、多支病变组的红细胞分布宽度、糖化血红蛋白水平对比,差异均有统计学意义(P<0.05);且红细胞分布宽度、糖化血红蛋白水平从高到低分别均为:多支病变组>双支病变组>单支病变组,差异均有统计学意义(P<0.05)。轻度狭窄组、中度狭窄组、重度狭窄组、完全闭塞组的红细胞分布宽度分别为(8.71±0.63)%、(11.86±0.92)%、(15.76±1.78)%、(20.36±3.04)%,糖化血红蛋白分别为(5.47±1.15)%、(6.97±1.83)%、(9.22±2.68)%、(14.86±3.89)%。轻度狭窄组、中度狭窄组、重度狭窄组、完全闭塞组的红细胞分布宽度、糖化血红蛋白水平对比,差异均有统计学意义(P<0.05);且红细胞分布宽度、糖化血红蛋白水平从高到低分别均为:完全闭塞组>重度狭窄组>中度狭窄组>轻度狭窄组,差异均有统计学意义(P<0.05)。Pearson分析法显示,不稳定型心绞痛患者冠状动脉病变支数的多少与红细胞分布宽度、糖化血红蛋白水平之间呈正相关(r=0.25、0.15,P<0.05);不稳定型心绞痛患者冠状动脉狭窄程度的轻重与红细胞分布宽度、糖化血红蛋白水平之间呈正相关(r=0.49、0.65,P<0.05)。结论临床可以通过红细胞分布宽度、糖化血红蛋白水平的血清学检测来评估不稳定型心绞痛患者冠状动脉病变支数和狭窄程度,进而根据患者病情的轻重来指导临床治疗,从而使患者获得更好的预后。

ADO在慢性阻塞性肺疾病患者近期预后评估中的价值

目的探讨呼吸困难指数气流受限程度指数(dyspnea index air flow restriction degree,ADO)在慢性阻塞性肺疾病(chronic obstructive pulmonary disease,COPD)患者近期预后评估中的价值。方法选取新疆医科大学第二附属医院呼吸内科自2021年3月—2023年3月的COPD患者120例,并依照患者最终转归情况将其分为存活组(n=95)与死亡组(n=25)。观察2组患者的基础病情况及患者性别、年龄、第1秒用力呼气容积(first second forced expiratory volume,FEV1)占预计值的百分比和ADO指数等相关指标。比较ADO指数不同分数患者病死率。比较ADO指数预测180 d死亡的受试者工作特征(receiver operating characteristic,ROC)曲线面积。结果2组患者的高血压、冠心病、心律失常、糖尿病、慢性肝病、慢性肾病、亚临床甲减发生情况对比,差异无统计学意义(P>0.05)。死亡组患者的FEV1占预计值的百分比、FEV1占预计值的百分比评分、呼吸困难分[英国医学研究委员会(the Medical Research Council,MRC)]评分以及ADO指数均高于存活组患者(P<0.05)。ADO指数<5分者的死亡率高于ADO指数≥5分者(P<0.05)。ADO指数预测180 d死亡的ROC曲线面积为0.851(95%CI:0.767~0.928,P<0.001),ADO指数为5.5时,约登指数最大,为0.565。结论ADO可有效反映COPD病情严重程度,对于患者而言可准确反映其病情进展情况,帮助其获得良好的疾病治疗效果,对于患者近期预后而言也具有积极意义,临床应用效果良好。

颈部血管超声联合经颅多普勒超声对缺血性脑血管疾病患者颅内动脉狭窄程度的诊断价值

目的探讨颈部血管超声(CVUS)联合经颅多普勒超声(TCD)对缺血性脑血管疾病患者颅内动脉狭窄程度的诊断价值。方法回顾性分析2020年2月至2022年1月大连理工大学附属中心医院收治的130例缺血性脑血管疾病患者的临床资料,所有患者均行CVUS、TCD检查,以临床诊断结果为金标准,分析CVUS、TCD及联合诊断对缺血性脑血管疾病患者颅内动脉狭窄程度的诊断效能。结果临床诊断结果显示,130例患者中,轻度狭窄118例(90.77%),中重度狭窄12例(9.23%)。CVUS检出轻度狭窄114例,中重度狭16例;TCD检出轻度狭窄110例,中重度狭窄20例;联合诊断检出轻度狭窄100例,中重度狭窄例30。联合诊断灵敏度高于TCD单一诊断,差异有统计学意义(P<0.05),但CVUS与联合诊断的灵敏度,CVUS、TCD及联合诊断的特异度、准确度比较差异无统计学意义。结论CVUS及TCD分别对缺血性脑血管疾病的定性诊断具有一定价值,联合诊断对缺血性脑血管疾病的定性诊断价值较高。