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目的　总结 1例酒精性肝硬化并发食管胃静脉曲张出血 (EVB) 伴早期食管癌的治疗方法。方法　回顾 性分析1例酒精性肝硬化并发 EVB 伴早期食管癌患者的临床资料，总结其治疗方案。结果　患者中年男性，因“黑 便 2 d，腹痛、呕血5 h”入院，既往有“酒精性肝硬化，食管静脉曲张 (重度) ，门脉高压性胃病”病史 2 年余，“食管中上 段黏膜病变，早癌可能”病史 2 年余，“胃底静脉曲张组织胶注射”手术史4月余，“内镜下食管曲张静脉套扎术”手术 史9 d，饮酒史 30 余年，平均每日饮酒量折合乙醇约 200 g。入院后行急诊内镜检查提示急性上消化道出血，未见明 显活动性出血，给予药物止血、输血、保肝及营养支持等治疗。首次入院3个月后患者返院复查，明确诊断为肝硬化 失代偿期、门静脉高压、EVB、早期食管癌，既往有 EVB 史，符合经颈静脉肝内门体静脉分流术 (TIPSS) 手术适应证， 有内镜黏膜下剥离术 (ESD) 手术指征。排除禁忌证，于首次入院 3个月后行 TIPSS，术后随访 2月余，首次入院 4个 月胃镜检查显示曲张静脉直径较前缩小。排除禁忌证，于首次入院 6 个月行食管静脉曲张内镜下预防性套扎术，套 扎后接着进行早期食管癌 ESD，手术顺利，术后随访 10 个月，病情稳定。结论　对于肝硬化并发EVB伴早期食管癌 的患者，在对黏膜病变处采取内镜治疗等手术操作前可先行 TIPSS，TIPSS 可同时改善食管和胃底静脉的曲张程度， 能减少内镜手术中及术后再出血风险。 [ABSTRACT FROM AUTHOR]

Objective To observe the effect of curcumin on DNA methyltransferase (Dnmts) activity and tumor suppressor gene human H-cadherin (CDH13) in non-small-eell lung cancer i NSCLC A549 cells and to explore the mechanism of curcumin s demethylation. Methods A549 cells were divided into two groups: the observation group and the control group. Cells in the observation group were cultured with 40 μmol/ L curcumin and the culture medium, while cells in the control group only with the culture medium. MTT assay was used to detect the cell proliferation, and RT-PCR was used to detect the expression of CDH13 mRNA. CpG island methylation status of CDH13 promoter was detected by methylation-specific PCR (MSP) . and catalytic activity of Dnmts was detected by enzyme colorimetric determination kit. Results The OD of the observation group was 0. 638 ±0. 184. which was lower than that (0. 859 ±0. 040) of the control group (P < 0.05). The relative expression level of CDH13 mRNA in the observation group was 0.64 ±0.09. which was higher than that (0.43 ±0. 12) of the control group. There were methylation amplification bands, but no demethylation bands in the control group, and there were both methylation amplification bands and demethylation bands in the observation gmup. In the observation group and the control group, the activities of Dnmtl were separately (0. 153 ±0.016) and (0. 770 ± 0.014) μmol/min, and the activities of Dnmt3b were (0. 137 ±0.020) and (0. 179 ±0.013) μmol/min, respectively. The activities of Dnmtl and Dnmt3b in the observation group were lower than those in the control group (all P < 0. 05). Conclusion Curcumin inhibits the methylation status of CDH13 by decreasing the activity of Dnmts. and thereby inhibits A549 cell proliferation. [ABSTRACT FROM AUTHOR]

目的: 探讨血清脑钠肽(BNP)、肌钙蛋白I(TnI)及D-二聚体水平对急性肺栓塞患者病情及预后评估的价值。方法选取急性肺栓塞患者96例(观察组)，其中大面积肺栓塞12例、次大面积肺栓塞52例、非大面积肺栓塞32例；好转出院90例，死亡6例；另外选取体检健康者26例作为对照组。比较两组入院时外周静脉血血清BNP、TnI及D-二聚体水平。采用受试者工作特征(ROC)曲线分析血清BNP、TnI、D-二聚体单独及联合检测对急性肺栓塞患者预后的诊断价值。结果观察组血清BNP、TnI、D-二聚体水平均高于对照组(P均<0．05)，非大面积、次大面积、大面积肺栓塞患者血清BNP、TnI、D-二聚体水平逐渐升高(P均<0．05)，死亡患者血清BNP、TnI、D-二聚体水平均高于存活者(P均<0．05)。血清BNP、TnI、D-二聚体联合检测对急性肺栓塞患者预后评估的ROC曲线下面积为0．864、敏感性为0．825、特异性为0．835，均高于三项单独检测。结论急性肺栓塞患者血清BNP、TnI、D-二聚体水平升高，三者的水平变化可反映急性肺栓塞病情及预后，三者联合检测可提高对其预后的评估价值。 [ABSTRACT FROM AUTHOR]

目的：了解天津市居民丙型肝炎（丙肝）患病率和丙型肝炎病毒（HCV）感染情况，为丙肝的防治提供依据。方法①丙肝患病率调查：采用整群抽样方法随机抽取547782名区县所辖的街／乡和本市户籍居民，根据丙肝诊断标准（WS 213-2008）确诊丙肝。分析不同年龄、不同性别及不同地区丙肝患病率。②HCV感染情况调查：采取整体分层随机抽样的方法，从547782名调查对象中抽取1～59岁者2181名，采用ELISA法检测抗-HCV，分析不同年龄、不同性别及不同地区丙肝患病率。结果①丙肝患病率：天津市居民丙肝患病率为24．10／10万（132／547782），丙肝患病率随年龄增加而增高（χ2＝14．85，P＜0．05），远高于历年最高报告值。男性、女性居民丙肝患病率分别为33．04／10万、15．25／10万，P＜0．05；市内六区患病率最高，为42．97／10万，与其他地区比较P＜0．05。②抗-HCV阳性率：本次调查为0．64％（14／2181），远低于1992年的1．7％，男性与女性差异无统计学意义；50～59岁人群抗-HCV阳性率明显高于其他各年龄者，P均＜0．05。结论天津市居民抗-HCV感染率较1992年明显下降，但是丙肝患病率远高于历年最高报告值。 [ABSTRACT FROM AUTHOR]