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目的 观察依诺肝素钠抗凝对终末期肾病维持性血液透析患者血小板和血脂的影响及其安全性。方法 选 取 220 例 CKD 5 期患者, 随机分为观察组和对照组各 110 例。两组均行维持性血液透析治疗, 每周 3 次, 共治疗 6 个 月。于每次透析治疗前 20～30 min, 观察组给予依诺肝素钠注射液、对照组给予低分子量肝素钙注射液静脉注射。 治疗前后采集患者空腹静脉血, 检测血小板、总胆固醇（TC）、甘油三酯（TG）、高密度脂蛋白（HDL）、低密度脂蛋白 （LDL）、脂蛋白, 比较两组血小板和血脂变化, 记录透析过程中出现的凝血、出血、脱发等不良反应。结果 观察组 治疗后血小板计数升高, 对照组治疗后血小板计数下降, 观察组血小板计数高于对照组（P 均<0. 05). 观察组 治 疗后 血 清 TC 、HDL 、LDL 、脂 蛋 白 水 平 降 低（P 均 <0. 05), 对 照 组 治 疗 后 TG 水 平 升 高 、脂 蛋 白 水 平 降 低（P 均 <0. 05), 观察组 TG、TC、LDL 水平低于对照组（P 均<0. 05). 观察组不良反应发生率为 12. 73%, 低于对照组的 23. 64%（P<0. 05). 结论 依诺肝素钠可降低终末期肾病维持性血液透析患者血脂水平, 且不减少血小板, 具有较 好的安全性。 [ABSTRACT FROM AUTHOR]

Copyright of Shandong Medical Journal is the property of Shandong Medical Health Newspapers and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Shandong Medical Journal is the property of Shandong Medical Health Newspapers and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Shandong Medical Journal is the property of Shandong Medical Health Newspapers and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

多发性骨髓瘤(MM)是一种浆细胞恶性增殖性血液系统疾病,近年随着不同作用机制新药的引入患者生存率显著提高。达雷妥尤是一种人源化抗CD38IgG-κ单克隆抗体,具有补体依赖性细胞毒性作用、抗体依赖性细胞介导的细胞毒性作用、抗体依赖性细胞吞噬作用、直接凋亡活性和通过清除CD38~+免疫抑制细胞的免疫调节作用等多种作用机制。CD38、CD55、CD59、抗凋亡分子的表达水平及NK细胞活性可能与达雷妥尤耐药相关。达雷妥尤的安全性和有效性已获得美国食品和药品监督管理局批准用于MM的单药及联合治疗,联合治疗方案包括达雷妥尤+来那度胺+地塞米松方案、达雷妥尤+硼替佐米+地塞米松方案、达雷妥尤+泊马度胺+地塞米松方案、达雷妥尤+硼替佐米+美法仑+强的松方案、达雷妥尤+来那度胺+地塞米松方案、达雷妥尤+硼替佐米+沙利度胺+地塞米松方案、达雷妥尤+卡非佐米+地塞米松米方案、达雷妥尤+来那度胺+硼替佐米+地塞米松方案。 [ABSTRACT FROM AUTHOR]

目的探讨丙氨酸氨基转移酶(ALT) 升高与高血糖的交互作用对高脂血症的影响。方法选择湖北宜 昌地区2018 年3 ~ 1 1 月健康体检人群5 223 例资料完整者，检测血脂［ 包括甘油三月甘(TG) 、总胆固醇(TC汃低密度 脂蛋白胆固醇(LDL-c) 、商密度脂蛋白胆固醇( HDL-c) ］ 、ALT、空腹血糖指标。应用Logistic 回归模型研究危险因 索的独立效应，应用相加模型、相乘模型对危险因索f司的交互作用进行分析。结果ALT 升高人群中商脂血症患 病率商于ALT 正常人群(x2 = 167. 5 1,P < 0. 001) 。商血糖人群中商脂血症患病率商于血糖正常人群(x2 = 43. 45, P < 0 . 001 ) 。ALT 和血糖与血脂4 单项均相关，控制混杂因索后多因索Logistic 回归分析结果： ALT 升高和高血糖并 存时患高脂庄症的风险是正常ALT 和血糖的10. 4 倍(95% Cl 为3. 03 ~ 36. 50,P < 0. 001) ，两因索对高脂血症存在 正相加交互作用，不存在相乘交互作用。交互作用指数、相对超危险度比、归因比、纯因子归因交互效应百分比分 别为4. 68、7 . 39、71. 1% 、78. 6% 。结论ALT 升高与高血糖的正相加交互作用是商脂血症的重要危险因索， 两者 共存可显著增加患病风险。 [ABSTRACT FROM AUTHOR]

Copyright of Shandong Medical Journal is the property of Shandong Medical Health Newspapers and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Shandong Medical Journal is the property of Shandong Medical Health Newspapers and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

胆囊腺肌症（GA)是胆囊的一种非炎症性、非肿瘤性增生性病变，组织病理学表现为胆囊黏膜萎缩、肌层 增生，黏膜上皮向胆囊壁内凹陷形成胆囊壁内憩室。目前认为，GA的形成可能与远端胆道狭窄或神经源性功能障 碍、胚胎期胆囊芽发育不全、胆囊结石或慢性胆囊炎、雌激素、胰胆管汇合异常等因素有关。虽然对GA的病因有了 初步了解，但对其发病机制仍不十分清楚。就目前证据而言，尚不能认为GA是胆囊癌的癌前病变。 [ABSTRACT FROM AUTHOR]

Copyright of Shandong Medical Journal is the property of Shandong Medical Health Newspapers and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

目的分析、总结膀胱浆细胞样尿路上皮癌（PUC)的临床病理特点:方法膀胱PUC患者4例，男3 例、女1例，年龄52~83岁。收集4例患者的病理检查资料和免疫组化检查结果，并进行分析，结果3例组织学 形态基本相同:低倍镜下黏膜上皮脱失，固有膜和肌层内见肿瘤组织浸润；中倍镜下浸润的肿瘤细胞黏附性差，呈 实性巢状、片状生长，间质疏松;高倍镜下肿瘤细胞大小中等、核偏位、胞质嗜酸性;常出现不同比例胞质空泡的细 胞，核分裂象可见。另1例镜下部分表现为肉瘤样变异型。3例肿瘤组织侵犯膀胱壁全层，1例侵犯深肌层。2例 脉管内癌栓，3例淋巴结内见转移癌。1例侵犯神经，1例侵及左侧精囊腺，1例侵及双侧精囊腺。病理分期T4期3 例，T2期1例。4例免疫组化检査结果显示肿瘤细胞CK、HER-2、IgG表达均为阳性，LCA表达均为阴性，3例 CD138阳性结论膀胱PUC具有特殊的组织病理形态，肿瘤内常出现不同比例胞质空泡的细胞，核分裂象可 见，类似印戒细胞，伴或不伴细胞内黏液，但无细胞外黏液出现;肿瘤细胞CK表达阳性、LCA表达阴性有助于PUC 的诊断及鉴别诊断，CD138不是PUC特异性诊断标志物。 [ABSTRACT FROM AUTHOR]

Objective To explore the effects of curcumin on the cell proliferation. aggregation. and the sensitivity to bevacizumab of cen'ical cancer stem cells. Methods The CD133+ cen'ical cancer stem cells ( CCSCs) were isolated from CASKI cells by flow cytometry. The CCSCs were divided into seven groups; CC10 group, CC20 group. CC40 group. CC60 group, CC80 group. and CC100 group which were given a final concentration of 10 . 20.40 , 60 . 80 and 100 mg/mL curcumin, while cells in the control group were given the same amount of solvent and culture medium. The inhibition rate of cell proliferation in each group was detected by MTT. The cells in the control group and CC60 group were cultured in serum-free medium for 1 week. The number of stem cell spheres with diameter greater than 100 pan was counted by light microscope, and the proportion of CD133+ cells was detected by flow cytometry. The cervical cancer stem cells were divided into four groups, BY group (added with bevacizumab 10 mg/mL) , CC group ( added with 60 mg/mL curcumin) , BV + CC group (added with 10 mg/mL bevacizumab and 60 mg/mL curcumin) , and the control group (treated with the same a-mount of solvent and medium ). After 48-hour culture, the apoptosis rate was determined by flow cytometry. Results The rates of cell proliferation inhibition in the CC10 group, CC20 group, CC40 group, CC60 group, CC80 group, and CC100 group were higher than that of the control group (all L* <0.05) , and with the increase of curcumin concentration, the proliferation inhibition rate of cen'ical cancer stem cells gradually increased (all P< 0.05). The number of stem cell spheres with diameter greater than 100 pan of the CC60 group was less than that of the control group (P <0. 05 ). The proportion of cervical cancer stem cell in the CC60 group was lower than that in the control group (P <0. 05 ). The apoptosis rate in the BV + CC group was higher than that in the control group. BV group. and CC group ( P < 0. 05 ) , the apoptosis rate in the CC group was higher than that in the control group and BV group (P < 0. 05) , and the apoptosis rate in the BV group was higher than that in the control group (P <0. 05 ). Conclusion Curcumin can inhibit the proliferation and decrease the stem cell aggregation of CCSCs and increase the sensitivity of CCSCs to bevacizumab. [ABSTRACT FROM AUTHOR]

Copyright of Shandong Medical Journal is the property of Shandong Medical Health Newspapers and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Shandong Medical Journal is the property of Shandong Medical Health Newspapers and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Shandong Medical Journal is the property of Shandong Medical Health Newspapers and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Shandong Medical Journal is the property of Shandong Medical Health Newspapers and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objective To investigate the clinical characteristics and prognostic factors of elderly patients with non-ST-segment elevation acute myocardial infarction (NSTEMI). Methods Totally 135 elderly patients with acute myocardial infarction, including 72 patients with NSTEMI and 63 patients with ST segment elevation acute myocardial infarction (STEMI) were selected. The clinical data between patients with NSTEMI and with STEMI were compared. Cox regression model was used to analyze the prognostic factors for elderly patients with NSTEMI. Results The NSTEMI elderly patients had more cases of patients with diabetes mellitus (30 vs. 12), hypertension (49 vs. 31) and heart failure (45 vs. 27) than STEMI elderly patients and had less cases of persistent chest pain (40 vs. 53), lower levels of peak creatine kinase〔 (829. 55 ± 125. 64) IU / L vs. (2 354. 45 ±351. 01) IU / L〕and troponin I peak 〔 (0. 86 ± 0. 24) ng / m L vs. (1. 86 ± 0. 64) ng / m L〕 (all P<0.05). The rates of recurrent angina, heart failure and mortality in NSTEMI elderly patients were higher than STEMI patients during 1 year after discharge (24.3% vs. 11.7%, 18.6% vs. 6.7%, 25.7% vs. 8.3%) (all P 0.05). Old age (65 years) (HR =2.13), heart failure (HR =3.37) and Killip≥3 level at admission (HR =1.79) were risk prognostic factors for NSTEMI elderly patients and aspirin (HR =0.51) was the protective prognostic factor. Conclusions There are more diabetes, hypertension, heart failure and less persistent chest pain and lower peak creatine kinase and troponin I peak in NSTEMI elderly patients than those in the STEMI elderly patients. The long-term prognosis of elderly patients with NSTEMI is poor. The NSTEMI patients with old age (65 years), heart failure or multiple Killip≥3 level at admission are more likely to undergo poor prognosis and patients with aspirin may decrease the poor prognosis. [ABSTRACT FROM AUTHOR]

儿童抽动症（TS）是一种以慢性、多发性运动和发声抽动为特征的神经精神疾病，并伴有强迫多动等行为和情绪障碍。多种因素可诱发该病，例如神经生化水平失衡、免疫应答过度、遗传基因异常、心理压抑等内部因素，此外，环境压力等外部因素也可能引起TS发病。针对不同的病因，近年来已发展出多样化的治疗方法。除传统的药物治疗外，免疫调节治疗、刺激疗法等在临床应用中也取得了一定的疗效。针对患儿的个体情况，心理行为疗法也逐渐发展起来，成为一种辅助性的治疗手段。 [ABSTRACT FROM AUTHOR]

目的分析C反应蛋白(CRP)与白细胞计数(WBC)联合检测在儿科细菌性感染诊断中的应用。方法对203例疑似感染患儿分别采用免疫比浊法、血细胞分析仪检测CRP、WBC,根据出院诊断将患儿分为细菌感染组114例(局部感染组84例,重症感染组30例),病毒感染组46例,非感染组43例,比较各组CRP、WBC水平。结果细菌感染组CRP、WBC阳性率及定量值均高于病毒感染组、非感染组(P均<0.05);CRP、WBC诊断细菌感染的最佳临界值分别为44.36 mg/L、13.35×109/L,在临界值时联合检测对细菌感染诊断的敏感度、特异度、Youden指数均高于单独检测。结论 CRP联合WBC检测对儿科细菌性感染的确诊有重要价值。 [ABSTRACT FROM AUTHOR]