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Effect of Aspergillus niger prolyl endopeptidase in patients with celiac disease on a long-term gluten-free diet

World Journal of Gastroenterology 2024年第11期30卷 1545-1555页

作者： juan p.blo stefanolo Verónica Segura Martina Grizzuti Abel Heredia Isabel Comino Ana Florencia Costa Roberto puebla María paz Temprano Sonia Isabel Niveloni Gabriel de Diego María E Oregui Edgardo Gustavo Smecuol Mauricio C de Marzi Elena F Verdú Carolina Sousa Julio César Bai Small Bowel Section Department of MedicineGastroenterology Hospital of Buenos Aires“Dr.C.Bonorino Udaondo”Buenos Aires 1264Argentina Department of Microbiology and parasitology Faculty of PharmacyUniversity of SevilleSeville 41080Spain Department of Medicine Dr.C.Bonorino Udaondo Gastroenterology HospitalBuenos Aires 1264Argentina Basic and Applied Research Group in Immunology and Bioactives(GIBAIB) Institute of Ecology and Sustainable Development(INEDES)National University of LujanLuján 6700Buenos AiresArgentina Department of Medicine Farncombe Family Digestive Health Research InstituteMcMaster UniversityHamilton L8S 4L8OntarioCanada Facultad de Medicina Universidad del SalvadorBuenos Aires C1051ABBArgentina

BACKGROUND The gluten-free diet(GFD)has limitations,and there is intense research in the development of adjuvant *** To examine the effects of orally administered Aspergillus niger prolyl endopeptidase protease(AN-pEp)on inadvertent gluten exposure and symptom prevention in adult celiac disease(CeD)patients following their usual *** This was an exploratory,double-blind,randomized,placebo-controlled trial that enrolled CeD patients on a long-term *** a 4-wk run-in period,patients were randomized to 4 wk of two AN-pEp capsules(GliadinX;AVI Research,LLC,United States)at each of three meals per day or *** endpoints were:(1)Average weekly stool gluten immunogenic peptides(GIp)between the run-in and end of treatments and between AN-pEp and placebo;(2)celiac symptom index(CSI);(3)CeD-specific serology;and(4)quality of *** samples were collected for GIp testing by ELISA every Tuesday and Friday during run-ins and *** Forty patients were randomized for the intention-to-treat analysis,and three were excluded from the per-protocol ***,628/640(98.1%)stool samples were *** was undetectable(ples,and no differences between treatment arms were *** 0.5%of samples had GIp concentrations sufficiently high(>0.32μg/g)to potentially cause mucosal *** GIp concentration in the AN-pEp arm was 44.7%lower than in the run-in ***-third of patients exhibiting GIp>0.08μg/g during run-in had lower or undetectable GIp after AN-pEp *** with the run-in period,the proportion of symptomatic patients(CSI>38)in the AN-pEp arm was significantly lower(ppEp did not result in changes in specific *** This exploratory study conducted in a real-life setting revealed high adherence to the *** AN-pEp treatment did not significantly reduce the overall GIp stool ***,given the observation of a significantly lower prevale

关键词： Celiac disease Aspergillus niger prolyl endoprotease Gluten immunogenic peptides Trial Symptoms Real-life trial

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Upper gastrointestinal endoscopic findings in celiac disease at diagnosis:A multicenter international retrospective study

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World Journal of Gastroenterology 2022年第43期28卷 6157-6167页

作者： juan p.blo stefanolo Fabiana Zingone Carolina Gizzi Ilaria Marsilio María Luján Espinet Edgardo GustavoSmecuol Mark Khaouli María Laura Moreno María I pinto-Sánchez Sonia Isabel Niveloni Elena F Verdú Carolina Ciacci Julio César Bai Small Bowel Section Dr.C.Bonorino Udaondo Gastroenterology HospitalBuenos Aires 1264Argentina Department of Surgery Oncology and GastroenterologyUniversity of PaduaPadova 35124Italy Gastroenterology Unit Azienda Ospedale UniversitàPadova 35128Italy Department of Medicine SurgeryDentistryScuola Medica SalernitanaUniversity of SalernoSalerno 84081Italy Department of Medicine Farncombe Family Digestive Health Research InstituteMcMaster UniversityHamilton L8S 4K1Canada Research Institutes Universidad del SalvadorBuenos Aires 1020Argentina

BACKGROUND Gastroduodenal endoscopy and biopsy following positive specific serology is considered the gold standard to diagnose celiac disease(CeD)in *** upper endoscopy helps detect comorbid conditions is *** To investigate the prevalence of non-celiac endoscopic findings in patients in whom endoscopy was performed to confirm CeD *** This is an observational,descriptive,multicenter,retrospective study that reports endoscopic findings obtained in adult patients enrolled in local registries from four tertiary *** collected data reported on first endoscopy,indicated for investigation of *** of CeD was performed by histology(≥Marsh 2type mucosal damage)and specific *** European and one North American center included biopsy-confirmed CeD following positive serology.A fourth center(South America)included symptomatic patients undergoing endoscopy,irrespective of CeD *** latter cohort included a non-CeD control *** A total of 1328 patients(80%female;35 years median age)were enrolled,of whom 95.6%had positive specific *** 135 patients,endoscopy revealed 163 abnormalities unrelated to CeD(prevalence:10.1%).Erosive reflux esophagitis(6.4%),gastric erosions(2.0%),and suspicion of esophageal metaplasia(1.2%)were the most common ***-confirmed Barrett’s esophagus was infrequent(0.2%).No endoscopic cancer was *** patients(≥51 years of age)had a higher prevalence of endoscopic findings than those≤50(ppic findings compared with controls(29.1%;ppic abnormality(pptoms was associated with a 37%reduction in the risk of finding at least one endoscopic lesion(p<0.02).CONCLUSION In this large multicenter study,young adults w

关键词： Celiac disease Upper gastrointestinal endoscopy Concomitant endoscopic lesions Malignancies Multicenter study

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Gluten immunogenic peptide excretion detects dietary transgressions in treated celiac disease patients

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World Journal of Gastroenterology 2019年第11期25卷 1409-1420页

作者： Ana Florencia Costa Emilia Sugai María de la paz Temprano Sonia Isabel Niveloni Horacio Vázquez María Laura Moreno M.Remedios Domínguez-Flores Alba Mu?oz-Suano Edgardo Smecuol juan p.blo stefanolo Andrea F González Angel Cebolla-Ramirez Eduardo Mauri?o Elena F Verdú Julio César Bai Small Bowel Section Department of MedicineDr.C.Bonorino Udaondo Gastroenterology HospitalBuenos Aires 1263Argentina Department of Immunology Biomedal S.L.Sevilla 41092Spain Farncombe Family Digestive Health Research Institute McMaster UniversityHamiltonON L8S4L8Canada Research Institutes Universidad del SalvadorBuenos Aires 1050Argentina

BACKGROUND Life-long removal of gluten from the diet is currently the only way to manage celiac disease(CeD). Until now, no objective test has proven useful to objectively detect ingested gluten in clinical practice. Recently, tests that determine consumption of gluten by assessing excretion of gluten immunogenic peptides(GIp) in stool and urine have been developed. Their utility, in comparison with conventional dietary and analytical follow-up strategies, has not been fully *** To assess the performance of enzyme-linked immunosorbent assay(ELISA) and point-of-care tests(poCTs) for GIp excretion in CeD patients on gluten-free diet(GFD).METHODS We conducted an observational, prospective, cross-sectional study in patients following a GFD for at least two years. Using the Gastrointestinal Symptom Rating Scale questionnaire, patients were classified at enrollment as asymptomatic or symptomatic. Gluten consumption was assessed twice by 3-d dietary recall and GIp excretion(by ELISA in stool and poCTs(commercial kits for stool and urine) in two consecutive samples. These samples and dietary reports were obtained 10 day apart one from the other. patients were encouraged to follow their usual GFD during the study *** Forty-four patients were enrolled, of which 19(43.2%) were symptomatic despite being on a GFD. Overall, 83 sets of stool and/or urine samples were *** out of 44 patients(25.0%) had at least one positive GIp test. The occurrence of at least one positive test was 32% in asymptomatic patients compared with 15.8% in symptomatic patients. GIp was concordant with dietary reports in 65.9% of cases(Cohen′s kappa: 0.317). poCT detected dietary indiscretions. Both ELISA and poCT in stool were concordant(concomitantly positive or negative) in 67 out of 74(90.5%) samples. Excretion of GIp was detected in 7(8.4%) stool and/or urine samples from patients considered to be strictly compliant with the GFD by dietary *** GIp dete

关键词： Celiac disease Follow-up Gluten-free diet Gluten immunogenic peptide excretion Rapid tests

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Risk perception and knowledge of COVID-19 in patients with celiac disease

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World Journal of Gastroenterology 2021年第12期27卷 1213-1225页

作者： Jamie Zhen juan p.blo stefanolo María de la paz Temprano Caroline L Seiler Alberto Caminero Enrique de-Madaria Miguel Montoro Huguet Vivas Santiago Sonia Isabel Niveloni Edgardo Gustavo Smecuol Luis Uzcanga Dominguez Elena Trucco Virginia Lopez Carolina Olano pasquale Mansueto Antonio Carroccio peter H Green Donald Duerksen Andrew S Day Jason A Tye-Din Julio César Bai Carolina Ciacci Elena F Verdú Benjamin Lebwohl M Ines pinto-Sanchez Department of Medicine Farncombe Family Digestive Health Research InstituteMcMaster University Medical CenterHamilton Health SciencesHamilton L8S4K1ONCanada Department of Medicine Dr.C.Bonorino Udaondo Gastroenterology HospitalBuenos Aires 1264Argentina Department of pancreatic Unit Hospital General Universitario de AlicanteAlicante 03010Spain Department of Medicine Instituto Aragonés de Ciencias de la Salud(IACS)Zaragoza 50009Spain Department of Medicine Hospital Universitario San Jorge.HuescaZaragoza 50004Spain Department of Gastroenterology Univ Hosp LeonGastroenterol UnitAltos de Nava S-NLeon 24071Spain Department of Medicine Instituto Nacional de Ciencias Médicas y Nutrición Salvador ZubiránMexico DF 14080Mexico Department of Medicine Universidad de la RepublicMontevideo 11800Uruguay Department of Internal Medicine PROMISE DepartmentUniversity of PalermoPalermo 90127Italy Department of Internal Medicine V.Cervello HospitalPROMISE DepartmentUniversity of PalermoPalermo 90127Italy Celiac Disease Center Columbia University Medical CenterColumbia UnivCeliac Dis CtrDiv Digest and Liver DisNew YorkNY 10032United States Department of Medicine St Boniface Gen HospUniversity of ManitobaWinnipeg R2H 2A6Canada Department of paediatrics University of Otago ChristchurchChristchurch 8041New Zealand Department of Gastroenterology Royal Melbourne HospitalImmunology DivisionWalter and Eliza Hall InstituteMelbourne 3052Australia Department of Medicine Surgery and DentryScuola Medica SalernitanaUniversity of SalernoCeliac Center at the University Hospital San Giovanni di Dio e Ruggi di AragonaSalerno 84131Italy Department of Medicine Farncombe Family Digestive Research InstituteMcMaster UniversityHamilton L8S4K1ONCanada The Celiac Disease Center Columbia UniversityNew YorkNY 10032United States

BACKGROUND We recently demonstrated that the odds of contracting coronavirus disease 2019(COVID-19)in patients with celiac disease(CeD)is similar to that of the general ***,how patients with CeD perceive their COVID-19 risk may differ from their actual *** To investigate risk perceptions of contracting COVID-19 in patients with CeD and determine the factors that may influence their *** We distributed a survey throughout 10 countries between March and June 2020 and collected data on demographics,diet,COVID-19 testing,and risk perceptions of COVID-19 in patients with *** were recruited through various celiac associations,clinic visits,and social *** perception was assessed by asking individuals whether they believe patients with CeD are at an increased risk of contracting COVID-19 when compared to the general *** regression was used to determine the influencing factors associated with COVID-19 risk perception,such as age,sex,adherence to a gluten-free diet(GFD),and comorbidities such as cardiac conditions,respiratory conditions,and *** was presented as adjusted odds ratios(aORs)RESULTS A total of 10737 participants with CeD completed the *** them,6019(56.1%)patients with CeD perceived they were at a higher risk or were unsure if they were at a higher risk of contracting COVID-19 compared to the non-CeD population.A greater proportion of patients with CeD perceived an increased risk of contracting COVID-19 when compared to infections in general due to their CeD(56.1%vs 26.7%,pported taking extra COVID-19 precautions as a result of their *** of celiac associations were less likely to perceive an increased risk of COVID-19 when compared to non-members(49.5%vs 57.4%,ppp=0.001),and strict adherence to a GFD(aOR:0.89;95%CI:0.82 to 0.96,p=0.007)were associated

关键词： Celiac disease Gluten Risk Infection Knowledge perception Coronavirus COVID-19

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水质处理对雾培抗堵性能及番茄生长的影响

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节水灌溉 2023年第8期 95-101页

作者：侯诗宇肖娟杨杰彭志慧李艳丽太原理工大学水利科学与工程学院太原030024

为分析出一套较优的气雾栽培条件下抗堵塞水质处理方案,将不同水质处理方案进行对比,分析水质处理对气雾栽培灌水器堵塞情况和番茄生长发育的影响。水质处理方式分别为T1:磁化水处理、T2:无机酸(稀盐酸)调酸处理、T3:有机酸(食品级柠檬... 详细信息

为分析出一套较优的气雾栽培条件下抗堵塞水质处理方案,将不同水质处理方案进行对比,分析水质处理对气雾栽培灌水器堵塞情况和番茄生长发育的影响。水质处理方式分别为T1:磁化水处理、T2:无机酸(稀盐酸)调酸处理、T3:有机酸(食品级柠檬酸)调酸处理,根据番茄不同生长发育期调节营养液的浓度,用电导率(mS/cm)表示,幼苗期0.8~1.0mS/cm,开花结果期1.4~1.6mS/cm,盛果期2.2~2.4mS/cm。试验期间对番茄植株株高、茎粗、叶面积以及雾化灌水器日流量进行定期记录,在番茄第二穗果成熟后对番茄果实的品质进行监测。结果表明:雾化喷头堵塞程度随着营养液浓度和时间的增加表现出“快—慢—快”的增长趋势,T1、T2、T3处理在3个营养液浓度下对雾化喷头均表现出一定的抗堵塞影响,T1、T2效果相近,T3效果较差;3种水质处理对苗期和开花结果期番茄植株生长均有积极影响,且T3处理效果最好,盛果期T2、T3处理对番茄植株生长表现出抑制作用;T1处理对番茄果实大小及质量有显著提升,3组处理对番茄果实营养素含量无显著影响。综合考虑,抗堵塞水质处理应以磁化处理为主,在苗期辅以适当的柠檬酸调酸,最有利于雾化喷头抗堵以及番茄的生长。

关键词：气雾栽培雾化喷头番茄抗堵塞水质

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血清高敏C反应蛋白浓度与高血压病的临床相关性分析

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中国急救复苏与灾害医学杂志 2018年第8期13卷 770-773页

作者：赵娟周育松李斗北京市垡头社区卫生服务中心双合卫生站北京100023

目的高血压与动脉硬化密切相关，血压变异性（blood pressure variability，BpV）是指血压在一定时期内的血压波动程度。最近的研究表明，BpV的异常与器官功能受损相关。本研究旨在探讨高血压病患者血压波动性与脉搏波传导速度（pulse w... 详细信息

目的高血压与动脉硬化密切相关，血压变异性（blood pressure variability，BpV）是指血压在一定时期内的血压波动程度。最近的研究表明，BpV的异常与器官功能受损相关。本研究旨在探讨高血压病患者血压波动性与脉搏波传导速度（pulse wave velocity，pwv）和高敏C反应蛋白（high sensitive C—reactiveprotein，hsCRp）的关系。方法收集2015年10月-2016年5月垡头社区卫生服务中心双合卫生站的原发性高血压患者101例。采用24h动态血压监测对高血压患者24h、收缩压和舒张压的变化进行分析。使用柯林Vpl000自动动脉硬化仪，同时记录和分析包括肢体血压、脉压、肱动脉脉搏波速度（brachial—anklepulsewavevelocity，BApWV）的血清hsCRp，用酶标多克隆抗体夹心法测定。分析血压变异性与BApWV的关系。结果BApWV随平均收缩压、夜间平均收缩压、全天平均收缩压、平均脉压差（pulsepressure，pp）升高（r=0．292、0．328、0．312、0．289、p〈0．05）。在正常BApWV患者和BApWV增高患者中，BApWV、年龄、收缩压（systolic blood pressure，SBp）、舒张压（diastolic blood pressure，DBp）、pp、hsCRp、空腹血糖（1eftcircumflexartery，FpG）和血尿酸水平均高于正常的BApWV（p〈0．05）；进一步相关分析，BApWV与年龄、收缩压（systolicbloodpressure，SBp）的变化，FpG与hsCRp呈显著正相关。BApWV、hsCRp呈正相关（p〈0．05）。年龄、FpG、hsCRp是影响BApWV的独立因素（p〈0．01）。线性回归分析显示，调整平均血压和其他相关因素后，24h收缩压的变化与BApWV和炎性细胞因子hsCRp呈正相关（r=0．315，0．328，0．392，0．354，p〈0．05）。收缩压与BApWV和hsCRp呈正相关（p〈0．05）。结论随着收缩压的变化，BApWV和hsCRp随之增加。高血压患者的hsCRp水平反映了高血压的严重程度，对高血压的评价有一定的临床意义。

关键词：高血压 C反应蛋白炎症

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分化抑制因子1对鼻咽癌细胞增殖的影响及其途径

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解放军医学杂志 2012年第6期37卷 569-572页

作者：李春燕江山岳渝娟陈晓品重庆医科大学附属第一医院内分泌乳腺外科重庆400016 重庆医科大学附属第一医院肿瘤科重庆400016

目的探讨分化抑制因子1(Id1)对鼻咽癌细胞增殖和凋亡的影响及其机制。方法体外培养人鼻咽癌细胞Np69、CNE1。合成Id1小分子干扰RNA(siRNA),构建Id1表达载体并分别转染鼻咽癌细胞Np69、CNE1。收集Id1siRNA及对照质粒Scramble转染72h的Np6... 详细信息

目的探讨分化抑制因子1(Id1)对鼻咽癌细胞增殖和凋亡的影响及其机制。方法体外培养人鼻咽癌细胞Np69、CNE1。合成Id1小分子干扰RNA(siRNA),构建Id1表达载体并分别转染鼻咽癌细胞Np69、CNE1。收集Id1siRNA及对照质粒Scramble转染72h的Np69细胞(分别命名为Np69si-Id1、Np69-NC),pcDNA3.1-Id1及对照pcDNA3.1转染48h的CNE1细胞(分别命名为CNE1-Id1、CNE1-Vector),采用RT-pCR及Western blotting检测Id1的表达情况。采用MTT法比较顺铂(DDp)对Np69si-Id1、Np69-NC和CNE1-Id1、CNE1-Vector增殖的影响。采用CalcuSyn软件计算各组细胞对DDp的IC50值。将1μg/ml DDp与鼻咽癌细胞共同孵育24h后,采用Western blo ing检测凋亡蛋白Caspase-3、Bax、Bad的表达及蛋白激酶B(Akt)Thr308和Ser473的磷酸化情况。结果与Np69-NC比较,Np69si-Id1的Id1 mRNA和蛋白水平明显降低;与CNE1-Vector比较,CNE1-Id1的Id1 mRNA及蛋白水平明显升高。Np69si-Id1细胞对DDp的IC50值(0.207±0.008μg/ml)明显低于Np69-NC(0.405±0.009μg/ml,pp的IC50值(0.671±0.012μg/ml)明显高于CNE1-Vector(0.445±0.008/ml,pblotting检测结果显示,与Np69-NC比较,Np69si-Id1的Caspase-3断裂带增多,Akt Thr308和Ser473磷酸化减少;与CNE1-Vector比较,CNE1-Id1的Caspase-3断裂带减少,Akt Thr308和Ser473磷酸化增加。结论 Id1可促进鼻咽癌细胞的生长,抵抗DDp诱导的细胞凋亡,其机制可能与增加Akt磷酸化有关。

关键词：分化抑制因子1 鼻咽肿瘤 RNA干扰 AKT途径

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黄连温胆汤对代谢综合征大鼠核转录因子及肿瘤坏死因子的影响

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中医药信息 2012年第4期29卷 67-70页

作者：刘莉邓晓威金娟黑龙江中医药大学黑龙江哈尔滨150040

目的:通过对代谢综合征大鼠主动脉核转录因子及肿瘤坏死因子的检测,探讨黄连温胆汤对该指标的影响及其机制。方法:将8周龄雄性SD大鼠分组采用膳食饲料喂养,建立MS大鼠模型后将MS大鼠随机分为模型组,格华止组,黄连温胆汤高、低剂量组,灌... 详细信息

目的:通过对代谢综合征大鼠主动脉核转录因子及肿瘤坏死因子的检测,探讨黄连温胆汤对该指标的影响及其机制。方法:将8周龄雄性SD大鼠分组采用膳食饲料喂养,建立MS大鼠模型后将MS大鼠随机分为模型组,格华止组,黄连温胆汤高、低剂量组,灌胃4周后,检测体质量、血压、血糖、血清胰岛素、血脂、TNF-α,计算lee's指数和胰岛素敏感指数,测定大鼠主动脉NF-κB的表达。结果:与空白组比较,MS组大鼠体质量、空腹血糖、血脂等差异均有统计学意义(ppp<0.05)。结论:黄连温胆汤MS大鼠各组分有治疗作用,并且可以降低MS大鼠血清TNF-α,改善主动脉NF-κB的表达,其机制可能与核转录因子分子通路有关。

关键词：代谢综合征黄连温胆汤肿瘤坏死因子核转录因子

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石家庄市健康中学教师100人动态血压随龄的变化

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中国临床康复 2005年第19期9卷 10-11页

作者：邢恒国田俊芝李路明王明明张省娟河北医科大学第二医院功能科河北省石家庄市050000

目的:探讨健康中学教师动态血压变化规律。方法:选择2000-04/06石家庄市藁城中学健康中学教师100人,男45人,女55人,年龄21～60岁。采用Spacelabs动态血压监测仪对受试者进行24h动态血压监测。受试者年龄21～60岁,每10岁为一年龄组,21～3... 详细信息

目的:探讨健康中学教师动态血压变化规律。方法:选择2000-04/06石家庄市藁城中学健康中学教师100人,男45人,女55人,年龄21～60岁。采用Spacelabs动态血压监测仪对受试者进行24h动态血压监测。受试者年龄21～60岁,每10岁为一年龄组,21～30岁组32人,31～40岁组25人,41～50岁组20人,51～60岁组23人。记录收缩压、舒张压、平均动脉压、心率;计算血压负荷。动态血压均数正常参照值:24h低于130/80mmHg(1mmHg=0.133kpa),白昼低于135/85mmHg,夜间低于125/75mmHg;血压负荷(在一定时间内收缩压和舒张压超过正常范围的读数百分率)低于10%。结果:按意向处理分析,进入结果分析中学健康中学教师100人。①21～30岁组,31～40岁组,41～50岁组24h及白昼、夜间平均收缩压、平均舒张压、平均动脉压无明显差异(p>0.05)。②51～60岁组24h平均收缩压、平均舒张压及平均动脉压明显高于21～30岁组,31～40岁组,41～50岁组犤(119±4),(76±5),(90±4)mmHg;(110±7),(68±5),(82±4)mmHg;(112±8),(70±4),(84±4)mmHg;(112±5),(71±6),(86±4)mmHg,pppppp<0.01)。结论:健康中学教师24h及白昼平均收缩压、平均舒张压、平均动脉压有随年龄增高而增高的趋势;21～50岁教师血压增高不明显,50～60岁教师血压增高明显。健康中学教师的动态血压虽在正常范围内,但夜间血压负荷与白昼相比明显偏高,尤其是夜间舒张压负荷。

关键词：职业血压监测,便携式血压全体教工,院校

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妇产科术后感染患者血病原体培养的研究

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中华医院感染学杂志 2019年第19期29卷 3017-3021页

作者：张双燕李新新毛文娟王艳波王伟北京大学国际医院妇产科北京102206 河南省传染病医院妇产科河南郑州450000

目的对比妇产科术后感染患者血病原体培养阳性和阴性的实验室指标,为术后血流感染的诊断提供研究依据。方法选取2015年1月-2017年12月于北京大学国际医院就诊的妇产科手术患者4841例为研究对象,对术后感染情况和感染患者血病原体培养结... 详细信息

目的对比妇产科术后感染患者血病原体培养阳性和阴性的实验室指标,为术后血流感染的诊断提供研究依据。方法选取2015年1月-2017年12月于北京大学国际医院就诊的妇产科手术患者4841例为研究对象,对术后感染情况和感染患者血病原体培养结果进行分析,对血培养阴性和血培养阳性患者的外周血白细胞计数(WBC)、中性粒细胞计数(NEU)、中性粒细胞/淋巴细胞比率(NLR)、血小板计数(pLT)及血清C-反应蛋白(CRp)、降钙素原(pCT)、白细胞介素-6(IL-6)、IL-17、IL-23、IL-4、IL-10、IL-13、细胞间黏附分子-1(intercellular adhesion moleclar-1,ICAM-1)、血管细胞黏附分子-1(vascular cell adhesion molecule-1,VCAM-1)、嗜酸性粒细胞活化趋化因子-3(eosinophil activation chemokine-3,Eotaxin-3)、单核细胞趋化蛋白-1(monocyte chemotactic protein-1,I MCp-1)水平进行比较。结果妇产科手术患者术后感染率为3.86%(187/4841),感染部位以呼吸道、泌尿道、手术部位为主;血培养阳性率为11.23%(21/187),血培养阳性患者的外周血WBC、NEU、NLR与血清CRp、pCT、IL-6、IL-17、IL-23、IL-4、IL-10、IL-13、ICAM-1、VCAM-1、Eotaxin-3、MCp-1分别为(10.95±9.16)×10^9/L、(9.25±8.07)×10^9/L、(14.23±10.13)和(96.65±45.88)mg/L、(4.06±2.35)ng/ml、(293.88±40.96)ng/ml、(58.82±8.81)ng/ml、(86.08±11.53)pg/ml、(29.62±3.94)ng/ml、(55.06±7.82)ng/ml、(253.35±38.12)pg/ml、(126.08±17.15)ng/ml、(158.04±18.75)ng/ml、(227.41±39.56)ng/ml、(381.16±50.45)ng/ml均高于血培养阴性患者(ppLT为(172.28±82.05)×10^9/L低于血培养阴性患者(p=0.045)。结论相对于血培养阴性的患者,血培养阳性的妇产科术后感染患者表现为外周血感染标志物、炎症因子、黏附趋化因子的过表达和凝血功能恶化,机体的炎症反应、免疫失衡和凝血障碍更加严重,对这些实验室指标进行综合性评价,可弥补血培养的局限性,提高针对术后血流感染的诊断效率。

关键词：妇产科术后感染血培养实验室指标

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