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Cost burden following esophagectomy:A single centre observational study

World Journal of Gastrointestinal Surgery 2024年第7期16卷 2255-2269页

作者： Vered Buchholz Dong Kyu lee david S Liu Ahmad Aly Stephen A Barnett Riley Hazard Peter Le Benjamin Kioussis Vijayaragavan Muralidharan Laurence weinberg Department of Surgery Austin HealthMelbourne 3084VictoriaAustralia Department of Anesthesiology and Pain Medicine Dongguk University Ilsan HospitalSeoul 14566GoyangSouth Korea Department of Surgery Austin HealthThe University of MelbourneMelbourne 3084VictoriaAustralia Department of Anesthesia Austin HealthMelbourne 3084VictoriaAustralia Department of Anesthesia Austin HospitalHeidelberg 3084VictoriaAustralia Department of Critical Care The University of MelbourneMelbourne 3084VictoriaAustralia

BACKGROUND Cost analyses of patients undergoing esophagectomy is valuable for identifying modifiable expenditure drivers to target and curtail costs while improving the quality of *** aimed to define the cost-complication relationship after esophagectomy and delineate the incremental contributions to *** To assess the relationship between the hospital costs and potential cost drivers post esophagectomy and investigate the relationship between the cost-driving variables(predicting variables)and hospital costs(dependent variable).METHODS In this retrospective single center study,the severity of complications was graded using the Clavien-Dindo(CD)classification *** esophagectomy complications were categorized and defined according to consensus *** costing data included the in-hospital costs of the index admission and any unplanned admission within 30 postoperative *** used correlation analysis to assess the relationship between key clinical variables and hospital costs(in United States dollars)to identify cost drivers.A mediation model was used to investigate the relationship between these variables and hospital *** A total of 110 patients underwent primary esophageal *** median admission cost was $47822.7(interquartile range:35670.2-68214.0).The total effects on costs were $13593.9(95%CI:10187.1-17000.8,P<0.001)for each increase in CD severity grade,$4781(95%CI:3772.7-5789.3,P<0.001)for each increase in the number of complications,and $42552.2(95%CI:8309-76795.4,P=0.015)if a key esophagectomy complication *** esophagectomy complications drove the costs directly by $11415.7(95%CI:992.5-21838.9,P=0.032).CONCLUSION The severity and number of complications,and the development of key esophagectomy complications significantly contributed to total hospital *** institutional initiatives and strategies are needed to enhance patient outcomes and minimize costs.

关键词： Anesthesia Esophagectomy Complications Cancer Surgery

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得分是多少?

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空中英语教室（初级版．大家说英语） 2024年第6期 26-27,53页

作者： david lee 不详

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The HIF-1α/PLOD2 axis integrates extracellular matrix organization and cell metabolism leading to aberrant musculoskeletal repair

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Bone Research 2024年第2期12卷 289-301页

作者： Heeseog Kang Amy L.Strong Yuxiao Sun Lei Guo Conan Juan Alec C.Bancroft Ji Hae Choi Chase A.Pagani Aysel A.Fernandes Michael Woodard Juhoon lee Sowmya Ramesh Aaron W.James david Hudson Kevin N.Dalby Lin Xu Robert J.Tower Benjamin Levi Center for Organogenesis Regeneration and TraumaDepartment of SurgeryUniversity of Texas SouthwesternDallasTX 75390USA Section of Plastic Surgery Department of SurgeryUniversity of MichiganAnn ArborMI 48109USA Quantitative Biomedical Research Center Peter O’Donnell Jr.School of Public HealthUniversity of Texas SouthwesternDallasTX 75390USA Department of Orthopedics and Sports Medicine University of WashingtonSeattleWA 98195USA Division of Chemical Biology and Medicinal Chemistry College of PharmacyUniversity of Texas at AustinAustinTX 78712USA Department of Pathology Johns Hopkins UniversityBaltimoreMD 21218USA

While hypoxic signaling has been shown to play a role in many cellular processes,its role in metabolism-linked extracellular matrix(ECM)organization and downstream processes of cell fate after musculoskeletal injury remains to be ***(HO)is a debilitating condition where abnormal bone formation occurs within extra-skeletal *** andhypoxia-inducible factor 1α(HIF-1α)activation have been shown to promote ***,the underlying molecular mechanisms bywhich the HIF-1αpathway in mesenchymal progenitor cells(MPCs)contributes to pathologic bone formation remain to ***,we used a proven mouse injury-induced HO model to investigate the role of HIF-1αon aberrant cell ***-cell RNA sequencing(scRNA-seq)and spatial transcriptomics analyses of the HO site,we found that collagen ECM organizationis the most highly up-regulated biological process in *** mesenchymal cell-specific deletion of Hif1α(Hoxa11-CreER^(T2);Hif1a^(fl/fl))significantly mitigated HO in ***-seq analysis of these Hoxa11-CreER^(T2);Hif1a^(fl/fl)mice identified the PLOD2/LOXpathway for collagen cross-linking as downstream of the HIF-1αregulation of ***,our scRNA-seq data and mechanisticstudies further uncovered that glucose metabolism in MPCs is most highly impacted by HIF-1α*** a translational aspect,a pan-LOX inhibitor significantly decreased HO.A newly screened compound revealed that the inhibition of PLOD2 activity in MPCssignificantly decreased osteogenic differentiation and glycolytic *** suggests that the HIF-1α/PLOD2/LOX axis linked tometabolism regulates HO-forming MPC *** results suggest that the HIF-1α/PLOD2/LOX pathway represents a promisingstrategy to mitigate HO formation.

关键词： metabolism skeletal aberrant

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基于大语言模型的糖尿病管理:潜力与展望

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Science Bulletin 2024年第5期69卷 583-588页

作者：盛斌管洲榆 lee-Ling Lim 江泽铧 Nestoras Mathioudakis 李佳佳刘茹涵包玉倩 Yong Mong Bee 王亚星郑颖丰 Gavin Siew wei Tan 纪宏伟 Josip Car 王海波 david C.Klonoff 李华婷覃宇宗黄天荫贾伟平 Shanghai International Joint Laboratory of Intelligent Prevention and Treatment for Metabolic Diseases Department of Computer Science and EngineeringSchool of ElectronicInformationand Electrical EngineeringShanghai Jiao Tong UniversityDepartment of Endocrinology and MetabolismShanghai Sixth People’s Hospital Affiliated to Shanghai Jiao Tong University School of MedicineShanghai Diabetes InstituteShanghai Clinical Center for DiabetesShanghai 200240China MOE Key Laboratory of Artificial Intelligence Artificial Intelligence InstituteShanghai Jiao Tong UniversityShanghai 200240China Department of Medicine Faculty of MedicineUniversity of MalayaKuala Lumpur 50603Malaysia Department of Medicine and Therapeutics The Chinese University of Hong KongHong KongChina Asia Diabetes Foundation Hong KongChina Tsinghua Medicine of Tsinghua University Beijing 100084China School of Clinical Medicine Beijing Tsinghua Changgung HospitalBeijing 102218China Division of Endocrinology Diabetes&MetabolismJohns Hopkins University School of MedicineBaltimoreMD 21211USA Department of Endocrinology Singapore General HospitalSingapore 169608Singapore Beijing Institute of Ophthalmology Beijing Tongren HospitalCapital University of Medical ScienceBeijing Ophthalmology and Visual Sciences Key LaboratoryBeijing 100730China State Key Laboratory of Ophthalmology Zhongshan Ophthalmic CenterSun Yat-sen UniversityGuangdong Provincial Key Laboratory of Ophthalmology and Visual ScienceGuangzhou 510060China Singapore Eye Research Institute Singapore National Eye CentreSingapore 168751Singapore Department of Cardiology the Affiliated Hospital of Qingdao UniversityQingdao 266011China Centre for Population Health Sciences Lee Kong Chian School of MedicineNanyang Technological University SingaporeSingapore 639798Singapore Department of Primary Care and Public Health School of Public HealthImperial College LondonLondon SW72BUUK Clinical Trial Unit Research Centre of Big Data and Artificial Intelligence in Medicine

The increasing prevalence of diabetes has become a global public health concern in the 21st *** 2021,it was estimated that 537 million people had diabetes,and this number is projected to reach 643 million by 2030,and 783 million by 2045[1].Such a huge burden of diabetes brings great challenges in its prevention and management,including early diagnosis,timely interventions,and regular monitoring of risk factor control and complications *** self-care support and patient empowerment can enhance clinical and psychobehavioural outcomes[2],although these require additional resources including manpower,infrastructure(hard and technology),and *** emergence of digital health technologies(DHTs),especially artificial intelligence(AI),may help address these obstacles and alleviate the burden of diabetes[3].Large language models(LLMs),a generative AI that can accept image and text inputs and produce text outputs,have shown promise in various aspects of medical care.

关键词： prevention diagnosis finance

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Maternal Group B Streptococcus Infection Correlates Inversely With Preeclampsia in Pregnant African American Women

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Maternal-Fetal Medicine 2024年第1期6卷 23-28页

作者： Keun Soo Kwon Tzu Hsuan Cheng Simone A。Reynolds Jordan Zhou Huchong Cai Sharon lee Ivan Velickovic Mudar Dalloul david Wlody Ming Zhang Department of Anesthesiology State University of New York-Downstate Health Sciences UniversityNew York 11203USA Department of Epidemiology and Biostatistics School of Public HealthState University of New York-Downstate Health Sciences UniversityNew York 11203USA Department of Obstetrics and Gynecology State University of New York-Downstate Health Sciences UniversityNew York 11203USA

Objective:To determine whether an association exists between group B Streptococcus(GBS)colonization and preeclampsia among pregnant Black ***:This retrospective cross-sectional study involved Black women who gave birth at State University of New York Downstate Hospital between January 2010 and December *** were collected from the Obstetric Department,including delivery date,time,mode of delivery,age of the mother,weeks of gestation at delivery,and antepartum *** GBS test results were originally determined using the eSwab transport *** was defined based on the American College of Obstetricians and Gynecologists criteria for the periods 2010–2012 and 2013–*** primary outcome was whether GBS was associated with the outcome of preeclampsia in the population of Black ***,including smoking status,gestational age,parity,body mass index,maternal age,and presence of herpes simplex virus(HSV)and human immunodeficiency virus(HIV)were examined as potential ***-squared test and logistic regression model were used,presenting odds ratios with 95%confidence intervals(P<0.050),analyzed with SAS on Demand for Academics(SAS Institute,Inc.,NY).Results:Among the 8,019 Black women included in this study,GBS-positive women(n=977)had a 53%reduction in the likelihood of being diagnosed with preeclampsia compared to GBS-negative women(adjusted odds ratio,0.47;95%confidence interval,0.32–0.70).We did not find evidence of differences in the distribution of smoking habits(P=0.783)or maternal age(P=0.107)between GBS-positive and GBS-negative ***,the GBS-positive women tended to be less likely to have a preterm delivery(9.62%(94/977)vs.24.24%(1707/7042),P<0.001),less likely to be nulliparous(33.37%(326/977)vs.37.87%(2667/7042),P=0.006),and less likely to be obese(51.38%(502/977)vs.55.30%(3894/7042),P<0.001)compared with GBS-negative *** contrast,GBS-positive women were more likely to have a comorbid infecti

关键词： Pregnancy outcome Preeclampsia GBS colonization African American Afro-Caribbean

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Landscape of global urban environmental resistome and its association with local socioeconomic and medical status

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Science China(Life Sciences) 2024年第6期67卷 1292-1301页

作者： Jun Wu Yige Hu Michael H Perlin david Danko Jun Lu Manuela Oliveira Johannes Werner Maria M Zambrano Maria A Sierra Olayinka O Osuolale Paweł Łabaj Nicolás Rascovan Nur Hazlin Hazrin-Chong Soojin Jang Haruo Suzuki Marina Nieto-Caballero Bharath Prithiviraj Patrick K H lee Agnieszka Chmielarczyk Anna Różańska Yongxiang Zhao Lan Wang Christopher E Mason Tieliu Shi Center for Bioinformatics and Computational Biology and the Institute of Biomedical SciencesSchool of Life SciencesEast China Normal UniversityShanghai 200241China Department of Biology Program on Disease EvolutionUniversity of LouisvilleLouisville 40292USA weill Cornell Medicine New York 10065USA The Bin Talal Bin Abdulaziz Alsaud Institute for Computational Biomedicine New York 10065USA Department of Pulmonary Medicine Shanghai Chest HospitalShanghai Jiao Tong UniversityShanghai 200025China i3S-Instituto de Investiga玢o e Inova玢o em Saúde Universidade do PortoPorto 4050-290Portugal Ipatimup-Instituto de Patologia e Imunologia Molecular da Universidade do Porto Porto 4200-465Portugal Departamento de Biologia Faculdade de CiênciasUniversidade do PortoPorto 4050-290Portugal High Performance and Cloud Computing Group Zentrum für Datenverarbeitung(ZDV)Eberhard Karls University of TübingenW鋍hterstra遝7672074TübingenGermany Corporación Corpogen Research Center Bogotá110311Colombia Applied Environmental Metagenomics and Infectious Diseases Research(AEMIDR) Department of Biological SciencesElizade UniversityIlara-Mokin 340271Nigeria Maopolska Centre of Biotechnology Jagiellonian UniversityKraków 30-005Poland Aix-Marseille Université Mediterranean Institute of OceanologyUniversitéde ToulonCNRSIRDUM 110Marseille 83041France Department of Biological Sciences and Biotechnology Faculty of Science and TechnologyUniversiti Kebangsaan Malaysia43600 UKM BangiSelangor Institut Pasteur Korea Seoul 13488Republic of Korea Faculty of Environment and Information Studies Keio UniversityFujisawaKanagawa 252-0882Japan University of Colorado at Boulder CivilEnvironmental and Architectural DepartmentBoulder 80303USA Brooklyn College of the City University of New York Brooklyn 11210USA School of Energy and Environment City University of Hong KongHong Kong 999077China Department of Microbiology Faculty of MedicineJagiellonian UniversityKraków 30-005Poland Biological Targeting Diagnosis and The

Antimicrobial resistance(AMR)poses a critical threat to global health and development,with environmental factors—particularly in urban areas—contributing significantly to the spread of antibiotic resistance genes(ARGs).However,most research to date has been conducted at a local level,leaving significant gaps in our understanding of the global status of antibiotic resistance in urban *** address this issue,we thoroughly analyzed a total of 86,213 ARGs detected within 4,728 metagenome samples,which were collected by the Meta SUB International Consortium involving diverse urban environments in 60 cities of 27 countries,utilizing a deep-learning based *** findings demonstrated the strong geographical specificity of urban environmental resistome,and their correlation with various local socioeconomic and medical *** also identified distinctive evolutionary patterns of ARG-related biosynthetic gene clusters(BGCs)across different countries,and discovered that the urban environment represents a rich source of novel *** study provides a comprehensive overview of the global urban environmental resistome,and fills a significant gap in our knowledge of large-scale urban antibiotic resistome analysis.

关键词： urban environment metagenome antibiotic resistance resistance diversity biosynthetic gene clusters

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Quantitative analysis of the impact of droughts and floods on internal wars in China over the last 500 years

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Science China Earth Sciences 2017年第12期60卷 2078-2088页

作者： Harry F.lee david D.ZHANG PEI Qing JIA Xin Ricci P.H.yue Department of Geography and International Center for China Development Studies The University of Hong Kong School of Geographical Sciences Guangzhou University Department of Social Sciences The Education University of Hong Kong School of Geographic and Oceanographic Sciences Nanjing University

Although many large-N quantitative studies have evidenced the adverse effects of climatic extremes on social stability in China during the historical period, most of them rely on temperature and precipitation as major explanatory variables, while the influence of floods and droughts on social crises is rarely measured. Furthermore, a comparison of the climate-society nexus among different geographic regions and at different temporal scales is missing in those studies. To address this knowledge gap,this study examines quantitatively the influence of floods and droughts on internal wars in three agro-ecological(rice, wheat,and pastoral) regions in China in AD1470–1911. Poisson regression and wavelet transform coherence analyses are applied to allow for the non-linear and non-stationary nature of the climate-war nexus. Results show that floods and droughts are significant in driving internal wars in historical China, but are characterized by strong regional variation. In the rice region, floods trigger internal wars at the inter-annual and multi-decadal time scales. In the wheat region, both floods and droughts cause internal wars at the inter-annual and multi-decadal time scales. In the pastoral region, internal wars are associated with floods only at the multi-decadal time scale. In addition, the multi-decadal coherence between hydro-climatic extremes and internal wars in all three of the agro-ecological regions is only significant in periods in which population density is increasing or the upper limit of regional carrying capacity is being reached. The above results imply that the climate-war nexus is mediated by regional geographic factors such as physical environmental setting and population pressure. Hence, we encourage researchers who study the historical human-climate relationship to boil down data according to geographic regions in the course of statistical analysis and to examine each region individually in follow-up studies.

关键词： Floods and droughts Climatic extremes Internal wars Wars Social stability Ming-Qing period

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Pre-operative visceral adipose tissue radiodensity is a potentially novel prognostic biomarker for early endoscopic post-operative recurrence in Crohn’s disease

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World Journal of Gastrointestinal Surgery 2024年第3期16卷 740-750页

作者： Phillip Gu Shishir Dube Norman Gellada So Yung Choi Susan Win Yoo Jin lee Shaohong Yang Talin Haritunians Gil Y Melmed Eric A Vasiliauskas Niru Bonthala Gaurav Syal Andres J Yarur david Ziring Shervin Rabizadeh Phillip Fleshner Cindy Kallman Suzanne Devkota Stephan R Targan Dalin Li Dermot PB McGovern Department of Medicine Cedars-Sinai Medical CenterLos AngelesCA 90048United States Department of Imaging Cedars-Sinai Medical CenterLos AngelesCA 90048United States Department of Biostatistics Shared Resource Cedars-Sinai Medical CenterLos AngelesCA 90048United States Department of Internal Medicine Keimyung University School of MedicineDaegu 42601South Korea Department of Medicine University of California at Los AngelesLos AngelesCA 90095United States Department of Medicine University of California at San DiegoSan DiegoCA 92093United States Department of Pediatrics Cedars-Sinai Medical CenterLos AngelesCA 90048United States Department of Surgery Cedars-Sinai Medical CenterLos AngelesCA 90048United States

BACKGROUND Evidence suggests inflammatory mesenteric fat is involved in post-operative recurrence(POR)of Crohn’s disease(CD).However,its prognostic value is INTRODUCTION Crohn’s disease(CD)is a debilitating chronic immune-mediated inflammatory disease(IMID)of the gastrointestinal tract that is increasing in incidence and prevalence globally[1].CD patients often undergo surgery for disease-related complic-ations and/or medically refractory ***,surgery is not curative,and many patients develop post-operative recurrence(POR)of CD with a significant proportion eventually requiring additional *** advances in early detection and therapeutics,the contemporary 10-year risk of surgery has improved from 50%to 26%,but the risk of recurrent surgery has remained unchanged at 30%,suggesting a need to improve post-operative management strategies[2].Presently,there are two accepted strategies to mitigate POR,but each have potential ***,patients start early post-operative pharmacologic prophylaxis within 4-6 wk after *** strategy can potentially overtreat a subset of patient who may not develop long-term disease recurrence off ***,these patients are at risk of medication-related adverse events and the direct and indirect costs associated with therapy with little or no benefit[3].The second strategy is performing early colonoscopy within 6-12 months after surgery and escalating therapy based on FOOTNOTES Author contributions:Gu P is the guarantor of the article and was involved in concept and design,data collection,statistical analysis,drafting of manuscript,and final approval of manuscript;Dube S and Choi SY were involved in statistical analysis,drafting of the manuscript,and final approval of manuscript;Gellada N,Win S,lee YJ and Yang S were involved in the data collection,drafting of the manuscript,and final approval of manuscript;Haritunians T and Li D were involved in data analysis and interpretation,drafting

关键词： Crohn’s disease Surgery Visceral adipose tissue Mesenteric adipose tissue Creeping fat Computed tomography

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双孢菇内生枯草芽孢杆菌AB154中抑制人结肠癌Caco-2活性成分的发现及机理研究

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中国食品学报 2017年第12期17卷 26-34页

作者：刘灿生吉萍 david yue wei lee 李小可尚小雅陈林申琳中国农业大学食品科学与营养工程学院北京100083 美国哈佛大学医学院附属麦克林医院马萨诸塞州02478 中国人民大学农业与农村发展学院北京100872

在研究双孢菇的抗肿瘤活性成分时,发现其内生的一个枯草芽孢杆菌AB154的代谢产物,该产物具有较强的抑制人结肠癌Caco-2细胞活性。借助体外多种细胞毒活性跟踪测试,利用硫酸铵沉淀法和DEAESephadex阴离子交换柱层析,从枯草芽孢杆菌AB154... 详细信息

在研究双孢菇的抗肿瘤活性成分时,发现其内生的一个枯草芽孢杆菌AB154的代谢产物,该产物具有较强的抑制人结肠癌Caco-2细胞活性。借助体外多种细胞毒活性跟踪测试,利用硫酸铵沉淀法和DEAESephadex阴离子交换柱层析,从枯草芽孢杆菌AB154发酵液中分离得到抑制人结肠癌Caco-2细胞的活性组分,其IC50为109.94μg/m L,而对人正常支气管上皮细胞(NHBE)的抑制作用较弱。经高效液相色谱(HPLC)制备,结合MALDI-TOF MS、ESI-MS/MS分析和查阅文献,从活性组分中分离鉴定了2个亚组分表面活性肽(surfactin)和丰原素(fengycin)B1类脂肽,其抑制人结肠癌Caco-2细胞的IC_(50)依次为80.7μg/m L和312.5μg/m L。此研究首次发现fengycin B1类脂肽具有抑制人结肠癌Caco-2细胞的活性,机理研究发现fengycin B1在12 h时将细胞周期阻滞在G_0/G_1期,在24 h时阻滞在S期,同时能够损伤肿瘤细胞的细胞核。

关键词：双孢菇内生菌枯草芽孢杆菌丰原素人结肠癌Caco-2细胞

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补体相关蛋白在HIV/AIDS湿热内蕴证患者中的差异性表达

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中国艾滋病性病 2024年第6期30卷 579-583页

作者：孙雪晴王亚楠张海燕冯龙 david Y.W.lee 苏铄涵徐立然 Alan Wang 李青雅河南中医药大学中医学院郑州450000 河南中医药大学第一附属医院郑州450000 河南中医药大学医学院郑州450000 Harvard Medical School MA Boston 02115 Faculty of Medicine and Health Sciences of Auckland University New Zealand 6000

目的探讨补体系统相关因子在HIV/AIDS患者中及其与HIV/AIDS湿热内蕴证侯的表达特征。方法共纳入2023年3-5月于广西壮族自治区某地区就诊的HIV/AIDS患者(简称HIV组),其中包括HIV/AIDS湿热内蕴证患者组(简称HIVsr组)与HIV/AIDS无证可辨... 详细信息

目的探讨补体系统相关因子在HIV/AIDS患者中及其与HIV/AIDS湿热内蕴证侯的表达特征。方法共纳入2023年3-5月于广西壮族自治区某地区就诊的HIV/AIDS患者(简称HIV组),其中包括HIV/AIDS湿热内蕴证患者组(简称HIVsr组)与HIV/AIDS无证可辨患者组(简称HIVwz组)及同期在门诊进行体检的健康对照组。收集其基本信息并采集抗凝血液,应用流式细胞术检测T细胞亚群数量,酶联免疫吸附试验检测补体相关因子血浆表达水平,对数据进行统计分析。结果共纳入HIV组45例,其中包括HIVsr组30例与HIVwz组15例,与健康对照组15例。免疫指标对比中,HIVsr组与健康对照组相比TH/TS表达下降(P<0.05)。通路相关因子血浆表达水平对比中,HIV组与健康对照组相比除C3、C5aR、C5b因子外,C1q、MASP2、MBL等12个因子表达均下降(P<0.05),HIVsr组与HIVwz组相比C1q、C5aR、IL-6、TNF-α表达显著降低(P<0.05);HIVsr组因子C3aR与湿热内蕴证证候学量表积分呈负相关(r=-0.613,P<0.05),多元线性回归分析显示C3aR是量表积分的影响因素。结论补体系统中经典及凝集素通路参与HIV/AIDS患者病理过程,且HIV/AIDS湿热内蕴证患者的证候生物学基础与经典通路相关。C3aR对临床诊断HIV/AIDS湿热内蕴证患者有一定鉴别价值。

关键词：艾滋病湿热内蕴证补体证候诊断

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