【摘要】目的探索內鏡直視下應用帶膜記憶合金支架對晚期食管、賁門惡性狹窄的介入治療方法。方法2005年1月2009年11月對49例失去手術機會或拒絕手術的晚期食管癌或賁門癌致食管或賁門狹窄患者,行電子胃鏡引導下放置鎳鈦合金支架;對狹窄程度重、胃鏡不能通過者,先行Savary探條擴張再放置支架。結果49例均成功置入支架,解除狹窄有效率達100%。結論內鏡直視下帶膜支架置入操作方法簡便、安全,可改善患者的生存質量,延長生存時間。
Objective To analyze the screening effect and tuberculosis detection characteristics of close contacts with pathogen-positive tuberculosis in Baoding city, and build an infection risk prediction model based on risk factors, so as to provide reference for accurate screening and intervention. Methods A retrospective observational study design was used to collect the data of screening of tuberculosis patients and close contacts of pathogen-positive tuberculosis patients in Baoding "Tuberculosis Information Management System" from March 2023 to March 2025, and a retrospective analysis was conducted. A total of 83 cases of registered pathogen-positive pulmonary tuberculosis patients were enrolled, and 1208 cases of close contacts were identified, among which 1136 cases were actually screened, and the screening completion rate was 94.04%. According to the screening of suspicious symptoms and the detection of tuberculosis, they were divided into a positive group (n=102) and a negative group (n=1034). The general clinical data and clinical characteristics of the two groups were compared, and the risk factors of positive results of close contacts were analyzed by multivariate logistic regression analysis. At the same time, a prediction model was constructed, and the receiver operating characteristic (ROC) curve of subjects was drawn to analyze the value of predicting positive results of close contacts. Results The proportion of patients with body mass index (BMI), family annual income<50000 yuan, high-intensity contact, average daily contact time ≥ 4 hours, cumulative contact time ≥6 months, persistent cough time ≥2 weeks, weight loss ≥5% in the last three months, combined with immune system diseases, smoking history and no BCG vaccination in positive group was higher than that in negative group (all P<0.05). The results of multivariate logistic regression analysis showed that BMI (OR=0.832, 95%CI 0.738～0.938) was the protective factor for the positive results of close contacts, and the annual household income was less than 50,000 (OR=1.770, 95%CI 1.030～3.040), high-intensity contact (OR=1.940, 95%CI 1.071～3.624), cumulative contact time ≥6 months (OR=2.210, 95%CI 1.26～4.050), persistent cough time ≥2 weeks (OR=2.380, 95%CI 1.424～3.977) and non-BCG vaccination (OR=2.208, 95%CI 1.163～4.191) were the risk factors (P<0.05). The regression equation model was established: logit(P)= –2.931 + BMI×–0.184 + annual family income<50 000 × 0.571+high-intensity contact×0.678 + cumulative contact time ≥6 months × 0.793 + persistent cough time ≥2 weeks × 0.867 + combined immune system diseases × 1.264. ROC curve showed that when logit(P)>12.84, the area under the curve (AUC) was 0.789. Conclusions High BMI is a protective factor for screening positive close contacts of pathogen-positive pulmonary tuberculosis patients, and low annual family income, high intensity and long-term exposure, persistent cough, immune system diseases, smoking history and non-BCG vaccination are risk factors. Logistic regression prediction model based on the above factors has good discrimination ability and clinical practical value, which can provide reference for grading screening and individualized intervention of close contacts of tuberculosis. However, it should be noted that the protective effect of BCG vaccination on adult pulmonary tuberculosis is still controversial, and the relevant conclusions of this study should be carefully explained in combination with the specific population background and immune status.
ObjectiveTo investigate the association between single nucleotide polymorphism (SNP) rs3754219 in the glucose transporters 1 (GLUT1) gene and genetic susceptibility to type 2 diabetes mellitus (T2DM) in Han population in Guangdong Province.MethodsA total of 1 092 T2DM patients (case group) and 1 092 healthy controls (control group) diagnosed or examined between November 2011 and October 2014 form 10 hospitals were enrolled in this study. SNPscanTM SNP classification technology was used to detect the polymorphism of rs3754219 of GLUT1 genetype. Finally, 1 067 T2DM patients and 1 054 healthy controls were included, removing 37 individuals with SNP typing deletion rates >20% and 26 individucals with failed SNP site genotyping. The differences in allele frequency distribution, genotype, and genetic models between the two groups were analyzed.ResultsAfter correction for age and body mass index, there was no statistically significant difference in allele frequency or polymorphism genotype frequency of rs3754219 (P>0.05). There was no statistically significant difference between the two groups under different genetic models (P>0.05).ConclusionGenetic susceptibility to T2DM in Han population in Guangdong Province may be unrelated to the GLUT1 rs3754219 SNP.
Since the launch of anti-interleukin 5 monoclonal antibodies (anti-IL-5 mAbs), they have been widely used in various disease fields. The classic indications include severe eosinophilic asthma (SEA), chronic rhinosinusitis with nasal polyps (CRSwNP), eosinophilic granulomatosis with polyangiitis (EGPA), hypereosinophilic syndrome (HES), and chronic obstructive pulmonary disease (COPD). Moreover, there is evidence suggesting that anti-IL-5 mAbs can also be used in the treatment of allergic bronchopulmonary aspergillosis (ABPA) and other uncommon eosinophil (EOS)-related diseases. To standardize the clinical application of anti-IL-5 mAbs by clinicians, the expert group formulated a consensus by extensive review of high-quality clinical research data and authoritative guideline documents. The consensus paper was written based on the current best clinical evidence and Chinese clinical practice experience, aiming to provide authoritative reference and practical guidance for clinical colleagues in the standardized clinical use of anti-IL-5 mAbs. The content of this consensus covers the mechanism of anti-IL-5 mAbs, dosing regimens for different diseases, management strategies, etc. It emphasizes the importance of individualized diagnosis and treatment guided by biomarkers, long-term standardized follow-up, and multidisciplinary team collaboration.