胃癌外体（exosome）内miRNA-1的检测分析

目的检测胃癌细胞系来源外体(exosome)及其胃癌组织和血清中exosome内miRNA-1的表达水平并分析其临床意义。方法采用实时荧光定量RT-PCR分别检测胃癌细胞系来源exosome、胃癌患者组织及血清exosome内miRNA-1的表达水平,分析其与临床资料相关性,并绘制ROC曲线进行效能分析。结果 miRNA-1在人胃癌细胞系MGC-803(6.51±0.41)和SGC-7901(14.81±1.30)中的含量明显高于胃上皮细胞系GES-1(1.05±0.25),差异有统计学意义(t分别为11.26、10.38,P均0.01);而MGC-803、SGC-7901细胞培养上清exosome内miRNA-1的表达水平(49.98±11.77和28.68±4.66)显著高于GES-1来源exosome(1.00±0.02)差异有统计学意义(t分别为4.162、5.942,P均0.01);25对胃癌组织标本中有18例癌组织miRNA-1表达上调,7例表达下调,胃癌组织[1.110(0.070,4.307)]平均表达水平高于癌旁组织[1.149(1.110,2.075)],差异有统计学意义(Z=-1.897,P0.05)。miRNA-1在胃癌患者血清exosome内的表达水平[4.130(0.151,12.720)]较体检健康者血清exosome内表达水平[0.704(0.077,7.243)]明显增高(Z=-2.407,P0.05),且与胃癌的淋巴结转移相关;胃癌患者血清exosome内miRNA-1的ROC曲线下面积(AUCROC)为0.723 0,95%可信区间(CI)为0.627 0~0.818 7,cut off值为2.39,敏感性为66%,特异性为68%。结论胃癌组织及其胃癌患者血清来源exosome内富含miRNA-1,有望成为新的胃癌诊断标志物。     

胃癌患者血清LINC00978表达及其临床意义

目的检测胃癌患者血清中LINC00978表达水平,评估其表达水平与临床病理参数的关系,并探讨其临床诊断价值。方法实时荧光定量RT-PCR检测LINC00978在胃癌细胞、体检健康者、胃良性疾病及胃癌患者血清中的表达水平,分析其与胃癌患者临床病理参数的相关性,并用ROC曲线分析其诊断效能。结果 LINC00978在人胃癌细胞系MGC-803中的表达水平(18.88±1.15)明显高于胃黏膜上皮细胞(1.00±0.03),差异有统计学意义(t=-21.926,P0.05)。LINC00978在胃癌患者血清中的平均含量[3.525(1.385,8.954)]较胃良性疾病患者[0.419(0.258,1.369)]和体检健康者[0.814(0.351,2.510)]均明显升高(Z值分别为-4.834和-4.686;P均0.01),且与淋巴结转移、浸润深度和TNM分期相关(r分别为0.448、0.369和0.383,P均0.01);胃癌患者术后血清中LINC00978的表达水平[0.17(0.15,0.39)]较术前[0.98(0.59,1.61)]明显降低(Z=-5.731,P0.01)。与体检健康者相比,LINC00978在胃良性疾病患者血清中表达差异无统计学意义(Z=-1.693,P0.05)。胃癌患者血清LINC00978的ROC曲线下面积(AUCROC)为0.807,95%可信区间(CI)为0.723~0.882,当cut-off值为1.806时,其诊断胃癌的敏感性为71.4%,特异性为75.9%。结论 LINC00978在胃癌患者血清中呈高表达,且与淋巴结转移、浸润深度和TNM分期相关,有望成为潜在的胃癌诊断的生物学标志物。     

血清外体内fibulin-1检测在胃癌诊断中的应用

目的评价血清外体(exosome)内fibulin-1蛋白分子在胃癌诊断中的临床应用价值。方法 Exosome沉淀法提取胃癌细胞及胃上皮细胞上清、胃癌患者及体检健康人血清exosome;western blot、ELISA法检测exosome内fibulin-1蛋白的表达水平,绘制ROC曲线并进行诊断效能分析。结果胃癌细胞及其上清exosome内fibulin-1表达水平显著低于胃上皮细胞及其上清exosome;胃癌患者血清exosome内fibulin-1的表达水平(31.94±16.92)μg/mL明显低于体检健康者(47.16±17.27)μg/mL(P=0.045);胃癌患者血清exosome内fibulin-1的ROC曲线下面积(AUCROC)是0.727 5,95%可信区间(CI)为0.569 4~0.885 6,cut off值为43.19μg/mL,敏感性为70%,特异性为75%。结论血清exosome内fibulin-1分子有望作为胃癌诊断的潜在新型分子标志物。     

胃癌患者血清中exosome的水平及临床意义

目的探讨胃癌患者血清中外体(exosome)的水平及其临床意义。方法用ELISA法检测77例胃癌患者、34例体检健康者血清中EXOSC2(exosome component 2)的含量,以评估血清中exosome的水平,并分析其与胃癌患者临床病理特征的关系。结果胃癌患者血清中EXOSC2含量为[670.92(572.49,1 287.59)]pg/mL,健康对照组为[585.49(493.63,862.10)]pg/mL,两组间差异有统计学意义(P0.05)。胃癌患者中,淋巴结转移组血清中exosome水平明显高于无淋巴结转移组(P0.01);Ⅲ、Ⅳ期exosome水平明显高于Ⅰ、Ⅱ期(P0.05);低分化组水平明显高于高分化组(P0.05)。胃癌患者不同年龄、性别、肿瘤浸润深度、有无远处转移和肿瘤大小间exosome水平差异无统计学意义(P0.05)。结论胃癌患者血清中exosome水平的升高与肿瘤淋巴结转移、TNM分期及分化程度有关,测定血清中exosome的水平有助于判断胃癌的进展。     

miR-1288调控骨髓间质干细胞促进胃癌细胞迁移

目的探讨miR-1288在胃癌细胞培养上清诱导后骨髓间质干细胞(bone marrow-derived mesenchymal stem cell,BMMSC)中的表达情况及其调控BMMSC对胃癌细胞迁移能力的影响。方法采用SGC-7901、MGC-803和HGC-27 3种胃癌细胞培养上清分别处理BMMSC,实时荧光定量PCR检测处理前后BMMSC中miR-1288的表达水平。采用寡核苷酸片段NC-mimics和miR-1288-mimics转染BMMSC,Transwell试验检测转染后BMMSC对HGC-27细胞迁移能力的影响。收集胃炎和胃癌组织标本,实时荧光定量PCR检测组织中miR-1288的表达水平。结果经SGC-7901、MGC-803和HGC-27胃癌细胞上清处理后BMMSC中miR-1288的表达水平分别是对照组的(5.91±0.25)倍(t=15.55,P0.01)、(9.69±0.62)倍(t=13.34,P0.01)和(24.29±2.69)倍(t=8.631,P0.01)。miR-1288-mimics转染组迁移细胞数量为(623.3±26.03)个,明显高于NCmimics对照组[(326±32.08)个],差异有统计学意义(t=7.197,P0.01)。胃癌组织中miR-1288的表达水平显著高于胃炎组织(P0.05)。结论胃癌上清诱导后BMMSC和胃癌组织中异常高表达miR-1288,其可参与调控胃癌细胞的迁移。     

cir-ITCH在胃癌患者肿瘤组织中的表达及临床应用

目的检测胃癌患者组织中circ RNA ITCH(cir-ITCH)表达情况并评估其在胃癌诊断中的应用价值。方法采用实时荧光定量RT-PCR检测cir-ITCH在胃癌患者癌组织以及胃癌细胞系中的表达水平,分析cir-ITCH表达水平与胃癌患者临床病理参数的相关性。结果 cir-ITCH在胃癌细胞系SGC-7901(0.621±0.036)和MGC-803(0.118±0.003)中的表达水平明显低于胃黏膜上皮细胞GES-1(0.999±0.037),差异具有统计学意义(t分别为7.294和23.58,P均0.01)。88例胃癌患者癌组织中cir-ITCH的表达水平[0.635(0.137,1.506)]较癌旁组织[3.042(0.808,7.972)]明显下调(Z=-5.976,P0.01),且与TNM分期密切相关(r为0.137,P0.05)。结论 cir-ITCH在胃癌组织中表达下调,并与TNM分期密切相关,有望成为潜在的胃癌诊断新分子标志物。     

血清微小RNA-373在胃癌中的表达水平及其诊断价值

目的 探讨微小RNA-373(miR-373)在胃癌中的表达水平及其诊断价值。方法 选取2021年2月至2023年2月广东医科大学东莞第三临床医学院胃癌诊疗中心收治的胃癌患者80例作为胃癌组,选取同期在广东医科大学东莞第三临床医学院接受胃镜检查,经病理学检查未见肿瘤的胃良性疾病患者80例作为胃良性疾病组,选取同期行健康体检的体检健康者80例作为对照组。采集受试者血清样本,利用实时定量聚合酶链反应(qRT-PCR)技术检测miR-373的表达水平,并分析其与临床病理特征的相关性。采用全自动化学发光免疫分析法,检测血清糖类抗原199(CA199)和癌胚抗原(CEA)。采用受试者工作特征(ROC)曲线评估miR-373、CA199和CEA对胃癌的诊断效能。结果 胃癌组血清miR-373、CA199和CEA表达水平均高于胃良性疾病组和对照组,差异有统计学意义(P<0.05)。miR-373表达水平与胃癌患者的肿瘤最大径、淋巴结转移和TNM分期密切相关(P<0.05)。ROC曲线分析显示,miR-373、CA199和CEA诊断胃癌的曲线下面积分别为0.880(95%CI:0.819～...     

miR-494-3p在胃癌患者血清外泌体中的表达及价值

摘要:目的探究微小 RNA-494-3p(miR-494-3p)在胃癌患者血清外泌体中的表达水平及临床意义。方法采用 TaqMan探针 法RT-qPCR检测44例胃癌患者和44例健康人对照组血清外泌体中miR-494-3p的表达水平,采用ROC曲线分析并评估其对 胃癌的鉴别诊断价值。同时,在14例胃癌组织和16例胃良性疾病对照患者胃组织中进行进一步验证。结果与健康人对照 组( 1.00+0.36)相比,胃癌组血清外泌体中miR-494-3p的相对表达水平(0.21+0.03)显著降低,差异有统计学意义(Z=3.64,P< 0.01);胃癌组织中miR-494-3p的相对表达水平(0.22+0.07)亦显著低于胃良性疾病对照组( 1.00+0.39),差异有统计学意义 (Z= 2.66, P<0.01)。血清外泌体miR-494-3p筛查胃癌和健康人的ROC曲线下面积( AUCROC )为0.725( 95% CI :0.622 ~0.829 , P<0.01),当ecut-off 值为0.370时,其敏感性为50.0%，特异性为86.4%,阳性预测值为63.3%,阴性预测值为78.6%,准确性为 68.2%。结论miR-494-3p 在胃癌患者血清外泌体中呈低表达，有望成为胃癌筛查和辅助鉴别诊断的潜在生物学标志物。     

circRNA_ 0085135 在胃癌患者血清中的表达及意义

摘要:目的检测 环状非编码RNA( cireRNA)_ 0085135 在胃癌患者血清中的表达水平，分析其与患者临床病理参数的相关性以及对胃癌的临床诊断效能。方法收集62 例胃癌患者(胃癌组)、50例胃部良性疾病患者(良性疾病组)以及50例体检健 康者(健康人对照组)的血清样本。采用实时荧光定量PCR( RT-qPCR)检测胃癌患者、胃部良性疾病患者和体检健康者血清circRNA_ _0085135的表达水平。ROC曲线评估ceircRNA_ 0085135 对于胃癌的临床诊断价值,并分析circRNA_ 0085135 与胃癌患者临床病理参数的相关性。结果circRNA_ 0085135 在胃癌患者血清中的相对表达量为24.96( 10.51,41.45),显著高于胃部良性疾病组6.13(0.23,17.82)和健康人对照组0. 79(0.18,5.83),差异有统计学意义(H=61.79, P<0.0001),血清 circRNA_ _0085135诊断胃癌的ROC曲线下面积( AUCROC)为0.812 6( 95%Cl:0.7458~0.8794,P<0.000 1),当cut-off 值为6.390时,其敏感性为87.1% ,特异性为64.0%。血清circRNA. _0085135 表达量与TNM分期(x2=5.314,P=0.021)、肿瘤最大径(x2=9.789，P=0.002)、淋巴结转移(x2= 7.806,P=0.005)有关(P<0.05)。结论circRNA_ _0085135 在胃癌中呈高表达,并与TNM分期、大小和淋巴结转移有关，可作为胃癌潜在的诊断标志物。     

胃癌患者血清溶菌酶水平与癌组织溶菌酶表达的相关性研究

目的探讨胃癌组织中溶菌酶(LZM)表达与血清溶菌酶(LZM)水平的相关性以及两者与胃癌临床病理生理特征的关系。方法检测组织中LZM表达采用SP法;血清LZM水平检测采用MTS/PMS比色法。结果 (1)胃癌患者血清LZM水平为219.7±42.5 KU/L。癌组织中LZM表达阳性率为69.4%;胃癌患者血清LZM水平明显高于健康对照组和良性消化道疾病组,差异有统计学意义(P0.05)。(2)胃癌患者血清LZM水平与癌组织LZM阳性表达呈正相关(r=0.98,P0.001)。(3)胃癌组织中LZM阳性表达者血清LZM水平明显高于阴性表达者,差异有统计学意义(P0.05)。结论胃癌患者血清中LZM水平与癌组织中LZM的阳性表达率一样,能反映胃癌的发生、发展及评估预后。     

Guns and Knives in New Mexico: Patterns of Penetrating Trauma, 1978–1993

Objective: To identify patterns of nonfatal and fatal penetrating trauma among children and adults in New Mexico using ED and medical examiner data.
Methods: The authors retrospectively sampled in 5-year intervals all victims of penetrating trauma who presented to either the state Level-1 trauma center or the state medical examiner from a 16-year period (1978–1993). Rates of nonfatal and fatal firearm and stabbing injury were compared for children and adults.
Results: Rates of nonfatal injury were similar (firearm, 34.3 per 100,000 person-years; stabbing, 35.1). However, rates of fatal injury were significantly different (firearm, 21.9; stabbing, 2.7; relative risk: 8.2; 95% confidence interval: 5.4, 12.5). From 1978 to 1993, nonfatal injury rates increased for children (p = 0.0043) and adults (p < 0.0001), while fatal penetrating injury remained constant. The increase in nonfatal injury in children resulted from increased firearm injury rates. In adults, both stabbing and firearm nonfatal injury rates increased.
Conclusions: Nonfatal injury data suggest that nonfatal violence has increased; fatal injury data suggest that violent death rates have remained constant. Injury patterns vary by age, mechanism of trauma, and data source. These results suggest that ED and medical examiner data differ and that both are needed to guide injury prevention programs.     

Dissociable correlates of two classes of retrieval processing in prefrontal cortex

Although substantial evidence suggests that the prefrontal cortex (PFC) implements processes that are critical for accurate episodic memory judgments, the specific roles of different PFC subregions remain unclear. Here, we used event-related functional magnetic resonance imaging to distinguish between prefrontal activity related to operations that (1) influence processing of retrieval cues based on current task demands, or (2) are involved in monitoring the outputs of retrieval. Fourteen participants studied auditory words spoken by a male or female speaker and completed memory tests in which the stimuli were unstudied foil words and studied words spoken by either the same speaker at study, or the alternate speaker. On "general" test trials, participants were to determine whether each word was studied, regardless of the voice of the speaker, whereas on "specific" test trials, participants were to additionally distinguish between studied words that were spoken in the same voice or a different voice at study. Thus, on specific test trials, participants were explicitly required to attend to voice information in order to evaluate each test item. Anterior (right BA 10), dorsolateral prefrontal (right BA 46), and inferior frontal (bilateral BA 47/12) regions were more active during specific than during general trials. Activation in anterior and dorsolateral PFC was enhanced during specific test trials even in response to unstudied items, suggesting that activation in these regions was related to the differential processing of retrieval cues in the two tasks. In contrast, differences between specific and general test trials in inferior frontal regions (bilateral BA 47/12) were seen only for studied items, suggesting a role for these regions in post-retrieval monitoring processes. Results from this study are consistent with the idea that different PFC subregions implement distinct, but complementary processes that collectively support accurate episodic memory judgments.     

Systematic Reviews Published in the January 2011 Issue of The Cochrane Library

ABSTRACT

The Cochrane Library of Systematic Reviews is published quarterly as a DVD and monthly online. The January 2011 issue (first quarterly DVD for 2011) contains 4515 complete reviews, 1985 protocols for reviews in production, and 13,521 one-page summaries of systematic reviews published in the general medical literature. In addition, there are citations of 641,000 randomized controlled trials, and 14,018 cited papers in the Cochrane methodology register. The health technology assessment database contains over 9300 citations. One hundred and seven new reviews have been published in the last 3 months, of which five have potential relevance for practitioners in pain and palliative medicine.     

Interprofessional approaches to creating safe,high quality health care

Three supplementary perspectives are presented arguing that interprofessional collaboration is both necessary and desirable. Nonetheless, there are often too many serious intra-professional barriers and obstacles to interprofessional collaboration to make it successful. Some of these barriers, it is argued and illustrated, are found in the multiple ways in which professional identity is tacitly acquired and embodied in the practitioners' habitual, everyday practice. The paper then explores ways in which reflection, especially Second order reflection, can help to elucidate and overcome these obstacles, as well as increasing professional adaptability and competence.     

Modified micro-superior percutaneously-assisted total hip: early experiences & case reports

Because of the extensile nature and familiarity of the standard posterior-lateral approach to the hip, a family of "micro-posterior" approaches has been developed. This family includes the Percutaneously-Assisted Total Hip (PATH) approach, the Supercapsular (SuperCap) approach and a newer hybrid approach, the Supercapsular Percutaneously-Assisted Total Hip (SuperPATH) approach. Such approaches should ideally provide a continuum for the surgeon: from a "micro" (external rotator sparing) posterior approach, to a "mini" (external rotator sacrificing) posterior approach, to a standard posterior approach. This could keep a surgeon within his comfort zone during the learning curve of the procedure, while leaving options for complicated reconstructions for the more practiced micro-posterior surgeons. This paper details one author's experiences utilizing this combined approach, as well as permutations of this entire micro-posterior family of approaches as applied to more complex hip reconstructions.     

Prise en charge des entorses externes de cheville : étude clinique préliminaire sur l’efficacité du dispositif Myolux™

Ankle sprains are the most common injury of the musculoskeletal system and are associated with significant societal and economic impacts. It has been proven that classical therapeutic strategies may not be effective in preventing recurrent injuries: the recurrence rates reported in the literature can reach 73%. In order to provide an effective rehabilitation solution, a destabilizing orthosis was developed. This device is equipped with a mechanical articulator reproducing the subtalar mechanics and placed under the heel. In this paper, we present the main results of a preliminary clinical study conducted between 2004 and 2007. All subjects included in this study were treated with the abovementioned orthosis during 10 rehabilitation sessions of 30 minutes each. Data show a relatively low recurrence rate of 12% for the overall population. Moreover, it's of primary importance to note that this satisfactory ratio is largely reduced (3% of recurrence rate) for the 29 patients who performed one training session per month after the 10th initial rehabilitation sessions. Hence, the destabilizing orthosis appears to be an effective solution to prevent recurrent ankle sprains. However, joint protection requires long-term and regular training sessions. This result has motivated the development of a similar device allowing patients to perform training sessions at home. Finally, data obtained in this study are promising awaiting the final results of the comparative, multicentric and independent clinical trials currently managed by the Hospices Civils de Lyon.     

Determination of creatine kinase isoenzyme MB activity in serum using immunological inhibition of creatine kinase M subunit activity. Activity kinetics and diagnostic significance in myocardial infarction.

This is a new method for the determination of creatine kinase isoenzyme MB activity in serum. The method uses direct activity measurement of creatine kinase B subunit activity after blocking of CK-M subunit activity by inhibiting antibodies. The test takes no longer than 15 min. The method yields an intra-serial C.V. of 2.0-12.9%, and a C.V. from day to day of 5.5%. The detection limit is 3.4 U/l creatine kinase MB. In the 95 cases with proven myocardial infarction several types of creatine kinase MB activity kinetics could be determined. The percentage of creatine kinase MB of peak CK-total is 6-25%, with a mean of 11.1%. The amount of creatine kinase MB with respect to total CK activity after reinfarction is higher than the amount after initial infarction.