胰头皮样囊肿1例并文献复习

皮样囊肿也称成熟畸胎瘤,是一种生殖细胞起源的良性疾病,可起源于3种胚层中的任何一个.皮样囊肿通常由囊性和实性成分共同组成,具有表皮附属物(如毛囊或皮脂腺),多为外胚层残余的角质细胞发育而来,常见于卵巢、骶尾部和睾丸,在胰腺中的病例十分罕见,只见于少数病例报告[1].胰腺皮样囊肿可在胰腺的任何部位发展,胰体最为常见(37.8％),其次为胰尾部(17.8％),胰头皮样囊肿十分罕见(13.3％).胰腺皮样囊肿虽为良性病变,但辅助检查没有特异性,诊断比较困难,确诊多依靠术后病理检查.现报道1例66岁男性患者胰头皮样囊肿,并对之前发表的文献进行回顾,提高对胰腺皮样囊肿的认识.     

失代偿期肝硬化患者应用利伐沙班的安全性研究

目的 评价代偿期肝硬化患者应用利伐沙班的安全性.方法 2020年1-10月首都医科大学附属北京佑安医院收治的失代偿期肝硬化患者26例纳入本研究.患者为门静脉血栓(portal vein thrombosis,PVT)、经颈静脉肝内门体分流术(transjugular intrahepatic portosystemic shunt,TIPSS)术后或布加综合征,应用利伐沙班(10 mg/d)抗凝治疗≥3个月.主要观察终点为全因出血并发症;次要终点为利伐沙班导致的肝损伤;其他指标包括一般人口学特征、PVT变化等.结果 26例患者中,男8例,女8例;平均年龄(54.2±13.8)岁.利伐沙班治疗时间为4.0(3.0,8.0)个月.Child-Turcotte-Pugh(CTP)评分B级23例,C级3例.治疗前食管静脉曲张重度伴红色征17例(65.4％),消化道溃疡8例(30.8％),曾有消化道出血者12例(46.2％).抗凝治疗中未见消化道出血及卒中等出血事件,1例有轻微齿龈出血.抗凝治疗前后ALT [19.0(13.8,28.0)U/L比22.5(17.0,31.3)U/L]、AST [31.0(19.3,44.5)U/L比35.5(26.8,56.3)U/L]、CTP评分[8.0(7.0,9.0)比8.0(6.8,10.0)]比较,差异无统计学意义(P＞0.05);治疗后T-BIL[29.5 (19.2,53.1) μmol/L]较抗凝前[28.5(16.5,37.7) μmol/L]升高,差异有统计学意义(P＞0.05).结论 小剂量利伐沙班用于失代偿期肝硬化患者安全性好,无显著出血及肝损伤.     

Effect of Focused Cardiac Ultrasound in Combination with Lung Ultrasound on Critically Ill Patients:A Multicenter Observational Study in China

Objective Focused cardiac ultrasound (FCU) and lung ultrasound (LU) are increasingly being used in critically ill patients.This study aimed to investigate the effect of FCU in combination with LU on these patients and to determine if the timing of ultrasound examination was associated with treatment change.Methods This is a multicenter cross-sectional observational study.Consecutive patients admitted to the intensive care unit (ICU) were screened for enrollment.FCU and LU were performed within the first 24 h,and treatment change was proposed by the performer based on the ultrasound results and other clinical conditions.Results Among the 992 patients included,502 were examined within 6 h of ICU admission (early phase group),and 490 were examined after 6 h of admission (later phase group).The early phase group and the later phase group had similar proportions of treatment change (48.8％ vs.49.0 ％,x2 =0.003,P=0.956).In the multivariable analysis,admission for respiratory failure was an independent variable associated with treatment change,with an odds ratio (OR) of 2.357[95 ％ confidence interval (CI):1.284-4.326,P=0.006];the timing of examination was not associated with treatment change (OR=0.725,95％CI:0.407-1.291,P=0.275).Conclusions FCU in combination with LU,whether performed during the early phase or later phase,had a significant impact on the treatment of critically ill patients.Patients with respiratory failure were more likely to experience treatment change after the ultrasound examination.     

喷嘴型号的选择对流式分选效果的影响

目的 用70、100两种型号的喷嘴对不同颗粒进行流式分选,观察喷嘴型号对流式分选的影响.方法 BD Calibiite Bead,人单核细胞白血病细胞株Thp-1、白血病细胞株H6和人外周血分离单核细胞染色后进行流式分选,观察70、100两种不同型号的喷嘴对分选时液流的稳定性、分选纯度、细胞活性的影响.结果 BD Calibiite Bead、人外周血单核细胞,喷嘴的选择对其液流稳定性、分选纯度没有影响;人外周血单核细胞两种喷嘴分选后PI染色显示其细胞活性都在90％以上,使用100喷嘴分选活性较使用70喷嘴高;Thp-1、H6凋亡染色后进行分选,100喷嘴的分选纯度较70喷嘴高.结论 不同大小的喷嘴对小微球颗粒及小细胞分选影响不大.对脆弱、易激惹细胞及荧光抗体与细胞结合不稳定的实验选用较大的喷嘴,分选纯度高,分选后细胞的活性更好.     

冠脉造影术前应用思维导图宣教效果探讨

目的探讨思维导图在冠状动脉造影术前宣教中的应用效果。方法将354例在我科行冠状动脉造影术的冠心病患者随机分为实验组和对照组,对照组采取常规术前宣教模式,实验组采取思维导图宣教模式,收集两组患者宣教前的焦虑自评量表(SAS)评分、术前的焦虑自评量表(SAS)评分、发生不良反应例数以及患者出院时满意度评分。结果两组患者宣教前焦虑自评量表(SAS)评分以及发生不良反应率比较,P>0.05,差异无统计学意义;而实验组术前焦虑自评量表(SAS)评分低于对照组,实验组患者出院时满意度评分与对照组比较,P<0.05,差异有统计学意义。结论运用思维导图进行多元化的冠状动脉造影术前宣教,不仅可以降低患者术前焦虑的现象,减小术中风险,还有助于提高患者满意度。     

Effects of spironolactone on electrical and structural remodeling of atrium in congestive heart failure dogs

Background Renin-angiotensin-aldosterone system has been demonstrated to be associated with both congestive heart failure （CHF） and atrial fibrillation （AF）. This study investigated the effects of spironolactone, a kind of aldosterone antagonist, on atrial electrical remodeling and fibrosis in CHF dogs induced by chronic rapid ventricular pacing. Methods Twenty one dogs were randomly divided into sham-operated group, control group, and spironolactone group. In control group and spironolactone group, dogs were ventricular paced at 220 beats per minute for 6 weeks. Additionally, spironolactone at 15 mg.kgl.d1 was given to dogs 1 week before rapid ventricular pacing until pacing stopped. Transthoracic and transoesophageal echocardiographic examinations were performed to detect structural and functional changes of the atrium. Swan2 Ganz floating catheters were used to measure hemadynamics variances. Atrial effective refractory period （AERP）, AERP dispersion （AERPd） conduction velocity （CV） were determined. The inducib atrial fibrosis was quantified with Masson staining. intra- and inter-atrium conduction time （CT） and intra-atrium ity and duration of AF were also measured in all groups. Finally, Results AERP did not change significantly after dogs were ventricular paced for 6 weeks. However, AERPd, intra- and inter-atrium CT increased significantly, and CV decreased apparently, which was negatively correlated to the atrial fibrosis （r=-0.74, P〈0.05）. Simultaneously, left atriums were enlarged and cardiac hemadynamics worsened in pacing dogs. Although spironolactone could not affect cardiac hemadynamics effectively, it can obviously improve left atrial ejection fraction （P〈0.05）. Spironolactone treatment did not alter AERP duration, but this medicine dramatically decreased AERPd （P〈0.05）, shortened intra- and inter-atrium conduction time （P〈0.05）, and increased atrium CV. Moreover, spironolactone decreased the inducibility and duration of AF （P〈0.05）, as well as at     

MET overexpression and amplification define a distinct molecular subgroup for targeted therapies in gastric cancer

Background

Currently, only trastuzumab, ramucirumab, and apatinib effectively treat gastric cancer. Thus, additional novel targets are required for this disease.

Methods

We investigated the immunohistochemical and fluorescence in situ hybridization expression of MET, ROS1, and ALK in four gastric cell lines and a cohort of 98 gastric cancer patients. Crizotinib response was studied in vitro and in vivo.

Results

Crizotinib potently inhibited in vitro cell growth in only one cell line, which also showed MET amplification. A positive correlation between crizotinib sensitivity and MET overexpression was observed (P = 0.045) in the histoculture drug response assay. Meanwhile, patient-derived tumor xenograft mouse models transplanted with tissues with higher MET protein expression displayed a highly selective sensitivity to crizotinib. In the 98 patients, MET overexpression was found in 42 (42.9 %) and MET was amplified in 4 (4.1 %). ROS1 and ALK overexpression were found in 25 (25.5 %) and 0 patients, respectively. However, none of the patients screened harbored ALK or ROS1 rearrangements. No significant association was found between overall survival and MET or ROS1 status. We also observed a stage IV gastric cancer patient with MET amplification who experienced tumor shrinkage and clinical benefit after 3 weeks of crizotinib as fourth-line treatment.

Conclusions

Crizotinib may induce clinically relevant anticancer effects in MET-overexpressed or MET-amplified gastric cancer patients.

     

Green tea polyphenols as a natural tumour cell proteasome inhibitor

The cancer-preventive effects of green tea and its main constituent (-)-epigallocatechin gallate [(-)-EGCG] are widely supported by results from epidemiological, cell culture, animal and clinical studies although the molecular target has not been well defined. We previously reported that ester bond-containing tea polyphenols, e. g. (-)-EGCG, and their synthetic analogs potently and specifically inhibited the proteasomal activity. Subsequently, we further demonstrated that methylation on green tea polyphenols under physiological conditions decreased their proteasome-inhibitory activity, contributing to decreased cancer-preventive effects of tea consumption. Since (-)-EGCG is unstable under physiological conditions, we also developed the peracetate-protected or prodrug form of (-)-EGCG, Pro-EGCG (1), and shown that Pro-EGCG (1) increases the bioavailability, stability, and proteasome-inhibitory and anticancer activities of (-)-EGCG in human breast cancer cells and xenografts, suggesting its potential use for cancer prevention and treatment.     

HPLC assay with UV detection for determination of RBC purine nucleotide concentrations and application for biomarker study in vivo

ATP and other purine nucleotides are important biomarkers for ischemia and may have considerable potential as targets for management of ischemic heart disease and stroke. The main objective of the study is to develop a rapid HPLC assay, which has adequate sensitivity and specificity for measuring concentrations of ATP, ADP, AMP, GTP, GDP and GMP in erythrocytes (RBC). The assays used ion-pair chromatography coupled with ultraviolet detection at 254 nm to separate and detect the purine nucleotides. Using 50–100 μL of RBC lysate as blank biologic matrix, the assay was linear from 100 to 2000 μg/mL for ATP and ADP, and 20–400 μg/mL for AMP, GTP, and GDP with coefficients of determination (r²) >0.99. GDP and GMP were not measurable in the study because of low concentrations and interference from endogenous materials, respectively. The intra-assay and inter-assay variations over a period of 1 year were less than 10% and 20%, respectively for most of the nucleotides. The assay was successfully applied to two pilot biomarker studies to measure RBC concentrations of the purine nucleotides in rats under restraining and exercise conditions. Preliminary results showed that the RBC concentrations of ATP and GTP were higher in the spontaneously hypertensive rats (SHR) compared to the Sprague–Dawley (SD) rats, and that exercise increased RBC concentrations of ATP in rats treated with the calcium channel blocker diltiazem.