硬膜下积液治疗经验总结（附27例临床分析）

目的总结不同类型硬膜下积液治疗经验。 方法对解放军总医院第六医学中心神经外科自2009年1月至2014年10月手术治疗并完整随访的27例硬膜下积液患者进行回顾性分析。根据术前影像学特征鉴别积液是否为血性，将患者分为血性硬膜下积液患者（9例）和非血性硬膜下积液患者（18例）。根据积液是否为血性选择个性化治疗方案，观察其疗法。 结果9例血性硬膜下积液患者接受钻孔外引流手术，8例积液消退，另外1例无效，之后接受硬膜下腹腔分流后治愈。非血性硬膜下积液患者中14例接受硬膜下腹腔分流，12例有效，2例术后出现脑积水，经脑室-腹腔分流术治愈；2例术前合并脑积水接受脑室-腹腔分流术，均有效；另外2例最初接受积液外引流，无效，之后行硬膜下腹腔分流后积液消退。 结论对于硬膜下积液患者，术前需仔细评估积液是否为血性，是否合并脑积水。血性积液采取钻孔外引流，非血性积液采取硬膜下腹腔分流，合并脑积水的积液采取脑室-腹腔分流手术方式，给予个体化治疗，可获得满意疗效。     

ⅣA期胸腺瘤IMRT疗效及安全性初步分析

目的 初步评估IMRT对无法手术ⅣA期胸腺瘤的疗效及安全性。方法 回顾分析2010-2017年间15例无法手术接受IMRT的ⅣA期胸腺瘤患者,其中男9例、女6例,中位数59岁。PTV、CTV、GTV放疗剂量分别为50、60、70Gy分15~20次,分析近期疗效、总生存率及不良反应。结果 中位随访时间48个月,近期部分缓解率93%(14/15),1、3、5年总生存率分别为100%、75%、75%,仅1例出现3级血液系统反应。4例死亡患者均为肿瘤相关死亡。结论 初步证明ⅣA期胸腺瘤IMRT疗效较好、安全性高,可作为无法手术治疗的胸腺瘤患者安全、有效的治疗手段。     

<i>Sinomenium</i> Inhibits the Viability of Hepatoma Carcinoma Cells through Activating IFNA2

Hepatocellular carcinoma (HCC) ranks the sixth place of most common cancers. Meanwhile, it is the tertiary mortality cause of cancer. There is no effective therapeutic method to prevent and treat the liver cancer. Sinomenine is a kind of Chinese traditional medicine herbal, it is reported that it can inhibit the viability of several cancer cells. The study is to explore whether sinomenine is also able to inhibit the cell viability of HCC and its potential mechanism. The IC50 of sinomenine in BEL-7402 cells was 5.351 mmol/L, and the IC50 of sinomenine in SMMC-7721 cells was 6.204 mmol/L. The gene expression results showed the relative expression of FGF2, CCND2, DCN, F3, MMP7, NRG1, HMGB1, TRIM29, HAS2, EHF, CTGF, PLK2 were down-regulated, and the relative expression of VEGF A, CITED2, NUPR1, DDX58, IRF9, NAMPT, MMP1, NDRG1, HMGA2, PPARGC1A, IFIT2, PARP9, HEY1, LOX, ETV1, ISG15, BACH, CYLD were up-regulated. Moreover, the IPA analysis results suggested that IFIT3, IFIT1, OAS1, MX1, IRF9, IFI6, IFITM1, ISG15 were up-regulated in BEL-7402 cells treated with sinomenine by activating IFNA2. The findings presented in this study may provide a promising method for the prevention and treatment of liver cancer.     

miR-149与肿瘤关系的研究进展

miRNAs是一类长度约为20~25个核苷酸，参与基因调控表达的内源性非编码RNA。miR-149作为miRNAs的重要成员，在多种肿瘤中表达异常，其表达水平与肿瘤细胞增殖、转移、凋亡、耐药、患者的早期诊断及预后密切相关。因此，miR-149有望成为新一类抗肿瘤治疗的靶点。     

Utility of Tissue Similarity Maps Based on Relative Cerebral Blood Volume for Grading Gliomas as Validated by Histological Results

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Neutrophils Play an Important Role in Protective Immunity against Coxiella burnetii Infection

Coxiella burnetii is an obligate intracellular Gram-negative bacterium that causes the zoonotic disease Q fever. Although Q fever is mainly transmitted by aerosol infection, study of the immune responses in the lung following pulmonary C. burnetii infection is lacking. Neutrophils are considered the first immune cell to migrate into the lung and play an important role in host defense against aerosol infection with microbial pathogens. However, the role of neutrophils in the host defense against C. burnetii infection remains unclear. To determine the role of neutrophils in protective immunity against C. burnetii infection, the RB6-8C5 antibody was used to deplete neutrophils in mice before intranasal infection with C. burnetii. The results indicated that neutrophil-depleted mice developed more severe disease than their wild-type counterparts, suggesting that neutrophils play an important role in host defense against C. burnetii pulmonary infection. We also found that neither CXC chemokine receptor 2 (CXCR2) nor interleukin-17 (IL-17) receptor (IL-17R) deficiency changed the severity of disease following intranasal C. burnetii challenge, suggesting that keratinocyte-derived chemokine and IL-17 may not play essential roles in the response to C. burnetii infection. However, significantly higher C. burnetii genome copy numbers were detected in the lungs of IL-1R^−/− mice at 14 days postinfection. This indicates that IL-1 may be important for the clearance of C. burnetii from the lungs following intranasal infection. Our results also suggest that neutrophils are involved in protecting vaccinated mice from C. burnetii challenge-induced disease. This is the first study to demonstrate an important role for neutrophils in protective immunity against C. burnetii infection.