新型冠状病毒肺炎初期阶段的辨证论治

新型冠状病毒肺炎属于中医瘟疫范畴,病邪为时行疠气作祟。疫寒初犯者,治宜辛温疏散;疫热初犯者,治宜辛凉疏散;疫湿初犯者,治宜疏解化湿;疫湿入侵中焦,治宜开上、畅中、渗下,三焦分消;疫毒郁肺者,治宜宣泄肺热,解毒祛湿。做好初期阶段的诊治,防止病情恶化,至关重要。     

非小细胞肺癌患者血浆Cripto-1的水平及临床意义

目的探讨非小细胞肺癌患者(NSCLC)血浆中CR-1的表达水平与患者临床病理特征之间的关系,及其对肺癌预后的判断价值。方法收集35例正常人血浆,40例良性肺部疾病患者和102例NSCLC患者血浆,用酶联免疫吸附法(ELISA)检测血浆CR-1表达水平。结果NSCLC患者血浆CR-1水平远高于健康对照组(P<0.05),良性肺部疾病患者血浆CR-1浓度虽也有一定的升高,但较之肺癌组低,二者间差异有显著性(P<0.05)。肺癌患者血浆CR-1水平与淋巴结转移状态和临床分期有关(P<0.01)。血浆CR-1与患者生存期密切相关,生存>12个月患者血浆CR-1明显低于<12个月者(P<0.01)。结论血浆CR-1与NSCLC的病程进展及生存期相关,是一种有价值的预后判断指标。     

单孔荧光胸腔镜结合EDDA-IQQA三维重建软件在复杂肺段切除中的临床应用

目的探讨单孔荧光胸腔镜结合三维重建软件EDDA-IQQA在复杂肺段切除手术中的应用。方法收集215例在南京市胸科医院胸外科行肺段切除术的患者资料,包括术前行支气管检查、肺血管的三维重建数据,术中数据及术后并发症情况进行分析,所有患者手术方式均为拟单孔胸腔镜手术,手术中应用三维重建软件EDDA-IQQA荧光法界定段间平面后行肺段切除术。结果215例手术均顺利完成,未增加操作孔,无改变手术方式,平均手术时间79.73±30.14 min,术中出血量25.88±30.24 mL,术后胸管留置时间4.14±0.68 d,术后有10例出现痰中带血,口服云南白药一周后好转,8例出现短暂肺漏气(<4天),心律失常2例,肺部感染2例,无术后30天死亡病例。结论EDDA-IQQA三维重建软件为开展肺段,特别是复杂联合亚肺段切除提供了方便、有效的导航,同时,荧光法可以快速、准确、清晰地显示段间线,两者之间的完美结合可以降低复杂肺段的难度和风险,缩短学习曲线,是一种安全有效的方法,值得临床推广应用。     

p14<Superscript>ARF</Superscript> promoter region methylation as a marker for gliomas diagnosis

Methylation in the promoter region is one of the mechanisms through which tumor suppressors are inactivated, resulting in tumorigenesis and/or tumor progression. Herein, we studied the methylation status in the promoter region of the p14^ARF tumor suppressor gene in 33 brain tissues isolated from glioma patients (astrocytomas) and compared to 12 brain tissues isolated from autopsy donors using methylation-specific polymerase chain reaction (MSP). The correlation between the expression of P14 and P53 was investigated using immunohistochemistry (IHC). The average percentage of methylation in the promoter region of p14^ARF gene in brain samples from glioma patients is 39.4%, while 0 from autopsy donors. No difference in the methylation level between low-grade and high-grade gliomas was detected. The methylation status has no correlation with the prognosis in glioma patients. A significant correlation between the expression of mutant form of TP53 and the grade of the glioma was established. Furthermore, there was a negative correlation between methylation of the p14^ARF promoter and the expression of the mutant form of TP53. Therefore, our data suggest that methylation in the promoter region of the p14^ARF gene may be used as a biomarker for the diagnosis of gliomas.