肝硬化腹水并发自发性细菌性腹膜炎的危险因素分析

目的探讨肝硬化腹水并发自发性细菌性腹膜炎（SBP）的危险因素。方法选择40例肝硬化腹水并发SBP和28例未并发SBP的肝硬化腹水患者作为研究对象,采取回顾性研究的方法对相关临床资料进行分析。结果肝硬化腹水并发SBP者在并发休克、肝肾综合征、原发性肝癌、上消化道出血以及年龄区间、多次住院、既往是否发生腹水等方面与不合并SBP患者差异具有统计学意义（P均〈0.05）;两组患者的外周血TBil、ALB、PT、CR、UA以及血钠表达水平差异具有统计学意义（P均〈0.05）。患者年龄、TBil、ALB、PT、血钠和CR作为可作为单因素预测肝硬化腹水并发SBP发生（P均〈0.05）。多因素Logistic回归分析结果发现,TBil、ALB以及是否合并原发性肝癌两组间差异具有统计学意义（P均〈0.05）。结论高胆红素血症、低蛋白血症以及合并原发性肝癌为肝硬化腹水患者并发SBP的危险因素,对这类患者应及时预防性使用抗菌药物。     

B7-H3在食管癌中的研究进展

食管癌是一种高发恶性肿瘤,发病率逐年上升,常规手术治疗及放化疗疗效较差。近年来,免疫疗法的不断发展为食管癌的治疗提供了新思路。B7-H3(CD276)在食管癌等多种类型的肿瘤中过表达,与患者的不良预后密切相关,是一种有前景的免疫治疗靶点。B7-H3对食管癌免疫反应主要发挥负性调节作用,可能是食管癌潜在的生物标志物,有望为肿瘤免疫治疗拓展新方向。本文对B7-H3在食管癌中作用的研究进展作一综述。     

聚桂醇硬化注射治疗内痔的临床疗效

为探讨聚桂醇硬化注射治疗内痔的临床疗效,将120例内痔患者随机分为治疗组和对照组,各60例,治疗组给予聚桂醇硬化注射,对照组给予消痔灵硬化注射,对比两组总体疗效和并发症。结果显示,两组总有效率比较差异无统计学意义,P〉0．05;但治疗组治疗后肛门坠胀感、肛门疼痛、肛门狭窄、黏膜坏死发生率明显低于对照组,P＜0．05。结果表明,聚桂醇硬化注射治疗内痔疗效肯定,并发症少,优于消痔灵。     

A low level of GPR37 is associated with human hepatocellular carcinoma progression and poor patient survival

GPR37, also known as parkin-associated endothelin-like receptor (Pael-R), is an orphan G protein-coupled receptor (GPCR). It has been reported that GPCRs play vital roles in the development and progression of cancer. To investigate the potential roles of GPR37 in hepatocellular carcinoma (HCC), expression of GPR37 was examined in human HCC samples. Immunohistochemistry and Western blot analyses were performed for GPR37 in 57 hepatocellular carcinoma samples. GPR37 expression was low in hepatocellular carcinoma as compared with the adjacent non-tumorous tissues. Clinicopathological analysis showed that GPR37 expression was significantly correlated with histological grade and the level of alpha fetal protein (AFP) (P = 0.000 and 0.002, respectively). The Kaplan–Meier survival curves revealed that decreasing GPR37 expression was associated with poor prognosis in HCC patients, while in vitro, following the release from serum starvation of HuH7 HCC cell, the expression of GPR37 was downregulated. In addition, the transient GPR37 knockdown by siRNA in HuH7 cells significantly decreased the apoptosis of hepatoma cells with activation of the phosphatidylinositol 3-kinase-Akt signaling pathway. Our data suggest that GPR37 may play an important role in the pathogenesis of hepatocellular carcinoma by affecting the proliferation of H CC cells, and it could be a novel potential molecular therapy target for HCC.     

The expression levels and prognostic value of high temperature required A2 (HtrA2) in NSCLC

High temperature required A2 (HtrA2) is a serine kinase that is released from mitochondria into the cytosol upon apoptotic stimuli, inducing apoptosis in various cancers. Thus, analysis of the expression of HtrA2 in non-small-cell lung cancer (NSCLC) tissues is needed for the understanding of this malignancy. In this study we firstly analyzed the apoptosis effect of HtrA2 in A549 cells by RNA interference and cisplatin with Western blot and flow cytometry. Then HtrA2 expression was evaluated by Western blot and immunohistochemistry in NSCLC tissues. Western blot and flow cytometry analyses indicated that deletion of HtrA2 was negatively correlated with apoptosis-induced protein in A549 cells. HtrA2 was lowly expressed in NSCLC and significantly associated with histological differentiation and clinical stage. Besides, low expression of HtrA2 was a prognostic factor for NSCLC patients’ inferior survival. In conclusion, HtrA2 might promote the apoptosis of NSCLC cells, and serve as a target for NSCLC's treatment.     

基于“云班课”开展CDIO教学模式在非糖尿病科护士在职教育中的应用效果研究

目的探讨基于“云班课”开展构思-设计-实现-运作(CDIO)教学模式在非糖尿病科护士在职教育中的应用效果。方法选取2018年6月—12月医院在岗的351名临床一线护理人员作为研究对象,随机分为研究组(n=174)和对照组(n=177)。2组均接受糖尿病护理在职教育,对照组实施常规面授教学法,研究组采用基于“云班课”开展CDIO教学模式。比较2组教学效果。结果研究组护理人员理论成绩和技能操作成绩均高于对照组(P<0.01)。研究组护理人员在任务分析、自我评价和自主学习能力总分高于对照组(P<0.05)。研究组护理人员在分析能力、系统化能力、自信心、求知欲评分高于对照组(P<0.05)。结论基于“云班课”开展的CDIO教学模式在非糖尿病科护士在职教育中取得了较好的教学效果,可提升护理人员的理论及技能操作成绩,加强自主学习及评判性思维能力。     

血浆SIOOB蛋白在缺氧缺血性脑病新生儿的诊断评估

目的探讨血浆S100B蛋白对缺氧缺血性脑病（hypoxic ischemic encephalopathy，HIE）新生儿脑损伤的临床意义。方法选择54例临床诊断为HIE的新生儿在出生12h时抽血检测S100B、神经元特异性烯醇化酶（neuron specifice Dolase，NSE）及脑型肌酸激酶同功酶（creatine kinaes BB isozyme，CK-BB），与47例非HIE的窒息新生儿和22例健康新生儿进行对照比较。评价敏感性和特异性，绘制ROC曲线，计算ROC曲线下面积。结果出生12h时HIE患儿血浆S100B、NSE和CK-BB阳性率显著高于窒息组和对照组（均P〈0．01），S100B对HIE的敏感性为88．89％，特异性为82．61％，之和高于NSE及CK-BB。S100B的ROC曲线下面积最大（面积：0．950；95％可信区间0．918—0．983），临床诊断效能高于NSE及CK-BB。结论HIE患儿出生12h时血浆S100B、NSE和CK-BB均能预示HIE患儿的脑部损伤，S100B阳性率最高．三指标联合检测．有助于HIE的早期诊断和病情判断。     

乳腺癌还氧合酶-2表达的研究现状

还氧合酶-2(COX-2)过表达与很多肿瘤发生发展有关。最近研究显示COX-2在乳腺癌细胞株和组织标本中表达增加,提示COX-2可能直接参与乳腺癌的形成,并且与预后有关。因此,应用COX-2抑制剂治疗乳腺癌成为目前的研究热点。