Demarcation of arteriopulmonary segments: a novel and effective method for the identification of pulmonary segments

ObjectiveEach pulmonary segment is an anatomical and functional unit. However, it is fundamentally difficult to precisely distinguish every pulmonary segment using the conventional pulmonary intersegmental planes from computed tomography images. Building arteriopulmonary segments is likely to be an effective way to identify pulmonary segments.MethodsThe thoracic computed tomography images of 40 patients were collected. The anatomic structures of interest were extracted in the transverse, sagittal, and coronal planes using the semi-automated segmentation tools provided by Amira software. The intrapulmonary vessels were subsequently segmented and reconstructed. The distributions of the pulmonary arteries, veins, and bronchi were observed. In patients with pulmonary masses, the mass was also reconstructed.ResultsThe three-dimensional reconstructed images showed the branches of the pulmonary artery ramified up to their eighth order covering the entire lung as well as evident intersegmental gaps without pulmonary arteries. The segmental artery was closely accompanied by the segmental bronchi in 486 pulmonary segments (90% of total number of segments). The size and spatial location of the pulmonary mass within a pulmonary segment were also clearly visible.ConclusionsDemarcation of arteriopulmonary segments can be used to precisely distinguish every pulmonary segment and provide its detailed anatomical structure before pulmonary segmentectomy.     

A highly tumor-targeted nanoparticle of podophyllotoxin penetrated tumor core and regressed multidrug resistant tumors

Podophyllotoxin (PPT) exhibited significant activity against P-glycoprotein mediated multidrug resistant (MDR) tumor cell lines; however, due to its poor solubility and high toxicity, PPT cannot be dosed systemically, preventing its clinical use for MDR cancer. We developed a nanoparticle dosage form of PPT by covalently conjugating PPT and polyethylene glycol (PEG) with acetylated carboxymethyl cellulose (CMC-Ac) using one-pot esterification chemistry. The polymer conjugates self-assembled into nanoparticles (NPs) of variable sizes (20–120 nm) depending on the PPT-to-PEG molar ratio (2–20). The conjugate with a low PPT/PEG molar ratio of 2 yielded NPs with a mean diameter of 20 nm and released PPT at ∼5%/day in serum, while conjugates with increased PPT/PEG ratios (5 and 20) produced bigger particles (30 nm and 120 nm respectively) that displayed slower drug release (∼2.5%/day and ∼1%/day respectively). The 20 nm particles exhibited 2- to 5-fold enhanced cell killing potency and 5- to 20-fold increased tumor delivery compared to the larger NPs. The biodistribution of the 20 nm PPT-NPs was highly selective to the tumor with 8-fold higher accumulation than all other examined tissues, while the larger PPT-NPs (30 and 120 nm) exhibited increased liver uptake. Within the tumor, >90% of the 20 nm PPT-NPs penetrated to the hypovascular core, while the larger particles were largely restricted in the hypervascular periphery. The 20 nm PPT-NPs displayed significantly improved efficacy against MDR tumors in mice compared to the larger PPT-NPs, native PPT and the standard taxane chemotherapies, with minimal toxicity.     

Chalcone hybrids and their antimalarial activity

Malaria, one of the most striking, re-emerging infectious diseases caused by the genus Plasmodium, places a huge burden on global healthcare systems. A major challenge in the control and eradication of malaria is the continuous emergence of increasingly widespread drug-resistant malaria, creating an urgent need to develop novel antimalarial agents. Chalcone derivatives are ubiquitous in nature and have become indispensable units in medicinal chemistry applications due to their diverse biological profiles. Many chalcone derivatives demonstrate potential in vitro and in vivo antimalarial activity, so chalcone could be a useful template for the development of novel antimalarial agents. This review covers the recent development of chalcone hybrids as antimalarial agents. The critical aspects of the design and structure–activity relationship of these compounds are also discussed.     

65例多发性硬化患者的临床分析

目的总结多发性硬化(MS)患者的临床特点(精神情感障碍)以及脑脊液、诱发电位、影像学改变进行分析。方法回顾分析65例MS患者的有关临床和实验室资料。结果65例中,男17例,女48例;年龄16~68岁,平均(36.5±14.1)岁,男女比为1∶2.8。MS首发及常见症状为感觉异常、肢体无力、视力减退及括约肌功能障碍,病变部位以脊髓受累最多见,部分患者存在精神情感障碍。结论出现感觉异常有助于MS早期诊断,诱发电位及MRI有助于发现亚临床病变;括约肌功能异常多见,可能与脊髓受累较多有关;MS患者的精神情感应受人们关注。     

基层公共卫生人员心身健康状况分析

目的了解基层公共卫生人员心身健康状况及影响因素,为提高其健康水平和工作质量提供科学依据。方法应用中国心身健康量表,采用分层整群抽样的方式,抽取胶州、嘉祥、兖州和邹城疾病预防控制中心及下属防保站的公共卫生人员584名进行问卷调查。结果基层公共卫生人员心身障碍发生率为39.43%,其中最高为骨骼系统14.17%,其次为神经系统12.73%;呼吸系统、心血管系统、焦虑、抑郁、精神病性5项因子评分小于全国常模;运用二分类Logistic逐步回归分析显示,从事本行业年限的增加是引起眼和耳疾病的危险性因素（OR=1.067）,职务的增高是导致心血管系统（OR=1.878）、消化系统（OR=1.675）、精神病性（OR=1.841）疾患的危险性因素;核心家庭（OR=0.136）、扩展家庭（OR=0.143）是降低抑郁发生的保护性因素。结论相关部门应采取综合措施,从工作和家庭环境等方面入手,提高基层公共卫生人员的心身健康水平。     

EB病毒在结外NK/T细胞淋巴瘤中的预后价值：一项淮海淋巴瘤协作组的多中心回顾性研究

目的 基于倾向性评分逆处理概率加权(IPTW)法评估EB病毒(EBV)在结外NK/T细胞淋巴瘤患者中的预后价值。方法 收集2012年10月—2021年4月淮海淋巴瘤协作组中8家医疗机构初诊为结外NK/T细胞淋巴瘤且具有全血EBV-DNA数据的468例患者的临床资料。采用IPTW法分析EBV载量对结外NK/T细胞淋巴瘤患者生存期的影响;采用Cox比例风险模型进行多因素分析;绘制Kaplan-Meier曲线,组间比较采用Log rank χ²检验。结果 468例结外NK/T细胞淋巴瘤患者中,EBV-DNA阳性266例,EBV-DNA阴性202例。EBV-DNA阳性组和阴性组患者的5年OS分别为62.5%和89.2%,两组比较,经Log rank χ²检验,差异有统计学意义(χ²=42.900,P=0.000)。IPTW前,两组的美国东部肿瘤协作组(ECOG)活动状态(PS)评分(ECOG PS评分)、原发部位、CA分期、Ann Arbor分期、白蛋白、乳酸脱氢酶、治疗方案比较,差异均有统计学意义(P<0.05)。IPT...     

Inhibitory effect and mechanism of chuanxiongzine on multiplication of VSMC

Objective: To study the inhibitory effect of chuanxiongzine on vascular smooth muscle cell (VSMC) proliferation and explore its molecular biology basis. Methods: we selected the VSMC cultured 4～8 generation from rat aorta thoracalis as research object.The objects were divided into four groups( Ⅰ )control group, ( Ⅱ )chuanxiongzine(50 μg/ml)group, ( Ⅲ )chuanxiongzine (100 μg/ml) group and( Ⅳ ) chuanxiongzine (200 μg/ml) group. The inhib itory effect of chuanxiongzine on VSMC proliferation was investigated by cell counting, MTT and 3H-TdR incorporation assay. In order to illuminate the molecular biology mechanism of chuanxiongzine inhibiting VSMCs proliferation, the expression of proliferating cell nuclear antigen (PCNA) and C-myc were detected.Results: Chuanxiongzine could inhibit the proliferation of VSMC significantly in a dose- and time-dependent manner, compared with control group (P ＜ 0.05). The expression of PCNA and c-myc were inhibited obviously and correlated with the concentration of chuanxiongzine (P ＜ 0.05). Conclusion: Chuanxiongzine may play a considerable role in VSMC proliferation process. The inhibitory effect of chuanxiongzine in a dose- and time-dependent manner can be realized via down regulating the expression of PCNA and c-myc. In this study, The great theoretical fundament about Chinese medicine, which is used to treat atherosclerosis (AS), has been obtained.     

232例糖尿病患者对糖尿病与牙周病关系的认知、态度及保健行为

目的 了解糖尿病患者对糖尿病与牙周病相互作用的认知、态度及保健行为的现状,探讨并分析其影响因素,为糖尿病患者的口腔与全身健康治疗方案及口腔健康宣教计划制订提供依据。方法 2021年4—5月采用便利抽样方法,对济宁市内三级甲等医院和二级甲等医院各两家的内分泌科病房和门诊的糖尿病患者进行调查,共获得232份有效问卷。内容包括糖尿病患者的一般情况、保健行为、对糖尿病与牙周病相互作用的认知情况、对糖尿病并发牙周病的治疗态度及其影响因素。结果 232名糖尿病患者对糖尿病与牙周病的相互作用的认知、治疗态度和保健行为的总得分为(39.42±18.23)分,小学及以下学历者平均得分最低为(28.69±12.04)分,年龄≥60岁者平均得分最低为(34.10±16.27)分;单因素分析显示,糖尿病患者保健行为、认知、治疗态度得分在不同婚姻状况、年龄、文化程度等方面,差异有统计学意义(P<0.05);Pearson线性相关性分析显示,糖尿病患者的认知与保健行为、认知与治疗态度、治疗态度与保健行为的得分呈正相关;多重线性回归分析显示,年龄、家庭人均月收入、文化程度、有牙周病和无牙周病进入模型(P<0.01),共解释总变异的36.6%。结论 本次调查中,糖尿病患者对糖尿病与牙周病的相互作用的认知、治疗态度和保健行为三者之间相互影响,不同特征的糖尿病患者得分水平不同,年龄、文化程度和家庭人均月收入等因素是影响其得分的主要因素,应加强对高龄糖尿病患者的关注,积极对糖尿病患者开展口腔预防保健工作。     

TGF-β1、Smads在子宫内膜异位症中的表达和意义

目的通过比较卵巢子宫内膜异位囊肿(巧克力囊肿)患者异位囊壁、子宫在位内膜和其他卵巢良性肿瘤患者子宫内膜的组织学特点及分子生物学特征,探究TGF-β1、Smads在子宫内膜异位症(EMs)患者的表达和意义。方法募集行腹腔镜或宫腹腔镜联合术的巧克力囊肿患者,取其卵巢异位症囊壁组织作为卵巢异位症囊壁组,留取其子宫内膜组织作为子宫在位内膜组;同期行宫腹腔镜联合术的其它卵巢良性肿瘤患者,取其子宫内膜组织作为子宫内膜对照组。采用Masson染色、免疫组织化学法分别检测三种组织中纤维化形成和TGF-β1、Smads的表达情况。结果(1)Masson染色显示,卵巢异位症囊壁组可见大量的纤维化沉积,子宫在位内膜组、子宫内膜对照组均未见明显纤维化蓝染。(2)卵巢异位症囊壁组TGF-β1、p-Smad2/3表达水平分别为(0.039±0.024)和(0.035±0.014)均高于子宫内膜对照组(0.018±0.012和0.023±0.004),差异有统计学意义(P<0.05);子宫在位内膜组p-Smad2/3表达水平(0.034±0.011)高于子宫内膜对照组(0.023±0.004)(P<0.05);卵巢异位症囊壁组Smad7的表达水平(0.006±0.003)低于子宫在位内膜组(0.019±0.011)和子宫内膜对照组(0.041±0.023),差异有统计学意义(P<0.01);子宫在位内膜组Smad7的表达含量较子宫内膜对照组低(P<0.01)。结论TGF-β1、p-Smad2/3在子宫内膜异位症中存在高表达,可能通过促进纤维母细胞增生、胶原蛋白的沉积导致异位病灶纤维化的形成,而Smad7作为抑制因子,在EMs中表达降低,对Smads介导的TGF-β1致纤维化的抑制作用减弱,也促使了子宫内膜异位症纤维化的进展。