单孔与单操作孔胸腔镜肺癌根治术治疗早期肺癌的疗效对比

目的对比分析单孔与单操作孔胸腔镜肺癌根治术治疗早期肺癌的临床效果。方法回顾性分析我院162例行胸腔镜肺癌根治术患者的临床资料,根据手术方式的不同分为单孔组(n=97)和单操作孔组(n=65)。单孔组患者行单孔胸腔镜肺癌根治术,单操作孔组患者行单操作孔胸腔镜肺癌根治术。比较2组患者的围术期指标、术后疼痛情况、手术前后肺功能及术后并发症发生情况。结果2组患者在术中出血量、手术时间、淋巴结清扫数量、术后并发症发生率方面比较差异无统计学意义(P>0.05);单孔组胸腔引流管留置时间、下地时间、住院时间短于单操作孔组(P<0.05),引流量少于单操作孔组(P<0.05);单孔组术后第1天、第3天视觉模拟量表(VAS)评分低于单操作孔组(P<0.05);术后6个月,单孔组最大通气量(MVV)、第1秒用力呼气量(FEV₁)高于单操作孔组(P<0.05)。结论在早期肺癌治疗中,采用单孔和单操作孔胸腔镜肺癌根治术均可获得较好的效果,但单孔胸腔镜肺癌根治术在缓解患者术后疼痛、促进术后恢复方面更有优势。     

师生不同视角下危重症护理硕士专业学位研究生学习方法研究

目的基于导师与研究生不同视角,探讨危重症护理硕士专业学位研究生的最佳学习方法,为研究生的教与学工作提供依据。方法经过查阅文献、相关规范文件,在“危重症护理硕士专业学位研究生学习内容专家函询问卷”基础上,拟定“危重症护理硕士专业学位研究生学习方法”调查问卷,采用方便抽样法选取120名危重症护理硕士专业学位研究生导师、121名危重症护理硕士专业学位研究生作答此问卷,比较导师与研究生不同视角下的最佳学习方法。结果(1)导师建议的学习方法包括自学(18.2%)、课堂讲授(15.1%)、临床查房(13.5%)等;研究生选择的学习方法包括课堂讲授(20.3%)、临床查房(16.7%)、新媒体(13.7%)等。(2)师生在公共理论、科研方法等学习内容对应的学习方法的选择差异明显(P<0.05)。结论无论对于导师还是危重症护理硕士专业学位研究生,教与学的方法多样且存在差异。导师应根据具体学习内容灵活选择教的方法,特别是新媒体技术的应用,并创新课堂讲授形式,开展“对话式”教学,注重引导学生提高自学能力;学生则应根据具体学习内容灵活选择多种学的方法,注重提高自主学习的能力。     

自体颅骨修补术后影响骨瓣吸收的危险因素分析

目的探讨影响自体颅骨修补术后骨吸收的危险因素。方法回顾性分析2001年1月至2012年12月期间经临沂市人民医院神经外科行自体颅骨修补的患者178例,含201块自体骨瓣,根据术后CT特点对骨吸收进行分级,探讨各危险因素与骨吸收分级之间的关系。结果骨吸收分级在性别、修补时间和骨瓣面积间的差异无意义(P0.05),患者平均年龄随骨吸收分级上升呈下降趋势,但骨吸收各分级间的平均年龄之间差异无意义(P0.05)。骨吸收分级与缺损位置有关(P0.05),重度骨吸收多发生于额颞部和颞部。伴有骨折的骨瓣重度骨吸收发生率高于骨瓣完整者(P0.05)。伴发脑积水并行脑室-腹腔分流术的患者与未行脑室-腹腔分流术的患者相比,前者术后骨瓣塌陷的发生率高于后者(P0.05)。结论自体颅骨修补术后骨吸收分级与患者性别、年龄、修补时间和骨瓣面积无关。骨吸收分级与缺损位置有关,重度骨吸收多发生于额颞部和颞部。伴有骨折的骨瓣重度骨吸收发生率高于骨瓣完整者。伴发脑积水并行脑室-腹腔分流术后容易发生骨瓣塌陷。     

Protective effect of two new nanovaccines against Pseudomonas aeruginosa based on LPS and OPS: A comparison study

Pseudomonas aeruginosa is one of the most important infectious pathogens in medicine. This bacterium causes various infections, especially in patients with severe burns and people with defective immune systems. The purpose of this study was to develop a nanovaccine based on PLGA nanoparticles and lipopolysaccharide and oligopolysaccharide antigens for appropriate stimulation of the humoral and cellular immune systems against P. aeruginosa. LPS-PLGA and OPS-PLGA conjugates were synthesized using the carbodiimide reaction. The prepared conjugates of as well as the pure antigens of LPS and OPS were injected to BALB/c mice in three periods at 2 week intervals. The ELISA test showed that the IgM, IgA, IgG, IgG1, IgG2b, IgG2a and IgG3 antibodies produced against LPS-PLGA or OPS-PLGA conjugates were tens of times higher than the pure antigens. Also, the opsonophagocytosis test showed that the performance and the effect of produced anti-LPS-PLGA antibodies were higher than other groups. In addition, the mice treated with LPS-PLGA conjugate were more resistant to P. aeruginosa infection than other groups. These findings indicated that LPS and OPS antigens in conjugation with PLGA nanoparticles have the ability to create and effective immunity against P. aeruginosa and LPS-PLGA is more effective than OPS-PLGA.     

Non-coding RNA network associated with obesity and rheumatoid arthritis

Obesity causes epigenetic alterations mediated by non-coding RNAs (ncRNAs) that increase susceptibility to autoimmune and inflammatory pathways. Obese individuals with rheumatoid arthritis (RA) are particularly affected, with worse clinical outcomes and treatment responses. In order to identify micro RNAs (miRNAs) and long ncRNAs (lncRNAs) that may influence RA development, progression, treatment efficacy, and clinical outcomes in obese individuals, we systematically screened PubMed, Web of Science, and Scopus databases for articles on these topics, published in the last decade. We ended up with 38 of initially 1110 documents and found that both obesity and RA share dysregulated expression of miR-21, miR-143, miR-146a, miR-155 miRNAs, H19, and HOTAIR lncRNAs (all but H19, up-regulated). With one exception (H19 and BMI in brown fat tissue), they correlated positively with clinical measures and disease activity. H19 and HOTAIR regulate 24 miRNAs, some differentially expressed in the investigated diseases. Both regulate miR-143-3p. We also investigated eleven GWAS-identified SNVs found in exonic lncRNA regions (there were none in exonic miRNA genes). Eight were associated with RA and three with obesity-related traits, seven change binding sites for miRNAs, especially on LINC01184 and GATA3-AS1, four were associated with gene expression in adipocytes (including LINC01184) and two may also change the secondary structure of ENSG00000284825 and LINC02656. These ncRNAs compose a unique regulatory network in obese RA patients, compiled for the first time in this review, which we suggest as future therapeutic targets in these simultaneous conditions.     

LTC4及其合成酶与咳嗽变异性哮喘气道重建的相关性研究

目的研究白三烯C4（LTC4）及其合成酶表达与咳嗽变异性哮喘（CVA）气道重建的相关性,探讨CVA的发病机制,为CVA的早期诊断提供理论依据。方法将40例入选患者分为支气管哮喘组、CVA组各20例,另择20例健康人作为对照组。采用ELISA技术检测静脉血中LTC4的含量;应用RT-PCR检测LTC4合成酶在多形核细胞和淋巴细胞中的表达。选择对照组6例、支气管哮喘组6例、CVA组12例分别进行纤维支气管镜检查,取右中叶支气管组织,进行常规石蜡切片,HE染色,光镜下观察并测量基底膜厚度。结果支气管哮喘组LTC4含量及基底膜厚度显著高于CVA组和对照组,CVA组高于对照组（P〈0.01或〈0.05）。各组基底膜厚度与静脉血LTC4含量之间存在相关性（P〈0.05）。LTC4合成酶在CVA组和支气管哮喘组患者中的表达明显高于对照组（P〈0.05）。LTC4合成酶在多形核细胞中表达相对较强,在淋巴细胞中表达相对较弱。结论 CVA存在气道重建,静脉血中LTC4及其合成酶的表达可以作为CVA的快速诊断的指标之一。     

红花注射液后处理对大鼠缺血再灌注心肌的保护作用探讨

目的对比观察中药红花注射液后处理对大鼠心肌缺血再灌注(I/R)损伤中基质金属蛋白酶-2(MMP-2)、组织金属蛋白酶抑制剂-2(TIMP-2)的mRNA表达水平及MMP-2/TIMP-2 mRNA比值的影响,初步探讨红花注射液后处理保护I/R损伤心肌的可能性及可能机制。方法建立大鼠在体心肌I/R损伤模型,以缺血(I)30m in再灌注(R)30m in为观察点,选取健康成年雄性SD大鼠50只,随机分为假手术组(S组)、单纯缺血组(I组)、I/R组、红花注射液低剂量组(L组)、红花注射液高剂量组(H组),每组10只。采用RT-PCR技术检测各组心肌组织中MMP-2、TIMP-2的mRNA表达水平。结果 I组和I/R组心肌组织中MMP-2 mRNA表达水平明显高于S组(P<0.05),而TIMP-2 mRNA表达水平则显著低于S组(P<0.05),MMP-2/TIMP-2 mRNA比值明显高于S组(P<0.05);且I/R组MMP-2 mRNA表达水平高于I组(P<0.05),TIMP-2 mRNA表达水平低于I组(P<0.05),MMP-2/TIMP-2比值高于I组(P<0.05)。L组及H组与I/R组相比,MMP-2 mRNA表达水平显著下降(P<0.05),而TIMP-2 mRNA表达水平则明显升高(P<0.05),MMP-2/TIMP-2 mRNA比值明显降低(P<0.05)。结论红花注射液后处理可改善I/R心肌的损伤程度,并可通过调节MMP-2/TIMP-2比值而保护I/R损伤的心肌组织。     

高灵敏度荧光光度法测定人血清中的磷脂

目的:探讨以稀土离子络合物作为荧光探针测定血清中的磷脂及荧光增强的机理。方法:在pH8.00的Tris-HCl缓冲溶液中,土霉素可以和铕离子生成二元络合物,从土霉素到铕离子发生能量转移,发射出铕离子位于612 nm处的特征荧光。加入磷脂后,磷脂同样可以把能量转移给铕离子。结果:铕离子位于612 nm处的特征荧光强度显著增强,且增强的荧光强度与加入磷脂的浓度成正比。在最佳实验条件下,测量的线性范围为4.00×10-7～1.00×10-5mol.L-1,检测限为2.60×10-7mol.L-1。平均回收率为98.2%～103.0%。结论:该方法操作简单,可以较好的避免共存物质的干扰,并被成功地应用于人血清样品中磷脂的测定。测量结果与临床上常用的以钼蓝为显色试剂的分光光度法相比,无显著性差异。