Dysregulation of microRNA-106a-5p-RUNX1 axis associates with clinical progression and prognosis of osteosarcoma patients

MicroRNA-106a-5p (miR-106a-5p) functions as a tumor suppressor in osteosarcoma cells. Here, we aimed to identify novel target genes of miR-106a-5p in osteosarcoma, as well as to investigate their prognostic value and the biological functions. At first, the mammalian runt-related factor 1 (RUNX1) was identified as one of the target genes of miR-106a-5p in osteosarcoma cells by luciferase reporter gene assay, real-time quantitative RT-PCR and Western blot analysis. Then, the expression levels of miR-106a-5p and RUNX1 in osteosarcoma tissues were detected, and their associations with clinicopathological features and patients' prognosis were statistically analyzed. Compared with adjacent non-cancerous tissues, miR-106a-5p and RUNX1 mRNA/protein expression in osteosarcoma tissues were significantly decreased and increased, respectively (all P < 0.01). Low miR-106a-5p, high RUNX1 and miR-106a-5p-low/RUNX1-high expression in osteosarcoma tissues were all significantly associated with advanced Enneking stage, positive metastasis and shorter overall survival (all P < 0.05). Moreover, miR-106a-5p and RUNX1 expression, alone or in combination, were identified as independent prognostic factors for osteosarcoma patients' overall survival. Functionally, the enforced expression of miR-106a-5p significantly suppressed proliferation and invasion of osteosarcoma cells, while the overexpression of RUNX1 effectively reversed its suppressive roles. In conclusion, our findings show the dysregulation of miR-106a-5p-RUNX1 axis in human osteosarcoma tissues and suggest its crucial roles in cancer progression and patients' prognosis. More interestingly, miR-106a-5p may function as a tumor suppressor in osteosarcoma cells via regulating its target gene RUNX1.     

信息技术基础架构库服务管理系统在专科医院的应用

概述了信息技术基础架构库(ITIL)的基本情况,从运维管理、事件管理、任务管理、问题管理等方面介绍了ITIL服务管理流程及其在北京妇产医院的应用,并对应用效果进行了评述,对存在的问题提出了建议。     

北京市新农合大病保险实施效果分析与评价

目的:测算分析北京市新农合大病保险对患者疾病经济负担的减轻作用,对制度实施效果进行评价。方法:按照经济发展水平和大病保险承办方式选取北京市三个区县,再从中选择大病患者较多的2~3个乡镇。通过与大病保险管理者进行访谈,了解其运行现状;对样本乡镇全部大病患者进行问卷调查了解患者主观感受,收到有效问卷497份。利用新农合管理中心信息平台测算患者疾病经济负担。对定量和定性资料分别采用统计分析与主题框架法进行分析。结果:经大病保险报销,三个区县大病患者平均自付费用明显减轻,实际补偿比均有不同程度的提高,但灾难性卫生支出情况无显著改善。结论:应通过提高大病保险起付线与报销比例,拓宽报销目录等举措提高其补偿水平,重点缓解极重患者疾病经济负担。     

急性冠状动脉综合征患者失眠现况及影响因素分析

目的了解急性冠状动脉综合征(ACS)患者失眠现况,分析导致ACS患者失眠的影响因素,为制定针对ACS患者的失眠策略提供依据。方法本研究为一项多中心、前瞻性、观察性队列研究。筛选纳入2013年3月至2015年6月符合标准的ACS住院患者771例,入院7d内病情稳定后完成基线社会人口信息学资料、睡眠质量问卷、广泛性焦虑量表(GAD7)、患者健康问卷9项(PHQ9)、生活质量量表12(SF12)以及社会支持调查量表(ESSI),采用logistic回归分析影响ACS患者失眠的因素。结果共收回741例患者的有效问卷,741例患者中男510例(68.8%),女231例(31.2%)。487例(65.7%)存在至少一种失眠症状,其中308例(41.6%)存在入睡困难,369例(49.8%)存在夜间易醒,116例(15.7%)存在早醒,74例(10.0%)同时存在早醒和入睡困难,53例(7.2%)同时存在早醒、夜间易醒和入睡困难。Logistic回归分析显示,入院前体力活动情况(OR=0.636,95%CI 0.411~0.984)、抑郁(OR=1.908,95%CI 1.101~3.305)和低社会支持(OR=0.278,95%CI 1.198~3.301)是ACS患者存在失眠的独立影响因素。结论接近2/3的ACS患者存在失眠症状,入睡困难和夜间易醒是最常见的表现;体力活动情况、抑郁和社会支持与发生失眠独立相关。     

Quantitative Metabolomics Reveals Heart Failure With Midrange Ejection Fraction as a Distinct Phenotype of Heart Failure

BackgroundHeart failure with midrange ejection fraction (HFmrEF) has been recently acknowledged as a separate phenotype, but metabolomics evaluation of this subtype remains largely unexamined.MethodsA quantitative metabolomics study on amino acids and acylcarnitines was performed to characterize different states of heart failure (HF) in 628 participants. Both multivariate orthogonal partial least squares- discriminant analysis and univariate Mann-Whitney U test were used to explore reliable metabolic profiles associated with different HF states. The resulting metabolites were further refined to obtain diagnostic metabolite scores (DMSs) with the use of ordinal logistic regression. Lasso-penalized regression was applied to produce a survival-associated prognostic metabolite score (PMS). The Cox proportional hazards model, Kaplan-Meier curves, and time-dependent receiver operating characteristics were used for a comprehensive assessment of prognostic value using PMS versus traditional clinical biomarkers.ResultsThe optimized models identified a panel of 15 differential metabolites that were shared across different HF states, whereas some metabolites were associated with a specific state. PMS consisting of 9 metabolites demonstrated an appreciably better prognostic value (hazard ratio [HR] 1.62, 95% confidence interval [CI] 1.25-2.1) vs the natural logarithm of N-terminal pro–B-type natriuretic peptide (Ln[NT-proBNP]; HR 1.23, 95% CI 0.94-1.61; P < 0.001). The overall area under the receiver operating characteristic curve value of PMS was superior to that of Ln(NT-proBNP) in risk prediction for patients with HFmrEF and HF with reduced ejection fraction (HFrEF) subtypes (P < 0.001).ConclusionsTargeted metabolomics has provided a novel understanding of the molecular mechanism underlying HF. Both DMS and PMS clearly demonstrated HFmrEF as a distinct phenotype between a mild HF with preserved ejection fraction state and a severe HFrEF state. PMS exhibited superior prognostic value than Ln(NT-proBNP). Further investigation is needed with independent large-scale validation.     

羊膜腔灌注对足月孤立羊水过少产妇分娩结局的影响

 目的 探究羊膜腔灌注对足月孤立羊水过少产妇分娩结局的影响。方法 本研究为回顾性研究,选择2017-01至2019-01北京妇产医院产科93例足月孤立羊水过少经腹羊膜腔灌注后引产患者作为灌注组,取同期135例足月孤立羊水过少产妇未接受羊膜腔灌注而直接引产为对照组,比较两组分娩结局。结果 灌注组与对照组一般情况如年龄、孕次、产次、分娩孕周及羊水指数等方面比较,差异无统计学意义(均P>0.05)。灌注组中14例中转剖宫产手术, 剖宫产率15.0%;对照组中40例中转剖宫产,剖宫产率29.6%,灌注组剖宫产率低于对照组,差异有统计学意义(P<0.01)。灌注组与对照组比较,产后出血量[(352.58±163.05)ml vs. (353.78±99.09)ml]、胎儿窘迫发生率(25.8% vs. 34.1%)、羊水Ⅲ度粪染发生率(19.4% vs. 24.4%)、新生儿窒息率(1.1% vs. 4.4%)均无统计学差异。结论 羊膜腔灌注可降低足月羊水过少产妇剖宫产率,不增加并发症发生率,提高产科质量。     

一例速发型肝素诱导的血小板减少症患者的病例分析

1例62岁女性患者因下肢动脉栓塞收入院,入院第7天行手术,术后给予肝素钠微量泵泵入抗凝,尿激酶微量泵泵入溶栓,继续降脂、保肝、抗贫血治疗。启动肝素用药24 h内血小板计数从330×10^9/L下降至82×10^9/L,最低值为48×10^9/L。停用肝素后给予阿加曲班替代抗凝治疗,患者血小板计数3 d后升高至正常范围。根据APTT水平调整阿加曲班注射液泵速,持续泵入。下肢动脉栓塞病情加重未缓解。患者行截肢手术,术后使用阿司匹林抗血小板,利伐沙班维持抗凝治疗。患者病情稳定,8 d后出院。     

平滑肌电刺激对重度盆腔子宫内膜异位症术后肠功能恢复的疗效

 目的 观察平滑肌电刺激对促进重度盆腔子宫内膜异位症术后肠道功能恢复的疗效。方法 选择重度盆腔子宫内膜异位症术后患者150例,分为观察组及对照组各75例。2组患者均记录肠粘连的程度及部位,并于术后24 h开始腰腹部皮肤仿生物电刺激,观察组选择平滑肌电刺激模式,对照组使用传统横纹肌电刺激模式。对比两组患者术后规律肠鸣音出现、排气、排便、耐受普食的时间及腹胀情况。结果 观察组术后出现规律肠鸣音的时间、首次排气时间及首次耐受普食无不适的时间均早于对照组(P＜0.05),观察组腹胀持续时间短于对照组(P＜0.05)。所有患者均未出现肠梗阻、电刺激不良反应及出血等不良事件。结论 平滑肌电刺激对重度盆腔子宫内膜异位症患者术后肠道功能恢复治疗效果优于横纹肌电刺激模式。