Varian 23EX医用直线加速器故障分析与维修

本文介绍了Varian 23EX直线加速器的2例故障,分析了故障产生的原因,维修思路及处理方法。     

胰腺神经内分泌癌合并皮肌炎一例

神经内分泌肿瘤(neuroendocrine neoplasms,NENs)是来源于具有神经内分泌标志物的细胞且可以产生生物活性物质和/或多肽类激素的一类肿瘤,其中神经内分泌癌(neuroendocrine carcinoma,NEC)是病理分级为高级别的一种NENs。有报道称,皮肌炎(dermaomyositis,DM)与恶性肿瘤的发生具有相关性,但合并胰腺癌较为少见,合并胰腺NEC的更是鲜有报道,我科收治了一例胰腺NEC合并皮肌炎的患者,明确诊断后给予抗肿瘤治疗,二者均好转,本文旨在讨论胰腺NEC的诊治经过以及皮肌炎与恶性肿瘤发生的内在联系,为临床提供借鉴。     

Relation of genetic polymorphisms in microRNAs with diastolic and systolic function in type 2 diabetes mellitus

Background and aimsType 2 diabetes mellitus (T2DM) has high risk of developing cardiac dysfunction, increasing of either cardiovascular death or hospitalization for heart failure. MicroRNAs (miRNA) affect cardiac function of T2DM. The aim of this study was to investigate the relationships between five miRNA single nucleotide polymorphisms (SNP) and diastolic and systolic function of T2DM.Methods and resultsThree hundred untreated T2DM subjects were included. Each subject underwent SNP genotyping, conventional echocardiography, tissue doppler imaging, and speckle tracking imaging. The effects of miRNA SNPs on diastolic and systolic function were evaluated. The diastolic function of T2DM subjects with miR-133a-1-rs8089787 wild genotype or let-7f-rs10877887 variant genotype was lower than those with miR-133a-1-rs8089787 variant genotype or let-7f-rs10877887 wild genotype, manifesting as higher left atrial volume index, lower mean E′, and higher E/E’ (P < 0.05). There were no significant effects of miR-133a-2-rs13040413, let-7a-1-rs13293512 and miR-27a-rs895819 on the diastolic function of T2DM subjects (P > 0.05). These five miRNA SNPs had no effect on the systolic function of T2DM subjects (P > 0.05).ConclusionsMiRNA-133a-1-rs8089787 and let-7f-rs10877887 were associated with impaired cardiac diastolic function in T2DM. The findings may be a promising therapeutic targets for preventing diastolic dysfunction in T2DM.     

Individual and combined relationship of serum uric acid and alanine aminotransferase on metabolic syndrome in adults in Qingdao,China

Background and aimsAssociations of alanine aminotransferase (ALT) and serum uric acid (SUA) with metabolic syndrome (MetS) remain controversial. We aimed to explore individual and combined effects of ALT and SUA on MetS in community residents.Methods and resultsA population-based cross-sectional survey involving randomly selected Chinese adults aged 35–74 years was conducted in 2009 in Qingdao, China, and 4642 participants were included in the current study. Based on a combination of SUA and ALT levels in the tertile, subjects were grouped into Group 1-9. The individual and combined relations of SUA and ALT to MetS were analyzed by logistic regression models. The prevalence of MetS was 28.50% in males and 22.30% in females. ALT and SUA were independently associated with MetS and ORs (95% CIs) were 1.55 (1.42–1.70) and 1.92 (1.72–2.14), respectively, after adjusting for potential confounders. With the elevation of ALT and SUA levels, the risk of developing MetS increased. Compared to Group 1, ORs (95% CIs) of combined ALT and SUA for MetS were 2.21 (1.70–2.88), 4.02 (3.10–5.21), 2.19 (1.62–2.97), 2.53 (1.91–3.34), 4.69 (3.60–6.12), 1.76 (1.17–2.64), 3.65 (2.63–5.06) and 7.15 (5.41–9.46) in Group 2–9, respectively.ConclusionsALT and SUA were both related to MetS independently. Combined elevation of ALT and SUA levels could increase the risk of MetS and its components than an elevation in SUA and ALT alone. Therefore, measures should be taken to lower SUA and ALT levels to reduce the risk of having MetS.     

The risk of ischemic stroke in patients with idiopathic inflammatory myopathies: a systematic review and meta-analysis

Clinical Rheumatology - Idiopathic inflammatory myopathies (IIM) are a group of chronic rheumatic diseases that can affect multiple systems; the risk of ischemic stroke in patients with IIM remains...     

Laparoscopic versus open pancreatoduodenectomy: an individual participant data meta-analysis of randomized controlled trials

BackgroundRandomized trials have compared laparoscopic pancreatoduodenectomy (LPD) to open pancreatoduodenectomy (OPD) with conflicting results. An IPDMA may give more insight into the differences between LPD and OPD, and could identify high-risk subgroups.MethodsA systematic literature search was performed in the Pubmed, Embase, and the Cochrane library databases (October 2019). Out of 1410 studies, three randomized trials were identified. Primary outcome was major complications (Clavien-Dindo grade ≥ III). Subgroup analyses were performed for high-risk subgroups including patients with BMI of ≥25 kg/m2, pancreatic duct <3 mm, age ≥70 years, and malignancy.ResultsData from 224 patients were collected. After LPD, major complications occurred in 33/114 (29%) patients compared to 34/110 (31%) patients after OPD (adjusted odds ratio (OR) 0.62; 95% confidence interval (CI) 0.3–1.4, P = 0.257). No differences were seen for major complications and 90-day mortality LPD 8 (7%) vs OPD 4 (4%) (adjusted OR 0.2; 95% CI 0.02–1.3, P = 0.080). With LPD, operative time was longer (420 vs 318 min, p < 0.001) and hospital stay was shorter (mean difference ?6.97 days). Outcomes remained stable in the high-risk subgroups.ConclusionLPD did not reduce the rate of major postoperative complications as compared to OPD. LPD increased operative time and shortened hospital stay with 7 days.     

冠心宁注射液安全药理学研究

目的 观察冠心宁注射液对中枢神经系统、心血管系统和呼吸系统的影响,为临床用药提供参考。方法 采用遥测技术,研究冠心宁注射液对清醒Beagle犬血压和心电的影响;采用全身体积描记系统,研究冠心宁注射液对SD大鼠呼吸系统的影响;采用小鼠自主活动、协调运动和阈下剂量戊巴比妥钠催眠试验,研究冠心宁注射液对中枢神经系统的影响。结果 遥测试验结果显示,与溶媒对照组比较,注射用冠心宁1、2、4 mL·kg^-1三个剂量组Beagle犬给药后30 min内心率减慢,血压下降,30 min后逐渐恢复,其他心电指标无明显变化。大鼠呼吸试验结果显示,与溶媒对照组比较,冠心宁注射液4、8、16 mL·kg^-1剂量组大鼠呼吸频率、潮气量和每分通气量无明显差异。小鼠中枢神经系统试验结果显示,与溶媒对照组比较,冠心宁注射液5、10、20 mL·kg^-1剂量组小鼠药后15 min和30 min自主活动次数降低;而协调运动等级和睡眠率无明显差异。结论 冠心宁注射液可短暂降低动物血压和心率,抑制自主活动,对呼吸系统无明显影响。     

糖尿病足溃疡病原菌分布及耐药性分析

目的分析糖尿病足溃疡病原菌分布及耐药性。方法选择2015年12月-2019年1月于青岛大学医学院附属威海医院/威海市立第二医院治疗的糖尿病足溃疡患者200例,对溃疡部位的分泌物进行分离,测定其菌株及耐药性。结果 200例患者中培养出病原菌株的患者180例,培养出菌株215株,其中革兰阳性球菌120株,革兰阴性杆菌76株,真菌19株;对培养出的菌株进行耐药性分析,革兰阳性球菌及革兰阴性杆菌对头孢类抗菌药物、阿莫西林、四环素等有一定耐药性,对莫西沙星、庆大霉素的敏感性较好。结论糖尿病足溃疡病原菌以革兰阳性球菌为主,且具有一定的耐药性,临床应配合耐药性监测结果选择抗生素治疗。     

白藜芦醇对人结肠癌细胞上皮间质转化的抑制作用

目的观察白藜芦醇(Resveratrol,Res)对人结肠癌细胞HCT-8上皮间-质转化(EMT)的影响,初步探讨其可能存在的机制。方法取对数生长期的人结肠癌HCT-8细胞,采用不同浓度的白藜芦醇(0、40、80、120μmol/L)对细胞分别进行干预24、48、72 h;MTT法检测不同时间Res对HCT-8细胞增殖活性的影响;细胞黏附试验检测Res对HCT-8细胞黏附能力的影响;Transwell小室试验检测Res对HCT-8细胞迁移和侵袭能力的影响;进一步采用蛋白免疫印迹法和qRT-PCR分别检测Res对HCT-8细胞中蛋白激酶B(AKT)、磷酸化蛋白激酶B(P-AKT)、E-钙黏蛋白(E-cadherin)、N-钙黏蛋白(N-cadherin)、波形蛋白(Vimentin)和mRNA表达的影响。结果 Res(浓度为40、80、120μmol/L)在干预后24、48、72 h均可以明显抑制HCT-8细胞的增殖活性(P<0.05)。与空白对照组相比,细胞的同种黏附能力增强,异种黏附能力降低,差异有统计学意义(P<0.05)。与空白对照组相比,Res 120μmol/L对细胞迁移和侵袭能力均具有明显的抑制作用(P<0.05),Res 120μmol/L作用HCT-8细胞48 h后,HCT-8细胞中上皮间质标志性蛋白E-钙黏蛋白(E-cadherin)和mRNA的相对表达量增加(P<0.05),而AKT蛋白的表达无明显变化(P>0.05),P-AKT蛋白的表达明显减少(P<0.05);N-钙黏蛋白(N-cadherin)、波形蛋白(Vimentin)和mRNA的相对表达量显著减少,差异有统计学意义(P<0.05)。结论白藜芦醇通过调控细胞EMT抑制人结肠癌HCT-8细胞的迁移和侵袭能力,其作用机制可能受PI3K/AKT信号通路的调控。