乳腺癌针吸细胞学诊断与病理组织学诊断对比分析

目的:探讨针吸细胞学诊断乳腺癌的准确性。方法:针吸细胞学检查乳腺癌306例,其检查结果与病理组织学检查结果对照。结果:306例中301例针吸细胞学诊断为乳腺癌与病理组织学诊断结果一致、3例针吸细胞学诊断为良性病变而病理组织学诊断为乳腺癌、2例细胞学诊断为乳腺癌而病理组织学诊断为良性病变,符合率为98.37%(301/306),假阴性0.98%(3/306),假阳性0.65%(2/306)。结论:本组资料显示针吸细胞学检查诊断乳腺癌的准确性较高,是乳腺癌的重要筛查和诊断方法。     

硅油取出联合外路显微手术治疗硅油填充眼视网膜脱离

目的:探讨同期行硅油取出联合外路显微手术治疗硅油填充眼视网膜脱离的适应证及临床效果。方法:回顾性系列病例研究。收集2014-07/2018-07间在我院眼科同期行硅油取出联合外路显微手术治疗的硅油填充眼视网膜脱离患者21例21眼的临床资料。分析视网膜脱离的原因、视网膜复位的效果、视力改善情况以及手术并发症等。结果:所有病例手术后随访4~12(平均5.48±1.53)mo;一次手术视网膜解剖复位19眼,手术成功率90%,其它2眼需再次行内路玻璃体切除联合硅油填充术;术后最佳矫正视力(BCVA)≥0.4者4眼,0.06~0.3者9眼,≤0.05者8眼,术后LogMAR视力(1.10±0.58)与术前(1.66±0.74)相比有差异(t=3.58,P<0.05)。术后发生黄斑前膜1眼,继发青光眼2眼,并发性白内障5眼,未见其他严重并发症发生。结论:对于增殖性玻璃体视网膜病变(PVR)≤C1、裂孔位于赤道及以前的硅油填充眼视网膜脱离可采用同期硅油取出联合外路显微手术治疗,具有操作方便、视网膜复位率高、并发症少等优点,同时可减少再次玻璃体切除术或硅油填充的机会。     

Smilax China L. Rhizome Extract Inhibits Nuclear Factor-κB and Induces Apoptosis in Ovarian Cancer Cells

Objective: To study the antitumor effects and associated mechanisms of extract of the Smilax china L. rhizome (SCR) on ovarian cancer cells. Methods: Ovarian cancer cells A2780 were treated with different concentrations of SCR extract (SCRE), and compared with controls. Effects on cell growth were evaluated by cell counting kit-8 (CCK-8) assay; proliferation effects by EdU incorporation assay; cell cycle by propidium iodide staining; apoptosis by annexin V-fluorescein isothiocyanate/propidium iodide; cellular distribution of nuclear factor-κB (NF-κB) by immunofluorescence; protein levels of NF-κB, caspase-3, poly-adenosine diphosphate (ADP)-ribose polymerase (PARP), Bcl-2-associated X protein (Bax), cellular inhibitor of apoptosis (cIAP)-1, anti-X-linked inhibitor of apoptosis protein (XIAP), B-cell lymphoma-extra large (Bcl-XL), B-cell lymphoma-2 (Bcl-2) and AKT by Western blotting; and effects of SCRE combined with cisplatin or adriamycin on A2780 cells by CCK-8 assay. Results: SCRE suppressed A2780 cell proliferation in a dose-dependent manner (P<0.05, P<0.01), arrested cells in G2/M phase and induced apoptosis by activating caspase-3, PARP and Bax. SCRE treatment also correlated with inhibition of NF-κB and downregulation of Bcl-2, Bcl-XL, cIAP-1, XIAP and AKT. SCRE can promote chemosensitivity to cisplatin and adriamycin in A2780 cells (P<0.01). Conclusion: SCR effectively inhibits NF-κB, induces apoptosis and reduces chemoresistance to cisplatin and adriamycin in ovarian cancer cells, which might be its molecular basis for treating ovarian cancer.     

甲状腺癌131Ⅰ治疗对肝肾功能及白细胞影响

目的:观察分化型甲状腺癌患者131I治疗后6个月肝肾功能及白细胞变化。方法:分析分化型甲状腺癌患者131I治疗前及治疗后6个月的肝肾功能及白细胞计数的资料变化。肝功能以ALT、AST水平进行评价,两者均正常则认为肝功能正常,两者任一异常认为肝功能受损,将治疗前后进行配对两组二分类资料Mc-Nemar检验。肾功能取血尿素氮、血肌酐水平,进行配对两组二分类资料McNemar检验。结果:40例患者行72次131 I治疗,平均累计接受(7.86±5.67)GBq剂量。治疗前后6个月,患者治疗1次或多次白细胞计数比较差异无统计学意义;肝功能出现受损的几率无统计学差异,ALT及AST均无明显差异;所有患者治疗前肾功能均正常,经过单次或多次治疗均无一例肾功能异常。结论:甲状腺癌患者大剂量131I治疗后6个月未发现骨髓抑制及肝肾功能不良。     

罗格列酮对腹膜透析患者微炎症反应状态的影响

探讨罗格列酮治疗对腹膜透析患者微炎症状态的影响。方法：收集我院持续性腹膜透析患者50例,随机分为两组,治疗组患者给予常规腹膜透析及罗格列酮4mg·d^-1,对照组常规腹膜透析治疗,两组均治疗12周。观察两组患者治疗前后空腹血糖（FBG）、糖化血红蛋白、血红蛋白、血清总胆固醇、高密度脂蛋白胆固醇（HDL—C）、低密度脂蛋白胆固醇、三酰甘油、高敏C反应蛋白（hs．CRP）,肿瘤坏死因子α（TNF-α）、白细胞介素6（IL-6）、胰岛素抵抗指数（HOMA—JR）等指标变化。结果：治疗12周后,两组患者血FPG、HOMA—IR、hs．CRP、TNF-α、IL-6水平均有明显下降,HDL—C水平有明显升高,且与对照组比较差异具有统计学意义（P〈O．05）。结论：罗格列酮可改善腹膜透析患者微炎症反应状态及胰岛素抵抗,纠正脂代谢紊乱。     

Total glucosides of paeony for the treatment of rheumatoid arthritis: A methodological and reporting quality evaluation of systematic reviews and meta-analyses

ObjectiveTo assess the methodological, reporting and evidence quality of systematic reviews and meta-analyses of total glucosides of paeony (TGP) for rheumatoid arthritis (RA).MethodsWe comprehensively searched the literature in numerous databases from inception to July 29th, 2020. Two appraisers collected data and assessed the methodological and reporting quality of the included reviews by revised A MeaSurement Tool to Assess systematic Reviews (AMSTAR-2) tool and the Preferred Reporting Items for Systematic reviews and Meta-analyses (PRISMA), respectively. The level of evidence quality was evaluated by employing the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) scale.ResultsEleven relevant articles were collected. The results from AMSTAR-2 showed that the methodological quality of all included reviews was critically low; no authors met the standard of those critical domains (0%), particularly in item 2, item 4 and item 7. The PRISMA scores ranged from 16.5 to 25, and one meta-analysis almost conformed to the PRISMA structure. According to GRADE, the 11 studies included 59 outcomes: 27 had very low quality, 22 had low quality, 10 had moderate quality, and none had high quality evidence. The most prominent downgrading factors were risk of bias, followed by publication bias, inconsistency, imprecision, and indirectness.ConclusionsAlthough included studies summarized that TGP was effective and safe in the treatment of RA, the methodological and reporting quality and the quality of evidence was poor overall; decision-makers should be prudent when using TGP in treating RA patients. High-quality and multicenter studies investigating TGP for RA are urgently needed.     

经胸超声心动图声学造影与经颅多普勒超声声学造影同步试验对卵圆孔未闭的诊断价值

目的:探讨经胸超声心动图声学造影(cTTE)与经颅多普勒超声声学造影(cTCD)同步试验对卵圆孔未闭(PFO)的诊断价值。方法:选取我院疑似PFO患者769例,其中在静息和Valsalva动作下行cTTE 298例、cTTE与cTCD同步试验471例。以经食道超声心动图(TEE)为PFO的诊断标准,分析cTTE与cTCD同步试验对PFO的诊断价值。结果:共纳入769例患者,其中Valsalva动作下PFO阳性263例(34.2%)。298例患者行cTTE检查,静息时PFO阳性30例(10.1%),Valsalva动作下PFO阳性104例(34.9%),Valsalva动作下PFO阳性率较静息时显著提高(P<0.05)。471例患者行cTTE与cTCD同步试验,静息时PFO阳性50例(10.6%),Valsalva动作下PFO阳性159例(33.7%),Valsalva动作下PFO阳性率较静息时显著提高(P<0.05)。以TEE为PFO确诊标准,Valsalva动作下cTTE诊断PFO的准确性为87.5%(40/44),cTTE与cTCD同步实验诊断PFO的准确性为95.2%(40/42)。结论:cTTE与cTCD同步试验能提高PFO的诊断价值,尤其是Valsalva动作下PFO阳性率明显提高;cTTE与cTCD同步试验较cTTE诊断准确性提高。     

腺苷预适应对心脏的保护效应及机制探讨

目的探讨腺苷预适应对心肌缺血/再灌注(I/R)损伤的保护作用.方法通过建立家兔心脏I/R模型,观察腺苷预适应对I/R心肌损伤的保护效应,以左心室功能恢复率、心肌梗死面积、心肌细胞肌酸激酶(CK)和乳酸脱氢酶(LDH)漏出率的变化作为观察指标.结果腺苷预适应组心功能恢复明显好于对照组(P均＜0.01),CK、LDH漏出率及心肌梗死面积均低于单纯I/R组(P均＜0.01),这些心脏保护效应均被腺苷A1受体拮抗剂DPCPX阻断.结论腺苷通过其A1受体的激活介导了缺血预适应对I/R损伤的保护效应.     

多药耐药铜绿假单胞菌的耐药现状

目的 探讨医院多药耐药铜绿假单胞菌( MDRPA)的耐药特性,为临床医师合理使用抗菌药物提供实验室参考依据.方法 细菌培养严格按照《全国临床检验操作规程》进行；细菌鉴定采用法国生物梅里埃公司提供的API板条和软件系统；采用K-B法进行药敏试验,结果评价依据CLSI最新版本.结果 205株MDRPA中泛耐药株检出率为12.7％; MDRPA对亚胺培南、美罗培南、哌啦西林/他唑巴坦、头孢哌酮/舒巴坦已产生了12.7％,～15.1％的耐药率,对其他常用抗菌药物的耐药率为30.0％～71.0％,且耐药率呈上升趋势.结论 医院务必加强抗菌药物使用管理,坚持进行细菌耐药性监测,遏制细菌耐药性快速增长的不良趋势.