头部位移对纵向研究波谱结果可重复性的影响

目的 探讨不同形式位移经校正后对MRS结果可重复性的影响。方法 纳入20名被试者于无位移、平动位移、平动-转动位移时分别进行MRS扫描,每次间隔10 min,位移状态扫描前由SPM软件自动获取VOI位置,测量并比较平动位移、平动-转动位移经校正后VOI内N-乙酰天门冬氨酸(NAA)、肌酸(Cr)、磷酸肌酸(PCr)和胆碱复合物(Cho)含量及NAA/(Cr+PCr)和Cho/(Cr+PCr);计算上述参数位移对比无位移时差异性系数(CV)和重复性指数(RI)。结果 平动位移经校正后各参数与无位移间差异均无统计学意义(P均>0.05),平动-转动位移经校正后除Cr外,NAA、Cho、NAA/Cr+PCr、Cho/Cr+PCr与无位移间差异均有统计学意义(P均<0.01)。平动位移和平动-转动位移经校正后与无位移时比较,NAA、Cho、Cr含量及NAA/(Cr+PCr)、Cho/(Cr+PCr)的平均CV均<12%,重复性可接受;RI值除Cr外,余参数均<20%,重复性可接受。结论 MRS中对患者头部平动位移可准确校正,所得结果重复性较好。     

Differential loss of natural killer cell activity in patients with acute myocardial infarction and stable angina pectoris

Background: To evaluate the activity of natural killer cells through their inhibitory and activating receptors and quantity in peripheral blood mononuclear cells extracted from patients with acute myocardial infarction, stable angina pectoris and the controls. Methods: 100 patients with myocardial infarction, 100 with stable angina, and 20 healthy volunteers were recruited into the study. 20 randomly chosen people per group were examined for the whole human genome microarray analysis to detect the gene expressions of all 40 inhibitory and activating natural killer cell receptors. Flow cytometry analysis was applied to all 200 patients to measure the quantity of natural killer cells. Results: In myocardial infarction group, the mRNA expressions of six inhibitory receptors KIR2DL2, KIR3DL3, CD94, NKG2A, KLRB1, KLRG1, and eight activating receptors KIR2DS3, KIR2DS5, NKp30, NTB-A, CRACC, CD2, CD7 and CD96 were significantly down-regulated (P<0.05) compared with both angina patients and the controls. There was no statistical difference in receptor expressions between angina patients and control group. The quantity of natural killer cells was significantly decreased in both infarction and angina patients compared with normal range (P<0.001). Conclusions: The significant mRNAs down-regulation of several receptors in myocardial infarction group and reduction in the quantity of natural killer cells in both myocardial infarction and angina patients showed a quantitative loss and dysfunction of natural killer cells in myocardial infarction patients.     

Occult oncocytic papillary thyroid carcinoma with lymphoid stroma (Warthin-like tumor): report of a case with concomitant mutations of BRAF V600E and V600K

Warthin-Like tumor of the thyroid is a recently described rare variant of papillary thyroid cancer. The distinct histological feature of this variant is papillary architecture lining oncocytic epithelial cells with nuclear characteristics of papillary carcinoma, accompanied by prominent lymphocytic infiltration in the papillary stalks. Here, we present a case of occult Warthin-like papillary thyroid carcinoma, 0.5-cm in maximum dimension, underwent left thyroid lobectomy in a 65 years old Chinese woman. In this case, there was no extrathyroid extension, vascular invasion and lymphatic metastasis, as well as no complication of lymphocytic thyroiditis. Immunohistochemistry staining revealed that the tumor cells were positive for Leu-M1, HBME-1, 34βE12, and MIB-1 labeling index was low. RET/PTC expression was absent in tumor cells. Furthermore, activated point mutations of BRAF V600E and V600K were concurrently detected by DNA sequencing. Further studies are needed to elucidate the prevalence and role of BRAF^V600K mutation in papillary thyroid carcinoma, and long-term follow-up for the patient is needed to clarify the biological behavior of this variant with dual BRAF mutations.     

长链非编码RNA在风湿免疫病发病分子机制中的研究进展

长链非编码RNA(long non-coding RNA, lncRNA)是一类长度大于200个核苷酸且不具备蛋白编码功能的RNA。随着研究的进一步深入,lncRNA在生物学和人体发病过程中发挥的调控作用被发现。风湿免疫病是一系列机制复杂、影响多器官系统的自身免疫性疾病。近年来一些研究提示lncRNA通过多种途径参与调节多种风湿免疫病发病相关基因的表达,影响免疫系统多个环节的功能,影响该病的发病和进展。本文就lncRNA在风湿免疫病发病中分子机制的研究进展进行综述,为进一步研究提供参考。     

非酒精性脂肪性肝炎肝纤维化血清学无创诊断

由于肝活检的有创性和不足,非酒精性脂肪性肝炎（NASH）及其肝纤维化的无创诊断成为关注的热点。以血清学指标为基础的多参数模型公认为首选的NASH及肝纤维化的研究对象。本文阐述了各种特异性或非特异性血清学参数模型在NASH及肝纤维无创诊断中的应用现状。     

多靶区协同增强神经环路调控:思考与创新

运动功能损伤大多阻断或干扰运动神经传导通路。本团队创新设计的多靶区磁刺激（magnetic stimulation, MS）技术通过刺激皮层和神经根,激活人体中枢和外周神经系统,目前已在科研和临床探索中取得初步疗效。机制研究涉及神经元的激活、神经传导、损伤区微环境的调节和基因调控等。然而,如何使MS技术在临床康复中实现更精准有效的神经修复,是神经调控目前面临的瓶颈问题,可能需要从神经环路重建和任务导向训练去突破。本专题聚焦“神经再生调控与康复”,旨在将神经再生与神经调控的理念运用于临床的康复治疗中,并为探索康复效果的神经生物学机制提供有力依据。本述评将通过多靶区协同增强神经环路调控技术在神经环路重建中发挥的重要作用展开思考,建立更精准有效的MS创新技术与临床路径,以期推动神经调控的基础和临床应用研究。     

多通道食管腔内阻抗-pH监测对胃食管反流性咳嗽的诊断价值

 目的 探讨多通道食管腔内阻抗-pH监测（MII-pH）对胃食管反流性咳嗽（GERC）的诊断价值和局限性。方法 选择2010年5月—2011年7月在同济大学附属同济医院呼吸内科门诊就诊的可疑GERC患者,进行MII-pH,并经药物抗反流治疗证实诊断。分析MII-pH对GERC诊断的灵敏度、特异度、假阳性率、假阴性率、总符合率、阳性预计值和阴性预计值,并计算AUC_ROC和Kappa值。结果 在接受MII-pH的56例患者中,35例结果阳性,30例（85.7%）确诊为GERC,其中酸反流引起者25例（83.3%）,非酸反流引起者5例（16.7%）。在21例MII-pH阴性结果患者中,有6例（28.6%）经药物抗反流治疗,GERC诊断得到证实。MII-pH对GERC的诊断灵敏度为83.3%,特异度75.0%,假阳性率25.0%,假阴性率16.7%,总符合率80.4%,阳性预测值85.7%,阴性预测值71.4%,AUC_ROC 0.792,Kappa值0.577。结论 MII-pH能识别包括非酸反流在内的所有GERC,是较灵敏可靠的GERC诊断手段。     

Transferrin receptor and ferritin-H are developmentally regulated in oligodendrocyte lineage cells

Iron is an essential trophic element that is required for cell viability and differentiation, especially in oligodendrocytes, which consume relatively high rates of energy to produce myelin. Multiple iron metabolism proteins are expressed in the brain including transferrin receptor and ferritin-H. However, it is still unknown whether they are developmentally regulated in oligodendrocyte lineage cells for myelination. Here, using an in vitro cultured differentiation model of oligodendrocytes, we found that both transferrin receptor and ferritin-H are significantly upregulated during oligodendrocyte maturation, implying the essential role of iron in the development of oligodendrocytes. Additional different doses of Fe3+ in the cultured medium did not affect oligodendrocyte precursor cell maturation or ferritin-H expression but decreased the expression of the transferrin receptor. These results indicate that upregulation of both transferrin receptor and ferritin-H contributes to maturation and myelination of oligodendrocyte precursor cells.