老年难治性心力衰竭患者BNP、hs-CRP水平与心功能的相关性及其临床意义

【摘要】目的：探究老年难治性心力衰竭（心衰）患者BNP、hs-CRP水平与心功能的相关性及其临床意义。方法：以我院心内科近两年收治的61例老年难治性心衰患者为临床研究对象，作为心衰组，另选20例健康志愿者作为对照组。心衰组患者按照NYHA分级的不同，从低到高分成A、B、C三组。对患者进行BNP与hs-CRP测定，并测定患者的心功能LVDD和LVEF。跟踪记录患者的心血管事件发生情况，比较患者BNP、hs-CRP、LVEF、LVDD水平的差异。结果：与对照组相比，心衰组患者的LVDD、BNP与hs-CRP指标显著较高而LVEF指标显著较低；A、B、C三组患者的LVDD、BNP与hs-CRP指标逐渐升高、LVEF水平逐渐下降；与无心血管事件患者相比，出现心血管事件患者的BNP、hs-CRP、LVDD水平显著较高，LVEF指标则显著低。差异均具有统计学意义（P＜0.05）。结论：BNP与hs-CRP指标与老年难治性患者的心功能具有密切的关系，BNP、hs-CRP以及患者的LVEF、LVDD水平是临床诊断老年难治性心衰的重要标志物，具有重要的临床诊断价值。     

One hundred and fifty years on: The history,significance and scope of body psychotherapy today

From Janet to Reich to the present day, body psychotherapy involves a rich and explicit theory, study, and practice of the human body–mind. This relationship is not hierarchical, nor something that suggests the unification of an age-old split, but it represents a unitive functioning with indivisible interactive aspects of the whole human being. This concept is quite revolutionary for some, liberating for others, and it can also be quite threatening. It can act as a baseline and a resource as other psychotherapies and new sciences explore aspects of body psychotherapy and their own involvement with the body, and it may help integrate some of the direct technical knowledge of the body therapies. This article is a personal attempt to cover the history and the main lines of approach of body psychotherapy, and to show how its relationship to the rest of psychotherapy is changing rapidly.     

A familial amyotrophic lateral sclerosis pedigree discordant for a novel p.Glu46Asp heterozygous OPTN variant and the p.Ala5Val heterozygous SOD1 missense mutation

About 10% of Amyotrophic Lateral Sclerosis (ALS) cases are familial (FALS), mainly related to mutations in C9ORF72, SOD1, TARDBP, and FUS genes. Recent data revealed the presence of multiple variants in ALS-associated genes in FALS in excess of what is to be expected by chance. FALS patients not carrying a pathogenic genetic mutation detected in their kindred have been reported. We report a FALS case, who did not carry the p.Ala5Val heterozygous SOD1 mutation that had been detected in other affected subjects of his kindred. He underwent Next-Generation Sequencing, revealing a novel p.Glu46Asp heterozygous OPTN variant of uncertain significance (VUS). Discordant genetic test results in FALS cases within the same family and the detection of variants of uncertain significance increase the complexities of genetic counselling.     

Intraductal carcinoma of the prostate: What we know and what we do not know

Intraductal carcinoma of the prostate (IDC-P) is a malignant, clonal proliferation of cells growing within the basement membrane-bound structures of the prostate. IDC-P is usually associated with unfavorable clinicopathologic parameters such as large tumor volume, high-grade Gleason score, extra prostatic extension and seminal vesicle invasion. Majority of laboratory and patient data suggest that IDC-P represents intraductal spread of invasive carcinoma, rather than a precursor lesion. Additionally, relationship of IDC-P and adjacent invasive carcinoma has been investigated in a series of molecular studies. The differential diagnosis of IDC-P from other lesions is critical for patient management. In this article, we summarize current literatures regarding what we know about IDC-P, including its pathological morphology, incidence, differential diagnosis, molecular features and clinical significance. In addition, we propose several issues that we currently do not know about IDC-P. Further research is needed to better understand the biological nature of IDC-P.     

探索性研究子宫输卵管超声造影中输卵管通而不畅的分级方法及其临床意义

目的 探索性研究子宫输卵管超声造影中输卵管通而不畅的分级方法及其临床意义。     

糖尿病诊断指标糖化血红蛋白的检测方法及临床意义

糖尿病目前已被国际社会列为人类健康头号杀手的非传染性疾病。血糖的检测在糖尿病的诊断、治疗及预防急性和慢性并发症中尤为重要。糖化血红蛋白（glycatedhemoglobin Alc，HbAlc）是反映既往2～3个月平均血糖水平的指标，用于评估长期血糖控制状况。目前HbAlc检测已经被推荐作为糖尿病诊断试验。现对HbAlC的检测方法及其临床意义作一综述。     

GL50分子在活化T细胞表面的表达及对细胞增殖的影响

目的探讨GL50分子在活化T细胞表面的表达及其生物学意义。方法分别取不同时相（24-144h）激发型CD3单抗联合CD28单抗活化的T细胞，采用流式细胞术分析T细胞表面GL50分子表达阳性率，RT-PCR法检测T细胞内GL50分子mRNA转录水平；^3H-TdR掺入法分析阻断GL50信号对T细胞增殖的影响。结果激发型CD3单抗联合CD28单抗活化T细胞后24h GL50分子阳性表达率为17．2％，其后逐渐升高至活化120h时达最大阳性率95．7％，并维持至活化144h时基本不变；T细胞活化24—144h均可检测到GL50分子mRNA表达；阻断性GL50分子单抗对活化T细胞增殖具有显著抑制作用。结论GL50分子在活化T细胞表面呈诱导性表达，且可与T细胞表面自身受体结合在免疫应答放大效应中发挥重要作用。