嗜酸性细胞肺类癌18F-FDG PET/CT异常高摄取一例

患者女,40岁,因"咳嗽10个月余,咳绿色浓痰伴发热5 d"就诊本院。体格检查:神志清,一般情况可。2018年10月26日外院胸部CT平扫及增强(图1)示右肺上叶肺门旁直径约2.2 cm类圆形结节影,边缘光整,无毛刺及卫星灶,密度尚均匀;增强后明显强化,动脉期CT值约107 HU,静脉期CT值约89 HU,考虑为硬化性肺细胞瘤。于外院行抗炎、止咳、化痰等治疗,症状无缓解。     

Identification of key genes and pathways in discoid lupus skin via bioinformatics analysis

Discoid lupus erythematosus (DLE) is the most common skin manifestation of lupus; however, the molecular mechanisms underlying DLE remain unknown. Therefore, we aimed to identify key differentially expressed genes (DEGs) in discoid lupus skin and investigate their potential pathways.To identify candidate genes involved in the occurrence and development of the disease, we downloaded the microarray datasets {"type":"entrez-geo","attrs":{"text":"GSE52471","term_id":"52471"}}GSE52471 and {"type":"entrez-geo","attrs":{"text":"GSE72535","term_id":"72535"}}GSE72535 from the Gene Expression Database (GEO). DEGs between discoid lupus skin and normal controls were selected using the GEO2R tool and Venn diagram software (http://bioinformatics.psb.ugent.be/webtools/Venn/). The Database for Annotation, Visualization, and Integrated Discovery (DAVID), Enrichr, and Cytoscape ClueGo were used to analyze the Kyoto Encyclopedia of Gene and Genome pathways and gene ontology. Protein-protein interactions (PPIs) of these DEGs were further assessed using the Search Tool for the Retrieval Interacting Genes version 10.0.Seventy three DEGs were co-expressed in both datasets. DEGs were predominantly upregulated in receptor signaling pathways of the immune response. In the PPI network, 69 upregulated genes were selected. Furthermore, 4 genes (CXCL10, ISG15, IFIH1, and IRF7) were found to be significantly upregulated in the RIG-I-like receptor signaling pathway, from analysis of Enrichr and Cytoscape ClueGo.The results of this study may provide new insights into the potential molecular mechanisms of DLE. However, further experimentation is required to confirm these findings.     

National level data analysis of facial lacerations in Korea using the National Health Insurance Service (NHIS) database

No national epidemiological investigations have been conducted recently regarding facial lacerations. The study was performed using the data of 3,634,229 people during the 5-year period from 2014 to 2018 archived by the National Health Information Database (NHID) of the Health Insurance Review and Assessment Service. Preschool and children under 10 years old accounted for about one-third of patients. Facial lacerations were concentrated in the “T-shaped” area, which comprised forehead, nose, lips, and the perioral area. The male to female ratio for all study subjects was 2.16:1. Age and gender are significantly related with each other (P < .001). Mean hospital stays decreased, and numbers of outpatient department visits per patient were highest for hospitals and lowest for health agencies. Over the study period, hospital costs per patient in tertiary and general hospitals increased gradually. Preschool and school-aged children are vulnerable to trauma. Male patients outnumbered female patients by a factor of more than 2. The “T-shaped’” area around forehead is vulnerable to injury. Total cost of medical care benefits per patient in tertiary hospitals was about 7 times on average than in health agencies. Regarding functional, behavioral, and aesthetic outcomes, more attention should be paid to epidemiologic data and hospital costs for facial lacerations.     

GLP-1类似物在糖尿病肾病患者中的疗效分析

目的观察胰高血糖素样肽-1(glucagon-like peptide-1,GLP-1)类似物对2型糖尿病早期肾病患者的肾脏保护作用。方法2017年11月—2019年12月间选取使用GLP-1类似物并参与随访的2型糖尿病早期肾病患者30例,收集患者治疗6个月前后的体重,体质指数(body mass index,BMI),腰围,臀围,血糖,生化指标等,计算胰岛β细胞功能相关指标,进行对比分析。结果治疗后腰围、2 hPG、HbA1c、HOMA-IR、TC、TG、ALB、MA/Cr、UA较治疗前降低,HOMA-β较治疗前升高,差异有统计学意义(P<0.05)。Pearson相关性分析示:HbA1c与MA/Cr呈负相关性(r=-0.421,P<0.05);HOMA-β、TG、TC、UA与MA/Cr呈正相关性(r=0.777,P<0.05;r=0.757,P<0.05;r=0.470,P<0.05;r=0.443,P<0.05)。HbA1c与ALB呈负相关性(r=-0.433,P<0.05);HOMA-β、TG、TC、UA与ALB呈正相关性(r=0.723,P<0.05;r=0.756,P<0.05;r=0.493,P<0.05;r=0.374,P<0.05)。结论GLP-1类似物对2型糖尿病早期肾病患者有较好的降糖、调脂、改善胰岛功能、保护肾脏的作用,而且降血糖、降血脂、改善胰岛功能可能有益于肾脏保护。     

基于Oncomine数据库分析分泌性磷蛋白1在肝细胞癌中的表达及临床意义

目的分析分泌性磷蛋白1(SPP1)在肝细胞癌中的表达,探索其对肝癌患者预后的影响。方法基于Oncomine数据库,对肝细胞癌中的SPP1差异表达情况进行分析,探讨其意义;利用Kaplan Meier-Plotter在线分析工具,对患者生存情况进行分析;基于String数据库在线构建蛋白互作网络。结果在筛选到的4项研究中,肝癌组SPP1基因的表达分别为4.92±0.24,0.35±0.30,-0.92±0.29和5.12±0.50,与相应正常组表达量1.96±0.28,-1.23±0.06,-2.93±0.13和1.89±0.31相比较均显著增高,差异均有统计学意义(均P <0.001);SPP1高表达组患者诊断后总体中位生存期为37.8个月,较SPP1低表达组(84.4个月)明显降低,差异有统计学意义(P <0.001);在男性(41.0个月vs 84.7个月)、亚洲人群(7.2个月vs 56.2个月)、GradeⅢ级(5.7个月vs23.7个月)或未感染肝炎病毒患者(25.2个月vs 70.5个月)亚组中的总体生存期均显著下降(错误发现率<5%,P <0.001)。透明质酸受体、整合素β1、基质金属蛋白酶7、金属蛋白酶组织抑制因子1、白细胞介素6和纤维连接蛋白1等是显著的节点基因。结论 SPP1与肝细胞癌进展显著相关,高SPP1表达与HCC患者的不良存活密切相关。     

近端胃切除人工三角瓣成形抗反流术的力学机理仿真分析

目的:对食管胃结合部腺癌近端胃切除术（PG）人工三角瓣成形后残胃食糜进行流体动力学数值模拟，并计算不同性质胃内食糜的流动特征。方法:构建常规PG和人工三角瓣成形术术后胃仿真模型，运用Fluent软件对不同粘度胃内食糜反流问题进行数值模拟。结果:站立位姿态时，相对常规PG方案，人工三角瓣成形手术方案表现出较好的抗反流作用；卧位姿态时，当胃内食糜粘度大于0.145 2 Pa[?s，且胃内食糜不超过人工三角瓣情况下，人工三角瓣成形抗反流手术表现出较好的抗反流效果；人工三角瓣抗反流成形手术方案数值模拟结果与临床上患者表现一致。结论:本研究仿真分析为人工三角瓣成形抗反流手术方案的有效性机理分析、临床患者术后饮食及手术方案的进一步改进提供理论及数值依据。 【关键词】食管胃结合部腺癌；抗反流；人工三角瓣；计算流体力学     

杨宇飞教授舌癌的中医康复治疗与验案两则＊

舌癌患者手术及放化疗后会出现构音障碍、吞咽困难、口腔黏膜炎、口干、营养不良等并发症，使患者生存质量下降，甚至导致肿瘤的复发转移，影响生存期，单一方法往往顾此失彼。依托于中国中医科学院西苑医院肿瘤康复基地，杨宇飞教授在国内外调研考察基础上，结合中国国情，构建了一种“门诊多学科肿瘤康复模式”，在舌癌康复方面，以患者为中心，以中医肿瘤内科为主导，多学科共同参与，结合康复科、口腔科、营养科、药剂科等各科优势，形成全程个体化规范序贯康复方案，对患者及早进行康复，在放疗前进行预防性干预尤其重要，使患者能够快速缓解手术和放疗的不良反应，患者获益明显。现取两个典型案例总结其舌癌多学科康复的经验，以期为舌癌的康复提供借鉴。