抗GABABR抗体和抗KCTD16抗体双阳性自身免疫性脑炎(附1例报告及文献复习)

目的提高和拓展对抗γ-氨基丁酸B型受体(GABABR)抗体和抗钾离子通道四聚体结构域蛋白16(KCTD16)抗体双阳性自身免疫性脑炎的认识。方法收集1例抗GABABR抗体和抗KCTD16抗体双阳性的自身免疫性脑炎患者的临床资料,总结诊断、治疗经过等临床特点,结合文献复习进行分析和讨论。结果患者男性,50岁,亚急性起病,表现为精神行为异常、记忆障碍和癫痫发作。脑脊液蛋白增高(1.10g·L^-1),细胞数正常,血清和脑脊液抗GABABR抗体阳性。头颅磁共振检查示双侧海马信号增高。诊断为抗GABABR脑炎。对糖皮质激素、静脉注射免疫球蛋白、血浆置换治疗反应良好,但经历多次复发。随访过程中,患者血清中检测到抗KCTD16抗体阳性。发病1年后,患者全身正电子发射计算机断层显像示右肺近肺门软组织结节,远端阻塞性炎症,氟代脱氧葡萄糖代谢异常增高,行肺结节穿刺未见异形细胞,支气管镜未见出血及新生物。后续随访患者肺部结节进一步增大,最终病理活检证明为小细胞肺癌。结论抗KCTD16抗体可存在于抗GABAbR脑炎患者中,且与小细胞肺癌密切相关。     

Altered gut microbiota and mucosal immunity in patients with schizophrenia

Evidence shows that gut microbiota may play important roles in schizophrenia pathogenesis via the “gut-brain” axis, but the mechanisms remain unclear. Here, eighty-four patients with schizophrenia and 84 sex- and age-matched healthy controls were enrolled. Shotgun metagenomic sequencing and 16S rRNA sequencing were performed, and the gut microbiota-associated epitopes (MEs) were predicted, which, together with IgA content, were used to determine the gut microbiota composition associated with gut immune status. Patients with schizophrenia had significantly reduced gut microbiota richnesses compared with those of the healthy controls, and the gut microbiota compositions clearly distinguished the patients with schizophrenia from the healthy controls. Based on two-stage metagenomic-wide association studies, nineteen gut microbiota taxonomies were associated with schizophrenia, and the microbial dysbiosis (MD) index was calculated based on the abundance of differential taxonomies. We found that MD index was positively correlated with MEs diversity and gut IgA levels, and negatively correlated with gut microbiota richness. Glutamate synthase (GOGAT) was more active in the guts of patients with schizophrenia than in those of healthy controls, and high GOGAT activity was associated with altered gut microbiota taxonomies associated with gut IgA levels. Our results may imply a role of the microbiome in the etiology of schizophrenia and contribute to the development of microbiome targeted interventions for schizophrenia.     

结直肠癌微环境中细胞因子的表达及其与CD16a mRNA表达的相关性研究

目的探讨结直肠癌肿瘤微环境中细胞因子的表达及其与CD16a mRNA表达的关系。方法分别采用实时荧光定量PCR法和流式细胞术微球阵列法(CBA法)检测42例结直肠癌组织及其癌旁组织中CD16a mRNA和8种细胞因子[包括白细胞介素(IL)-2、IL-4、IL-6、IL-10、IL-12、肿瘤坏死因子-α(TNF-α)、γ-干扰素(IFN-γ)和血管内皮生长因子(VEGF)]的表达水平,分析两者之间的相关性。结果结直肠癌组织中IL-6、TNF-α和VEGF的表达水平高于癌旁组织(P<0.05),而IL-2、IL-4、IL-10、IL-12和IFN-γ在2种组织中的表达水平比较差异均无统计学意义(P>0.05)。术前CEA正常组的IL-6和VEGF的表达水平高于术前CEA升高组(P<0.05)。相关性分析结果显示:结直肠癌组中IL-6的相对表达水平与CD16a mRNA的表达水平呈负相关(P<0.05)。结论结直肠癌组织中IL-6、TNF-α和VEGF的表达水平较癌旁组织明显升高,提示促血管生成作用及免疫抑制增强。此外,结直肠癌肿瘤微环境中CD16a mRNA的表达与IL-6的表达呈负相关。     

p16、Ki67及FRα预测低度宫颈上皮内瘤变转归的研究进展

宫颈上皮内瘤变(cervical intraepithelial neoplasia,CIN)已发现与宫颈癌密切相关,根据异常程度分3级CIN(CIN1,CIN2和CIN3)。约60%的CIN1可自然消退,仅有少部分发生进展。目前,迫切需要一些生物标志物作为预测因子来预测病变的转归。经检索国内外文献发现,目前大部分研究结果发现生物标志物p16、Ki67的染色结果对于CIN1的预后有预测意义,并且有部分学者研究了p16/Ki67双染结果也可以很好的预测,而目前仅少数人研究了FRα在预测CIN1转归时的意义,认为FRα可能有一定预测价值。关于这些生物标志物的预测价值,还需要其他大型的、长时间的临床随访来进一步研究它们的准确性和可靠性,也需要进行更加深入的研究去发现其他更为精准的标志物。     

Tim-3在变应性鼻炎中的作用及机制研究进展

变应性鼻炎(AR)是一种慢性非特异性鼻黏膜炎性病变,属于Ⅰ型变态反应,是一个全球性健康问题,可导致许多疾病和劳动力丧失,给社会带来的负担也越来越重。其发病过程中所包括的免疫细胞受到了不同的基因组的调控作用。现已有研究论证T细胞免疫球蛋白黏蛋白结构域分子-3(Tim-3)参与到免疫细胞的表达中,对很多免疫反应都有调节作用,与免疫系统疾病密切相关。目前针对变应性鼻炎的药物及治疗方法存在一定的局限性,因此找到更多有效的治疗方法刻不容缓。关于Tim-3在变应性鼻炎中的作用机制的相关研究很多,但其综述却是匮乏的,希望该文章,希望能丰富AR的免疫调控机制研究,并且为其治疗方法提供新的思路。     

Effectiveness of a microabrasion technique using 16% HCL with manual application on fluorotic teeth: A series of studies

BACKGROUND Dental fluorosis is caused by excessive fluoride ingestion during tooth formation.As a consequence,there is a higher porosity on the enamel surface,which causes an opaque look.AIM The aim of this study was to identify a dental intervention to improve the smile in patients with tooth fluorosis.Additional aims were to relate the stain size on fluorotic teeth with the effectiveness of stain removal,enamel loss and procedure time using a manual microabrasion technique with 16%hydrochloric acid(HCL).METHODS An experimental study was carried out on 84 fluorotic teeth in 57 adolescent patients,33 females and 24 males,with moderate to severe fluorosis.The means,standard deviations and percentages were analyzed using nonparametric statistics and ArchiCAD 15 software was used for the variables including stain size and effectiveness of stain removal.RESULTS The average enamel loss was 234μm and was significantly related to the procedure time categorized as 1-4 min and 4.01-6 min,resulting in a P>0.000.The microabrasion technique using 16%HCL was effective in 90.6%of patients and was applied manually on superficial stains in moderate and severe fluorosis.Procedure time was less than 6 min and enamel loss was within the acceptable range.CONCLUSION Microabrasion is a first-line treatment;however,the clinician should measure the average enamel loss to ensure that it is within the approximate range of 250μm in order to avoid restorative treatment.     

16排螺旋CT扫描技术在脊柱外伤诊断中的应用

目的:探究分析在脊柱外伤诊断中运用16排螺旋CT扫描技术的诊断效果。方法:选取我院2018年8月-2019年8月期间收治的50例脊柱外伤患者为本次研究资料来源,对所有患者安排进行16排螺旋CT扫描检查,通过多平面重建和表面遮盖等方式成像,对所有患者的伤情进行观察记录。结果:经过扫查,发现在50例患者中,单纯屈曲压缩型外伤的患者有28例(56%),爆裂性外伤的患者有9例(18%),骨折脱位伤的患者有11例(22%);其中,有2例患者漏诊误诊,诊断准确率为48例(96%),漏诊误诊率为2例(4%)。结论:在脊柱外伤患者诊断中运用16排螺旋CT扫描技术进行诊断扫查,有助于快速查清患者受伤原因,能够取得较高的诊断准确率,漏诊误诊率较低,对制定科学有效的治疗方案具有重要意义,是一种具有较高应用价值的值得大力推广应用于临床的伤情诊断方式。     

头颈部鳞癌相关生物标志物与免疫治疗预后的关系

头颈部鳞癌(HNSCC)是世界上第六大常见的恶性肿瘤,每年发病超过55万,死亡超过30万人,吸烟和饮酒是其主要危险因素。HNSCC的治疗方案主要是基于TNM分期、以外科手术为主的综合疗法(放疗、化疗及生物治疗)。对于HNSCC的治疗,其5年生存率近年来一直没有改善,因此,需要新的治疗方法提高患者生存率,改善患者生活质量。当今研究热点是以免疫治疗为主的生物靶向治疗在HNSCC的广泛应用,本研究旨在探讨HNSCC相关生物标志物与免疫治疗预后的关系。     

多组学联用在中药作用机制研究中的应用

组学技术的运用主要基于高通量分析检测技术,包括转录组学、蛋白质组学和代谢组学等。生物信息学的飞速发展,为探索中药治疗疾病的机制提供新的思路和方法。在过去的数十年间,组学技术广泛应用于中药作用机制的研究当中。中药具有多成分、多靶点的特点,单一通路研究难以诠释中药"整体观念"的治疗思想,而多组学联用研究与这一观点不谋而合。查阅近年文献,对转录组学、蛋白质组学、代谢组学及16S rRNA测序等联用在中药治疗疾病中发挥的作用进行综述。